INSERM U1085, ESTER team, Faculté de santé - Département Médecine, 28 rue Roger Amsler, CS 74521, 49045 Angers cedex, France.
Scand J Work Environ Health. 2023 Nov 1;49(8):549-557. doi: 10.5271/sjweh.4118. Epub 2023 Sep 5.
This study aimed to construct and evaluate a gender-specific job exposure matrix (JEM) for 27 physical work exposures, based on self-report.
We constructed a JEM using questionnaire data on current physical exposures from 29 381 male and 35 900 female asymptomatic workers aged 18-69 years in the French CONSTANCES cohort study. We excluded workers with musculoskeletal pain to reduce potential reporting bias. We grouped 27 self-reported physical exposures using the French national job codes and stratified by gender. We compared individual and group-based exposures using the performance indicators Cohen's kappa (κ), sensitivity, specificity, and area under the receiver operating curve (AUC).
JEM validation showed fair-to-moderate agreement (κ 0.21-0.60) for most physical exposures for both genders except for 'reach behind' (poor), 'bend neck' (poor), 'finger pinch' (poor), standing' (good), 'use computer screen' (good), and 'use keyboard or scanner' (good). We found the highest AUC for 'standing' (men 0.85/ women 0.87), 'kneel/squat' (men 0.80/women 0.81), 'use computer screen' (men/women 0.81), and 'use keyboard or scanner' (men 0.82/ women 0.84). The AUC was <0.60 for only three exposures: 'bend neck' (men 0.58/women 0.57), 'finger pinch' (men 0.56/ women 0.55), and 'reach behind' (men 0.54/ women 0.51).
The constructed JEM validation measures were comparable for men and women for all exposures. Further research will examine the predictive ability of this gender-specific JEM for musculoskeletal disorders and the relevance of gender-stratification in this process, knowing accuracy of each exposure.
本研究旨在构建并评估一个基于自我报告的针对 27 种物理工作暴露的性别特异性工作暴露矩阵(JEM)。
我们使用法国 CONSTANCES 队列研究中 29381 名男性和 35900 名无症状 18-69 岁工人的当前物理暴露问卷数据构建 JEM。我们排除了有肌肉骨骼疼痛的工人,以减少潜在的报告偏倚。我们根据法国国家工作代码对 27 种自我报告的物理暴露进行分组,并按性别分层。我们使用个体和基于群体的暴露比较指标 Cohen's kappa(κ)、敏感性、特异性和接收者操作特征曲线下面积(AUC)进行比较。
JEM 验证结果显示,除了“伸手够到”(差)、“转头”(差)、“手指捏压”(差)、“站立”(好)、“使用电脑屏幕”(好)和“使用键盘或扫描仪”(好)外,对于大多数物理暴露,男性和女性的 JEM 都显示出了中等至良好的一致性(κ 0.21-0.60)。我们发现“站立”(男性 0.85/女性 0.87)、“蹲下/跪坐”(男性 0.80/女性 0.81)、“使用电脑屏幕”(男性/女性 0.81)和“使用键盘或扫描仪”(男性 0.82/女性 0.84)的 AUC 值最高。仅有三个暴露的 AUC 值<0.60:“转头”(男性 0.58/女性 0.57)、“手指捏压”(男性 0.56/女性 0.55)和“伸手够到”(男性 0.54/女性 0.51)。
对于所有暴露,构建的 JEM 验证指标在男性和女性中均具有可比性。进一步的研究将检验这种性别特异性 JEM 对肌肉骨骼疾病的预测能力,以及在这一过程中性别分层的相关性,同时也会考虑到每种暴露的准确性。