LOW BACK PAIN: PHYSICAL AND PSYCHOSOCIAL JOB FACTORS

本项目旨在前瞻性地研究身体和心理社会工作因素在职业性腰痛（LBP）发展中的作用，分为五个连续阶段：（1）残疾前症状阶段，（2）残疾前正式受伤报告阶段，（3）三个残疾阶段-急性，亚急性和慢性-定义为失去工作时间的持续时间增加。据推测，无论是身体和心理社会的工作因素是LBP在所有五个阶段的独立预测因子，其相对影响大小的变化跨阶段。 主要目的是确定特定阶段的风险因素概况，特别关注心理社会和生物力学风险因素的相对影响。 长期目标是为工作场所干预措施的设计提供有用的信息，这些干预措施将联合收割机组织和人体工程学工作重新设计结合起来，以防止腰部受伤和工作残疾。该项目结合了两个现有数据集的资源-两个预期的旧金山弗朗西斯科城市交通运营商队列（n = 1，449，n = 1，640）。 这两项纵向研究提供了3至5年随访的工人赔偿数据，允许研究残疾过程的每个阶段，包括慢性残疾阶段（超过90天的工作），这占与工作相关的腰痛相关费用的80%。 这两项研究提供了与工作相关的，社会人口，伤害，医疗法律的和经济因素的可比信息。初步分析将检查身体和心理社会工作因素的独立和综合影响，包括心理和身体的工作要求，工作控制，工作压力和工作中的社会支持。 此外，独特的工作压力，由独立观察员与创新的工作分析工具测量的数据，将用于协议分析与自我报告的措施，以评估预测有效性的调查工具中使用的大型流行病学研究的职业性LBP。

This project seeks to prospectively examine the role of physical and psychosocial job factors in the development of occupational low back pain (LBP) during five successive phases: (1) the pre- disability symptom phase, (2) the pre-disability formal injury report phase, and (3) three disability phases - acute, subacute, and chronic - defined by increasing durations of lost work time. It is hypothesized that both physical and psychosocial job factors are independent predictors of LBP at all five phases and that their relative effect sizes change across phases. The main objective is to determine phase-specific risk factor profiles with particular focus on the relative impact of psychosocial and biomechanical risk factors. The long-term goal is to yield useful information for the design of workplace interventions which combine organizational and ergonomic job redesign to prevent low back injuries and work disability. This project combines the resources of two existing data sets - two prospective cohorts of San Francisco urban transit operators (n = 1,449, n = 1,640). These two longitudinal studies provide workers' compensation data with 3 to 5 years of follow-up, allowing for the study of each phase of the disability process, including the chronic disability phase (greater than 90 days off work), which accounts for 80 percent of the costs associated with work-related low back injuries. Both studies provide comparable information on job-related, sociodemographic, injury, medico- legal, and economic factors. Primary analyses will examine the independent and combined effects of physical and psychosocial job factors, including psychological and physical job demands, job control, job strain and social support at work. In addition, unique data on job stress, measured by independent observers with an innovative job analysis instrument, will be used for agreement analyses with self-reported measures to evaluate the predictive validity of survey instruments used in large epidemiological studies of occupational LBP.