Study On Correlation And Intervention Between Physical And Mental Health And Musculoskeletal Injury Of Coal Miners In Xinjiang

Objective: The physical and mental health status of coal miners in Xinjiang and the influence of psychological factors on the physical health are investigated based on occupational stress,job burnout,mental disorder,physical health,musculoskeletal injury.The influencing factors of musculoskeletal injuries are studied,the influences of psychological factors on musculoskeletal injuries are analyzed,the health intervention measures are implemented and the intervention effect is evaluated.This study provides references to health management of coal miners.Method: 1)A total of 4,409 coal miners were randomly selected from nine coal mines in Xinjiang by stratified cluster sampling.4,800 questionnaires were distributed and 4,460 were recovered,with a recovery rate of 93%.Those not conforming to the standard or filled in less than 80%were eliminated,and 4,409 valid questionnaires were obtained,with an effective rate of98.8%;2)Job-Demand Control(JDC),Maslach Burnout Inventory(MBI),Symptom Checklist(SCL-90)were used to investigate the general demographic characteristics(e.g.,gender,age,education background,marital status,income,smoking,drinking)and occupational characteristics(e.g.,working age,type of work,shift situation).The occupational stress,job burnout,mental disorder and influencing factors of coal miners were investigated;3)1,199 coal miners were randomly selected for occupational health examination,blood pressure,physiological and biochemical index examination,and special examination(lung function,chest X-ray,and electrocardiography examination).The effects of general demographic characteristics,occupational characteristics,and psychological characteristics on physical health were analyzed;4)The musculoskeletal injuries of 4,409 coal miners were investigated by means of the domestic musculoskeletal injury questionnaire.The correlation between psychological factors and musculoskeletal injuries was explored by eliminating confounding factors through propensity score,and the structural equation model was established to explore its mediating effect;5)A total of 440 coal miners were randomly selected for mental health and musculoskeletal injury intervention,which was divided into intervention based on the protection motivation theory and routine intervention.After 7 months of intervention,JDC,MBI,SCL-90,the brief health questionnaire,the general self-efficacy scale and the cognitive assessment scale of musculoskeletal injuries were used to evaluate the intervention effect.Results: 1)A total of 4,409 coal miners were investigated in this study.The JDC scale was employed to investigate the occupational stress of coal miners.There were 1,884 cases with JDC score ? 1,accounting for 42.73%.Coal miners of Uygur,over 50 years old,undergraduate education background or above,income<6000,drinking,working age ? 30 years,tunneling workers,and three shifts working in two shifts have high occupational stress level.The Logistic regression analysis of the occupational stress shows that the risk of occupational stress are nation working years working types educational background and working shifts;2)Job burnout of coal miners:the results show that there are 688(15.60%)cases of zero burnout,1,450(32.89%)cases of mild burnout,1,891(42.89%)cases of moderate burnout and 380(8.62%)cases of severe burnout among coal miners.According to the multi-factor analysis of the job burnout of coal miners,age,working years,working shifts,job requirements and social support are the risk factors of job burnout(P<0.05);3)22.43% coal miners suffer from mental disorders.The univariate analysis shows that male,working age over 30 years,electrical fitter,high job requirements,low social support and severe burnout have statistical significance in the difference of detection rate of psychological disorders(P<0.001).The multivariate analysis of the mental disorders of coal miners shows that working years,job requirement,social supports and job burnout are risk factors;4)In this study,physical health examination information of 1,199 coal miners was randomly selected.The highest detection rate of physiological diseases was 29.20% of dyslipidemia,28.8% of abnormal blood pressure and 22.50% of abnormal electrocardiogram.The results of occupational physical examination show that the highest detection rate of abnormal hearing of coal miners is 14.30%;5)As suggested by comparison of different demographic characteristics and abnormal detection rate of physical examination,there is statistical significance in comparative difference in the detection rate of liver function abnormality among gender,smoking and drinking(P < 0.05);there is statistical significance in comparative difference in the detection rate of blood pressure abnormality among smoking and drinking groups(P<0.05).The detection rate of abnormal blood pressure in the smoking and the drinking groups is higher than that in the non-smoking and the non-drinking groups.There is statistical significance in comparative difference in the detection rate of electrocardiographic abnormality in different gender(P<0.05);there is statistical significance in comparative difference in the detection rate of dyslipidemia in different gender groups(P < 0.05);and there is there is statistical significance in comparative difference in the detection rate of glucose abnormality in different smoking and drinking groups(P< 0.05);As suggested by comparison of different occupational characteristics with the abnormality detection rate of health examination,there is statistical significance in comparative difference in the detection rate of hearing abnormality among different shift groups(P < 0.05);there is statistical significance in comparative difference in the detection rate of lung function abnormality among different working age groups(P<0.05);there is statistical significance in comparative difference in the detection rate of liver function abnormality among different working age,work type and shift groups(P<0.05);there is statistical significance in comparative difference in the detection rate of blood pressure abnormality among different work type and shift groups;there is statistical significance in comparative difference in the detection rate of electrocardiographic abnormality among different work type and shift groups(P<0.05);As suggested by comparison of different mental characteristics with the abnormality detection rate of health examination,there is statistical significance in comparative difference in the detection rate of hearing abnormality,liver function abnormality,blood pressure abnormality,electrocardiographic abnormality and blood glucose abnormality in the occupational stress group(P<0.05);there is statistical significance in comparative difference in the detection rate of liver function abnormality,blood pressure abnormality,electrocardiographic abnormality and blood glucose abnormality among different job burnout groups(P<0.05);there is statistical significance in comparative difference in the detection rate of lung function abnormality,blood pressure abnormality and liver function abnormality among different mental disorder groups(P < 0.05);6)According to the multi-factor analysis of hearing abnormality of coal miners,occupational stress is the risk factor of hearing abnormality.According to the multi-factor analysis of blood pressure abnormality of coal miners shows that occupational stress,job burnout are the risk factors.According to the multi-factor analysis of electrocardiographic abnormality of coal miners,the risk of electrocardiographic abnormality is working types,working shifts,job burnout and occupational stress.According to the multi-factor analysis of dyslipidemia of coal miners,the risk of dyslipidemia gender and mental disorder;7)The former prevalence rate,annual prevalence rate and weekly prevalence rate of new coal miners are 59.38%,58.70% and 55.18%,respectively.The top four annual prevalence rates occur at the waist,the neck,the shoulder and the back.The prevalence rate of musculoskeletal injuries in more than three parts in recent year is 59.60%.There is significant difference in the annual absence rate among different gender,age and working age(P<0.05);8)(P<0.05);8)According to the analysis of the factors affecting MSDS of coal miners,it can be seen that the female primary school or below education income is less than 6000 yuan,working age of 30 years,maintenance workers,fixed night shift,static load factor,dynamic load factor,physical load factor,environmental ergonomics factor,vibration factor,repetitive operation factor,labor organization factor,coal miners have a high prevalence of MSDs;9)After the data confounding factors(general characteristics,occupational characteristics,workplace characteristics)were matched with PSM,the correlation between psychological factors and musculoskeletal injuries was discussed.The caliper value was 0.02,and 1:1 proximity matching method was used to screen 1,804 coal miners with the same baseline.According to the analysis of the influencing factors of occupational stress,job burnout,mental disorder and musculoskeletal injury,there is statistical significance in the comparative difference in the prevalence of MSDs among different occupational stress groups and burnout groups(P<0.005).According to the multivariate analysis of mental health and the prevalence of MSDs of coal miners,occupational stress and job burnout are risk factors of MSDs;10)The effects of occupational stress and burnout on musculoskeletal injuries were studied by establishing the structural equation model.Path analysis took occupational stress level and burnout level of coal miners as potential variables to explore their effects on the musculoskeletal injuries.The occupational stress positively affects the injury(P<0.001,the nonstandard path coefficient = 0.144),the occupational stress positively affects the burnout(P<0.001,the nonstandard path coefficient =1.164),and the job burnout positively affects the musculoskeletal injuries(P<0.001,the nonstandard path coefficient = 0.125).In terms of effect estimation,the total effect,direct effect and indirect effect(intermediary)are0.289,0.144 and 0.145 respectively,and the intermediary accounts for about 50.1%;11)440 coal miners were given the PTM-based health intervention and routine intervention.In PTM-based health intervention group,there is statistical significance in occupational stress,job burnout,musculoskeletal injury cognition,quality of life,protective attitude,protective behavior,sense of self-efficacy and absence rate before and after intervention(P < 0.05).In the control group,there is statistical significance in job burnout,musculoskeletal injury cognition,quality of life,protective attitude,protective behavior and sense of self-efficacy before and after the intervention(P<0.05).Conclusions: 1)The mental health level of coal miners in Xinjiang is low,the level of occupational stress,occupational burnout is high,psychological disorders,incidence of hypertension,abnormal blood lipid,abnormal electrocardiogram,abnormal hearing is high,and detection rate of musculoskeletal injury is high.The physical and mental health status of coal miners is worth paying attention;2)Mental health level can affect physical health status and musculoskeletal injury.Therefore,the influence of psychological factors on physical health should be considered in the prevention of coal miners' diseases;3)The study on the correlation between psychological factors and MSDs found that job burnout played a mediating role in the relationship between occupational stress and MSDs,which provided a theoretical basis for the prevention of musculoskeletal injury;4)The health intervention measures based on the theory of protective motivation can effectively improve the mental health level of coal miners and the cognition of musculoskeletal injury,and provide ideas and methods for improving the physical and mental health level of coal miners in the future.