de Zwart B C, Broersen J P, Frings-Dresen M H, van Dijk F J
Coronel Institute for Occupational and Environmental Health, Academic Medical Center, University of Amsterdam, The Netherlands.
Occup Environ Med. 1997 Nov;54(11):793-9. doi: 10.1136/oem.54.11.793.
To examine changes in musculoskeletal complaints over four years in groups of employees relative to age and work demands.
Repeated questionnaire data of male employees in heavy physical work (exposed group, n = 7324) and mental work (control group, n = 4686), stratified for age (20-9, 30-9, 40-9, 50-9), were analysed. For each employee, data on the occurrence of musculoskeletal complaints from two surveys with a mean interval of around four years were available. Changes in prevalences over the follow up interval were analysed. Proportions of new, recovered, and chronic cases as well as those free of complaints at both surveys were studied.
For most complaints, there were significantly greater increases in prevalences in the exposed group compared with the control group over the follow up interval particularly within the group aged 40-9 for back, neck, and several sites of the upper and lower limbs. The 20-9 year age group also had significantly greater changes for several musculoskeletal complaints. Within the oldest age group (50-9) exposure to heavy physical work demands only affected changes in prevalences of neck and upper arm complaints. After four years in the cohort free of complaints at the start of the follow up the group aged 40-9 had the highest prevalence of complaints of the back, neck, and the upper and lower limbs.
Middle aged and younger employees develop musculoskeletal complaints as a result of exposure to heavy physical work. In the oldest age group health related selection seems to mask the occupational health risks under study. To prevent the expected increase in musculoskeletal disorders and related work disability in our aging workforce, preventive measures should be taken at all stages of a working life.
研究四年来不同年龄组和工作需求组员工肌肉骨骼疾病的变化情况。
对从事重体力劳动的男性员工(暴露组,n = 7324)和从事脑力劳动的男性员工(对照组,n = 4686)进行重复问卷调查,按年龄(20 - 29岁、30 - 39岁、40 - 49岁、50 - 59岁)分层分析。每位员工均有两次调查中肌肉骨骼疾病发生情况的数据,两次调查平均间隔约四年。分析随访期间患病率的变化情况。研究新发病例、康复病例和慢性病例的比例,以及两次调查均无疾病的病例比例。
在随访期间,与对照组相比,暴露组大多数疾病的患病率显著增加,尤其是在40 - 49岁年龄组的背部、颈部以及上下肢多个部位。20 - 29岁年龄组的几种肌肉骨骼疾病也有显著变化。在最年长的年龄组(50 - 59岁),从事重体力劳动仅影响颈部和上臂疾病患病率的变化。随访开始时无疾病的队列中,40 - 49岁年龄组在四年后背部、颈部以及上下肢疾病的患病率最高。
中年及年轻员工因从事重体力劳动而出现肌肉骨骼疾病。在最年长的年龄组,与健康相关的选择似乎掩盖了正在研究的职业健康风险。为防止老年劳动力中肌肉骨骼疾病及相关工作残疾的预期增加,应在职业生涯的各个阶段采取预防措施。