Kaila-Kangas Leena, Leino-Arjas Päivi, Riihimäki Hilkka, Luukkonen Ritva, Kirjonen Juhani
Finnish Institute of Occupational Health, Helsinki, Finland.
Spine (Phila Pa 1976). 2003 Aug 15;28(16):1860-8. doi: 10.1097/01.BRS.0000083284.47176.80.
A prospective cohort study.
To study the relationship of smoking and overweight with severe back disorders leading to hospitalization.
Many epidemiological studies have shown an association between smoking or overweight and back pain, but the results are still equivocal. Longitudinal studies are few.
A cohort of metal industry employees (n = 902) was studied for lifestyle, work history, and health in 1973 by questionnaire and interview. The weight of the subjects was measured and body mass index (kg/m2) was calculated. Based on intensity and duration, smoking was categorized as: never smoked (reference), stopped smoking, smoked <or=9 or >9 pack-years. Information on hospital admissions from 1973 to 2000 from the Finnish Hospital Discharge Register was linked to the data. Seventy-five individuals had been admitted to hospital because of back disorders. Intervertebral disc disorders and other common back disorders were analyzed separately. Cox proportional hazards regression was used to estimate the time between the assessment of potential risk factors and the first hospitalization for a back disorder.
The rate ratio of heavy smokers (>9 pack-years) for hospitalization because of intervertebral disc disorders was 3.4 (95% confidence interval 1.3-9.0) as compared with never-smokers, allowing for other risk factors. Accordingly, the rate ratio of body mass index >27.5 kg/m2 was 2.7 (1.1-6.45) as compared with people with normal weight. The results retained when patients with chronic back disease at baseline were excluded from the analyses. Other back-related diagnoses of hospitalization were not consistently associated with smoking or overweight.
Heavy smoking and overweight predicted hospitalization for intervertebral disc disorders.
前瞻性队列研究。
研究吸烟和超重与导致住院的严重背部疾病之间的关系。
许多流行病学研究表明吸烟或超重与背痛之间存在关联，但结果仍不明确。纵向研究较少。
1973年通过问卷调查和访谈对一组金属行业员工（n = 902）的生活方式、工作史和健康状况进行了研究。测量了受试者的体重并计算了体重指数（kg/m²）。根据吸烟强度和持续时间，吸烟被分类为：从不吸烟（参照组）、戒烟、吸烟<或=9包年或>9包年。将1973年至2000年芬兰医院出院登记处的住院信息与这些数据相关联。75人因背部疾病住院。分别分析了椎间盘疾病和其他常见的背部疾病。采用Cox比例风险回归来估计潜在危险因素评估与首次因背部疾病住院之间的时间。
考虑到其他危险因素，与从不吸烟者相比，重度吸烟者（>9包年）因椎间盘疾病住院的率比为3.4（95%置信区间1.3 - 9.0）。相应地，体重指数>27.5 kg/m²者与体重正常者相比，率比为2.7（1.1 - 6.45）。当从分析中排除基线时患有慢性背部疾病的患者时，结果依然成立。其他与背部相关的住院诊断与吸烟或超重没有始终如一的关联。
重度吸烟和超重可预测因椎间盘疾病住院。
