Musculoskeletal Disorders and Health Behaviors among US Workers

描述（由申请人提供）：肌肉骨骼疾病（MSD）包括各种炎症和退行性疾病，在所有报告和/或可补偿的工作相关疾病中占很大比例，导致美国大量工作日损失和医疗保健利用。MSD具有多种相互关联的职业和非职业风险因素，如重复性创伤、肥胖、吸烟和体力活动。虽然MSDs和工伤之间的关系已经得到了全面的表征，但尚未研究使用大型全国代表性人口数据库对工人健康行为的检查。利用1997 - 2007年国民健康访谈调查和1996 - 2007年医疗费用小组调查，将检验以下具体目的和假设：1。按职业/行业、年龄、性别、人种和种族记录并比较所有美国工人、青年工人和老年工人特定肌肉骨骼疾病（MSD）的患病率、趋势和地理变异。2.评估工人健康行为（体力活动模式，肥胖，饮酒和烟草暴露）与职业和国家职业研究议程（诺拉）行业部门报告的肌肉骨骼疾病之间的关系。3.使用按职业和诺拉行业划分的质量调整生命年（QQQRS），估计肌肉骨骼疾病对健康相关生活质量的影响。研究美国工人职业，健康行为（体力活动模式，肥胖和烟草暴露），健康相关的生活质量，经济影响和肌肉骨骼疾病的地理位置之间的关联，对于我们了解其当前和未来对医疗保健和公共卫生系统的潜在影响至关重要。随着老年人在未来几年继续或重新进入劳动力市场，以工作场所为基础的人体工程学和肌肉骨骼疾病健康促进将成为接触老年人和新进入工作的成年人的越来越重要的场所。虽然在这一领域几乎没有完成研究，但少数民族F31申请的目标是检查这些协会，这些协会为工作场所战略提供信息，以满足有肌肉骨骼疾病风险的工人群体的独特需求。公共卫生相关性：作为一个非传统的学位寻求DO/博士生，我的总体职业目标是发展成为一个全面的医生科学家。我有兴趣在肌肉骨骼流行病学方面发展职业生涯，特别关注人体工程学和职业风险因素，包括与健康相关的生活质量措施。作为一名流行病学家，我也对一级和二级预防计划的发展感兴趣，以提高人们对风湿性疾病对肌肉骨骼疾病发病率和死亡率的贡献的认识。Kirschstein-NRSA F31少数民族学生个人奖学金将成为我在学术流变学和流行病学方面发展富有成效的职业生涯的平台，重点是调查与大规模人群中的肌肉骨骼疾病相关的因素。在这个奖学金期间，在我的导师Lora Fleming博士、大卫李博士和罗伯特霍夫曼博士的帮助下，我将获得许多流行病学和肌肉骨骼疾病的宝贵技能和应用。首先，我将学习如何使用来自大型临床可用数据集的数据来检查肌肉骨骼疾病。其次，我将学习重建数据，选择相关的变量，并使用先进的统计软件包进行数据分析。最后，我将从临床和流行病学的角度深入了解职业健康和肌肉骨骼疾病。这个NRSA少数民族学生奖学金培训将使我能够扩大我的知识和技能需要在肌肉骨骼和职业流行病学领域。

DESCRIPTION (provided by applicant): Musculoskeletal disorders (MSDs) include a wide range of inflammatory and degenerative conditions and they constitute a major proportion of all reported and/or compensable work-related diseases contributing to substantial numbers of lost work days and medical care utilization in the United States. MSDs have multiple and inter-connected risk factors, both occupational and non-occupational, such as repetitive trauma, obesity, smoking, and physical activity. While the relationship between MSDs and work-related injuries has been comprehensively characterized, examination of worker health behaviors using a large nationally representative population database has not been studied. Using the 1997-2007 National Health Interview Survey and the 1996-2007 Medical Expenditure Panel Survey the following Specific Aims and Hypotheses will be examined: 1. Document and compare the prevalence, trends, and geographical variation of specific musculoskeletal disorders (MSDs) for all US workers, youth workers and older workers by occupation/industry, age, gender, race, and ethnicity. 2. Assess the relationship between worker health behaviors (physical activity patterns, obesity, alcohol use, and tobacco exposure) with reported musculoskeletal disorders by occupation and National Occupational Research Agenda (NORA) Industry sector. 3. Estimate the health-related quality of life effects of having musculoskeletal disorders using Quality Adjusted Life Years (QALYS) by occupation and NORA Industry sector. Examining the under-explored associations between US Worker occupation, health behaviors (physical activity patterns, obesity, and tobacco exposure), health-related quality of life, economic impact and geographical location of musculoskeletal disorders is paramount to our understanding of their current and potential future impact on the health care and public health systems. As older adults remain in or re-enter the workforce in the coming years, worksite-based health promotion of ergonomic and musculoskeletal disorders will become an increasingly important venue for reaching older and newly entering working adults. Although little research has been completed in this area, it is the goal of this Minority F31 Application to examine these associations that inform workplace strategies to meet the unique needs of worker populations at-risk for musculoskeletal disorders. PUBLIC HEALTH RELEVANCE: As a non-traditional degree seeking DO/PhD student, my overall career goal is to develop into a well-rounded physician-scientist. I am interested in developing a career in musculoskeletal epidemiology with a particular focus on ergonomic and occupational risk factors including health-related quality of life measures. As an epidemiologist, I am also interested in the development of primary and secondary prevention programs to increase awareness of the rheumatic contributions to the morbidity and mortality of musculoskeletal disorders. The Kirschstein-NRSA F31 Individual Fellowship for Minority students will serve as a platform for me to develop a productive career in academic rheumatology and epidemiology, with an emphasis on investigating factors that are associated with musculoskeletal disorders in large populations. During this fellowship, with the assistance of my mentors, Drs Lora Fleming, David Lee and Robert Hoffman, I will garner many valuable skills and applications of epidemiology and musculoskeletal disorders. First, I will learn how to use data from large publically available datasets to examine musculoskeletal disorders. Secondly, I will learn to reconstruct data, select pertinent variables, and conduct data analyses using advanced statistical software packages. Lastly, I will develop an in-depth knowledge of occupational health and musculoskeletal disorders from both a clinical and epidemiologic point of view. This NRSA minority student fellowship training will enable me to expand my knowledge and skills needed in the fields of musculoskeletal and occupational epidemiology.