Biomedical subjects

Yves Roquelaure

Publications and source records attributed to Yves Roquelaure.

9 recordsLinked to original sources

PubMed2007

Predictive factors for incident musculoskeletal disorders in an in-plant surveillance program.

OBJECTIVES: A surveillance program for upper-limb work-related musculoskeletal disorders (UWMSD) based on assessment of health and risk factors was implemented between 1996 and 2000 in a large shoe factory with overall high levels for biomechanical exposure. The study aimed to identify workers with an increased risk of UWMSD incidence. METHODS: In 1996, 1997 and 2000, 166 workers filled out a questionnaire and underwent a standardized physical examination. Factors from the 1996 questionnaire (general, personal and occupational factors) associated with UWMSD incidence in 1997 were selected. The predictive role of these variables was studied with a logistic model, taking into account also gender and age. The performance of a risk score based on this model was studied in 2000, using the Wilcoxon test and ROC curves. RESULTS: In 1997, 28 incident cases of UWMSD were observed (N = 107, 26.2%). Work pace and prior history of UWMSD were the only factors significantly associated with UWMSD incidence in 1997 (respectively 33% versus 13%, P = 0.02 and 58% versus 22%, P = 0.01). Psychological distress (36% versus 21%, P = 0.10), physical fatigue (35% versus 22%, P = 0.14), repetitiveness (30% versus 18%, P = 0.17) and task precision (33% versus 21%, P = 0.16) were also included in the logistic model for 1997 UWMSD incidence. Controlling for these variables, prior history of UWMSD remained associated with incidence in 1997 (OR = 5.5, 95% CI = 1.4-21.8). In the period from 1997 to 2000, 24 incident cases were observed (N = 102, 23.5%). The risk score, based on variables from the 1997 model, was significantly higher for incident cases (median = 6 in incident cases versus 4.5 for healthy subjects, P = 0.02). ROC curves indicated that the highest agreement reached 67% for sensitivity and 59% for specificity. Among subjects who did not change their task (N = 71, 18 incident cases), performance reached 66% for specificity with the same sensitivity. CONCLUSION: These results suggest that surveillance programs of UWMSD at a company level are possible even with overall high levels for biomechanical exposure and should take into account occupational and personal factors, including prior history of UWMSD.

Adult↗

PubMed2006

Neuroendocrine pathway involvement in the loss of the cutaneous pressure-induced vasodilatation during acute pain in rats.

Pain is regarded as a risk factor in pressure ulcer development by contributing to immobility. Pressure-induced vasodilatation (PIV) is a mechanism whereby cutaneous blood flow increases in response to progressive locally applied pressure, thereby delaying the occurrence of ischaemia and appearing to be a protective response to local pressure. When the interaction between nervous and vascular systems is deregulated, PIV, which relies on both systems, is absent. We thus hypothesized that acute pain could alter PIV. This study investigated the effects on PIV of acute pain triggered by noxious heat (50 degrees C) applied to the tail of anaesthetized rats. To address the mechanisms underlying these effects, chronic sympathectomy was performed using guanethidine, and the plasma concentrations of pituitary adrenocorticotrophin (ACTH) and catecholamines were measured. Our results show that acute pain induces a loss of PIV associated with an increase of ACTH. Direct involvement of hypertensive effects and peripheral sympathetic nervous system are excluded in the loss of PIV, whereas the activation of brain structures that have descending inhibitory control cannot be excluded. A low dose of systemic morphine prevented this loss of PIV and maintained the ability of the cutaneous microcirculation to adapt to the applied pressure. The loss of a protective response to local pressure (PIV) induced by acute pain lends physiological support to the direct involvement of pain in pressure ulcer development. Therefore, an adequate evaluation and treatment of pain is crucial.

Acute Disease↗

PubMed2006

Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population.

OBJECTIVE: Since 2002, an epidemiologic surveillance system of work-related, upper-limb musculoskeletal disorders (MSDs) has been implemented in France's Pays de la Loire region to assess the prevalence of MSDs and their risk factors in the working population. METHODS: The surveillance was based on a network of occupational physicians (OPs) and used the recommendations of a group of European experts (criteria document consensus). In 2002-2003, 80 of 400 OPs volunteered to participate. All underwent a training program to standardize the physical examination. Health status was assessed by self-administered questionnaire and physical examination. Occupational risk factors were assessed by self-administered questionnaire. Exposure scores were computed for each anatomic zone by summing the risk factors taken into account by the criteria document. RESULTS: More than 50% of the 2,685 men and women randomly included in 2002-2003 experienced nonspecific musculoskeletal symptoms during the preceeding 12 months and approximately 30% experienced them in the preceeding week. The prevalence of clinically diagnosed MSDs was high: approximately 13% of workers experienced at least 1 of the MSDs. The most frequent disorder was rotator cuff syndrome followed by carpal tunnel syndrome and lateral epicondylitis. The prevalence of MSDs increased with age and varied widely across economic sectors and occupations. More than half of the workers were exposed to at least 2 risk factors of MSDs. Exposure varied according to industrial activity and occupation. According to the criteria document, a high percentage of MSD cases could be classified as probably work related (95% in men and 89% in women age <50, and 87% in men and 69% in women age >50). CONCLUSION: Nonspecific upper-limb symptoms and specific upper-limb MSDs are common in the working population. These results show the need to implement prevention programs in most sectors to reduce the prevalence of MSDs.

Adult↗

PubMed2004

Surveillance program of neck and upper limb musculoskeletal disorders: assessment over a 4 year period in a large company.

OBJECTIVE: A company-wide surveillance program for musculoskeletal disorders (MSDs) based on the assessment of health and risk factors was implemented between 1996 and 2000 in a large shoe factory. The study aimed to compare the results of the surveillance program in 1996 and 1997 with the occurrence of MSDs in 2000. METHODS: A health and ergonomic assessment of workstations was performed for 253 workers in 1996. Of these, 166 were examined again in both 1997 and 2000. A set of criteria was used to predict whether or not a job category could be predicted to have a potentially high risk of MSDs in 1996 and 1997 and the results were compared with the incidence rate of MSDs in the job category in 2000. RESULTS: The criteria based on prevalence data in 1996 were unable to detect the job categories characterized by the occurrence of MSDs in 2000. The criterion based on an incidence rate >1% in 1997 was sensitive and specific. The agreement between the ranking of the job categories according to incidence rate of MSDs in 1997 and 2000 was good (rho=0.57, P=0.11). Agreement of the prediction based on ergonomic exposure was lower than that based on incidence data. CONCLUSION: The efficacy of the surveillance program to predict on a collective basis the job categories in which numerous cases of MSDs occurred in 2000 depended on the decision criteria used. The criteria based on the incidence of MSDs were more reliable to predict the risk of MSDs than those based on prevalence data or on exposure assessment. Because exposure assessment plays a greater role in determining the priorities for ergonomic intervention, surveillance of health and exposure must nevertheless be combined to predict the risk of MSDs in the plant in the short and middle terms.

Adult↗

PubMed2004

Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.

STUDY DESIGN: Randomized parallel-group comparative trial with a 6-month follow-up period. OBJECTIVE: To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks. SUMMARY OF BACKGROUND DATA: Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs. METHODS: Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months. RESULTS: After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake. CONCLUSIONS: This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Absenteeism↗

PubMed2004

Biomechanical assessment of new hand-powered pruning shears.

The aim of the study was to assess the biomechanical strains on the hand-wrist system during grapevine pruning with newly designed pruning shears. Surface electromyography of the finger flexor muscle and wrist postures were analyzed in four vineyard workers during actual work with the new and reference hand-powered pruning shears. Due to the large inter-individual differences in biomechanical data observed with both pruning shears, no systematic effect of the new pruning shears on "extreme" flexion/extension (F/E) and ulnar/radial (U/R) wrist deviations was demonstrated. However, the use of the new pruning shears was associated with a higher frequency of "neutral and moderate" U/R deviations (U/R < 20%(max)) and, to a lesser extent, of "neutral and moderate" F/E deviations (F/E < 20%(max)). Due to the small sample of workers, this result must be confirmed in a larger population of vineyard workers.

Adult↗

PubMed2004

Incidence of ulnar nerve entrapment at the elbow in repetitive work.

OBJECTIVES: Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work. METHODS: In 1993-1994 and 3 years later, 598 workers whose jobs involved repetitive work underwent an examination by their occupational health physicians and completed a self-administered questionnaire. Predictive factors associated with the onset of ulnar nerve entrapment at the elbow were studied with bivariate and multivariate analyses. RESULTS: The annual incidence was estimated at 0.8% per person-year, on the basis of 15 new cases during the 3-year period. Holding a tool in position was the only predictive biomechanical factor [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.4-12.0]. Obesity increased the risk of ulnar nerve entrapment at the elbow (OR 4.3, 95% CI 1.2-16.2), as did the presence of medial epicondylitis, carpal tunnel syndrome, radial tunnel syndrome, and cervicobrachial neuralgia. The associations with "holding a tool in position" and obesity were unchanged when the presence of other diagnoses was taken into account. CONCLUSIONS: Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially medial epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes).

Adult↗

PubMed2003

[1,1, 1-trichloroethane-induced chronic active hepatitis].

1,1, 1-trichloroéthane is derived from carbon tetrachloride and has been widely used as an industrial solvent since 1954, because of its supposed lack of toxicity. However, several cases of central nervous system toxicity and heart disorders due to intoxication by 1,1, 1-trichloroéthane have been reported. Cases of liver injury are infrequent, with less than 10 cases, unlike 1,1, 2-trichloroéthane that it replaced. We report a case of hepatotoxicity probably due to 1,1, 1-trichloroéthane exposure, characterized by an original pathologic feature of chronic active hepatitis.

Adult↗

PubMed2002

Biomechanical strains on the hand-wrist system during grapevine pruning.

OBJECTIVES: In order to understand the high prevalence of musculoskeletal disorders of the hand among vineyard workers, we conducted a study to evaluate biomechanical strains on the hand-wrist system during grapevine pruning. METHODS: Surface electromyography (sEMG) activity of the right flexor digitorum muscle and wrist posture were analysed in six healthy vineyard workers using the same hand-powered pruning shears during grapevine pruning. RESULTS: The biomechanical strains on the hand-wrist system were high during grapevine pruning. Mean sEMG activity during pruning was high [23.5% (standard error of the mean (SEM): 0.4) in the maximal voluntary handgrip contraction (MVC)], as was the mean cutting frequency per minute (38; range=24-48). Approximately 14% of cuts were performed with the wrist in extreme flexion/extension (F/E) (>60% of the maximum range). Numerous cuts required moderate (20%-40% of the maximum range) or extreme (>50% of the maximum range) ulnar deviation (17% and 12% of cuts, respectively). Approximately 18% of cuts required both high muscular activity (sEMG >15% MVC) and extreme ulnar/radial (U/R) deviation of the wrist (>50% of the maximum range). CONCLUSION: Pruning imposes high biomechanical strains on the hand-wrist system in view of the repetitiveness of the task. The magnitude of physical exposure during pruning explains the high prevalence of hand disorders among vineyard workers. The use of ergonomic pruning shears is advised to lower force exertion and to reduce the frequency of awkward wrist postures during pruning.

Adult↗