Bourgkard Eve, Wild Pascal, Massin Nicole, Meyer Jean-Pierre, Otero Sierra Carmen, Fontana Jean-Marc, Benamghar Lahoucine, Mur Jean-Marie, Ravaud Jean-François, Guillemin Francis, Chau Nearkasen
Institut National de Recherche et de Sécurité (INRS), WHO Collaborative Centre, Département d'Epidémiologie en Entreprises, France.
J Occup Health. 2008;50(1):31-40. doi: 10.1539/joh.50.31.
This study assessed the relationships of physical job demands (PJD), smoking, and alcohol abuse, with premature mortality before age 70 (PM-70) among the working or inactive population. The sample included 4,268 subjects aged 15 or more randomly selected in north-eastern France. They completed a mailed questionnaire (birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr). PJD score was defined by the cumulative number of the following high job demands at work: hammer, vibrating platform, pneumatic tools, other vibrating hand tools, screwdriver, handling objects, awkward posture, tasks at heights, machine tools, pace, working on a production line, standing about and walking. The data were analyzed using the Poisson regression model. Those with PM-70 were 126 (3.81 per 1,000 person-years). The leading causes of death were cancers (46.4% in men, 57.1% in women), cardiovascular diseases (20.2% and 11.9%), suicide (9.5% and 7.1%), respiratory diseases (6.0% and 4.8%), and digestive diseases (2.4% and 4.8%). PJD3, smoker, and alcohol abuse had adjusted risk ratios of 1.71 (95% CI 1.02-2.88), 1.76 (1.08-2.88), and 2.07 (1.31-3.26) respectively for all-cause mortality. Manual workers had a risk ratio of 1.84 (1.00-3.37) compared to the higher socio-economic classes. The men had a two-fold higher mortality rate than the women; this difference became non-significant when controlling for job, PJD, smoker and alcohol abuse. For cancer mortality the factors PJD3, smoker, and alcohol abuse had adjusted risk ratios of 2.00 (1.00-3.99), 2.34 (1.19-4.63), and 2.22 (1.17-4.20), respectively. Health promotion efforts should be directed at structural measures of task redesign and they should also concern lifestyle.
本研究评估了体力工作需求（PJD）、吸烟和酗酒与工作或非工作人群中70岁前过早死亡（PM - 70）之间的关系。样本包括在法国东北部随机选取的4268名15岁及以上的受试者。他们于1996年完成了一份邮寄问卷（出生日期、性别、体重、身高、工作、PJD、吸烟习惯、酗酒情况（Deta问卷）），并随访至2004年（9年）以获取死亡率数据。PJD得分由以下工作中高体力工作需求的累积数量定义：锤子、振动平台、气动工具、其他振动手动工具、螺丝刀、搬运物体、不良姿势、高处作业、机床、工作节奏、生产线工作、站立和行走。数据使用泊松回归模型进行分析。PM - 70的人数为126人（每1000人年3.81人）。主要死因是癌症（男性为46.4%，女性为57.1%）、心血管疾病（分别为20.2%和11.9%）、自杀（分别为9.5%和7.1%）、呼吸系统疾病（分别为6.0%和4.8%）以及消化系统疾病（分别为2.4%和4.8%）。PJD3、吸烟者和酗酒者全因死亡率的调整风险比分别为1.71（95%置信区间1.02 - 2.88）、1.76（1.08 - 2.88）和2.07（1.31 - 3.26）。与社会经济阶层较高的人群相比，体力劳动者的风险比为1.84（1.00 - 3.37）。男性的死亡率是女性的两倍；在控制工作、PJD、吸烟和酗酒因素后，这种差异变得不显著。对于癌症死亡率，PJD3、吸烟者和酗酒者的调整风险比分别为2.00（1.00 - 3.99）、2.34（1.19 - 4.63）和2.22（1.17 - 4.20）。健康促进措施应针对任务重新设计的结构性措施，同时也应关注生活方式。
