Prevalence Rates Of Musculoskeletal Disorders Research Articles

Ergonomic Evaluation of Working Conditions in Orthotists and Prosthetists by Rapid Entire Body Assessment (REBA)

Background and Objectives: This study aimed to determine the prevalence rate of musculoskeletal disorders and evaluate the body position in routine tasks among orthotists and prosthetists. Methods: Forty orthotists and prosthetists were included. The scores of the Nordic Musculoskeletal Questionnaire and the Rapid Entire Body Assessment were used to determine the prevalence rate of musculoskeletal disorders and analyze the work position of orthotists and prosthetists, respectively. An examiner evaluated 10 working postures that were dominantly used every day, in each orthotist and prosthetist. Results: Among the orthotists, 55.6% of men and 47% of women suffered from pain in the trunk, neck, and lower limbs. Nearly similar results were seen in the upper limbs (74.1% men and 45.5% women). Such high prevalence rates were not seen in prosthetists. The analysis of the Rapid Entire Body Assessment scores based on the working task and gender of the orthotist and prosthetist showed that more than 60% of the workers achieved a score of 4 to 7 approximately in half of the tasks. It shows the medium risk of musculoskeletal disorders, thus, corrective action is necessary. Conclusion: Based on the findings, musculoskeletal disorders are highly prevalent among orthotists and prosthetists, especially in the orthotist workers. To reduce these disorders, it is recommended to add ergonomic topics and training courses for working with devices to increase the knowledge of specialists and apply and select practical tools based on the principles of ergonomics.

Association of individual and device usage factors with musculoskeletal disorders amongst handheld devices users during homestay due to pandemic

PurposeThe COVID-19 pandemic is spreading in India and different parts of the world. The outbreak delivered not only the condition of dying from infection but also forced people (especially office workers and students) to perform all working (office work, classes, assignments, etc.) and non-working activities (leisure activities such as social media, gaming, etc.) at home using handheld devices (HHDs). In this situation, HHD usage for longer durations is mainly responsible for work-related health issues. Therefore, the paper aims to explore HHD usage patterns and musculoskeletal disorders (MSDs) amongst HHD users during homestay and the impact of individual and HHD usage–related factors on MSDs.Design/methodology/approachFrom different states of India, 651 people (especially HHD users from universities and industries) were sampled by using systematic cluster random sampling. In addition, an online questionnaire was used to collect data on the prevalence and risk factors of MSDs. Finally, mean comparisons and chi-square analysis was used to analyse the collected data.FindingsThe prevalence rate of MSDs was higher in upper body parts as compared to the lower body parts. The association of gender with MSDs in various body parts was substantial. The time spent on various working and non-working activities using HHDs was significantly associated with MSDs in upper body parts.Practical implicationsHomestay work may be used as an alternative working arrangement, and the risk factors that have the most significant impact on the health of HHD users may be identified by organizations. The findings suggest the proper use of HHDs as per their essential need with intermediate recreational activities.Originality/valueIt is observed that the musculoskeletal health of office workers and university students is a cause for concern during homestay. The current study provides the prevalence of MSDs experienced by HHD users and the association of individual and HHD usage factors with MSDs.

Prevalence, Deaths, and Disability-Adjusted Life Years Due to Musculoskeletal Disorders for 195 Countries and Territories 1990-2017.

To report the levels and trends of prevalence, deaths, and disability-adjusted life years (DALYs) due to musculoskeletal disorders, categorized as low back pain, neck pain, osteoarthritis (OA), rheumatoid arthritis (RA), gout, and other musculoskeletal disorders, across 195 countries and territories from 1990 to 2017 according to age, sex, and Sociodemographic Index (SDI; a composite of sociodemographic factors). Data were obtained from the Global Burden of Disease (GBD) Study 2017. The fatal and nonfatal burdens of musculoskeletal disorders were estimated using the Cause of Death Ensemble model and Bayesian meta-regression tool, respectively. Estimates were provided for all musculoskeletal disorders and the corresponding 6 categories at global, regional, and national levels from 1990 to 2017. Counts and age-standardized rates per 100,000 population along with 95% uncertainty intervals (95% UIs) were reported for prevalence, deaths, and DALYs. Globally, there were ~1.3 billion prevalent cases (95% UI 1.2 billion, 1.4 billion), 121.3 thousand deaths (95% UI 105.6 thousand, 126.2 thousand), and 138.7 million DALYs (95% UI 101.9 million, 182.6 million) due to musculoskeletal disorders in 2017. Age-standardized prevalence, death, and DALY rates per 100,000 population were 16,276.2 (95% UI 15,495.5, 17,145.8), 1.6 (95% UI 1.4, 1.6), and 1,720 (95% UI 1,264.4, 2,259.2), respectively. Age-standardized prevalence (-1.6% [95% UI -2.4, -0.8]) and DALY rates (-3.5% [95% UI -4.7, -2.3]) decreased slightly from 1990. The global point prevalence rate of musculoskeletal disorders in 2017 was higher in women than in men and increased with age up to the oldest age group. Globally, the proportion of prevalent cases according to category of musculoskeletal disorders in 2017 was greatest for low back pain (36.8%), followed by other musculoskeletal disorders (21.5%), OA (19.3%), neck pain (18.4%), gout (2.6%), and RA (1.3%). These proportions did not change appreciably compared with 1990. The burden due to musculoskeletal conditions was higher in developed countries. The countries with the highest age-standardized prevalence rates of musculoskeletal disorders in 2017 were Switzerland (23,346.0 [95% UI 22,392.6, 24,329.8]), Chile (23,007.9 [95% UI 21,746.5, 24,165.8]), and Denmark (22,166.1 [95% UI 20,817.2, 23,542.1]). The greatest increases from 1990 were found in Chile (10.8% [95% UI 6.6, 15.4]), Benin (8.8% [95% UI 6.7, 11.1]), and El Salvador (8.5% [95% UI 5.5, 11.9]). There is a large burden of musculoskeletal disorders globally, with some notable inter-country variation. Some countries have twice the burden of other countries. Increasing population awareness regarding risk factors, consequences, and evidence-informed treatment strategies for musculoskeletal disorders with a focus on the older female population in developed countries is needed, particularly for low back and neck pain and OA, which contribute a large burden among this cohort.

Epidemiology of musculoskeletal complaints and diseases in Qatar: A cross-sectional study.

Background: Musculoskeletal (MSK) conditions are considered a significant public health problem on account of their high prevalence in communities worldwide and their pervasive impact. Knowledge of the epidemiology of MSK symptoms and diseases is lacking in Qatar. Obtaining this information will guide local health policymakers in the future strategic planning of the health budget.Objective: To estimate the prevalence rate of MSK disorders in the Qatari population above 15 years of age using the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) survey.Methods: This cross-sectional study targeted 1000 Qatari participants, including 500 males and 500 females. A door-to-door survey was conducted using the Arabic version of the COPCORD questionnaire with the help of research assistants. Participants with positive surveys were asked to visit Hamad General Hospital Rheumatology outpatient clinics for clinical evaluation by a rheumatologist. When necessary, laboratory testing and X-rays were conducted to confirm any MSK diagnosis.Results: A total of 1239 (males, 50.8%) Qatari individuals randomly selected from the different municipalities of Qatar completed the COPCORD survey. Among the participants, 563 (45.4%) screened positive for MSK pain. Knee pain (24.5%) and back pain (23.3%) were the most common sites of pain, and both conditions showed no gender predominance (p = 0.073 and 0.108, respectively). Shoulder, wrist, hand, hip, and neck pain were significantly predominant in females (p < 0.001 for all). A total of 237 MSK disorders were diagnosed in 196 (15.8%) participants, including 181 degenerative joint diseases, 52 soft-tissue rheumatism conditions, and 4 autoimmune inflammatory disorders. Among degenerative joint diseases, knee osteoarthritis (6.4%) was the most common. Among soft-tissue rheumatic conditions, muscular lower back pain (1.9%), myofascial neck pain (0.64%), generalized body pain (0.32%), and shoulder tendinitis (0.7%) were the most common diseases. The autoimmune inflammatory disorders identified included rheumatoid arthritis (n = 2), connective tissue disease (n = 1), and inflammatory bowel disease-associated arthritis (n = 1).Conclusion: The overall prevalence rate of MSK disorders in this small cross-sectional cohort of Qatari individuals was 15.8%. Knee pain (24.5%) and knee osteoarthritis (6.4%) were the most common MSK complaints and diagnosis in the studied Qatari population. This study guides future efforts directed toward the prevention and management of MSK diseases. Further studies with a larger sample size are needed to verify the findings.

Agricultural Risk Factors Related Musculoskeletal Disorders among Older Farmers in Pathum Thani Province, Thailand

ABSTRACT Background Agriculture is one of the most hazardous jobs in terms of occupational illness, especially musculoskeletal disorders (MSDs). This paper is a cross-sectional study designed to identify agricultural risk factors related to MSDs among older farmers. Methods A convenience sampling method was used to select 481 older farmers from the Nong Suea district in Pathum Thani province. A three-part questionnaire generated data that included demographics, work conditions, and environment, and self-reported MSDs. Multiple logistic regression analysis was used to identify the risk factors for MSDs. Results The results indicated the prevalence of musculoskeletal symptoms in the past 7 days and 12 months were 87.9% and 88.9%, respectively. The three body parts with highest prevalence rates of MSDs were lower extremities (65.4%), lower back (42.6%), and shoulders (29.9%). Factors significantly associated with reporting MSDs during the past 12 months (p value <.05) were women (adjusted odds ratio = 2.52: 95% CI; 1.19–5.36), using agricultural tools (adjusted odds ratio = 4.40: 95% CI; 1.18–13.79), prolonged static postures (adjusted odds ratio = 3.81: 95% CI; 1.05–13.82), and lifting >10 kg (adjusted odds ratio = 2.87: 95% CI; 1.22–6.82). Conclusions Study results revealed older farmers had high prevalence of MSDs and various related risk factors. Occupational ergonomic issues for promoting safety awareness of agricultural risk factors among elderly farmers should be considered.

Comparison the Effect of Educational Interventions Based on Brochure and Virtual Education in Compliance Principles of Ergonomic Operating Room Technologist of Iran University of Medical Sciences

Background: High prevalence rate of musculoskeletal disorders and their control among personnel is one of the most important concerns for ergonomics experts across the globe. Prevention of musculoskeletal disorders is among national priorities of many countries. Objectives: This study aimed to determine and compare the effect of educational interventions based on brochure and virtual education in compliance with principles of ergonomics in operating room technologist. Methods: This quasi-experimental study was conducted with experimental groups (brochures and virtual education) and a control group with pre-test and post-test design. One hundred operating room technologists of Iran University of Medical Sciences were selected with simple random sampling method and assigned randomly to three groups. Data were collected by REBA checklist, and analyzed using Wilcoxon and U Mann-Whitney non-parametric tests in SPSS V.20. Results: The results showed that statistically significant differences among the three groups of control, brochures and virtual (P = 0.0001). Education was more effective in the virtual group in comparison to the brochure group (P = 0.0002). There was a statistically significant difference between control and brochure groups (P = 0.0001). Conclusions: This study showed the effectiveness of teaching interventions based on brochure and virtual methods in compliance with ergonomics principles, therefore, it is recommended to use these methods instead of conventional methods to prevent complications of musculoskeletal disorders.

Meta-analysis of the prevalence rate of work-related musculoskeletal disorders in operation room nurses in China

Objective To understand the prevalence of musculoskeletal diseases among nurses in operation rooms in China, and to provide reference for their treatment and prevention. Methods CNKI (China National Knowledge Infrastructure) , VIP (China Science and Technology Journal Database) , Wangfang Data Knowledge service platform, CMB disc (China Biology Medicine disc) , PubMed, Web of Science and other databases are searched by computer. The searching time is limited to the 31st of December 2017. Two researchers independently screened the literature according to the selected and excluded criteria. The authors, publishing time, total sample size, number of patients and morbidity of the literature were extracted. The quality of the selected literature was evaluated by the evaluation criteria of descriptive study of JBI Evidence-based Health Care Center in Australia. Meta analysis was performed by Stata 14.0 software. Results Totally 10 studies were retrieved, including 3 A Class and 7 B Class, and 2 374 samples were include. Results of Meta-analysis showed that the prevalence rate of musculoskeletal disorders in nurses in the operation room was 87% (95%CI: 83.0%-91.0%) . The prevalence of waist was the highest (73%, 95%CI: 68%-77%) , followed by neck prevalence (66%, 95%CI: 57%-76%) and shoulder joint morbidity (57%, 95%CI: 49%-66%) . The results of subgroup analysis showed that the incidence of musculoskeletal disease in operation room nurses increased with the age of nurses and working years. The prevalence rate in nurses working longer than 8 hours per day was 92% (95%CI: 89%-95%) , which was higher than that in nurses working less than 8 hours per day by 79% (95%CI: 72%-85%) . The prevalence rate of night shift nurses was 84%, (95%CI: 74%-93%) , which was significantly higher than that of nurses who did not work at night shift (95%CI: 50%-86%) . Conclusions The prevalence rate of musculoskeletal disease in operation room nurses in China is high. The morbidity of musculoskeletal diseases in waist, neck and shoulder is the highest. Older age, longer working years, daily nursing working hours and whether to take part in night shift work are the high risk factors. Key words: Meta-analysis; Operation Room; Nurses; Occupational diseases; Prevalence; Work-related musculoskeletal disorders

Individual, physical, and organizational risk factors for musculoskeletal disorders among municipality solid waste collectors in Shiraz, Iran.

In Iran-Shiraz, municipal solid waste is collected manually requiring strenuous physical activities. This study was conducted to determine the prevalence rate of musculoskeletal disorders (MSDs) and its associated risk factors. Two hundred male waste collectors participated in this cross-sectional study, in which task analysis followed by motion and timeline analysis were performed. The data were collected using demographic, occupation-specific physical and organizational demands, and Nordic musculoskeletal questionnaires. Logistic regression analysis was used for identifying independent risk factors for MSDs. Ten motions observed during waste collection, and the most physical and organizational demands were related to the running along with bag carriage, and the time pressure, respectively. About 39% and 36.5% of the workers reported very high physical and psychological workloads, respectively. Totally, 92.5% of waste collectors reported MSDs symptom at least in one body region during the last 12 months. Lower back and knee injuries were more prevalent and more severe. Some individual factors (age, body weight, and waste collecting duration), physical demands (lifting bag/bucket, pulling/pushing waste container, walking along with bag/bucket carriage, and jumping up/down on the garbage truck), and organizational demands (low vacation and high decision authority) were the most important risk factors for developing MSDs.

Cumulative IT Use Is Associated with Psychosocial Stress Factors and Musculoskeletal Symptoms.

This study aimed to examine the relationship between cumulative use of electronic devices and musculoskeletal symptoms. Smartphones and tablet computers are very popular and people may own or operate several devices at the same time. High prevalence rates of musculoskeletal symptoms associated with intensive computer use have been reported. However, research focusing on mobile devices is only just emerging in recent years. In this study, 285 persons participated including 140 males and 145 females (age range 18–50). The survey consisted of self-reported estimation of daily information technology (IT) exposure hours, tasks performed, psychosocial stress factors and relationship to musculoskeletal discomfort in the past 12 months. Total IT exposure time was an average of 7.38 h (±5.2) per day. The psychosocial factor of “working through pain” showed the most significant association with odds ratio (OR) ranging from 1.078 (95% CI = 1.021–1.138) for elbow discomfort, to 1.111 (95% CI = 1.046–1.180) for shoulder discomfort. Desktop time was also significantly associated with wrist/hand discomfort (OR = 1.103). These findings indicate only a modest relationship but one that is statistically significant with accounting for confounders. It is anticipated that prevalence rates of musculoskeletal disorders would rise in the future with increasing contribution due to psychosocial stress factors.

Effect of personal risk factors on the prevalence rate of musculoskeletal disorders among workers of an Iranian rubber factory.

Musculoskeletal Disorders (MSDs) are among the most common occupational disorders in many countries and have an increasing trend. The present study was conducted in order to determine the prevalence rate of MSDs in different body regions and the effect of personal factors on the prevalence rate of MSDs among rubber industry workers. This analytical and cross-sectional study was performed on 206 workers of an Iranian rubber factory in 2014. The samples were randomly selected. Data were gathered by means of personal information form, the Nordic Musculoskeletal Questionnaire (NMQ) and the Rapid Entire Body Assessment (REBA). The results were analyzed using SPSS16; by descriptive and analytical statistics. The mean age and work history of subjects were 34.54±6.36 and 12.34±6.28 years, respectively. The highest prevalence rate of MSDs in the last twelve-months was related to the lower back region with a prevalence rate of 62.1%. Based on logistic regression, a significant correlation was found between MSDs and the final REBA score so that for a one-unit increase in score, the risk or complaint of neck and low back pain increased by 48.5% and 37.1%, respectively. Many rubber factory workers experience MSDs especially in the lower back region as a consequence of occupational risk factors. Therefore, detecting the occupational risk factors, work position standards and following ergonomic interventions are highly recommended.

Symptoms and musculoskeletal diseases in hospital nurses and in a group of university employees: a cross-sectional study

Background. Most studies have shown that nurses have a higher risk of developing musculoskeletal symptoms compared with other occupational groups. Aim. A cross-sectional study was performed to gain more insight into the prevalence rates of musculoskeletal disorders (MSDs) in nurses. Methods. The presence of musculoskeletal symptoms was revealed by personal interviews in a sample of 177 hospital nurses and in a reference group of 185 university employees. Musculoskeletal diseases were based on radiological examinations in all subjects. Results. Lower back pain (61% vs 42.2%) was the most frequently reported symptom, followed by neck pain (48.6% vs 38.4%) and shoulder pain (36.7% vs 25.9%), with a significantly higher prevalence in nurses. Women had about a 2-fold risk of upper limb region and neck pain compared with men. The most common abnormal findings on radiological examinations were disc herniations (n = 40). Conclusions. Nurses showed a significantly higher risk of MSDs. Prevalence rates in nurses increased significantly with age. Musculoskeletal symptoms were also common in university employees. This suggests the need for effective intervention strategies involving workers’ active participation, in order to improve the process and organization of work and promote a positive psychosocial work environment.

Prevalence of Musculoskeletal Disorders Among Farmers in Eastern Azerbaijan, Iran

Background/Objectives: The farming employs about half the world’s entire workforce. In most countries, farming is recognized as one of the most hazardous industries. Farming activities lead to awkward physical postures. These postures are: leaning, kneeling, crawling, bending, twisting to one side and repeated work that can result in physical stress and traumatic injuries. This study aimed to evaluate the ergonomic conditions and musculoskeletal symptoms among farmers in Eastern Azerbaijan, Iran. Methods/Statistical Analysis: This Descriptive-Analytical study was conducted on 130 farmers from different regions of east Azerbaijan who were between 16 to 80 years old and harvesting traditionally (not industrial). Nordic questionnaire (NMQ) was used for determining prevalence rate of musculoskeletal disorders. The postures and other ergonomic status of farmers were evaluated via REBA method. Regression and chi-square statistics tests were used to statistical data analysis. Findings: The obtained results indicated that the most reported musculoskeletal disorders in farmers are low back, wrist and ankles pain with 81.5, 40, and 30percent, respectively. Based on REBA final scores, 19 percent of farmer’s posture was at risk (4th risk level). The result also showedsignificant relationship between farmers Stature and low back pain (p-value <0.001). As well asthe relationshipbetweendifferent phase of farmingand REBA final scorewas significant (p-value <0.001). Application/Improvements: according to the results low back pain is the major problemamongfarmers caused duringcollection of harvests from farm. Results show that the harvesting have importance role in prevalence of musculoskeletal disorders in the different part of farmers body. Stature and age of farmers have considerable role in prevalence of farmer’s musculoskeletal disorders. This study showed that the studied farmers work condition is unacceptable and needs to be modified. Because, most of farming activities are done traditionally, Remedy actions to decline musculoskeletal disorders based on priorities canbe listed as training of principles of ergonomics in farming activities, regular examination, replacement of technical methods of farming (industrialized).

근위축성측삭경화증 환자의 사상체질 특성

Objectives The purpose of this study was to analyze the Sasang constitution and psychological traits of amyotrophic lateral sclerosis (ALS) patients and to utilize the results in treatment and management. Methods The differences of Sasang Constitution distribution, psychological characteristics, comorbid disorders between ALS group of 26 patients and general group of 1132 persons were investigated and analyzed. Results There was no significant different distribution of Sasang Constitution between ALS group and general group but there was Yang-like personality tendency in ALS group than general group. In overall constitution, ALS group had the high prevalence rate of musculoskeletal disorders and diabetes than general group. In Soyangin constitution, ALS group had a high prevalence rate of musculoskeletal disorders than genral group. In Taeeumin constitution, ALS group had a high prevalence rate of diabetes and hypertension than general group. Conclusion ALS patients have the Yang-like personality. It is due to the adaptation of personality on the environmental change or coping strategy on diseases rather than the characteristics of congenital Sasang Constitution.

Work-related injuries and musculoskeletal disorders among factory workers in a major city of China

This study describes the frequency of occurrence of work-related injuries and musculoskeletal disorders (MSDs) among factory workers in Shenzhen, China, and examines the determinants of injuries and MSDs.A cross-sectional survey was conducted with 3479 frontline workers in 60 factories during 2008–2009. We calculated the annual incidence rates of work-related injuries and the prevalence rates of MSD (based on the Nordic Standard Form) for the factory workers. Logistic regression analysis was applied to explore the associations between potential risk factors and occupational injury and MSD.Among all participating workers, 8.3% reported acute traumatic injuries in the previous 12 months. The event-based incidence rate was 119.6 per 1000 person-years. About half of the frontline workers reported suffering from MSDs during the previous 12 months. The injury risk was reduced for female workers (Odds ratio, OR: 0.48; 95% confidence interval, CI: 0.36–0.66) and those with higher educational levels, but increased in workers with over 55 work hours/week (OR: 1.64; 95% CI: 1.21–2.22), high mental stress at work (OR: 3.50; 95% CI: 1.70–7.19) and previous injury history (OR: 3.94; 95% CI: 2.78–5.58). The MSD risk was increased among female workers (OR: 1.58; 95% CI: 1.34–1.87), and those with over 55 work hours/week (OR: 1.56; 95% CI: 1.28–1.90), high mental stress at work (OR: 3.16; 95% CI: 2.04–4.89) and a past injury history (OR: 3.04; 95% CI: 2.14–4.32).High proportions of frontline workers were affected by work injuries and MSDs in these factories in China. Long work hours, high mental stress at work and previous injury history were important risk factors for work-related injury and MSD.

Analyzing the factors of influencing the musculoskeletal disorders of greenhouse vegetable farmers

To study the prevalence of musculoskeletal disorders (MSDs) among greenhouse vegetable farmers and to explore the risk factors of MSDs. A household questionnaire survey was conducted to investigate 203 greenhouse vegetable farmers and 127 non-greenhouse vegetable farmers in February, 2011. The one-year prevalence rates of MSDs were 70.0% and 33.9% among greenhouse vegetable farmers and non-greenhouse vegetable farmers, respectively. The three main positions of MSDs in greenhouse farmers were low back, knee (s) and shoulder (s). Age, working years, body weight and usage of rolling machine were statistically associated with MSDs of greenhouse farmers, ORadj values were 1.17, 1.82, 1.08 and 0.07, respectively. The prevalence of MSDs is high in greenhouse workers. Low back pain, knee (s), and shoulder (s) disorders are the main disorders. Age, working years, body weight and usage of rolling machine are main risk factors for the development of MSDs in greenhouse farmers.

Predictors for effective prevention of low back pain in nurses

Background: In the frame of the multi-dimensional training program Back Protective Patient Transfer (BPPT) „instructors“ are trained to teach their colleagues on the wards, to give practical support and refresher courses. The aim is to generate sustainability. Patient transfers are planned using team structures with special regard to ergonomic devices and work place adjustment related to the specific transfer situations. By statistical analysis we found criteria for successful implementation strategies and effects on several outcomes (back health, work load). Methods: The cross-sectional questionnaire investigation took place in 2008 (21 German health care institutions), measuring prevalence rates of musculoskeletal disorders compared to a control group. Predictor variables of a) the program to ensure sustainability of effects and b) factors of individual implementation in the intervention group (n=249) were estimated by multivariate logistic and linear regression (forward elimination, p&lt;0.05, most parsimonious model). Effect sizes were calculated using RRR (relative risk reduction) and RBI (relative benefit increase). Results: The most dominant predictors on back pain related outcomes are competencies in the use of BPPT-principles and of ergonomic equipment, aspects of sustainability (refresher courses) and work organization (RRR/RBI one half to at least two thirds). The personal support of instructors/nursing management increases effects on the application frequency of BPPT-principles by one third. Conclusions: The analysis demonstrates that the comparison of prevalence rates between intervention- and control group is not sufficient to estimate effects. Also the degree of the development of a „preventive culture“ in the intervention group should be controlled for final as well as for intermediate outcomes. Keywords: Health care workers, prognosis of MSD, early prevention

Les troubles musculosquelettiques du membre supérieur liés au travail

Musculoskeletal disorders of the upper extremities represent more of the two thirds of occupational diseases in France. This umbrella concept indicates at the same time many pathologies and the fact that environment requests support their development. Many epidemiological studies have showed the importance of work in these affections. Thus, biomechanical risk factors such as repetitivity, efforts and extreme articular postures as well as psychosocial risk factors were highlighted. Elements of biological plausibility consolidate the validity of the epidemiological studies. The high incidence and prevalence rates of musculoskeletal disorders imply a reflection on patients'treatment, granting a broader place to the prevention.