Burdorf A, Naaktgeboren B, Post W
Department of Public Health, Erasmus University Rotterdam, The Netherlands.
Occup Environ Med. 1998 Jul;55(7):490-5. doi: 10.1136/oem.55.7.490.
To analyse factors that determine the occurrence of sickness absence due to musculoskeletal problems and the time it takes to return to work.
A longitudinal study with two year follow up was conducted among 283 male welders and metal workers. The survey started with a standardised interview on the occurrence of musculoskeletal complaints. 61 (22%) workers were lost to follow up. Data on sickness absence among 222 workers during the follow up were collected from absence records and self reports. Regression analysis based on proportional hazards models was applied to identify risk factors for the occurrence and duration of sickness absence due to various musculoskeletal complaints.
During the follow up 51% of the workers attributed at least one period of sickness absence to musculoskeletal complaints which accounted for 44% of all work days lost. A history of back pain was not associated with sickness absence for back pain, partly because subjects with back pain were more likely to be lost to follow up. Neck or shoulder pain and pain of the upper extremities contributed significantly to neck or shoulder absence (relative risk (RR) 3.35; 95% confidence interval (95% CI) 1.73 to 6.47) and to upper extremities absence (RR 2.29; 95% CI 1.17 to 4.46), respectively. Company and job title were also significant predictors for sickness absence due to these musculoskeletal complaints. Absence with musculoskeletal complaints was not associated with age, height, body mass index, smoking, and duration of employment. Return to work after neck or shoulder absence was worse among metal workers than welders (RR 2.12; 95% CI 1.08 to 4.17). Return to work after lower extremities absence was strongly influenced by visiting a physician (RR 11.31; 95% CI 2.94 to 43.46) and by musculoskeletal comorbidity (RR 2.81; 95% CI 1.18 to 6.73).
Complaints of the neck or shoulder and upper extremities in the 12 months before the study were associated with sickness absence for these complaints during the follow up. Workers with absence due to pain from back, neck or shoulder, upper extremities, or lower extremities were at higher risk of subsequent sickness absence in the next year.
分析导致因肌肉骨骼问题而缺勤的因素以及恢复工作所需的时间。
对283名男性焊工和金属工人进行了一项为期两年随访的纵向研究。调查从关于肌肉骨骼疾病发生情况的标准化访谈开始。61名（22%）工人失访。从缺勤记录和自我报告中收集了222名工人在随访期间的缺勤数据。应用基于比例风险模型的回归分析来确定因各种肌肉骨骼疾病导致缺勤的发生和持续时间的风险因素。
在随访期间，51%的工人将至少一段缺勤时间归因于肌肉骨骼疾病，这些疾病占所有缺勤工作日的44%。背痛病史与因背痛缺勤无关，部分原因是背痛患者更有可能失访。颈部或肩部疼痛以及上肢疼痛分别对颈部或肩部缺勤（相对风险（RR）3.35；95%置信区间（95%CI）1.73至6.47）和上肢缺勤（RR 2.29；95%CI 1.17至4.46）有显著影响。公司和职位也是因这些肌肉骨骼疾病导致缺勤的重要预测因素。因肌肉骨骼疾病缺勤与年龄、身高、体重指数、吸烟和工作年限无关。金属工人颈部或肩部缺勤后的恢复工作情况比焊工差（RR 2.12；95%CI 1.08至4.17）。下肢缺勤后的恢复工作情况受到看医生（RR 11.31；95%CI 2.94至43.46）和肌肉骨骼合并症（RR 2.81；95%CI 1.18至6.73）的强烈影响。
研究前12个月的颈部或肩部以及上肢疼痛与随访期间因这些疾病缺勤有关。因背部、颈部或肩部、上肢或下肢疼痛而缺勤的工人在次年再次缺勤的风险更高。
