Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, Aarhus N, Denmark.
Scand J Work Environ Health. 2024 Jul 1;50(5):329-340. doi: 10.5271/sjweh.4165. Epub 2024 May 13.
This study aimed to explore the association between occupational psychosocial exposures and chronic low-back pain (LBP) by conducting a systematic review and meta-analysis.
The research protocol was registered in PROSPERO. A systematic literature search was performed in six databases, identifying articles complying with predefined inclusion criteria. In our PECOS, we defined outcome as chronic LBP ≥3 months, exposures as occupational psychosocial exposures, and restricted study design to case-control and cohort studies. Two authors independently excluded articles, extracted data, assessed risk of bias, and graded evidence levels. Meta-analyses were performed using random-effects models.
The 20 included articles encompassed six different occupational psychosocial exposures (job control, demand, strain, support, stress, and satisfaction), only 1 had low risk of bias. For all occupational psychosocial exposures, odds ratios ranged from 0.8 to 1.1. Sensitivity analyses based on risk of bias was conducted for two outcomes ie, job control and job demand, finding no differences between high and low-to-moderate risk of bias studies. Using GRADE, we found a very low level of evidence of the association for all occupational psychosocial exposures.
In this study, we found no association between occupational psychosocial exposures and chronic LBP. However, it is important to underline that the level of evidence was very low. High quality studies are highly warranted.
本研究旨在通过系统评价和荟萃分析探讨职业心理社会因素与慢性下背痛（LBP）之间的关联。
研究方案已在 PROSPERO 中注册。我们在六个数据库中进行了系统文献检索，确定了符合预定义纳入标准的文章。在我们的 PECOS 中，我们将结局定义为慢性 LBP≥3 个月，暴露定义为职业心理社会因素，并将研究设计限于病例对照和队列研究。两名作者独立排除文章、提取数据、评估偏倚风险和分级证据水平。使用随机效应模型进行荟萃分析。
20 篇纳入的文章涵盖了六种不同的职业心理社会因素（工作控制、需求、紧张、支持、压力和满意度），只有 1 篇的偏倚风险较低。对于所有职业心理社会因素，比值比范围在 0.8 到 1.1 之间。我们对两个结局（工作控制和工作需求）进行了基于偏倚风险的敏感性分析，发现高风险和低-中度风险研究之间没有差异。使用 GRADE，我们发现所有职业心理社会因素与慢性 LBP 之间的关联证据水平非常低。
在这项研究中，我们没有发现职业心理社会因素与慢性 LBP 之间存在关联。然而，需要强调的是，证据水平非常低。高质量的研究是非常需要的。
