d'Errico Angelo, Ricceri Fulvio, Descatha Alexis, Leclerc Annette, Roquelaure Yves, Goldberg Marcel
Local Health Unit TO3, Epidemiology Department, Turin, Italy.
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
Front Public Health. 2020 Nov 12;8:412. doi: 10.3389/fpubh.2020.00412. eCollection 2020.
The study aimed to assess the proportion mediated by the duration of exposure to ergonomic factors at work on the relationship between socioeconomic position (SEP) and low walking speed. This cross-sectional study was performed on data collected at baseline on 19,704 men and 20,273 women 45-70 years old, currently or previously employed, enrolled in the Constances cohort. SEP was assigned through current or last occupation, categorized in three classes, based on the European Socioeconomic Classification. Walking speed was assessed through one measurement of normal walking for 3 m and dichotomized at the lowest quintile of the sex- and age- (5-year) specific distribution. Self-reported workplace exposure throughout working life to repetitive work, intense physical work, and lifting/carrying heavy loads was used to assess the duration of exposure to each factor, categorized in four classes. Through Poisson regression models, adjusted for BMI, smoking, alcohol intake, hypertension, physical activity, diabetes, cardiovascular diseases, and a cognitive score, the attenuation in the prevalence ratio (PR) of low walking speed by SEP produced by the inclusion of duration of exposure to each factor was evaluated. The mediating effect of work ergonomic exposures on the relationship between SEP and low walking speed was assessed using the weighted method by Vanderweele. In the fully adjusted model without ergonomic exposures, both men and women in the middle and the lowest SEP had a significantly increased risk of low walking speed compared with those in the highest SEP (men: PR = 1.30 and PR = 1.46, respectively; women: PR = 1.24 and PR = 1.45, respectively). The inclusion in separate regression models of exposure duration to repetitive work, intense physical work, and handling of heavy loads produced modest risk attenuations in both men and women, all smaller or around 10%. Mediation analysis revealed in both sexes significant mediation effects for most ergonomic exposures considered, although also with low mediation effects. Significant differences in walking speed by SEP were observed in this large sample, but the proportion of such differences explained by the duration of exposure to ergonomic factors at work was low using either the risk attenuation or the mediation analysis methods.
该研究旨在评估工作中人体工程学因素暴露时长对社会经济地位（SEP）与低步行速度之间关系的中介作用比例。这项横断面研究基于康斯坦茨队列中19704名45至70岁的男性和20273名45至70岁的女性在基线时收集的数据进行，这些人目前或曾经就业。SEP通过当前或最后职业来确定，根据欧洲社会经济分类分为三类。步行速度通过对3米正常步行的一次测量进行评估，并在按性别和年龄（5岁分组）的特定分布的最低五分位数处进行二分法划分。通过自我报告整个工作生涯中在工作场所接触重复性工作、高强度体力工作以及搬运重物的情况来评估每个因素的暴露时长，分为四类。通过泊松回归模型，对体重指数、吸烟、饮酒、高血压、体力活动、糖尿病、心血管疾病和认知得分进行调整后，评估纳入每个因素暴露时长后SEP导致的低步行速度患病率比值（PR）的衰减情况。使用范德维尔的加权方法评估工作人体工程学暴露对SEP与低步行速度之间关系的中介作用。在未考虑人体工程学暴露的完全调整模型中，与最高SEP组相比，处于中等和最低SEP组的男性和女性低步行速度风险均显著增加（男性：PR分别为1.30和1.46；女性：PR分别为1.24和1.45）。在单独的回归模型中纳入重复性工作、高强度体力工作和重物搬运的暴露时长后，男性和女性的风险均有适度降低，降幅均较小或约为10%。中介分析显示，在考虑的大多数人体工程学暴露方面，男女均存在显著的中介作用，尽管中介作用也较低。在这个大样本中观察到SEP与步行速度存在显著差异，但使用风险衰减或中介分析方法时，工作中人体工程学因素暴露时长对这种差异的解释比例较低。
