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

Low back pain around retirement age and physical occupational exposure during working life

<p>Abstract</p> <p>Background</p> <p>Physical occupational exposure is a risk factor for low back pain in workers but the long term effects of exposure remain unclear. As several countries consider increasing the retirement age, further information on this topic is relevant. This study aimed to describe the prevalence of low back pain among middle aged and aging individuals in the general French population according to physical occupational exposure and retirement status.</p> <p>Methods</p> <p>The study population originated from the French national survey 'Enquête décennale santé 2002'. Low back pain for more than 30 days within the previous twelve months (LBP) was assessed using a French version of the Nordic questionnaire. Occupational exposure was self assessed. Subjects were classified as "exposed" if they were currently or had previously been exposed to handling of heavy loads and/or to tiring postures. The weighted prevalence of LBP was computed separately for men and women, for active (aged 45-59) and retiree (aged 55-74), according to 5-year age group and past/present occupational exposure.</p> <p>Results</p> <p>For active men, the prevalence of LBP was significantly higher in those currently or previously exposed (n = 1051) compared with those never exposed (n = 1183), respectively over 20% versus less than 11%. Among retired men, the prevalence of LBP tended towards equivalence with increasing age among those previously exposed (n = 748) and those unexposed (n = 599).</p> <p>Patterns were quite similar for women with a higher prevalence in exposed active women (n = 741) compared to unexposed (n = 1260): around 25% versus 15%. Similarly, differences between previously exposed (n = 430) and unexposed (n = 489) retired women tended to reduce with age.</p> <p>Conclusion</p> <p>The prevalence of LBP in active workers was associated with occupational exposure. The link with past exposure among retirees decreased with age. These results should be considered for policies dealing with prevention at the workplace and retirement.</p

[Personal and occupational factors associated with low-back pain in a general working population in France].: low-back pain in working population in France

International audienceThis study showed strong associations between occupational exposures and persistent/recurrent low-back pain in a general working population in France. Targeting these exposures in prevention programs could be useful

Seeking care for lower back pain in the French population aged from 30 to 69: the results of the 2002-2003 Décennale Santé survey.

International audienceOBJECTIVES: To describe the frequency with which members of the French general population in the 30-to-69 age class sought care for lower back pain (LBP) from various healthcare professionals and to identify associated parameters. MATERIAL AND METHODS: Data were collected in the 2002-2003 Décennale Santé survey, which is representative of ordinary households in continental France. We assessed the frequency with which the 17,792 surveyed individuals sought care for LBP by considering consultations with healthcare professionals in general and consultations with general practitioners and physiotherapists in particular. RESULTS: Among the survey subjects, 4.5% reported that they had sought treatment for LBP from a healthcare professional at least once during the 2-month survey period. The decision to seek care was correlated with the characteristics of the LBP. The duration of the pain was associated with the frequency of all types of consultation studied here. Sociodemographic, economic and occupational risk factors were also involved. Consultation with a physiotherapist was related to income. CONCLUSION: These results from a representative sample of the French general population show that the factors associated with seeking treatment for LBP differ according to the type of healthcare professional consulted

Level of education and back pain in France: the role of demographic, lifestyle and physical work factors.

International audiencePURPOSE: To investigate the pathways from level of education to low back pain (LBP) in the adult population, especially concerning the role of physical working constraints, and personal factors (overweight, tobacco consumption, and tallness). METHODS: The study population consisted of 15,534 subjects from the National Health Survey, with data on LBP, level of education, personal factors, and physical working constraints. Logistic models for LBP (pain more than 30 days during the previous 12 months) were compared in order to check the consistency of the data with specific causal pathways. RESULTS: Low back pain was strongly associated with level of education. This association was almost completely explained if present or past exposure to tiring work postures and handling of heavy loads were taken into account. For men, the OR for "no diploma", adjusted only for age, was 1.75; it was 1.02 after additional adjustment on physical work factors. Personal factors played also a role, especially overweight for women. Among them, the OR associated with a body mass index = 27 or more was 1.58 after adjustment on all the other factors. CONCLUSIONS: In this national population the main pathways from education to LBP were through occupational exposure and lifestyle factors

Constructing a Cohort: Experience with the French Elfe Project

The project to construct a multidisciplinary study cohort of 20,000 children to be monitored from birth to adulthood was launched in France in 2005. It was designed to address the concerns of various public bodies, especially those concerned with the environment, and researchers from a variety of disciplines. The result was the formation of the Elfe (Étude longitudinale française depuis l’enfance) longitudinal cohort of children, scheduled to commence in March/April 2011. The authors describe the origins of the project. The approach was deliberately intended to be multidisciplinary, and a large number of research teams were associated in designing the project, suggesting research questions in three major fields: social sciences, health and the links between health and the environment. To make the most of the life course approach, observations will be frequent (annually during the early years). A major place is given to fathers, who play an increasing role in children’s upbringing and socialization. The sample will be representative of births in 2011 throughout metropolitan France. The vast quantity of information to be collected and its highly personal nature require particular caution in the creation and management of data files, for which an innovative procedure will be used. The results of a pilot cohort study launched in 2007 are also presented. They cover several hundred families, whose children are now three years old

La construction d’une cohorte : l’expérience du projet français Elfe

Le projet de mise en place d’une cohorte pluridisciplinaire de 20 000 enfants suivis depuis la naissance jusqu’à l’âge adulte a été lancé en France en 2005. Il résulte de préoccupations de diverses instances publiques – notamment dans le domaine de l’environnement – comme de chercheurs de disciplines variées. L’aboutissement en a été la constitution de la cohorte Elfe, Étude longitudinale française depuis l’enfance, dont le démarrage est prévu en mars/avril 2011. Les auteurs retracent la genèse du projet. La démarche s’est voulue résolument pluridisciplinaire, et un grand nombre d’équipes de recherche ont été associées à l’élaboration du projet, en proposant des questions de recherche dans trois grands domaines : sciences sociales, santé et relations entre santé et environnement. Pour bénéficier au maximum de la puissance de la Life course approach, les observations seront fréquentes (annuelles pendant les premières années). Une place importante est faite aux pères, qui jouent un rôle croissant dans l’éducation et la socialisation des enfants. L’échantillon sera représentatif des naissances de l’année 2011 sur l’ensemble du territoire de France métropolitaine. La grande quantité d’informations collectées et leur caractère très personnel exigent une prudence particulière dans la constitution et la gestion des fichiers pour laquelle une procédure originale est mise en œuvre. Les résultats du suivi d’une cohorte pilote lancée en 2007 sont aussi présentés. Ils concernent plusieurs centaines de familles, dont les enfants ont maintenant 3 ans

The first estimation of Fleuve Manche palaeoriver discharge during the last deglaciation: Evidence for Fennoscandian ice sheet meltwater flow in the English Channel ca 20–18 ka ago

International audienceThe Fleuve Manche (English Channel) palaeoriver represents the largest river system that drained the European continent during Pleistocene lowstands, particularly during the Elsterian (Marine Isotope Stage 12) and Saalian Drenthe (MIS 6) glaciations when extensive ice advances into the North Sea area forced the central European rivers to flow southwards to the Bay of Biscay (NE Atlantic). Numerous long piston cores and high-resolution acoustic data from the northern Bay of Biscay have been correlated using a well-constrained chronostratigraphical framework, and for the first time allow the estimation of the discharge of the Fleuve Manche palaeoriver at the end of the last glacial period (i.e. Weichselian). Our results, discussed in the light of relationships between river loads and drainage area characteristics, strongly suggest that the Bay of Biscay collected sediment-laden meltwater from the Northern European lowlands and the southern part of the Fennoscandian ice sheet at the end of the last glacial period and particularly during the paroxysmal phase of the European deglaciation ca 20–18 ka ago. This demonstrates that the Fleuve Manche drainage area at that time was equivalent to those dating from the major Elsterian and Saalian Drenthe glaciations. Based on our data, we propose a revision of the palaeogeographical and palaeoglaciological evolution of the North Sea area while showing that the British and Fennoscandian ice sheets entered the North Sea basin until ca 18 ka initiating isostatic adjustment of the basin. This allowed the North Sea fluvial system to flow southwards through the Dover Strait. Finally, we discuss the Fleuve Manche freshwater discharge during the maximum European ice sheet retreat ca 18 ka. The estimated discharge at this time appears important and sufficiently sustained to possibly contribute to the profound destabilisation of the thermohaline circulation recognised in the North Atlantic from ca 18 to 16 ka

Cohort Profile: The French National cohort of children ELFE: birth to 5 years

International audienceELFE is the first French national birth cohort. Its objective is to study determinants of the development, health and socialization of children from birth to adulthood through a multidisciplinary approach. A total of 18 329 children were recruited at birth in a random sample of maternity units in metropolitan France during 25 selected days of 2011 spread over the year. Follow-up in the first 5 years consisted of telephone interviews of both parents of the child at age 2 months and 1 year and 2 years, and of one parent at age 3.5 years; a home visit at age 3.5 years; questionnaires to the child’s physician at age 2 years, the child’s nursery school doctor at age 3 to 4 years, and the child’s nursery schoolteacher at age 4 years. Participation rates at the age 2-month, 1- and 2-year and 3.5-year parental interviews were 92%, 86%, 82% and 80%, espectively, of contacted participants. The main categories of data collected concern: sociodemographic characteristics; family life; parental health, behaviour and life values; child development and health; child school performance, behaviour, and socialization; day care and school; and childhood environmental exposures. The ELFE has an open-data policy after an 18-month exclusivity period following each release of new data. The data-access policy, study protocols, questionnaires and data catalogue can be found online: [https://www.ELFE-france.fr/en/

À trois ans et demi, les enfants d’origine modeste utilisent moins les dispositifs péri et surtout extrascolaires

Rares sont les enfants n’allant pas à l’école maternelle à 3 ans et demi, mais tous n’en font pas la même expérience, puisque le temps passé avec l’enseignant ne représente qu’une partie de la journée en dehors du domicile. Les activités « non scolaires » amplifient le temps passé en collectivité par les enfants, qu’il s’agisse de la cantine, du centre de loisirs ou encore des pratiques physiques ou d’éveil artistique le mercredi ou le week-end. Un grand nombre d’enfants fréquentent précocement au moins l’un de ces services : la moitié des enfants âgés de 3 ans et demi mange tous les jours à la cantine, un quart fréquente quotidiennement le centre de loisirs, un tiers pratique une activité périscolaire le mercredi après‑midi ou extrascolaire en club, en association ou ailleurs. Les enfants de milieu populaire ou ceux dont l’un des parents est sans emploi y vont moins. Dans les 20 % de familles les plus modestes, un quart des enfants ne va à l’école que le matin. Leur journée est moins nourrie par cette forme de socialisation. L’accès quotidien des enfants à la cantine et au centre de loisirs présente peu de disparités territoriales, à l’exception des grandes agglomérations. En revanche, les enfants vivant en dehors des unités urbaines ont 20 % à 40 % moins de chances de pratiquer une activité extrascolaire en semaine que ceux habitant dans une unité urbaine hors agglomération parisienne. L’apprentissage d’une activité spécifique dans un club ou une association est socialement assez inégalitaire, car plutôt lié à des attentes éducatives propres aux parents diplômés. La fréquentation du centre de loisirs le mercredi découle plutôt des conditions de vie matérielles liées au statut familial et professionnel. Outre ces contacts plus fréquents avec des intervenants éducatifs, les enfants des parents les plus diplômés et les plus aisés consultent davantage un pédiatre