Burdorf A, Rossignol M, Fathallah F A, Snook S H, Herrick R F
Liberty Mutual Research Center for Safety and Health, Hopkinton, MA, USA.
Am J Ind Med. 1997 Aug;32(2):142-52. doi: 10.1002/(sici)1097-0274(199708)32:2<142::aid-ajim5>3.0.co;2-0.
In epidemiologic studies on musculoskeletal disorders, some risk factors, especially physical load, cannot be determined independently from the worker. Posture, movement and external load are the result both of physical work requirements forced on the worker and of the worker's capacity to adopt particular techniques. Risk factors are also adjusted in relation to the worker's health. This paper presents a dynamic model that links exposure to risk factors for back pain and disability. Its aim is to help identify core elements in exposure assessment strategies for epidemiologic studies on back disorders. In this dynamic model, risk factors are determined relative to health status in order to distinguish between etiological and prognostic factors. Measurement techniques for various risk factors are classified into self-reports, observations, and direct instrumentation. Features of commonly used techniques are discussed with respect to feasibility, accuracy, and precision. In addition, consideration is given to the optimum allocation of measurements taking into account the effects of random and systematic variation in exposure due to tasks, workplaces, and workers.
在关于肌肉骨骼疾病的流行病学研究中，一些风险因素，尤其是身体负荷，无法独立于工人来确定。姿势、动作和外部负荷既是强加给工人的体力工作要求导致的结果，也是工人采用特定技术能力的结果。风险因素也会根据工人的健康状况进行调整。本文提出了一个动态模型，该模型将背痛和残疾的风险因素暴露联系起来。其目的是帮助识别背部疾病流行病学研究暴露评估策略中的核心要素。在这个动态模型中，风险因素是相对于健康状况来确定的，以便区分病因学因素和预后因素。各种风险因素的测量技术分为自我报告、观察和直接仪器测量。就可行性､准确性和精确性而言，对常用技术的特点进行了讨论。此外，考虑到任务、工作场所和工人导致的暴露中随机和系统变化的影响，对测量的最佳分配进行了考量。
