Leino-Arjas P, Hänninen K, Puska P
Finnish Institute of Occupational Health, Helsinki.
Eur J Epidemiol. 1998 Jan;14(1):79-87. doi: 10.1023/a:1007448402954.
Differences in the prevalence of back and joint pain by occupational class and education were studied in surveys representative of adult Finns. The effects of lifestyle factors and mental distress on these differences were also analysed. The material comprised 3915 women and 3629 men, all occupationally active. Occupational class and level of education were associated with back and joint pain; the associations were more obvious in men than in women. Among men, the age-adjusted odds ratio of joint pain in farmers was 3.2 (95% CI: 2.1-5.0), in manual workers 2.6 (1.9-3.6), in entrepreneurs 2.4 (1.5-3.7) and in lower white-collar workers 1.7 (1.1-2.4) as compared with upper white-collar employees. Similar odds ratios of back pain were 2.1 (1.6-2.9) in farmers, 1.8 (1.5-2.3) in manual workers, 1.7 (1.2-2.4) in entrepreneurs and 1.4 (1.1-1.7) in lower white-collar workers. Most of the associations persisted in multivariate analyses, in which height, marital status, lifestyle (smoking, leisure-time physical activity and body mass index (BMI)) and mental distress were considered; in these models, mental distress was consistently associated with pain. Back pain was associated with smoking in men and with BMI in women; BMI was also associated with joint pain in both sexes. In women, height showed an association with back pain for which a doctor had been consulted. Marital status, alcohol consumption, leisure-time physical activity and the urbanization level of the community were not important as determinants of pain.
Obvious differences occurred in back and joint pain by indicators of social class that were not due to socioeconomic differences in lifestyle, height or mental distress.
在具有芬兰成年人代表性的调查中,研究了按职业类别和教育程度划分的背痛和关节痛患病率差异。还分析了生活方式因素和精神困扰对这些差异的影响。该材料包括3915名女性和3629名男性,均为在职人员。职业类别和教育程度与背痛和关节痛相关;这些关联在男性中比在女性中更明显。在男性中,与白领相比,农民关节痛的年龄调整优势比为3.2(95%可信区间:2.1 - 5.0),体力劳动者为2.6(1.9 - 3.6),企业家为2.4(1.5 - 3.7),低白领为1.7(1.1 - 2.4)。背痛的类似优势比在农民中为2.1(1.6 - 2.9),体力劳动者为1.8(1.5 - 2.3),企业家为1.7(1.2 - 2.4),低白领为1.4(1.1 - 1.7)。在多变量分析中,大多数关联仍然存在,其中考虑了身高、婚姻状况、生活方式(吸烟、休闲体育活动和体重指数(BMI))和精神困扰;在这些模型中,精神困扰始终与疼痛相关。背痛在男性中与吸烟相关,在女性中与BMI相关;BMI在两性中也与关节痛相关。在女性中,身高与因背痛而咨询医生的情况有关。婚姻状况、饮酒、休闲体育活动和社区的城市化水平作为疼痛的决定因素并不重要。
社会阶层指标在背痛和关节痛方面存在明显差异,这并非由于生活方式、身高或精神困扰方面的社会经济差异所致。