Bilan et perspectives du programme de surveillance épidémiologique des troubles musculo-squelettiques

Le programme pilote de surveillance épidémiologique des troubles musculo-squelettiques (TMS) développé dans la région des Pays de la Loire fêtera bientôt ses 10 ans. Ce programme a largement contribué à la mesure de ce problème majeur de santé au travail, mesure jusqu’alors essentiellement basée sur les statistiques de reconnaissance en maladie professionnelle; de même, il a contribué à la mise en visibilité dans le débat social du poids des facteurs professionnels dans leur survenue. Des pistes restent à explorer pour rendre cette surveillance plus efficiente et plusrégulière à l’échelon national. Par ailleurs, une réflexion est engagée sur la manière dont on peut traduire, pour les pouvoirs publics, les entreprises et le public, les résultats issus de l’épidémiologie de façon qu’ils puissent se les approprier à des fins de prévention. Car prévenir de façon durable les TMS et prendre en compte les situations de handicap des salariés souffrant de TMS est un impératif de santé au travail et de santé publique, sur lequel doivent se mobiliser tous les acteurs de la prévention des risques professionnels dans le cadre d’une politique structurée et coordonnée

The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network

Objectives: An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France’s Pays de la Loire region to assess the incidence and prevalence of MSDs in the general and working populations, identify levels of exposure to occupational risk factors and investigate the proportion of cases attributable to work exposure.Methods: The program combines (1) surveillance of sentinel health events in the general population (carpal tunnel syndrome (CTS) was the sentinel event for upper limb MSDs), (2) assessment of the prevalence of the main upper limb MSDs and their risk factors in the workplace based on a network of occupational physicians and (3) registration of the notification of work-related diseases (WRDs). Results: 1168 incident cases of CTS were included over a 3 year period. The estimated incidence of CTS was 1.00 per 1000 person-years in those aged 20–59 years (0.60 in men and 1.40 in women). The incidence rate was higher in employed than unemployed persons in the year of diagnosis (0.6 per 1000 vs 0.3 in men and 1.7 vs 0.8 in women). The occupational physician network noted high prevalence rates: 11% of men and 15% of women had at least one of the six main upper limb clinically-diagnosed MSDs. The WRD survey showed that MSDs represented 65% of notified WRDs. Conclusion: The Pays de la Loire program plays a significant role in informing the authorities and the public about the state of current MSDs. It is planned to extend it to a routine national surveillance program

Des indicateurs en santé travail - Les troubles musculo-squelettiques du membre supérieur en France

France has sought to develop a series of indicators intended to monitor health trends at the national level. Since its creation in 1998, the Department of Occupational Health (DST) of the French Institute of Public Health Surveillance (InVS) has worked to develop monitoring programs, with the goal of producing such data regularly and thus improving our knowledge of occupational health risks. The data sources have expanded over time. In 2009, the DST established a program for the regular production of indicators intended to report the national workplace health situation and its trends over time. These indicators come from various sources and will be published regularly on the InVS website: www.invs.sante.fr. This third report covers musculoskeletal diseases of the upper limbs. This document summarizes data about their frequency in terms of prevalence and incidence, as well as about the frequency of exposures to the principal known risk factors, according to sex, age, occupational categories, and broad activity sectors. It also provides information about the proportion of these musculoskeletal diseases that are attributable to work, according to occupational categories and broad activity sectors, and about the scale of their under-reporting generally and as compensable occupational diseases. Finally, some questions enable us to put the results presented into perspective

Comparison of risk factors for shoulder pain and rotator cuff syndrome in the working population

BACKGROUND: To compare risk factors for shoulder pain without and with rotator cuff syndrome (RCS).METHODS: A total of 3,710 workers of a French region were randomly included in the cross-sectional study between 2002 and 2005. Personal and occupational risk factors were assessed during a physical examination and by a self-administered questionnaire. Multinomial logistic modeling was used for the following outcomes: no shoulder pain and no RCS (reference), shoulder pain without RCS (called "shoulder pain") and RCS, separately for men and women. RESULTS: The prevalence rates of "shoulder pain" for men and women were 28.0% and 31.1%, respectively, and the prevalence rates of RCS were 6.6% and 8.5%, respectively. In men, "shoulder pain" and RCS were associated with age, high-perceived physical exertion, and arm abduction. Automatic work pace and low supervisor support were associated with "shoulder pain," and high psychological demand and low skill discretion with RCS. In women, "shoulder pain" and RCS were associated with age, repetitiveness of tasks, and low supervisor support. High perceived physical exertion and exposure to cold temperatures were associated with "shoulder pain." CONCLUSIONS: Age was more strongly associated with RCS than with shoulder pain without RCS for both genders. Biomechanical and psychosocial factors were associated with "shoulder pain" and RCS and differed between genders

Floating islands implementation in marine and freshwater environments

Rapid industrialization, changes in human activities, and agricultural practices have led to the widespread use of toxic organic compounds, resulting in increased concentrations of pollutants in the environment that can be transmitted through air, water, or soil, resulting in numerous environmental and health problems. Therefore, the efficient management of water in these polluted sites is urgently needed. Aiming at this, this work proposes the use of floating wetland islands (FWI) for phytoremediation of these environments, since they have a great potential to promote several ecosystem services, such as biodiversity and water quality improvement. Having that in consideration it will be carried out an assessment related to the most adequate materials for the floating platform to be applied in marine and freshwater environments. Plants will be selected based on previous research carried out by the group It is intended that the floating platform developed under the present study will be compared with a commercial system cork based. It will be monitored the plant development and establishment in the two floating platforms materials and environments, the associated fauna and the water characterization. From the analysis of these results, this work hopes that these nature-based solutions can contribute to better water management, in such a way that will involve the conservation and rehabilitation of ecosystems.info:eu-repo/semantics/publishedVersio

Personal, biomechanical, and psychosocial risk factors for rotator cuff syndrome in a working population

OBJECTIVE: Rotator cuff syndrome (RCS) is a major health problem among workers. The aim of the study was to examine the risk factors for RCS among workers exposed to various levels of shoulder constraints.METHODS: From 3710 workers, representative of a French region`s working population, trained occupational physicians diagnosed a total of 142 cases of RCS among men and 132 among women between 2002-2005. Diagnoses were established by standardized physical examination while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between RCS and personal and work-related factors were analyzed for each gender using logistic regression modeling. RESULTS: The personal risk factors for RCS were age [odds ratio (OR) for 1-year increment 1.07, 95% confidence interval (95% CI) 1.05-1.09, among men and 1.08, 95% CI 1.06-1.10, among women] and diabetes mellitus (OR 2.9, 95% CI 1.0-8.6, among women). The work-related risk factors were (i) sustained or repeated arm abduction (≥ 2 hours/day) >90 degrees among men (OR 2.3, 95% CI 1.3-3.9) and >60 degrees among women (OR 1.8, 95% CI 1.0-3.2) or both conditions among men (OR 2.0, 95% CI 1.1-3.7) and women (OR 3.6, 95% CI 1.8-7.3); (ii) high repetitiveness of the task (≥ 4 hours/day) among men (OR 1.6, 95% CI 1.0-2.4) and women (OR 1.7, 95% CI 1.1-2.5); (iii) high perceived physical demand among men (OR 2.0, 95% CI 1.3-3.1); (iv) high psychological demand among men (OR 1.7, 95% CI 1.2-2.5); and (v) low decision authority among women (OR 1.5, 95% CI 1.0-2.3). CONCLUSION: Personal (ie, age) and work-related physical (ie, arm abduction) and psychosocial factors were associated with RCS for both genders in this working population

Epidemiological surveillance of lumbar disc surgery in the general population: a pilot study in a French region.

OBJECTIVES: Disc-related sciatica (DRS) is a significant and costly health problem in the working population. The aim of this pilot study was to assess the feasibility of a surveillance system for DRS using hospital databases for lumbar disc surgery (LDS). METHODS: A total of 272 inpatients (119 men and 153 women) living in a French region and discharged in 2002-2003 from a spine center of a large University Hospital following LDS were compared with demographic and socioeconomic data on the population of the same region. Medical and occupational histories were gathered using a mailed questionnaire. The age-adjusted relative risks and population attributable fraction of risk (PAF) were calculated in relation to occupations and industries. RESULTS: Information on employment was available for the 75 women and 71 men. The risk of LDS varied according to occupations and industries. PAFs ranged between 30% (12-48) for male blue collar workers and 22% (4-40) for female lower white collar workers. PAFs ranged between 7 and 17% in the economic sectors at high risk. CONCLUSION: The surveillance of LDS can identify occupations and industries at risk

Population attributable risk of lumbar disc surgery according to occupation: a study in a French general population

Aims: Disc-related sciatica represents one of the most significant and costly health problems occurring in the working population. The aim of this study was to assess the work-related population attributable fraction (PAF) of lumbar disc surgery (LDS) for disc-related sciatica in occupational categories at high risk in the general population. Methods: Patients living in a French region in 2003 and discharged from a large University Hospital following LDS were compared with demographic and socioeconomic data from the population census. Medical and occupational histories from 75 women and 71 men were gathered using a mailed questionnaire. The ageadjusted relative risks and PAF of CTS were calculated according to occupational categories. Results: The PAFs of lumbar disc surgery was 37% [19-54] for the male blue-collar workers suggesting that about 37% of the cases occurring in this category of workers could be avoided if the excess risk of LDS could be eliminated. The PAF value for male and female lower-grade white collar workers and female intermediate occupations were 18%, 33% and 13%, respectively. Conclusion: The study suggested that 13–37% of LDS for disc-related sciatica might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industries. However, these preliminary findings must be confirmed by a larger study conducted in the whole region to assess more accurately the proportion of avoidable cases of LDS in the population

Utilisation du protocole de surveillance en entreprise : expérience du programme de surveillance épidémiologique des TMS dans les Pays de la Loire

Les troubles musculo-squelettiques des membres supérieurs (TMS-MS) resteront, avec les rachialgies, l’un des enjeux majeurs de la santé au travail des années à venir en raison de leur augmentation probable par conjugaison d’une intensification des conditions de travail et du vieillissement de la population active. Le programme pilote de surveillance épidémiologique des TMS mis en place en 2002 dans la région des Pays de la Loire par l’institut de veille sanitaire [8] a permis d’estimer les prévalences des TMS et de leurs facteurs de risque en population salariée [2], [17] and [18].Ce programme utilise pour la première fois en Europe les définitions des TMS-MS et la démarche diagnostique standardisée proposées par le consensus européen Saltsa pour la surveillance des TMS-MS [7], [13], [15] and [20]. L’objectif de cet article est de décrire le protocole du programme TMS et de discuter la faisabilité de l’utilisation en France d’un protocole européen de surveillance des TMS-MS