The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire Network

Abstract

Objectives: An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France's Pays de la Loire region by the French Institute for Public Health Surveillance, to assess the incidence and prevalence rates of MSDs in the general and working populations, to identify the levels of exposure to occupational risk factors and to investigate the proportion of cases attributable to work exposure.

Methods: The program combines three main components: 1/ surveillance of sentinel health events in the general population and carpal tunnel syndrome (CTS) was chosen as sentinel event for upper limb MSDs; 2/ the second component, based on a network of occupational physicians (OPs), assesses the prevalence of the main upper-limb MSDs and their risk factors in the workplace; 3/ the third is based on the registration of notification of work-related diseases.

Results: 1,168 incident cases of CTS were included during a 3 year-period. The estimated incidence of CTS was 1.00 per 1,000 person-years aged 20-59 (0.60 in men and 1.40 in women). The incidence rate was higher in employed than unemployed persons in the year of diagnosis (0.6 per 1,000 vs. 0.3 in men and 1.7 vs. 0.8 in women). Through the OP network, prevalence rates were high: 11% of men and 15% of women suffered from at least one of the six main upper limb clinically-diagnosed MSDs. The survey on WRD showed that MSDs represented 65% of the notified work-related diseases.

Conclusion: The Pays de la Loire program already plays a significant role in informing the authorities and the public on the state of the current epidemic of MSDs. It is planned to extend it to a national surveillance program.