Abstract
BackgroundMusculoskeletal disorders are the most frequent occupational diseases in Europe. However, their multifactorial aetiology poses several challenges concerning not only the estimation of relative prevalence rates across occupational groups but also how the co-occurrence of known risk factors might differ between disorders of the upper and lower limbs. Against this background, the following objectives are pursued: (1) to estimate the relative odds and prevalence rates of self-reported disorders of the upper limbs and/or shoulders and neck (upper body) and the lower limbs for major ISCO-88 occupational groups, (2) to evaluate to what extent the associations between known risk factors differ for musculoskeletal disorders of the upper body and the lower limbs.MethodsStatistical analysis of cross-sectional data from the European Working Conditions Survey 1995-2010. The probability of reporting upper body and lower limbs pain in the survey sample 2010 is estimated by mixed logistic regression models using the Markov chain Monte Carlo Sampler. Independent variables include some known physical and psychosocial risk factors.ResultsConcerning the first objective, an excess risk of reporting musculoskeketal disorders of the upper body was observed among craft workers (ISCO 7), machine operators (ISCO 8) and workers in elementary occupations (ISCO 9). Concerning musculoskeletal disorders of the lower limbs, service and sales workers (ISCO 5) and workers in ISCO groups 7, 8 and 9 reported symptoms more frequently. Regarding the second objective, similar association patterns were observed for upper body and lower limbs symptoms. Major physical risk factors associated with both symptom types were very frequent exposure to tiring positions, carrying heavy loads and performing repetitive tasks. Standing appears to be an important risk factor for lower limbs symptoms only.ConclusionsResults suggest that the unequal burden of exposure has not changed substantially across occupational groups since 1995, and that there is urgent need of delivering and evaluating the effects of specific interventions targeting workers at high risk of developing musculoskeletal disorders.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-285) contains supplementary material, which is available to authorized users.
Highlights
Musculoskeletal disorders are the most frequent occupational diseases in Europe
Epidemiological research has been focused on musculoskeletal disorders of the neck, lower back and upper limbs, so that it is not clear to what extent the co-occurrence of known risk factors might differ between disorders of the upper and lower limbs. In this contribution these challenges are addressed by analysing cross-sectional data from the European Working Conditions Survey (EWCS) with the following research objectives: (1) to estimate the relative odds and prevalence rates of self-reported disorders of the upper limbs and/or shoulders and neck and the lower limbs for major International Standard Classification of Occupations (ISCO) occupational groups, (2) to evaluate to what extent the associations between known risk factors differ for musculoskeletal disorders of the upper body and the lower limbs
A comparison of the estimates since EWCS 1995 reveals that the inequalities of exposure to physical risk factors remain consistent and extremely concentrated in specific occupational groups
Summary
Musculoskeletal disorders are the most frequent occupational diseases in Europe Their multifactorial aetiology poses several challenges concerning the estimation of relative prevalence rates across occupational groups and how the co-occurrence of known risk factors might differ between disorders of the upper and lower limbs. Concerning physical risk factors, another prospective twin study in Finland confirmed that shift work, monotonous work, lifting and carrying, physically demanding work are strongly associated with work incapacity and disability pension [13]. The results of both studies were consistent after controlling for genetic and shared-environment factors. Prevalence rates of self-reported MSD by occupational ISCO groups from European cross-sectional data are highest among service and sales workers (ISCO 5), elementary occupations (ISCO 9), plant and machine operators (ISCO 8), and skilled agricultural and fishery workers (ISCO 6) [2]
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