Occupational mechanical exposures as risk factor for chronic low-back pain: a systematic review and meta-analysis.

IF 4.7 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Scandinavian journal of work, environment & health Pub Date : 2023-10-01 Epub Date: 2023-08-15 DOI:10.5271/sjweh.4114

Alexander Jahn, Johan Hviid Andersen, David Høyrup Christiansen, Andreas Seidler, Annett Dalbøge

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Abstract

Objectives: The association between occupational mechanical exposures and low-back pain (LBP) has been studied in several systematic reviews. However, no systematic review addressing chronic LBP exists. The aim of this systematic review and meta-analysis was to examine the association between occupational mechanical exposures and chronic LBP.

Methods: The study was registered in PROSPERO. We used an existing systematic review to identify articles published before January 2014. For studies published between January 2014 and September 2022, a systematic literature search was conducted in six databases. Two authors independently excluded articles, extracted data, and assessed risk of bias and level of evidence (GRADE). Meta-analyses were conducted using random-effects models comparing highest versus lowest exposure group with sensitivity analyses based on study quality (low/moderate versus high risk of bias), study design (cohort versus case-control), and outcome definition (non-specific LBP versus specific chronic LBP).

Results: Twenty-six articles were included. Highest pooled odd ratios (OR) were found for combined mechanical exposures [OR 2.2, 95% confidence interval (CI) 1.4-3.6], lifting/carrying loads (OR 1.7, 95% CI 1.4-2.2), and non-neutral postures (OR 1.5, 95% CI 1.2-1.9). For the remaining mechanical exposures (ie, whole-body vibrations, standing/walking, and sitting), OR ranged between 1.0 and 1.4. In the sensitivity analyses, generally, higher pooled OR were found in low/moderate risk of bias studies, case-control studies, and studies of specific chronic LBP.

Conclusions: Moderate evidence of an association was found for lifting/carrying loads, non-neutral postures, and combined mechanical exposures. Low or very low evidence was found for whole-body vibrations, standing/walking, and sitting. Studies using standardized exposure definition, metric, and technical measurements are highly warranted.

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职业机械暴露作为慢性腰痛的危险因素：一项系统综述和荟萃分析。

目的：职业性机械暴露与腰痛（LBP）之间的关系已在几项系统综述中进行了研究。然而，目前还没有针对慢性LBP的系统综述。本系统综述和荟萃分析的目的是检验职业机械暴露与慢性LBP之间的关系。方法：该研究在PROSPERO注册。我们使用现有的系统综述来确定2014年1月之前发表的文章。对于2014年1月至2022年9月期间发表的研究，在六个数据库中进行了系统的文献检索。两位作者独立排除了文章，提取了数据，并评估了偏倚风险和证据水平（GRADE）。使用随机效应模型进行荟萃分析，比较最高和最低暴露组，并根据研究质量（低/中度与高偏倚风险）、研究设计（队列与病例对照）和结果定义（非特异性LBP与特异性慢性LBP）进行敏感性分析。结果：纳入26篇文章。组合机械暴露（OR 2.2，95%置信区间（CI）1.4-3.6]）、举重/负重（OR 1.7，95%CI 1.4-2.2）和非中性姿势（OR 1.5，95%CI 1.2-1.9）的合并奇数比（OR）最高。其余机械暴露（即全身振动、站立/行走和坐着）的OR在1.0至1.4之间。在敏感性分析中，通常在低/中度风险的偏倚研究、病例对照研究和特定慢性LBP研究中发现较高的合并OR。结论：在举重/负重、非中性姿势和联合机械暴露中发现了中等程度的关联证据。发现全身振动、站立/行走和坐姿的证据很少或非常少。使用标准化暴露定义、指标和技术测量的研究是非常有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian journal of work, environment & health 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.20

自引率

9.50%

发文量

审稿时长

>12 weeks

期刊介绍： The aim of the Journal is to promote research in the fields of occupational and environmental health and safety and to increase knowledge through the publication of original research articles, systematic reviews, and other information of high interest. Areas of interest include occupational and environmental epidemiology, occupational and environmental medicine, psychosocial factors at work, physical work load, physical activity work-related mental and musculoskeletal problems, aging, work ability and return to work, working hours and health, occupational hygiene and toxicology, work safety and injury epidemiology as well as occupational health services. In addition to observational studies, quasi-experimental and intervention studies are welcome as well as methodological papers, occupational cohort profiles, and studies associated with economic evaluation. The Journal also publishes short communications, case reports, commentaries, discussion papers, clinical questions, consensus reports, meeting reports, other reports, book reviews, news, and announcements (jobs, courses, events etc).