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Personal and work-related risk factors for incident rotator cuff syndrome in a French working population

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Personal and work-related risk factors for incident rotator cuff syndrome in a French working population

J Bodin 1 , C Ha 2 , A Petit Le Manac'h 1 , C Sérazin 1 , A Descatha 3 , A Leclerc 3 , M Goldberg 3 , E Imbernon 2 , Y Roquelaure 1

1

LUNAM University, LEEST, Angers, France

2

Department of Occupational Health, French Institute for Public Health Surveillance, Saint-Maurice, France

3

Inserm U1018, Villejuif, France

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Context

 Surveillance system for MSD implemented in the Pays de la Loire region by the French

Institute for Public Health Surveillance in 2002-2005

 Rotator cuff syndrome (RCS):

7% of workers

 Musculoskeletal disorders (MSDs): One of the

most significant and costly health problems in the

working population

(3)

Aim

To identify personal and work-related factors for incident RCS

among a large French working population

(4)

Methods

 Baseline: 2002-2005

 Network of 83 occupational physicians

 3,710 workers randomly selected

Self-administered Questionnaire

 Individual factors

 Work-related factors (work organization, biomechanical and psychosocial factors)

Physical examination

 Follow-up: 2007-2010

Physical examination

(5)

Case definition

 Rotator cuff syndrome defined following the

recommendations of the European consensus Saltsa 1

1

Sluiter JK, Rest KM, Frings-Dresen MH. Criteria document for evaluating the work-relatedness of upper-extremity

musculoskeletal disorders. Scand J Work Environ Health. 2001;27 Suppl 1:1–102.

(6)

Analysis

 Logistic regression

 Outcome:

 Workers free of RCS at baseline with diagnosed RCS at follow-up.

 Potential risk factors at baseline:

 Personal factors (age, BMI,…)

 Work organization (work pace dependent on automatic rate, job/task rotation, temporary employment, …)

 Biomechanical factors (arms above shoulder level, use of vibrating hand tools, perceived physical exertion (Borg),…)

 Psychosocial work factors ( validated French version of Karasek’s Job Content Questionnaire)

 By gender

(7)

Results (1)

150 workers with RCS at baseline

5 workers with unknown diagnosis of RCS at follow-up

2002-2005

2007-2010

3,710 workers

1,611 workers seen during a regularly scheduled mandatory

health examination

1,456 workers included

in the analyses

(8)

Results (2)

 51 incident cases of RCS in men (6.1%)

 45 cases in women (7.3%)

(9)

Results (3)

 Bivariate analyses showed that:

 personal characteristics,

 work organization,

 biomechanical factors and

 psychosocial factors

were associated with incident RCS

(10)

Risk factors for incident RCS in men

Variable OR 95% CI

Age

<40 1

40-44 2.3 (1.0 to 5.2)

45-49 4.7 (2.2 to 10.0)

≥50 3.7 (1.5 to 9.0)

High perceived physical exertion

AND

Arms above shoulder level (≥2h/day)

No factor 1

One factor 2.0 (1.0 to 3.8)

Both factors 3.3 (1.3 to 8.4)

Low coworker support (yes vs no) 2.0 (1.1 to 3.9)

RPE Borg scale ≥15.

(11)

Variable OR 95% CI

Age

<40 1

40-44 3.0 (1.2 to 7.4)

45-49 3.4 (1.4 to 8.0)

≥50 5.5 (2.3 to 13.2)

Work with temporary workers (yes vs no) 2.2 (1.2 to 4.2) Arm abduction (60° to 90°) (yes vs no) 2.6 (1.4 to 5.0)

Risk factors for incident RCS in women

(12)

Discussion

 Positive points

 Large working population

 RCS clinically diagnosed by trained OPs

 Limitations

 Exposure data self-reported: some misclassification ?

 Extra-occupational physical activities and individual

psychological factors (anxiety, depression, traumatic life

events, etc) not assessed

(13)

Conclusion

Main results

 Different risk factors according to gender

Arm abduction was the major work-related risk factor

 Psychosocial factor only for men

 Effect of age

 Mechanical and psychosocial exposure should be an important target for strategies for the prevention of RCS in the working population

Bodin J, Ha C, Petit Le Manac’h A, Sérazin C, Descatha A, Leclerc A, Goldberg M,

Roquelaure Y. Risk factors for incidence of rotator cuff syndrome in a large working

population. Scand J Work Environ Health. 2012 [Epub ahead of print]

(14)

Thank you for your

attention

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