title: The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers.
abstract: BACKGROUND
  The combined effect of socioeconomic, organizational, psychosocial, and physical factors on work-related musculoskeletal disorders (WRMSDs) were studied in a heterogeneous, socioeconomically diverse sample (cases and their matched referents) of hospital workers.
  
  
  METHODS
  Cases were defined by a new acute or cumulative work-related musculoskeletal injury; referents were matched by job group, shift length, or at random. Information was obtained through telephone interviews and on-site ergonomics observation. Questionnaire items included sociodemographic variables, lost work time, work effectiveness, health status, pain/disability, and psychosocial working conditions using Effort Reward Imbalance (ERI) and Demand-Control (DC) models. Two multivariate models were tested: Model 1 included occupation as a predictor; Model 2 included education-income as a predictor.
  
  
  RESULTS
  Cases reported greater pain, disability, lost time, and decreased work effectiveness than the referents. Model 1 was statistically significant for neck/upper extremity injury (Chi-square = 19.3, P = 0.01), back/lower extremity injury (Chi-square = 14.0, P = 0.05), and all injuries combined (Chi-square = 25.4, P = 0.001). "Other Clinical" occupations (34% mental health workers) had the highest risk of injury (OR 4.5: 95%CI, 1.7-12.1) for all injuries. The ERI ratio was a significant predictor for neck and upper extremity (OR 1.5: 95%CI, 1.1-1.9) and all injuries (OR 1.3; 95%CI, 1.04-1.5), per SD change in score.
  
  
  CONCLUSIONS
  In this study, the risk of WRMSDs was more strongly influenced by specific psychosocial and physical job-related exposures than by broad socioeconomic factors such as education and income.
authors.affiliation: Department of Community Health Systems, School of Nursing, University of California, San Francisco, California 94143-0608, USA. marion.gillen@nursing.ucsf.edu
authors.forename: Marion
authors.initials: M
authors.lastname: Gillen
authors.forename: Irene H
authors.initials: IH
authors.lastname: Yen
authors.forename: Laura
authors.initials: L
authors.lastname: Trupin
authors.forename: Louise
authors.initials: L
authors.lastname: Swig
authors.forename: Reiner
authors.initials: R
authors.lastname: Rugulies
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mullen
authors.forename: Aurelio
authors.initials: A
authors.lastname: Font
authors.forename: David
authors.initials: D
authors.lastname: Burian
authors.forename: Greg
authors.initials: G
authors.lastname: Ryan
authors.forename: Ira
authors.initials: I
authors.lastname: Janowitz
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Quinlan
authors.forename: John
authors.initials: J
authors.lastname: Frank
authors.forename: Paul
authors.initials: P
authors.lastname: Blanc
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000503:physiopathology; D016272:Occupational Health / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000523:psychology / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology