Céline Sérazin

Risk factors for incidence of rotator cuff syndrome in a large working population.

OBJECTIVES The aim of this study was to assess the effects of personal and work-related factors on the incidence of rotator cuff syndrome (RCS) in a large working population. METHODS A total of 3710 French workers were included in a cross-sectional study in 2002-2005. All completed a self-administered questionnaire about personal factors and work exposure. Using a standardized physical examination, occupational physicians established a diagnosis of RCS. Between 2007-2010, 1611 workers were re-examined. Associations between RCS and risk factors at baseline were analyzed by logistic regression. RESULTS A total of 839 men and 617 women without RCS at baseline were eligible for analysis. RCS was diagnosed in 51 men (6.1%) and 45 women (7.3%). The risk of RCS increased with age for both genders [odds ratio (OR) 4.7 (95% confidence interval [95% CI] 2.2-10.0) for men aged 45-49 years and 5.4 (95% CI 2.3-13.2) for women aged 50-59 years; reference <40 years]. For men, the work-related risk factors were repeated posture with the arms above the shoulder level combined with high perceived physical exertion [OR 3.3 (95% CI 1.3-8.4)] and low coworker support [OR 2.0 (95% CI 1.1-3.9)]. For women, working with colleagues in temporary employment [OR 2.2 (95% CI 1.2-4.2)] and repeated arm abduction (60-90°) [OR 2.6 (95% CI 1.4-5.0)] were associated with RCS. CONCLUSIONS Age was the strongest predictor for incident cases of RCS, and arm abduction was the major work-related risk factor for both genders. Lack of social support was a predictor for RCS among men.

Effects of Individual and Work-related Factors on Incidence of Shoulder Pain in a Large Working Population

Effects of Individual and Work‐related Factors on Incidence of Shoulder Pain in a Large Working Population: Julie BODIN, et al. LUNAM Université, Université d’Angers, Laboratoire d’ergonomie et d’épidémiologie en santé au travail (LEEST), France—

Work-related risk factors for incidence of lateral epicondylitis in a large working population

OBJECTIVES This study aims to estimate the association between repeated measures of occupational risk factors and the incidence of lateral epicondylitis in a large working population. METHODS A total of 3710 workers in a French region were included in 2002-2005, and among them 1046 had a complete follow-up in 2007-2010. At both stages, occupational health physicians assessed the presence of lateral epicondylitis and workers self-reported their occupational exposures. Poisson models were performed to assess the incidence rate ratios (IRR) separately by sex using multiple imputed data. RESULTS The annual incidence rate of lateral epicondylitis was estimated as 1.0 [95% confidence interval (95% CI) 0.7-1.3] per 100 workers among men and 0.9 (95% CI 0.6-1.3) among women. Workers aged >45 years had higher incidence than those aged <30 years (significant at 10%). Among men, high physical exertion combined with elbow flexion/extension or extreme wrist bending (>2 hours/day) was a risk factor, with an age-adjusted IRR of 3.2 (95% CI 1.5-6.4) for workers exposed at both questionnaires [3.3 (95% CI 1.4-7.6) among women]. CONCLUSIONS This study highlights the importance of temporal dimensions for occupational risk factors on the incidence of lateral epicondylitis. Further research should evaluate the risk associated with the duration and repetition of occupational exposure on the incidence of lateral epicondylitis.

Employment and occupational outcomes of workers with musculoskeletal pain in a French region

Objectives To study the employment and occupational outcomes of workers who were diagnosed with upper limb musculoskeletal disorders (UL-MSDs) or had complained of upper limb musculoskeletal pain a few years before compared with workers who had no upper limb pain. Methods In 2002–2005, an epidemiological surveillance system was set up. Occupational physicians examined 3710 randomly selected workers. It focused on six UL-MSDs: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, de Quervains disease, carpal tunnel syndrome and ulnar tunnel syndrome. Three groups were constituted: a ‘UL-MSD’ group (workers with a clinically diagnosed UL-MSD at baseline, 13% of the cohort); a ‘PAIN’ group (workers with pain in the previous 7 days at baseline and without any clinically diagnosed form, 38%); and a ‘HEALTHY’ group (workers with no disorder or upper limb pain in the previous 7 days, 49%). They completed a questionnaire between 2007 and 2009. Results A total of 2332 responded. Fewer subjects were still in work in the ‘UL-MSD’ group (79.3%) than in the ‘PAIN’ (85.9%) and ‘HEALTHY’ (90.4%) groups, the difference remaining significant after adjusting for gender, age, occupational category, type of company and comorbidities. Of the subjects still in work, 24% had changed their work station in the same company in the ‘PAIN’ group compared with 19% in the ‘HEALTHY’ group and 21% in the ‘UL-MSD’ group. Conclusions This study showed the impact of musculoskeletal pain on employment outcome and the difficulty of keeping workers with musculoskeletal problems at work.

Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees

BACKGROUND CONTEXT Low back pain (LBP) is a major public health problem, with a considerable impact on workers. PURPOSE To model the risk of LBP in the male general working population. STUDY DESIGN/SETTING Repeated cross-sectional surveys in a wide occupational setting. PATIENT SAMPLE A random sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002, and 1,313 of these (60.8%) participated in a second survey in 2007. OUTCOME MEASURE The self-reported prevalence of LBP during the previous week in the second survey. METHODS Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey. The association between these potential risk factors and the prevalence of later LBP (in the second survey) was studied, using multistep logistic regression models. RESULTS Three hundred ninety-four men reported LBP in the second survey (prevalence 30.0%). The final multivariate model highlighted four risk factors: frequent bending (odds ratio [OR], 1.45, 95% confidence interval [CI], 1.07-1.97 for bending forward only; and OR, 2.13, 95% CI, 1.52-3.00 for bending both forward and sideways), driving industrial vehicles (OR, 1.35; 95% CI, 1.00-1.81), working more hours than officially planned (OR, 1.38; 95% CI, 1.05-1.81), and reported low support from supervisors (OR, 1.35; 95% CI, 1.02-1.79). CONCLUSIONS These results emphasize that biomechanical factors remain worth considering, even when psychosocial factors are taken into account, and provide a significant contribution to preventive strategies.

Facteurs associés à la lombalgie chez les hommes salariés des Pays de la Loire

Objectif : Les lombalgies ont des repercussions majeures sur le monde du travail. Un manque de donnees prospectives et representatives de la diversite des emplois limite l’analyse des facteurs de risque chez les travailleurs. L’objectif de cette etude etait d’estimer, a l’aide d’une modelisation, les facteurs associes a la lombalgie chez les salaries des Pays de la Loire.Methodes : Un echantillon aleatoire de salaries a fait l’objet de deux enquetes successives. La prevalence des lombalgies lors de la deuxieme enquete a ete modelisee, par regression logistique multi-etapes, a partir de facteurs de risque individuels et professionnels recueillis lors de la premiere enquete. Des analyses de sensibilite ont ete realisees. Les analyses ont ete stratifiees par sexe ; seuls les resultats pour les hommes sont presentes.Resultats : Parmi les 3 710 participants a la premiere enquete, 2 332 ont repondu a la deuxieme enquete, dont 1 313 hommes. La prevalence des lombalgies etait de 30 % chez les hommes. Des douleurs du cou ou des membres superieurs, se pencher frequemment et travailler plus que prevu etaient les facteurs de risque principaux de lombalgie ulterieure. L’association observee entre un faible soutien de la hierarchie et des lombalgies ulterieures devenait non significative dans une analyse restreinte aux salaries sans lombalgie lors de la premiere enquete.Conclusions : Le role des facteurs biomecaniques et organisationnels semble predominant sur celui des facteurs psychosociaux. Celui des facteurs individuels est d’interpretation delicate. Quelques limites methodologiques doivent etre discutees, mais l’analyse simultanee de multiples facteurs dans une population diversifiee de travailleurs constitue un apport original et utile pour des actions de prevention.Prat Organ Soins. 2011;42(3):157-68

Biomechanical constraints remain major risk factors for low back pain: results from a prospective cohort study in French male employees

Objectives Low back pain (LBP) has a major impact on work. Prospective data dealing with a wide range of jobs are needed to determine the main risk factors for workers. The objective of this study was to model the risk of LBP in the male general working population. Methods A random sample of 2161 men working in various occupations and industry sectors in the Pays de la Loire (West France) participated in a first survey in 2002. In 2007, 1313 of these (60.8%) participated in a second survey. The association between 21 biomechanical, organisational, psychosocial and individual risk factors (assessed in the first survey) and the prevalence of LBP (during the week preceding the second survey) was studied, using multi-step logistic regression models. Results 394 men reported LBP in the second survey (prevalence: 30.0%). The final multivariate model highlighted four risk factors for subsequent LBP: frequent bending (ORs 1.45; 95% CIs 1.07 to 1.97 for bending forward only, and 2.13; 1.52 to 3.00 for bending both forward and sideways), driving industrial vehicles (1.35; 1.00 to 1.81), working more hours than officially planned (1.38; 1.05 to 1.81), and reported low support from supervisors (1.35; 1.02 to 1.79). Conclusions Whereas current research on LBP mostly focuses on psychosocial issues, these results emphasise that biomechanical factors remain worth considering. Some methodological limitations are discussed, but the prospective analysis of numerous factors in a varied range of workers provides an original contribution to preventive strategies.