Cantley Linda F, Tessier-Sherman Baylah, Slade Martin D, Galusha Deron, Cullen Mark R
Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut, USA.
Stanford Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, USA.
Occup Environ Med. 2016 Apr;73(4):229-36. doi: 10.1136/oemed-2015-102831. Epub 2015 Jul 10.
To examine associations between workplace injury and musculoskeletal disorder (MSD) risk and expert ratings of job-level psychosocial demand and job control, adjusting for job-level physical demand.
Among a cohort of 9260 aluminium manufacturing workers in jobs for which expert ratings of job-level physical and psychological demand and control were obtained during the 2 years following rating obtainment, multivariate mixed effects models were used to estimate relative risk (RR) of minor injury and minor MSD, serious injury and MSD, minor MSD only and serious MSD only by tertile of demand and control, adjusting for physical demand as well as other recognised risk factors.
Compared with workers in jobs rated as having low psychological demand, workers in jobs with high psychological demand had 49% greater risk of serious injury and serious MSD requiring medical treatment, work restrictions or lost work time (RR=1.49; 95% CI 1.10 to 2.01). Workers in jobs rated as having low control displayed increased risk for minor injury and minor MSD (RR=1.45; 95% CI 1.12 to 1.87) compared with those in jobs rated as having high control.
Using expert ratings of job-level exposures, this study provides evidence that psychological job demand and job control contribute independently to injury and MSD risk in a blue-collar manufacturing cohort, and emphasises the importance of monitoring psychosocial workplace exposures in addition to physical workplace exposures to promote worker health and safety.
研究工作场所受伤与肌肉骨骼疾病(MSD)风险之间的关联,以及工作层面心理社会需求和工作控制的专家评级情况,并对工作层面的身体需求进行调整。
在一组9260名铝制造业工人中,这些工人的工作在评级获得后的2年内获取了工作层面身体和心理需求及控制的专家评级,使用多变量混合效应模型来估计轻伤和轻度MSD、重伤和MSD、仅轻度MSD以及仅重度MSD的相对风险(RR),按需求和控制的三分位数进行划分,并对身体需求以及其他公认的风险因素进行调整。
与被评为心理需求低的工作岗位的工人相比,心理需求高的工作岗位的工人遭受需要医疗治疗、工作限制或误工时间的重伤和重度MSD的风险高49%(RR = 1.49;95% CI 1.10至2.01)。与被评为控制高的工作岗位的工人相比,被评为控制低的工作岗位的工人轻伤和轻度MSD的风险增加(RR = 1.45;95% CI 1.12至1.87)。
本研究利用工作层面暴露的专家评级,提供了证据表明心理工作需求和工作控制在蓝领制造业队列中对受伤和MSD风险有独立影响,并强调了除了监测工作场所的身体暴露外,监测工作场所的心理社会暴露对促进工人健康和安全的重要性。