Le Aurora B, Shkembi Abas, Scott Earnest G, Garza Elizabeth, Trout Douglas, Choi Sang D
Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA.
Department of Environmental Health Sciences, School of Public Heath, University of Michigan, Ann Arbor, Michigan, USA.
Am J Ind Med. 2025 Mar;68 Suppl 1(Suppl 1):S158-S170. doi: 10.1002/ajim.23630. Epub 2024 Jun 20.
U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.
A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.
Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.
This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.
美国建筑工人受伤率很高，可能导致慢性疼痛。这项试点研究调查了建筑工人使用的非药物（未经医疗保健提供者开处方用药）和药物（如处方阿片类药物）疼痛管理方法。
与美国国家职业安全与健康研究所（NIOSH）建筑部门计划合作，对美国建筑工人进行了便利抽样调查。使用逻辑回归模型评估了不同人口统计学特征在非药物和药物疼痛管理方法的熟悉程度和使用方面的差异。一个增强回归树模型研究了与药物疼痛管理使用相关的最具影响力的因素，并对使用量的潜在减少进行了反事实建模。
在去年报告有疼痛/不适的195名参与者中，有166名（85%），其中72%报告使用了药物疼痛管理方法，包括19%使用阿片类药物。在性别、教育程度、工作经验和职位方面，对非药物方法的熟悉程度存在显著差异。在预测使用药物和非药物疼痛管理方法的37个因素中，关于阿片类药物风险的培训、无薪休假和带薪残疾的工作福利，以及对音乐疗法、冥想或正念呼吸以及身体扫描的熟悉程度是可能减少药物方法使用的最重要预测因素。向工人提供这些非药物方法可能会使药物疼痛管理方法的使用估计减少23%（95%置信区间：16%-30%）。
这项试点研究表明，与培训、工作福利以及工人对非药物疼痛管理方法的熟悉程度相关的特定因素会影响这些方法的使用。
