d'Errico Angelo, Gore Rebecca, Gold Judith E, Park Jung-Soon, Punnett Laura
Department of Work Environment, University of Massachusetts Lowell, Lowell, MA, USA.
Appl Ergon. 2007 Mar;38(2):167-75. doi: 10.1016/j.apergo.2006.03.002. Epub 2006 May 15.
The literature is sparse on reproducibility of self-reported exposure to physical ergonomics risk factors for musculoskeletal disorders (MSDs). Aims of this study were to evaluate, in a cohort of workers interviewed up to three times: 1-year test-retest reliability; and 5- and 6-year recall of physical exposures. We also examined whether reproducibility was influenced by the presence of UE MSD or by technological changes introduced between the last two surveys.
A cohort of automobile manufacturing employees was interviewed at baseline, one and six years later about work history, physical and psychosocial exposures at work, upper limb symptoms, injury and medical history, and demographics. Agreement between interviews was evaluated by intraclass correlation and Spearman coefficients. Differences in exposure between 1- and 6-year follow-up were analyzed by Wilcoxon matched-pairs signed-ranks test.
Large and significant decreases in work pace and physical effort were observed from baseline, although an upper extremity composite index was quite stable in the total population. One-year test-retest reliability was fair to good for the composite exposure index (ICC=0.58), whole-body vibration, handling parts, and tool use, but poor for the other variables considered. Long-term reproducibility, from baseline or 1-year follow-up to 6-year follow-up, was poor for the composite index and almost all single items. UE MSD case status influenced 1-year test-retest reliability, with subjects who changed case status from baseline displaying higher reliability, but not reproducibility of recalled exposures. A strong regression to the mean effect was observed on exposures reported at follow-up surveys.
Recalled ergonomics exposures could be employed in retrospective cohort studies as a somewhat reliable and unbiased estimate of the self-reported exposures that would have been obtained up to one year earlier, but not over a longer period (5-6 years). These longer-term results may have been limited by difficulty in matching jobs between interviews; also the regression to the mean effect likely contributed to reduce agreement. Changes in production technology and work organization produced a decrease in physical workload intensity and job pace, but did not have a substantial impact on an exposure index for the upper limb.
关于自我报告的肌肉骨骼疾病（MSD）物理工效学风险因素暴露的可重复性，相关文献较少。本研究的目的是在一组接受了多达三次访谈的工人中评估：1年的重测信度；以及5年和6年的身体暴露回忆情况。我们还研究了可重复性是否受到上肢MSD的存在或最后两次调查之间引入的技术变化的影响。
对一组汽车制造员工在基线、1年后和6年后进行访谈，内容包括工作经历、工作中的身体和社会心理暴露、上肢症状、损伤和病史以及人口统计学信息。通过组内相关系数和斯皮尔曼系数评估访谈之间的一致性。通过威尔科克森配对符号秩检验分析1年和6年随访之间的暴露差异。
从基线开始观察到工作节奏和体力消耗大幅且显著下降，尽管上肢综合指数在总体人群中相当稳定。综合暴露指数（ICC = 0.58）、全身振动、搬运零件和工具使用的1年重测信度为中等至良好，但所考虑的其他变量的重测信度较差。从基线或1年随访到6年随访的长期可重复性，对于综合指数和几乎所有单项指标都较差。上肢MSD病例状态影响1年重测信度，从基线改变病例状态的受试者显示出更高的信度，但回忆暴露的可重复性不受影响。在随访调查中报告的暴露情况观察到强烈的向均值回归效应。
回忆的工效学暴露可用于回顾性队列研究，作为对早至一年前自我报告暴露的某种可靠且无偏估计，但不适用于更长时期（5 - 6年）。这些长期结果可能受到访谈之间难以匹配工作的限制；向均值回归效应也可能导致一致性降低。生产技术和工作组织的变化导致体力工作量强度和工作节奏下降，但对上肢暴露指数没有实质性影响。
