Prevalence and related factors of musculoskeletal disorders among dentists in Taiwan: a cross-sectional study using the National Health Insurance Research Database

台灣牙醫師肌肉骨骼疾病的盛行率與相關因素：以全民健保資料庫進行橫斷性研究

10.6288/TJPH.202008_39(4).109018

李淑芬(Shu-Fen Li)；洪錦墩(Chin-Tun Hung)；吳啟明(Chi-Ming Wu)；李美文(Mei-Wen Lee)

dentist ； musculoskeletal disorders ； risk factors ； comorbidity ； 牙醫師 ； 肌肉骨骼疾病 ； 危險因素 ； 共病症

台灣公共衛生雜誌

39卷4期（2020 / 08 / 24）

453 - 463

英文

Objectives: Musculoskeletal disorders (MSDs) are common occupational diseases that consume medical resources and reduce productivity and work quality. When treating patients, dentists often must maintain a fixed posture. Thus, dentists have a higher chance of MSDs. This study examined the prevalence and frequency distribution of MSDs among dentists and the related factors for MSDs. Methods: A cross-sectional study design was used, and 8,303 dentists with 12 consecutive months of practice in 2011 from the Taiwan National Health Insurance Research Database were selected as study subjects. The study variables included sex, age, mean number of consultations per month per dentist, level of medical institution, and comorbidity. The logistic regression model was used to analyze related factors for MSDs in dentists. Results: In 2011, the prevalence of MSDs in dentists was 15.8% (Overall, 84.2% of the dentists had no record of visiting a doctor; in addition, 2.1%, 0.6%, 0.2%, and 12.9% of the dentists had visited a doctor once, twice, three times , and four times or more frequently, respectively). Male dentists had a marginally significant lower risk of MSDs than did female dentists (odds ratio [OR]: 0.86; 95% confidence interval [CI]: 0.74-1.01). Compared with dentists in the age group of 26-35 years, dentists in the age groups of 36-45, 46-55, and 56-65 years had a higher risk of MSDs (OR: 1.28; 95% CI: 1.07-1.54; OR: 1.70; 95% CI: 1.43-2.02; OR: 1.69; 95% CI: 1.38-2.06, respectively). Compared with dentists without comorbidities, dentists with insomnia, depression, or anxiety had a higher risk of MSDs (OR: 1.44; 95% CI: 1.09-1.90; OR: 1.67; 95% CI: 1.10-2.53; OR: 1.70; 95% CI: 1.25-2.31). Conclusions: In total, 15.8% of the dentists had MSDs. For dentists with MSDs with records of visiting a doctor, those who visited once accounted for 13%, and those with over two visits accounted for 87%. MSDs of the back accounted for most MSD cases. Female sex; older age; and comorbidities of insomnia, depression, and anxiety were factors associated with MSDs in dentists.

目標：肌肉骨骼疾病是工作場所中常見的職業病，罹病者除耗用醫療資源外，也會影響生產力與工作品質。牙醫師在治療病患時經常需長時間維持固定姿勢，使其有較高機會發生肌肉骨骼疾病。本研究目的主要是調查牙醫師肌肉骨骼疾病的盛行率、次數分布與肌肉骨骼疾病的相關因素。方法：使用橫斷式研究設計，從台灣全民健保研究資料庫中擷取2011年連續執業12個月之牙醫師共8,303位作為研究對象。研究變項包括性別、年齡、每月平均門診次數、執業醫院層級、共病症等。使用邏輯式迴歸模型分析牙醫師肌肉骨骼疾病之相關因素。結果：2011年台灣牙醫師肌肉骨骼疾病盛行率是15.8%（無就醫記錄者佔84.2%，1次佔2.1%、2次佔0.6%、3次佔0.2%、4次以上佔12.9%）。男性牙醫師罹患肌肉骨骼疾病的風險邊際顯著低於女牙醫師（odds ratio [OR]:0.86; 95% confidence interval [CI]:0.74-1.01）；相較於26-35歲之牙醫師，牙醫師36-45歲、46-55歲56-65歲有較高的肌肉骨骼疾病的風險（OR: 1.28; 95% CI: 1.07-1.54;OR: 1.70; 95% CI: 1.43-2.02; OR:1.69; 95% CI:1.38-2.06）；相較於無共病者，共病失眠、憂鬱、焦慮症的牙醫師有較高的肌肉骨骼疾病風險（OR: 1.44; 95% CI: 1.09-1.90, OR: 1.67; 95%CI:1.10-2.53, OR: 1.70; 95% CI: 1.25-2.31）。結論：牙醫師實際上有肌肉骨骼疾病醫療利用的盛行率是15.8%。有肌肉骨骼疾病就診記錄的牙醫師，就醫次數僅為單次者只佔13%，2次以上者佔了87%。背部是最容易發生肌肉骨骼疾病的部位。女性、年齡增加與共病失眠、憂鬱或焦慮皆是牙醫師罹患肌肉骨骼疾病的相關因素。

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