Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Spine J. 2010 Mar;10(3):252-61. doi: 10.1016/j.spinee.2009.12.005. Epub 2010 Jan 25.
Low back pain (LBP) is a common and disabling musculoskeletal disorder that often occurs in a working-age population. Determining the precise causation of LBP remains difficult. Any attempt to implicate a specific occupational activity in the genesis of LBP requires a methodologically rigorous approach.
To conduct a systematic review of the scientific literature focused on evaluating the causal relationship between occupational sitting and LBP.
Systematic review of the literature using Medline, EMBASE, CINAHL, Cochrane Library, Occupational Safety and Health database, grey literature, hand-searching occupational health journals, reference lists of included studies, and content experts. Evaluation of study quality using a modified version of the Newcastle-Ottawa Scale. Summary levels of evidence supporting Bradford-Hill criteria for different categories of sitting and types of LBP.
Studies reporting an association between occupational sitting and LBP.
Numerical association between different levels of exposure to occupational sitting and the presence or severity of LBP.
A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria, between occupational sitting and LBP.
This search yielded 2,766 citations. Twenty-four studies met the inclusion/exclusion criteria and five were high-quality studies, including two case-controls and three prospective cohorts. Strong, consistent evidence was found for no association between occupational sitting and LBP. A moderate level of evidence was found for the absence of any dose-response trend. Risk estimates evaluating temporality were not statistically significant. Biological plausibility was not discussed in these studies. No evidence was available to assess the experiment criterion.
This review failed to uncover high-quality studies to support any of the Bradford-Hill criteria to establish causality between occupational sitting and LBP. Strong and consistent evidence did not support criteria for association, temporality, and dose response. Based on these results, it is unlikely that occupational sitting is independently causative of LBP in the populations of workers studied.
下腰痛（LBP）是一种常见且使人丧失能力的肌肉骨骼疾病，通常发生在工作年龄段的人群中。确定 LBP 的确切病因仍然很困难。任何试图将特定的职业活动与 LBP 的发生联系起来的尝试都需要一种方法严谨的方法。
对专注于评估职业坐姿与 LBP 之间因果关系的科学文献进行系统综述。
使用 Medline、EMBASE、CINAHL、Cochrane 图书馆、职业安全与健康数据库、灰色文献、职业健康期刊的手工检索、纳入研究的参考文献以及内容专家，对文献进行系统综述。使用纽卡斯尔-渥太华量表的修改版本评估研究质量。支持不同类别的坐姿和不同类型的 LBP 的布拉德福德-希尔标准的证据汇总水平。
报告职业坐姿与 LBP 之间存在关联的研究。
不同水平的职业坐姿暴露与 LBP 的存在或严重程度之间的数值关联。
根据布拉德福德-希尔标准，进行系统综述以确定、评估和总结与建立职业坐姿与 LBP 之间因果关系相关的文献。
该搜索产生了 2766 条引文。24 项研究符合纳入/排除标准，其中 5 项为高质量研究，包括 2 项病例对照研究和 3 项前瞻性队列研究。有强有力的一致证据表明职业坐姿与 LBP 之间没有关联。没有任何剂量反应趋势的中度证据水平。评估时间关系的风险估计没有统计学意义。这些研究没有讨论生物学上的合理性。没有证据可用于评估实验标准。
本综述未能发现高质量的研究来支持布拉德福德-希尔标准中的任何一个来确定职业坐姿与 LBP 之间的因果关系。强有力且一致的证据不支持关联、时间关系和剂量反应的标准。基于这些结果，职业坐姿不太可能独立导致研究人群中的 LBP。
