Risk Factors for Musculoskeletal Disorders肌肉骨骼疾病的心理社会危险因素课件.pptVIP

Institute for Work Health A Case-Control Study of Biomechanical and Psychosocial Risk Factors for Occupational Low-Back Pain Michael S. Kerr, PhD Institute for Work Health Toronto, Ontario, CANADA Study Collaborators Why a case-control study? Research Question Study Weaknesses Possible Biological Mechanisms Institute for Work Health, 2001 8 PREMUS 2001, Amsterdam Kerr et al. (2001) Am J Pub Health 91:1069-1075 Institute for Work Health: Kerr MS, Frank JW, Shannon HS, Bombardier C University of Waterloo: Norman RW, Wells RW, Neumann P General Motors: Mr. Elmer Beddome CAW: Mr. John Graham The Ontario Universities Back Pain Study (OUBPS) Group Andrews D, Beaton DE, Dobbyn M, Edmonstone E, Ferrier S, Hogg-Johnson S, Ingelman P, Mondlock M, Peloso P, Smith J, Stanfield SA, Tarasuk V, Woo H Uncertainty about role of physical demands necessitated concentration of effort on developing valid workplace measures Cohort model required multiple measures at multiple times to assess valid exposure Does a prospective cohort study with limited (e.g. once only) exposure assessment really provide more rigorous evidence than a case-control study with more detailed assessments? After controlling for individual characteristics, what are the main work-related biomechanical and psychosocial risk factors for reported low-back pain? The GM Study of Low-back Pain baseline questionnaire and physical exam 10,000 car and truck plant workers (hourly-paid) random selection (job-matched) accrued via workplace health stations conducted at home physical demands assessment CASES workers without LBP STUDY POPULATION workers with LBP CONTROLS Incidence density sampling at work doing usual job video, EMG, checklists, posture (n=137) (n=179) (n2=65) How did we control for Bias? Directly measured physical demands data rather than self-report Job-matched controls used to examine potential recall bias (none observed) Used newly incident cases rather than prevalent cases Compared ca