Determinants of Multisite Musculoskeletal Pain Among Construction Workers

描述（由申请人提供）：基于人群的研究表明，多部位肌肉骨骼疼痛可能比单一解剖部位疼痛更常见。与单部位疼痛相比，多部位肌肉骨骼疼痛在短期和长期病假、工作能力丧失和功能能力方面的后果更严重。我们所知甚少， 然而，随着时间的推移，什么因素会影响多部位肌肉骨骼疼痛的严重程度，特别是在建筑工人谁是暴露在艰苦的精神和危险的身体工作环境。在建筑工人中，需要进行重复测量的纵向研究，以更好地了解多部位肌肉骨骼急性和慢性疼痛的发生和过程及其严重程度，以及其与职业和非职业风险因素的关系。对于这个为期三年的指导研究科学家发展K奖培训期，在我的K01导师团队的指导下，我提出了以下培训和研究计划：1）一个战略性的五管齐下的培训方法，以学习如何设计和实施工作场所健康干预措施，2）作为本申请的研究目标，通过为期一年的前瞻性队列研究收集试点数据， 建筑工人中多部位肌肉骨骼急性和慢性疼痛的发生率。该研究提案有两个具体目标：具体目标1a：设计并实施一项为期1年的前瞻性队列研究，纳入350名新英格兰建筑工人，使用经验证的调查工具，通过解剖部位和疼痛严重程度以及职业风险因素来测量自我报告的肌肉骨骼疼痛的主要结局（即体力工作量、人体工程学使用、组织/工地政策和做法）和非职业风险因素（即工人健康行为和人口统计学、健康状况、心理社会因素）和缺勤目标1b：记录队列研究的可行性，包括每个建筑工地邀请和招募的建筑工人的数量和类型的指标;工人入组和保留到队列研究中;以及队列中失访;以及目标1c：使用队列数据，我将提供全面的描述性统计量，并估计基线、6个月和12个月随访时多部位肌肉骨骼急性和慢性疼痛位置和严重程度的总体发生率和患病率。具体目标二：从建筑工人队列中收集的数据将用于估计广义线性混合模型，以检查基线时职业和非职业风险因素之间在预测自我报告的多部位肌肉骨骼疼痛发生位置、严重程度和影响方面的前瞻性关联。拟议工作的预期成果是初步数据，以告知设计的干预，纳入了NIOSH的总工人健康"框架，以减少肌肉骨骼疼痛的建筑工人。研究结果预计将对肌肉骨骼健康产生重要的积极影响，因为研究人员可以在将职业健康和安全活动与工作场所健康促进相结合时修改某些职业和个人工人水平的因素。

DESCRIPTION (provided by applicant): Population-based studies have shown that multisite musculoskeletal pain can be more common than single anatomic site pain. The consequences of multisite musculoskeletal pain are more severe when compared with single site pain in terms of short- and long-term sickness absence, work disability, and functional ability. Little is known, however, about what factors influence multisite musculoskeletal pain severity over time particularly in construction workers who are exposed to strenuous mental and hazardous physical work environments. In the construction workforce, there is a need for longitudinal studies with repeated measurements to better understand the occurrence and course of multisite musculoskeletal acute and chronic pain and its severity, as well as its association to occupational and non-occupational risk factors. For this three-year Mentored Research Scientist Development K-Award training period, and with the guidance of my K01 mentorship team, I propose the following training and research plan: 1) a strategic five prong training approach to learn how to design and implement workplace health interventions, and 2) as the research objective of this application, collect pilot data through a 1- year prospective cohort study on the occurrence of multisite musculoskeletal acute and chronic pain among construction workers. The research proposal has two specific aims: Specific Aim 1a: Design and implement a 1- year prospective cohort study of 350 New England construction workers that will use validated survey instruments, to measure the main outcome of self-reported musculoskeletal pain by anatomic location and pain severity, as well as occupational risk factors (i.e. physical workload, ergonomic use, organizational/worksite policies and practices) and non-occupational risk factors (i.e. worker health behaviors and demographics, health conditions, psychosocial factors) and absenteeism (secondary outcome measure) at baseline, 6-month and 12-month follow up time periods; Aim 1b: Document cohort study feasibility including metrics on the number and type of construction workers invited and recruited per construction site; the enrollment and retention of workers into the cohort study; and the loss to follow up in the cohort; and Aim 1c: Using the cohort data, I will provide comprehensive descriptive statistics and estimate the incidence and prevalence of multisite musculoskeletal acute and chronic pain location and severity overall at baseline, 6-month, and 12-month follow up. Specific Aim 2: Data collected from the cohort of construction workers will be used to estimate generalized linear mixed models to examine the prospective association between occupational and non-occupational risk factors at baseline on predicting the occurrence of self-reported multisite musculoskeletal pain location, severity and impact. The expected outcome of the proposed work is preliminary data to inform the design of an intervention that incorporates a NIOSH Total Worker Health" framework to reduce musculoskeletal pain in construction workers. The results are expected to have an important positive impact on musculoskeletal health, because researchers can modify certain occupational and individual worker-level factors when integrating occupational health and safety activities with workplace health promotion.