Sim Julius, Lacey Rosie J, Lewis Martyn
Primary Care Musculoskeletal Research Centre, Keele University, Staffordshire ST5 5BG, UK.
BMC Public Health. 2006 Sep 19;6:234. doi: 10.1186/1471-2458-6-234.
Work-related neck and upper limb pain has mainly been studied in specific occupational groups, and little is known about its impact in the general population. The objectives of this study were to estimate the prevalence and population impact of work-related neck and upper limb pain.
A cross-sectional survey was conducted of 10,000 adults in North Staffordshire, UK, in which there is a common local manual industry. The primary outcome measure was presence or absence of neck and upper limb pain. Participants were asked to give details of up to five recent jobs, and to report exposure to six work activities involving the neck or upper limbs. Psychosocial measures included job control, demand and support. Odds ratios (ORs) and population attributable fractions were calculated for these risk factors.
The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and: repeated lifting of heavy objects (OR = 1.4); prolonged bending of neck (OR = 2.0); working with arms at/above shoulder height (OR = 1.3); little job control (OR = 1.6); and little supervisor support (OR = 1.3). The population attributable fractions were 0.24 (24%) for exposure to work activities and 0.12 (12%) for exposure to psychosocial factors.
Neck and upper limb pain is associated with both physical and psychosocial factors in the work environment. Inferences of cause-and-effect from cross-sectional studies must be made with caution; nonetheless, our findings suggest that modification of the work environment might prevent up to one in three of cases of neck and upper limb pain in the general population, depending on current exposures to occupational risk.
与工作相关的颈部和上肢疼痛主要在特定职业群体中进行研究,对其在普通人群中的影响了解甚少。本研究的目的是估计与工作相关的颈部和上肢疼痛的患病率及人群影响。
对英国北斯塔福德郡10000名成年人进行了横断面调查,该地区存在常见的当地体力劳动行业。主要结局指标是是否存在颈部和上肢疼痛。参与者被要求详细说明最近最多五份工作的情况,并报告是否接触过六项涉及颈部或上肢的工作活动。心理社会指标包括工作控制、需求和支持。计算这些风险因素的比值比(OR)和人群归因分数。
颈部和上肢疼痛的年龄标准化一个月患病率为44%。颈部和上肢疼痛与以下因素之间存在显著的独立关联:反复搬运重物(OR = 1.4);颈部长时间弯曲(OR = 2.0);手臂在肩部高度及以上工作(OR = 1.3);工作控制少(OR = 1.6);上级支持少(OR = 1.3)。工作活动暴露的人群归因分数为0.2(24%),心理社会因素暴露的人群归因分数为0.12(12%)。
颈部和上肢疼痛与工作环境中的身体和心理社会因素均有关。横断面研究的因果推断必须谨慎;尽管如此,我们的研究结果表明,根据目前对职业风险的暴露情况,改善工作环境可能预防普通人群中高达三分之一的颈部和上肢疼痛病例。