Fanavoll Rannveig, Nilsen Tom Ivar Lund, Holtermann Andreas, Mork Paul Jarle
Norwegian University of Science and Technology, Trondheim, Norway (Department of Public Health and General Practice).
National Research Centre for the Working Environment, Copenhagen, Denmark.
Int J Occup Med Environ Health. 2016;29(4):585-95. doi: 10.13075/ijomeh.1896.00606.
To prospectively investigate if the risk of chronic neck/shoulder pain is associated with work stress and job control, and to assess if physical exercise modifies these associations.
The study population comprised 29 496 vocationally active women and men in the Norwegian Nord-Trøndelag Health Study (HUNT Study) without chronic pain at baseline in 1984-1986. Chronic neck/shoulder pain was assessed during a follow-up in 1995-1997. A generalized linear model (Poisson regression) was used to calculate adjusted relative risks (RRs).
Work stress was dosedependently associated with the risk of neck/shoulder pain (ptrend < 0.001 in both sexes). The women and men who perceived their work as stressful "almost all the time" had multi-adjusted RRs = 1.27 (95% confidence interval (CI): 1.1-1.47) and 1.71 (95% CI: 1.46-2), respectively, referencing those with no stressful work. Work stress interacted with sex (p < 0.001). Poor job control was not associated with the risk of neck/shoulder pain among the women (RR = 1.04, 95% CI: 0.92-1.19) nor the men (RR = 1.09, 95% CI: 0.95-1.26). Combined analyses showed an inverse dose-dependent association between hours of physical exercise/week and the risk of neck/shoulder pain in the men with no stressful work (ptrend = 0.05) and among the men who perceived their work as "rarely stressful" (ptrend < 0.02). This effect was not statistically significant among the women or among men with more frequent exposure to work stress.
Work stress is an independent predictor of chronic neck/shoulder pain and the effect is stronger in men than in women. Physical exercise does not substantially reduce the risk among the persons with frequent exposure to work stress.
前瞻性调查慢性颈/肩痛风险是否与工作压力和工作控制相关，并评估体育锻炼是否会改变这些关联。
研究人群包括挪威北特伦德拉格健康研究（HUNT研究）中29496名在1984 - 1986年基线时无慢性疼痛的职业活跃男女。1995 - 1997年随访期间评估慢性颈/肩痛。使用广义线性模型（泊松回归）计算调整后的相对风险（RRs）。
工作压力与颈/肩痛风险呈剂量依赖性相关（男女p趋势均<0.001）。认为工作“几乎一直”有压力的女性和男性，多因素调整后的RRs分别为1.27（95%置信区间（CI）：1.1 - 1.47）和1.71（95%CI：1.46 - 2），以无压力工作者为参照。工作压力与性别存在交互作用（p < 0.001）。工作控制不佳与女性（RR = 1.04，95%CI：0.92 - 1.19）和男性（RR = 1.09，95%CI：0.95 - 1.26）的颈/肩痛风险均无关。综合分析显示，每周体育锻炼时长与无压力工作男性（p趋势 = 0.05）以及认为工作“很少有压力”的男性（p趋势<0.02）的颈/肩痛风险呈反向剂量依赖性关联。在女性或工作压力暴露更频繁的男性中，这种效应无统计学意义。
工作压力是慢性颈/肩痛的独立预测因素，且男性的影响强于女性。体育锻炼并不能显著降低工作压力频繁暴露人群的风险。
