下背痛或脊椎損傷是職業駕駛員經常會遭遇的下背問題，其中對於宅配業駕駛員而言，人工物料搬運作業(Manual Material Handling, MMH)為主要造成下背問題的原因。因此本研究的目的為探討宅配業駕駛員之搬運作業對其下背痛及脊椎損傷的影響，並分析搬運作業的負荷與下背脊椎損傷、主觀肌肉骨骼不適、工作能力及生活品質等面向之關係。
本研究一方面分析宅配業駕駛員脊椎損傷的類型、嚴重程度及發生比例，另外一方面採用挪威肌肉骨骼不適問卷、工作能力指數問卷、世界衛生組織生活品質問卷評估其主觀自覺感受及工作壓力問卷，除此之外，以生物力學模式探討MMH對脊椎負荷的影響。本研究在脊椎損傷調查及主觀評量的部份有效樣本為32位駕駛員，而其中20位駕駛員再進行作業現場之分析。
研究結果發現駕駛員脊椎損傷最嚴重的類型為骨刺(65%)、其次為椎間狹窄(36%)，在肌肉骨骼不適的部份，比例最高的部位為下背/臀部(56%)，其次為頸部(47%)、肩膀(38%)，而有下背痛的駕駛員不一定會有骨刺或椎間狹窄。
本研究發現與脊椎損傷正相關的危險因子，包含年齡、年資、人際關係不佳、下班後的疲勞程度，而與工作相關因子則包含MMH時前傾75°-105°的比例、搬運時貨物超過23公斤的比例、採用徒手推物的比例以及L5/S1椎間盤的年累積負荷量。此外，有脊椎損傷的駕駛員也會使得生活品質下降、工作能力指數(WAI)下降、工作壓力增加，及使用推車的比例變高。
本研究根據與脊椎損傷相關的工作危險因子，建立主觀與客觀的迴歸模型，可以良好的預測出骨刺、椎間狹窄、脊椎退化的嚴重程度(R2為0.6~0.8)，藉此可以得知個別危險因子對於脊椎損傷的影響程度，相關管理人員應在工作場所中盡量避免此因子的發生，以降低駕駛員下背傷害並延長其工作生命週期。此外，本研究所建立之方法論及研究結果亦可應用於其他以搬運作業為主的職業工作者，對降低勞工下背問題的發生與節省勞保給付支出有很大的助益。

Low back pain (LBP) and spine disorder are common problems for occupational drivers. For home delivery drivers, the Manual Materials Handling (MMH) task is the main risk factor that causes low back problems. The purpose of this study was to investigate the correlations between low back problems, and physical, biomechanical as well as psychosocial factors for the home delivery drivers.
A total of 32 male home delivery drivers participated in the study. Four questionnaires, including Nordic Musculoskeletal Questionnaire (NMQ), Work Ability Index (WAI), the brief version World Health Organization Quality of Life (WHOQOL-BREF) and Job Stress Questionnaire were used. Besides, a rehabilitation doctor diagnosed the subjects’ spine disorder based on lumbar x-ray results. Furthermore, the biomechanical loading of spine was analyzed while drivers performing MMH.
The study results show that osteophytes (65%) and disc space narrowing (36%) were the most common disorders for home delivery drivers. Over one third of the subjects felt back/hip (56%), neck (47%), and shoulder (38%) discomfort. There was no absolute association between LBP and spine disorder. However, there were significant positive correlations between spine disorder and age, job seniority, poor human relation, the fatigue strength off duty. When performing MMH, the percent of trunk flexion over 75°, weight of goods over 23 kg, the percent of push, and the accumulated biomechanical loading of L5/S1 spine disc showed positive correlations with the severity of spine disorder. Moreover, this study constructed logistic and multivariable regression models to predict spine disorder from physical, biomechanical and psychosocial factors. The prediction models explained at least 60% of the variations. Some improvements are recommended to reduce the home delivery drivers low back problem.

Keyword：Home delivery driver, low back pain, spine disorder, Manual Materials Handling, psychosocial factors

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