Job-Related Arthritis and Disability in Retirement

两个广泛共享的医学观点激发了拟议的研究： 在生活中的某个时候关节受伤会导致骨关节炎， 在以后的生活中。2)也许预测未来腰痛的最佳方法是 先前的腰痛。对于我们的目的来说，时间维度很重要。的 最初的伤害或疼痛可能发生在工作中，而随后的 骨关节炎或疼痛可能会在很久以后发生，也许在退休期间。 这些后续的骨关节炎和疼痛事件将产生直接成本 （看医生、住院、药物）和间接费用（生产力损失 在工作中和家中）。目标1是估算与工作相关的成本 骨关节炎目前对所有与工作有关的伤害和疾病的估计 忽略这些成本。目的二是研究就业与就业之间的关系。 在退休前从事造成伤害的工作， 退休 与工作有关的骨关节炎和退休后功能性残疾的成本是 这至少有三个原因。首先，忽略它们会导致 严重低估了工伤的总体成本， 疾病。其次，这些费用主要由受害者、家庭和 纳税人，而不是工人的赔偿（WC）系统。第三，当前经济 职业安全与健康（OSHA）标准，如 那些与人机工程学有关的技术也忽略了这些成本。如果这些标准 减少最初的障碍和伤害，那么他们也应该减少 后续费用。这意味着目前的人体工程学标准可能是 比通常认为的更具成本效益。 骨关节炎的患病率和成本将根据以下主要数据进行估计： 国家健康访问调查，国家健康统计中心， 美国劳工统计局、美国医疗保健研究机构， 质量和来自已发表研究的次要数据。我们将展示一系列 在明确陈述的假设下进行的估计，以便读者可以选择 他们认为最合理的情况。 在造成伤害的工作中就业与随后的 功能性残疾将与国家卫生和 营养检查调查III（NHANES III）。NHANES III提供的信息 关于退休人员的功能残疾（日常生活活动），以及 作为受试者退休前最长时间工作的信息。

Two widely-shared medical views motivate the proposed study: 1) Injuries to joints at some time in life can produce osteoarthritis in those joints later in life. 2) Perhaps the best predictor of future low-back pain is prior low-back pain. For our purposes, the time dimension is important. The initial injury or pain could occur on-the-job whereas the subsequent osteoarthritis or pain could occur much later, perhaps during retirement years. These subsequent osteoarthritis and pain events will generate direct costs (doctor visits, hospitalizations, drugs) and indirect costs (lost productivity on-the-job and in the home). Aim 1 is to estimate the costs of job-related osteoarthritis. Current estimates of all job-related injuries and illnesses ignore these costs. Aim 2 is to investigate the connection between employment in injury-producing jobs prior to retirement and functional disability after retirement. Costs of job-related osteoarthritis and functional disability in retirement are important for at least three reasons. First, ignoring them leads to a significant underestimate of the overall costs of job-related injuries and illnesses. Second, these costs were largely borne by victims, families, and taxpayers, not by workers' compensation (WC) systems. Third, current economic evaluations of some Occupational Safety and Health (OSHA) standards, such as those pertaining to ergonomics, also ignore these costs. If these standards reduce initial disorders and injuries, then they should also reduce the subsequent costs. The implication is that current ergonomic standards may be more cost-effective than is commonly believed. Prevalence and costs of osteoarthritis will be estimated with primary data from the National Health Interview Surveys, National Center for Health Statistics, the Bureau of Labor Statistics, and the Agency for Healthcare Research and Quality and with secondary data from published studies. We will present a range of estimates under clearly- stated assumptions so readers can select the scenario they find most reasonable. The connection between employment in injury-producing jobs and subsequent functional disability will be investigated with the National Health and Nutrition Examination Survey III (NHANES III). The NHANES III has information on the functional disability (Activities of Daily Living) of retirees, as well as information on subjects' longest held jobs prior to retirement.