목적: 스트레스와 요통의 연관성에 대한 연구들이 활발히 진행되어 왔다. 하지만 대부분의 연구들이 단면연구로 시행된 한계를 가지고 있다. 따라서 이 연구에서는 후향적인 생존분석을 통하여 직무 스트레스와 요통의 연관성을 밝히고자 하였다. 연구방법: 한 조선소 근로자들을 대상으로 설문조사를 실시하여 976명에 대해 분석을 실시하였다. 요통은 NIOSH 증상설문지 기준에 따라 분류하였고, 직무 스트레스는 Karasek의 JCQ(Job Contents Questionnaire)의 설문 문항을 번역하여 사용하였으며, 육체적 작업 요인은 QEC(Quick Exposure Check) 설문을 사용하였다. 건강근로자 효과를 최소화하기 위하여 전체 조사 대상자군 뿐만 아니라 근무연수 5년 이하인 군에 대하여 요통의 발생여부, 요통이 발생하기까지의 기간을 종속변수로 하고 일반적 특성, 직무 스트레스, 육체적 작업 요인을 독립변수로 하여 Cox 비례위험 모형을 통한 생존분석을 실시하였다. 결과: 전체 조사 대상군에서는 허리굽힘이 20도 이상인군, 6 ㎏이상을 드는군, 직무요구도가 높은 군에서 요통 발생의 위험도가 증가하였다. 근무연수 5년 이하인 군에서는 직무 요구도가 높은 경우 요통 발생의 위험도가 1.6배 증가하였다. 결론: 직무 스트레스, 특히 높은 직무 요구도는 직업성 요통의 발생 위험을 증가시켰다.
Objectives: Occupational low back pain is a major cause of morbidity and the increases of medical and industrial costs. Efforts to control occupational low back pain have been largely unsuccessful, and further understanding of the risks including the psychological factors is needed. This retrospective study was designed to identify the effect of job stress on occupational low back pain among shipyard workers. Methods: The study group consisted of 976 male workers who were working at a Korean shipyard. A structured self-reported questionnaire was used to assess the participants’ physical work factors, job stress and general characteristics. Job stress was measured using Karasek’s JCQ(Job Content Questionnaire). Occupational low back pain was identified according to the NIOSH symptom survey criteria. Physical work factors were assessed using the Quick Exposure Check. Since the work duration can affect the relationship of physical work factors and job stress to occupational low back pain, we analyzed this association by dividing workers into two groups by work duration: 1) all workers, and 2) less than 5 years. Cox’s proportional hazard model was used to elucidate the relationship of job stress with occupational low back pain in these two groups. Data were analysed with SAS 8.1. Results: In the all workers group, job demand, bending or twisting of the back, and carrying heavy materials were associated with an increased the risk of occupational low back pain. In the workers with less than 5 years work experience, people with high job demand were more likely to experience occupational low back pain than those with low job demand. Conclusions: These results suggest that job stress as well as physical work factors can raise the risk of occupational low back pain. Especially, in the workers with less than 5 years work duration, job stress played a more crucial effect on the occurrence of occupational low back pain than physical work factors did.