Hartman Esther, Oude Vrielink Huub H E, Huirne Ruud B M, Metz Jos H M
Farm Management Group, Institute for Risk Management in Agriculture, Wagenigen University, Wageningen, The Netherlands.
Am J Ind Med. 2006 Mar;49(3):204-14. doi: 10.1002/ajim.20276.
In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder, upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and quantify risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers.
Sick leave, claimed at an insurance company from 1998 to 2001 for back (SL-BP, n = 198) or neck/shoulder/upper extremity trouble (SL-EXT, n = 89) was analyzed; the controls did not file any claim in this period (n = 816).
Multivariate analysis showed that risk factors for SL-BP were increased age (OR = 1.06 per year, CI = 1.04-1.09), body mass index (BMI) >27 (OR = 1.93, CI = 1.2-3.2), smoking (OR = 1.90, CI = 1.2-2.9), former pain (OR = 3.28, CI = 2.1-5.1), tractor driving >1,000 hr/year (OR = 2.44, CI = 1.0-6.4), and "high work pace and workload" (OR = 1.59, CI = 1.0-2.4). SL-EXT was associated with pig (OR = 3.63, CI = 1.4-9.7), mushroom (OR = 6.14, CI = 1.4-27.2), or dairy/pig farming (OR = 4.56, 1.1-19.5), while age (OR = 1.10, CI = 1.06-1.14), smoking (OR = 1.79, CI = 1.0-3.2), and former pain (OR = 3.37, CI = 1.9-6.1) were also contributing.
Prevention of sick leave of self-employed farmers should focus on life style (obesity, smoking), reducing older farmers' exposure to physical load, exposure to long-term tractor driving. Specific attention should be paid to animal and mushroom farmers.
在荷兰农业中，肌肉骨骼疾病是病假的主要原因。在自营保险的农民中，颈部、肩部、上肢和背部疾病占不到1年病假申请的30%。本病例对照研究旨在识别和量化荷兰自营农民因肌肉骨骼疾病导致病假的风险因素。
分析了1998年至2001年期间向保险公司申请的背部病假（SL-BP，n = 198）或颈部/肩部/上肢疾病病假（SL-EXT，n = 89）；对照组在此期间未提出任何索赔（n = 816）。
多变量分析显示，SL-BP的风险因素包括年龄增加（每年OR = 1.06，CI = 1.04 - 1.09）、体重指数（BMI）>27（OR = 1.93，CI = 1.2 - 3.2）、吸烟（OR = 1.90，CI = 1.2 - 2.9）、既往疼痛（OR = 3.28，CI = 2.1 - 5.1）、每年拖拉机驾驶时间>1000小时（OR = 2.44，CI = 1.0 - 6.4）以及“高工作节奏和工作量”（OR = 1.59，CI = 1.0 - 2.4）。SL-EXT与养猪（OR = 3.63，CI = 1.4 - 9.7）、种植蘑菇（OR = 6.14，CI = 1.4 - 27.2）或奶牛/养猪养殖（OR = 4.56, 1.1 - 19.5）有关，同时年龄（OR = 1.10，CI = 1.06 - 1.14）、吸烟（OR = 1.79，CI = 1.0 - 3.2）和既往疼痛（OR = 3.37，CI = 1.9 - 6.1）也有影响。
预防自营农民病假应关注生活方式（肥胖、吸烟），减少老年农民的体力负荷暴露，避免长期驾驶拖拉机。应特别关注养殖动物和种植蘑菇的农民。
