Annals of Occupational Hygiene Advance Access originally published online on January 15, 2007
Annals of Occupational Hygiene 2007 51(3):337-344; doi:10.1093/annhyg/mel080
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Predictive Factors for Incident Musculoskeletal Disorders in an In-Plant Surveillance Program
1 INSERM, U687 Saint-Maurice, F-94410, France
2 Université Paris XI, IFR69 Villejuif, F-94807, France
3 Occupational health department, Poincaré teaching hospital AP-HP Garches, F-92380,France
4 Laboratory of Ergonomics and Occupational Health, Angers F-49000, France
5 Division of General Medical Sciences, Washington University School of Medicine St Louis, MO 63110, USA
6 Occupational Health Service of Anjou, Angers F-49000, France
*Author to whom correspondence and reprints should be addressed. Alexis Descatha MD, INSERM, U687, HNSM, 14 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France, Tel: +33 47 10 77 54; fax: +33 47 10 77 68; e-mail: alexis.descatha{at}rpc.aphp.fr
Objectives: A surveillance program for upper-limb work-related musculoskeletal disorders (UWMSD) based on assessment of health and risk factors was implemented between 1996 and 2000 in a large shoe factory with overall high levels for biomechanical exposure. The study aimed to identify workers with an increased risk of UWMSD incidence. Methods: In 1996, 1997 and 2000, 166 workers filled out a questionnaire and underwent a standardized physical examination. Factors from the 1996 questionnaire (general, personal and occupational factors) associated with UWMSD incidence in 1997 were selected. The predictive role of these variables was studied with a logistic model, taking into account also gender and age. The performance of a risk score based on this model was studied in 2000, using the Wilcoxon test and ROC curves. Results: In 1997, 28 incident cases of UWMSD were observed (N = 107, 26.2%). Work pace and prior history of UWMSD were the only factors significantly associated with UWMSD incidence in 1997 (respectively 33% versus 13%, P = 0.02 and 58% versus 22%, P = 0.01). Psychological distress (36% versus 21%, P = 0.10), physical fatigue (35% versus 22%, P = 0.14), repetitiveness (30% versus 18%, P = 0.17) and task precision (33% versus 21%, P = 0.16) were also included in the logistic model for 1997 UWMSD incidence. Controlling for these variables, prior history of UWMSD remained associated with incidence in 1997 (OR = 5.5, 95% CI = 1.4–21.8). In the period from 1997 to 2000, 24 incident cases were observed (N = 102, 23.5%). The risk score, based on variables from the 1997 model, was significantly higher for incident cases (median = 6 in incident cases versus 4.5 for healthy subjects, P = 0.02). ROC curves indicated that the highest agreement reached 67% for sensitivity and 59% for specificity. Among subjects who did not change their task (N = 71, 18 incident cases), performance reached 66% for specificity with the same sensitivity. Conclusion: These results suggest that surveillance programs of UWMSD at a company level are possible even with overall high levels for biomechanical exposure and should take into account occupational and personal factors, including prior history of UWMSD.
Keywords: ergonomics (musculoskeletal diseases, upper extremity, predictive factors, surveillance, physical exposures) • health surveillance • measurement strategy musculoskeletal injury
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  A. K. Burton, N. A. S. Kendall, B. G. Pearce, L. N. Birrell, and L. C. Bainbridge Management of work-relevant upper limb disorders: a review Occup. Med., January 1, 2009; 59(1): 44 - 52. [Abstract] [Full Text] [PDF]
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