Documents Roquelaure, Yves 30 results

"Objective
The aim of this study was to describe time trends of incidence/prevalence of carpal tunnel syndrome (CTS), one of the most common musculoskeletal disorders, in a French region over an 8-year period.
Methods
Three independent data sources were analyzed for the population of the Pays de la Loire region aged 20–59 between 2004 and 2011: hospital discharge records for “surgically treated CTS” (SURG-CTS), the social insurance data on “CTS compensated for as an occupational disease” (OD-CTS), and the regional surveillance program of “work-related diseases” (WRD-CTS). Case counts were analyzed using negative binomial regression models and cubic spline curves with year as the main covariate.
Results
The annual incidence rates of SURG-CTS decreased from 3.35 to 2.98 per 1000 person-years over the 8-year period, with an overall declining trend [-2.00%, 95% confidence interval (95% CI) -3.07– -0.91%), P<0.001]. The annual incidence rate of OD-CTS per 1000 person-years decreased (from 1.52 to 1.01) between 2004 and 2007 and increased after 2007 (from 1.45 to 2.34), with an overall gain of 54% during the study period. The prevalence rate of WRD-CTS decreased from 5.04 (95% CI 3.90–6.13) to 3.08 (95% CI 2.11–4.06) per 1000 employed person-years, with a non-significant trend between 2004 and 2011.
Conclusion
The study showed declining rates of SURG-CTS and WRD-CTS in the population of working age between 2004 and 2011, contrasting with increasing rate of OD-CTS after 2007. More research and surveillance data are needed to assess whether and to what extent the declining rates of CTS are actually attributable to improvement in working conditions and/or to non-occupational factors."

"Les troubles musculosquelettiques (TMS) liés au travail sont connus depuis le début des années 1700, lorsque Bernardino Ramazzini a noté les effets néfastes des postures non naturelles et des mouvements répétitifs, tels que l'engourdissement du membre supérieur chez les scribes dû au « mouvement incessant de la main et toujours dans la même direction », ou la sciatique chez les potiers due au fait qu'ils tournent continuellement le tour du potier avec leurs pieds. À la fin des années 1990, d'importants travaux collectifs ont précisé les classifications et les déterminants de ces troubles."

This work is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).

"Work disability prevention interventions are complex innovations competing against usual care, workplace habits, and social insurance systems' complexity. The trial effectiveness of these interventions does not guarantee their implementation and sustainability. Multilevel barriers in the healthcare, workplace and insurance systems must be identified and tackled, and implementation strategies must be evaluated to monitor the implementation process and fidelity."

"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: 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)."

Objectives A longitudinal study was conducted to determine the predictability of personal and occupational factors with respect to the incidence of upper-limb disorders in occupations requiring repetitive work.Conclusions This study considered different sets of risk factors simultaneously with a longitudinal approach, in a population with a high level of occupational exposure. The results indicate that three sets of risk factors independently affect the incidence of upper-limb disorders. In addition to biomechanical constraints, psychosocial and personal factors play a role.

"Objectives The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants.Methods Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed.Results The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. Conclusions The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination."

"Objectives
A job exposure matrix (JEM) is a tool to estimate workers' exposure to occupational physical risk factors. We evaluated the performance of two general population JEM (CONSTANCES and O*NET) to detect known exposure–disease relationships in an American prospective cohort study. We compared exposure estimates from three data sources and explored whether combining exposures from these two JEM, or combining exposure from each JEM with individual-level measures, improved prediction of carpal tunnel syndrome (CTS).
Methods
Using Cox proportional hazard models, we evaluated relationships between physical work exposure and incident CTS of 2393 workers using JEM-assigned and individual-level measure exposure information. We compared exposure estimates using Spearman's rank correlation and Cohen's kappa. We compared combined exposure models to single source exposure models by using binomial logistic regression and examined differences based on model fit and performance.
Results
The O*NET JEM [hazard ratio (HR) range 1.3–2.01] demonstrated generally similar exposure–disease associations as individual-level measures (HR range 1.00–1.42); we found fewer associations with the CONSTANCES JEM (HR range 1.08–2.05). Comparisons between the three sources showed stronger correlations and agreement at the job versus worker level. Combined models improved goodness-of-fit and had lower Akaike information criterion (AIC) values compared to single-source models.
Conclusions
JEM can be applied cross nationally and there is potential to combine complementary exposure methods to improve estimation of workplace physical exposures in the prediction of CTS. More investigations are needed to explore exposure-disease associations in other samples and combinations of exposure data from different methods."