Kaila-Kangas Leena, Leino-Arjas Päivi, Karppinen Jaro, Viikari-Juntura Eira, Nykyri Erkki, Heliövaara Markku
Finnish Institute of Occupational Health, Helsinki, Finland. leena
Spine (Phila Pa 1976). 2009 Apr 20;34(9):964-9. doi: 10.1097/BRS.0b013e31819b2c92.
Cross-sectional study with retrospectively assessed work determinants.
To study the association between the history of physically demanding work and sciatica, among the occupationally active, and among persons of working age who are not occupationally active.
Few studies have examined the association of physically loading work with sciatica, and studies concerning women are scarce.
A nationally representative sample of The Health 2000 survey comprised 4811 Finns aged 30 to 64, which we further stratified into 2 groups based on working status during the preceding 12 months. The diagnosis of sciatica was based on characteristic symptoms and a standardized clinical examination by physicians trained for the purpose. Life-long exposure to physically demanding work tasks was assessed retrospectively by interview.
A total of 3.8% of working subjects and 7.9% of nonworking subjects had sciatica; men more often than women. In the multivariable logistic regression models, a history of physically demanding work in general was associated with sciatica among men. The risk increased with the length of exposure for the first 20 years (OR: 1.85; 95% CI: 1.17-2.91 for 1-10 years and 2.67; 1.61-4.43 for 11-20 years of exposure), but decreased thereafter. When analyzing manual handling of heavy objects, bending, and kneeling separately, odds ratios for these factors were high for both working and nonworking men. However, they remained at the borderline of statistical significance among working men. None of the physical work exposures were associated with sciatica among working women, whereas a long history of handling heavy objects and bending were related to sciatica among nonworking women.
Physically demanding work in general is a risk factor for sciatica among men. Sciatica may be a significant cause of premature health-related selection out of the heavy work among both genders.
一项对工作决定因素进行回顾性评估的横断面研究。
研究在职业活跃人群以及非职业活跃的工作年龄人群中,从事体力要求高的工作的历史与坐骨神经痛之间的关联。
很少有研究探讨体力负荷工作与坐骨神经痛之间的关联,且关于女性的研究较少。
“健康2000”调查的全国代表性样本包括4811名30至64岁的芬兰人,我们根据前12个月的工作状态将其进一步分为两组。坐骨神经痛的诊断基于特征性症状以及由为此目的接受培训的医生进行的标准化临床检查。通过访谈回顾性评估一生当中从事体力要求高的工作任务的情况。
共有3.8%的在职受试者和7.9%的非在职受试者患有坐骨神经痛;男性比女性更常见。在多变量逻辑回归模型中,总体而言,从事体力要求高的工作的历史与男性的坐骨神经痛相关。在前20年中,风险随着暴露时间的延长而增加(1至10年的暴露时间,比值比:1.85;95%置信区间:1.17 - 2.91;11至20年的暴露时间,比值比:2.67;1.61 - 4.43),但此后风险降低。分别分析重物搬运、弯腰和跪姿时,这些因素在在职和非在职男性中的比值比都很高。然而,在在职男性中,它们仍处于统计学意义的临界值。体力工作暴露与在职女性的坐骨神经痛均无关联,而长期搬运重物和弯腰与非在职女性的坐骨神经痛有关。
总体而言,从事体力要求高的工作是男性患坐骨神经痛的一个风险因素。坐骨神经痛可能是导致两性过早因健康相关原因退出繁重工作的一个重要原因。