0252 Occupation and surgery for subacromial impingement syndrome - a nationwide Danish cohort study
基于丹麦全国登记数据，评估累积职业性肩部暴露（如手臂抬高、重复动作）对肩峰下撞击综合征手术风险的影响，发现10年内累积暴露效应显著。
<h3>Objectives</h3> Little is known about the time window for accumulation of occupational exposures and shoulder disorders. We aimed to evaluate cumulative occupational shoulder exposures as risk factors for surgery for subacromial impingement syndrome (SIS), and to examine how long the relevant exposure time period is. <h3>Method</h3> We conducted a nationwide register study of all persons born in Denmark (1933–1977), with at least 5 years of full-time employment (1993–2007). In the follow-up period (2003–2008), first-time events of surgery for SIS were identified. Cumulative exposure estimates for a 10-year period were obtained by linking occupational codes with a job exposure matrix. Exposure estimates were expressed according to the pack-year concept of smoking (e.g. arm-elevation-years). We used logistic regression equivalent to discrete survival analysis with a one year time lag, adjusting for age, sex, region, and calendar year, and compared the ORs for exposure time windows of increasing length. <h3>Results</h3> The adjusted OR (ORadjusted) for surgery for SIS reached 2.0 for arm-elevation-years, repetitive-movement-years, and force-years, and the ORadjusted for hand-arm-vibration-years reached 1.5. We found an increase in ORadjusted from 1.0 to 2.1 when expanding the exposure time window from 2 to 10 years back in time. <h3>Conclusions</h3> Our findings suggested that upper arm-elevation, repetitive movements, forceful exertions, and hand-arm-vibration were risk factors for surgery for SIS, and indicated a cumulative exposure effect within a 10 year time span.