Kilbom A
National Institute of Occupational Health, Solna, Sweden.
Scand J Work Environ Health. 1994;20 Spec No:30-45.
Establishing an association between physical work load and work-related musculoskeletal disorders requires a quantitative assessment of exposure to the main risk factors. Commonly used methods are questionnaires, diaries, interviews, systematic observations, and direct measurements. While questionnaires provide subjective information and have low reliability, measurements are technically sophisticated, expensive, and unable to identify some important risk factors. Systematic observations offer a compromise. The observation methods devised during the past 15 years are described, together with their reliability and validity. Most of them use duration or frequency of certain postures or events as the main measure of exposure. Their ability to quantify the main risk factors posture, manual handling, and repetitive work differs. All available methods have drawbacks and have been used to a limited extent in epidemiologic studies. There have been improvements however, and it is concluded that observation methods will have a place in epidemiologic studies on musculoskeletal disorders.
要确定体力工作负荷与工作相关肌肉骨骼疾病之间的关联，需要对主要风险因素的暴露情况进行定量评估。常用的方法有问卷调查、日记记录、访谈、系统观察和直接测量。问卷调查虽然能提供主观信息，但可靠性较低；测量方法技术复杂、成本高昂，且无法识别一些重要的风险因素。系统观察则提供了一种折衷方案。本文描述了过去15年中设计的观察方法及其可靠性和有效性。其中大多数方法将特定姿势或事件的持续时间或频率作为暴露的主要衡量指标。它们在量化主要风险因素（姿势、手工操作和重复性工作）方面的能力各不相同。所有可用方法都有缺点，且在流行病学研究中的应用程度有限。不过，已经有了一些改进，得出的结论是观察方法在肌肉骨骼疾病的流行病学研究中将占有一席之地。
