Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Occup Environ Med. 2020 Jun;77(6):393-401. doi: 10.1136/oemed-2019-106335. Epub 2020 Mar 18.
To determine the associations of lifestyle factors and cumulative physical workload exposures with sickness absence (SA) due to a shoulder lesion and to calculate their population attributable fractions (PAF).
Our nationally representative cohort consisted of 4344 individuals aged 30-62 years who participated in the Finnish Health 2000 Survey. Education, smoking, chronic diseases and work exposures were assessed during interviews and leisure time physical activity with a questionnaire. Weight and height were measured. We followed the individuals for 15 years for the first SA due to a shoulder lesion. We used competing risk regression models. We calculated PAFs to assess the proportion of SA that was attributed to modifiable risk factors.
In the entire study population, risk factors of SA were age, daily smoking, being exposed for more than 10 years to physically heavy work and being exposed for more than 10 years to at least two specific physical workload factors. The overall PAF for the modifiable risk factors was 49%. In men, number of specific cumulative exposures, obesity and daily smoking predicted SA with PAF values of 34%, 30% and 14%, respectively. Among women, being exposed for more than 10 years to physically heavy work, number of specific cumulative exposures and daily smoking accounted for 23%, 22% and 15% of SA, respectively.
Reducing significantly prolonged exposure to physical workload factors, avoiding regular smoking in both genders and obesity in men has a high potential to prevent SA due to a shoulder lesion.
确定生活方式因素和累积体力工作负荷暴露与肩部病变缺勤(SA)的关联,并计算其人群归因分数(PAF)。
我们的全国代表性队列包括 4344 名年龄在 30-62 岁之间的参与者,他们参加了芬兰健康 2000 调查。在访谈和闲暇时间体育活动中通过问卷评估了教育、吸烟、慢性疾病和工作暴露情况。测量了体重和身高。我们对这些个体进行了 15 年的随访,以记录首次因肩部病变导致的 SA。我们使用竞争风险回归模型。我们计算了 PAF 以评估可改变的危险因素导致的 SA 比例。
在整个研究人群中,SA 的危险因素为年龄、每日吸烟、从事体力繁重工作超过 10 年以及从事至少两种特定体力工作负荷因素超过 10 年。可改变危险因素的总体 PAF 为 49%。在男性中,特定累积暴露的数量、肥胖和每日吸烟分别预测 SA,其 PAF 值分别为 34%、30%和 14%。在女性中,从事体力繁重工作超过 10 年、特定累积暴露的数量和每日吸烟分别占 SA 的 23%、22%和 15%。
显著减少对体力工作负荷因素的长期暴露、避免两性中规律吸烟以及男性肥胖,对于预防肩部病变导致的 SA 具有很高的潜力。