Sundstrup Emil, Hansen Åse Marie, Mortensen Erik Lykke, Poulsen Otto Melchior, Clausen Thomas, Rugulies Reiner, Møller Anne, Andersen Lars L
National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, -Denmark. E-mail:
Scand J Work Environ Health. 2017 Sep 1;43(5):415-425. doi: 10.5271/sjweh.3663. Epub 2017 Aug 7.
Objectives The aim of this study was to determine the prospective association of cumulative mechanical exposure during working life with health-related labor market outcomes. Methods This prospective cohort study combines data from 5076 older workers (age 49-63 years) from the Copenhagen Aging and Midlife Biobank with a job exposure matrix and a national register containing information on social transfer payment. By coding individual job histories from the Danish version of ISCO-codes (International Standard Classification of Occupations), we calculated cumulative occupational mechanical exposures from a JEM for ton-years (lifting 1000 kg each day in one year), lifting-years (lifting loads weighing ≥20 kg >10 times each day in one year), kneeling-years (kneeling for one hour each day in one year) and vibration-years (whole-body vibration for one hour each day in one year). Cox-regression analyses estimated the relative risk of register-based long-term sickness absence (LTSA) and disability pension with cumulative occupational mechanical exposures throughout working life. Analyses were censored for competing events and adjusted for multiple confounders. Results During the follow-up period, 970 persons (19.3%) had ≥1 episode of LTSA and 85 persons (1.7%) were granted a disability pension. Number of ton-, lifting- and kneeling-years showed an exposure-response association with increased risk of LTSA (P<0.0001). In addition, both long term [≥20 years; hazard ratio (HR) 1.76 95% CI 1.39-2.22] and short term (<10 years; HR 1.20 95% CI 1.02-1.41) exposure to kneeling work increased the risk of LTSA. Lifting-years, but not the other mechanical exposures, were associated with risk of disability pension (HR 1.75 95% CI 1.01-3.04). Conclusions Cumulative occupational mechanical exposures during working life - such as lifting and kneeling work - increased the risk of LTSA. Importantly, being exposed to lifting increased the risk of disability pension.
目的 本研究旨在确定工作生涯中累积机械暴露与健康相关劳动力市场结局之间的前瞻性关联。方法 这项前瞻性队列研究将来自哥本哈根衰老与中年生物银行的5076名老年工人（年龄49 - 63岁）的数据与工作暴露矩阵以及包含社会转移支付信息的国家登记册相结合。通过根据丹麦版国际标准职业分类（ISCO - 代码）对个人工作经历进行编码，我们计算了来自工作暴露矩阵的累积职业机械暴露量，以吨 - 年（一年中每天搬运1000千克）、搬运 - 年（一年中每天搬运重量≥20千克超过10次）、跪姿 - 年（一年中每天跪一小时）和振动 - 年（一年中每天全身振动一小时）为单位。Cox回归分析估计了基于登记册的长期病假（LTSA）和残疾抚恤金与整个工作生涯中累积职业机械暴露的相对风险。分析针对竞争事件进行了删失处理，并对多个混杂因素进行了调整。结果 在随访期间，970人（19.3%）有≥1次长期病假发作，85人（1.7%）获得了残疾抚恤金。吨 - 年、搬运 - 年和跪姿 - 年的数量显示出与长期病假风险增加的暴露 - 反应关联（P < 0.0001）。此外，长期[≥20年；风险比（HR）1.76，95%置信区间1.39 - 2.22]和短期（<10年；HR 1.20，95%置信区间1.02 - 1.41）接触跪姿工作都会增加长期病假的风险。搬运 - 年，但不是其他机械暴露，与残疾抚恤金风险相关（HR 1.75，95%置信区间1.01 - 3.04）。结论 工作生涯中的累积职业机械暴露，如搬运和跪姿工作，会增加长期病假的风险。重要的是，接触搬运工作会增加获得残疾抚恤金的风险。
