RISK FACTORS FOR MUSICIAN UPPER EXTREMITY DISORDERS

器乐音乐家可能是上肢肌肉骨骼疾病（UEMSD）高风险的最不被认可和最缺乏服务的大型职业群体。本研究将调查由自我报告症状定义的UEMSD的横断面患病率、一年累积发病率和持续性，研究对象是至少属于两个或三个音乐家联盟的专业音乐家群体，代表1000-1500名成员。每个工会的活跃音乐家将被要求完成一份关于主要（音乐）和次要工作中身体和心理压力因素的邮寄问卷，包括一般的人体工程学暴露和音乐特定因素。其他项目将包括人口统计、病史和UEMSD症状。第一份调查的所有参与者将在一年后被要求完成第二份调查问卷。我们将估计音乐和其他工作以及UEMSD的特定暴露频率，以及这些暴露对UEMSD的患病率，累积发病率和持久性的单独和综合贡献，包括物理（生物力学）和社会心理因素之间的相互作用以及次要工作暴露的影响改变。风险因素的影响将根据乐器类型、音乐作品类型、演奏年数和每周练习时间对专业音乐家进行整体分析。本研究的结果可能有助于预防这些疾病，为音乐家、音乐家组织/机构（音乐家团体、交响乐团、工会、音乐学院）的管理人员、教育工作者、乐器设计师和卫生专业人员提供信息。发展和修改音乐训练计划（例如，建立曲目的顺序或程序）；2. 在制定工作要求和实践/工作时间表时纳入工作组织因素；3. 重新设计仪器或设计外部支持设备或家具/工作空间；和4。就音乐家的UEMSD，加强适当的医疗及预防教育。

Instrumental musicians may constitute the least recognized and most under-served large occupational group at high risk for upper-extremity musculoskeletal disorders (UEMSD). This study will investigate the cross-sectional prevalence and the one-year cumulative incidence and persistence of UEMSD, as defined by self-reported symptoms, within a population of professional musicians belonging to at least two and possibly three musician union(s), representing 1000-1500 members. Active musicians in each union will be asked to complete a mailed questionnaire on physical and psychosocial stressors in both primary (music) and secondary jobs, covering both generic ergonomic exposures and music-specific factors. Other items will include demographics, medical history and UEMSD symptoms. All participants in the first survey will be asked to complete a second questionnaire, one year later. We will estimate the frequency of specific exposures in music and other jobs as well as of UEMSD, and the separate and combined contributions of these exposures in the prevalence, cumulative incidence and persistence of UEMSD, including interactions between physical (biomechanical) and psychosocial factors and effect modification by exposures in secondary jobs. The effects of risk factors will be analyzed among professional musicians as a whole, by type of instrument, type of musical work, duration of years played, and hours per week practiced. The results of this study could be useful in preventing these disorders, by providing information for musicians, administrators of musician organizations/institutions (musician groups, symphonies, unions, conservatories), educators, instrument designers, and health professionals to use in 1. developing and modifying music training programs (i.e., establishing sequence or program of repertoire); 2. incorporating work organization factors in establishing job requirements and practice/work schedules; 3. redesigning instruments or designing external supportive devices or furniture/work space; and 4. enhancing efforts toward appropriate medical treatment and prevention education regarding musicians' UEMSD.