Prospective Study of UEMSD and Physical Job Stressors

描述：四肢肌肉骨骼疾病(UEMSD)影响手部、手臂、肩部和颈部的肌腱、腱鞘、肌肉、神经、法氏囊和血管。2000年，与反复创伤相关的疾病“占美国所有与工作有关的疾病的67%。体力工作压力源和UEMSD之间的不一致联系经常被报道。这些不一致与暴露的测量不精确、混杂的控制不完全、健康结果的确定差以及几乎完全依赖横断面设计研究有关。为了更好地评估工作对肌肉骨骼健康的影响，提出了一项针对制造业工人的前瞻性流行病学研究。大约600名研究参与者将在1.5年内登记，并跟踪调查长达3年。在注册时，将记录肌肉骨骼症状，并收集人口统计、个人健康、工作历史和职业心理社会压力信息。有关暴露在身体工作压力下的信息将从两个来源组合获得。首先，对于每个研究参与者，与其工作中执行的所有任务相关的用力、上肢重复和上肢姿势将通过观察和直接方法来量化。其次，所有研究参与者将被要求每天在任务日志中记录他/她执行其工作所需的每项具体任务的小时数。每项任务的实际工作压力源将与每个参与者随时间执行的特定任务日志中的信息相结合，以创建独特的暴露信息时间序列。员工任务的任何更改都将记录在任务日志中，并将触发和暴露重新评估。研究参与者还将记录上肢症状的发生情况和严重程度。那些出现符合先验标准的新症状的参与者将接受标准的临床检查。 研究的两个主要目标是：1)估计特定的UEMSD在制造业工人中的发生率；2)进行包含时变自变量的多变量分析，以检验在控制潜在的混杂变量后，发生的UEMSD与体力工作压力因素相关的假设。

DESCRIPTION: Musculoskeletal disorders of the extremities (UEMSDs) affect tendons, tendons sheaths, muscles, nerves, bursae, and blood vessels of the hands arms, shoulders, and neck. In 2000, disorders associated with repeated trauma "accounted for 67% of all work-related illness in the United States. Inconsistent associations between physical job stressors and UEMSDs are commonly reported. These inconsistencies are related to imprecise measures of exposure, incomplete control of confounding, poor ascertainment of health outcome, and near exclusive reliance on studies of cross-sectional design. To better estimate effects of work on musculoskeletal health, a prospective epidemiologic study of manufacturing workers is proposed. Approximately 600 study participants will be enrolled over 1.5 years and followed for up to 3 years. At the time of enrolment, musculoskeletal symptoms will be documented and demographic, personal health, work history, and occupational psychosocial stress information will be collected. Information about exposure to physical job stressors will be obtained from a combination of two sources. First, for each study participant, forceful exertions, upper extremity repetition, and upper extremity postures associated with all tasks performed at his/her job will be quantified by observations and direct methods. Second, all study participants will be asked to record in a task log, on a daily basis, the number of hours he/she spent performing each of the specific tasks that are required by his/her job. The physical job stressors for each task will be combined with information from each participant's log of specific tasks performed over time to create a unique time series of exposure information. Any changes to the employee's tasks will be recorded in the task log and will trigger and exposure reassessment. Study participants will also record occurrences and severity of upper extremity symptoms. Those participants with new onset of symptoms that meet a priori criteria will undergo standard clinical examination. Two primary aims will be addressed: 1) the incidence of specific UEMSDs will be estimated among manufacturing workers and 2) multivariate analyses that incorporate time-varying independent variables will be performed to test the hypothesis that incident UEMSDs are associated with physical job stressors after controlling for potential confounding variables.