Physical workload and accelerated occurrence of lumbar spine diseases: risk and rate advancement periods in a German multicenter case–control study
| Autor: | Joachim Grifka, Rolf Ellegast, Andreas Seidler, Ulrike Euler, Martina Michaelis, Matthias Jäger, Johannes Haerting, Oliver Kuss, Ulrich Bolm-Audorff |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male epilift medicine.medical_specialty Workload Logistic regression Lumbar Internal medicine Germany Epidemiology risk acceleration medicine risk and rate advancement Humans Risk factor rap Aged Lumbar Vertebrae Exposure Category business.industry Public Health Environmental and Occupational Health case–control study Middle Aged medicine.disease Trunk Confidence interval physical workload Occupational Diseases lumbar disc disease Case-Control Studies Physical therapy Female Spinal Diseases lumbar spine disease Public aspects of medicine RA1-1270 business Lumbar disc disease |
| Zdroj: | Scandinavian Journal of Work, Environment & Health, Vol 37, Iss 1, Pp 30-36 (2011) Scopus-Elsevier |
| ISSN: | 0355-3140 |
| Popis: | Objective In a German multicenter case–control study of lumbar disc diseases, we calculated risk and rate advancement periods (RAP) for physical workload. Methods Patients aged 25–70 years with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were compared with population control subjects (453 males and 448 females). For this analysis, all manual handling of objects of about ≥5 kg and postures with trunk inclination of ≥20 °, as assessed by technical experts, were included in the calculation of cumulative lumbar load, determined by biomechanical model calculations. Logistic regression analysis was applied to calculate RAP, adjusted for region. Results We found a steep positive dose–response relationship between age and lumbar disc narrowing among men as well as women; however, we did not find a monotonic increase in lumbar disc herniation risk with age. As a monotonic increase in disease risk with age constitutes a fundamental assumption underlying the RAP concept, we restricted our RAP analysis to cases with symptomatic lumbar disc narrowing. Among men, there was a positive dose–response relationship between the cumulative lumbar load and the acceleration of lumbar disc narrowing. In the highest exposure category, a RAP of 28.0 years [95% confidence interval (95% CI) 9.7–46.3 years] was found. Among women, the RAP was 8.8 years (95% CI 2.4–15.2 years) in the highest exposure category. Conclusion This study emphasizes the conceptual importance of risk acceleration – causation not only comprises the occurrence of a disease (that without a specific exposure would not have occurred at all) but also the accelerated occurrence of a disease (that without exposure would have occurred later in life). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|