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首页> 外文期刊>Occupational and environmental medicine >The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints.
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The role of cumulative physical work load in lumbar spine disease: risk factors for lumbar osteochondrosis and spondylosis associated with chronic complaints.

机译：累积体力劳动负荷在腰椎疾病中的作用：与慢性病有关的腰椎骨软骨病和脊椎病的危险因素。

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OBJECTIVES: To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending. METHODS: From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc herniation. A total of 197 control subjects was recruited: 107 subjects with anamnestic exclusion of lumbar spine disease were drawn as a random population control group and 90 patients admitted to hospital for urolithiasis who had no osteochondrosis or spondylosis of the lumbar spine radiographically were recruited as a hospital based control group. Data were gathered in a structured personal interview and analysed using logistic regression to control for age, region, nationality, and other diseases affecting the lumbar spine. To calculate cumulative forces to the lumbar spine over the entire working life, the Mainz-Dortmund dose model (MDD), which is based on an overproportional weighting of the lumbar disc compression force relative to the respective duration of the lifting process was applied with modifications: any objects weighing >or=5 kg were included in the calculation and no minimum daily exposure limits were established. Calculation of forces to the lumbar spine was based on self reported estimates of occupational lifting, trunk flexion, and duration. RESULTS: For a lumbar spine dose >9 x 10(6) Nh (Newton x hours), the risk of having radiographically confirmed osteochondrosis or spondylosis of the lumbar spine as measured by the odds ratio (OR) was 8.5 (95% confidence interval (95% CI) 4.1 to 17.5) compared with subjects with a load of 0 Nh. To avoid differential bias, forces to the lumbar spine were also calculated on the basis of an internal job exposure matrix based on the control subjects' exposure assessments for their respective job groups. Although ORs were lower with this approach, they remained significant. CONCLUSIONS: The calculation of the sum of forces to the lumbar spine is a useful tool for risk assessment for symptomatic osteochondrosis or spondylosis of the lumbar spine. The results suggest that cumulative occupational exposure to lifting or carrying and extreme forward bending increases the risk for developing symptomatic osteochondrosis or spondylosis of the lumbar spine.
机译：目的：探讨有症状的骨软骨病或腰椎病与累积的职业暴露于抬高或搬运以及极端向前弯曲的工作姿势之间的关系，进行病例对照研究。方法：从两个诊所和四个诊所中招募了229名经X线摄影证实为慢性软骨病或腰椎病的男性患者。其中135例还患有急性腰椎间盘突出症。总共招募了197名对照受试者：随机抽取107名腰椎病遗忘患者作为随机人群对照组，并通过影像学方法将90名因尿路结石入院但无骨软骨病或腰椎脊柱病的患者入选医院。基础的对照组。在结构化的个人访谈中收集数据，并使用逻辑回归分析以控制年龄，区域，国籍和其他影响腰椎的疾病。为了计算整个工作过程中对腰椎的累积力，对Mainz-Dortmund剂量模型（MDD）进行了修正，该模型基于腰椎间盘压缩力相对于提升过程各自持续时间的过比例加权：任何重量大于或等于5千克的物体都包括在计算中，并且没有设定最低每日暴露极限。腰椎受力的计算是基于自我报告的职业举重，躯干屈曲和持续时间的估计。结果：对于腰椎剂量大于9 x 10（6）Nh（牛顿x小时）的患者，通过比值比（OR）进行影像学证实的腰椎骨软骨病或脊椎病的风险为8.5（95％置信区间（95％CI）4.1至17.5），而负重为0 Nh的受试者。为避免差异偏见，还基于内部工作暴露矩阵，根据对照组受试者对各自工作组的暴露评估，计算了对腰椎的作用力。尽管使用此方法的OR较低，但它们仍然很重要。结论：腰椎受力总和的计算是评估症状性腰椎病或腰椎病的有用工具。结果表明，累积的职业性暴露于提举或搬运以及极端向前弯曲会增加患上症状性骨软骨病或腰椎病的风险。

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