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韩国消防员的腰椎间盘退变及相关因素。

Lumbar intervertebral disc degeneration and related factors in Korean firefighters.

机构信息

Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Korea.

Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.

出版信息

BMJ Open. 2016 Jun 28;6(6):e011587. doi: 10.1136/bmjopen-2016-011587.

Abstract

OBJECTIVES

The job of firefighting can cause lumbar burden and low back pain. This study aimed to identify the association between age and lumbar intervertebral disc degeneration and whether the association differs between field and administrative (non-field) firefighters.

METHODS

Subjects were selected using a stratified random sampling method. Firefighters were stratified by geographic area, gender, age and type of job. First, 25 fire stations were randomly sampled considering regional distribution. Then firefighters were stratified by gender, age and their job and randomly selected among the strata. A questionnaire survey and MRI scans were performed, and then four radiologists used Pfirrmann classification methods to determine the grade of lumbar intervertebral disc degeneration.

RESULTS

Pfirrmann grade increased with lumbar intervertebral disc level. Analysis of covariance showed that age was significantly associated with lumbar intervertebral disc degeneration (p<0.05). The value of β (parameter estimate) was positive at all lumbar intervertebral disc levels and was higher in the field group than in the administrative group at each level. In logistic regression analysis, type of job was statistically significant only with regard to the L4-5 intervertebral disc (OR 3.498, 95% CI 1.241 to 9.860).

CONCLUSIONS

Lumbar intervertebral disc degeneration is associated with age, and field work such as firefighting, emergency and rescue may accelerate degeneration in the L4-5 intervertebral disc. The effects of field work on lumbar intervertebral disc degeneration were not clear in discs other than at the level L4-5.

摘要

目的

消防工作会导致腰椎负担过重和下背痛。本研究旨在确定年龄与腰椎间盘退变之间的关系,以及这种关系在现场和行政(非现场)消防员之间是否存在差异。

方法

采用分层随机抽样法选取研究对象。消防员按地理区域、性别、年龄和工作类型分层。首先,考虑区域分布随机抽取 25 个消防站。然后根据性别、年龄和工作对消防员进行分层,并在各层中随机选择。进行问卷调查和 MRI 扫描,然后由 4 名放射科医生使用 Pfirrmann 分级方法确定腰椎间盘退变程度。

结果

Pfirrmann 分级随腰椎间盘水平的升高而增加。协方差分析表明,年龄与腰椎间盘退变显著相关(p<0.05)。在所有腰椎间盘水平上,β(参数估计)的值均为正,且在每个水平上,现场组的值均高于行政组。在逻辑回归分析中,只有工作类型对 L4-5 椎间盘有统计学意义(OR 3.498,95%CI 1.241 至 9.860)。

结论

腰椎间盘退变与年龄有关,而消防、应急和救援等现场工作可能会加速 L4-5 椎间盘的退变。现场工作对 L4-5 椎间盘以外椎间盘的腰椎间盘退变的影响尚不清楚。

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