Environmental-Wide Association Study of Job Families Related to Musculoskeletal Disorders

摘要

Background: Musculoskeletal disorders (MSDs) are a leading cause of absenteeism that impact productivity. An environmental-wide association study (EWAS) is a computational approach to systematically evaluate multiple factors for potential associations with a specific outcome adapted from the genome-wide association study (GWAS) method. We examined job titles grouped by function for potential associations with MSD among U.S.-based workers of a global company. Methods: Eligibility and MSD status were determined from health insurance claims data from 2006 through 2011. Employees were categorized as ever having any MSD according to the presence of at least one claim for a list of conditions corresponding to ICD-9 codes. We fitted logistic regression models by calendar year with MSD as a dichotomous outcome to evaluate associations across 38 job families, defined as multiple job titles grouped by a similar function. Estimated odds ratios (OR) adjusting for age, sex, race, and pay type indicated the association between MSD claims and job families relative to no MSD claim during a calendar year. Results: Eligible workers (n=18,244) were predominantly white (81%) and male (73%). The annual average proportion of employees who had at least one MSD-related claim was 43% during the 5-year period of analysis. Female employees were more likely to have an MSD-related claim than males (p＜0.01). Increased odds of an MSD were estimated for job families in production and maintenance (OR=1.1, p=0.02) and sales (OR=1.2, p=0.01). Decreased odds of an MSD were observed for job families in engineering (OR=0.8, p=0.02) and senior management (OR=0.7, p=0.03). Conclusion: Cross-sectional associations between MSDs are reported for 38 job families. Four job families had significant associations with MSD claims for more than one calendar year. The EWAS approach is helpful for assessing the general distribution of MSD prevalence among a large number of job families over multiple calendar years.