Suchergebnisse

Objectives: To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course. Design: A longitudinal and cross-sectional study. Setting: A nationwide health survey supplemented with data from records of prior compulsory military service. Participants: Premilitary health records (baseline) were searched for men aged 30–50 years (n=1385) who participated in a national health examination survey (follow-up). Methods and outcome measures: Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica. Results: Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m2) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m2). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP. Conclusions: Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.

OBJECTIVE: The Scandinavian Journal of Work, Environment & Health (SJWEH) was established half a century ago. This paper provides an overview of research on musculoskeletal disorders (MSD) published over these 50 years. Three themes are described: risk assessment, interventions to prevent work-related MSD, and interventions to support work participation. Finally, implications for future research are highlighted.
METHODS: A systematic literature search was performed for all papers on MSD published in SJWEH. Each paper was coded on several criteria including research topic, type of MSD, risk factor(s), and number of citations. Findings were tabulated, and discussions within the author team defined the main results and future research directions.
RESULTS: The search resulted in 1056 papers, of which 474 were included. The most reported-on MSD was low-back pain (LBP, 18%) and the most reported-on work-related risk factors were physically demanding work (14%) and psychosocial factors (12%). Research has contributed to improving case definitions, refining work-related exposure criteria, and recognizing the varying importance of physical and psychosocial factors across different MSD. Research on the association between work-related risk factors and LBP continues to emerge. Effective interventions for prevention of MSD are characterised by sufficient exposure reduction, while supporting work participation requires integrating health care, with multidisciplinary actions directed at factors involving the worker, employer, and workplace.
CONCLUSION: Research has provided valuable insights into risk assessment, interventions for preventing work-related MSD, and supporting work participation. Intervention studies remain warranted and new areas include adopting whole-system approaches to prevent work-related MSD and promoting the concept of musculoskeletal health.

Abstract

Objective
Within the scope of the Exposome Project for Health and Occupational Research on applying the exposome concept to working life health, we aimed to provide a broad overview of the status of knowledge on occupational exposures and associated health effects across multiple noncommunicable diseases (NCDs) to help inform research priorities.


Methods
We conducted a narrative review of occupational risk factors that can be considered to have "consistent evidence for an association," or where there is "limited/inadequate evidence for an association" for 6 NCD groups: nonmalignant respiratory diseases; neurodegenerative diseases; cardiovascular/metabolic diseases; mental disorders; musculoskeletal diseases; and cancer. The assessment was done in expert sessions, primarily based on systematic reviews, supplemented with narrative reviews, reports, and original studies. Subsequently, knowledge gaps were identified, e.g. based on missing information on exposure–response relationships, gender differences, critical time-windows, interactions, and inadequate study quality.


Results
We identified over 200 occupational exposures with consistent or limited/inadequate evidence for associations with one or more of 60+ NCDs. Various exposures were identified as possible risk factors for multiple outcomes. Examples are diesel engine exhaust and cadmium, with consistent evidence for lung cancer, but limited/inadequate evidence for other cancer sites, respiratory, neurodegenerative, and cardiovascular diseases. Other examples are physically heavy work, shift work, and decision latitude/job control. For associations with limited/inadequate evidence, new studies are needed to confirm the association. For risk factors with consistent evidence, improvements in study design, exposure assessment, and case definition could lead to a better understanding of the association and help inform health-based threshold levels.


Conclusions
By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review will help setting priorities in occupational health research. Future epidemiological studies should prioritize to include large sample sizes, assess exposures prior to disease onset, and quantify exposures. Potential sources of biases and confounding need to be identified and accounted for in both original studies and systematic reviews.