Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81, Lund, Sweden.
BMC Musculoskelet Disord. 2019 Apr 1;20(1):139. doi: 10.1186/s12891-019-2491-6.
We have previously reported quantitative exposure-response relationships between physical exposures recorded by technical methods, and complaints and diagnoses in the neck/shoulders, and the elbows/hands, based on group data. In the present study the number of workers was doubled, and information on individual factors, and psychosocial working conditions was used. Relationships between various kinds of exposure and response have been analysed in this larger and more detailed sample.
The prevalence of complaints (Nordic Questionnaire) and diagnoses (clinical examination) were recorded in a number of occupational groups within which the participants had similar work tasks, 34 groups of female employees (N = 4733 women) and 17 groups of male employees (N = 1107 men). Age and other individual characteristics were recorded, as well as psychosocial work environment factors (job-content questionnaire) for most participants. Postures and velocities (inclinometry) of the head (N = 505) and right upper arm (N = 510), right wrist postures and velocities (electrogoniometry; N = 685), and muscular activity (electromyography; EMG) in the right trapezius muscle (N = 647) and forearm extensors (N = 396) were recorded in representative sub-groups. Exposure-response relationships between physical exposure and musculoskeletal disorders, adjusted for individual factors with Poisson regression were then calculated. The effect of introducing psychosocial conditions into the models was also assessed.
Associations were found between head velocity, trapezius activity, upper arm velocity, forearm extensor activity and wrist posture and velocity, and most neck/shoulder and elbow/hand complaints and diagnoses. Adjustment for age, other individual characteristics and psychosocial work conditions had only a limited effect on these associations. For example, the attributable fraction for tension neck syndrome among female workers with the highest quintile of trapezius activity was 58%, for carpal tunnel syndrome versus wrist velocity it was 92% in men in the highest exposure quintile.
Based on the findings, we propose threshold limit values for upper arm and wrist velocity.
我们之前曾根据群体数据报告过，通过技术方法记录的身体暴露与颈部/肩部和肘部/手部的投诉和诊断之间存在定量的暴露-反应关系。在本研究中，工人人数增加了一倍，并使用了个人因素和心理社会工作条件的信息。在这个更大和更详细的样本中，分析了各种暴露与反应之间的关系。
在具有相似工作任务的一些职业群体中记录了投诉（北欧问卷）和诊断（临床检查）的患病率，包括 34 组女性员工（N=4733 名女性）和 17 组男性员工（N=1107 名男性）。记录了年龄和其他个人特征，以及大多数参与者的心理社会工作环境因素（工作内容问卷）。在代表性子组中记录了头部（N=505）和右上臂（N=510）的姿势和速度（倾斜计）、右手腕姿势和速度（测角计；N=685）以及右斜方肌（N=647）和前臂伸肌（N=396）的肌肉活动（肌电图）。然后，使用泊松回归计算了物理暴露与肌肉骨骼疾病之间的暴露-反应关系，并调整了个体因素。还评估了将心理社会条件引入模型的效果。
发现头部速度、斜方肌活动、上臂速度、前臂伸肌活动和手腕姿势与速度与大多数颈部/肩部和肘部/手部投诉和诊断之间存在关联。对年龄、其他个体特征和心理社会工作条件的调整对这些关联的影响有限。例如，女性工人中最高五分位组斜方肌活动与紧张性头痛综合征之间的归因分数为 58%，而男性工人中最高五分位组腕速与腕管综合征之间的归因分数为 92%。
基于这些发现，我们建议为上臂和手腕速度制定阈值限值。
