Varadi Imre, Toth Tibor, Fejes Eva, Nemeskeri Zsolt, Kovacs Miklos, Tibold Antal, Nyulas Rita, Feher Gergely
Centre for Occupational Medicine, Medical School, University of Pécs, Pecs, 7624, Hungary.
Margit Slachta National Social Policy Institute, Budapest, 1142, Hungary.
Arch Public Health. 2025 Jul 9;83(1):180. doi: 10.1186/s13690-025-01674-5.
Low back pain (LBP) is a leading cause of disability worldwide and neuropathic low back pain (NLBP) represents a subset of LBP that involves nerve injury or dysfunction. This condition has been shown to have significant impacts on physical, psychological, and social well-being. The aim of our study was to investigate the association of NLBP on Work Ability Index (WAI) among postal delivery workers taking many covariates into account. Demographic data, risk factors and concomitant diseases were included into our analysis as well as psychometric questionnaires of burnout (Mini Oldenburg Questionnaire-MOLBI), depression (Beck Depression Inventory-BDI) and insomnia (Athens Insomnia Scale-AIS). Low back pain categories (nociceptive, mixed or neuropathic) were assessed by the painDETECT questionnaire. Working capacity was measured by the Work Ability Index (WAI). This cross-sectional study was conducted between May 2021 and January 2022 among postal delivery workers in Hungary. Overall 1034 responders took part in our survey, 368 males (35.6%) and 666 females (64.4%). Based on the results of the WAI questionnaire, participants could be divided as having poor (3.8%, 39/1034), moderate (18.5%, 191/1034), good (43.8%, 453/1034) and excellent 33,9%, 351/1034) working ability. Due to the low number of participant in the poor WAI group after the setup of a logistic regression analysis we also employed LASSO (Least Absolute Shrinkage and Selection Operator) regression with tenfold cross-validation as well as we applied Firth's penalized likelihood regression, which reduces small-sample bias in logistic regression. In the final analysis poor WAI was associated with depression (aOR = 2.31, 95% CI: 1.89-2.82, p = 0.008), sleep disturbance (aOR = 1.85, 95% CI: 1.42-2.41, p = 0.012) and NLBP (aOR = 3.10, 95% CI: 2.95-3.98, p = 0.002). Targeted interventions addressing depression and sleep disturbance in individuals with NLBP may help preserve or improve work ability and overall functioning.
腰痛（LBP）是全球残疾的主要原因，而神经性腰痛（NLBP）是LBP的一个子集，涉及神经损伤或功能障碍。已证明这种情况对身体、心理和社会福祉有重大影响。我们研究的目的是在考虑多个协变量的情况下，调查邮政投递工人中NLBP与工作能力指数（WAI）之间的关联。人口统计学数据、风险因素和伴随疾病以及倦怠（Mini Oldenburg问卷 - MOLBI）、抑郁（贝克抑郁量表 - BDI）和失眠（雅典失眠量表 - AIS）的心理测量问卷都纳入了我们的分析。通过painDETECT问卷评估腰痛类别（伤害性、混合型或神经性）。工作能力通过工作能力指数（WAI）来衡量。这项横断面研究于2021年5月至2022年1月在匈牙利的邮政投递工人中进行。共有1034名应答者参与了我们的调查，其中男性368名（35.6%），女性666名（64.4%）。根据WAI问卷结果，参与者可分为工作能力差（3.8%，39/1034）、中等（18.5%，191/1034）、良好（43.8%，453/1034）和优秀（33.9%，351/1034）。由于在进行逻辑回归分析后，工作能力差的WAI组参与者数量较少，我们还采用了带有十折交叉验证的LASSO（最小绝对收缩和选择算子）回归，以及应用了Firth惩罚似然回归，该回归减少了逻辑回归中的小样本偏差。在最终分析中，工作能力差与抑郁（调整后比值比[aOR]= 2.31，95%置信区间[CI]：1.89 - 2.82，p = 0.008）、睡眠障碍（aOR = 1.85，95% CI：1.42 - 2.41，p = 0.012）和NLBP（aOR = 3.10，95% CI：2.95 - 3.98，p = 0.002）相关。针对NLBP个体的抑郁和睡眠障碍进行有针对性的干预可能有助于保持或提高工作能力和整体功能。
