Pope D P, Croft P R, Pritchard C M, Silman A J, Macfarlane G J
Arthritis and Rheumatism Council Epidemiology Research Unit, School of Epidemiology and Health Sciences, University of Manchester.
Occup Environ Med. 1997 May;54(5):316-21. doi: 10.1136/oem.54.5.316.
To determine, in a population based study, the influence of occupational factors on the occurrence of shoulder pain and disability.
A random sample of patients was selected from the register of a general practice in the Greater Manchester area of the United Kingdom. Information was collected by a posted questionnaire with specific enquiries about symptoms in the shoulder region and related disability. A lifetime occupational history was obtained including physical exposures, working conditions, and psychosocial aspects of each workplace. Analysis has been conducted as a case-control study, comparing occupational exposures at the time of onset of symptoms in those with shoulder pain and disability with corresponding occupational exposures in those without shoulder pain and disability.
An increased risk of shoulder pain and disability in men was associated with carrying weights on one shoulder (relative risk (RR) 5.5, 95% confidence interval (95% CI) 1.8 to 17), whereas those who reported working with hands above shoulder level, using wrists or arms in a repetitive way, or stretching down to reach below knee level had about twice the risk of shoulder pain and disability. Men working frequently in very cold or damp conditions had a fourfold and sixfold risk respectively of shoulder pain and disability. Reporting of shoulder pain and disability was also more common among men and women who reported that their work caused a lot of stress (RR 1.9, 95% CI 0.9 to 4.1) or was very monotonous (RR 2.7, 95% CI 1.3 to 5.4). The relations between physical exposures, working conditions, and psychosocial factors were independent.
This population based study has shown that physical activities carried out at work, the physical conditions under which the work is conducted, psychosocial aspects of work, or the working environment are all independently related to the occurrence of shoulder symptoms and disability, emphasising the multifactorial nature of this condition.
在一项基于人群的研究中，确定职业因素对肩痛和残疾发生情况的影响。
从英国大曼彻斯特地区一家普通诊所的登记册中随机抽取患者样本。通过邮寄问卷收集信息，其中特别询问了肩部区域的症状及相关残疾情况。获取了终生职业史，包括每个工作场所的身体暴露、工作条件和社会心理方面。作为病例对照研究进行分析，比较肩痛和残疾患者症状发作时的职业暴露与无肩痛和残疾者相应的职业暴露。
男性肩痛和残疾风险增加与单肩负重有关（相对风险（RR）5.5，95%置信区间（95%CI）1.8至17），而报告在肩部以上高度用手工作、重复性使用手腕或手臂或向下伸展至膝盖以下高度的人，肩痛和残疾风险约为两倍。经常在非常寒冷或潮湿环境中工作的男性，肩痛和残疾风险分别为四倍和六倍。报告称工作造成很大压力（RR 1.9，95%CI 0.9至4.1）或非常单调（RR 2.7，95%CI 1.3至5.4）的男性和女性中，肩痛和残疾的报告也更常见。身体暴露、工作条件和社会心理因素之间存在独立关系。
这项基于人群的研究表明，工作中的体力活动、工作时的身体条件、工作的社会心理方面或工作环境均与肩部症状和残疾的发生独立相关，强调了这种情况的多因素性质。
