Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Int Arch Occup Environ Health. 2022 Jul;95(5):939-952. doi: 10.1007/s00420-021-01816-6. Epub 2021 Nov 26.
We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA).
This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: "moderate", "rather poor" and "very poor" indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27.
MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00-8.15, women: AOR: 3.25 95% CI 1.81-5.83). The SI was non-significant for both sexes.
Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces.
我们研究了肌肉骨骼疼痛（MSP）和高强度工作（重体力工作负荷（PWL）/低决策权限）对较差的身体工作能力（WA）的单独和联合影响。
本研究使用了 2010 年斯德哥尔摩公共卫生问卷（SPHQ）的基线数据，包括 9419 名身体 WA 良好的工人。使用性别特异性工作暴露矩阵来估计 PWL 和决策权限的暴露情况，并与职业相关联。暴露（高/低）与 MSP 的存在相结合。身体 WA 的随访数据来自 2014 年的 SPHQ，并分为（“中等”、“相当差”和“非常差”表示 WA 较差）。使用逻辑回归模型调整年龄、教育、健康和生活方式因素，计算性别特异性优势比。使用协同指数（SI）检查 MSP 和高强度工作之间的相互作用。使用 SPSS.27 进行分析。
MSP、重体力 PWL 和低决策权限分别与较差的 WA 相关。对于女性，MSP 与较差 WA 的关联高于高强度工作，而对于男性则相反。MSP 和高强度工作的组合通常会导致较差 WA 的风险高于添加单一暴露的影响（例如，MSP 和重体力 PWL 男性：OR 4.04 95%CI 2.00-8.15，女性：OR：3.25 95%CI 1.81-5.83）。对于男女两性，SI 均无统计学意义。
患有 MSP 和高强度工作的工人往往比预期的添加单一暴露的影响更容易出现较差的 WA。为了降低该人群的较差 WA，应降低高强度工作，并在工作场所解决 MSP 问题。
