Division of Occupational and Environmental Medicine, Lund University, SE-223 81, Lund, Sweden.
Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden.
BMC Musculoskelet Disord. 2020 Mar 12;21(1):156. doi: 10.1186/s12891-020-3096-9.
Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/hand pain at follow-up.
A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up.
Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50-2.76], for neck/shoulders and (PR 3.45; CI 2.29-5.22) for elbows/hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05-1.49), a high mechanical exposure index (PR 1.66; CI 1.09-2.52), and adverse visual conditions (PR 1.24; CI 1.00-1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01-3.12), and a high mechanical exposure index (PR 2.0; CI 0.98-4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08-2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53-7.31).
Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.
超声医师报告称，他们患有肌肉骨骼疼痛的比例超过 25 年。以前对职业风险因素的评估是基于横断面调查。本纵向研究的目的是确定基线时哪些因素与随访时的颈部/肩部和肘部/手部疼痛相关。
248 名女性超声医师在基线和随访时（原始队列的 85%）回答了一份问卷。208 人纳入分析。在基线时评估了身体、视觉和心理社会工作相关条件。在基线和随访时评估了两个身体区域（颈部/肩部和肘部/手部）的疼痛。
基线时的疼痛与两个身体区域的随访时疼痛（颈部/肩部的患病率比 [PR] 2.04；95%置信区间 [CI] 1.50-2.76）和肘部/手部的疼痛（PR 3.45；CI 2.29-5.22）相关性最强。随访时的颈部/肩部疼痛与超声设备的人体工程学调整能力不足（PR 1.25；CI 1.05-1.49）、高机械暴露指数（PR 1.66；CI 1.09-2.52）和不良视觉条件（PR 1.24；CI 1.00-1.54）相关。此外，在基线时无颈部/肩部疼痛的参与者中，高工作需求（PR 1.78；CI 1.01-3.12）和高机械暴露指数（PR 2.0；CI 0.98-4.14）预测了随访时的疼痛。随访时肘部/手部疼痛与基线时的高感觉需求相关（PR 1.63；CI 1.08-2.45），而在基线时无疼痛的参与者中，高感觉需求预测了随访时肘部/手部疼痛（PR 3.34；CI 1.53-7.31）。
基线时的疼痛是两个身体区域随访时疼痛的最强预测因素。我们还发现基线时的一些职业因素与随访时的疼痛相关：无法调整设备、不良视觉条件、高 MEI、高工作需求和高感觉需求。这些结果表明，通过更好的人体工程学，有可能减轻疼痛。
