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Biomedical subjects

Y Roquelaure

Publications and source records attributed to Y Roquelaure.

18 recordsLinked to original sources
PubMed2006

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).

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.

Adult↗
PubMed2004

[Prospective study of the outcome at one year of patients with chronic low back pain in a program of intensive functional restoration and ergonomic intervention. Factors predicting their return to work].

OBJECTIVES: Evaluation of 1-year outcome after patients with chronic low back pain participated in an intensive functional restoration program associated with an ergonomic intervention on the workplace. Study of the factors predicts a return to work. METHODS: Prospective study of a cohort of 87 patients face major difficulties due to low back pain at work. Patients who visited a multidisciplinary clinic were included. Parameters, evaluating physical and psychological status, quality of life, presence at work, length of sick leaves, were determined before and after the program and at 6 and 12 months' followup. The correlation between these parameters and presence at work at 1 year was studied. RESULTS: A total of 86 patients completed the program; three were lost to followup at 1 year. Ergonomic interventions were tried in 53 patients. All parameters were improved at the end of the program and remained significantly improved at 12 months. A total of 90% of the patients returned to work at the end of the program, whereas only 17% were at work before; 72% were at work in 1 year. The number of sick leave days decreased by 60%. The Dallas index at the beginning and the end of the program, the number of sick leave days before the program and score on the item "feels able to work" correlated with the presence at work in 1 year. There was no correlation between presence at work and physical parameters. CONCLUSION: This study shows the effect of the program and determines factors predictive of successful return to work for patients with chronic low back pain. Further data are necessary to discuss the specific effect of ergonomic interventions.

Absenteeism↗
PubMed2004

Incidence of shoulder pain in repetitive work.

AIMS: To determine the predictiveness of personal and occupational factors for the onset of shoulder pain in occupations requiring repetitive work. METHODS: A sample of 598 workers in five activity sectors completed a self administered questionnaire in 1993-94 and again three years later. Both questionnaires included questions about shoulder pain. The associations between various factors at baseline and subsequent shoulder pain were studied among subjects free from shoulder pain at baseline. RESULTS: The incidence of shoulder pain was associated with several independent risk factors: depressive symptoms, low level of job control, and biomechanical constraints. After adjustment for other risk factors, the presence of depressive symptoms predicted occurrence of shoulder pain. A low level of job control was also associated with the onset of shoulder pain in both sexes. For men, repetitive use of a tool was a strong predictor, while the two most important biomechanical risk factors for women were use of vibrating tools and working with arms above shoulder level. CONCLUSION: This study used a longitudinal approach to examine different sets of risk factors for shoulder pain simultaneously. The results confirm the role of several biomechanical constraints. Psychological symptoms and a low level of job control also play a role.

Adult↗
PubMed2004

Work status after workers' compensation claims for upper limb musculoskeletal disorders.

AIM: To provide information on employment status after workers' compensation (WC) claims for musculoskeletal disorders of the limbs (MSDs). METHODS: Two-year follow up of the workers who filed a WC claim for MSDs in 1996 in the Pays de la Loire region. Of the 701 eligible workers, 514 workers (70%) participated. Information was requested by means of a mailed questionnaire about the characteristics of the MSDs and job status at the time of the WC claim and two years later. RESULTS: Two years after the WC claim, 65% of the claimants had returned to work in the same company, often without any ergonomic improvement, 12% had retired or had left employment voluntarily, and 18% had been dismissed. The risk of dismissal was associated with three factors: being older than 45 years, having two or more MSDs at claim, and working in the cleaning services sector.

Adult↗
PubMed2003

[Occupational risk factors for radial tunnel syndrome in factory workers].

STUDY: The purpose of the study was to evaluate the professional and extraprofessional risk factors for radial tunnel syndrome (RTS) in employees of three large companies. METHOD: Twenty-one cases of RTS were compared to 21 controls, matched for age, sex, and activity. In nine cases, RTS was associated with carpal tunnel syndrome. The analysis considered medical history, extraprofessional activity, and the ergonomic and organisational aspects of work. RESULTS: The study demonstrated three risk factors of RTS related to work conditions. The regular use of a force of at least 1 kg (OR = 9.1 (1.4-56.9)) more than 10 times per hour is the main biomechanical risk factor. Static work (OR = 5.9 (1.2-29.9)) as well as work with the elbow constantly extended 0 degree to 45 degrees, is strongly associated with an increased risk of RTS (OR = 4.9 (1.0-25.0)). Complete extension of the elbow associated with pronation and supination of the forearm may cause trauma to the radial nerve in the radial tunnel. On the other hand, we found no personal factors and no extraprofessional activities which were associated with an increased risk of RTS. CONCLUSIONS: This study shows that motions of the forearm requiring intense effort and performed with the elbow in extension and the forearm in pronation and supination increase the risk of RTS.

Adult↗
PubMed2003

Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors.

Because medial epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work and its course. A total of 1757 workers were examined by an occupational health physician in 1993-1994. Five hundred ninety-eight of them were reexamined 3 years later. Prevalence was between 4% and 5%, with an annual incidence estimate at 1.5%. Forceful work was a risk factor (odds ratio [OR], 1.95; confidence interval [CI] = 1.15-3.32), but not exposure to repetitive work (OR, 1.11; CI = 0.59-2.10). Workers with medial epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for medial and lateral epicondylitis. The prognosis for medial epicondylitis in this population was good with a 3-year recovery rate at 81%. Medial epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good.

Adult↗
PubMed2002

Active epidemiological surveillance of musculoskeletal disorders in a shoe factory.

AIMS: (1) To evaluate an active method of surveillance of musculoskeletal disorders (MSDs). (2) To compare different criteria for deciding whether or not a work situation could be considered at high risk of MSDs in a large, modern shoe factory. METHODS: A total of 253 blue collar workers were interviewed and examined by the same physician in 1996; 191 of them were re-examined in 1997. Risk factors of MSDs were assessed for each worker by standardised job site work analysis. Prevalence and incidence rates of carpal tunnel syndrome, rotator cuff syndrome, and tension neck syndrome were calculated for each of the nine main types of work situation. Different criteria used to assess situations with high risk of MSDs were compared. RESULTS: On the basis of prevalence data, three types of work situation were detected to be at high risk of MSDs: cutting, sewing, and assembly preparation. The three types of work situations identified on the basis of incidence data (sewing preparation, mechanised assembling, and finishing) were different from those identified by prevalence data. At least one recognised risk factor for MSDs was identified for all groups of work situations. The ergonomic risk could be considered as serious for the four types of work situation having the highest ergonomic scores (sewing, assembly preparation, pasting, and cutting). CONCLUSION: The results of the health surveillance method depend largely on the definition of the criteria used to define the risk of MSDs. The criteria based on incidence data are more valid than those based on prevalence data. Health and risk factor surveillance must be combined to predict the risk of MSDs in the company. However, exposure assessment plays a greater role in determining the priorities for ergonomic intervention.

Adult↗
PubMed2001

Transient hand paresthesias in Champagne vineyard workers.

BACKGROUND: The aim of the study was to assess the prevalence of hand paresthesias (HP) and their relationship with pruning activities. METHODS: A cross-sectional study was conducted among 537 workers pruning grapevines in the region of Champagne. All workers completed a questionnaire about nocturnal HP and musculoskeletal pain during the preceding 12-month period. RESULTS: The 12-month prevalence of nocturnal HP and hand-wrist pain were 37 and 12%, respectively. HP, predominantly affecting the dominant hand, only began during the pruning period and ended after the pruning season in 90% of cases. HP were transient in most cases, with a mean duration of symptoms of 3.3 +/- 3.2 months. Risk factors associated with HP were: female gender (OR = 2.3 [1.3-3.0]), being overweight (OR = 1.6 [1.1-2.5]), payment on a piecework basis (OR = 2.0 [1.2-2.3]) and traditional blade sharpening method (OR = 1.7 [1.1-2.7]). HP were less frequent in employees who used electric pruning shears (OR = 0.5 [0.2-1.6], P = 0.09). CONCLUSIONS: The development of HP, which affected a third of employees, was different from HP observed in industrial workers since most vineyard workers recovered without medical treatment after the pruning season.

Adult↗
PubMed2001

Musculoskeletal complaints, functional capacity, personality and psychosocial factors.

OBJECTIVES: The aim of the research was to study the association between psychosocial and personality factors, and neck and wrist-hand musculoskeletal complaints, taking account of the occupational factors of force, posture and repetitiveness, and non-occupational risk factors such as sport, hobbies, medical history. METHODS: During personal interviews 133 women from seven different companies, working at constraining workplaces (very repetitive work), answered several questionnaires. These concerned: personal characteristics and history; work characteristics; psychosocial factors (perception and appreciation of the work situation, satisfaction at work, stress symptoms, Karasek questionnaire) and personality factors (neuroticism, conscientiousness, type-A behavior). They also undertook functional and psychomotor tests (wrist angles, grip strength and a dexterity test). Logistic regression models were calculated. RESULTS: Wrist-hand complaints appear to be associated with some personal characteristics (smoking habits, fewer hobbies), work constraints (fewer breaks, heavy lifting efforts) and some personality (introversion) and psychosocial factors (worse appreciation of work). Neck complaints are also associated with some personal characteristics (young people, small, bad health, hormonal problems, fewer hobbies), some personality (urgency of time) and psychosocial factors (constraints as seen by the supervisor). CONCLUSION: The study confirms the multifactorial character of the musculoskeletal disorders and underlines the need for a global ergonomic approach to work situations, taking into account all their physical, psychological and social components.

Adult↗
PubMed2001

Upper-limb disorders in repetitive work.

OBJECTIVES: A longitudinal study was conducted to determine the predictability of personal and occupational factors with respect to the incidence of upper-limb disorders in occupations requiring repetitive work. METHODS: A sample of 598 workers in five activity sectors completed a self-administered questionnaire; the workers were examined by an occupational health physician in 1993-1994 and 3 years later. Three disorders were considered, carpal tunnel syndrome (CTS), lateral epicondylitis and wrist tendinitis. RESULTS: The results of this longitudinal study indicated that the following three sets of risk factors independently affect the incidence of upper-limb disorders: (i) biomechanical constraints, (ii) psychosocial factors, and (iii) personal factors. The combination of risk factors differed between CTS, lateral epicondylitis, and wrist tendinitis. The presence of psychosomatic problems was a strong predictor of wrist tendinitis. Social support at work was also associated with the incidence of wrist tendinitis. The presence of depressive symptoms and other upper-limb disorders predicted the first occurrence of lateral epicondylitis. Age was associated only with epicondylitis. The results were consistent with those concerning the role of forceful movements of the elbow for epicondylitis and confirmed the role of forceful movements for CTS. CONCLUSIONS: This study considered different sets of risk factors simultaneously with a longitudinal approach, in a population with a high level of occupational exposure. The results indicate that three sets of risk factors independently affect the incidence of upper-limb disorders. In addition to biomechanical constraints, psychosocial and personal factors play a role.

Adult↗
PubMed2001

Prevalence, incidence and risk factors of carpal tunnel syndrome in a large footwear factory.

The study was conducted to assess the prevalence and incidence of carpal tunnel syndrome (CTS) in a large modern footwear factory and to identify factors predictive of CTS. To this end, 199 workers were examined in 1996, and 162 of them were re-examined in 1997. Ergonomic and psychosocial risk factors of CTS were assessed by workpost analysis and self-administered questionnaire. The prevalence of CTS at baseline in 1996 and in 1997 was 16.6% (95%CI: 11.4-21.7) and 11.7% (95%CI: 6.7-16.8), respectively. The incidence rate of CTS in 1997 was 11.7% (95%CI: 6.7-7.8). No specific type of job performance was associated with CTS. Obesity (OR = 4.4; 95%CI: 1.1-17.1) and psychological distress at baseline (OR = 4.3; 95%CI: 1.0-18.6) were strongly predictive of CTS. Rapid trigger movements of the fingers were also predictive of CTS (OR = 3.8; 95%CI: 1.0-17.2). A strict control of thework by superiors was negatively associatedwith CTS (OR = 0.5; 95%CI: 0.2-1.3). The prevalence and incidence of CTS in this workforce were largely higher than in the general population and numerous industries. The study highlights the role of psychological distress in workers exposed to a high level of physical exposure and psychological demand.

Adult↗
PubMed2000

Occupational risk factors for radial tunnel syndrome in industrial workers.

OBJECTIVES: The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. CONCLUSIONS: The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination.

Adult↗
PubMed1999

Evaluation of an educational low back pain prevention program for hospital employees.

OBJECTIVES: To evaluate the impact of an educational low back pain prevention program in a cohort of hospital employees. METHODS: A cohort of 136 nonclerical hospital employees attended classes on safe postures and patient handling, then received advice by educators who observed them while they performed their typical workday tasks. Each of the subjects in this intervention group was matched on age, sex, and job category with a control. Musculoskeletal complaints and changes in habits during work and recreational activities were evaluated before the intervention (or the corresponding date in the control group) and after two years. RESULTS: In the intervention group, 36% of subjects with low back pain at baseline were free of this symptom at follow-up, whereas only 26% were in the opposite situation. The proportion of subjects with low back pain episodes lasting longer than 30 days increased significantly from baseline to follow-up in the control group (from 30% to 49%) but not in the intervention group. The number of sick leaves longer than 30 days decreased significantly in the intervention group. Only 33% of the intervention group subjects felt the intervention had been helpful; this proportion varied across job categories. CONCLUSION: Our data suggest that differences in job categories should be taken into account when designing educational programs for preventing low back pain. They also indicate that back school programs may be more effective in subjects with a history of low back pain, whereas instruction on safe postures and patient handling may be the best approach in subjects who have not previously experienced low back pain. Observing and providing advice to employees while they are performing their usual duties may be an essential component of low back pain prevention.

Humans↗
PubMed1997

Occupational and personal risk factors for carpal tunnel syndrome in industrial workers.

OBJECTIVES: The purpose of the study was to evaluate both nonoccupational and occupational factors associated with carpal tunnel syndrome (CTS) in industrial workers. METHODS: Sixty-five workers with CTS were compared with 65 referents matched for gender, age, and plant. The medical history and household activities of the workers and the ergonomic and organizational characteristics of the job were analyzed. RESULTS: Exertion of force over 1 kg was associated with CTS [odds ratio (OR) 9.0]. Two risk factors were related to motion repetitiveness: length of the shortest elementary operation of < or = 10 s (OR 8.8) and lack of change in tasks or lack of breaks for at least 15% of the daily worktime (OR 6.0). No posture of the upper limb was associated with CTS. Workstation design involving the manual supply of the workers (OR 5.0) and the lack of job rotation (OR 6.3) were associated with CTS. The only personal factor associated with CTS was a parity of at least 3 (OR 3.2). There was a continuous increase in the odds ratio against the number of risk factors accumulated by the workers; the odds ratio thus ranged from 5.6 when 3 of the 6 risk factors were present to > or = 90 when 4, 5, or 6 risk factors were accumulated. CONCLUSIONS: The results were in agreement with a model for CTS which included 1 personal and 5 occupational risk factors. The number of risk factors cumulated by the workers seems to be a major determinant of CTS.

Adolescent↗
PubMed1995

Alcohol consumption and visual contrast sensitivity.

Visual contrast sensitivity (VCS) was measured in 30 alcoholic patients and 52 controls. The results showed a significant reduction in VCS for all the spatial frequencies. The mean reduction for all spatial frequencies was 2.49 dB below the level of the control group. Optimal sensitivity corresponded to a lower spatial frequency in patients than controls, i.e. 1 cycle/degree (c/d) versus 2 c/d. Curves for VCS were normal for five patients. Abnormalities in VCS were suggestive of optic nerve dysfunction for 15 patients (50%), which were probable in seven cases (23%) and possible in eight others (27%). For 10 subjects, the abnormalities were indicative of ametropia. Daily alcohol intake and daily tobacco consumption were not significantly different in the patients who displayed VCS abnormalities, reflecting alcohol-tobacco amblyopia, from those who did not. The presence of higher gamma-glutamyl transpeptidase and mean corpuscular volume levels in patients who had VCS abnormalities indicative of alcohol-tobacco amblyopia suggests that alcohol consumption is involved in the development of these abnormalities.

Adult↗
PubMed1992

[Lower back pain in physicians. Epidemiological aspect and risk factors].

The purpose of this study was to evaluate as accurately as possible, in a well-defined population subgroup, the prevalence and incidence of lower back pain, the impact of this symptom on professional activities and personal life, and the influence of risk factors. Members of the medical profession were considered particularly apt to accurately and reliably report their personal experience with lower back pain and were therefore selected for this survey. Five hundred 93-item questionnaires were sent to a representative sample of physicians in the Maine-et-Loire district, France. Response rate was 93%. Prevalence of lower back pain at the time of the survey was 32% and cumulative prevalence was 62%. Static spinal disorders (exaggerated lordosis, scoliosis, unequal length of lower limbs) and injury to the spine were found to be risk factors. Occupation-related stresses to the spine reported as being responsible for lower back pain included bending forward for prolonged periods, lifting weights, driving, and prolonged sitting.

Adult↗
PubMedDate not supplied

Evaluation of a training program for the prevention of lower back pain among hospital employees.

An evaluation of a training program for the prevention of lower back pain (LBP) was conducted over a two-year period in the Regional Hospital of Le Mans, which is located in the west of France and employs 2400 staff. The training program was based on a multidisciplinary approach to worker training in the prevention of LBP and in ergonomic efforts in the workplace. Workers received theoretical training on LBP, patient handling and ergonomics, and on-the-job ergonomics instruction to help them to implement participative ergonomics in their working groups. A cohort of 136 employees attended classes on safe posture and patient handling, then received advice from instructors who observed them while they performed their typical workday tasks.

Adult↗