PT - JOURNAL ARTICLE AU - M Melchior AU - Y Roquelaure AU - B Evanoff AU - J-F Chastang AU - C Ha AU - E Imbernon AU - M Goldberg AU - A Leclerc TI - 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) AID - 10.1136/oem.2005.025122 DP - 2006 Nov 01 TA - Occupational and Environmental Medicine PG - 754--761 VI - 63 IP - 11 4099 - http://oem.bmj.com/content/63/11/754.short 4100 - http://oem.bmj.com/content/63/11/754.full SO - Occup Environ Med2006 Nov 01; 63 AB - 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.