Abstract
ObjectiveTo analyze relationships between physical occupational exposures, post-retirement shoulder/knee pain, and obesity.Methods9 415 male participants (aged 63–73 in 2012) from the French GAZEL cohort answered self-administered questionnaires in 2006 and 2012. Occupational exposures retrospectively assessed in 2006 included arm elevation and squatting (never, <10 years, ≥10 years). “Severe” shoulder and knee pain were defined as ≥5 on an 8-point scale. BMI was self-reported.ResultsMean BMI was 26.59 kg/m2 +/−3.5 in 2012. Long-term occupational exposure to arm elevation and squatting predicted severe shoulder and knee pain after retirement. Obesity (BMI≥30 kg/m2) was a risk factor for severe shoulder pain (adjusted OR 1.28; 95% CI 1.03, 1.90). Overweight (adjusted OR 1.71; 1.28,2.29) and obesity (adjusted OR 3.21; 1.90,5.41) were risk factors for severe knee pain. In stratified models, associations between long-term squatting and severe knee pain varied by BMI.ConclusionObesity plays a role in relationships between occupational exposures and musculoskeletal pain. Further prospective studies should use BMI in analyses of musculoskeletal pain and occupational factors, and continue to clarify this relationship.
Highlights
Musculoskeletal disorders (MSDs) include a wide range of diseases and injuries that comprise the largest category of workrelated illnesses
[1] Many studies have shown that occupational factors such as repeated exposure to arm elevation or squatting in the workplace predict subsequent MSDs in the shoulders and knees. [2,3,4] Previous analyses have been performed on these joints with a particular focus on associations between long-term biomechanical exposure and incidence of severe pain; consistent associations have been found between repeated exposure to arm elevation or squatting in the workplace and severe shoulder and knee pain. [5,6] Self-reported symptoms of pain are the most common criterion used to assess the presence of MSDs
In addition to being a risk factor for MSDs, recent studies have found that obesity may be a consequence of occupational exposures, potentially mediating and/or modifying effects of occupational factors on musculoskeletal pain. [15,16,17] occupational exposures may be risk factors for obesity. [15,16] Some suggest that obesity may increase mechanical forces on the joints and change the metabolic demands of the body, both of which would lead to higher rates of MSDs. [13,18] the nature of the interrelationships between occupational exposures, obesity, and musculoskeletal pain are complex; more research is needed to understand the nature of such relationships
Summary
Musculoskeletal disorders (MSDs) include a wide range of diseases and injuries that comprise the largest category of workrelated illnesses. [1] Many studies have shown that occupational factors such as repeated exposure to arm elevation or squatting in the workplace predict subsequent MSDs in the shoulders and knees. [2,3,4] Previous analyses have been performed on these joints with a particular focus on associations between long-term biomechanical exposure and incidence of severe pain; consistent associations have been found between repeated exposure to arm elevation or squatting in the workplace and severe shoulder and knee pain. [9] Obesity may be a risk factor for shoulder and knee pain [10,11,12,13]; rising obesity rates could partly explain the increasing levels of observed musculoskeletal pain and disability [14]. We hypothesized that occupational exposures may be significant contributors to incidence of musculoskeletal pain among overweight and obese patients, and that the relationships may differ for upper and lower limbs
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