Matsudaira Ko, Konishi Hiroaki, Miyoshi Kota, Isomura Tatsuya, Inuzuka Kyoko
Clinical Research Center for Occupational Musculoskeletal Disorders, Kanto Rosai Hospital, Kawasaki, Kanagawa, Japan.
Department of Orthopaedic Surgery, Nagasaki Rosai Hospital, Sasebo, Nagasaki, Japan.
PLoS One. 2014 Apr 8;9(4):e93924. doi: 10.1371/journal.pone.0093924. eCollection 2014.
Two-year, prospective cohort data from the Japan epidemiological research of occupation-related back pain study in urban settings were used for this analysis.
To examine the association between aggravated low back pain and psychosocial factors among Japanese workers with mild low back pain.
Although psychosocial factors are strongly indicated as yellow flags of low back pain (LBP) leading to disability, the association between aggravated LBP and psychosocial factors has not been well assessed in Japanese workers.
At baseline, 5,310 participants responded to a self-administered questionnaire including questions about individual characteristics, ergonomic work demands, and work-related psychosocial factors (response rate: 86.5%), with 3,811 respondents completing the 1-year follow-up questionnaire. The target outcome was aggravation of mild LBP into persistent LBP during the follow-up period. Incidence was calculated for the participants with mild LBP during the past year at baseline. Logistic regression was used to explore risk factors associated with persistent LBP.
Of 1,675 participants who had mild LBP during the preceding year, 43 (2.6%) developed persistent LBP during the follow-up year. Multivariate analyses adjusted for individual factors and an ergonomic factor found statistically significant or almost significant associations of the following psychosocial factors with persistent LBP: interpersonal stress at work [adjusted odds ratio (OR): 1.96 and 95% confidence interval (95%CI): 1.00-3.82], job satisfaction (OR: 2.34, 95%CI: 1.21-4.54), depression (OR: 1.92, 95%CI: 1.00-3.69), somatic symptoms (OR: 2.78, 95%CI: 1.44-5.40), support from supervisors (OR: 2.01, 95%CI: 1.05-3.85), previous sick-leave due to LBP (OR: 1.94, 95%CI: 0.98-3.86) and family history of LBP with disability (OR: 1.98, 95%CI: 1.04-3.78).
Psychosocial factors are important risk factors for persistent LBP in urban Japanese workers. It may be necessary to take psychosocial factors into account, along with physical work demands, to reduce LBP related disability.
本分析使用了来自日本城市职业性背痛研究的两年前瞻性队列数据。
探讨日本轻度下背痛工人中，下背痛加重与心理社会因素之间的关联。
尽管心理社会因素被强烈视为导致残疾的下背痛（LBP）的警示信号，但在日本工人中，下背痛加重与心理社会因素之间的关联尚未得到充分评估。
在基线时，5310名参与者回答了一份自填式问卷，内容包括个人特征、工作中的人体工程学要求以及与工作相关的心理社会因素（回复率：86.5%），其中3811名受访者完成了1年的随访问卷。目标结果是随访期间轻度下背痛恶化为持续性下背痛。计算了基线时过去一年有轻度下背痛的参与者的发病率。采用逻辑回归分析来探究与持续性下背痛相关的危险因素。
在前一年有轻度下背痛的1675名参与者中，43名（2.6%）在随访年中发展为持续性下背痛。在对个体因素和人体工程学因素进行调整的多变量分析中，发现以下心理社会因素与持续性下背痛存在统计学上显著或几乎显著的关联：工作中的人际压力[调整后的优势比（OR）：1.96，95%置信区间（95%CI）：1.00 - 3.82]、工作满意度（OR：2.34，95%CI：1.21 - 4.54）、抑郁（OR：1.92，95%CI：1.00 - 3.69）、躯体症状（OR：2.78，95%CI：1.44 - 5.40）、上级支持（OR：2.01，95%CI：1.05 - 3.85）、既往因下背痛请病假（OR：1.94，95%CI：0.98 - 3.86）以及有下背痛致残家族史（OR：1.98，95%CI：1.04 - 3.78）。
心理社会因素是日本城市工人持续性下背痛的重要危险因素。为减少与下背痛相关的残疾，可能有必要在考虑体力工作要求的同时，也将心理社会因素考虑在内。
