Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
Occup Environ Med. 2012 Jul;69(7):485-92. doi: 10.1136/oemed-2011-100453. Epub 2012 Apr 26.
The aim of this prospective study was to examine the role of physical workload, leisure-time physical activity, obesity and smoking in predicting the occurrence and course of multisite musculoskeletal pain (MSP).
Data on physical and psychosocial workload, lifestyle factors and MSP were based on questionnaire surveys of 385 Finnish female kitchen workers. MSP (defined as pain at three or more of seven sites) during the past 3 months was measured repeatedly at 3-month intervals over 2 years. Four different patterns (trajectories) in the course of MSP were identified. The authors analysed whether the determinants at baseline predicted the occurrence of MSP (1) at the 2-year follow-up and (2) over the total of nine measurements during the 2 years by exploiting the MSP trajectories. Logistic regression was used.
High physical workload at baseline was an independent predictor of MSP at the 2-year follow-up (OR 3.8, 95% CI 1.7 to 8.5) in a model allowing for age, psychosocial factors at work and lifestyle. High physical workload (OR 2.0, 95% CI 1.0 to 4.0) and moderate (OR 2.4, 95% CI 1.2 to 4.9) or low (OR 2.3, 95% CI 1.1 to 4.7) physical activity predicted persistent MSP. Obesity (OR 2.8, 95% CI 1.0 to 7.8) predicted an increased, and not being obese (OR 3.7, 95% CI 1.1 to 12.7) a decreased, prevalence of MSP in models similarly including all covariates. Smoking had no effect.
The results emphasise the importance of high physical workload, low to moderate physical activity and obesity as potential modifiable risk factors for the occurrence and course of MSP over time.
本前瞻性研究旨在探讨体力工作负荷、休闲时间体力活动、肥胖和吸烟在预测多部位肌肉骨骼疼痛(MSP)发生和病程中的作用。
基于对 385 名芬兰女性厨房工作人员的问卷调查,收集了体力和心理社会工作负荷、生活方式因素和 MSP 数据。在过去的 3 个月中,MSP(定义为 7 个部位中有 3 个或更多部位疼痛)在 2 年内每 3 个月重复测量一次。确定了 MSP 病程中的 4 种不同模式(轨迹)。作者通过利用 MSP 轨迹分析了基线时的决定因素是否预测了 MSP 的发生:(1)在 2 年随访时,以及(2)在 2 年内 9 次测量中的总体情况。采用逻辑回归进行分析。
在考虑年龄、工作中的心理社会因素和生活方式的模型中,基线时高体力工作负荷是 MSP 在 2 年随访时发生的独立预测因素(OR 3.8,95%CI 1.7 至 8.5)。高体力工作负荷(OR 2.0,95%CI 1.0 至 4.0)和中等(OR 2.4,95%CI 1.2 至 4.9)或低(OR 2.3,95%CI 1.1 至 4.7)体力活动预测 MSP 的持续性。肥胖(OR 2.8,95%CI 1.0 至 7.8)预测 MSP 的患病率增加,而不肥胖(OR 3.7,95%CI 1.1 至 12.7)则预测 MSP 的患病率降低,这两种情况在纳入所有协变量的模型中均得到了证实。吸烟没有影响。
研究结果强调了高体力工作负荷、低至中等体力活动和肥胖作为潜在可改变的危险因素在预测 MSP 的发生和病程中的重要性。