Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Radiological Flattening of Lumbar Lordosis and Related Factors in Some Korean Farmers

일부 한국 농업인의 방사선학적 요추 편평화와 관련 요인

  • Song, Han-Soo (Department of Occupational & Environmental Medicine, School of Medicine Chosun University) ;
  • Yoo, Sang-Kon (Department of Occupational & Environmental Medicine, School of Medicine Chosun University) ;
  • Choi, Chang-Ki (Department of Occupational & Environmental Medicine, School of Medicine Chosun University) ;
  • Lee, Chul-Gab (Department of Occupational & Environmental Medicine, School of Medicine Chosun University) ;
  • Lee, Kyung-Suk (Rural Development Administration)
  • 송한수 (조선대학교 의과대학 산업의학과) ;
  • 유상곤 (조선대학교 의과대학 산업의학과) ;
  • 최창기 (조선대학교 의과대학 산업의학과) ;
  • 이철갑 (조선대학교 의과대학 산업의학과) ;
  • 이경숙 (농촌진흥청)
  • Received : 2010.04.29
  • Accepted : 2010.09.06
  • Published : 2010.12.31
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Abstract

Objectives: To determine if agricultural work is related to radiological flattening of lumbar lordosis, and to identify the relationship between of back pain and flat back in selected Korean farmers. Methods: Between June 2006 and July 2008, 414 farmers, 155 (37.4%) males and 259 (62.6%) females participated in this study. We collected data on hazardous agricultural work postures and other factors from interviews, surveys, and x-ray views of lateral lumbar. The operational definition of a flat back was below -1 SD of lordotic angle, with a normal distribution between L1 and S1 level. Logistic regression analysis was conducted to evaluate the relationship between flat back and hazardous working posture ratio, sex, the severity of back pain. Results: Mean lordotic angle was 42.9${\pm}$15.7$^{\circ}$. Flat back had a higher prevalence in the females (24.7%) than the males (5.8%). The odds ratio of flat back risk is 3.30 (95% CI: 1.46~7.46) in the females compared to the males, 1.31 (95% CI: 0.61~2.79), 4.11 (95% CI: 1.77~9.55) in the group of hazardous working posture ratio compared to the low risk group, 2.78 (95% CI: 1.27~6.07), 5.74 (95% CI: 2.27~14.49) in the group of L4-L5 disc space narrowing compared to normal group, 3.06 (95% CI: 1.27~7.31), 5.45 (95% CI: 1.70~17.46) in the group of lumbar spine compression fracture compared to no fracture. Odds ratio of severe back pain is 2.29 (95% CI: 1.12~4.72) in the group of flat back compared to normal group. Conclusions: Hazardous agricultural working postures, such as 'low- lifting, pulling, pushing work and high- squatting posture work' are associated with flat back. Low back pain is significantly associated with flat back group in female farmers.

목적: 일부 한국 농업인에서 요추 전만각의 편평화와 관련된 요인을 파악하고, 요추 편평화가 요통과 관련이 있는지 확인하기 위함이다. 방법: 2006년 5월부터 2008년 6월 사이에 전라남도 지역의 농민 414명 (남자 155, 37.4%, 여자 259, 62.6%)을 대상으로 요추 방사선 촬영과 설문조사를 시행하였다. 요추 측면사진에서 요추1번과 천추 1번이 이루는 요추 전만각을 측정하여, 표준정규분포의 -1 표준편차 이하에 해당되는 경우를 '편평요추(flat back)'로 정의하였다. 편평요추 유무를 종속변수로 하고, 성 및 연령, 요추 추간판 간격의 협소화 및 압박골절의 정도, 쪼그려 앉는 작업과 같은 위험한 농작업에 노출정도 등을 독립변수로 한 로지스틱 회귀분석을 하였다. 요통의 심한 정도와 위험한 농작업에 노출정도와 관련성을 확인하기 위해 다항로지스틱 회귀분석을 하였다. 결과: 연구대상자의 요추 전만각 평균은 42.9${\pm}$15.7$^{\circ}$로, 여자에서 39.9${\pm}$16.6$^{\circ}$로 남자의 48.1${\pm}$12.6$^{\circ}$보다 유의하게 작았다(p<0.01). 편평요추가 발생할 교차비는 여성에서 3.30 (95% CI: 1.46~7.46), 추간판 간격의 감소가 심할수록 2.78 (95% CI: 1.27~6.07), 5.74 (95% CI: 2.27~14.49), 압박골절이 심할수록 3.06 (95% CI: 1.27~7.31), 5.45 (95% CI: 1.70~17.46), 쪼그려 앉는 작업자세 등 위험한 농작업 자세의 비중이 클수록 1.31 (95% CI: 0.61~2.79), 4.11 (95% CI: 1.77~9.55), 5.99 (95% CI: 2.44~14.71) 유의하게 높았다. 성과 연령을 보정하였을 때 편평요추가 있는 경우 심한 요통이 발생할 교차비는 2.29 (95% CI: 1.12~4.72)이었다. 결론: 편평요추는 쪼그려 앉거나 허리를 숙이는 농작업 자세와 관련이 있고, 이러한 작업에 주로 많이 종사하는 여자 농업인에서 발생할 위험성이 높다. 요추 전만각이 감소된 경우 심한 요통이 발생할 가능성이 많다.

Keywords

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