Cohen J E, Goel V, Frank J W, Gibson E S
Ontario Workers' Compensation Institute, Toronto, Ontario, Canada.
J Occup Med. 1994 Oct;36(10):1093-9. doi: 10.1097/00043764-199410000-00011.
Preplacement screening is put forth by some as an effective method for preventing low back disability at the workplace. Although there are still large gaps in knowledge regarding the natural history of and risk factors for back disability, it is clear that the majority of costs are derived from the small proportion of those that will suffer with back symptoms for 6 months or more. Thus, if preplacement screening is to have an impact on health care spending and compensation costs, the screening test will have to be predictive not so much of all back injuries, but rather of work absenteeism and especially chronic disability. This paper presents some criteria for evaluating a screening program and explores the effect of choosing different outcomes for evaluation. The literature on the effectiveness of a number of preplacement screening techniques is examined. Current legislation related to preplacement screening is also described. The natural history, etiologic factors, and prognostic markers for back injuries need to be elucidated further before effective screening strategies can be developed to reduce the incidence of back injuries and back disability in the population.
一些人提出职前筛查是预防工作场所腰痛致残的有效方法。尽管在腰痛致残的自然史和危险因素方面仍存在很大的知识空白，但很明显，大部分成本来自于那些将遭受背部症状6个月或更长时间的小部分人群。因此，如果职前筛查要对医疗保健支出和赔偿成本产生影响，筛查测试必须更多地预测所有背部损伤，而是旷工，尤其是慢性残疾。本文提出了一些评估筛查计划的标准，并探讨了选择不同评估结果的影响。研究了一些职前筛查技术有效性的文献。还描述了与职前筛查相关的现行立法。在制定有效的筛查策略以降低人群中背部损伤和背部残疾的发生率之前，需要进一步阐明背部损伤的自然史、病因因素和预后标志物。
