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家庭医护人员的背部和颈部疼痛残疾及上肢症状:来自意大利北部的一项病例对照研究。

Back and neck pain disability and upper limb symptoms of home healthcare workers: A case-control study from Northern Italy.

作者信息

Riccò Matteo, Pezzetti Federica, Signorelli Carlo

机构信息

Provincial Agency for Health Services of the Autonomous Province of Trento, Trento, Italy (Department of Prevention, Occupational Health and Safety Unit).

University of Parma, Parma, Italy (Specialization School in Hygiene and Public Health, Department of Biomedical, Biotechnological and Translational Sciences).

出版信息

Int J Occup Med Environ Health. 2017 Mar 30;30(2):291-304. doi: 10.13075/ijomeh.1896.00629. Epub 2017 Mar 14.

Abstract

OBJECTIVES

Work-related musculoskeletal disorders (MSD) are quite frequent in healthcare workers (HCWs), but data about MSD in home-based healthcare workers (HHWs) are lacking. In this study we describe the prevalence of MSD among Italian HHWs.

MATERIAL AND METHODS

A case-control study was carried out among 300 random-selected female HCWs, the sample comprising 100 HHWs, 100 HCWs with a low exposure to patient handling (MAPO - Movimentazione e Assistenza Pazienti Ospedalizzati - Movement and Assistance of Hospital Patients index 0-5) and 100 HCWs with high exposure to patient handling (MAPO index ≥ 5.01). As a negative control group, 200 visual display unit workers were also randomly selected. Musculoskeletal disorder cases were collected using a standardized case definition. A multivariate logistic regression analysis was performed comparing the MSD prevalence in the 4 groups.

RESULTS

The overall prevalence of MSD was 17% in the reference group and 28.3% for HCWs. HHWs and HCWs with MAPO index ≥ 5.01 had similar prevalence of neck pain (9% and 11%, respectively), whereas lumbosacral pain prevalence was higher in the HHWs group (31%), with similar results in residential HCWs groups (21% in MAPO index 0-5 group and 25% in MAPO index ≥ 5.01 group). HCWs of group MAPO index ≥ 5.01 and HHWs showed the higher prevalence of upper limb complaints, with a prevalence of 20% and 10%, respectively. In multivariate regression analysis, prevalence of MSD complaints was quite similar in HHWs (adjusted odds ratio (OR) = 2.335, 95% confidence interval (CI): 1.318-4.138) and in HCWs of the group MAPO ≥ 5.01 (OR = 2.729, 95% CI: 1.552-4.797).

CONCLUSIONS

The prevalence of MSD in the examined HCWs was relatively high, with HHWs appearing as a particularly high-risk group for lumbosacral back pain. In higher exposed HCWs, upper-limb symptoms were particularly frequent, probably reflecting the different tasks required to manage residential and homebased patients. In conclusion, this study reaffirms the high prevalence of MSD in HHWs, seemly similar to high-risk residential groups. Int J Occup Med Environ Health 2017;30(2):291-304.

摘要

目的

工作相关肌肉骨骼疾病(MSD)在医护人员(HCW)中相当常见,但缺乏关于居家医护人员(HHW)中MSD的数据。在本研究中,我们描述了意大利HHW中MSD的患病率。

材料与方法

对300名随机选择的女性HCW进行了病例对照研究,样本包括100名HHW、100名患者搬运暴露程度低的HCW(MAPO - 医院患者移动与协助指数0 - 5)和100名患者搬运暴露程度高的HCW(MAPO指数≥5.01)。作为阴性对照组,还随机选择了200名视屏显示终端工作者。使用标准化病例定义收集肌肉骨骼疾病病例。进行多因素逻辑回归分析,比较4组中MSD的患病率。

结果

参照组中MSD的总体患病率为17%,HCW中为28.3%。MAPO指数≥5.01的HHW和HCW颈部疼痛患病率相似(分别为9%和11%),而HHW组腰骶部疼痛患病率更高(31%),住院HCW组结果相似(MAPO指数0 - 5组为21%,MAPO指数≥5.01组为25%)。MAPO指数≥5.01组的HCW和HHW上肢不适患病率较高,分别为20%和10%。在多因素回归分析中,HHW中MSD不适的患病率(调整优势比(OR) = 2.335,95%置信区间(CI):1.318 - 4.138)与MAPO≥5.01组的HCW相似(OR = 2.729,95% CI:1.552 - 4.797)。

结论

在所检查的HCW中,MSD的患病率相对较高,HHW似乎是腰骶部疼痛的特别高危人群。在暴露程度较高的HCW中,上肢症状尤为常见,这可能反映了管理住院患者和居家患者所需的不同任务。总之,本研究再次证实HHW中MSD的患病率较高,似乎与高危住院人群相似。《国际职业医学与环境卫生杂志》2017年;30(2):291 - 304。

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