Documents Descatha, Alexis 25 results

"OBJECTIVE: This study aimed to test longitudinal associations linking the work-unit-level psychosocial and organizational work environment and biomechanical constraints to workers' shoulder pain in the French multi-centre cohort ORSOSA study of registered nurses (RN) and nursing assistants (NA).
METHODS: We analyzed 1896 female RN and NA, who were free of shoulder pain in 2006 and in the same position and work unit in 2008. Incident shoulder pain (SP) was defined as self-reported pain that persists for ≥ 4 days and/or increases during a lateral movement of the arm away from the midline of the body (abduction). Both cross-sectional and longitudinal models were built to test if work-unit-level features or their influences on both work tasks and individual perception of the work environment directly influence the risk of developing incident SP.
RESULTS: RN in work units with understaffing issues or poor relationships reported higher levels of biomechanical constraints in movements and postures and a lower level of perceived job security and stability. NA who experienced such issues reported higher levels of biomechanical constraints in indirect patient-handling activities only. The exposure to these latter factors was associated with higher two-year incident SP among workers.
CONCLUSION: This study shows that the work-unit-level organizational characteristics may impact workers' musculoskeletal disorders by conditioning both work-task-related biomechanical exposures and individual perception of the working environment. In healthcare settings, primary prevention programs to reduce MSD would benefit from a focus on work unit level exposures."

"Trois enjeux positionnent la santé au travail des soignants comme un problème de santé publique?: le maintien au travail des soignants dans un contexte de forte insatisfaction au travail, la préservation de la santé des soignants et enfin, le maintien de la qualité des soins.
Le programme pluridisciplinaire ORSOSA (ORganisation des SOins et SAnté des soignants) est un programme de recherche interventionnelle en santé des populations visant l'amélioration de la qualité de vie au travail des soignants. Il vise à développer un outil de diagnostic des contraintes psychosociales et organisationnelles (CPO) et des contraintes mécaniques (CM) puis à le mettre en œuvre dans une démarche de prévention primaire. Il comprend deux phases?: la recherche (ORSOSA 1) et l'intervention (ORSOSA 2). Dans ORSOSA 1, une cohorte prospective de soignants a été développée et a permis de construire et valider un outil de diagnostic des CPO et des CM au niveau de l'Unité Fonctionnelle (UF). La démarche ORSOSA 2 repose sur l'utilisation de l'outil pour mettre en place une dynamique collective et consensuelle, à partir des restitutions collectives des forces et faiblesses de l'UF, pour faire émerger des préconisations pour améliorer la qualité de vie au travail. ORSOSA est actuellement déployé sur 4 CHU (Lille, Bordeaux, Grenoble et Strasbourg) avec chacun 5 hôpitaux de proximité. La réflexion continue sur l'évaluation et le suivi de la démarche."

"Objectives This study aims to estimate the association between repeated measures of occupational risk factors and the incidence of lateral epicondylitis in a large working population.Methods A total of 3710 workers in a French region were included in 2002–2005, and among them 1046 had a complete follow-up in 2007–2010. At both stages, occupational health physicians assessed the presence of lateral epicondylitis and workers self-reported their occupational exposures. Poisson models were performed to assess the incidence rate ratios (IRR) separately by sex using multiple imputed data.Results The annual incidence rate of lateral epicondylitis was estimated as 1.0 [95% confidence interval (95% CI) 0.7–1.3] per 100 workers among men and 0.9 (95% CI 0.6–1.3) among women. Workers aged >45 years had higher incidence than those aged <30 years (significant at 10%). Among men, high physical exertion combined with elbow flexion/extension or extreme wrist bending (>2 hours/day) was a risk factor, with an age-adjusted IRR of 3.2 (95% CI 1.5–6.4) for workers exposed at both questionnaires [3.3 (95% CI 1.4–7.6) among women].Conclusions This study highlights the importance of temporal dimensions for occupational risk factors on the incidence of lateral epicondylitis. Further research should evaluate the risk associated with the duration and repetition of occupational exposure on the incidence of lateral epicondylitis."

"Objective De Quervain's disease (DQD) is a significant cause of musculoskeletal pain among workers. The aim of this study was to assess the relative importance of personal and occupational risk factors for DQD in a working population. Methods A total of 3710 workers from a French region were randomly included in the cross-sectional study between 2002–2005. There were 45 subjects with DQD (of these, 5 subjects had a bilateral condition), diagnosed by 83 trained occupational physicians performing a standardized physical examination. Individual factors and work exposure were assessed by a standardized physical and a self-administered questionnaire. Statistical associations between DQD and individual and occupational factors were analyzed using logistic regression modeling in the whole sample and among women.Results The prevalence rates of uni- or bilateral DQD for the whole, male and female working populations were 1.2% [95% confidence interval (95% CI) 0.9–1.6], 0.6% (95% CI 0.3–0.9) and 2.1% (95% CI 1.4–2.8), respectively. Personal risk factors for DQD were mainly age (1.1 for 1-year increase in age) and female gender [odds ratio (OR) 4.9, 95% CI 2.4–10.1]. Work-related factors were workpace dependent on (i) technical organization (OR 2.0, 95% CI 1.0–4.0), (ii) repeated or sustained wrist bending in extreme posture (OR 2.6, 95% CI 1.3–5.3) and (iii) repeated movements associated with the twisting or driving of screws (OR 3.4, 95% CI 1.7–7.1). No association was found with psychosocial factors. Conclusions Personal and work-related factors were associated with DQD in the working population; wrist bending and movements associated with the twisting or driving of screws were the most significant of the work-related factors."

"The underlying purpose of this commentary and position paper is to achieve evidence-based recommendations on prevention of work-related musculoskeletal disorders (MSDs). Such prevention can take different forms (primary, secondary and tertiary), occur at different levels (i.e. in a clinical setting, at the workplace, at national level) and involve several types of activities. Members of the Scientific Committee (SC) on MSDs of the International Commission on Occupational Health (ICOH) and other interested scientists and members of the public recently discussed the scientific and clinical future of prevention of (work-related) MSDs during five round-table sessions at two ICOH conferences (in Cape Town, South Africa, in 2009, and in Angers, France, in 2010). Approximately 50 researchers participated in each of the sessions. More specifically, the sessions aimed to discuss new developments since 1996 in measures and classification systems used both in research and in practice, and agree on future needs in the field.The discussion focused on three questions: At what degree of severity does musculoskeletal ill health, and do health problems related to MSDs, in an individual worker or in a group of workers justify preventive action in occupational health? What reliable and valid instruments do we have in research to distinguish 'normal musculoskeletal symptoms' from 'serious musculoskeletal symptoms' in workers? What measures or classification system of musculoskeletal health will we need in the near future to address musculoskeletal health and related work ability?Four new, agreed-upon statements were extrapolated from the discussions: 1. Musculoskeletal discomfort that is at risk of worsening with work activities, and that affects work ability or quality of life, needs to be identified. 2. We need to know our options of actions before identifying workers at risk (providing evidence-based medicine and applying the principle of best practice). 3. Classification systems and measures must include aspects such as the severity, frequency, and intensity of pain, as well as measures of impairment of functioning, which can help in prevention, treatment and prognosis. 4. We need to be aware of economic and/or socio-cultural consequences of classification systems and measures."

"Objective: Carpal tunnel syndrome (CTS) represents one of the most significant and costly health problems occurring in the working population. An estimation of the potential impact of CTS prevention programs in the workplace would be useful for public policy. The aim of this study was to assess the work-related population-attributable fraction (PAF) of CTS in industrial sectors and occupational categories at high risk of CTS in the general population.
Methods: All cases of CTS occurring in patients living in a French region were included prospectively between 2002–2004. Using a mailed questionnaire, we gathered medical and occupational history from 815 women and 320 men. We calculated the age-adjusted relative risks and PAF of CTS in relation to industrial sectors and occupational categories.
Results: The PAF for women was higher in lower-grade, white-collar workers (24%, 95% CI 19–29) than blue-collar workers (19%, 95% CI 15–22). The PAF was higher for the service industries sector (16%, 95% CI 8–22) than manufacturing (10%, 95% CI 7–13) or agricultural (5%, 95% CI 3–7) sectors. The PAF was high for men in blue-collar workers (50%, 95% CI 41–57) and in the construction (13%, 95% CI 9–18) and manufacturing industries (17%, 95% CI 10–23).
Conclusion: The study suggested that 5-50% of CTS cases might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industrial sectors."

"Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work.Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially medial epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes)."

"Après Boston en 2007, le congrès PREMUS 2010 (Seventh International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders) s'est déroulé en France pour la première fois depuis sa création en 1992. Il s'agit du principal congrès international sur les troubles musculosquelettiques (TMS) qui regroupe, tous les trois ans, sous l'égide de l'International Commission of Occupational Health (ICOH - CIST), les spécialistes internationaux du sujet (biomécaniciens, physiologistes, épidémiologistes, médecins du travail, ergonomes, préventeurs, cliniciens, psychologues, sociologues, spécialistes de gestion, etc.). Plus de 650 chercheurs et préventeurs de 40 pays ont participé à ce congrès scientifique de haut niveau qui tient aussi lieu de forum international pour les acteurs de la prévention des TMS des membres et du rachis. Après une présentation des principaux thèmes abordés au cours de la semaine, une sélection des sujets qui ont particulièrement marqué cette 7e conférence est développée."

"BackgroundPhysical examination is often used to screen workers for carpal tunnel syndrome (CTS). In a population of newly hired workers, we evaluated the yield of such screening.MethodsOur study population included 1,108 newly hired workers in diverse industries. Baseline data included a symptom questionnaire, physical exam, and bilateral nerve conduction testing of the median and ulnar nerves; individual results were not shared with the employer. We tested three outcomes: symptoms of CTS, abnormal median nerve conduction, and a case definition of CTS that required both symptoms and median neuropathy.ResultsOf the exam measures used, only Semmes–Weinstein sensory testing had a sensitivity value above 31%. Positive predictive values were low, and likelihood ratios were all under 5.0 for positive testing and over 0.2 for negative testing.ConclusionPhysical examination maneuvers have a low yield for the diagnosis of CTS in workplace surveillance programs and in post-offer, pre-placement screening programs."