J Occup Health published a systematic review of the prevalence of musculoskeletal pain among professional drivers.1 The meta 12-month prevalence estimates of musculoskeletal pain for specific body regions were calculated with a total sample size of 18 882 respondents. The sample was pooled from 56 cross-sectional, case-control, or prospective cohort studies from 23 countries that reported the prevalence of musculoskeletal pain in professional drivers. Findings of the review show that the low back was the most frequently reported body region for musculoskeletal pain with a meta mean prevalence rate of 53% (N = 9998), followed by neck (42.4%, N = 3480), shoulder (39.2%, N = 2751), and other body regions. Collectively, the prevalence rates of musculoskeletal pain indicate that professional drivers are at an increased risk of developing musculoskeletal pain in many body regions, compared with other occupational groups. The review was the first to calculate the meta prevalence rates of musculoskeletal pain for nine body regions in professional drivers. The findings highlighted the severity of the global musculoskeletal problem in professional drivers, in particular, low back pain (LBP). It, however, did not review the magnitudes of the musculoskeletal problem in terms of sickness absence, disability, total healthcare cost, and other societal burden. LBP is the pre-cursor for underlying spinal or musculoskeletal disorders (MSDs), which have caused significant burden to individuals and the society as a whole. The Global Burden of Disease 2017 study demonstrated that among 354 diseases and injuries, LBP was ranked highest in terms of leading casue of disability and years lived with disability.2 Katz estimated the total costs of LBP in the United States exceed $100 billion per year, with approximately one third accounted for by direct medical expenses and two thirds resulting from indirect costs, such as productivity loss and sickness absence.3 Despite the absence of information on the direct economic impact of musculoskeletal pain in professional drivers, the high prevalence of musculoskeletal pain among professional drivers warrants research into interventions that are effective in reducing the risk factors for musculoskeletal pain. To devise effective interventions, understanding the contributing factors of musculoskeletal pain in various body regions is imperative. The studied physical risk factors for musculoskeletal pain in professional drivers are prolonged and constrained sitting, whole body vibration (WBV) from the seat, and the long duration of driving.4 In many studies, LBP is associated with an increasing number of driving hours per day and length of employment. Seating comfort and design is often studied for reducing the risk factors associated with vibration and poor spinal posture (ie, loss of lordosis). Work-related psychosocial factors have been linked to LBP among professional drivers. High job strain, effort-reward imbalance, lack of supervisory support, and organizational injustice are typical psychosocial stressors associated with an increased risk of LBP.5 Among professional drivers, taxi and truck drivers may be engaged in baggage and manual materials handling, respectively. These additional physical exertions increase their exposure to the physical risk factors for musculoskeletal pain. It should be noted that most of the evidence in the literature described above is based on cross-sectional studies with a limited power of inferring causal pathways from the risk factors. The review in this issue indicates a lack of prospective studies investigating the relationship between the incidence of musculoskeletal pain and contributing factors. Four of five prospective studies found in the literature came from Dr Bovenzi's research group. Their 2006 study investigating the dose-response relationship between WBV and three LBP outcome measures (12-month incidence of LBP, high pain intensity, and LBP disability) provides significant evidence in the dose-response relationship. That recent study supports one of the main findings in a landmark review conducted by the National Institute for Occupational Safety and Health (NIOSH) in 1997. That is, after controlling personal, workplace psychosocial factors and other physical risk factors, there is strong evidence that a dose-response relationship between WBV and LBP exists. Please notice that the psychosocial factors in Dr Bovenzi's series of studies were not found to be significantly associated

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社论：职业司机肌肉骨骼疼痛的预防

J Occup Health 发表了一篇关于职业司机肌肉骨骼疼痛患病率的系统评价。1 特定身体部位肌肉骨骼疼痛的元 12 个月患病率估计值是根据 18882 名受访者的总样本量计算得出的。该样本来自 23 个国家的 56 项横断面、病例对照或前瞻性队列研究，这些研究报告了职业司机肌肉骨骼疼痛的患病率。审查结果显示，腰背部是肌肉骨骼疼痛最常报告的身体部位，元平均患病率为 53% (N = 9998)，其次是颈部 (42.4%, N = 3480)、肩部 (39.2%) , N = 2751) 和其他身体区域。总的来说，肌肉骨骼疼痛的流行率表明，与其他职业群体相比，职业司机在许多身体部位发生肌肉骨骼疼痛的风险更高。该评价是第一个计算职业驾驶员九个身体部位肌肉骨骼疼痛的元患病率的综述。调查结果强调了职业司机整体肌肉骨骼问题的严重性，尤其是腰痛 (LBP)。然而，它没有从病假、残疾、总医疗费用和其他社会负担方面审查肌肉骨骼问题的严重程度。LBP 是潜在的脊柱或肌肉骨骼疾病 (MSD) 的先兆，这对个人和整个社会造成了重大负担。2017 年全球疾病负担研究表明，在 354 种疾病和伤害中，LBP 在残疾的主要原因和残疾年限方面排名最高。 2 Katz 估计美国 LBP 的总成本每年超过 1000 亿美元，大约三分之一是直接医疗费用，三分之二是间接费用，例如生产力损失和疾病缺勤。 3 尽管缺乏关于肌肉骨骼疼痛对专业司机的直接经济影响的信息，但肌肉骨骼疼痛的高患病率在专业司机中，有必要研究有效降低肌肉骨骼疼痛风险因素的干预措施。为了设计有效的干预措施，了解导致身体各部位肌肉骨骼疼痛的因素势在必行。所研究的职业司机肌肉骨骼疼痛的身体风险因素包括久坐和受限坐姿、座椅的全身振动 (WBV) 以及长时间驾驶。 4 在许多研究中，LBP 与每人的驾驶小时数增加有关。工作天数和时长。座椅舒适度和设计经常被研究以减少与振动和不良脊柱姿势（即脊柱前凸丧失）相关的风险因素。在职业司机中，与工作相关的社会心理因素与 LBP 有关。高工作压力、努力与回报不平衡、缺乏监督支持和组织不公正是与 LBP 风险增加相关的典型心理社会压力因素。 5 在职业司机中，出租车和卡车司机可能分别从事行李和人工材料处理。这些额外的体力消耗增加了他们暴露于肌肉骨骼疼痛的身体风险因素。应该注意的是，上述文献中的大多数证据都是基于横断面研究，从风险因素推断因果途径的能力有限。本期综述表明缺乏前瞻性研究调查肌肉骨骼疼痛的发生率与影响因素之间的关系。在文献中发现的五项前瞻性研究中有四项来自 Bovenzi 博士的研究小组。他们 2006 年的研究调查了 WBV 与三种 LBP 结果指标（LBP 的 12 个月发生率、高疼痛强度、和 LBP 残疾）为剂量反应关系提供了重要证据。最近的研究支持了国家职业安全与健康研究所 (NIOSH) 于 1997 年进行的具有里程碑意义的审查中的主要发现之一。 也就是说，在控制个人、工作场所心理社会因素和其他身体风险因素之后，有强有力的证据表明WBV 和 LBP 之间存在剂量反应关系。请注意，Bovenzi 博士的系列研究中的社会心理因素并未发现显着相关 工作场所心理社会因素和其他身体风险因素，有强有力的证据表明 WBV 和 LBP 之间存在剂量反应关系。请注意，Bovenzi 博士的系列研究中的社会心理因素并未发现显着相关 工作场所心理社会因素和其他身体风险因素，有强有力的证据表明 WBV 和 LBP 之间存在剂量反应关系。请注意，Bovenzi 博士的系列研究中的社会心理因素并未发现显着相关