Kristensen Petter, Bjerkedal Tor, Irgens Lorentz M
National Institute of Occupational Health, Oslo, Norway.
Soc Sci Med. 2007 Feb;64(3):646-55. doi: 10.1016/j.socscimed.2006.09.032. Epub 2006 Nov 7.
In order to investigate the extent to which musculoskeletal sickness absence was influenced by a range of circumstances concerning family background and health in early life, we established a register-based cohort of all live-born in Norway between 1967 and 1976. Personal data on parental factors and health early in life were recorded prospectively from birth onward in the Medical Birth Registry of Norway, the National Insurance Administration, Statistics Norway, and the Central Population Register. We collected data in the National Insurance Administration on the first spell of medically certified long-term (>16 days) musculoskeletal (International Classification of Primary Care group L) sickness absence in 2000-2003 among 378, 356 participants who were considered to be at risk of sickness absence on January 1st, 2000. The 4-year musculoskeletal absence risk was 0.264 for women and 0.156 for men. Parental education level was associated with musculoskeletal sickness absence, with increasing adjusted relative risks by decreasing educational level for both genders. Associations with other early determinants (birth weight, childhood disease, parental survival, parental disability, parental income, and parental marital status) were all close to unity. Parental education level attributed 36% (95% confidence interval 33-38) to the population risk for women and 67% (64-70) for men. The parental education association was partly mediated through own educational attainment, which was strongly associated with musculoskeletal sickness absence in itself. Our data suggest that mechanisms acting early in life could influence later risk of musculoskeletal sickness absence.
为了探究一系列与早年家庭背景和健康状况相关的因素对肌肉骨骼疾病缺勤的影响程度，我们建立了一个基于登记册的队列，纳入了1967年至1976年在挪威所有活产婴儿。关于父母因素和早年健康状况的个人数据从出生起就前瞻性地记录在挪威医疗出生登记册、国家保险管理局、挪威统计局和中央人口登记册中。我们在国家保险管理局收集了2000 - 2003年期间378356名被认为在2000年1月1日有疾病缺勤风险的参与者首次经医学认证的长期（>16天）肌肉骨骼（初级保健国际分类L组）疾病缺勤数据。女性4年的肌肉骨骼缺勤风险为0.264，男性为0.156。父母教育水平与肌肉骨骼疾病缺勤有关，两性的调整后相对风险均随着教育水平的降低而增加。与其他早期决定因素（出生体重、儿童疾病、父母存活情况、父母残疾、父母收入和父母婚姻状况）的关联均接近1。父母教育水平对女性人群风险的贡献率为36%（95%置信区间33 - 38），对男性为67%（64 - 70）。父母教育水平的关联部分通过自身教育程度介导，而自身教育程度本身与肌肉骨骼疾病缺勤密切相关。我们的数据表明，早年起作用的机制可能会影响后期肌肉骨骼疾病缺勤的风险。
