title: Higher risk for cervical herniated intervertebral disc in physicians: A retrospective nationwide population-based cohort study with claims analysis.
abstract: There is no study about cervical herniated intervertebral disc (cervical HIVD) in physicians in the literature; therefore, we conceived a retrospective nationwide, population-based cohort study to elucidate the topic. We identified 26,038 physicians, 33,057 non-physician healthcare providers (HCPs), and identical numbers of non-HCP references (i.e., general population). All cohorts matched a 1:1 ratio with age and gender, and each were chosen from the Taiwan National Health Insurance Research Database (NHIRD). We compared cervical HIVD risk among physicians, nonphysician HCPs, and non-HCP references and performed a follow-up between 2007 and 2011. We also made comparisons among physician specialists. Both physicians and nonphysician HCPs had higher cervical HIVD risk than non-HCP references (odds ratio [OR]: 1.356; 95% confidence interval (CI): 1.162-1.582; OR: 1.383; 95% CI: 1.191-1.605, respectively). There was no significant difference of cervical HIVD risk between physicians and nonphysician HCPs. In the comparison among physician specialists, orthopedists had a higher cervical HIVD risk than other specialists, but the difference was not statistically significant (adjusted OR: 1.547; 95% CI: 0.782-3.061). Physicians are at higher cervical HIVD risk than the general population. Because unknown confounders could exist, further prospective studies are needed to identify possible causation.
authors.affiliation: Hyperbaric Oxygen Therapy Center and Division of Plastic Surgery, Chi-Mei Medical Center Department of Electrical Engineering, Southern Taiwan University of Science and Technology Department of Emergency Medicine, Chi-Mei Medical Center Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology Department of Occupational Medicine Department of Geriatrics and Gerontology, Chi-Mei Medical Center Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan Department of Emergency Medicine, Taipei Medical University, Taipei Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology Department of Medical Research, Chi-Mei Medical Center, Liouying Department of Medical Research, Chi-Mei Medical Center, Tainan Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng
authors.initials: C
authors.lastname: Liu
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Chien-Chin
authors.initials: CC
authors.lastname: Hsu
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review; D007405:Intervertebral Disc Displacement / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010820:Physicians / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology