Musculoskeletal Disorders and Health Behaviors among US Workers

描述(申请人提供)：肌肉骨骼疾病(MSD)包括广泛的炎症和退行性疾病，它们构成了所有报告的和/或可补偿的与工作相关的疾病的主要比例，导致美国损失大量工作日和医疗保健利用。MSD有多种相互关联的职业性和非职业性危险因素，如反复创伤、肥胖、吸烟和体力活动。虽然MSD和工伤之间的关系已经被全面描述，但使用具有全国代表性的大型人口数据库来检查工人的健康行为还没有研究过。利用1997-2007年全国健康访谈调查和1996-2007年医疗支出小组调查，将检验以下具体目标和假设：1.按职业/行业、年龄、性别、种族和民族记录和比较所有美国工人、青年工人和老年工人特定肌肉骨骼疾病(MSD)的患病率、趋势和地理变异。2.按职业和国家职业研究议程(NORA)行业评估工人健康行为(身体活动模式、肥胖、饮酒和烟草暴露)与报告的肌肉骨骼疾病之间的关系。3.使用按职业和劳拉工业部门划分的质量调整寿命年(QALY)估计肌肉骨骼疾病对健康相关生活质量的影响。研究美国工人职业、健康行为(身体活动模式、肥胖和烟草暴露)、与健康相关的生活质量、经济影响和肌肉骨骼疾病的地理位置之间的联系，对于我们理解它们目前和未来对医疗保健和公共卫生系统的潜在影响至关重要。随着老年人在未来几年继续或重新进入劳动力大军，基于工作场所的人体工学和肌肉骨骼疾病健康促进将成为接触到老年人和新进入职场的成年人的一个越来越重要的场所。尽管这方面的研究还很少，但这项少数民族F31应用程序的目标是检查这些关联，这些关联为工作场所战略提供信息，以满足处于肌肉骨骼疾病风险的工人群体的独特需求。与公共健康相关：作为一名非传统学位的DO/博士生，我的总体职业目标是发展成为一名全面的内科科学家。我对发展肌肉骨骼流行病学的职业感兴趣，特别关注人体工程学和职业风险因素，包括与健康有关的生活质量衡量标准。作为一名流行病学家，我还对制定初级和二级预防计划感兴趣，以提高人们对风湿对肌肉骨骼疾病的发病率和死亡率的影响的认识。Kirschstein-NRSA F31少数民族学生个人奖学金将作为我在风湿病和流行病学领域发展富有成效的学术生涯的平台，重点是调查与大规模人口肌肉骨骼疾病相关的因素。在这次团契期间，在我的导师洛拉·弗莱明博士、大卫·李博士和罗伯特·霍夫曼博士的帮助下，我将获得许多关于流行病学和肌肉骨骼疾病的宝贵技能和应用。首先，我将学习如何使用公开的大型数据集中的数据来检查肌肉骨骼疾病。其次，我将学习如何重建数据，选择相关变量，并使用先进的统计软件包进行数据分析。最后，我将从临床和流行病学的角度深入了解职业健康和肌肉骨骼疾病。这次NRSA少数民族学生奖学金培训将使我能够扩大我在肌肉骨骼和职业流行病学领域所需的知识和技能。

DESCRIPTION (provided by applicant): Musculoskeletal disorders (MSDs) include a wide range of inflammatory and degenerative conditions and they constitute a major proportion of all reported and/or compensable work-related diseases contributing to substantial numbers of lost work days and medical care utilization in the United States. MSDs have multiple and inter-connected risk factors, both occupational and non-occupational, such as repetitive trauma, obesity, smoking, and physical activity. While the relationship between MSDs and work-related injuries has been comprehensively characterized, examination of worker health behaviors using a large nationally representative population database has not been studied. Using the 1997-2007 National Health Interview Survey and the 1996-2007 Medical Expenditure Panel Survey the following Specific Aims and Hypotheses will be examined: 1. Document and compare the prevalence, trends, and geographical variation of specific musculoskeletal disorders (MSDs) for all US workers, youth workers and older workers by occupation/industry, age, gender, race, and ethnicity. 2. Assess the relationship between worker health behaviors (physical activity patterns, obesity, alcohol use, and tobacco exposure) with reported musculoskeletal disorders by occupation and National Occupational Research Agenda (NORA) Industry sector. 3. Estimate the health-related quality of life effects of having musculoskeletal disorders using Quality Adjusted Life Years (QALYS) by occupation and NORA Industry sector. Examining the under-explored associations between US Worker occupation, health behaviors (physical activity patterns, obesity, and tobacco exposure), health-related quality of life, economic impact and geographical location of musculoskeletal disorders is paramount to our understanding of their current and potential future impact on the health care and public health systems. As older adults remain in or re-enter the workforce in the coming years, worksite-based health promotion of ergonomic and musculoskeletal disorders will become an increasingly important venue for reaching older and newly entering working adults. Although little research has been completed in this area, it is the goal of this Minority F31 Application to examine these associations that inform workplace strategies to meet the unique needs of worker populations at-risk for musculoskeletal disorders. PUBLIC HEALTH RELEVANCE: As a non-traditional degree seeking DO/PhD student, my overall career goal is to develop into a well-rounded physician-scientist. I am interested in developing a career in musculoskeletal epidemiology with a particular focus on ergonomic and occupational risk factors including health-related quality of life measures. As an epidemiologist, I am also interested in the development of primary and secondary prevention programs to increase awareness of the rheumatic contributions to the morbidity and mortality of musculoskeletal disorders. The Kirschstein-NRSA F31 Individual Fellowship for Minority students will serve as a platform for me to develop a productive career in academic rheumatology and epidemiology, with an emphasis on investigating factors that are associated with musculoskeletal disorders in large populations. During this fellowship, with the assistance of my mentors, Drs Lora Fleming, David Lee and Robert Hoffman, I will garner many valuable skills and applications of epidemiology and musculoskeletal disorders. First, I will learn how to use data from large publically available datasets to examine musculoskeletal disorders. Secondly, I will learn to reconstruct data, select pertinent variables, and conduct data analyses using advanced statistical software packages. Lastly, I will develop an in-depth knowledge of occupational health and musculoskeletal disorders from both a clinical and epidemiologic point of view. This NRSA minority student fellowship training will enable me to expand my knowledge and skills needed in the fields of musculoskeletal and occupational epidemiology.