Why are manual workers at high risk of upper limb disorders? The role of physical work factors in a random sample of workers in France (the Pays de la Loire study)
- M Melchior1,
- Y Roquelaure2,3,
- B Evanoff4,
- J-F Chastang1,
- C Ha2,
- E Imbernon2,
- M Goldberg1,2,
- A Leclerc1,
- and the Pays de la Loire Study Group
- 1U687-IFR69, INSERM (National Institute of Health Research) Saint-Maurice, France
- 2Department of Work and Health, InVS (National Institute of Health Surveillance), France
- 3Faculty of Medicine, Angers, France
- 4Washington University School of Medicine, WA, USA
- Correspondence to: Dr M Melchior INSERM U687, HNSM, 14 rue du Val d’Osne, 94415 Saint-Maurice Cédex, France
- Accepted 13 June 2006
- Published Online First 20 June 2006
Objective: To investigate the reasons for the excess risk of upper limb musculoskeletal disorders among manual workers compared with other workers in a random sample of 2656 French men and women (20–59 years old) participating in a study on the prevalence of work related upper limb disorders conducted by France’s National Institute of Health Surveillance.
Methods: Prevalence ratios (PR) of physician-diagnosed musculoskeletal disorders of the shoulder, elbow, wrist, and hand (any of six leading disorders, rotator cuff syndrome, carpal tunnel syndrome) in manual versus non-manual workers were calculated using Cox regression models with a constant time of follow up and robust variance.
Results: 11.3% of men and 15.1% of women were diagnosed with an upper limb disorder. The risk was especially high in manual workers (PRs: 1.40 to 2.10). Physical work factors accounted for over 50% of occupational disparities overall, 62% (men) to 67% (women) for rotator cuff syndrome, and 96% (women) for carpal tunnel syndrome. The authors calculated that under lower levels of physical work exposures, up to 31% of cases among manual workers could have been prevented.
Conclusions: In working men and women, upper limb musculoskeletal disorders are frequent. Physical work exposures, such as repetitive and forceful movements, are an important source of risk and in particular account for a large proportion of excess morbidity among manual workers.
- INSERM, Institut National de la Santé et de la Recherche Médicale
- InVS, Institut National de Veille Sanitaire
- biomechanical exposures
- manual worker
- musculoskeletal diseases
- occupational exposures
- upper extremity
Published Online First 20 June 2006