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      Prevalence of multisite musculoskeletal symptoms: a French cross-sectional working population-based study

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          Abstract

          Background

          The musculoskeletal disorders in working population represent one of the most worrying work-related health issues at the present time and although the very great majority of available data on the subject focus on musculoskeletal disorders defined by anatomical site, a growing number of studies indicate the low prevalence of disorders strictly confined to a specific anatomical site. The objective of this study was to describe the prevalence and characteristics of multisite musculoskeletal symptoms (multisite MS) in a large French working population.

          Methods

          This study was performed on surveillance data of the cross-sectional survey (2002–2005) conducted by a network of occupational physicians in the working population of the Loire Valley region (from 20 to 59 years old). Data concerning MS were collected in the waiting room of the occupational physicians by means of the self-administrated standardized NORDIC questionnaire.

          Results

          The study population comprised 3,710 workers (2,162 men (58%) and 1,548 women (42%)) with a mean age of 38.4 years (standard deviation: 10.4 years). The prevalence of MS during the past 12 months was 83.8% with 95% confidence interval of [82.8-85.3] for men and 83.9% [82.0-85.7] for women. The prevalence of subacute MS (lasting at least 30 days) over the past 12 months was 32.8% [30.9-34.8] for men and 37.3% [34.9-39.7] for women. Two-thirds of workers reported MS in more than one anatomical site and about 20% reported MS lasting at least 30 days in more than one anatomical site. The anatomical sites most frequently associated with other MS were the upper back, hip, elbow and neck. The majority of these multisite MS were widespread, involving at least two of the three anatomical regions (upper limb, axial region and lower limb).

          Conclusions

          The frequency and extent of multisite MS reported by workers are considerable. Further research must be conducted in this field in order to provide a better understanding of the characteristics and determinants of these multisite MS.

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          Most cited references45

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          Localized or widespread musculoskeletal pain: does it matter?

          Although epidemiological descriptions indicate that musculoskeletal pain is often widespread, still a lot of musculoskeletal pain is diagnosed and treated as localized pain. This led us to question whether localized pain exists at all and to evaluate its functional impact compared with that of widespread musculoskeletal pain. Therefore, this study aimed to describe the prevalence of localized and widespread musculoskeletal pain and its association to functional ability. In 2004, questionnaires about musculoskeletal pain were mailed to seven age groups in Ullensaker, Norway: 24-26, 34-36, 44-46, 54-56, 64-66, 74-76, and 84-86 years old. In total, 3325 persons participated (participation rate 54.4%). We excluded the oldest age group and persons who did not respond to any questions about pain during the previous week, thus reducing the participants in this study to 3179. Although musculoskeletal pain occurred frequently in the population, localized pain, in the meaning of single site pain, was relatively rare. Most people having musculoskeletal pain reported pain from a number of sites. Furthermore, experiencing single site pain did not have a large impact on physical fitness, feelings, or daily and social activities. Functional problems increased markedly, in an almost linear way with increasing number of pain sites. These findings suggest that musculoskeletal pain usually coexists with pain in other body regions and that the functional consequences are highly dependent on how widespread the pain is. This should have important implications for future research into musculoskeletal pain, and for clinical and social insurance medicine.
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            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). 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.
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              The relation between multiple pains and mental disorders: results from the World Mental Health Surveys.

              It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.
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                Author and article information

                Journal
                BMC Musculoskelet Disord
                BMC Musculoskelet Disord
                BMC Musculoskeletal Disorders
                BioMed Central
                1471-2474
                2012
                20 July 2012
                : 13
                : 122
                Affiliations
                [1 ]LUNAM Université, Université d’Angers, Laboratoire d’ergonomie et d’épidémiologie en santé au travail (LEEST), 49045, Angers, France
                [2 ]CHU d’Angers, 49933, Angers, France
                [3 ]Université de Versailles St-Quentin, UMRS 1018, Centre for Research in Epidemiology and Population Health, Population-Based Epidemiological Cohorts Research Platform, 94807, Villejuif, France
                [4 ]Département santé travail, Institut de veille sanitaire, 94415, Saint-Maurice, France
                Article
                1471-2474-13-122
                10.1186/1471-2474-13-122
                3495201
                22818516
                7200f98c-bd89-4565-adb6-b8b57cbabd79
                Copyright ©2012 Parot-Schinkel et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 August 2011
                : 29 June 2012
                Categories
                Research Article

                Orthopedics
                Orthopedics

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