Occupational back pain : an unhelpful polemic.
In most industrialized countries, disability and work absence due to occupational back pain have risen steadily in recent decades.
Conventional views of the causes of this slow epidemic tend to fall into one of the following three areas :
(i) the clinical pathology view, which attributes the level of pain and disability to either the severity of the initial injury or to psychosomatic conditions ;
(ii) the biomechanical exposures view, which attributes the problem to hazardous and preventable conditions of work ;
and (iii) the perverse incentives view, which suggests that reporting and disability are influenced by a combination of work dissatisfaction and accessible disability benefits.
This paper reviews, from an epidemiologic perspective, the specific methodological hurdles faced during investigations of the etiology of occupational back pain.
It is argued that methodological issues have contributed to the perpetuation of the three distinct but incomplete views of the problem.
New research directions are suggested and a broader interdisciplinary perspective is proposed to help resolve the existing polemic.
Mots-clés Pascal : Lombalgie, Exposition professionnelle, Homme, Epidémiologie, Facteur risque, Etiologie, Méthodologie, Article synthèse, Médecine travail, Douleur, Rachis lombaire, Système ostéoarticulaire pathologie, Rachis pathologie, Rachialgie
Mots-clés Pascal anglais : Low back pain, Occupational exposure, Human, Epidemiology, Risk factor, Etiology, Methodology, Review, Occupational medicine, Pain, Lumbar spine, Diseases of the osteoarticular system, Spine disease, Rachialgia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0210787
Code Inist : 002B15F. Création : 09/06/1995.