Introduction Upper limb Musculoskeletal disorders (UL-MSDs) in occupationally active populations represent an important health issue that affect millions of people worldwide. They lead to high healthcare costs and represent a significant burden to the national economy.

Objectives To assess the incidence of UL- MSDs in the industrial private sector since 2000 and to determine projection for 2026.

Methods Using a national retrospective study that concerned all the Occupational MSDs reported to the Tunisian National Health Insurance Fund, in all industrial private sectors from January 2000 to May 2018, we gathered all the medical and administrative data available.

Results Six thousand and forty-two cases of UL-MSDs were totaled. Most of the declared occupational UL-MSDs were those of female workers (sex ratio=0.15). Moreover, the present study showed a young age of declaration of MSDs (44 ± 7.5 years). The most common industrial sector affected was in textile manufacturing (63.9%). Mono-site MSDs were significantly more prevalent in almost all the industrial sectors. Central district had a significantly higher yearly number of cases than the two others (p<10 -3). The study showed that approximately 71% of all initial medical certificates were reported by occupational health physicians graduated in Occupational Medicine. Seventy-two percent of these declarations were accepted by the recognition committee (p=0.007). In 2026, it is expected to count 2,626 new occupational declared UL-MSDs, with a crude prevalence in female workers 27 times as high as in male workers. The textile and clothing manufacture will remain the main affected sector by the UL-MSDs till 2026.

Conclusion The risk of UL-MSDs in the Tunisian private sector workforce is considerable; it requires the implementation of rapid ergonomic preventive measures in the next decade. Further biomechanical and psycho-organizational studies of the most at-risk workstations in the Tunisian clothing industry are key to preventing these occupational disorders.