Roquelaure Yves, Ha Catherine, Rouillon Clarisse, Fouquet Natacha, Leclerc Annette, Descatha Alexis, Touranchet Annie, Goldberg Marcel, Imbernon Ellen
Université d'Angers, Laboratoire d'Ergonomie et d'Epidémiologie en Santé au Travail, IFR 132, Centre Hospitalier Universitaire, Angers, France.
Arthritis Rheum. 2009 Oct 15;61(10):1425-34. doi: 10.1002/art.24740.
To assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders in the working population.
A total of 3,710 workers (58% men) participating in a surveillance program of musculoskeletal disorders in a French region in 2002-2005 were included. Upper-extremity musculoskeletal disorders were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between musculoskeletal disorders, personal, and occupational factors were analyzed using logistic regression modeling.
A total of 472 workers experienced at least 1 upper-extremity musculoskeletal disorder. The risk of upper-extremity musculoskeletal disorders increased with age for both sexes (P < 0.001, odds ratio [OR] < or =4.9 in men and < or =5.0 in women), and in cases of prior history of upper-extremity musculoskeletal disorders (OR 3.1 and 5.0, respectively, P < 0.001). In men, upper-extremity musculoskeletal disorders were associated with obesity (OR 2.2, P = 0.014), high level of physical demand (OR 2.0, P < 0.001), high repetitiveness of the task (OR 1.5, P = 0.027), postures with the arms at or above shoulder level (OR 1.7, P = 0.009) or with full elbow flexion (OR 1.6, P = 0.006), and high psychological demand (OR 1.5, P = 0.005). In women, upper-extremity musculoskeletal disorders were associated with diabetes mellitus (OR 4.9, P = 0.001), postures with extreme wrist bending (OR 2.0, P < 0.001), use of vibrating hand tools (OR 2.2, P = 0.025), and low level of decision authority (OR 1.4, P = 0.042).
Personal and work-related physical and psychosocial factors were strongly associated with clinically diagnosed upper-extremity musculoskeletal disorders.
评估工作人群中上肢肌肉骨骼疾病的个人和职业风险因素的相对重要性。
纳入了2002年至2005年参与法国某地区肌肉骨骼疾病监测项目的3710名工人（58%为男性）。由83名经过培训的职业医生通过标准化体格检查诊断上肢肌肉骨骼疾病。个人因素和工作暴露情况通过自填问卷进行评估。使用逻辑回归模型分析肌肉骨骼疾病、个人因素和职业因素之间的统计关联。
共有472名工人经历过至少1次上肢肌肉骨骼疾病。男女上肢肌肉骨骼疾病的风险均随年龄增加而升高（P<0.001，男性优势比[OR]≤4.9，女性≤5.0），且有上肢肌肉骨骼疾病既往史者风险升高（分别为OR 3.1和5.0，P<0.001）。在男性中，上肢肌肉骨骼疾病与肥胖（OR 2.2，P = 0.014）、高强度体力需求（OR 2.0，P<0.001）、任务高重复性（OR 1.5，P = 0.027）、手臂处于或高于肩部水平的姿势（OR 1.7，P = 0.009）或完全屈肘姿势（OR 1.6，P = 0.006）以及高心理需求（OR 1.5，P = 0.005）相关。在女性中，上肢肌肉骨骼疾病与糖尿病（OR 4.9，P = 0.001）、极端手腕弯曲姿势（OR 2.0，P<0.001）、使用振动手工具（OR 2.2，P = 0.025）以及低决策权限（OR 1.4，P = 0.042）相关。
个人因素以及与工作相关的身体和心理社会因素与临床诊断的上肢肌肉骨骼疾病密切相关。
