Annals of Occupational Hygiene Advance Access published online on January 15, 2007
Annals of Occupational Hygiene, doi:10.1093/annhyg/mel080
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1 INSERM, U687, Saint-Maurice, F-94410, France; Université Paris XI, IFR69, Villejuif, F-94807, France; Occupational health department, Poincaré teaching hospital AP-HP, Garches, F-92380, France
* To whom correspondence should be addressed. 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.
Received September 30, 2006
Accepted November 28, 2006
Article
Predictive Factors for Incident Musculoskeletal Disorders in an In-Plant Surveillance Program
Alexis Descatha 1 *, Yves Roquelaure 2, Bradley Evanoff 3, Jean Mariel 4, and Annette Leclerc 5
2 Laboratory of Ergonomics and Occupational Health, Angers, F-49000, France
3 Division of General Medical Sciences, Washington University School of Medicine, St Louis, MO 63110, USA
4 Occupational Health Service of Anjou, Angers, F-49000, France
5 INSERM, U687, Saint-Maurice, F-94410, France; Université Paris XI, IFR69, Villejuif, F-94807, France
Alexis Descatha, E-mail: alexis.descatha{at}rpc.aphp.fr
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