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

Factors affecting return to work after carpal tunnel syndrome surgery in a large French cohort

OBJECTIVE: To evaluate occupational outcomes after surgical release of the median nerve in carpal tunnel syndrome (CTS).DESIGN: Retrospective study 12 to 24 months after surgery. SETTING: Hand centers (N=3) in 2 different areas. PARTICIPANTS: Patients who had undergone surgical release of the median nerve in 2002 to 2003. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Duration of sick leave after surgery and associated factors were analyzed by using bivariate (log rank) and multivariate analyses of survival (Cox model). RESULTS: Questionnaires mailed in 2004 regarding medical condition (history and surgery), employment (occupational category codes in 1 digit), and compensation were returned (N=1248; 62%), with 253 men and 682 women stating they were employed at the time of surgery (N=935). Most were working at the time of the study (n=851; 91.0%). Median duration of sick leave before returning to work was 60 days. The main factors associated with adverse occupational outcome (long duration of sick leave) were simultaneous intervention for another upper-extremity musculoskeletal disorder, belief (by the patient) in an occupational cause, and "blue-collar worker" occupational category (the strongest determinant). CONCLUSION: This study emphasizes the multifactorial nature of the occupational outcome of CTS after surgery, including occupational category. The probability of return to work for each risk factor provides a fair description of prognosis for physicians and patients

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

Description of Outcomes of Upper-Extremity Musculoskeletal Disorders in Workers Highly Exposed to Repetitive Work

PurposeThe outcomes of workers with upper-extremity musculoskeletal (UEMS) symptoms or disorders were evaluated over a 3-year period in a population highly exposed to repetitive work. Methods Data were derived from a survey focused on the health effects of repetitive tasks, with a standardized physical examination by an occupational physician, in 1993 to 1994 and again in 1996 to 1997. All workers with UEMS symptoms or disorders in 1993 to 1994 were included. We classified 3-year outcomes into 3 categories in 1996 to 1997: neither UEMS disorder nor symptoms, UEMS symptoms only, and UEMS disorder. Results A total of 464 workers were included (125 men and 339 women). At baseline, most of them experienced a UEMS disorder (n = 421). The 3-year recovery rate differed according to the site of the disorders: high for elbow disorders only (10 of 21), moderate for neck or shoulder, or hand or wrist disorders only (17 of 74 and 22 of 119, respectively), and low for multiple sites of UEMS disorders (25 of 207). Conclusions In this population exposed to repetitive work, a large proportion of workers have persistent UEMS symptoms or disorders, with recovery rates differing according to the site involved and the presence of multiple disorders

Étude des facteurs associés au devenir professionnel après intervention chirurgicale pour un syndrome du canal carpien dans les Pays de la Loire

L’objectif était d’étudier le pronostic professionnel après intervention pour syndrome du canal carpien.Les patients opérés en 2002-2003 dans les Pays de la Loire ont rempli un autoquestionnaire. 1 248 questionnaires ont été retournés (62%) ; 253 hommes et 682 femmes déclaraient un emploi au moment de l’opération. Les facteurs de mauvais pronostic identifiés étaient : intervention simultanée sur un autre trouble musculo-squelettique du membre supérieur, catégorie socioprofessionnelle "ouvriers", arrêt de travail pour maladie professionnelle et imputabilité par le patient à une cause professionnelle. Cette étude souligne l’implication de multiples facteurs à prendre en compte pour le pronostic professionnel

Validity of a Job-Exposure Matrix for Psychosocial Job Stressors: Results from the Household Income and Labour Dynamics in Australia Survey

International audienceIntroductionA Job Exposure Matrix (JEM) for psychosocial job stressors allows assessment of these exposures at a population level. JEMs are particularly useful in situations when information on psychosocial job stressors were not collected individually and can help eliminate the biases that may be present in individual self-report accounts. This research paper describes the development of a JEM in the Australian context.MethodsThe Household Income Labour Dynamics in Australia (HILDA) survey was used to construct a JEM for job control, job demands and complexity, job insecurity, and fairness of pay. Population median values of these variables for all employed people (n = 20,428) were used to define individual exposures across the period 2001 to 2012. The JEM was calculated for the Australian and New Zealand Standard Classification of Occupations (ANZSCO) at the four-digit level, which represents 358 occupations. Both continuous and binary exposures to job stressors were calculated at the 4-digit level. We assessed concordance between the JEM-assigned and individually-reported exposures using the Kappa statistic, sensitivity and specificity assessments. We conducted regression analysis using mental health as an outcome measure.ResultsKappa statistics indicate good agreement between individually-reported and JEM-assigned dichotomous measures for job demands and control, and moderate agreement for job insecurity and fairness of pay. Job control, job demands and security had the highest sensitivity, while specificity was relatively high for the four exposures. Regression analysis shows that most individually reported and JEM measures were significantly associated with mental health, and individually-reported exposures produced much stronger effects on mental health than the JEM-assigned exposures.DiscussionThese JEM-based estimates of stressors exposure provide a conservative proxy for individual-level data, and can be applied to a range of health and organisational outcomes

Mesure de l’exposition aux contraintes biomécaniques : quels liens entre évaluations standardisées de type ergonomique et de type questionnaire ?

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Le pronostic des pathologies périarticulaires d’hypersollicitation du membre supérieur est-il lié aux critères diagnostiques retenus pour leur étude ?

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