中央滅菌供應部工作流程中的人因危害與肌肉骨骼健康調查研究

An Investigation of Ergonomic Hazards and Musculoskeletal Health Among Central Sterile Supply Department Personnel

本研究旨在探討中央滅菌供應部（Central Sterile Supply Department，CSSD）工作人員之人因危害與肌肉骨骼不適之關聯性。採橫斷性研究設計，以某中部醫學中心CSSD全職人員為研究對象，共納入39名受試者，使用結構式問卷（包含基本資料、工作特性、工作環境危害評估及北歐肌肉骨骼問卷）進行資料收集與分析。
結果顯示，研究對象以女性為主（87.2%），平均年齡為41.7±12.2歲，BMI為24.6±4.5。工作特性方面，多數人員需經常搬運重物（59.0%），顯示搬運作業為主要工作負荷來源。肌肉骨骼不適盛行率以肩部（79.5%）、下背（79.5%）、頸部（71.8%）及手腕（66.7%）最高，顯示上肢與軀幹為主要受影響部位。
工作環境危害分析結果指出，滑倒、熱暴露、燙傷及針扎等風險普遍存在，其中肌肉酸痛與疲勞亦具有一定盛行比例，顯示CSSD作業同時涉及物理性、機械性與生理性多重人因危害。在統計分析方面，搬運重物與下背、手肘及膝蓋不適達顯著相關（p<.01），顯示搬運負荷為重要危險因子；此外，工作年資與肩部及下背不適亦呈顯著關聯（p <.05）。
結論指出，CSSD工作人員長期暴露於高重複性動作、不良姿勢及搬運負荷之工作環境中，易增加肌肉骨骼不適風險。建議透過改善工作環境設計、導入輔助搬運設備、優化作業流程及推動健康促進措施，以降低人因危害並提升職業健康安全。

This study aimed to investigate the association between ergonomic hazards and musculoskeletal discomfort among personnel working in the Central Sterile Supply Department (CSSD). A cross-sectional study design was employed, targeting full-time CSSD staff at a medical center in central Taiwan. A total of 39 participants were recruited. Data were collected using a structured questionnaire that included demographic characteristics, job features, workplace hazard assessment, and the Nordic Musculoskeletal Questionnaire.
The results showed that the majority of participants were female (87.2%), with a mean age of 41.7±12.2 years and a mean body mass index (BMI) of 24.6±4.5. Regarding job characteristics, most participants frequently handled heavy loads (59.0%), indicating that manual handling was a major source of workload. The prevalence of musculoskeletal discomfort was highest in the shoulders (79.5%), lower back (79.5%), neck (71.8%), and wrists (66.7%), suggesting that the upper extremities and trunk were the most affected regions.
Analysis of workplace hazards revealed that risks such as slipping, heat exposure, burns, and needlestick injuries were common. Additionally, muscle soreness and fatigue were prevalent, indicating that CSSD operations involve multiple ergonomic hazards, including physical, mechanical, and physiological factors. Statistical analysis demonstrated that manual handling of heavy loads was significantly associated with discomfort in the lower back, elbows, and knees (p < .01), identifying it as a key risk factor. Furthermore, years of work experience were significantly associated with shoulder and lower back discomfort (p < .05).
In conclusion, CSSD personnel are exposed to work environments characterized by repetitive tasks, awkward postures, and manual handling demands, which increase the risk of musculoskeletal discomfort. It is recommended to improve workplace design, introduce assistive handling equipment, optimize workflow processes, and implement health promotion strategies to reduce ergonomic hazards and enhance occupational health and safety.