Heavy Lifting and Risk of Retinal Detachment: A Case Control Study

举重物与视网膜脱离的风险：病例对照研究

• 批准号: 8760778
• 负责人: DAVID KRIEBEL
• 金额: $ 32.39万
• 依托单位: UNIVERSITY OF MASSACHUSETTS LOWELL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8760778
• 关键词: Heavy; Lifting; Risk; Retinal; Detachment

DESCRIPTION (provided by applicant): Retinal detachment (RD) is one of the most common ophthalmologic emergencies and frequently leads to irreversible damage to vision. When rapid access to repair surgery is available, sight is generally preserved, although up to 40% suffer permanent loss of visual acuity. In large parts of the world without access to advanced medical care, blindness often results. Until recently, the major known risk factors were not very useful in prevention: advancing age, myopia and cataract surgery all increase the risk of RD. Only a minority of RD cases was currently thought to be preventable - those caused by acute eye trauma and by diabetes. In 2008, a member of our research team published the first epidemiologic study identifying a strong association between occupational exposure to heavy lifting and risk of RD: the odds ratio of RD was approximately 4 for those reporting a history of heavy lifting compared to no heavy lifting. This first study used a simple measure of lifetime heavy lifting and now a more detailed exposure assessment for a larger population is needed to further evaluate the results. Experimental and clinical evidence for the biologic plausibility of tis association exists and can be used for a biologically-based exposure assessment. If the lifting - RD association is confirmed in a larger study, heavy lifting could explain a substantial fraction o the risk of RD in working adults. The first study also reported a strong association between obesity and risk of RD, a finding with enormous potential public health impact which will be further investigated in the proposed study. The objective of the proposed study is to evaluate the risk of RD from lifting and related manual materials handling (MMH) exposures by conducting a large case control study of incident cases of retinal detachment. We propose a pathophysiologic mechanism linking physical effort to RD which suggests a hierarchy of testable hypotheses about the timing of exposures and the likely forms of exposure metrics. This proposal has the following specific aims: Aim 1: Develop metrics of occupational exposures to lifting that will enable epidemiologic evaluation of alternative biologic hypotheses of the association with RD. Aim 2: Measure the associations between alternative metrics of lifting and related MMH tasks and RD in a case control study [using telephone interviews]. The role of obesity, including as a modifier of the effect of heavy lifting, will also be studied. The finding of this study will be useful in guiding translational research to develop new prevention strategies for RD. Heavy lifting and related MMH tasks are very common hazards in nearly all the NIOSH NORA industry sectors. [The NIOSH NORA Sector Councils that have prioritized MMH will be consulted to disseminate these findings and apply them in existing MMH risk prevention programs].

描述（由申请人提供）：视网膜脱离（RD）是最常见的眼科急症之一，经常导致视力不可逆的损害。当可以快速进行修复手术时，视力通常可以保留，但高达 40% 的人会遭受永久性视力丧失。在世界大部分地区，如果无法获得先进的医疗护理，往往会导致失明。直到最近，已知的主要风险因素在以下方面还没有多大用处： 预防：年龄增长、近视和白内障手术都会增加患RD的风险。目前只有少数 RD 病例被认为是可以预防的，即由急性眼外伤和糖尿病引起的病例。 2008 年，我们研究团队的一名成员发表了第一份流行病学研究，确定了职业性举重与 RD 风险之间存在密切关联：对于那些报告有举重史的人与没有举重史的人来说，RD 的优势比约为 4。第一项研究使用了简单的终生举重测量方法，现在需要对更多人群进行更详细的暴露评估，以进一步评估结果。存在这种关联的生物学合理性的实验和临床证据，并且可用于基于生物学的暴露评估。如果一项更大规模的研究证实了举重与 RD 之间的关联，那么重物举重可以解释职业成年人患 RD 风险的很大一部分。第一项研究还报告了肥胖与 RD 风险之间的密切关联，这一发现具有巨大的潜在公共健康影响，将在拟议的研究中进一步研究。 拟议研究的目的是通过对视网膜脱离事件进行大型病例对照研究，评估因举重和相关手动材料处理（MMH）暴露而导致的 RD 风险。我们提出了一种将体力消耗与 RD 联系起来的病理生理学机制，该机制提出了关于暴露时间和暴露指标的可能形式的可检验假设的层次结构。 该提案有以下具体目标： 目标 1：制定举重职业暴露指标，以便能够对与 RD 相关的替代生物学假设进行流行病学评估。目标 2：在病例对照研究中[使用电话访谈]衡量举重替代指标与相关 MMH 任务和 RD 之间的关联。还将研究肥胖的作用，包括作为举重效果的调节剂。 这项研究的发现将有助于指导转化研究以制定新的 RD 预防策略。重型起重和相关的 MMH 任务是几乎所有 NIOSH NORA 工业部门中非常常见的危险。 [将咨询优先考虑 MMH 的 NIOSH NORA 部门理事会，以传播这些发现并将其应用到现有的 MMH 风险预防计划中]。