MUSCULOSKELETAL WORK INJURY--EPIDEMIOLOGY AND DISABILITY

这个为期五年的项目将调查可补偿的（职业） 肌肉骨骼工伤和相关神经系统损伤，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;重复性运动损伤， 关节、肌肉或肌腱发炎或发炎;以及腕骨 隧道综合征 受伤部位包括：背部;上肢-- 肩、上臂/前臂、肘、腕、手;下肢-髋， 大腿/下肢、膝关节、踝关节和足部。 该项目的目的是：1）描述这些疾病的流行病学， （2）确定所造成的残疾的特征， 错过工作日的累积持续时间;以及，3）执行假设 测试，以确定是否性别，年龄，受伤的来源，类型， 事故，行业，职业和工作场所的就业规模是 伤害发生的危险因素，并估计其贡献， 如果有的话，累计错过的工作时间。 项目的长期目标是 利用研究结果重新思考和调整当前的预防措施， 康复战略的角度来看， 一个主要工业化国家的全体劳动力的职业伤害 状态 该项目使用了42，773例肌肉骨骼损伤的数据， 1986年密歇根数据库 密歇根州数据库链接错过的工作日 工人赔偿制度的资料， 从受伤之日起随访超过三年半， 伤害特征信息编码为联邦局的一部分， 劳工统计补充数据系统。 密歇根数据库 似乎是唯一提供纵向数据的整个 一个主要工业化国家的劳动力。 初步分析 表明在所产生的残疾中有很大的年龄和性别影响 背部扭伤/拉伤和重复性运动损伤。 将使用以下实验设计和方法。 实现 第一个项目的目标，发病率和比率，其标准 误差和95%置信区间，交叉分类的各种 将计算协变量。 第二，一组表格， 错过的工作时间的分位数分布， 将建立各种协变量的交叉分类。 到 实现第三个目标，假设的检验和量化， 预测变量的影响（如果有），多元回归 将进行分析。 将包括一阶相互作用 在回归模型中，如果得到确认， 还将报告分析结果。 因为精细的分类法 在协变量中，将使用各种统计技术， 校正潜在的多重共线性。 此外，特别注意 将支付生物相容性和因果关系问题， 汇总用于代表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.