Workplace Ergonomic and Psychosocial Factors in Occupational Back Disorders, Healthcare Utilization, and Lost Time: Cross-Sectional and Prospective Studies

摘要

Occupational back disorders represent a prevalent source of physical disability in active duty U.S. Army soldiers. An analysis of jobs associated with back disability has identified certain military occupations that appear to be at particularly high risk of these disorders. Differences in job-tasks among these military occupations suggest that soldiers in these jobs are potentially exposed to both ergonomic and psychosocial stressors. These physical and psychosocial stressors could contribute to increased levels of exertion, back disorder symptoms, and lost time from work or the need for limited duty assignments. If these exposures continue unabated, it is possible that symptoms can progress into recurrent and/or chronic back disorders and concomitant chronic work disability. The present study is a cross-sectional and prospective investigation in 431 U.S. Army active duty soldiers (248 cases and 183 comparison subjects) of the relationship among ergonomic and psychosocial factors, and individual social problem solving ability, as correlates of back disorder symptoms, and predictors of lost work time, and healthcare utilization. While statistically controlling for potential confounding variables, the study determined the relative contribution of ergonomic and psychosocial factors in the workplace, and their interaction with problem solving ability, on levels of perceived exertion, back symptoms, lost work time, and healthcare utilization. The study found significant effects of ergonomic stressors and the psychosocial work environment associated with case status, however, the hypothesized effects of social problem solving on back disorders and lost time were not supported. Prospectively, symptom severity, length of time in military occupation, and frequency of aerobic exercise were modestly predictive of healthcare utilization.