Mustard Cameron A, Chambers Andrea, Ibrahim Selahadin, Etches Jacob, Smith Peter
Institute for Work & Health, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Institute for Work & Health, Toronto, Ontario, Canada.
Occup Environ Med. 2015 Apr;72(4):252-7. doi: 10.1136/oemed-2014-102442. Epub 2014 Oct 13.
Work-related musculoskeletal disorders (MSDs) are the leading cause of work disability in the developed economies. The objective of this study was to describe trends in the incidence of MSDs attributed to work exposures in Ontario over the period 2004-2011.
An observational study of work-related morbidity obtained from three independent sources for a complete population of approximately six million occupationally active adults aged 15-64 in the largest Canadian province. We implemented a conceptually concordant case definition for work-related non-traumatic MSDs in three population-based data sources: emergency department encounter records, lost-time workers' compensation claims and representative samples of Ontario workers participating in consecutive waves of a national health interview survey.
Over the 8-year observation period, the annual per cent change (APC) in the incidence of work-related MSDs was -3.4% (95% CI -4.9% to -1.9%) in emergency departments' administrative records, -7.2% (-8.5% to -5.8%) in lost-time workers' compensation claims and -5.3% (-7.2% to -3.5%) among participants in the national health interview survey. Corresponding APC measures for all other work-related conditions were -5.4% (-6.6% to -4.2%), -6.0% (-6.7% to -5.3%) and -5.3% (-7.8% to -2.8%), respectively. Incidence rate declines were substantial in the economic recession following the 2008 global financial crisis.
The three independent population-based data sources used in this study documented an important reduction in the incidence of work-related morbidity attributed to non-traumatic MSDs. The results of this study are consistent with an interpretation that the burden of non-traumatic MSDs arising from work exposures is declining among working-age adults.
在发达经济体中，与工作相关的肌肉骨骼疾病（MSD）是导致工作残疾的主要原因。本研究的目的是描述2004年至2011年期间安大略省因工作暴露导致的MSD发病率趋势。
一项关于与工作相关发病情况的观察性研究，数据来自三个独立来源，针对加拿大最大省份中约600万年龄在15至64岁的职业活跃成年人的全部人口。我们在三个基于人群的数据源中实施了概念上一致的与工作相关的非创伤性MSD病例定义：急诊科就诊记录、误工工人的工伤赔偿申请以及参与全国健康访谈调查连续几轮的安大略省工人代表性样本。
在8年观察期内，急诊科行政记录中与工作相关的MSD发病率的年变化百分比（APC）为-3.4%（95%置信区间-4.9%至-1.9%），误工工人工伤赔偿申请中的为-7.2%（-8.5%至-5.8%），全国健康访谈调查参与者中的为-5.3%（-7.2%至-3.5%）。所有其他与工作相关疾病的相应APC指标分别为-5.4%（-6.6%至-4.2%）、-6.0%（-6.7%至-5.3%）和-5.3%（-7.8%至-2.8%）。2008年全球金融危机后的经济衰退期间，发病率大幅下降。
本研究中使用的三个独立的基于人群的数据源记录了因非创伤性MSD导致的与工作相关发病情况的显著减少。本研究结果与以下解释一致，即在工作年龄成年人中，因工作暴露引起的非创伤性MSD负担正在下降。
