Population and Work Ability Program, Finnish Institute of Occupational Health, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
Occup Environ Med. 2018 Nov;75(11):786-791. doi: 10.1136/oemed-2018-105202. Epub 2018 Oct 4.
To examine the impact of recurrent, as compared with single, reports of back pain on exit from paid employment over decades of follow-up.
The study sample was from the British Whitehall II Study cohort (n=8665, 69% men, aged 35-55 at baseline), who had provided information about their reports of back pain between 1985 and 1994. Data about exit from paid employment (health-related and non-health related exit, unemployment and other exit) were collected between 1995 and 2013. Repeated measures logistic regression models were fitted to examine the associations, and adjust for covariates.
Recurrent pain was reported by 18% of participants, while 26% reported pain on an occasion and 56% did not report pain. Report of back pain on an occasion was not associated with health-related job exit, whereas recurrent pain was associated with such an exit (OR 1.51; 95% CI 1.15 to 1.99), when compared with those who did not report pain. These associations were somewhat stronger among middle-grade and lower-grade employees, while these associations were not seen among higher-grade employees. Differences in associations by age and psychosocial working conditions were small.
These results highlight the need for early detection of recurrent back pain to prevent exit out of paid employment for health reasons. As the risk varies by occupational grade, this emphasises the importance of identification of high-risk groups and finding ways to address their modifiable risk factors.
考察与单次报告相比，反复发作的背痛报告对随访数十年后退出有酬工作的影响。
研究样本来自英国白厅 II 研究队列（n=8665，69%为男性，基线时年龄为 35-55 岁），他们在 1985 年至 1994 年间提供了背痛报告信息。关于退出有酬工作（与健康相关和非健康相关的退出、失业和其他退出）的数据在 1995 年至 2013 年之间收集。采用重复测量逻辑回归模型来检验关联，并调整协变量。
18%的参与者报告反复发作疼痛，26%报告偶尔疼痛，56%则未报告疼痛。偶尔报告背痛与与健康相关的工作退出无关，而反复发作的疼痛与这种退出相关（OR 1.51；95%CI 1.15-1.99），与未报告疼痛的人相比。这些关联在中低级员工中更为明显，而在高级员工中则没有发现这些关联。年龄和心理社会工作条件对关联的影响差异较小。
这些结果强调了早期发现反复发作的背痛以预防因健康原因退出有酬工作的必要性。由于风险因职业等级而异，这强调了识别高风险群体并寻找方法解决其可改变的风险因素的重要性。
