Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-49000 Angers, France.
INSPQ-Institut National de Santé Publique du Québec, Montréal, QC H2P 1E2, Canada.
Int J Environ Res Public Health. 2021 Apr 7;18(8):3858. doi: 10.3390/ijerph18083858.
The objective of this paper is to assess the combined effect of occupational biomechanical and psychosocial risk factors on the incidence of work-related upper-extremity musculoskeletal disorders (UEMSDs) and estimate the proportion and number of incident cases attributable to these risk factors in a working population. Using data from the French COSALI (COhorte des SAlariés LIgériens) cohort (enrolment phase: 2002-2005; follow-up phase: 2007-2010), a complete case analysis including 1246 workers (59% men, mean age: 38 years ± 8.6 at baseline) was performed. All participants underwent a standardized clinical examination at enrolment and 1611 workers were re-examined at follow-up. Population attributable fractions and the number of UEMSD cases attributable to occupational risk factors were calculated. During follow-up, 139 UEMSD cases were diagnosed, representing an estimated 129,320 projected incident UEMSD cases in the working population. After adjusting for personal factors, in model 1, 8664 cases (6.7%) were attributable to low social support, 19,010 (14.7%) to high physical exertion, and 20,443 (15.8%) to co-exposure to both factors. In model 2, 16,294 (12.6%) cases were attributable to low social support, 6983 (5.4%) to posture with arms above shoulder level, and 5043 (3.9%) to co-exposure to both factors. Our findings suggest that many cases of UEMSD could be potentially prevented by multidimensional interventions aimed at reducing exposure to high physical exertion and improving social support at work.
本文旨在评估职业生物力学和心理社会风险因素对工作相关上肢肌肉骨骼疾病（UEMSD）发病率的综合影响，并估计这些风险因素在工作人群中导致发病的比例和数量。使用来自法国 COSALI（COhorte des SAlariés LIgériens）队列的数据（登记阶段：2002-2005 年；随访阶段：2007-2010 年），对包括 1246 名工人（59%为男性，平均年龄：基线时 38 岁±8.6 岁）的完整病例进行了分析。所有参与者在登记时接受了标准化的临床检查，1611 名工人在随访时接受了重新检查。计算了人群归因分数和归因于职业危险因素的 UEMSD 病例数。在随访期间，诊断出 139 例 UEMSD 病例，估计在工作人群中，有 129320 例预计的 UEMSD 新发病例。在调整个人因素后，在模型 1 中，有 8664 例（6.7%）病例归因于低社会支持，19010 例（14.7%）归因于高体力劳动，20443 例（15.8%）归因于两者同时暴露。在模型 2 中，有 16294 例（12.6%）病例归因于低社会支持，6983 例（5.4%）归因于手臂高于肩部水平的姿势，5043 例（3.9%）归因于两者同时暴露。我们的研究结果表明，通过多维干预措施减少高体力劳动暴露和改善工作中的社会支持，可以预防许多 UEMSD 病例。
