Chau N, Bourgkard E, Bhattacherjee A, Ravaud J F, Choquet M, Mur J M
INSERM, U669, IFR25-IFRH, Paris, 75014, France.
Int Arch Occup Environ Health. 2008 Feb;81(4):379-89. doi: 10.1007/s00420-007-0223-y. Epub 2007 Aug 16.
To assess the roles of job demands, living conditions and lifestyle in occupational injury.
The sample included 2,888 workers, aged > or =15 years, randomly selected from the north-eastern France. The subjects completed a mailed questionnaire. Data were analyzed with adjusted odds ratios (ORa) computed with the logistic model.
In total, 9.2% of workers had an injury during the previous 2 years. The high job demands: tasks at height, handling objects, pneumatic tools, other vibrating hand tools, work in adverse climate, physical workload, vibrating platform, machine tools, cold, heat, awkward posture, noise, hammer, and pace had crude odds ratios between 1.81 and 5.25 for injury. A strong exposure-response relationship was found between the cumulated job demands (CJD, defined by their number) and injury: OR 1.88 (95% CI 1.23-2.87) for CJD1, 4.39 (2.98-4.46) for CJD2-3, and 9.93 (6.70-14.7) for CJD > or = 4, versus CJD0. These ORs decreased to 1.68, 3.70, and 7.15 respectively, when adjusted for sex, age, and living conditions/lifestyle confounders; and to 1.54, 2.99, and 5.45 respectively when also adjusted for job category. The following factors had significant ORa: age <30 years (1.54, 1.12-2.12), male (1.64, 1.18-2.30), smoking (1.60, 1.22-2.10), musculoskeletal disorders (1.54, 1.17-2.04), and frequent drug use for fatigue (2.03, 1.17-3.53). The workmen, farmers/craftsmen/tradesmen, and foremen had a 5.7-8.7-fold while the clerks and technicians a 2.7-3.6-fold higher risk compared with upper class. The risk associated with CJD was twofold higher among the workers aged > or =40 or with frequent drug use for fatigue compared with the others. Obesity had ORa 2.05 (1.11-3.78) among the subjects aged > or =40, and excess alcohol use had ORa 2.44 (1.26-4.72) among those free of disease.
This study identified a wide range of job demands and living conditions/lifestyle which predicted injury. Preventive measures should be conducted to reduce job demands and to help workers to be aware of the risk and to improve their living conditions/lifestyle.
评估工作要求、生活条件和生活方式在职业伤害中的作用。
样本包括从法国东北部随机选取的2888名年龄≥15岁的工人。受试者完成一份邮寄问卷。数据采用逻辑模型计算的调整优势比(ORa)进行分析。
在过去两年中,共有9.2%的工人受过伤。高工作要求:高处作业、搬运物体、气动工具、其他振动手动工具、在恶劣气候下工作、体力工作量、振动平台、机床、寒冷、炎热、不良姿势、噪音、锤子和工作节奏,受伤的粗优势比在1.81至5.25之间。累积工作要求(CJD,由其数量定义)与受伤之间存在强烈的暴露-反应关系:CJD1的OR为1.88(95%CI 1.23-2.87),CJD2-3的OR为4.39(2.98-4.46),CJD≥4的OR为9.93(6.70-14.7),与CJD0相比。在对性别、年龄和生活条件/生活方式混杂因素进行调整后,这些OR分别降至1.68、3.70和7.15;在对工作类别也进行调整后,分别降至1.54、2.99和5.45。以下因素具有显著的ORa:年龄<30岁(1.54,1.12-2.12)、男性(1.64,1.18-2.30)、吸烟(1.60,1.22-2.10)、肌肉骨骼疾病(1.54,1.17-2.04)以及频繁使用药物缓解疲劳(2.03,1.17-3.53)。与上层阶级相比,工人、农民/工匠/商人以及工头的风险高5.7至8.7倍,而职员和技术人员的风险高2.7至3.6倍。与CJD相关的风险在年龄≥40岁或频繁使用药物缓解疲劳的工人中比其他人高出两倍。在年龄≥40岁的受试者中,肥胖的ORa为2.05(1.11-3.78),在无疾病的受试者中,过量饮酒的ORa为2.44(1.26-4.72)。
本研究确定了多种预测伤害的工作要求以及生活条件/生活方式。应采取预防措施以降低工作要求,并帮助工人意识到风险并改善其生活条件/生活方式。