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Featured researches published by Yves Roquelaure.


Family Practice | 2011

Psychosocial risk factors for chronic low back pain in primary care—a systematic review

Aline Ramond; Céline Bouton; Isabelle Richard; Yves Roquelaure; Christophe Baufreton; Erick Legrand; Jean-François Huez

BACKGROUND Low back pain (LBP) is a major public health problem, often encountered in primary care. Guidelines recommend early identification of psychosocial factors that could prevent recovery from acute LBP. METHODS To review the evidence on the prognostic value of psychosocial factors on transition from acute to chronic non-specific LBP in the adult general population. Systematic review is the design of the study. A systematic search was undertaken for prospective studies dealing with psychosocial risk factors for poor outcome of LBP in primary care, screening PubMed, PsychInfo and Cochrane Library databases. The methodological quality of studies was assessed independently by two reviewers using standardized criteria before analysing their main results. RESULTS Twenty-three papers fulfilled the inclusion criteria, covering 18 different cohorts. Sixteen psychosocial factors were analysed in three domains: social and socio-occupational, psychological and cognitive and behavioural. Depression, psychological distress, passive coping strategies and fear-avoidance beliefs were sometimes found to be independently linked with poor outcome, whereas most social and socio-occupational factors were not. The predictive ability of a patients self-perceived general health at baseline was difficult to interpret because of biomedical confounding factors. The initial patients or care providers perceived risk of persistence of LBP was the factor that was most consistently linked with actual outcome. CONCLUSION Few independent psychosocial risk factors have been demonstrated to exist. Randomized clinical trials aimed at modifying these factors have shown little impact on patient prognosis. Qualitative research might be valuable to explore further the field of LBP and to define new management strategies.


Arthritis & Rheumatism | 2009

Risk factors for upper-extremity musculoskeletal disorders in the working population.

Yves Roquelaure; Catherine Ha; Clarisse Rouillon; Natacha Fouquet; Annette Leclerc; Alexis Descatha; Annie Touranchet; M. Goldberg; Ellen Imbernon

OBJECTIVE To assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders in the working population. METHODS A total of 3,710 workers (58% men) participating in a surveillance program of musculoskeletal disorders in a French region in 2002-2005 were included. Upper-extremity musculoskeletal disorders were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between musculoskeletal disorders, personal, and occupational factors were analyzed using logistic regression modeling. RESULTS A total of 472 workers experienced at least 1 upper-extremity musculoskeletal disorder. The risk of upper-extremity musculoskeletal disorders increased with age for both sexes (P < 0.001, odds ratio [OR] < or =4.9 in men and < or =5.0 in women), and in cases of prior history of upper-extremity musculoskeletal disorders (OR 3.1 and 5.0, respectively, P < 0.001). In men, upper-extremity musculoskeletal disorders were associated with obesity (OR 2.2, P = 0.014), high level of physical demand (OR 2.0, P < 0.001), high repetitiveness of the task (OR 1.5, P = 0.027), postures with the arms at or above shoulder level (OR 1.7, P = 0.009) or with full elbow flexion (OR 1.6, P = 0.006), and high psychological demand (OR 1.5, P = 0.005). In women, upper-extremity musculoskeletal disorders were associated with diabetes mellitus (OR 4.9, P = 0.001), postures with extreme wrist bending (OR 2.0, P < 0.001), use of vibrating hand tools (OR 2.2, P = 0.025), and low level of decision authority (OR 1.4, P = 0.042). CONCLUSION Personal and work-related physical and psychosocial factors were strongly associated with clinically diagnosed upper-extremity musculoskeletal disorders.


Occupational and Environmental Medicine | 2006

Why are manual workers at high risk of upper limb disorders? The role of physical work factors in a random sample of workers in France (the Pays de la Loire study).

Maria Melchior; Yves Roquelaure; Bradley Evanoff; Jean-François Chastang; Catherine Ha; Ellen Imbernon; Marcel Goldberg; Annette Leclerc

Objective: To investigate the reasons for the excess risk of upper limb musculoskeletal disorders among manual workers compared with other workers in a random sample of 2656 French men and women (20–59 years old) participating in a study on the prevalence of work related upper limb disorders conducted by France’s National Institute of Health Surveillance. Methods: Prevalence ratios (PR) of physician-diagnosed musculoskeletal disorders of the shoulder, elbow, wrist, and hand (any of six leading disorders, rotator cuff syndrome, carpal tunnel syndrome) in manual versus non-manual workers were calculated using Cox regression models with a constant time of follow up and robust variance. Results: 11.3% of men and 15.1% of women were diagnosed with an upper limb disorder. The risk was especially high in manual workers (PRs: 1.40 to 2.10). Physical work factors accounted for over 50% of occupational disparities overall, 62% (men) to 67% (women) for rotator cuff syndrome, and 96% (women) for carpal tunnel syndrome. The authors calculated that under lower levels of physical work exposures, up to 31% of cases among manual workers could have been prevented. Conclusions: In working men and women, upper limb musculoskeletal disorders are frequent. Physical work exposures, such as repetitive and forceful movements, are an important source of risk and in particular account for a large proportion of excess morbidity among manual workers.


Journal of Occupational and Environmental Medicine | 2003

Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors.

Alexis Descatha; Annette Leclerc; Jean-François Chastang; Yves Roquelaure

Learning ObjectivesRecall the approximate prevalence of medial epicondylitis in this study of workers required by their jobs to make repetitive movements, as well as the incidence in those re-examined after 3 years.Specify the clinical, demographic, and work-related factors associated with medial epicondylitis in this study population.Discuss the outlook for workers with medial epicondylitis and the place of this condition in the spectrum of work-related musculoskeletal disorders of the upper extremity. Because medial epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work and its course. A total of 1757 workers were examined by an occupational health physician in 1993–1994. Five hundred ninety-eight of them were reexamined 3 years later. Prevalence was between 4% and 5%, with an annual incidence estimate at 1.5%. Forceful work was a risk factor (odds ratio [OR], 1.95; confidence interval [CI] = 1.15–3.32), but not exposure to repetitive work (OR, 1.11; CI = 0.59–2.10). Workers with medial epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for medial and lateral epicondylitis. The prognosis for medial epicondylitis in this population was good with a 3-year recovery rate at 81%. Medial epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good.


Muscle & Nerve | 2008

Work increases the incidence of carpal tunnel syndrome in the general population

Yves Roquelaure; Catherine Ha; Marie‐Christine Pelier‐Cady; Guillaume Nicolas; Alexis Descatha; Annette Leclerc; G. Raimbeau; Marcel Goldberg; Ellen Imbernon

The purpose of this study was to estimate the incidence of carpal tunnel syndrome (CTS) in a general population according to employment status and to assess the proportion of cases attributable to work. CTS occurring in patients aged 20–59 years living in the French Maine and Loire region were included prospectively from 2002 to 2004. Medical and occupation history was gathered by mailed questionnaire. Incidence rates of CTS and relative risks (RRs) of CTS were computed in relation to employment status. The attributable fractions of risk of CTS to work among the exposed persons (AFEs) were calculated. A total of 1168 patients (819 women, 349 men) were included during the 3‐year period. The mean incidence rate of CTS per 1000 person‐years was higher in employed than unemployed persons (1.7 vs. 0.8 in women and 0.6 vs. 0.3 in men). The excess risk of CTS was statistically significant for male (RR 4.2) and female (RR 3.0) blue‐collar workers and female lower‐grade white‐collar workers (RR 2.5). The AFE to work in general was 47% (95% confidence interval: 39–54) in women. AFEs reached higher values in female blue‐collar workers [67% (65–68)] and lower‐grade services, sales, and clerical white‐collar workers [61% (57–64)]. The AFE in male blue‐collar workers was 76% (72–80). These data show a higher incidence of CTS in the working than the non‐working population and suggest that a substantial proportion of CTS cases diagnosed in lower‐grade white‐collar and blue‐collar workers are attributable to work. Muscle Nerve, 2008


Occupational and Environmental Medicine | 2002

Active epidemiological surveillance of musculoskeletal disorders in a shoe factory.

Yves Roquelaure; Mariel J; Serge Fanello; Boissière Jc; Chiron H; Dano C; Bureau D; D. Penneau-Fontbonne

Aims: (1) To evaluate an active method of surveillance of musculoskeletal disorders (MSDs). (2) To compare different criteria for deciding whether or not a work situation could be considered at high risk of MSDs in a large, modern shoe factory. Methods: A total of 253 blue collar workers were interviewed and examined by the same physician in 1996; 191 of them were re-examined in 1997. Risk factors of MSDs were assessed for each worker by standardised job site work analysis. Prevalence and incidence rates of carpal tunnel syndrome, rotator cuff syndrome, and tension neck syndrome were calculated for each of the nine main types of work situation. Different criteria used to assess situations with high risk of MSDs were compared. Results: On the basis of prevalence data, three types of work situation were detected to be at high risk of MSDs: cutting, sewing, and assembly preparation. The three types of work situations identified on the basis of incidence data (sewing preparation, mechanised assembling, and finishing) were different from those identified by prevalence data. At least one recognised risk factor for MSDs was identified for all groups of work situations. The ergonomic risk could be considered as serious for the four types of work situation having the highest ergonomic scores (sewing, assembly preparation, pasting, and cutting). Conclusion: The results of the health surveillance method depend largely on the definition of the criteria used to define the risk of MSDs. The criteria based on incidence data are more valid than those based on prevalence data. Health and risk factor surveillance must be combined to predict the risk of MSDs in the company. However, exposure assessment plays a greater role in determining the priorities for ergonomic intervention.


Occupational and Environmental Medicine | 2009

The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network

Catherine Ha; Yves Roquelaure; Annette Leclerc; Annie Touranchet; Marcel Goldberg; Ellen Imbernon

Objectives: An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France’s Pays de la Loire region to assess the incidence and prevalence of MSDs in the general and working populations, identify levels of exposure to occupational risk factors and investigate the proportion of cases attributable to work exposure. Methods: The program combines (1) surveillance of sentinel health events in the general population (carpal tunnel syndrome (CTS) was the sentinel event for upper limb MSDs), (2) assessment of the prevalence of the main upper limb MSDs and their risk factors in the workplace based on a network of occupational physicians and (3) registration of the notification of work-related diseases (WRDs). Results: 1168 incident cases of CTS were included over a 3 year period. The estimated incidence of CTS was 1.00 per 1000 person-years in those aged 20–59 years (0.60 in men and 1.40 in women). The incidence rate was higher in employed than unemployed persons in the year of diagnosis (0.6 per 1000 vs 0.3 in men and 1.7 vs 0.8 in women). The occupational physician network noted high prevalence rates: 11% of men and 15% of women had at least one of the six main upper limb clinically-diagnosed MSDs. The WRD survey showed that MSDs represented 65% of notified WRDs. Conclusion: The Pays de la Loire program plays a significant role in informing the authorities and the public about the state of current MSDs. It is planned to extend it to a routine national surveillance program.


Scandinavian Journal of Work, Environment & Health | 2012

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

Julie Bodin; Catherine Ha; Petit Le Manac’h A; Céline Sérazin; Alexis Descatha; Annette Leclerc; M. Goldberg; Yves Roquelaure

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.


Spine | 2011

Multidisciplinary Intensive Functional Restoration Versus Outpatient Active Physiotherapy in Chronic Low Back Pain A Randomized Controlled Trial

Ghislaine Roche-Leboucher; Audrey Petit-Lemanacʼh; L. Bontoux; Valérie Dubus-Bausière; Elsa Parot-Shinkel; Serge Fanello; D. Penneau-Fontbonne; Natacha Fouquet; Erick Legrand; Yves Roquelaure; Isabelle Richard

Study Design. Randomized parallel group comparative trial with a 1-year follow-up period. Objective. To compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up. Summary of Background Data. Controlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration. Methods. A total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847). Results. In both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group. Conclusion. Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.


Arthritis & Rheumatism | 2008

Attributable risk of carpal tunnel syndrome according to industry and occupation in a general population.

Yves Roquelaure; Catherine Ha; Guillaume Nicolas; Marie‐Christine Pelier‐Cady; Camille Mariot; Alexis Descatha; Annette Leclerc; G. Raimbeau; M. Goldberg; Ellen Imbernon

OBJECTIVE An epidemiologic surveillance network for carpal tunnel syndrome (CTS) was set up in the general population of a French region to assess the proportion of CTS cases attributable to work in high-risk industries and occupations. METHODS Cases of CTS occurring among patients ages 20-59 years living in the Maine and Loire region were included prospectively from 2002 to 2004. Medical and occupation history was gathered by mailed questionnaire for 815 women and 320 men. Age-adjusted relative risks of CTS and the attributable risk fractions of CTS among exposed persons (AFEs) were computed in relation to industry sectors and occupation categories. RESULTS Twenty-one industry sectors and 8 occupational categories for women and 10 sectors and 6 occupational categories for men were characterized by a significant excess risk of CTS. High AFE values were observed in the manufacturing (42-93% for both sexes), construction (66% for men), and personal service industries (66% for women) and in the trade and commerce sectors (49% for women). High AFE values were observed in lower-grade white-collar occupations for women (43-67%) and blue-collar occupations for men (60-74%) and women (48-88%). CONCLUSION The attributable proportions of CTS cases among workers employed in industry sectors and occupation categories identified at high risk of CTS varied between 36% and 93%.

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Catherine Ha

Institut de veille sanitaire

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Ellen Imbernon

Institut de veille sanitaire

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M. Goldberg

Institut de veille sanitaire

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