Holland P, Burström B, Möller I, Whitehead M
Division of Public Health, University of Liverpool, UK.
Rheumatology (Oxford). 2006 Aug;45(8):1016-22. doi: 10.1093/rheumatology/kel044. Epub 2006 Feb 20.
To establish whether the employment consequences of musculoskeletal disorder vary by gender and socio-economic group in Sweden.
Two linked registers, containing diagnostic and socio-economic data for the 1.8 million residents of Stockholm County, were used to investigate the subsequent employment consequences over 5 yr of having a musculoskeletal disorder requiring hospital admission in 1996. Age-standardized employment rates of all patients with musculoskeletal disorder (n = 2185) were compared with patients employed prior to hospital admission (n = 1286) and with the general population of Stockholm. Odds of leaving employment between 1996-2001 were calculated for men, women and patients from different socio-economic groups.
Employment rates increased and social differentials narrowed in the general population, while employment declined and social differentials widened among patients with musculoskeletal disorders. These trends were masked when analyses were restricted to individuals employed at baseline. Following hospital admission, the odds of leaving employment increased annually for patients; by 2001, their adjusted odds were over three times greater [odds ratio (OR) = 3.36, 95% confidence interval (CI) 2.89-3.91] than for the general population. Women with musculoskeletal disorders were significantly more likely to leave employment during follow-up than men (OR = 1.95, 95% CI 1.49-2.56). Semi- and unskilled manual workers with musculoskeletal disorders were over three times as likely to leave employment than their professional counterparts (OR = 3.40, 95% CI 2.41-4.81).
People with musculoskeletal disorders, particularly women and semi- and unskilled manual workers, are vulnerable to leaving employment. Health and social policies must do more to protect the employment of people with musculoskeletal disorders.
确定在瑞典，肌肉骨骼疾病对就业的影响是否因性别和社会经济群体而异。
利用两个相互关联的登记册，其中包含斯德哥尔摩县180万居民的诊断和社会经济数据，调查1996年因肌肉骨骼疾病需住院治疗的患者在5年期间随后的就业影响。将所有肌肉骨骼疾病患者（n = 2185）的年龄标准化就业率与入院前就业的患者（n = 1286）以及斯德哥尔摩的普通人群进行比较。计算了1996 - 2001年间不同性别和社会经济群体的患者离职几率。
普通人群的就业率上升且社会差异缩小，而肌肉骨骼疾病患者的就业率下降且社会差异扩大。当分析仅限于基线时就业的个体时，这些趋势被掩盖。入院后，患者每年的离职几率都在增加；到2001年，他们的调整后几率比普通人群高出三倍多[优势比（OR）= 3.36，95%置信区间（CI）2.89 - 3.91]。患有肌肉骨骼疾病的女性在随访期间离职的可能性明显高于男性（OR = 1.95，95% CI 1.49 - 2.56）。患有肌肉骨骼疾病的半熟练和非熟练体力劳动者离职的可能性是其专业同行的三倍多（OR = 3.40，95% CI 2.41 - 4.81）。
患有肌肉骨骼疾病的人，尤其是女性以及半熟练和非熟练体力劳动者，容易离职。健康和社会政策必须采取更多措施来保护患有肌肉骨骼疾病者的就业。
