A prospective cohort study of risk factors for disability retirement because of back pain in the general working population
A prospective cohort study of risk factors for disability retirement because of back pain in the general working population
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DOI：
10.1097/00007632-200208150-00019
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发表时间：
2002-08-15
期刊：
影响因子：
3
通讯作者：
Bjerkedal, T
中科院分区：
文献类型：
--
作者：
Hagen, KB;Tambs, K;Bjerkedal, T
研究设计。对34,754名在职男女进行了一项为期7年的前瞻性队列研究。确定职业危险因素、生活方式因素、合并症、心理和社会因素对普通工作人群腰痛致残退休发生率的相对贡献。背景资料摘要。永久性职业残疾是致残过程的严重后果。尽管这种情况对个人来说是巨大的负担，对社会来说也是极其昂贵的，但基于人群的研究很少涉及因背痛而导致残疾的危险因素。获得背痛残疾抚恤金的患者从国家残疾登记册中确定。暴露变量取自挪威一个国家所有居民的健康筛查。参与率为72%至90%。在随访期间，715人（2.1%）获得了背痛残疾抚恤金。在最后的多变量联合模型中，未来背痛残疾的最强预测因子是职业风险因素“体力要求高的工作”（比值比[OR]， 4.1； 95%置信区间[CI]， 2.7-6.4）和合病因素“一般健康状况差”（比值比[OR]， 3.7； 95%置信区间[CI]， 2.4-5.8）。“疲惫的感觉”（OR, 1.7, 95% CI, 1.1-2.4）、当前吸烟（OR, 1.4； CI, 1.2-1.7）和身体质量指数在较高百分位数（OR, 1.6; 95% CI, 1.2-2）也预测了背痛残疾养老金。从欧洲福利系统的广泛公共健康角度来看，未来背痛残疾风险高的受试者认为他们的工作经常需要体力，除了背痛之外还有健康问题，大多数人普遍感到疲倦和疲惫。结果表明，仅针对背部疼痛的干预措施可能无法预防残疾养老金。
Study Design. A 7-year prospective cohort study of 34,754 employed men and women was conducted.Objective. To determine the relative contribution of occupational risk factors, lifestyle factors, comorbidity, and psychological and social factors to the incidence of disability retirement bacause of back pain in the general working population.Summary of Background Data. Permanent occupational disability is a serious consequence of a disabling process. Although this condition is a great burden to the individual and extremely costly for society, few population-based studies exist on the risk factors for obtaining disability persion because of back pain.Methods. Patients granted back pain disability pension were asvertained from the national disability register. The exposure variables were taken from a health screening of all the inhabitants in one country Norway. The participation rate was 72% to 90%.Results. During the follow-up period, 715 induviduals (2.1%) were granted a back pain disability pension. In the final combined multivariate model, the strongest predictors for future back pain disability were the occupational risk factor "physically demanding work" (odds ration [OR], 4.1; 95% confidence interval [CI], 2.7-6.4) and the comorbidity factor "poor general gealth" (OR, 3.7; 95% CI, 2.4-5.8). "Feeling of being worn out" (OR, 1.7, 95% CI, 1.1-2.4), current smoking (OR, 1.4; CI, 1.2-1.7), and body mass index in the upper percentile (OR, 1.6; 95% CI, 1.2-2) also predicted back pain disability pension.Conclusions. In a broad public health perspective within a European welfare system, subjects at high risk for future back pain disability persion perceived their work as constantly phisically demanding, had health complaints other than back pain, and most felt generally tired and worn out. The results indicate that interventions directed toward the painful back alone may be unsuccessful in preventing disability pernsions.