Collaborative Study:Workplace Musculoskeletal Disorders

描述（由申请人提供）：这是一项为期3年的前瞻性研究，涉及来自不同行业、职业和地点的800名员工，以确定暴露于生物力学因素与手、手腕和肘部肌肉骨骼疾病（MSDs）（如上髁炎、手腕肌腱炎和腕管综合征）发展之间的剂量-反应关系。尽管有大量的流行病学数据将各种工作场所因素与上肢msd的发展联系起来，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。公司和工作岗位将成为目标，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择学习。在首次招募和每年招募时，所有参与者将完成以下内容：基线问卷、上肢体检和职业分析。每季度，员工将完成一份简短的调查问卷，如果他们报告的疼痛程度超过阈值，将再次进行体检。如果工作任务发生变化，将重复进行工作分析。预计第一次实地考察将征聘约650名雇员，后续考察将征聘另外150名新雇员。将使用Cox比例风险模型检查暴露与特定和综合肌肉骨骼疾病发展之间的关系，该模型控制了历史和重要的协变量（例如，性别、年龄、社会心理因素）。将评估这些数据的剂量-反应和阈值关系。参与的员工将被告知体检结果，雇主和员工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盟协调。

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.