Ha C, Roquelaure Y, Leclerc A, Touranchet A, Goldberg M, Imbernon E
Département Santé Travail, Institut de Veille Sanitaire, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France.
Occup Environ Med. 2009 Jul;66(7):471-9. doi: 10.1136/oem.2008.042812. Epub 2009 Mar 5.
An epidemiological surveillance system for work-related musculoskeletal disorders (MSDs) was implemented in 2002 in France's Pays de la Loire region to assess the incidence and prevalence of MSDs in the general and working populations, identify levels of exposure to occupational risk factors and investigate the proportion of cases attributable to work exposure.
The program combines (1) surveillance of sentinel health events in the general population (carpal tunnel syndrome (CTS) was the sentinel event for upper limb MSDs), (2) assessment of the prevalence of the main upper limb MSDs and their risk factors in the workplace based on a network of occupational physicians and (3) registration of the notification of work-related diseases (WRDs).
1168 incident cases of CTS were included over a 3 year period. The estimated incidence of CTS was 1.00 per 1000 person-years in those aged 20-59 years (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 1000 vs 0.3 in men and 1.7 vs 0.8 in women). The occupational physician network noted high prevalence rates: 11% of men and 15% of women had at least one of the six main upper limb clinically-diagnosed MSDs. The WRD survey showed that MSDs represented 65% of notified WRDs.
The Pays de la Loire program plays a significant role in informing the authorities and the public about the state of current MSDs. It is planned to extend it to a routine national surveillance program.
2002年,法国卢瓦尔河地区实施了一项与工作相关的肌肉骨骼疾病(MSD)的流行病学监测系统,以评估普通人群和工作人群中MSD的发病率和患病率,确定职业风险因素的暴露水平,并调查可归因于工作暴露的病例比例。
该项目结合了(1)对普通人群中哨点健康事件的监测(腕管综合征(CTS)是上肢MSD的哨点事件),(2)基于职业医生网络评估工作场所主要上肢MSD的患病率及其风险因素,以及(3)工作相关疾病(WRD)通报的登记。
在3年期间纳入了1168例CTS发病病例。20至59岁人群中CTS的估计发病率为每1000人年1.00例(男性为0.60例,女性为1.40例)。在诊断当年,就业人员的发病率高于失业人员(男性分别为每1000人0.6例和0.3例,女性分别为1.7例和0.8例)。职业医生网络指出患病率很高:11%的男性和15%的女性至少患有一种临床上诊断的六种主要上肢MSD。WRD调查显示,MSD占通报的WRD的65%。
卢瓦尔河地区项目在向当局和公众通报当前MSD状况方面发挥了重要作用。计划将其扩展为一项常规的国家监测项目。