Exposure Response Relationships for CTS and Epicondylitis from Pooled Data

汇总数据中 CTS 和上髁炎的暴露反应关系

• 批准号: 8733196
• 负责人: ARUN GARG
• 金额: $ 27.11万
• 依托单位: UNIVERSITY OF WISCONSIN MILWAUKEE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8733196
• 关键词: Exposure; Response; Relationships; CTS; Epicondylitis

DESCRIPTION (provided by applicant): The proposed research offers a unique opportunity to provide exposure-response estimates between measured occupational biomechanical stressors, non-occupational physical activities, demographics, medical history, psychosocial factors; and risk of carpal tunnel syndrome (CTS), lateral epicondylitis (LEPI), and medial epicondylitis (MEPI). Three prospective cohort studies will pool data from 35 US workplaces, representing a wide range of occupations, industries, and physical exposure levels. 1,973 employees were enrolled and 1,698 were followed for up to 110 months (average follow-up = 34 months). Comprehensive data are available on each worker's biomechanical stressors, physical examination maneuvers, and median and ulnar nerve conduction studies at the wrist. Exposure-response relationships will be estimated between biomechanical stressors and the prevalence and incidence of: CTS, LEPI, and MEPI, while adjusting for relevant effect modifiers and confounders. Measures of biomechanical stressors used in this study include established models of ACGIH Threshold Limit Value (TLV) for Hand Activity Level (HAL), and the 1995 Strain Index (SI), as well as newly developed models: (i) Revised Strain Index (RevSI), (ii) Composite Strain Index (COSI), and (iii) Cumulative Strain Index (CUSI). Comprehensive physical exposure data from these studies feature: (i) individual worker exposure with changes in exposure over time, and (ii) detailed data for each combination of force, repetition, and posture (sub-task data). These data allow us to model biomechanical stressors in detail not previously possible using innovative approaches such as RevSI, COSI, and CUSI. The three sites all have comprehensive data on potential confounders and covariates including worker demographics, past medical history, non-occupational hobbies and activities, and psychosocial factors. All sites used matching case definitions for CTS, LEPI, and MEPI that included symptoms plus physical maneuvers and nerve conduction studies. Pooling existing data across the three studies will enable us to estimate the magnitude and shape of the relative risk function across a wider range of biomechanical stressors: (i) with improved confidence and precision, (ii) for workers with job rotation, and (iii) for tasks with multiple combinations of force, repetition, and posture. Results from this proposed research will help employers to design safe and productive jobs and provide public-health agencies and occupational health researchers with information to more effectively guide prevention programs.

描述（由申请人提供）：拟议的研究提供了一个独特的机会，可以在测量的职业生物力学压力源，非职业体育活动，人口统计学，病史，心理社会因素之间提供暴露响应估计；腕管综合征（CTS），外侧上环炎（LEPI）和内侧上环炎（MEPI）的风险。三项前瞻性队列研究将汇集来自35个美国工作场所的数据，代表广泛的职业，行业和身体暴露水平。招募了1,973名员工，然后随访了1,698名员工，最多110个月（平均随访= 34个月）。每个工人的生物力学压力源，体格检查操作以及手腕的中位和尺神经传导研究都可以找到全面的数据。在生物力学应力源和发生率和发生率之间，将估算暴露 - 响应关系：CTS，LEPI和MEPI，同时调整相关效应修饰剂和混杂因素。本研究中使用的生物力学应激源的度量包括既定的ACGIH阈值极限值（TLV）的模型（HAL）和1995年的应变指数（SI），以及新开发的模型：（i）修订后的应变指数（REVSI）（REVSI），（II）综合应变指数（COSI）和（IIIII）累积菌株（III）。这些研究的全面身体暴露数据具有：（i）随着时间的推移暴露的单个工人接触，以及（ii）武力，重复和姿势组合的详细数据（子任务数据）。这些数据使我们能够使用REVSI，COSI和CUSI等创新方法对生物力学应力源进行详细建模。这三个站点都有有关潜在的混杂因素和协变量的全面数据，包括工人人口统计，过去的病史，非职业爱好和活动以及社会心理因素。所有站点均使用匹配的案例定义，用于CTS，LEPI和MEPI，其中包括症状以及身体动作和神经传导研究。在这三项研究中汇总现有数据将使我们能够估算更广泛的生物力学压力源的相对风险功能的大小和形状：（i）（i）具有提高的置信度和精确度，（ii）用于工作旋转的工人，以及（iii）具有多种力量组合，重复，重复，重复，重复，重复，重复，重复的任务， 和姿势。这项拟议的研究的结果将帮助雇主设计安全有效的工作，并为公共卫生机构和职业健康研究人员提供信息，以更有效地指导预防计划。