Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys.

International audienceINTRODUCTION: In France, most studies of low back pain (LBP) have been carried out among workers or patients. Until very recently, the frequency of LBP in the general population was not known, because National Health Surveys did not include questions on LBP. OBJECTIVE: To estimate the prevalence of LBP in the French population aged 30 to 64 years. MATERIALS AND METHODS: The main data were from the National Health Survey 2002-2003 (n=14,248). LBP was assessed by an accompanying self-administered questionnaire asking details about duration of LBP in the previous 12 months. Weights were used to estimate the prevalence of LBP in the French population, with two definitions of LBP. Additional results dealing with chronic LBP, from another national survey (Handicap, Disability and Dependence), are also briefly presented. RESULTS: More than half of the French population in this age group experienced LBP at least one day in the previous 12 months (LBP1), with 17% experiencing LBP for more than 30 days in the previous 12 months (LBP30); prevalence differed between men and women and that of LBP30 increased with age. DISCUSSION-CONCLUSION: The prevalence of LBP as assessed by the National Health Survey is similar to that found in countries other than France. These estimates can be used as a reference for surveys in specific populations, provided that comparable methodologies are used

The CONSTANCES cohort: an open epidemiological laboratory

<p>Abstract</p> <p>Background</p> <p>Prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an "open epidemiologic laboratory" accessible to the epidemiologic research community. Although designed as a "general-purpose" cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on aging.</p> <p>Methods/Design</p> <p>The CONSTANCES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200,000 subjects will be included over a five-year period. At inclusion, the selected subjects will be invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities will be performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data will be collected from the French national retirement, health and death databases. The data that will be collected include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data will cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death.</p> <p>To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants will be set up and followed through the same national databases as participants.</p> <p>A field-pilot was performed in 2010 in seven HSCs, which included about 3,500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data.</p> <p>Discussion</p> <p>The constitution of the full eligible sample is planned during the last trimester of 2010, and the cohort will be launched at the beginning of 2011.</p

Autoantibodies against type I IFNs in patients with critical influenza pneumonia

In an international cohort of 279 patients with hypoxemic influenza pneumonia, we identified 13 patients (4.6%) with autoantibodies neutralizing IFN-alpha and/or -omega, which were previously reported to underlie 15% cases of life-threatening COVID-19 pneumonia and one third of severe adverse reactions to live-attenuated yellow fever vaccine. Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-alpha 2 alone (five patients) or with IFN-omega (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-alpha 2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-omega. The patients' autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients 70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-alpha 2 and IFN-omega (OR = 11.7, P = 1.3 x 10(-5)), especially those <70 yr old (OR = 139.9, P = 3.1 x 10(-10)). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for similar to 5% of cases of life-threatening influenza pneumonia in patients <70 yr old

Etude des facteurs prédictifs de douleur chronique et d'incapacité chez des patients en activité professionnelle ayant des antécédents de lombalgie

Il s'agit d'une étude sur les facteurs prédictifs de passage à la lombalgie chronique dans une population en activité professionnelle. Après un rappel de quelques définitions (douleur, incapacité, chronicité) et une revue des facteurs de risque de lombalgie chronique, nous présentons un modèle prédictif de la lombalgie chronique en milieu professionnel basé sur les données d'une étude longitudinale. Deux définitions différentes de la lombalgie chronique ont été considérées, l'une axée sur la durée de la douleur et l'autre sur la récurrence de l'arrêt de travail. Un outil de prédiction pour la lombalgie quotidienne est proposé pour une utilisation en routine. Enfin, les interventions efficaces sur le retour au travail ont également été explorées à travers une revue de la littérature. Les résultats de notre travail devraient permettre de prédire parmi des sujets lombalgiques, ceux qui risquent d'évoluer vers une pathologie chronique invalidante.This study concerns the predictive risk factors of chronic low back pain (CLBP). After having defined some concepts (pain, disability, chronicity) and proposed a review on CLBP risk factors, we presented a study, which main objective was to propose a predictive model for chronic low back pain in an occupational setting. Two different dimensions of CLBP were studied : pain duration and recurrent sick leave. A predictive tool for daily LBP is developed for a routine use. Finally, a rewiew on the efficiency of some interventions on return to work was performed. Our results could help to predict among low back pain sufferers, those who will have a disabling CLBP.PARIS5-BU Saints-Pères (751062109) / SudocSudocFranceF

Chronic back problems among persons 30 to 64 years old in France.

STUDY DESIGN: A national population-based survey focusing on disability. OBJECTIVE: To describe the frequency of chronic back conditions among those aged 30 to 64 years, the consequences on their daily lives, their employment status, and source of income. SUMMARY OF BACKGROUND DATA.: Descriptive data from community-based surveys are sparse. METHODS: In the French Handicap, Disability and Dependence survey, 1,289 subjects with chronic back problems were compared with the general population. RESULTS: The estimates for prevalence of chronic back problems were 7.9% for men (95% confidence interval, 7.2-8.5) and 7.5% for women (95% confidence interval, 7.0-8.1). Despite functional limitations, most people in France who had back problems were employed in a ordinary work: 71.5% among men (77.7% in the general population), 53.5% among women (60.2% in the general population). Among them, blue-collar workers were overrepresented. Of the subjects with back conditions, a very small proportion had a source of permanent income related to their health problems. CONCLUSIONS: The results from this national population-based survey emphasize the weight of chronic back problems in the community, in a country where the legislation offers few alternatives to ordinary work for those who suffer from chronic limitations due to low back pain

Comparison of manual and automated measures of walking speed: Distance and pace matter

International audienceBackground: Walking speed (WS) represents a global marker of individual health and provides a simple and objective measure of motor performances for use in clinical and research settings. WS is most often measured over relatively short distances at usual (UWS) or fast (FWS) pace, using manual (e.g., stopwatch) or automated methods (e.g., photoelectric cells). As the time needed to walk over these distances is very short, we hypothesized that measurement error related to manual compared to automated WS measures is more pronounced for shorter distances and FWS and investigated the reliability and agreement of WS in a subsample of the Constances cohort at two paces and over two distances. Methods: We recruited 100 community-dwelling participants (50 % women) aged 45–70y (mean = 56.1y). WS was measured manually (stopwatches) and using photoelectric cells, at two paces (UWS/FWS) and over two distances (3 m/5 m). Agreement was examined using Bland and Altman plots and intraclass correlation coefficients (ICC). Results: Participants were on average 169.8 cm tall, and their mean body mass index was 25.4 kg/m2. Agreement between manual stopwatches and photoelectric cells was excellent (ICCs between 0.92 and 0.97), but it was lower for smaller distances, with significantly lower ICCs over 3 m compared to 5 m both for UWS (differenceICC = −0.04) and FWS (differenceICC = −0.05). Bias of manual measures was constant for UWS and increased with increasing FWS. There were inter-rater effects, with better agreement for UWS and 5 m compared to FWS and 3 m. Conclusions: Both distance and pace have an influence on the reliability of WS measures using manual timing methods. Our findings also suggest the presence of rater effects and better agreement for 5 m and UWS. These findings are helpful for the design of studies that include manual measures of WS, especially FWS, in order to reduce measurement error and suggest that longer distances are preferable

Association of hormonal exposure with walking function among French women: data from the CONSTANCES Study

International audienceBACKGROUND - Ageing is characterized by a progressive decline in motor function associated with an increased risk of disability, institutionalization, and death. There is an important inter-individual heterogeneity of motor function in older subjects and the identification of its determinants may help define preventive measures. Biologically, estrogens are known to have neuroprotective effects and to be involved in maintenance of muscular mass and osteoporosis prevention. However, data of the association of estrogen exposure with walking speed (WS) are scarce. METHODS - Between 2012 and 2017, more than 200000 subjects between 18 and 69 were recruited from health centers in France and participant >45 yr underwent physical function tests among operational centers (N=33892 women). Information on hormonal exposure were self-reported using detailed questionnaires. After multiple imputation by chained equations procedures, linear mixed models with the center as a random effect were used to estimate the baseline association of WS with hormonal exposures, including characteristics of reproductive life and exogenous hormones. RESULTS - Mean WS was 175 cm/s. After adjusting for several confounders including sociodemographic and anthropometric characteristics and a mutual adjustment for the different hormonal exposures, the association of age with WS varied according to the menopausal status (b for 1 yr increase=-0.33; 95%CI: -0.53; -0.13 and b for 1 yr increase=-0.65; 95%CI: -0.71; -0.59, for pre and post menopausal women respectively, p for interaction< 0.01). In addition, WS significantly increased with increase in age at menarche (b for 1 yr increase=0.30; 95%CI: 0.13; 0.48), parity (b for 1 child among parous women=0.50, 95%CI: 0.15; 0.86), age at first birth (b for 1 yr increase=0.20; 95%CI: 0.14; 0.27) and duration of breastfeeding (b for 12 months vs less than 3 months=1.61; 95%CI: 0.31; 2.90). Finally, there was no interaction between type of menopause (natural vs artificial) and age at menopause (before and after 45 yr). Compared to women with natural menopause after 45 yr, WS decreased among women with artificial menopause after 45 yr (b=-1.12; 95%CI: -2.23; -0.01), with early natural menopause (b=- 1.64; 95%CI: -2.75; -0.54) and with artificial and early menopause (b=-1.63; 95%CI: -3.05; -0.21). CONCLUSION - Our findings suggest that high levels of hormonal exposure may be associated with better WS and that time of exposure could have an important role