在职人群中因颈部或背部疼痛导致新的病假发作的风险因素。一项为期18个月和三年随访的前瞻性研究。
Risk factors for new episodes of sick leave due to neck or back pain in a working population. A prospective study with an 18-month and a three-year follow-up.
作者信息
Bergström Gunnar, Bodin Lennart, Bertilsson Helena, Jensen Irene B
机构信息
The Karolinska Institute, Section for Personal Injury Prevention, Stockholm, Sweden.
出版信息
Occup Environ Med. 2007 Apr;64(4):279-87. doi: 10.1136/oem.2006.026583. Epub 2006 Nov 9.
OBJECTIVES
To identify risk factors for new episodes of sick leave due to neck or back pain.
METHODS
This prospective study comprised an industrial population of 2187 employees who were followed up at 18 months and 3 years after a comprehensive baseline measurement. The potential risk factors comprised physical and psychosocial work factors, health-related and pain-related characteristics and lifestyle and demographic factors. The response rate at both follow-ups was close to 73%.
RESULTS
At the 18-month follow-up, 151 participants reported at least one episode of sick-listing due to neck or back pain during the previous year. Risk factors assessed at baseline for sick leave due to neck or back pain at the follow-up were blue-collar work, back pain one or several times during the previous year, 1-99 days of cumulative sickness absence during the previous year (all causes except neck or back pain), uncertainty of one's own working ability in 2 years' time and the experience of few positive challenges at work. After 3 years, 127 participants reported at least one episode of sick leave due to back or neck pain during the year previous to follow-up. The risk factors for this pain-related sick leave were blue-collar work, several earlier episodes of neck pain, no everyday physical activities during leisure time (cleaning, gardening and so on), lower physical functioning and, for blue-collar workers separately, repetitive work procedures.
CONCLUSION
The most consistent risk factors for new episodes of sick leave due to neck or back pain found during both the follow-ups were blue-collar work and several earlier episodes of neck or back pain assessed at baseline. Preventive efforts to decrease sick leave due to neck or back pain may include measures to increase the occurrence of positive challenges at work and to minimise repetitive work procedures. An evidence-based secondary prevention of neck and back pain including advice to stay active is also warranted.
目的
确定因颈部或背部疼痛导致新的病假发作的风险因素。
方法
这项前瞻性研究纳入了2187名产业工人，在进行全面的基线测量后，对他们进行了18个月和3年的随访。潜在风险因素包括身体和社会心理工作因素、与健康和疼痛相关的特征以及生活方式和人口统计学因素。两次随访的应答率均接近73%。
结果
在18个月的随访中，151名参与者报告在前一年至少有一次因颈部或背部疼痛而列入病假名单。在随访时，基线评估的因颈部或背部疼痛导致病假的风险因素包括蓝领工作、前一年背部疼痛一次或多次、前一年累计病假1 - 99天（除颈部或背部疼痛外的所有原因）、对自己两年后工作能力的不确定性以及工作中积极挑战较少的经历。3年后，127名参与者报告在随访前一年至少有一次因背部或颈部疼痛而病假。这种与疼痛相关的病假的风险因素包括蓝领工作、早期多次颈部疼痛发作、休闲时间无日常体育活动（清洁、园艺等）、身体功能较低，对于蓝领工人单独而言，还有重复性工作程序。
结论
在两次随访中发现的因颈部或背部疼痛导致新的病假发作的最一致的风险因素是蓝领工作和基线评估的早期多次颈部或背部疼痛发作。减少因颈部或背部疼痛导致病假的预防措施可能包括增加工作中积极挑战的发生率以及尽量减少重复性工作程序的措施。对颈部和背部疼痛进行基于证据的二级预防，包括建议保持活跃，也是必要的。
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