聯結車司機肌肉骨骼危害探討

台灣因四面環海且以出口貿易為主，而當貨物進出口時，皆需仰賴聯結車24小時無間斷運送至各個廠家及碼頭，由此顯示駕駛聯結車之司機為最不可或缺之角色，而聯結車由曳引車與重型拖車所組成，因其拖載拖車所造成振動幅度較大，依據職業性頸椎椎間盤突出認定參考指引說明當脊柱遭受不正常力量時，椎間盤可能受到微傷害，而重複性之微傷害，最終可能導致椎間盤突出。另外，參考職業病給付統計顯示職業病下背痛及振動引起之疾病，其百分比皆有上升之趨勢。本研究將調查中部港區從事駕駛聯結車工作滿一年以上之駕駛員之肌肉骨骼不適症狀情形。本研究使用了北歐肌肉骨骼傷害問卷以及針對衝擊性振動暴露與脊椎危害評估的相關研究問卷，將兩者的內容合併以問卷方式進行調查分析，並針對不適症狀分數大於3分者，安排現場訪視，並以關鍵指標法分析KIM-ABP不良姿勢作業檢核表進行評估。問卷包含以下三個部分：個人基本資料、工作狀況、肌肉骨骼狀況，並使用SPSS進行多元線性回歸分析。本次研究共回收了66份有效問卷，統計結果顯示受訪司機平均年齡為49.3歲，平均工作年資13.55年，平均每日開車時數為8.37小時。聯結車駕駛員最近一年自覺肌肉骨骼不適症狀中，以下背部佔比最高（26.2%），其次為右肩部（14.3%）、頸部(13.1%)、左肩部（9.5%）、上背部（8.3%）等。受測司機的肌肉骨骼不適症狀多與神經學相關，如疼痛和痠軟無力等症狀。疼痛持續程度多為輕微至中等，但大多數受測者在作業內容時受到不適症狀的影響。八成的受測司機認為工作累積是造成肌肉骨骼不適症狀的主要原因。此外，現場訪視結果顯示，駕駛聯結車時，因長時間專注直行或車輛轉彎時的坐姿不良及倒車姿勢，都可能導致肩頸和上背部的不適情形。此外，特定裝載方式如曳引車搭載車斗或貨櫃車輛，也易造成駕駛人的下背部需承受振動所致的不正常力量。以線性回歸分析受訪駕駛員作業工具中變速箱種類、定速功能及車齡與各部位不適症狀之相關性，由分析中可見變速箱種類與左側肢體不適有顯著負相關，左手肘/左前臂(P=.030)、左手/左手腕(P=.026)、左臀/左大腿(P=.022)、左腳踝/左腳(P=.038)，推測因手排車皆須仰賴左側肢體進行方向盤轉動及踩離合器等有關。綜合問卷統計和現場作業觀察，聯結車駕駛員的肌肉骨骼不適症狀主要出現在下背部和肩頸部，且大部分自覺不適症狀多為工作累積所致，建議聯結車駕駛要接受適當之教育訓練，改善不良之駕駛姿勢，學習舒緩肌肉骨骼不適的方法，避免工作累積之傷害。

Taiwan is surrounded by the sea and mainly engaged in export trade. When the goods are imported and exported, they need to rely on the coupling vehicle to transport it to various manufacturers and terminals 24 hours a day, which shows that the driver of the coupling vehicle is the most indispensable role. The coupling vehicle is composed of a traction vehicle and a heavy-duty trailer, because of the large vibration amplitude caused by the trailer, according to the reference guidelines for the identification of occupational cervical intervertebral disc herniation, when the spine suffers abnormal force, the intervertebral disc may be slightly injured. Repetitive minor injury, Eventually, it can lead to a herniated disc. In addition, the statistics on occupational disease benefits show that the percentage of diseases caused by occupational diseases, lower back pain, and vibration has increased. This study will investigate the musculoskeletal symptoms of drivers driving a connected car for more than one year in the Chubu Minato area.In this study, a total of 66 valid questionnaires were collected. The statistical results show that the average age of the interviewed drivers is 49.3 years, with an average of 13.55 years of work experience, and an average daily driving time of 8.37 hours. Among the musculoskeletal discomfort symptoms perceived by truck drivers in the past year, the lower back had the highest proportion (26.2%), followed by the right shoulder (14.3%), neck (13.1%), left shoulder (9.5%), and upper back (8.3%). The musculoskeletal discomfort symptoms of the tested drivers are mostly related to neurological issues, such as pain and weakness. The severity of the pain is mostly mild to moderate, but most respondents reported that their work was affected by these discomfort symptoms. Eighty percent of the drivers believe that work accumulation is the main cause of musculoskeletal discomfort symptoms.The reported musculoskeletal symptoms among drivers were mostly related to neurological issues, such as tingling, numbness, and muscle weakness. The pain intensity ranged from mild to moderate, but most respondents experienced discomfort during work. Over 50% of the surveyed drivers attributed their symptoms to cumulative work-related factors.Additionally, on-site inspection results indicate that while driving a truck, poor posture during prolonged straight driving, turning, and reversing can lead to discomfort in the shoulders, neck, and upper back. Furthermore, specific loading methods, such as tractor-trailers carrying flatbeds or container vehicles, can cause the driver’s lower back to endure abnormal forces due to vibrations. A linear regression analysis of the correlation between the type of transmission, cruise control function, vehicle age, and discomfort symptoms in various body parts among the interviewed drivers showed a significant negative correlation between the type of transmission and discomfort in the left limbs. Specifically, left elbow/forearm (P=.030), left hand/wrist (P=.026), left hip/thigh (P=.022), and left ankle/foot (P=.038). This is likely because manual transmission vehicles require the left limbs for steering and clutch operation.Based on the questionnaire statistics and on-site work observations, musculoskeletal discomfort symptoms in truck drivers mainly occur in the lower back and shoulder/neck areas. Most of these discomfort symptoms are perceived to be caused by cumulative work-related factors. It is recommended that truck drivers receive appropriate education and training to improve poor driving posture, learn methods to alleviate musculoskeletal discomfort, and avoid cumulative work-related injuries.