Hincapié Cesar A, Cassidy J David, Côté Pierre
Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network, Toronto, Canada.
BMC Musculoskelet Disord. 2008 Feb 19;9:22. doi: 10.1186/1471-2474-9-22.
Little is known about the role of prior occupational low back injury in future episodes of low back pain and disability in the general population. We conducted a study to determine if a lifetime history of work-related low back injury is associated with prevalent severity-graded low back pain, depressive symptoms, or both, in the general population.
We used data from the Saskatchewan Health and Back Pain Survey - a population-based cross-sectional survey mailed to a random, stratified sample of 2,184 Saskatchewan adults 20 to 69 years of age in 1995. Information on the main independent variable was gathered by asking respondents whether they had ever injured their low back at work. Our outcomes, the 6-month period prevalence of severity-graded low back pain and depressive symptoms during the past week, were measured with valid and reliable questionnaires. The associations between prior work-related low back injury and our outcomes were estimated through multinomial and binary multivariable logistic regression with adjustment for age, gender, and other important covariates.
Fifty-five percent of the eligible population participated. Of the 1,086 participants who responded to the question about the main independent variable, 38.0% reported a history of work-related low back injury. A history of work-related low back injury was positively associated with low intensity/low disability low back pain (OR, 3.66; 95%CI, 2.48-5.42), with high intensity/low disability low back pain (OR, 4.03; 95%CI, 2.41-6.76), and with high disability low back pain (OR, 6.76; 95%CI, 3.80-12.01). No association was found between a history of work-related low back injury and depression (OR, 0.85; 95%CI, 0.55-1.30).
Our analysis shows an association between past occupational low back injury and increasing severity of prevalent low back pain, but not depression. These results suggest that past work-related low back injury may be an important risk factor for future episodes of low back pain and disability in the general population.
对于既往职业性腰背痛在普通人群未来腰背痛发作及残疾方面所起的作用，人们了解甚少。我们开展了一项研究，以确定在普通人群中，与工作相关的腰背痛终生病史是否与普遍存在的严重程度分级的腰背痛、抑郁症状或两者都有关联。
我们使用了萨斯喀彻温省健康与背痛调查的数据——这是一项基于人群的横断面调查，于1995年邮寄给萨斯喀彻温省20至69岁的2184名成年人的随机分层样本。主要自变量的信息是通过询问受访者是否曾在工作中伤到过腰部来收集的。我们的结局指标，即过去一周内严重程度分级的腰背痛和抑郁症状的6个月期间患病率，是通过有效且可靠的问卷来测量的。既往与工作相关的腰背痛与我们的结局指标之间的关联，是通过多项和二元多变量逻辑回归进行估计的，并对年龄、性别和其他重要协变量进行了调整。
55%的符合条件人群参与了调查。在1086名回答了关于主要自变量问题的参与者中，38.0%报告有与工作相关的腰背痛病史。与工作相关的腰背痛病史与低强度/低残疾程度的腰背痛呈正相关（比值比，3.66；95%置信区间，2.48 - 5.42），与高强度/低残疾程度的腰背痛呈正相关（比值比，4.03；95%置信区间，2.41 - 6.76），与高残疾程度的腰背痛呈正相关（比值比，6.76；95%置信区间，3.80 - 12.01）。未发现与工作相关的腰背痛病史和抑郁之间存在关联（比值比，0.85；95%置信区间，0.55 - 1.30）。
我们的分析表明，过去的职业性腰背痛与普遍存在的腰背痛严重程度增加之间存在关联，但与抑郁无关。这些结果表明，过去与工作相关的腰背痛可能是普通人群未来腰背痛发作及残疾的一个重要危险因素。
