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下肢关节疼痛的在职成年人开始限制工作:个体因素和地区社会经济条件。

Onset of work restriction in employed adults with lower limb joint pain: individual factors and area-level socioeconomic conditions.

机构信息

Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.

出版信息

J Occup Rehabil. 2013 Jun;23(2):180-8. doi: 10.1007/s10926-013-9443-z.

Abstract

PURPOSE

To examine individual and area-level socioeconomic factors that predict the onset of work restriction in employed persons with lower limb joint pain.

METHODS

Population-based prospective cohort study. Adults were aged 50-59, reported hip, knee, foot pain or a combination and maintained employment through 3 year follow-up (n = 716). Work restriction was measured as inability to participate in work as desired. Multi-level logistic regression was used to assess the associations of work restriction onset with baseline factors: health (severity of knee pain/functional limitation, comorbidity, anxiety, depression, cognitive impairment, abnormal weight), demographic socio-economic, environment and area-level employment deprivation.

RESULTS

108 (15.1 %) reported the onset of work restriction over 3 years. Severe lower limb joint pain and functional limitation, number of affected body sites and area employment deprivation were independently associated with onset. Significant interactions indicated a greater effect of area employment deprivation on older and more depressed workers.

CONCLUSIONS

Results suggest that effectively preventing work disability in those with OA will require both condition-specific interventions to decrease pain and maintain function, and providing alternative employment opportunities for those with progressive functional limitations. Results in older workers are particularly concerning, as retirement ages are expected to increase in the general population.

摘要

目的

探讨下肢关节疼痛的在职人群工作受限发病的个体和地区社会经济因素。

方法

基于人群的前瞻性队列研究。50-59 岁成年人报告髋关节、膝关节、足部疼痛或组合疼痛,并在 3 年随访期间保持就业(n=716)。工作受限的测量指标为无法按意愿参与工作。多水平逻辑回归用于评估工作受限发病与基线因素的相关性:健康状况(膝关节疼痛/功能限制严重程度、合并症、焦虑、抑郁、认知障碍、体重异常)、人口统计学社会经济、环境和地区就业剥夺。

结果

108 人(15.1%)在 3 年内报告工作受限发病。严重下肢关节疼痛和功能限制、受累身体部位数量和地区就业剥夺与发病独立相关。显著的交互作用表明,地区就业剥夺对年龄较大和抑郁程度较高的工人的影响更大。

结论

结果表明,要有效预防 OA 患者的工作残疾,不仅需要针对特定疾病的干预措施来减轻疼痛和维持功能,还需要为那些功能逐渐受限的人提供替代就业机会。在老年工人中的结果尤其令人担忧,因为预期一般人群的退休年龄会增加。

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