Sterud Tom, Johannessen Håkon A, Tynes Tore
Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, 0033, Oslo, Norway,
Int Arch Occup Environ Health. 2014 Jul;87(5):471-81. doi: 10.1007/s00420-013-0886-5. Epub 2013 May 26.
This study examines the impact of work-related psychosocial and mechanical exposure on the development of neck/shoulder pain in the general working population.
A randomly drawn cohort from the general population in Norway aged 18-66 was followed up for 3 years (n = 12,550, response rate = 67 %). Eligible respondents were in paid work during the reference week in 2006 and 2009, or temporarily absent from such work (n = 6,745). Four work-related psychosocial factors and six mechanical exposures were measured. Outcomes of interest were moderate or severe neck/shoulder pain at follow-up adjusted for baseline neck/shoulder pain.
In total, 16.9 % (1,138 individuals) reported neck/shoulder pain during the last month at follow-up. Work related psychosocial predictors of neck/shoulder pain were high job demands (highest OR 1.41, 95 % CI 1.11-1.78) and low levels of supportive leadership (highest OR 1.66, 95 % CI 1.08-2.54). Mechanical factors were neck flexion (highest OR 1.77, 95 % CI 1.31-2.39) and lifting in awkward postures (highest OR 1.81, 95 % CI 1.21-2.71). The estimated population risk attributable to these factors was about 23 %. The relative risk for neck/shoulder pain associated with psychosocial exposure was slightly influenced by adjustment for physical risk factors, and vice versa. There was no substantial confounding related to age, gender, education, occupation or psychological distress.
Highly demanding jobs, neck flexion and awkward lifting appear as the most important predictors of neck/shoulder pain.
本研究探讨工作相关的心理社会因素和机械性暴露对一般工作人群颈部/肩部疼痛发生的影响。
从挪威18 - 66岁的普通人群中随机抽取一个队列，随访3年（n = 12,550，应答率 = 67%）。符合条件的受访者在2006年和2009年的参考周内从事有偿工作，或暂时缺勤（n = 6,745）。测量了四个与工作相关的心理社会因素和六种机械性暴露。感兴趣的结局是在对基线颈部/肩部疼痛进行调整后，随访时出现中度或重度颈部/肩部疼痛。
总体而言，16.9%（1,138人）在随访的最后一个月报告有颈部/肩部疼痛。与颈部/肩部疼痛相关的工作相关心理社会预测因素是高工作要求（最高比值比1.41，95%可信区间1.11 - 1.78）和低水平的支持性领导（最高比值比1.66，95%可信区间1.08 - 2.54）。机械因素是颈部前屈（最高比值比1.77，95%可信区间1.31 - 2.39）和在 awkward姿势下提举（最高比值比1.81，95%可信区间1.21 - 2.71）。归因于这些因素的估计人群风险约为23%。心理社会暴露与颈部/肩部疼痛相关的相对风险受身体风险因素调整的影响较小，反之亦然。与年龄、性别、教育程度、职业或心理困扰没有实质性的混杂关系。
高要求的工作、颈部前屈和 awkward提举似乎是颈部/肩部疼痛的最重要预测因素。 （注：“awkward”此处原文有误，推测可能是“awkward”，暂按此翻译，若有误请根据正确内容调整）
