MUSCULOSKELETAL WORK INJURY--EPIDEMIOLOGY AND DISABILITY

这个五年计划将调查有偿(职业) 肌肉骨骼工伤和相关的神经损伤，按 身体受伤的部位。该项目将研究以下内容 损伤：挫伤、挤压伤、瘀伤；扭伤、拉伤； 脱位；骨折；重复运动损伤 关节、肌肉或肌腱发炎或刺激；以及腕骨 隧道综合症。受伤部位包括：背部；上肢-- 肩部，上臂/前臂，肘部，手腕，手；下肢--臀部， 大腿/小腿、膝盖、脚踝和脚。 该项目的目标是：1)描述这些疾病的流行病学 条件；2)通过以下方式来表征所导致的残疾 累计错过工作日的持续时间；以及，3)执行假设 测试以确定性别、年龄、损伤来源、类型 工作地点的意外、行业、职业和就业人数如下 伤害发生的危险因素并估计其贡献， 如果有，则为累计错过的工作时间。项目的长期目标是 利用调查结果重新思考和微调当前的预防和 从影响的角度谈康复策略 主要工业化国家整个劳动力的职业伤害 州政府。 该项目使用了关于42,773个肌肉骨骼损伤的数据 1986年密歇根数据库。密歇根数据库链接错过的工作日 来自工人补偿系统的信息，平均 自受伤之日起三年半以上的随访， 伤害特征信息编码为联邦局的一部分 劳动统计补充数据系统。密歇根数据库 似乎是独一无二的，在提供整个 一个主要工业化国家的劳动力。初步分析 说明所产生的残疾对年龄和性别的重大影响 分别是背部扭伤/拉伤和重复运动损伤。 将采用以下实验设计和方法。要实现 第一个项目的目标、发病率和发病率比率及其标准 误差和95%的可信区间，按不同的 协变量，将被计算。对于第二个，一组表格给出了 错失工作时间的分位数分布 将创建各种协变量的交叉分类。至 实现第三个目标，检验假设和量化 预测变量、多元回归的影响(如果有的话) 将执行分析。将包括一阶相互作用 在回归模型中，如果得到证实，分层的主效应 分析也将被报告。因为精细详细的分类 在协变量中，将使用各种统计技术来 修正了潜在的多重共线性。此外，还特别注意 将关注生物学的似然性和因果关系问题 聚合用于表示以下子组的分类变量 协变量。

This five year project will investigate compensable (occupational) musculoskeletal work injuries and related neurologic injury, grouped by the part of body injured. The project will study the following injuries: contusions, crush injuries, bruises; sprains, strains; dislocations; fractures; repetitive motion injuries in the form of inflammation or irritation of the joints, muscles or tendons; and carpal tunnel syndrome. The injury areas include: back; upper extremity -- shoulder, upper arm/forearm, elbow, wrist, hand; lower extremity -- hip, thigh/lower extremity, knee, ankle and foot. The aims of the project are: 1) to describe the epidemiology of these conditions; 2) to characterize the resulting disability measured by the cumulative duration of missed workdays; and, 3) to perform hypothesis testing to determine whether gender, age, source of injury, type of accident, industry, occupation and employment size of the workplace are risk factors for injury occurrence and to estimate their contribution, if any, to cumulative missed worktime. The long-term project goals are to use the results to rethink and fine-tune current prevention and rehabilitation strategies from the perspective of the impact of occupational injuries on the entire workforce of a major industrialized state. The project uses data on 42,773 musculoskeletal injuries contained in the 1986 Michigan Database. The Michigan Database links missed workday information from the workers' compensation system with an average follow-up of more than three and a half years from the injury date, with injury characteristic information coded as part of the federal Bureau of Labor Statistics Supplementary Data System. The Michigan Database appears to be unique in providing longitudinal data for the entire workforce of a major industrialized state. Preliminary analyses indicate substantial age and gender effects in the disability produced by back sprains/strains and repetitive motion injuries, respectively. The following experimental design and methods will be used. To achieve the first project aim, incidence rates and rate ratios, their standard errors and 95% confidence intervals, cross-classified by the various covariables, will be calculated. For the second, a set of tables giving the quantile distributions for missed worktime for finely detailed cross-classifications of the various covariables will be created. To achieve the third aim, the testing of hypotheses and quantitation of effects, if any, of the predictor variables, multiple regression analyses will be performed. First-order interactions will be included in the regression models and, if confirmed, stratified main effects analyses will also be reported. Because of the finely detailed taxonomy of the covariables, various statistical techniques will be used to correct for potential multicollinearity. In addition, special attention will be paid to biologic plausibility and causality issues in aggregating the categorical variables used to represent the subgroups of a covariable.