336 Risk factors for new-onset sciatica in Japanese workers: Findings from the Japan epidemiological research of occupation-related back pain (JOB) study

Abstract

Objectives To explore whether neurophysiologically confirmed carpal tunnel syndrome (CTS) has different risk factors from sensory symptoms in the hand that occur in the absence of impaired median nerve conduction. Methods We compared 475 patients with neurophysiologically confirmed (NP+ve) CTS, 409 patients investigated for CTS but negative on neurophysiological testing (NP-ve), and 799 controls. Exposures to risk factors were ascertained by self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Results NP+ve CTS was associated with obesity, use of vibratory tools, repetitive movement of the wrist or fingers, poor mental health and workplace psychosocial stressors. NP-ve illness was also related to poor mental health and occupational psychosocial stressors, but differed from NP+ve disease in showing associations also with prolonged use of computer keyboards and tendency to somatise, and no relation to obesity. In direct comparison of NP+ve relative to NP-ve cases, the most notable differences were for obesity (OR 2.7, 95% CI 1.9-3.9), somatising tendency (OR 0.6, 95% CI 0.4-0.9), diabetes (OR 1.6, 95% CI 0.9-3.1) and work with vibratory tools (OR 1.4, 95% CI 0.9-2.2). Conclusions When viewed in the context of earlier research, our findings suggest that obesity, diabetes, use of hand-held vibratory tools, and repeated forceful movements of the wrist and hand are causes of impaired median nerve function. In addition, sensory symptoms in the hand, whether from identifiable pathology or non-specific in origin, may be rendered more prominent and distressing by hand activity, low mood, tendency to somatise, and psychosocial stressors at work. Objective Determine long-term efficacy of a comprehensive, multi-facility ergonomic intervention, utilising patient handling devices and participatory approach, on patient handling injuries to nursing personnel and comfort and safety of patients. Background Musculoskeletal injuries (MSDs), in particular back and shoulder injuries, are a major problem for nursing personnel in patient care. In USA, nursing aides (NAs) have the highest incidence rate of days-away from-work injuries and illnesses (465/10,000 workers) from MSDs, a rate more than seven times the national MSD average for all occupations. The majority of injuries and illnesses (56%) among NAs involved contact with patients, with 86% of those injuries due to overexertion. Methods A pre-post design (pre: 38.9 months, post: 51.2 months) was used to evaluate the efficacy of an ergonomic intervention using patient handling devices in six long-term care facilities and one chronic care hospital. Each facility formed teams consisting of: worker representatives, management, and an ergonomic specialist. These teams developed comprehensive ergonomics programs using participatory approach to reduce patient handling injuries, primarily through implementation of "no-manual-lifting-policies". Results Compared to pre-intervention, post-intervention data showed sig...

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

“…The search strategy identified 7,765 unique studies that were all screened based on title and abstract, and resulted in 81 potentially eligible studies. Sixty-two studies were excluded based on full-text screening and, therefore, 19 articles (reporting data from 16 studies) were included in the review (6)(7)(8)(9)(10)(11)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Two published articles (20,22) reported findings of the same study and were both included in the review, as they provided results for different time points.…”

“…The samples were recruited from the general population in 13 articles (6)(7)(8)19,21,(23)(24)(25)(26)(27)(28)(29)(30) and from a workplace in 6 articles (9)(10)(11)18,20,22). The assessment of symptoms of depression varied across the studies, but overall they could be categorized into 3 groups: diagnostic interview, self-report screening questionnaires, and nonspecific screening questionnaires (questionnaires that assessed more general categories of psychological distress, including but not limited to, symptoms of depression).…”

“…Our pooled analyses are based on summary data from 11 studies (6,8,11,19,23,(25)(26)(27)(28)(29)(30). Two studies reported ORs from continuous data and were not included in the pooled analysis, as all the other 11 studies reported ORs from categorical data (9,10).…”

“…One of the recurring questions that is still unanswered is whether depression is a risk factor for LBP. Some studies have found depression to be associated with an increased risk of developing LBP (6)(7)(8), while other studies have failed to show a significant association (9)(10)(11). Previous reviews investigating the role of psychological variables in LBP have shown evidence of depression as a predictor of poor outcomes, such as chronicity, disability, and work absenteeism (12)(13)(14).…”

Effort‐reward Imbalance and Low Back Pain among Eldercare Workers in Nursing Homes: A Cross‐sectional Study in Kagawa Prefecture, Japan

“…Regardless of the response to the above question, we measured previous LBP experience. Previous LBP experience is reportedly a risk factor for LBP among Japanese workers 4) .…”