Palmer Keith T, Harris Clare E, Griffin Michael J, Bennett James, Reading Isabel, Sampson Madelaine, Coggon David
MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, United Kingdom.
Scand J Work Environ Health. 2008 Oct;34(5):364-73. doi: 10.5271/sjweh.1282. Epub 2008 Oct 14.
This study investigated risk factors for low-back pain among patients referred for magnetic resonance imaging (MRI), with special focus on whole-body vibration.
A case-control approach was used. The study population comprised working-aged persons from a catchment area for radiology services. The cases were those in a consecutive series referred for a lumbar MRI because of low-back pain. The controls were age- and gender-matched persons X-rayed for other reasons. Altogether, 252 cases and 820 controls were studied, including 185 professional drivers. The participants were questioned about physical factors loading the spine, psychosocial factors, driving, personal characteristics, mental health, and certain beliefs about low-back pain. Exposure to whole-body vibration was assessed by six measures, including weekly duration of professional driving, hours driven in one period, and current root mean square A(8). Associations with whole-body vibration were examined with adjustment for age, gender, and other potential confounders.
Strong associations were found with poor mental health and belief in work as a causal factor for low-back pain, and with occupational sitting for > or =3 hours while not driving. Associations were also found for taller stature, consulting propensity, body mass index, smoking history, fear-avoidance beliefs, frequent twisting, low decision latitude, and low support at work. However, the associations with the six metrics of whole-body vibration were weak and not statistically significant, and no exposure-response relationships were found.
Little evidence of a risk from professional driving or whole-body vibration was found. Drivers were substantially less heavily exposed to whole-body vibration than in some earlier surveys. Nonetheless, it seems that, at the population level, whole-body vibration is not an important cause of low-back pain among those referred for MRI.
本研究调查了因磁共振成像（MRI）而转诊患者的腰痛危险因素，特别关注全身振动。
采用病例对照研究方法。研究人群包括来自放射科服务覆盖区域的工作年龄人群。病例为因腰痛而连续转诊进行腰椎MRI检查的患者。对照为因其他原因进行X线检查且年龄和性别匹配的人群。总共研究了252例病例和820例对照，其中包括185名职业司机。研究人员询问了参与者有关脊柱负荷的身体因素、心理社会因素、驾驶情况、个人特征、心理健康以及对腰痛的某些看法。通过六种测量方法评估全身振动暴露情况，包括每周职业驾驶时长、一次驾驶时长以及当前均方根加速度（A8）。在对年龄、性别和其他潜在混杂因素进行调整后，研究了与全身振动的关联。
发现心理健康状况差、认为工作是腰痛的病因、非驾驶时职业性久坐≥3小时之间存在强关联。还发现身高较高、咨询倾向、体重指数、吸烟史、恐惧回避信念、频繁扭转、决策自由度低和工作支持度低之间存在关联。然而，与全身振动的六个指标的关联较弱且无统计学意义，未发现暴露-反应关系。
未发现职业驾驶或全身振动存在风险的证据。与一些早期调查相比，司机接触全身振动的程度明显较低。尽管如此，在人群层面，全身振动似乎不是因MRI而转诊患者腰痛的重要原因。
