Employment and occupational outcomes of workers with musculoskeletal pain in a French region

OBJECTIVES: To study the employment and occupational outcomes of workers who were diagnosed with upper limb musculoskeletal disorders (UL-MSDs) or had complained of upper limb musculoskeletal pain a few years before compared with workers who had no upper limb pain. METHODS: In 2002-2005, an epidemiological surveillance system was set up. Occupational physicians examined 3710 randomly selected workers. It focused on six UL-MSDs: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, de Quervain\u27s disease, carpal tunnel syndrome and ulnar tunnel syndrome. Three groups were constituted: a \u27UL-MSD\u27 group (workers with a clinically diagnosed UL-MSD at baseline, 13% of the cohort); a \u27PAIN\u27 group (workers with pain in the previous 7 days at baseline and without any clinically diagnosed form, 38%); and a \u27HEALTHY\u27 group (workers with no disorder or upper limb pain in the previous 7 days, 49%). They completed a questionnaire between 2007 and 2009. RESULTS: A total of 2332 responded. Fewer subjects were still in work in the \u27UL-MSD\u27 group (79.3%) than in the \u27PAIN\u27 (85.9%) and \u27HEALTHY\u27 (90.4%) groups, the difference remaining significant after adjusting for gender, age, occupational category, type of company and comorbidities. Of the subjects still in work, 24% had changed their work station in the same company in the \u27PAIN\u27 group compared with 19% in the \u27HEALTHY\u27 group and 21% in the \u27UL-MSD\u27 group. CONCLUSIONS: This study showed the impact of musculoskeletal pain on employment outcome and the difficulty of keeping workers with musculoskeletal problems at work

Devenir professionnel de salariés des Pays de la Loire souffrant de troubles musculo-squelettiques

The objective was to study the employment and occupational outcomes of workers who were diagnosed with upper limb musculoskeletal disorders (UL-MSDs) or had complained of upper limb musculoskeletal pain a few years before, compared to workers without upper limb pain. In 2002-2005, 83 occupational physicians examined 3,710 randomly selected workers. Three groups were constituted between 2007 and 2009: a “UL-MSD” group (workers with a clinically diagnosed UL-MSD); a “MS PAIN” group (workers with pain in the previous seven days and without any clinically diagnosed form); and a “HEALTHY” group (workers with no disorder or upper limb pain). A total of 2,287 responded to a questionnaire. Fewer subjects were still working in the “UL-MSD” group (79.3%) than in the “MS PAIN” (85.9%) and “HEALTHY” (90.4%) groups. Among the subjects still working, 24% had changed their position in the same company in the “MS PAIN” group, compared to 21% in the “UL-MSD” group, and 19% in the “HEALTHY” group. This study showed the impact of UL-MSDs on employment outcome and of musculoskeletal pain on occupational outcome

Effects of Individual and Work-related Factors on Incidence of Shoulder Pain in a Large Working Population

Objectives: The aim of this study was to assess the effects of individual and work-related factors on the incidence of shoulder pain in a large French working population. Methods: A total of 3,710 workers of a French region were randomly included in a cross-sectional study between 2002 and 2005. They completed a self-administered questionnaire about musculoskeletal symptoms, individual factors and exposure to work constraints. In 2007, 2,332 responded to a follow-up questionnaire. The Nordic questionnaire was used both times to assess shoulder pain during the preceding 7 days. Associations between incident shoulder pain and individual and work-related factors at baseline were studied by multivariate logistic regression for both genders. Results: A total of 946 men and 709 women without shoulder pain at baseline were eligible for the analyses. At follow-up, 105 men (11.1%) and 145 women (20.5%) reported shoulder pain. For men, age (OR 3.3, 95% CI, 1.7–6.5 for ≥50 yr), working with arms above the shoulder (1.5; 1.0–2.3) and high perceived physical exertion (1.6; 1.0–2.5) increased the risk of incident shoulder pain. For women, the factors associated with incident shoulder pain were age (2.9; 1.5–5.8 for ≥50 yr), obesity (2.5; 1.4–4.5), temporary employment (2.1; 1.1–3.7), high perceived physical exertion (2.2; 1.4–3.5) and low decision latitude (1.6; 1.0–2.3). Conclusion: Age was the strongest predictor of incident shoulder pain in both genders. BMI and biomechanical and psychosocial factors were also identified as risk factors, whereas no factor related to work organization remained in the final models

Les difficultés d’un suivi épidémiologique longitudinal dans les services de santé au travail

INTRODUCTION: This study was designed to describe the difficulties of epidemiological follow-up of employees by occupational health services. METHODS: This study was based on two transverse studies conducted by the Pays de la Loire musculoskeletal disorders (MSD) surveillance network. Eighty-three occupational health physicians included 3,710 employees between 2002 and 2005 and had to review them between 2007 and 2009. Thirteen of these physicians changed jobs and 7 changed geographical sector in the same occupational health service. RESULTS: Another 94 physicians were contacted and 85 agreed to participate in the network. The follow-up rate was 43%: 1,044 employees were reviewed by the physician who saw them on inclusion and 567 employees were reviewed by another physician of the network. The other employees were distributed as follows: 25% were lost to follow-up and their occupational status remained unknown; 23% were still employed with an identified occupational health physician but had not attended a medical visit during the follow-up study; 5% had left the occupational health surveillance system. Only 23 employees refused to participate in the follow-up and 105 employees had a physician who refused to participate. DISCUSSION: There is therefore a considerable mobility of occupational health physicians, which interfered with follow-up despite their good mobilization and a high percentage of employee are lost to follow-up after having left their jobs. More appropriate systems must be set up to follow populations of employees, such as new collaborations with general practitioners

Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees

BACKGROUND CONTEXT: Low back pain (LBP) is a major public health problem, with a considerable impact on workers. PURPOSE: To model the risk of LBP in the male general working population. STUDY DESIGN/SETTING: Repeated cross-sectional surveys in a wide occupational setting. PATIENT SAMPLE: A random sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002, and 1,313 of these (60.8%) participated in a second survey in 2007. OUTCOME MEASURE: The self-reported prevalence of LBP during the previous week in the second survey. METHODS: Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey. The association between these potential risk factors and the prevalence of later LBP (in the second survey) was studied, using multistep logistic regression models. RESULTS: Three hundred ninety-four men reported LBP in the second survey (prevalence 30.0%). The final multivariate model highlighted four risk factors: frequent bending (odds ratio [OR], 1.45, 95% confidence interval [CI], 1.07-1.97 for bending forward only; and OR, 2.13, 95% CI, 1.52-3.00 for bending both forward and sideways), driving industrial vehicles (OR, 1.35; 95% CI, 1.00-1.81), working more hours than officially planned (OR, 1.38; 95% CI, 1.05-1.81), and reported low support from supervisors (OR, 1.35; 95% CI, 1.02-1.79). CONCLUSIONS: These results emphasize that biomechanical factors remain worth considering, even when psychosocial factors are taken into account, and provide a significant contribution to preventive strategies

Internal-tide vertical structure and steric sea surface height signature south of New Caledonia revealed by glider observations

In this study, we exploit autonomous underwater glider data to infer internal-tide dynamics south of New Caledonia, an internal-tide-generation hot spot in the southwestern tropical Pacific. By fitting a sinusoidal function to vertical displacements at each depth using a least-squares method, we simultaneously estimate diurnal and semidiurnal tides. Our analysis reveals regions of enhanced tidal activity, strongly dominated by the semidiurnal tide. To validate our findings, we compare the glider observations to a regional numerical simulation that includes tidal forcing. This comparison assesses the simulation's realism in representing tidal dynamics and evaluates the glider's ability to infer internal-tide signals and their signature in sea surface height (SSH). The glider observations and a pseudo glider, simulated using hourly numerical model output with identical sampling, exhibit similar amplitude and phase characteristics along the glider track. Existing discrepancies are in large part explained by tidal incoherence induced by eddy–internal-tide interactions. We infer the semidiurnal internal-tide signature in steric SSH by the integration of vertical displacements. Within the upper 1000 m, the pseudo glider captures roughly 78 % of the steric SSH total variance explained by the full water column signal. This value increases to over 90 % when projecting the pseudo glider's vertical displacements onto climatological baroclinic modes and extrapolating to full depth. Notably, the steric SSH from glider observations aligns closely with empirical estimates derived from satellite altimetry, highlighting the internal tide's predominant coherent nature during the glider's sampling.</p

Risk factors for incidence of rotator cuff syndrome in a large working population

Objectives The aim of this study was to assess the effects of personal and work-related factors on the incidence of rotator cuff syndrome (RCS) in a large working population.Methods A total of 3710 French workers were included in a cross-sectional study in 2002–2005. All completed a self-administered questionnaire about personal factors and work exposure. Using a standardized physical examination, occupational physicians established a diagnosis of RCS. Between 2007–2010, 1611 workers were re-examined. Associations between RCS and risk factors at baseline were analyzed by logistic regression. Results A total of 839 men and 617 women without RCS at baseline were eligible for analysis. RCS was diagnosed in 51 men (6.1%) and 45 women (7.3%). The risk of RCS increased with age for both genders [odds ratio (OR) 4.7 (95% confidence interval [95% CI] 2.2–10.0) for men aged 45–49 years and 5.4 (95% CI 2.3–13.2) for women aged 50–59 years; reference &lt;40 years]. For men, the work-related risk factors were repeated posture with the arms above the shoulder level combined with high perceived physical exertion [OR 3.3 (95% CI 1.3–8.4)] and low coworker support [OR 2.0 (95% CI 1.1–3.9)]. For women, working with colleagues in temporary employment [OR 2.2 (95% CI 1.2–4.2)] and repeated arm abduction (60–90°) [OR 2.6 (95% CI 1.4–5.0)] were associated with RCS. Conclusions Age was the strongest predictor for incident cases of RCS, and arm abduction was the major work-related risk factor for both genders. Lack of social support was a predictor for RCS among men

Facteurs associés à la lombalgie chez les hommes salariés des Pays de la Loire

Objectif : Les lombalgies ont des répercussions majeures sur le monde du travail. Un manque de données prospectives et représentatives de la diversité des emplois limite l’analyse des facteurs de risque chez les travailleurs. L’objectif de cette étude était d’estimer, à l’aide d’une modélisation, les facteurs associés à la lombalgie chez les salariés des Pays de la Loire.Méthodes : Un échantillon aléatoire de salariés a fait l’objet de deux enquêtes successives. La prévalence des lombalgies lors de la deuxième enquête a été modélisée, par régression logistique multi-étapes, à partir de facteurs de risque individuels et professionnels recueillis lors de la première enquête. Des analyses de sensibilité ont été réalisées. Les analyses ont été stratifiées par sexe ; seuls les résultats pour les hommes sont présentés. Résultats : Parmi les 3 710 participants à la première enquête, 2 332 ont répondu à la deuxième enquête, dont 1 313 hommes. La prévalence des lombalgies était de 30 % chez les hommes. Des douleurs du cou ou des membres supérieurs, se pencher fréquemment et travailler plus que prévu étaient les facteurs de risque principaux de lombalgie ultérieure. L’association observée entre un faible soutien de la hiérarchie et des lombalgies ultérieures devenait non significative dans une analyse restreinte aux salariés sans lombalgie lors de la première enquête. Conclusions : Le rôle des facteurs biomécaniques et organisationnels semble prédominant sur celui des facteurs psychosociaux. Celui des facteurs individuels est d’interprétation délicate. Quelques limites méthodologiques doivent être discutées, mais l’analyse simultanée de multiples facteurs dans une population diversifiée de travailleurs constitue un apport original et utile pour des actions de prévention

East Australian cyclones and air‐sea feedbacks

The importance of resolving mesoscale air-sea interactions to represent cyclones impacting the East Coast of Australia, the so-called East Coast Lows (ECLs), is investigated using the Australian Regional Coupled Model based on NEMO-OASIS-WRF (NOW) at urn:x-wiley:2169897X:media:jgrd57355:jgrd57355-math-0001 resolution. The fully coupled model is shown to be capable of reproducing correctly relevant features such as the seasonality, spatial distribution and intensity of ECLs while it partially resolves mesoscale processes, such as air-sea feedbacks over ocean eddies and fronts. The mesoscale thermal feedback (TFB) and the current feedback (CFB) are shown to influence the intensity of northern ECLs (north of urn:x-wiley:2169897X:media:jgrd57355:jgrd57355-math-0002), with the TFB modulating the pre-storm sea surface temperature by shifting ECL locations eastwards and the CFB modulating the wind stress. By fully uncoupling the atmospheric model of NOW, the intensity of northern ECLs is increased due to the absence of the cold wake that provides a negative feedback to the cyclone. The number of ECLs might also be affected by the air-sea feedbacks but large interannual variability hampers significant results with short term simulations. The TFB and CFB modify the climatology of sea surface temperature (mean and variability) but no direct link is found between these changes and those noticed in ECL properties. These results show that the representation of ECLs, mainly north of urn:x-wiley:2169897X:media:jgrd57355:jgrd57355-math-0003, depend on how air-sea feedbacks are simulated. This is particularly important for atmospheric downscaling of climate projections as small-scale sea surface temperature interactions and the effects of ocean currents are not accounted for