Macfarlane G J, Thomas E, Papageorgiou A C, Croft P R, Jayson M I, Silman A J
Arthritis and Rheumatism Council Epidemiology Research Unit, School of Epidemiology and Health Sciences, University of Manchester, England.
Spine (Phila Pa 1976). 1997 May 15;22(10):1143-9. doi: 10.1097/00007632-199705150-00015.
A population-based longitudinal study conducted in northwest England for a 12-month period involving adults aged 18-75 years.
To determine physical factors related to employment that predict a new episode of low back pain.
Most epidemiologic studies that have examined the relation between occupation and back pain have been cross-sectional or retrospective in design. Because workers who have experienced low back pain may have changed jobs or work activities, it is important to use longitudinal studies that define "exposures" before the onset of symptoms.
From adults registered with two general practices in northwest England, 1412 people who were currently in employment and free of low back pain were identified. A lifetime occupational history was recorded for all participants, with details of activities performed in each occupation. Data on consultations for low back pain during the follow-up year were collected through computerized medical records, whereas those who had not consulted with low back pain were sent another questionnaire at the end of the 1-year follow-up.
An increased risk of a new episode of low back pain was found in those whose jobs involved lifting/pulling/pushing objects of at least 25 lbs, or whose jobs involved prolonged periods of standing or walking. Risks were, in general, greater in women, for a first ever episode of back pain and for back pain that led to a general practice consultation. No clear relation between years of exposure to such factors and magnitude of risk was evident.
Occupational activities, particularly in women, such as working with heavy weights or lengthy periods of standing or walking, were associated with the occurrence of low back pain. Short-term influences may be more important in the occurrence of new episodes rather than cumulative lifetime exposure, and emphasize that such morbidity may be avoidable.
在英格兰西北部进行的一项为期12个月的基于人群的纵向研究，涉及18至75岁的成年人。
确定与就业相关的身体因素，这些因素可预测新发下背痛。
大多数研究职业与背痛之间关系的流行病学研究在设计上都是横断面研究或回顾性研究。由于经历过下背痛的工人可能已经更换了工作或工作活动，因此使用在症状出现前定义“暴露因素”的纵向研究很重要。
从英格兰西北部两家全科诊所登记的成年人中，确定了1412名目前在职且无下背痛的人。记录了所有参与者的终生职业史，以及每个职业中所从事活动的详细信息。通过计算机化医疗记录收集随访年度中下背痛咨询的数据，而那些没有咨询过下背痛的人在1年随访结束时又收到了一份问卷。
发现从事搬运/拉动/推至少25磅重物工作的人，或工作中需要长时间站立或行走的人，新发下背痛的风险增加。一般来说，女性首次出现背痛以及导致全科诊所咨询的背痛风险更高。暴露于这些因素的年限与风险程度之间没有明显关系。
职业活动，尤其是女性的职业活动，如搬运重物或长时间站立或行走，与下背痛的发生有关。短期影响在新发下背痛中可能比终生累积暴露更重要，并强调这种发病率可能是可以避免的。
