Original article

Scand J Work Environ Health 2009;35(2):96-112    pdf

doi:10.5271/sjweh.1310

Should studies of risk factors for musculoskeletal disorders be stratified by gender? Lessons from the 1998 Québec Health and Social Survey

by Messing K, Stock SR, Tissot F

Objectives Several studies have reported male-female differences in the prevalence of symptoms of work-related musculoskeletal disorders (MSD), some arising from workplace exposure differences. The objective of this paper was to compare two strategies analyzing a single dataset for the relationships between risk factors and MSD in a population-based sample with a wide range of exposures.

Methods The 1998 Québec Health and Social Survey surveyed 11 735 respondents in paid work and reported “significant” musculoskeletal pain in 11 body regions during the previous 12 months and a range of personal, physical, and psychosocial risk factors. Five studies concerning risk factors for four musculoskeletal outcomes were carried out on these data. Each included analyses with multiple logistic regression (MLR) performed separately for women, men, and the total study population. The results from these gender-stratified and unstratified analyses were compared.

Results In the unstratified MLR models, gender was significantly associated with musculoskeletal pain in the neck and lower extremities, but not with low-back pain. The gender-stratified MLR models identified significant associations between each specific musculoskeletal outcome and a variety of personal characteristics and physical and psychosocial workplace exposures for each gender. Most of the associations, if present for one gender, were also found in the total population. But several risk factors present for only one gender could be detected only in a stratified analysis, whereas the unstratified analysis added little information.

Conclusions Stratifying analyses by gender is necessary if a full range of associations between exposures and MSD is to be detected and understood.

See 2009;35(5):400 for a correction.
This article refers to the following texts of the Journal: 2005;31(2):138-151  2007;33(5):344-350
The following articles refer to this text: 2010;36(6):515-516; 2014;40(2):167-175; 2017;43(5):405-414