Epidemiologic screening of occupational neck and upper limb disorders. Methods and criteria.
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Biomedical subjects
Publications and source records attributed to J Nummi.
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Two hundred and ninety-five male Finnish concrete reinforcement workers, aged 19 to 64 years and engaged in heavy physical work including prolonged stooping, were radiologically examined by antero-posterior and lateral views of the lumbar spine while they were standing. The findings of lumbar disc degeneration were classified as none, slight, moderate or severe. The prevalence and degree of radiologically detectable lumbar disc degeneration depended strongly on age and increased especially rapidly from 40 to 44 years on. Lumbar disc degeneration showed an age-independent association to both a history of lumbago (chi2 = 10.5, p less than 0.01) and a history of sciatica (chi2 = 11.8, p less than 0.001). When disc degeneration was compared to reports of stiffness, fatigue, ache, and sharp pain in the back during an ordinary workday, no statistically significant associations were found, while disc degeneration was found to be slightly more common (chi2 = 4.6, p less than0.05) in the men reporting back symptoms as they bent down than in the men who did not report such symptoms. No association between length of exposure to static and dynamic back loads in reinforcement work and the prevalence of lumbar disc degeneration could be established, but definite conclusions on the possible effect of reinforcement work on the lumbar spine could not be drawn from the data.
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To investigate whether parachuting causes permanent changes in the spine, 50 military parachutists (mean number of jumps 490 per parachutist) and 50 matched controls were studied. In X-rays of parachutists and controls, the frequency of degenerative changes differed in the cervical spine (46 and 20%; p less than 0.01), and in the thoracic spine (62 and 28%; p less than 0.05) but not in the lumbar spine (44 to 36%; not significant). Parachutists suffered significantly more often from stiff neck, but the incidence of other neck and back symptoms was the same in the two groups. The increased frequency of degenerative changes in the spine in military parachutists is probably due to repeated traumata which parachutists sustain on landing and, possibly, during the training period before parachute jumps.
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