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骨质疏松症在医护人员队列中的早期检测:是否有筛查计划的空间?

The Early Detection of Osteoporosis in a Cohort of Healthcare Workers: Is There Room for a Screening Program?

机构信息

Department of Translational Medicine, University of Eastern Piedmont (UPO), 28100 Novara, Italy.

University Hospital "Maggiore della Carità", 28100 Novara, Italy.

出版信息

Int J Environ Res Public Health. 2021 Feb 2;18(3):1368. doi: 10.3390/ijerph18031368.

Abstract

Workforce aging is becoming a significant public health problem due to the resulting emergence of age-related diseases, such as osteoporosis. The prevention and early detection of osteoporosis is important to avoid bone fractures and their socio-economic burden. The aim of this study is to evaluate the sustainability of a screening workplace program able to detect workers with osteoporosis. The screening process included a questionnaire-based risk assessment of 1050 healthcare workers followed by measurement of the bone mass density (BMD) with a pulse-echo ultrasound (PEUS) at the proximal tibia in the at-risk subjects. Workers with a BMD value ≤ 0.783 g/cm² were referred to a specialist visit ensuring a diagnosis and the consequent prescriptions. Any possible association between the outcome variable BMD ≤ 0.783 g/cm² and the risk factors was evaluated. The costs were calculated with a full costing method. We identified 60 pathological subjects. We observed increased risks for women, older ages, and menopause ( < 0.01). The yearly cost of our screening program estimated for this study was 8242 euros, and, considering the fragility bone fracture costs, we hypothesize a considerable economic savings, with a possible positive benefits/cost ratio of 2.07. We can say that the margin between the investment and results leads to a preference for this type of screening program. Osteoporosis is an occupational health problem, and a workplace screening program could be a cost-effective intervention.

摘要

劳动力老龄化正成为一个重大的公共卫生问题,因为随之而来的与年龄相关的疾病,如骨质疏松症。预防和早期发现骨质疏松症对于避免骨折及其带来的社会经济负担非常重要。本研究旨在评估一种能够发现骨质疏松症患者的筛查工作场所计划的可持续性。筛查过程包括对 1050 名医护人员进行基于问卷的风险评估,然后对有风险的受试者进行脉冲回波超声(PEUS)测量胫骨近端的骨密度(BMD)。BMD 值≤0.783g/cm²的工人被转介到专家处就诊,以确保诊断和随后的处方。评估了 BMD≤0.783g/cm²这一结果变量与风险因素之间的任何可能关联。使用完全成本法计算了成本。我们确定了 60 名病理患者。我们观察到女性、年龄较大和绝经(<0.01)的风险增加。我们的筛查计划每年的成本估计为 8242 欧元,并且,考虑到脆性骨折的成本,我们假设会有相当大的经济节省,可能会有 2.07 的正收益/成本比。我们可以说,投资和结果之间的差距导致人们更倾向于这种筛查计划。骨质疏松症是一种职业健康问题,工作场所筛查计划可能是一种具有成本效益的干预措施。

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