Ariëns G A, Bongers P M, Hoogendoorn W E, Houtman I L, van der Wal G, van Mechelen W
TNO Work and Employment, Hoofddorp, The Netherlands.
Spine (Phila Pa 1976). 2001 Sep 1;26(17):1896-901; discussion 1902-3. doi: 10.1097/00007632-200109010-00016.
A 3-year prospective cohort study among 1334 workers was conducted.
To determine whether the work-related psychosocial factors of quantitative job demands, conflicting job demands, skill discretion, decision authority, supervisor support, coworker support, and job security are risk factors for neck pain.
Among the various risk factors for neck pain, work-related psychosocial factors play a major role. Previous studies on risk factors for neck pain often had a cross-sectional design, and did not take both physical and psychosocial factors into account.
At baseline, data on work-related psychosocial factors were collected by means of a questionnaire. During the 3-year follow-up period, data on the occurrence of neck pain were collected by means of postal questionnaires. Individuals without neck pain at baseline were selected for the analyses. Cox regression analysis was applied to examine the relation between the work-related psychosocial factors and the cumulative incidence of neck pain. Adjustments were made for various physical factors and individual characteristics.
The analysis included 977 patients. Altogether, 141 workers (14.4%) reported that they had experienced neck pain at least once during the 3-year follow-up period. The relation of neck pain to high quantitative job demands (relative risk [RR], 2.14; 95% confidence interval [CI], 1.28-3.58) and low coworker support (RR, 2.43; 95% CI, 1.11-5.29) was statistically significant. An increased risk was found for low decision authority in relation to neck pain (RR, 1.60; 95% CI, 0.74-3.45), but this relation was not statistically significant.
High quantitative job demands and low coworker support are independent risk factors for neck pain. There are indications that another risk factor for neck pain is low decision authority.
对1334名工人进行了一项为期3年的前瞻性队列研究。
确定定量工作需求、相互冲突的工作需求、技能自主性、决策权力、上级支持、同事支持和工作保障等与工作相关的社会心理因素是否为颈部疼痛的危险因素。
在颈部疼痛的各种危险因素中，与工作相关的社会心理因素起主要作用。以往关于颈部疼痛危险因素的研究通常采用横断面设计，未同时考虑身体和社会心理因素。
在基线时，通过问卷调查收集与工作相关的社会心理因素数据。在3年的随访期内，通过邮寄问卷收集颈部疼痛发生情况的数据。选择基线时无颈部疼痛的个体进行分析。应用Cox回归分析来检验与工作相关的社会心理因素和颈部疼痛累积发病率之间的关系。对各种身体因素和个体特征进行了调整。
分析纳入了977例患者。共有141名工人（14.4%）报告在3年随访期内至少经历过一次颈部疼痛。颈部疼痛与高定量工作需求（相对风险[RR]，2.14；95%置信区间[CI]，1.28 - 3.58）和低同事支持（RR，2.43；95%CI，1.11 - 5.29）之间的关系具有统计学意义。发现低决策权力与颈部疼痛相关的风险增加（RR，1.60；95%CI，0.74 - 3.45），但这种关系无统计学意义。
高定量工作需求和低同事支持是颈部疼痛的独立危险因素。有迹象表明，颈部疼痛的另一个危险因素是低决策权力。
