Cunha-Miranda Luís, Carnide Filomena, Lopes M Fátima
Reumatologista, Médico do Trabalho, Instituto Português de Reumatologia.
Acta Reumatol Port. 2010 Apr-Jun;35(2):215-26.
Work related musculoskeletal diseases (WRMSDs) have a huge social and economic impact being a public health problem.
To determine the prevalence of WRMSDs in Portuguese active workers.
A questionnaire was sent by regular mail to the occupational physician of 822 large dimension companies in Portugal (over 250 employees). This questionnaire was addressed to the physician and contemplated data on file from the occupational medical doctor of clinically relevant WRMSDs (rather than addressing workers complaints). A reply form and a telephone reminder were used to assure a higher number of respondents.
Of the selected 822 companies, 515 responded (response rate of 62.3%) involving a total population of 410,496 workers. The prevalence of clinically relevant WRMSD was of 5.9% (24,269 cases). The more prevalent WRMSD were back pain with a prevalence of low back pain of 2.27% (n=9310 , 38.4% of total WRMSD). Dorsal pain 0.82% (n= 3379, 13.9% of total WRMSDs) and cervical pain 1.13% (n=4651, 19.2% of total WRMSD). Back pain accounts for 4.22% (n= 17340) and a total of 74.9% of all WRMSDs. Regarding the upper limb we found a prevalence of 1.61% (n= 6493). From this total, shoulder tendonitis was 0.59%(n= 2398, 9.9% of total WRMSDs), carpal tunnel syndrome 0.29% (n=1170, 4.8% of total WRMSDs), elbow tendonitis 0.29% (n=1202, 5% of total WRMSDs) and hand tendonitis 0.44% (n=1823, 7.5% of total WRMSDS). A lower prevalence was observed in the lower limbs with lower limb tendonitis of 0.08% (n=336, 0.01% of total WRMSDs).
DISCUSSION/CONCLUSION: Our work was representative of 11% of the working Portuguese population. We have found a prevalence of clinically relevant WRMSD of 5,9%. If we extrapolate for the total of the working population we would have 220 467 workers with WRMSDs. Our data are in conflict with national social security services regarding these diseases with much lower reported diseases that proves the inefficacy of the national reporting system. There are clear differences in our data when compared with the literature. We found a higher number of back pain, and in proportion of cervical pain, and lower numbers of upper and lower limb WRMSDs. In the upper limb we found a higher level of hand tendonitis and a decrease of elbow tendonitis and carpal tunnel syndrome. This work was a first effort to characterize WRMSDs in Portugal. Due to the study design we believe that further studies aimed for higher risk populations should be performed.
工作相关肌肉骨骼疾病（WRMSDs）作为一个公共卫生问题，具有巨大的社会和经济影响。
确定葡萄牙在职员工中WRMSDs的患病率。
通过普通邮件向葡萄牙822家大型公司（员工超过250人）的职业医生发送问卷。该问卷针对医生，涵盖了临床相关WRMSDs的职业医生档案数据（而非员工投诉）。使用了回复表和电话提醒以确保更高的回复率。
在选定的822家公司中，515家做出了回应（回复率为62.3%），涉及员工总数为410,496人。临床相关WRMSD的患病率为5.9%（24,269例）。较常见的WRMSD是背痛，其中腰痛患病率为2.27%（n = 9310，占WRMSD总数的38.4%）。背痛0.82%（n = 3379，占WRMSD总数的13.9%），颈痛1.13%（n = 4651，占WRMSD总数的19.2%）。背痛占4.22%（n = 17340），占所有WRMSD的74.9%。关于上肢，患病率为1.61%（n = 6493）。其中，肩腱炎为0.59%（n = 2398，占WRMSD总数的9.9%），腕管综合征0.29%（n = 1170，占WRMSD总数的4.8%），肘腱炎0.29%（n = 1202，占WRMSD总数的5%），手部腱炎0.44%（n = 1823，占WRMSD总数的7.5%）。下肢患病率较低，下肢腱炎为0.08%（n = 336，占WRMSD总数的0.01%）。
讨论/结论：我们的研究代表了11%的葡萄牙在职人口。我们发现临床相关WRMSD的患病率为5.9%。如果将其推算至整个在职人口，我们将得出有220467名员工患有WRMSDs。我们的数据与国家社会保障服务机构关于这些疾病的数据存在冲突，报告的疾病数量要低得多，这证明了国家报告系统的无效性。与文献相比，我们的数据存在明显差异。我们发现背痛的数量较多，颈痛的比例较高，而上肢和下肢WRMSDs的数量较少。在上肢，我们发现手部腱炎的水平较高，肘腱炎和腕管综合征的数量减少。这项工作是对葡萄牙WRMSDs特征进行描述的首次尝试。由于研究设计，我们认为应该针对更高风险人群进行进一步研究。
