Collaborative Study:Workplace Musculoskeletal Disorders

描述(申请人提供)：这是一项为期3年的前瞻性研究，涉及不同行业、职业和地点的800名员工，以确定暴露于生物力学因素与手部、手腕和肘部肌肉骨骼疾病(MSD)发展之间的剂量-反应关系，如上髁炎、手腕肌腱炎和腕管综合征。虽然有大量的流行病学数据将各种工作场所因素与上肢MSD的发生联系起来，但生物力学因素与特定疾病之间的剂量-反应关系尚未得到很好的表征。这些数据对于雇主、雇员和政府机构制定最有效的预防策略至关重要。公司和工作将成为目标，以实现生物力学风险因素暴露水平的分布。一般来说，稳定的、单一任务的工作将被选为学习对象。在最初招聘时，然后每年将为所有参与者完成以下工作：基线调查问卷、侧重于上肢的体检和工作分析。每季度，员工将完成一份简短的问卷调查，如果他们报告的疼痛程度超过门槛，就会重复体检。如果工作任务发生变化，将重复进行工作分析。预计将在第一次实地考察时招聘约650名雇员，在后续考察中再征聘150名新雇员。将使用控制历史和重要协变量(例如，性别、年龄、心理社会因素)的COX比例风险模型来研究暴露与特定和集合的肌肉骨骼疾病的发展之间的关系。将对数据进行剂量-反应和阈值关系的评估。参与的雇员将被告知体检结果，雇主和雇员将被告知最终的研究结果。研究方法、仪器和数据格式将与NIOSH与工作相关的肌肉骨骼疾病联合会协调。

DESCRIPTION (provided by applicant): This is a 3-year prospective study of 800 employees across a variety of industries, occupations and locations to determine the dose-response relationships between exposure to biomechanical factors and the development of hand, wrist, and elbow musculoskeletal disorders (MSDs), such as epicondylitis, wrist tendonitis and carpal tunnel syndrome. Although there is a substantial body of epidemiologic data linking various workplace factors to the development of upper extremity MSDs, the dose-response relationships between biomechanical factors and specific disorders are not well characterized. This data is critical for employers, employees and government agencies in order to establish the most effective prevention strategies. Companies and jobs will be targeted to achieve a distribution of exposure levels to biomechanical risk factors. Generally, stable, monotask jobs will be selected for study. At initial recruitment and then annually the following will be completed for all participants: baseline questionnaire, physical examination focused on the upper extremity, and a job analysis. On a quarterly basis, employees will complete a brief questionnaire and if their reported pain level is above a threshold, the physical exam will be repeated. If the job tasks change the job analysis will be repeated. It is anticipated that approximately 650 employees will be recruited on first site visit with an additional 150 new hires recruited at follow-up visits. The relationships between exposures and the development of specific and pooled musculoskeletal disorders will be examined using a Cox proportional hazards model controlling for historical and significant covariates (e.g., gender, age, psychosocial factors). The data will be evaluated for dose-response and threshold relationships. Participating employees will be notified of physical exam findings and employers and employees will be notified of the final study findings. Study methods, instruments, and data format will be coordinated with the NIOSH Work-related Musculoskeletal Disorders Consortium.