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Associations between self-reported carpal tunnel syndrome (CTS) and co-exposure to physical constraints and neurotoxic chemicals in male agricultural workers in France in 2010

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HAL Id: hal-02921421

https://hal.archives-ouvertes.fr/hal-02921421

Submitted on 21 Sep 2020

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Associations between self-reported carpal tunnel

syndrome (CTS) and co-exposure to physical constraints and neurotoxic chemicals in male agricultural workers in

France in 2010

X Pascal, Julie Bodin, Natacha Fouquet, R Garlantézec, Y. Roquelaure

To cite this version:

X Pascal, Julie Bodin, Natacha Fouquet, R Garlantézec, Y. Roquelaure. Associations between self- reported carpal tunnel syndrome (CTS) and co-exposure to physical constraints and neurotoxic chem- icals in male agricultural workers in France in 2010. VIIe Congrès International d’Épidémiologie - ADELF - EPITER, Sep 2016, Rennes, France. �hal-02921421�

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Associations between self-reported carpal tunnel syndrome (CTS) and co-exposure to physical constraints and neurotoxic chemicals

in male agricultural workers in France in 2010

X. Pascal

1

, J. Bodin

1

, N. Fouquet

1,2

, R. Garlantézec

3,4

, Y. Roquelaure

1,5

1 University of Angers, Laboratory of ergonomics and epidemiology in occupational health (LEEST), Angers, France. 2 The French Public Health Agency, Department of Occupational Health, Saint-Maurice, France. 3 IRSET INSERM U1085 University Rennes I, Rennes, France. 4 CHU Rennes, Rennes, France. 5 CHU Angers, Angers, France

Background

Musculoskeletal disorders (MSDs) are a significant health problem in the agricultural working population. According to recent data from the French Agricultural Health Insurance System (Mutualité sociale agricole – MSA), 93% of compensated occupational diseases were MSDs, including 38% of carpal tunnel syndrome (CTS).

CTS is an entrapment neuropathy of the median nerve at the wrist which produces paresthesia and weakness of the muscles of the hand.

Exposure to neurotoxic chemicals over a long period may lead to central or peripheral neuropathy. Combination with physical constraints, which are know risk factors for MSDs, may increase the risk of CTS.

The aim of this study was to assess the associations between CTS and co-exposure to physical constraints of the wrist in the last 12 month and neurotoxic chemicals in the preceding 10 years in male agricultural workers.

Methods

Co-exposure to physical constraints and neurotoxic chemicals and CTS reported in the last 12 months

Contact: xavier.pascal@univ-angers.fr - LEEST - Unité associée Santé publique France- UFR Santé - Département Médecine - Rue Haute de Reculée - 49045 ANGERS Cedex 01. Website: http://leest.univ-angers.fr

Discussion

 We found a significant association between self-reported CTS in the last 12 months and co-exposure to at least one physical constraint of the hand in the last 12 months and to at least one neurotoxic chemical in the preceding 10 years , after adjustment for personal risk factors.

 Limitations of this study

• Cross-sectional study

• Personal declaration of exposure to neurotoxic chemicals

 To improve this result, it will be necessary to study the effects of co- exposure according to the type of neuropathy (central or peripheral) caused by exposure to neurotoxic chemicals in the occurrence of CTS

Funding: The French National Research Program for Environmental and Occupational Health of Anses (2014/1/077)

Results

Premus2016, Toronto, Canada, June 20-23 2016

Study population

 2,363 respondants (response rate 25%)

 802 men working in agriculture,

forestry and fishing sector (Figure 1)

• 46.2% farmers

• 30.1% agricultural blue collar workers (BCW)

• 14.6% craftsmen, salesmen and managers; upper grade white-collar and professional workers; technicians, associate professionals; lower grade white-collar workers

• 9.1% BCW (except agricultural BCW)

 CTS and co-exposure to at least one physical constraint of the wrist and to at least one neurotoxic chemical were associated (Figure 3):

OR=2.6 [2.2-3.0]

Exposure to at least one physical constraint of the

wrist: 27.3%

CTS prevalence: 3.9%

Exposure to at least one neurotoxic chemical:

24.0%

CTS prevalence: 3.9%

Co-exposure: 17.8%

CTS prevalence: 8.8%

No exposure to neurotoxic chemical and physical constraint of the wrist: 30.9%

CTS prevalence 2.7%

% weighted percentage

Figure 2: Exposure to neurotoxic chemicals and physical constraints and CTS prevalence for male agricultural workers

 39 (4.4% [2.6-5.4]) male agricultural workers reported CTS

 The prevalence of CTS differed according to the four groups (p=0.04).

 Prevalence was higher for co-exposed male agricultural workers (Figure 2)

Variables

 Self-reported CTS in the last 12 months

 6 physical constraints of the wrist in the last 12 months: repetitiveness, use of vibrating hand-tools, manipulating loads (more than 4kg), twisting the wrist, holding objects in a pinch grip, pressing with the base of the palm

 11 neurotoxic chemicals

in

the preceding 10 years: pesticides, petrol (solvent), white spirit, cellulosic thinner, other solvents, glue, paint, ink, trichloroethylene, paraffin oil, diesel

 4 personal variables: age, obesity, alcohol consumption and smoking

Statistical analysis

 Estimations of prevalence taking into account the sampling method and non-response.

 Chi-2 tests for weighted data were used to compare groups.

 Statistical associations between CTS and co-exposure were modelled using logistic regression, adjusted for personal factors.

Figure 1: Flow chart of participants

9,477 people received questionnaire 7,114 non-respondants

2,363 respondants

406 people working for less 12 months

1,957 workers in the last 12 months 728 women

73 men working in the construction sector

250 men working in the tertiary sector

68 men working in other industry sectors

36 male agricultural workers without complete information 802 male agricultural workers

Study population

 Data were collected in 2010 by a self- administered questionnaire for the pilot phase in a COSET-MSA cohort implemented by the French Public Health Agency.

 People aged 18 to 65 years were randomly selected from the MSA database of 5 French administrative areas.

 For the study, we selected male agricultural workers who had worked for at least 12 months.

Figure 3: Multivariate model of risk factors for CTS reported in the last 12 months for male agricultural workers

*Adjusted for age, obesity, alcohol consumption and smoking. p-value (Hosmer-Lemeshow)=0.11

OR (95% CI)*

Exposure to at least one physical constraint of the wrist in the last 12 months

Exposure to at least one neurotoxic chemical in the preceding 10 years Ref: No exposure to neurotoxic chemical in

the preceding 10 years and physical constraint of the wrist in the last 12 months

Co-exposure to at least one physical constraint of the wrist in the last 12 months and to at least one neurotoxic chemical in the preceding 10 years

0 0.5 1.0 1.5 2.0 2.5 3.0 3.5

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