Population-Based Epidemiological Cohorts, Research Platform, Versailles Saint-Quentin-en-Yvelines University, UMRS 1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
Am J Ind Med. 2013 Apr;56(4):400-9. doi: 10.1002/ajim.22140. Epub 2012 Nov 13.
This study was designed to assess the relationship between work-related combined physical and psychosocial factors and elbow disorders (lateral epicondylitis and non-specific disorders without lateral epicondylitis) in the working population.
A total of 3,710 workers (58% men) in a French region in 2002-2005 participated in physical examinations by occupational health physicians and assessed their personal factors and work exposure by self-administered questionnaire. Statistical associations between elbow disorders and risks factors were analyzed using multinomial logistic regression.
A total of 389 (10.5%) workers had elbow pain without lateral epicondylitis and 90 (2.4%) workers had lateral epicondylitis. Age, body mass index (>25), and low social support (only for men) were significant risks factors. Hard perceived physical exertion combined with elbow flexion/extension (>2 hr/day) and wrist bending (>2 hr/day) was a strong significant risk factor for elbow pain and epicondylitis: among men, adjusted Odds Ratio (ORa) = 2.6 (1.9-3.7) and ORa = 5.6 (2.8-11.3), respectively; among women, ORa = 1.4 (0.9-2.2) and ORa = 2.9 (1.3-6.5).
This study emphasizes the strength of the associations between combined physical exertion and elbow movements and lateral epicondylitis. Certain observed differences in associations with lateral epicondylitis and elbow pain only indicate the need for additional longitudinal studies on different stages of elbow disorders and known risk factors.
本研究旨在评估与工作相关的体力和心理社会因素的综合作用与肘部疾病（外侧肱骨上髁炎和无外侧肱骨上髁炎的非特异性疾病）之间的关系，研究对象为劳动人群。
2002 年至 2005 年，法国某地区共有 3710 名工人（58%为男性）参加了职业健康医生的体格检查，并通过自我管理问卷评估了他们的个人因素和工作暴露情况。使用多项逻辑回归分析肘部疾病与危险因素之间的统计学关联。
共有 389 名（10.5%）工人出现无外侧肱骨上髁炎的肘部疼痛，90 名（2.4%）工人患有外侧肱骨上髁炎。年龄、体重指数（>25）和低社会支持（仅男性）是显著的危险因素。被认为体力活动强度大，同时肘部弯曲/伸展（>2 小时/天）和手腕弯曲（>2 小时/天）的工作与肘部疼痛和肱骨外上髁炎存在强烈的显著相关性：对于男性，调整后的优势比（ORa）分别为 2.6（1.9-3.7）和 5.6（2.8-11.3）；对于女性，ORa 分别为 1.4（0.9-2.2）和 2.9（1.3-6.5）。
本研究强调了体力活动和肘部运动与外侧肱骨上髁炎之间关联的强度。与外侧肱骨上髁炎和肘部疼痛相关的某些观察到的差异仅表明需要对不同阶段的肘部疾病和已知危险因素进行更多的纵向研究。
