Miedema H S, van der Molen H F, Kuijer P P F M, Koes B W, Burdorf A
Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands; Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur J Pain. 2014 Jul;18(6):873-82. doi: 10.1002/j.1532-2149.2013.00430.x. Epub 2013 Dec 16.
Until recently, no evidence-based criteria were available to determine the work-relatedness of low back pain (LBP) in an individual worker. Incidence figures for LBP that can be qualified as occupational disease (OD) are scarce. We studied the trend in the number of OD notifications due to LBP in the Netherlands and estimated incidence rates of LBP-related OD notifications.
We developed an instrument for the assessment of work-relatedness of non-specific LBP (NLBP) in 2004, accompanied by an OD registration guideline. We analysed the trend in LBP-related OD notifications in the register of the Netherlands Centre for Occupational Diseases (NCOD) from 2004 to 2011. We estimated incidence rates for LBP-related OD notifications with data from a prospective cohort study, performed by NCOD in 2009-2011.
After implementation of the instrument and guideline, we noticed a huge increase in numbers of LBP-related OD-notifications, from 0.7% of all notified ODs in 2004, via 8.6% in 2005 and 13.6% in 2008, to 9.1% in 2011. We estimated the incidence rate of ODs due to LBP at 24.1 per 100,000 worker years (19.2 for NLBP), with a large difference between men and women (31.3 and 3.2, respectively).
The instrument for the assessment of work-relatedness of NLBP played an important role in the recognition of LBP-related ODs. It provides a basis for a more uniform and objective evaluation of the role of work-related risk factors in the occurrence of NLBP. This knowledge can be used to initiate or direct preventive actions towards subgroups with higher incidence rates.
直到最近，仍没有基于证据的标准来确定个体劳动者中腰痛（LBP）与工作的相关性。可被认定为职业病（OD）的腰痛发病率数据很少。我们研究了荷兰因腰痛导致的职业病通报数量趋势，并估计了与腰痛相关的职业病通报发病率。
我们在2004年开发了一种用于评估非特异性腰痛（NLBP）与工作相关性的工具，并配套了一份职业病登记指南。我们分析了荷兰职业病中心（NCOD）登记册中2004年至2011年与腰痛相关的职业病通报趋势。我们利用NCOD在2009 - 2011年进行的一项前瞻性队列研究的数据，估计了与腰痛相关的职业病通报发病率。
在实施该工具和指南后，我们注意到与腰痛相关的职业病通报数量大幅增加，从2004年占所有通报职业病的0.7%，到2005年的8.6%、2008年的13.6%，再到2011年的9.1%。我们估计因腰痛导致的职业病发病率为每100,000工作年24.1例（非特异性腰痛为19.2例），男性和女性之间存在很大差异（分别为31.3例和3.2例）。
非特异性腰痛与工作相关性评估工具在识别与腰痛相关的职业病方面发挥了重要作用。它为更统一、客观地评估与工作相关的风险因素在非特异性腰痛发生中的作用提供了基础。这些知识可用于针对发病率较高的亚组启动或指导预防行动。
