Associated Laboratory for Energy, Transports and Aeronautics, (LAETA/ROA), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Institute of Public Health, University of Porto, 4200-319 Porto, Portugal.
Int J Environ Res Public Health. 2021 Aug 3;18(15):8223. doi: 10.3390/ijerph18158223.
Occupational-specific classifications of musculoskeletal disorders (MSD) are scarce and do not answer specific clinical questions. Thus, a specific classification was developed and proposed, covering criteria applicable to daily clinical activity. It was considered that the disorder development process is the same across all work-related MSDs (WRMSDs). Concepts of clinical pathology were applied to the characteristics of WRMSDs pathophysiology, cellular and tissue alterations. Then, the correlation of the inflammatory mechanisms with the injury onset mode was graded into four levels (MSDs 0-3). Criteria of legal, occupational and internal medicine, semiology, physiology and orthopaedics, image medicine and diagnostics were applied. Next, the classification was analysed by experts, two occupational physicians, two physiatrists and occupational physicians and one orthopaedist. This approach will allow WRMSD prevention and improve therapeutic management, preventing injuries from becoming chronic and facilitating communication between occupational health physicians and the other specialities. The four levels tool relate aetiopathogenic, clinical, occupational and radiological concepts into a single classification. This allows for improving the ability to determine a WRMSD and understanding what preventive and therapeutic measures should be taken, avoiding chronicity. The developed tool is straightforward, easy to understand and suitable for WRMSDs, facilitating communication between occupational physicians and physicians from other specialities.
职业特异性肌肉骨骼疾病（MSD）分类很少，无法回答特定的临床问题。因此，开发并提出了一种特定的分类，涵盖了适用于日常临床活动的标准。人们认为，所有与工作相关的肌肉骨骼疾病（WRMSD）的疾病发展过程是相同的。临床病理学的概念应用于 WRMSD 病理生理学、细胞和组织改变的特征。然后，将炎症机制与损伤起始模式的相关性分为四个等级（MSD0-3）。法律、职业和内科、症状学、生理学和矫形学、影像医学和诊断标准均适用。接下来，由两位职业医生、两位物理治疗师和一位职业医生和一位矫形外科医生对分类进行了分析。这种方法将允许预防 WRMSD 并改善治疗管理，防止损伤变为慢性，并促进职业健康医生和其他专业之间的沟通。四级工具将病因发病学、临床、职业和放射学概念联系到一个单一的分类中。这有助于提高确定 WRMSD 的能力，并了解应采取哪些预防和治疗措施，避免慢性化。开发的工具简单易懂，适用于 WRMSD，促进了职业医生和其他专业医生之间的沟通。
