Upper-extremity musculoskeletal disorders: how many cases can be prevented? Estimates from the COSALI cohort.

Aboubakari Nambiema,Sandrine Bertrais,Yves Roquelaure,Bradley Evanoff,Susan Stock,Julie Bodin,Agnès Aublet-Cuvelier,Natacha Fouquet,Alexis Descatha

doi:10.5271/sjweh.3911

Aboubakari Nambiema, Sandrine Bertrais + Show 7 more

Open Access

https://doi.org/10.5271/sjweh.3911

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Abstract

Objective:This study aimed to estimate the proportion and number of incident upper-extremity musculoskeletal disorders (UEMSD) cases attributable to occupational risk factors in a working population.Methods:Between 2002−2005, occupational physicians randomly selected 3710 workers, aged 20–59, from the Pays de la Loire (PdL) region. All participants underwent a standardized clinical examination. Between 2007−2010, 1611 workers were re-examined. This study included 1246 workers who were free of six main clinically diagnosed UEMSD at baseline but were diagnosed with at least one of these UEMSD at follow-up [59% of men, mean age: 38 (standard deviation 8.6) years]. Relative risks and population-attributable fractions (PAF) were calculated using Cox multivariable models with equal follow-up time and robust variance. The total number of incident UEMSD in the PdL region was estimated after adjustment of the sample weights using 2007 census data. The estimated number of potentially avoidable UEMSD was calculated by multiplying PAF by the total number of incident UEMSD in PdL.Results:At follow-up, 139 new cases of UEMSD (11% of the study sample) were diagnosed. This represented an estimated 129 320 incident cases in the PdL in 2007. Following adjustment for personal factors, 26 381 (20.4% of all incident UEMSD) were attributable to high physical exertion, 16 682 (12.9%) to low social support, and 8535 (6.6%) to working with arms above shoulder level.Conclusions:A large number and important proportion of incident UEMSD may be preventable by reducing work exposures to physical exertion and working with arms above shoulder level as well as improving social support from co-workers/supervisors.

Highlights

Key terms cohort study; France; MSD; musculoskeletal disease; occupational risk factor; physical exertion; preventable case; prevention
A comparison of characteristics and working conditions at baseline between the eligible participants included in the analyses and those excluded is provided in an additional file [see supplementary material, www.sjweh.fi/show_abstract.php?abstract_id=3911]
Considering occupational risk factors for incident upper-extremity musculoskeletal disorders (UEMSD), our results showed that an estimated 26 381 incident cases, representing 20.4% of all new projected UEMSD cases in the Pays de la Loire (PdL) region in 2007, were attributable to high physical exertion, 8535 incident cases (6.6%) to working with arms above shoulder level, and 16 682 incident cases (12.9%) to low social support from coworkers and supervisors

Summary

Methods

We used data from the COSALI cohort, a prospective study of MSD and their risk factors in the working population based on two successive surveys of workers from the PdL region [30, 31]. Between 2002–2005, 83 occupational physicians (OP) (18% of OP in the region) volunteered to take part in the study They selected 3710 workers (2161 men, 1549 women) at random (out of 184 600 under the surveillance of the 83 OP, 2.0%). Each participating OP in charge of medical surveillance of salaried workers received guidelines describing the clinical protocol (including diagnostic criteria charts and photographs of clinical tests) and underwent a 3-hour training program to standardize clinical examinations. Between 2007–2010, the OP re-examined 1611 workers using the same procedure as the initial assessment [see [30, 31] for more details about the COSALI cohort]

Results

Discussion

Conclusion