UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
J Occup Rehabil. 2024 Sep;34(3):594-605. doi: 10.1007/s10926-023-10148-w. Epub 2023 Nov 6.
Musculoskeletal disorders (MSDs) are common worldwide and gender differences exist in terms of prevalence and disability. MSDs are a leading cause of sick leave and physical work exposures. To assess the association between physical exposures assessed by the gender-specific CONSTANCES Job-Exposure Matrix (JEM) and musculoskeletal pain in six areas: neck pain, shoulder pain, elbow/arm pain, hand/wrist pain, low back pain, knee/leg pain; and to compare the results with those obtained using the non-gendered CONSTANCES JEM and with individual self-report exposures.
We included 48,736 male and 63,326 female workers from the CONSTANCES cohort (France). The association between 27 physical exposures and musculoskeletal self-reported pain in six body areas was assessed using logistic regression. We conducted the analysis with three types of exposures: (1) individual self-reported exposures; (2) gender-specific CONSTANCES JEM; (3) non-gendered CONSTANCES JEM, and adjusted for age and Body Mass Index (BMI). Analyses were stratified by gender.
The associations to the gender-specific and non-gendered JEM were similar. The odds ratios using individual self-reported exposures were comparable to the JEM-based associations, with the exceptions of the exposures 'change tasks', 'rest eyes' and 'reach behind'. In some comparisons, there were differences in the direction and/or significance of effects between genders (regardless of whether the JEM used was gender-specific or not).
The gender-specific and non-gendered JEMs gave similar results, hence, developing physical work exposures JEMs that are gender-specific may not be essential. However, when predicting musculoskeletal pain, it seems relevant to stratify the analysis by gender.
肌肉骨骼疾病(MSD)在全球范围内很常见,在患病率和残疾方面存在性别差异。MSD 是病假和身体工作暴露的主要原因。评估性别特异性 CONSTANCES 工作暴露矩阵(JEM)评估的身体暴露与六个部位的肌肉骨骼疼痛之间的关联:颈部疼痛、肩部疼痛、肘部/手臂疼痛、手部/手腕疼痛、下背部疼痛、膝盖/腿部疼痛;并将结果与使用非性别 CONSTANCES JEM 和个体自我报告暴露获得的结果进行比较。
我们纳入了 CONSTANCES 队列(法国)的 48736 名男性和 63326 名女性工人。使用逻辑回归评估 27 种身体暴露与六个身体部位肌肉骨骼自我报告疼痛之间的关联。我们使用三种类型的暴露进行了分析:(1)个体自我报告的暴露;(2)性别特异性 CONSTANCES JEM;(3)非性别 CONSTANCES JEM,并根据年龄和体重指数(BMI)进行了调整。分析按性别分层。
性别特异性和非性别 JEM 的关联相似。使用个体自我报告暴露的比值比与基于 JEM 的关联相当,除了“改变任务”、“休息眼睛”和“伸手到背后”这三种暴露外。在某些比较中,无论使用的 JEM 是否具有性别特异性,性别之间的效应方向和/或显著性都存在差异。
性别特异性和非性别 JEM 得出了相似的结果,因此,开发专门针对性别的物理工作暴露 JEM 可能不是必需的。然而,在预测肌肉骨骼疼痛时,按性别分层分析似乎是相关的。