视屏作业人员视疲劳及干眼的流行病学调查

doi:10.19723/j.issn.1671-167X.2025.03.020

摘要/Abstract

摘要：

目的: 调查视疲劳及干眼的流行情况, 并进一步探索可能存在的职业有害因素, 为视疲劳及干眼的防控提供理论依据。方法: 选择的调查对象为银行、高校、政府部门等工作单位的视屏作业人员, 利用课题组自行研制的电子问卷进行人群横断面调查, 收集一般情况、工作情况、工作环境、眼视光健康、工效学条件等信息。根据是否罹患视疲劳和干眼对调查对象进行分析, 通过t检验、卡方检验筛选视疲劳和干眼的相关因素, 之后进行二元Logistic回归分析, 确定视屏作业人员视疲劳及干眼的危险因素。结果: 视屏作业人员视疲劳的总体患病率为52.5%(235/448), 干眼的总体患病率为36.8%(165/448)。视疲劳及干眼的患病率在性别、各年龄组、各视屏作业工龄组间差异无统计学意义; 低体重者的干眼患病率最高(42.9%), 其次分别为正常体重(40.6%)、超重(28.0%)和肥胖(17.4%)者, 不同体重指数(body mass index, BMI)组别的患病率差异有统计学意义(χ²=9.505, P=0.023);视疲劳的患病率在证券工作人员中最低(22.6%), 在企业(59.5%)和其他工作单位(68.8%)人员中较高, 在不同工作单位类型间视疲劳的患病率差异有统计学意义(χ²=14.832, P=0.022)。Logistic回归分析结果显示, 较长的视屏作业工龄(OR=1.006, P < 0.001)、较长的工作外电子设备使用时长(OR=1.002, P=0.032)、显示器亮度过高(OR=2.875, P=0.022)、工作时存在眩光(OR=1.500, P=0.038)、较大的工作环境噪声(OR=1.586, P=0.012)、罹患工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)(OR=4.366, P < 0.001)等为视疲劳的独立危险因素; 佩戴框架眼镜(OR=0.452, P=0.037)为视疲劳的独立保护因素。工作时存在眩光(OR=2.198, P < 0.001)和罹患WMSDs(OR=2.226, P=0.001)为干眼的独立危险因素, 超重(OR=0.448, P=0.006)和肥胖(OR=0.228, P=0.032)为干眼的独立保护因素。结论: 视屏作业人员视疲劳及干眼的患病率较高, 多种危险因素与之相关, 防控时应注重合理进行工间休息, 控制眩光, 加强视觉健康培训与宣传。

关键词: 视觉显示终端, 视疲劳, 干眼综合征, 危险因素

Abstract:

Objective: To investigate the prevalence of asthenopia and dry eye, and to further explore the potential occupational hazard factors, so as to provide a theoretical basis for their prevention and control. Methods: A cross-sectional survey was conducted on the selected respondents. For visual display terminal (VDT) workers in employing organizations such as banks, colleges, and government departments, an online questionnaire independently developed by the research group was used for population surveys. Information including general information, work-related situations, work environment, visual health, and ergonomic factors was collected. The respondents were analyzed according to whether they suffered from asthenopia and dry eye. Relevant factors of asthenopia and dry eye were screened through t-test and Chi-square test. Subsequently, binary Logistic regression analysis was carried out to determine the risk factors of asthenopia and dry eye among the VDT workers. Results: The overall prevalence of asthenopia was 52.5% (235/448) and dry eye was 36.8% (165/448). There were no significant diffe-rences in the prevalence of asthenopia and dry eye among different genders, age groups, and groups of length of service in VDT work. However, the highest prevalence of dry eye was observed in underweight individuals (42.9%), followed by normal weight (40.6%), overweight (28.0%), and obese indivi-duals (17.4%). There was a significant difference in the prevalence of dry eye among different body mass index (BMI) groups (χ²=9.505, P=0.023). The lowest prevalence of asthenopia was observed among securities industry employees (22.6%), while higher rates were found in employees in companies (59.5%) and other employing organizations (68.8%). A significant difference in the prevalence of asthenopia among different employing organizations (χ²=14.832, P=0.022). The result of Logistic regression showed that a longer length of service in VDT work (OR=1.006, P < 0.001), a longer duration of VDT after working hours (OR=1.002, P=0.032), a too-bright monitor (OR=2.875, P=0.022), glare during work (OR=1.500, P=0.038), a louder noise in work environment (OR=1.586, P=0.012), work-related musculoskeletal disorders (WMSDs) (OR=4.366, P < 0.001) and other factors were independent risk factors of asthenopia, while wearing frame glasses (OR=0.452, P=0.037) was an independent protective factor. Glare during work (OR=2.198, P < 0.001), WMSDs (OR=2.226, P=0.001) and other factors were independent risk factors of dry eye, while overweight (OR=0.448, P=0.006), obesity (OR=0.228, P=0.032) were independent protective factors of dry eye. Conclusion: The prevalence of asthenopia and dry eye among VDT workers is relatively high, and it is associated with multiple risk factors. During prevention and control, attention should be paid to taking reasonable breaks during work, controlling glare, and strengthening visual health training and promotion.

Key words: Visual display terminal, Asthenopia, Dry eye syndromes, Risk factor

中图分类号:

R181.3

杨龙傲, 金旭, 黄文初, 何丽华, 陈娟. 视屏作业人员视疲劳及干眼的流行病学调查[J]. 北京大学学报（医学版）, 2025, 57(3): 554-561.

Longao YANG, Xu JIN, Wenchu HUANG, Lihua HE, Juan CHEN. Epidemiological investigation of asthenopia and dry eye among visual display terminal workers[J]. Journal of Peking University (Health Sciences), 2025, 57(3): 554-561.

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Variables	n	Proportion/%
Gender
Male	217	48.4
Female	231	51.6
Age group/years
< 20	6	1.3
20-	210	46.9
30-	113	25.2
40-	78	17.4
≥50	41	9.2
Career
Securities	31	6.9
Bank	14	3.1
Hospital	115	25.7
College/Research institution	101	22.5
Public/Government institution	87	19.4
Company	84	18.8
Other	16	3.6
BMI
Underweight	42	9.4
Normal weight	283	63.2
Overweight	100	22.3
Obesity	23	5.1
Education
High school and below	17	3.8
Junior college	58	13.0
College	286	63.8
Postgraduate and above	87	19.4
Monthly income/yuan
≤5 000	118	26.3
5 001-7 000	98	21.9
7 001-8 000	50	11.2
8 001-10 000	52	11.6
>10 000	130	29.0

Demographic factors	Total	Asthenopia, n (%)	Dry eye, n (%)
Gender
Male	217	104 (47.9)	84 (38.7)
Female	231	131 (56.7)	81 (35.1)
χ²		3.461	0.639
P value		0.063	0.424
Age group/years
< 20	6	5 (83.3)	3 (50.0)
20-	210	104 (49.5)	87 (41.4)
30-	113	57 (50.4)	34 (30.1)
40-	78	45 (57.7)	26 (33.3)
≥50	41	24 (58.5)	15 (36.6)
χ²		4.667	4.974
P value		0.323	0.290
BMI
Underweight	42	20 (47.6)	18 (42.9)
Normal weight	283	150 (53.0)	115 (40.6)
Overweight	100	54 (54.0)	28 (28.0)
Obesity	23	11 (47.8)	4 (17.4)
χ²		0.721	9.505
P value		0.868	0.023^*
Types of employing organizations
Securities	31	7 (22.6)	6 (19.4)
Bank	14	7 (50.0)	7 (50.0)
Hospital	115	59 (51.3)	42 (36.5)
College/Research institution	101	53 (52.5)	45 (44.6)
Public/Government institution	87	48 (55.2)	30 (34.5)
Company	84	50 (59.5)	30 (35.7)
Other	16	11 (68.8)	5 (31.3)
χ²		14.832	8.173
P value		0.022^*	0.226
Length of service in VDT work/years
< 5	234	116 (49.6)	73 (31.2)
5-	69	33 (47.8)	18 (26.1)
10-	101	60 (59.4)	29 (28.7)
≥20	44	26 (59.1)	17 (38.6)
χ²		4.106	2.209
P value		0.250	0.530

Variables	B	SE	Wald χ²	P value	OR (95%CI)
Types of employing organizations
Securities					Reference
Bank	2.621	0.941	7.758	0.005	13.751 (2.174-86.964)
Hospital	1.457	0.603	5.844	0.016	4.291 (1.317-13.980)
College/Research institution	1.211	0.608	3.972	0.046	3.356 (1.020-11.042)
Public/Government institution	1.899	0.635	8.947	0.003	6.682 (1.925-23.197)
Company	2.318	0.644	12.941	< 0.001	10.158 (2.873-35.923)
Other	2.648	0.878	9.100	0.003	14.119 (2.528-78.860)
Length of service in VDT work (by month)	0.006	0.001	13.617	< 0.001	1.006 (1.003-1.008)
Duration of VDT after working hours (by minute)	0.002	0.001	4.605	0.032	1.002 (1.000-1.004)
Monitor brightness
Suitable					Reference
Too bright	1.056	0.461	5.250	0.022	2.875 (1.165-7.094)
Frequent head-down postures (over 4 times per minute)	0.386	0.111	12.175	< 0.001	1.471 (1.184-1.828)
Completion of conflicting tasks	0.297	0.125	5.657	0.017	1.346 (1.054-1.721)
Utilizing special talents	-0.256	0.129	3.962	0.047	0.774 (0.602-0.996)
Glare	0.406	0.195	4.307	0.038	1.500 (1.023-2.200)
Noise	0.461	0.184	6.287	0.012	1.586 (1.106-2.275)
Myopia	1.413	0.388	13.268	< 0.001	4.107 (1.920-8.783)
Astigmatism	0.686	0.291	5.547	0.019	1.986 (1.122-3.517)
Glasses
No glasses					Reference
Frame glasses	-0.794	0.380	4.364	0.037	0.452 (0.215-0.952)
Eye drops using	1.566	0.339	21.322	< 0.001	4.787 (2.463-9.306)
WMSDs	1.474	0.248	35.360	< 0.001	4.366 (2.686-7.098)

Variables	B	SE	Wald χ²	P value	OR (95%CI)
BMI
Normal weight					Reference
Overweight	-0.804	0.291	7.615	0.006	0.448 (0.253-0.792)
Obesity	-1.479	0.688	4.616	0.032	0.228 (0.059-0.878)
Smoking
No smoking					Reference
Quitting smoking	1.314	0.428	9.419	0.002	3.722 (1.608-8.614)
Monthly income	-0.151	0.076	3.996	0.046	0.860 (0.741-0.997)
Duration of computer during working hours (by minute)	-0.005	0.001	16.662	< 0.001	0.995 (0.993-0.998)
Work shifts
Day shifts					Reference
Swing shifts	1.852	0.686	7.293	0.007	6.370 (1.662-24.421)
Frequent head-turning postures (over 4 times per minute)	0.318	0.114	7.804	0.005	1.374 (1.100-1.718)
Glare	0.787	0.178	19.553	< 0.001	2.198 (1.550-3.115)
Eye drops using	0.645	0.295	4.765	0.029	1.905 (1.068-3.399)
WMSDs	0.800	0.237	11.417	0.001	2.226 (1.400-3.542)