Chiron Elise, Roquelaure Yves, Ha Catherine, Touranchet Annie, Chotard Anne, Bidron Patrick, Ledenvic Béatrice, Leroux François, Mazoyer Annick, Goldberg Marcel, Imbernon Ellen
Laboratoire d'Ergonomie et d'Epidémiologie en Santé au Travail, Unité associée InVS, Médecine E-CHU, 4 rue Larrey, 49933 Angers Cedex.
Sante Publique. 2008 May-Jun;20 Suppl 3:S19-28. doi: 10.3917/spub.083.0019.
Work-related musculoskeletal disorders of the upper limbs (MSDs) are the first cause of occupational illness in France, as in Europe. A pilot network for epidemiological surveillance system of MSDs has been implemented in France's Loire Valley region to assess the prevalence of MSDs and their risk factors in the working population, namely the ageing workforce. The surveillance was based on a network of occupational physicians and used the recommendations of a group of European experts ('Saltsa Criteria document' consensus). Between 2002 and 2004, 3710 men and women (aged 20-59) representative of the regional workforce were randomly selected. Exposure to risk factors of MSDs was evaluated by the use of a self-administered questionnaire which aimed to assess bio-mechanical and psychosocial risk factors. With at least one of the six primary MSDs of the upper limbs having been clinically diagnosed using a rigorous protocol, the prevalence of clinically-diagnosed MSDs was high: about 11% of male and 15% of female workers suffered from at least one of the MSDs studied. After age fifty, about 19% of male and 27% of female workers suffered from at least one MSD and 4% of male and 6% of female workers from at least two disorders. Blue-collar workers were the most affected, regardless of age or gender, followed by office employees. Exposure to MSD risk factors of remained high after age fifty: 77% of male and 72% of female blue-collar workers were exposed to at least two MSD risk factors. The implications for the prevention of MSDs and job security of workers are discussed. The high prevalence of specific MSDs of the upper limb combined with a high exposure to risk factors of MSDs in ageing workers emphasizes the need to implement comprehensive prevention programs in most sectors to reduce the exposure to risk, the prevalence of MSDs and ensure the capacity to keep employees suffering from MSDs working, or at least to quickly return to work after recovery.
与工作相关的上肢肌肉骨骼疾病(MSDs)是法国以及欧洲职业疾病的首要病因。法国卢瓦尔河谷地区已实施了一个MSDs流行病学监测系统的试点网络,以评估工作人群(即老龄劳动力)中MSDs的患病率及其风险因素。该监测基于职业医生网络,并采用了一组欧洲专家的建议(《萨尔察标准文件》共识)。在2002年至2004年期间,随机选取了3710名代表该地区劳动力的男性和女性(年龄在20至59岁之间)。通过使用一份自我管理问卷来评估MSDs风险因素的暴露情况,该问卷旨在评估生物力学和社会心理风险因素。使用严格方案对上肢六种主要MSDs中的至少一种进行临床诊断后,临床诊断的MSDs患病率很高:约11%的男性和15%的女性工人患有至少一种所研究的MSDs。五十岁以后,约19%的男性和27%的女性工人患有至少一种MSD,4%的男性和6%的女性工人患有至少两种疾病。无论年龄或性别,蓝领工人受影响最大,其次是办公室职员。五十岁以后,接触MSD风险因素的情况仍然很高:77%的男性和72%的女性蓝领工人接触至少两种MSD风险因素。文中讨论了对预防MSDs和工人工作安全的影响。上肢特定MSDs的高患病率以及老龄工人中MSDs风险因素的高暴露率,凸显了在大多数部门实施全面预防计划的必要性,以减少风险暴露、MSDs患病率,并确保患有MSDs的员工能够继续工作,或者至少在康复后能迅速重返工作岗位。