Alipour Akbar, Ghaffari Mostafa, Shariati Batoul, Jensen Irene, Vingard Eva
Department of Public Health, Section for Intervention and Implementation, Karolinska Institute, Stockholm, Sweden.
Spine (Phila Pa 1976). 2009 Feb 15;34(4):413-8. doi: 10.1097/BRS.0b013e3181948185.
Four-year prospective cohort study.
To find the incidence of sick leave because of neck and shoulder pain (NSP) in industrial workers, and its association with work and lifestyle risk factors.
Longitudinal studies to investigate NSP incidence and risk factors are rare, and even fewer have been conducted in middle- and low-income countries.
After inviting all full-time employees of an Iranian car manufacturing company with 18,031 employees to participate in a baseline study, they were followed for 4 years. New episodes of sick leave because of NSP have been calculated based on sickness absence registration between the years 2003 and 2007. The incidence was compared for participants and nonparticipants. The association between sick leave, physical, and psychosocial risk factors at work, and previous self-reported NSP, was calculated for the remaining population of baseline participants (12,184 employees) during a 4-year follow-up.
During a 4-year follow-up of study subjects for the remaining participants of the baseline study, the incidence of sick leave was 0.8% (98 sick leave cases in 12,184 employees). For nonparticipants this incidence was 4.2% (130 cases in 3127 employees). In the final regression model for sick leave cases, the remaining factors for potential physical risk factors were repetitive work and sitting positions at work; for psychosocial factors unattractive work was the only significant remaining factor.
The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.
四年前瞻性队列研究。
确定产业工人因颈肩痛（NSP）而请病假的发生率，及其与工作和生活方式风险因素的关联。
调查NSP发生率及风险因素的纵向研究较少，在中低收入国家进行的此类研究更少。
在邀请一家拥有18031名员工的伊朗汽车制造公司的所有全职员工参与一项基线研究后，对他们进行了4年的随访。基于2003年至2007年期间的病假登记情况，计算了因NSP导致的新病假事件。比较了参与者和非参与者的发生率。在4年随访期间，针对基线参与者的剩余人群（12184名员工），计算了病假、工作中的身体和心理社会风险因素以及先前自我报告的NSP之间的关联。
在对基线研究的剩余参与者进行的4年随访中，研究对象的病假发生率为0.8%（12184名员工中有98例病假）。非参与者的这一发生率为4.2%（3127名员工中有130例）。在病假病例的最终回归模型中，潜在身体风险因素的剩余因素是重复性工作和工作时的坐姿；心理社会因素方面，无吸引力的工作是唯一显著的剩余因素。
与高收入国家先前的研究相比，基于病假的NSP发生率肯定非常低。这种发生率在参与者和非参与者之间有所不同。病假的风险因素与自我报告疼痛的风险因素不同。年轻人群、工作保障、保险制度、不同的健康行为以及健康工人偏差，都是可能影响结果的因素，在中低收入国家，将病假作为一种结果必须更加谨慎地进行解读。
