Anonymous asked in 社會與文化語言 · 1 decade ago




Knee disorders in coalminers and analogous knee stressing trades and activities

Nineteen reports published in the scientific literature were reviewed formally to explore the relation between knee disorders and occupation as a miner or in an analogous trade. The principal characteristics and selected results from each paper are summarized in tables 2 and 3. Table 2 summarises studies which estimate the risks of knee injury associated with kneeling and squatting. Table 3 summarises studies that estimate the prevalence of knee injury in working populations. In both of these tables the papers are listed in order of the strength of evidence they were judged to contribute. There was very little disagreement in the scoring between the two reviewers. Only five papers were given differing scores.

The earliest paper included in this review describes a case control study in the Manchester coal fields. The incidence of rheumatic complaints was found to be no greater in miners than in the population as a whole. The degree of incapacity (unfitness for work) was greater in miners and there was evidence of an earlier onset of symptoms as shown by a steeper rise in incidence at the fourth decade, principally due to back-hip-sciatic pain.

Kellgren and Lawrence followed this field study with a clinical and radiographic investigation of a random sample of male coal miners in their fifth decade, matched for sex and age with two control groups. They were careful to avoid bias in history taking, clinical examination, and reading the radiographs. Their definitions for the classification of survey radiographs are still used as the standard practice for such surveys. A positive diagnosis was made on the presence of osteophytes alone rather than coupling that finding with loss of joint space. Although this more rigorous application may have restricted cases to moderately severe and severe arthritis, it would have ignored cases of early disease and is not a serious flaw in the study design. There was a general trend in favour of an excess of OA among the miners but the differences in prevalence were not statistically significant. From this observation Kellgren and Lawrence justifiably, and cautiously, concluded that miners aged 41-50 years of age possibly suffer more OA ( osteoarthritis) of the knees than either manual or office workers of the same age. This was the first real evidence to support that contention.

Lawrence expanded the series of studies by comparing the knees of men emploved as coalface workers and as roadway workers in the same colliery, face workers in a nearby wet mine of similar seam height, and dock workers. Comparing face and other underground workers was a serious flaw because, as noted in the paper, it is likely that knee pain would be a frequent cause of transfer from the face to roadways. This study’s

principal contribution is its demonstration of a more than twofold excess risk of definite radiographic OA of the knee in underground coal workers compared with manual workers and almost fourfold excess risk when compared with office workers, the latter difference being statistically significant.

The importance of the next paper is enhanced in terms of official appreciation, as the author was employed in the Medical Inspectorate of Mines, Ministry of Power. The aim of this study was to investigate the prevalence of internal derangements of the knee and the factors which might be responsible for such injuries. Although precise figures were not available for the incidence of internal derangements of the knee among miners, this disadvantage was overcome by working from admissions to rehabilitation centres to derive an estimate of minimum incidence. The rates for internal derangement of the knee in miners may be adjusted to give 180 per 100 000 men-more than twice the rate in men doing heavy work in a Welsh steel works. Kneeling in narrow seams was shown to be not the only, or even the main, cause of injury-these being slipping and tripping. It seems that, rather than wear and tear causing degeneration, repeated trauma incidents account for the incidence observed in miners.

The 1962 paper by Sharrard and Liddell demonstrated that miners, notably face workers and especially those aged 25-54 years, appear to have an excess incidence of meniscus damage of up to 5:1 over the general population. Although cartilage tears were most common in those who knelt at work, the evidence showed that the injury might actually occur when a man is more active or undertakes sudden movements on the knee. Laxity of the knee joint was linked to kneeling at work, thus increasing the susceptibility of the knee to rotatory injuries and consequent damage of the menisci. This study is flawed only by the possible bias of miners, driven by the fitness requirements of their work, seeking hospital treatment at an earlier stage than other men. This paper appears to have been the last one focused solely on miners to be published in the literature in English. The next paper relevant to occupational strains on the knees was a study by Lindberg and Montgomery who used an archive of existing radiographs to demonstrate that the prevalence and severity of definite OA of the knee was significantly greater in those who had done heavy work over tens of years.


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  • 1 decade ago
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    在科學文獻裡出版的19 份報告被正式評論探索在膝紊亂和頭班之間的關係作為一個礦工或者在類似貿易裡。 主要特性和每紙的選擇結果被用表格2 和3 總結。 2表格總結研究哪個估計膝傷的危險同跪並且蹲交往。 3表格總結研究估計膝傷在工作人口內的流行。 在這兩個桌子裡報紙被按他們被判斷獻出的證據的力量次序列舉。 在在兩評論家之間贏得過程中有極少意見不合。 只有5 份文件被給不同得分。

    早紙在這回顧內包括描述一箱控制在曼徹斯特煤領域內研究。 風濕症抱怨的發生發現並不大礦工比在人口內整體上。 無能力(工作的不相宜)的度在礦工裡更大 並且象在第4 十年透過在發生方面的一次更陡的升高顯示的那樣有一次症狀的更盡快進攻的證據, 主要將要回來時髦sciatic 痛苦。

    凱爾葛蘭和勞倫斯在他們的第5 十年把一個男性煤礦工的隨意抽樣的臨床和X射線照相的調查接在這次實地考察后面, 為性別和年齡與兩對照組匹配。 他們仔細在帶的歷史,臨床檢查並且讀X光照片上避免偏見。 調查X光照片的分類的他們的定義仍然被作為這樣的調查的標準實踐使用。 一原級診斷在osteophytes的存在上打單獨而不是連合與共同空間的損失一起發現。 雖然這更嚴格的應用可能對適中嚴重和嚴重的關節炎限制病例, 它將忽視盡快疾病的箱並且在書房裡不一嚴重瑕疵設計是。 在那些礦工中有利于OA的過度有一個一般的趨勢但是流行的差別不據統計顯著。 從這觀察凱爾葛蘭和勞倫斯無可非議, 並且謹慎, 斷定41-50歲的礦工也許遭受膝的更多OA(osteoarthritis)或者手工或者相同的年齡的辦公室從業人員。 這是支持那爭論的第一個真正的證據。

    勞倫斯透過比較人emploved的膝作為coalface 工人和作為在相同的煤礦裡的車行道工人擴大一系列研究, 在一座相似的縫高度的在附近潮濕的礦,以及碼頭工人裡的臉工人。 比較臉和其他地下工人是一處嚴肅的瑕疵因為, 如所提及文章那兒,可能痛苦膝將在頻繁原因的從那些臉到車行道的轉移的。 這study s

    主要貢獻是在地下煤工人裡的它的膝的明確的X射線照相的OA的超過雙重的過度危險的示範, 與藍領和幾乎四褶層過度危險相比較與辦公室從業人員相比較, 后面差別據統計重要。

    下一紙的重要性被就正式的欣賞而言提升, 因為作者受雇于礦的醫學Inspectorate,權力的內閣。 這項研究的目的是調查膝的內部的故障和可以對這樣的傷負責的原素的流行。 雖然準確的數字在礦工中對膝的內部的故障的發生沒效, 這不利條件從門票工作到恢復得到一最小發生的估計的中心壓倒。 內部的故障的比率 礦工那些膝可能被調整每100 000人180給多于做鋼廠威爾士繁重的工作的人那些比率兩倍。 用狹窄的縫跪被顯示不唯一,或者甚至主要,傷的原因這些正滑過和旅行。 好像,而不是磨損引起退步,重複創傷事件解釋那些發生在礦工內觀察。

    透過Sharrard 和利德爾的1962 文章證明那礦工, 特別是臉工人和特別那些年老的25-54 年,看起來有一個最多在普通人上方的5︰1的凹凸透鏡損害的過度發生。 雖然軟骨眼淚在起作用跪的那些人裡非常普通, 證據顯示當一個人更活躍時,傷實際上可能發生或者在膝上承擔突然的運動。 膝關節的輕瀉藥與在工作時跪,因此增加凹凸透鏡的旋轉的傷和隨之而來的損害的膝的靈敏性有關係。 這項研究只透過礦工的可能的偏見被有缺陷, 透過他們的工作的健康要求推展,比其他人在早期尋找住院治療。 僅僅集中于礦工被在英國文學方面出版,這篇文章似乎是最後一個。 在膝上對頭班的勞累相關的下一紙是 林德伯格和蒙哥馬利的一項研究, 其使用現有的X光照片的檔案證明膝的明確的OA的流行和嚴厲在那些裡更相當大, 其已經做繁重的工作超過數十年。

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  • Anonymous
    6 years ago



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  • 1 decade ago

    膝誘Q九個報告出版在科學文獻的混亂在coalminers 和近似膝貌`重貿易和活動正式被回顧得探索聯繫在膝輔V亂和職業之間作為礦工或在近似貿易。主要特性和選擇的結果從各張紙被總結在表2 和3 。表2 總結估計膝傷風險與下跪和蹲交往的研究。表3 總結估計膝傷的流行在就業人口的研究。在這兩張桌裡他們被判斷貢獻的本文被列出按證據的順序力量。有很少分歧在計分在二個評論者之間。只五張紙被給了不同的比分。早報包括在這回顧描述案件控制研究在曼徹斯特煤田。風濕性怨言的發生被發現沒有偉大的在礦工比在人口整體上。程度無才(不相宜為工作) 依照由更加陡峭的上升顯示是偉大的在礦工和那裡是症狀一個更加早期的起始的證據在發生在第四個十年, 主要由於臀部臀部的痛苦。Kellgren 和勞倫斯跟隨了這現場研究以男性煤礦工人隨意抽樣的一次臨床和幅射線照相的調查在他們的第五個十年, 被匹配為性和年齡與二個控制群。他們小心避免傾斜在歷史採取, 臨床考試, 和讀射線照相。他們的定義為勘測射線照相的分類仍然被使用如同標準操作為這樣勘測。一個正面診斷被做了在osteophytes 出現單獨而不是聯結那發現以聯合空間損失。雖然這種更加嚴謹的應用也章嚝A度地嚴厲和嚴厲關節炎制約了盒, 它會忽略早期疾病案件和不是一個嚴肅的缺點在研究設計。有一個一般趨向傾向於OA 剩餘在礦工之中但在流行上的區別統計地不是重大的。從這觀察Kellgren 和勞倫斯情有可原, 和謹慎, 認為, 礦工年歲41-50 年紀比或指南或同樣年齡的辦公室工作者可能遭受更多OA (骨關節炎) 膝說C這是第一真正的證據支持那個論點。勞倫斯擴展了研究系列由比較人膝蜜mploved 當coalface 工作者和當車行道工作者在同樣煤礦, 面孔工作者在相似的縫高度一個附近的濕礦, 和船塢工作者。比較面孔和其它地下工?/p>

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  • 1 decade ago

    To Polarbear


    Don't you have shame to put an answer like that for everyone to see? It is such a disgrace as a human being to surrender your brain to a compuer translation program. Dignity is on sale now, for merely 5 point.

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