Development and validation of a job exposure matrix for physical risk factors in low back pain.
Development and validation of a job exposure matrix for physical risk factors in low back pain.
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DOI：
10.1371/journal.pone.0048680
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Viikari-Juntura E
中科院分区：
文献类型：
--
作者：
Solovieva S;Pehkonen I;Kausto J;Miranda H;Shiri R;Kauppinen T;Heliövaara M;Burdorf A;Husgafvel-Pursiainen K;Viikari-Juntura E
目的是构建和验证一个性别特异性的工作暴露矩阵（JEM）的物理暴露用于下腰痛（LBP）的流行病学研究。我们利用了两个大型的芬兰人口调查，一个是构建JEM，另一个是测试矩阵的有效性。矩阵的暴露轴包括与LBP相关的暴露（重体力劳动、举重、笨拙的躯干姿势和全身振动）和增加下背部生物力学负荷的暴露（手臂抬高）或与其他已知风险因素结合可能与LBP相关的暴露（跪或蹲）。具有类似工作任务和暴露的职位被分组。暴露信息基于面对面访谈。矩阵的有效性进行了探讨，通过比较JEM（基于组）的二进制措施与个人为基础的措施。通过比较基于组（JEM）的暴露与基于个人的暴露的关联来评估矩阵对LBP的预测有效性。该矩阵包括348个职位，占21世纪初芬兰所有职位的81%。构建的基质的特异性良好，尤其是在女性中。用卡帕统计量测量的有效性从好到差不等，对大多数暴露来说是公平的。在男性中，所有基于组（JEM）的暴露与LBP的一个月患病率在统计学上显著相关。在女性中，六分之四的群体暴露与LBP有关。针对不同性别的物理暴露的JEM显示出相对较高的特异性，而不影响敏感性。因此，当更精确但更劳动密集型的方法不可行时，该矩阵可被视为大规模流行病学研究中暴露评估的有效工具。虽然该矩阵是以芬兰的数据为基础的，但我们预见，经过一些修改，它也可以适用于具有类似技术水平的其他国家。
The aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP). We utilized two large Finnish population surveys, one to construct the JEM and another to test matrix validity. The exposure axis of the matrix included exposures relevant to LBP (heavy physical work, heavy lifting, awkward trunk posture and whole body vibration) and exposures that increase the biomechanical load on the low back (arm elevation) or those that in combination with other known risk factors could be related to LBP (kneeling or squatting). Job titles with similar work tasks and exposures were grouped. Exposure information was based on face-to-face interviews. Validity of the matrix was explored by comparing the JEM (group-based) binary measures with individual-based measures. The predictive validity of the matrix against LBP was evaluated by comparing the associations of the group-based (JEM) exposures with those of individual-based exposures. The matrix includes 348 job titles, representing 81% of all Finnish job titles in the early 2000s. The specificity of the constructed matrix was good, especially in women. The validity measured with kappa-statistic ranged from good to poor, being fair for most exposures. In men, all group-based (JEM) exposures were statistically significantly associated with one-month prevalence of LBP. In women, four out of six group-based exposures showed an association with LBP. The gender-specific JEM for physical exposures showed relatively high specificity without compromising sensitivity. The matrix can therefore be considered as a valid instrument for exposure assessment in large-scale epidemiological studies, when more precise but more labour-intensive methods are not feasible. Although the matrix was based on Finnish data we foresee that it could be applicable, with some modifications, in other countries with a similar level of technology.
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