Hagen Kåre B, Tambs Kristian, Bjerkedal Tor
Department of Population Health Sciences, National Institute of Public Health, National Insurance Administration, Oslo, Norway.
Spine (Phila Pa 1976). 2002 Aug 15;27(16):1790-6. doi: 10.1097/00007632-200208150-00019.
A 7-year prospective cohort study of 34,754 employed men and women was conducted.
To determine the relative contribution of occupational risk factors, lifestyle factors, comorbidity, and psychological and social factors to the incidence of disability retirement because of back pain in the general working population.
Permanent occupational disability is a serious consequence of a disabling process. Although this condition is a great burden to the individual and extremely costly for society, few population-based studies exist on risk factors for obtaining disability pension because of back pain.
Patients granted back pain disability pension were ascertained from the national disability register. The exposure variables were taken from a health screening of all the inhabitants in one county: Norway. The participation rate was 72% to 90%.
During the follow-up period, 715 individuals (2.1%) were granted a back pain disability pension. In the final combined multivariate model, the strongest predictors for future back pain disability were the occupational risk factor "physically demanding work" (odds ratio [OR], 4.1; 95% confidence interval [CI], 2.7-6.4) and the comorbidity factor "poor general health" (OR, 3.7; 95% CI, 2.4-5.8). "Feeling of being worn out" (OR, 1.7; 95% CI, 1.1-2.4), current smoking (OR, 1.4; 95% CI, 1.2-1.7), and body mass index in the upper percentile (OR, 1.6; 95% CI, 1.2-2) also predicted back pain disability pension.
In a broad public health perspective within a European welfare system, subjects at high risk for future back pain disability pension perceived their work as constantly physically demanding, had health complaints other than back pain, and mostly felt generally tired and worn out. The results indicate that interventions directed toward the painful back alone may be unsuccessful in preventing disability pensions.
对34754名在职男性和女性进行了一项为期7年的前瞻性队列研究。
确定职业风险因素、生活方式因素、合并症以及心理和社会因素对一般劳动人口中因背痛导致残疾退休发生率的相对贡献。
永久性职业残疾是致残过程的严重后果。尽管这种情况给个人带来巨大负担且对社会成本极高，但针对因背痛获得残疾抚恤金的风险因素的基于人群的研究却很少。
从国家残疾登记处确定获得背痛残疾抚恤金的患者。暴露变量取自挪威一个县所有居民的健康筛查。参与率为72%至90%。
在随访期间，715人（2.1%）获得了背痛残疾抚恤金。在最终的综合多变量模型中，未来背痛残疾的最强预测因素是职业风险因素“体力要求高的工作”（优势比[OR]，4.1；95%置信区间[CI]，2.7 - 6.4）和合并症因素“总体健康状况差”（OR，3.7；95% CI，2.4 - 5.8）。“感到疲惫不堪”（OR，1.7；95% CI，1.1 - 2.4）、当前吸烟（OR，1.4；95% CI，1.2 - 1.7）以及体重指数处于较高百分位（OR，1.6；95% CI，1.2 - 2）也预测了背痛残疾抚恤金。
从欧洲福利体系中的广泛公共卫生角度来看，未来有背痛残疾抚恤金高风险的受试者认为他们的工作持续体力要求高，有除背痛之外的健康问题，并且大多感到总体疲倦和疲惫不堪。结果表明仅针对疼痛背部的干预措施在预防残疾抚恤金方面可能不会成功。
