中国不同职业人群下背痛归因于工效学危险因素的疾病负担  

Disease burden of low back pain attributable to ergonomic risk factors in selected Chinese occupational groups

作　　者：周芳 刘孟双 赖嘉怡 金克峙[1] ZHOU Fang;LIU Mengshuang;LAI Jiayi;JIN Kezhi(School of Public Health/Key Laboratory of Public Health and Safety of Ministry of Education,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学,公共卫生学院/公共卫生安全教育部重点实验室,上海200032

出　　处：《环境与职业医学》2022年第12期1319-1328,共10页Journal of Environmental and Occupational Medicine

基　　金：上海市三年公共卫生行动计划项目(GWV-10.1-XK11)。

摘　　要：[背景]近半个世纪以来,随着工作场所中存在的物理化学危害因素及其相关不良健康结局得到有效控制,与涉及工作操作的工效学危险因素相关的下背痛(LBP)的患病和疾病负担则越来越受到重视,并成为全球重要的公共卫生问题之一。[目的]定量估计中国两类职业人群LBP健康损失及其工效学危险因素归因疾病负担,为制定合理有效的工作场所LBP预防和控制政策提供参考依据。[方法]基于全球疾病负担研究(GBD)的方法框架,应用meta分析总结按设定标准纳入的文献,估计2013年中国两类职业人群(包括专业技术及专业辅助人员,简称专技组;工厂机械操作工及装配工,简称操作组)不同年龄组LBP的患病率,结合GBD 2019提供的相关流行病学参数(包括伤残权重、缓解率和发病率),使用DisMod II软件估算平均病程和发病年龄,计算2013年中国两类职业人群LBP及其归因于工效学危险因素所致的伤残损失寿命年(YLD)和伤残调整寿命年(DALY)等,并与2013年GBD的研究结果进行比较。[结果]经DisMod II软件调整后,计算得到2013年中国专技组LBP的患病率为13.00%(其中男性11.25%,女性14.84%),操作组LBP的患病率为14.80%(其中男性13.56%,女性16.10%),患病率均随年龄的增长而增加。专技组与LBP相关的疾病负担的DALY率为8.02‰(其中男性7.68‰,女性8.33‰)。操作组与LBP相关的疾病负担的DALY率为10.34‰(其中男性10.30‰,女性10.44‰),DALY率均随年龄的增加呈整体上升的趋势。2013年专技组的工效学危险因素对LBP的归因分值为11.42%,操作组为29.17%。专技组归因于工效学危险因素的LBP的DALY为4498人年(其中男性为2108人年),45~49岁组最高(951人年);平均归因DALY率为0.92‰。操作组归因DALY为48529人年,其中男性为33046人年,40~44岁组最高(10852人年);平均归因DALY率为3.02‰。在20岁及以上年龄组中,两类职业人群LBP相关DALY率(专技组:8.06‰,�[Background]As traditional chemical and physical hazards as well as associated adverse health outcomes in workplace were wildly controlled in the past half century,the prevalence and disease burden of low back pain(LBP)have drawn more and more attention and become one of the important public health problems in the world.[Objective]To analyze the health loss and attributable disease burden of ergonomic risk factors for LBP in two major categories of occupations in China,aiming to provide evidence for formulating effective prevention and control policies of LBP in the workplace.[Methods]Based on the methodological framework of the Global Burden of Disease Study(GBD),a meta-analysis was firstly applied to summarize relevant literature results and estimate the prevalence of LBP in two occupational groups(including technicians and associate professionals and machine operators and assemblers)by different age groups in China.Then important epidemiologic parameters(including disability weight,remission rate,and incidence)from GBD 2019 were used to estimate mean duration of disease and age at onset using DisMod II software,and to calculate health loss indexes in the selected occupational groups in China in 2013,such as years lived with disability(YLD)and disability-adjusted life year(DALY)of LBP and its attributable fractions by ergonomic risk factors,which were compared to the outcome of GBD 2013.[Results]After the adjustment by DisMod II,the prevalence rate of LBP was 13.00%in technicians and associate professionals(11.25%for males and 14.84%for females)and 14.80%in machine operators and assemblers(13.56%for males and 16.10%for females)in 2013,which increased with age.The DALY rate of LBP was 8.02‰in technicians and associate professionals(7.68‰for males and 8.33‰for females)and 10.34‰in machine operators and assemblers(10.30‰for males and 10.44‰for females),which also showed an overall increasing trend with age.In 2013,the population attributable fraction(PAF)of ergonomic risk factors to LBP was 11.42%in te

关 键 词：工效学危险因素 下背痛 患病率 归因疾病负担 伤残调整寿命年 

分 类 号：R135[医药卫生—劳动卫生]