Occupational risk factors for activity limiting musculoskeletal impairments in the United States adult population

Abstract

There has not been a comprehensive assessment of all occupations as risk factors associated with musculoskeletal disorders in US. This population-based complex survey study uses the National Health Interview Survey data collected during the period from 2004 to 2008 that randomly sampled non-institutionalized adults of the United States (US), applying weights necessary to make accurate population prevalence estimates. Musculoskeletal impairment was self-reported; occupation categories were based on US census bureau coding of Standard Occupation Classification. A sample of 22,635 subjects 18 years of age or older were included in the study. Based on weighted data, certain occupations are significantly associated with arthritis/rheumatism (p<0.001). Healthcare support, healthcare practitioners and technical occupations have the highest prevalence (30.1%), followed by military (29.7%), production (27.5%), and farming/fishing/forestry (27.2%). Similarly, certain occupations are significantly associated with back/neck problems (p<0.001), with the highest prevalence occurring in protective service (28.5%), followed by construction and extraction (28.3%), farming/fishing/forestry (28.2%), military (26.8%), and installation/maintenance/repair (26.7%). After controlling for age, gender and race, compared with a reference group of respondents working in architecture and engineering, respondents working in the military were 2.9 times (95% CI 1.6-5.4) more likely to develop arthritis/rheumatism, while the likelihood of developing arthritis/rheumatism was 2.4 times higher (95% CI 1.5-4.1) in construction and extraction, and 2.1 times higher (95% CI 1.3-3.5) in installation/maintenance/repair. Individuals working in the military have the highest risk of developing back/neck problems, with an elevated likelihood of 2.1 times (95% CI 1.2-3.9), followed by arming/fishing/forestry with 2.0 times increase (95% CI 1.2-3.4), and construction and extraction with 1.9 times increase (95% CI 1.2-2.9). The findings of this study suggest that major musculoskeletal impairments are associated with physically demanding occupations. Impairment prevention as a part of provisional rehabilitation should use this information to identify individuals who work in a high risk occupation. There has not been a comprehensive assessment of all occupations as risk factors associated with musculoskeletal disorders in US. This population-based complex survey study uses the National Health Interview Survey data collected during the period from 2004 to 2008 that randomly sampled non-institutionalized adults of the United States (US), applying weights necessary to make accurate population prevalence estimates. Musculoskeletal impairment was self-reported; occupation categories were based on US census bureau coding of Standard Occupation Classification. A sample of 22,635 subjects 18 years of age or older were included in the study. Based on weighted data, certain occupations are significantly associated with arthritis/rheumatism (p<0.001). Healthcare support, healthcare practitioners and technical occupations have the highest prevalence (30.1%), followed by military (29.7%), production (27.5%), and farming/fishing/forestry (27.2%). Similarly, certain occupations are significantly associated with back/neck problems (p<0.001), with the highest prevalence occurring in protective service (28.5%), followed by construction and extraction (28.3%), farming/fishing/forestry (28.2%), military (26.8%), and installation/maintenance/repair (26.7%). After controlling for age, gender and race, compared with a reference group of respondents working in architecture and engineering, respondents working in the military were 2.9 times (95% CI 1.6-5.4) more likely to develop arthritis/rheumatism, while the likelihood of developing arthritis/rheumatism was 2.4 times higher (95% CI 1.5-4.1) in construction and extraction, and 2.1 times higher (95% CI 1.3-3.5) in installation/maintenance/repair. Individuals working in the military have the highest risk of developing back/neck problems, with an elevated likelihood of 2.1 times (95% CI 1.2-3.9), followed by arming/fishing/forestry with 2.0 times increase (95% CI 1.2-3.4), and construction and extraction with 1.9 times increase (95% CI 1.2-2.9). The findings of this study suggest that major musculoskeletal impairments are associated with physically demanding occupations. Impairment prevention as a part of provisional rehabilitation should use this information to identify individuals who work in a high risk occupation.