van den Heuvel S G, van der Beek A J, Blatter B M, Bongers P M
Work and Employment, TNO Quality of Life, P.O. Box 718, 2130 AS, Hoofddorp, The Netherlands.
Int Arch Occup Environ Health. 2006 Aug;79(7):585-92. doi: 10.1007/s00420-006-0093-8. Epub 2006 May 19.
The objective of this study was to examine the influence of physical exposure at work on neck and upper limb symptoms in office workers.
Data were used from a prospective cohort study with a follow-up period of 3 years. Independent variables were physical exposure at work, observed and self-reported. Outcome measures were neck-shoulder symptoms and elbow-wrist-hand symptoms. Data were analyzed with the generalized estimating equation (GEE) method, with adjustment for age, gender, psychosocial work characteristics and the outcome at baseline.
Neck rotation was associated with neck-shoulder symptoms in the analyses with observed data (OR: 1.57; CI: 0.99-2.50) as well as those with self-reported data (OR: 1.43; CI: 1.02-2.01). Neck extension was also statistically significantly associated with neck-shoulder symptoms (OR: 2.42; CI: 1.22-4.80), but only self-reported data were available. Neck flexion, self-reported wrist pronation, self-reported arm elevation and self-reported duration of computer work, were not associated with symptoms. An indication was found of an adverse effect on neck-shoulder symptoms of long working days and on elbow-wrist-hand symptoms of self-reported wrist flexion and full-time work or longer compared to part-time work.
Only a limited number of work-related physical factors were related to neck and upper limb symptoms in office workers. Only neck rotation and self-reported neck extension were identified as risk factors for neck-shoulder symptoms.
本研究的目的是调查工作中的身体暴露对办公室职员颈部和上肢症状的影响。
数据来自一项随访期为3年的前瞻性队列研究。自变量为工作中的身体暴露,包括观察到的和自我报告的。结局指标为颈肩症状和肘腕手部症状。采用广义估计方程(GEE)方法对数据进行分析,并对年龄、性别、心理社会工作特征和基线时的结局进行调整。
在观察数据的分析中(比值比:1.57;可信区间:0.99 - 2.50)以及自我报告数据的分析中(比值比:1.43;可信区间:1.02 - 2.01),颈部旋转与颈肩症状相关。颈部伸展也与颈肩症状有统计学显著关联(比值比:2.42;可信区间:1.22 - 4.80),但仅有自我报告数据。颈部屈曲、自我报告的手腕旋前、自我报告的手臂抬高以及自我报告的电脑工作时长与症状无关。发现工作日长对颈肩症状有不良影响,自我报告的手腕屈曲以及全职工作或比兼职工作时间更长对肘腕手部症状有不良影响。
在办公室职员中,仅有有限数量的与工作相关的身体因素与颈部和上肢症状有关。仅颈部旋转和自我报告的颈部伸展被确定为颈肩症状的危险因素。