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

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.

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.

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).

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.