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Hartikainen E, Salonen L, Solovieva S, Blomgren J, Böckerman P, Viikari-Juntura E, Leinonen T. Labour market trajectories after part-time sickness absence: a nationwide cohort study from Finland. BMJ Open 2023; 13:e075584. [PMID: 37907303 PMCID: PMC10619081 DOI: 10.1136/bmjopen-2023-075584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES The use of part-time sickness absence (pSA) enables return to part-time work from full sickness absence. However, subsequent labour market outcomes of pSA users depend on various individual and work-related characteristics. We investigated labour market paths of private and public sector employees after having a pSA spell. Moreover, we examined individual and work-related factors associated with following them. DESIGN Longitudinal register-based cohort study. SETTING Finnish employed population. PARTICIPANTS 9896 receivers of partial sickness allowance aged 45-56 in the years 2010-2014. OUTCOME We constructed labour market trajectories based on the proportion of time spent in various labour market statuses measured over 3 years after the end of the pSA spell using multiresponse trajectory analysis. We then examined how different individual and work-related factors were associated with assignment to the different trajectory groups using logistic regression analyses. RESULTS The majority of the pSA users followed paths where work participation was consistently elevated (Sustained Work group, 40.4%), or only slightly reduced (Slightly Reduced Work group, 31.6%). Moreover, more than 1/10th of the users followed a path where receiving partial work disability benefits became predominant (Partial Work Disability group, 12.5%). The rest followed paths where other non-employment (Other Non-Employed group, 7.8%) or full work disability (Full Work Disability group, 7.7%) became the prevailing status. Lower educational level and income predicted assignment to all other groups than the Sustained Work group. Additional predictors were identified, yet these differed between the trajectory groups. CONCLUSIONS The majority of the pSA users maintained a connection to working life, yet weaker working life paths were also identified. The paths were determined by various individual and work-related factors that can help health professionals and employers to better target support measures particularly towards individuals whose connection to working life is at risk to weaken after the use of pSA.
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Affiliation(s)
| | - Laura Salonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | - Petri Böckerman
- Labour Institute for Economic Research, Helsinki, Finland
- University of Jyväskylä School of Business and Economics, Jyvaskyla, Finland
| | | | - Taina Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Pichené-Houard A, Sirveaux F, Clerc-Urmès I, Paris N, Michel B, Jacquot A, Martinet N, Claudon L, Paysant J, Wild P. Predictive factors of return-to-work trajectory after work-related rotator cuff syndrome: A prospective study of 96 workers. Am J Ind Med 2023; 66:759-774. [PMID: 37460254 DOI: 10.1002/ajim.23511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/10/2023] [Accepted: 06/07/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Sustained return to work after surgery for work-related rotator cuff syndrome (WRRCS) remains quite difficult. The main purpose of the present study was to identify predictive factors of a return-to-work (RTW) trajectory. METHODS A total of 96 workers with WRRCS were identified by 4 surgeons. They were followed prospectively before and after the surgery, until 1 year after RTW, or for 20 months after surgery when they did not. Participants completed a series of standardized questionnaires related to working conditions, health, and beliefs, and performed functional tests at the inclusion time. During the follow-up period, they were regularly asked about their working conditions (present or not at work), activity (normal or lightened physical duties) and schedules (full- or part-time job). Statistical analysis was based on single- and multiple-factor models of prediction of the workers' trajectory. RESULTS Three trajectories of RTW were distinguished, considering RTW and absenteeism that occurred during the follow-up: stable, unstable, and non-RTW. The median age of the sample was 49.5 [45.0-54.0], with 67.7% of workers employed in highly physically demanding jobs. In the multiple factor model, three factors were highly predictive of the trajectory: perceived health before surgery, having had a repaired ruptured-rotator-cuff tendinopathy, and the level of physical demand of the job. CONCLUSION Three easy-to-collect predictive factors of RTW trajectory have been identified. They may be useful for healthcare professionals and care givers to identify vulnerable workers' risk of occupational dropout after arthroscopic surgery for rotator cuff tendinopathy.
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Affiliation(s)
- Anne Pichené-Houard
- Département Homme au Travail, Institut National de Recherche et de Sécurité (INRS), Vandoeuvre-lès-Nancy Cedex, France
| | - François Sirveaux
- Pôle lorrain de chirurgie de l'appareil locomoteur, Centre Chirurgical Emile Gallé, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
| | - Isabelle Clerc-Urmès
- Département Homme au Travail, Institut National de Recherche et de Sécurité (INRS), Vandoeuvre-lès-Nancy Cedex, France
| | | | - Blaise Michel
- Clinique Louis Pasteur, service de chirurgie orthopédique, Essey-lès- Nancy, France
| | - Adrien Jacquot
- Clinique Louis Pasteur, service de chirurgie orthopédique, Essey-lès- Nancy, France
| | - Noël Martinet
- Institut Régional de Médecine Physique et de Réadaptation de Nancy, Centre Louis Pierquin, UGECAM du Nord-Est, Nancy, France
| | - Laurent Claudon
- Département Homme au Travail, Institut National de Recherche et de Sécurité (INRS), Vandoeuvre-lès-Nancy Cedex, France
| | - Jean Paysant
- Institut Régional de Médecine Physique et de Réadaptation de Nancy, Centre Louis Pierquin, UGECAM du Nord-Est, Nancy, France
| | - Pascal Wild
- Département Homme au Travail, Institut National de Recherche et de Sécurité (INRS), Vandoeuvre-lès-Nancy Cedex, France
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Kärkkäinen S, Bergström J, Ropponen A, Wang M, Narusyte J, Svedberg P. Sickness absence transitions among Swedish twins with back, neck or shoulder pain and common mental disorders applying a multi-state approach. Sci Rep 2023; 13:10520. [PMID: 37386053 PMCID: PMC10310811 DOI: 10.1038/s41598-023-37572-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
We aimed to investigate transitions to and from sickness absence, or disability pension among individuals with back, neck, or shoulder pain and/or with common mental disorders (CMDs), and the role of familial (genetics and shared environment) influences on the transitions. Swedish twins born 1935-1985 who responded to pain and CMDs survey items (N = 41,516) were followed on average 8.7 years for sickness absence states in national registers. Multi-state Cox regression models were applied for three exposure groups: pain, CMDs, and presence of both, compared to unexposed. Exposure discordant twin pairs, stratified by zygosity, were analysed to assess the role of familial factors. Hazard Ratios (HR) with 95% confidence intervals and transition intensities were calculated. HRs were similar for transitions between states among those with pain or CMDs. The highest HRs were for transitions from entry to sickness absence and sickness absence to disability pension among those with both pain and CMDs (HRs: 1.61 and 1.43, respectively). Higher HRs for dizygotic compared to monozygotic twins for the first transition to sickness absence and for altering back to not being sickness absent indicate familial confounding. Back, neck, or shoulder pain and/or CMDs indicate a higher risk to become sickness absent and for repeated sickness absence episodes over time compared to unaffected.
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Affiliation(s)
- Sanna Kärkkäinen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jakob Bergström
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Jetha A, Tucker L, Shahidi FV, Backman C, Kristman VL, Hazel EM, Perlin L, Proulx L, Chen C, Gignac MAM. How Does Job Insecurity and Workplace Activity Limitations Relate to Rheumatic Disease Symptom Trajectories in Young Adulthood? A Longitudinal Study. Arthritis Care Res (Hoboken) 2023; 75:14-21. [PMID: 35866747 PMCID: PMC10087832 DOI: 10.1002/acr.24982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 06/22/2022] [Accepted: 07/19/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Workplace and labor market conditions are associated with the health of the working population. A longitudinal study was conducted among young adults with rheumatic disease to examine workplace activity limitations and job insecurity and their relationship with disease symptom trajectories. METHODS Three online surveys were administered to young adults with rheumatic disease over 27 months. Self-reported data on pain, fatigue, and disease activity were collected. Workplace activity limitations and job insecurity were measured. Group-based discrete mixture models determined pain, fatigue, and disease activity trajectory groups. Robust Poisson regression models were fitted to examine the relationship among workplace activity limitations, job insecurity, and trajectory group membership. RESULTS In total, 124 participants (mean ± SD age 29 ± 4.5 years) with rheumatic disease were recruited. At baseline, participants reported considerable workplace activity limitations (10.35 ± 5.8), and 36% of participants indicated experiencing job insecurity. We identified 2 latent rheumatic disease symptom trajectory groups. The first group had high persistent pain, fatigue, or disease activity; the second group had low persistent disease symptoms over time. Greater workplace activity limitations were associated with an increased relative risk (RR) of being in the high persistent severe pain (RR 1.02 [95% confidence interval (95% CI) 1.01, 1.03]), fatigue (RR 1.02 [95% CI 1.01, 1.03]), and disease activity trajectory groups (RR 1.02 [95% CI 1.01, 1.03]). Job insecurity was associated with an increased RR of membership in the high persistent pain (RR 1.14 [95% CI 1.04, 1.25]) and disease activity trajectory groups (RR 1.11 [95% CI 1.00, 1.22]). CONCLUSION Workplace activity limitations and job insecurity represent working conditions that are associated with the health of young adults with rheumatic disease and should be examined as potential targets for intervention.
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Affiliation(s)
- Arif Jetha
- Institute for Work & Health and University of Toronto, Toronto, Ontario, Canada
| | - Lori Tucker
- University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Faraz Vahid Shahidi
- Institute for Work & Health and University of Toronto, Toronto, Ontario, Canada
| | - Catherine Backman
- University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Vicki L Kristman
- Institute for Work & Health, Toronto, Ontario, Canada and EPID@Work Research Institute, Lakehead University, Thunder Bay, Canada
| | | | - Louise Perlin
- University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada
| | - Laurie Proulx
- Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
| | - Cynthia Chen
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Monique A M Gignac
- Institute for Work & Health and University of Toronto, Toronto, Ontario, Canada
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López-Bueno R, Andersen LL, Calatayud J, Casaña J, Martínez-Jarreta B, López-Gil JF, Del Pozo Cruz B. Association of occupational physical activity and disability pension in 756,159 Spanish workers: A prospective cohort study with 13 years follow-up. Prev Med 2023; 166:107380. [PMID: 36495922 DOI: 10.1016/j.ypmed.2022.107380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
Recent research from Nordic countries identified occupational physical activity (OPA) as a risk factor for disability pension, but further research accounting for exhaustive analyses in novel populations is warranted. Our objective was to assess the association between OPA and disability pension using administrative data. This prospective registry-based cohort study used data from the Spanish Continuous Working Life Sample (CWLS). Participants were followed up from baseline (January 1, 2006) to first event of disability pension, mortality, or end of follow-up (September 1, 2019). The assessment of OPA was based on registers of economic activity and their correspondence with a validated OPA index. To examine the association between OPA and disability pension, adjusted proportional hazard, and Fine-Gray models using mortality as competing risk were conducted. We retrieved data from 756,159 workers (57.7% men) with an average age of 38.5 years (SD 11.9). During 13.6 years from baseline to the end of follow-up (9,463,041 person-years), 18,191 men (4.2%) and 9631 (3.0%) women received a disability pension. In the fully adjusted model, participants exposed to higher levels of OPA showed higher risk for disability pension in an exposure-response fashion. Men and women exposed to very high OPA showed the highest HR for disability pension (2.31 [95% CI, 2.17 to 2.46] and 1.68 [95% CI, 1.56 to 1.81], respectively. These results warrant preventative measures to address early involuntary exit from the labour market in workers exposed to high physical work demands.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | | | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | | | | | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Rempel D, Potvin J. A design tool to estimate maximum acceptable manual arm forces for above-shoulder work. ERGONOMICS 2022; 65:1338-1351. [PMID: 35040744 DOI: 10.1080/00140139.2022.2030806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
There is a need for design criteria for above-shoulder work to prevent shoulder fatigue and supraspinatus injuries. A tool is developed to estimate maximum acceptable manual arm forces for above-shoulder work based on 25th % female strength with adjustments for supraspinatus tendon impingement and shoulder fatigue. The tool equations are presented along with tables of maximum acceptable manual arm forces in 77 locations in the 3 D space above the shoulder that accommodates a 50th % female reach. The largest acceptable anterior force, 140.3 N, occurs at shoulder height, 0.5 m anterior to the shoulder. The largest acceptable superior force, 84.4 N, occurs at shoulder height, 0.1 m anterior and 0.2 m medial to the shoulder. The new tool provides design criteria for arm exertions at a higher level of detail than prior ergonomic tools, making it useful for engineers. Based on sensitivity analyses, the tool is robust to parameter assumptions. Practitioner summary: Above-shoulder work is associated with increased risk for shoulder fatigue and injuries. A new tool is developed that estimates maximum acceptable manual arm forces for work at or above shoulder height. The tool can be used to design acceptable above-shoulder work so that it can be accomplished by most workers. Abbreviations: AFF: arm force field; AP: anterior/posterior; DC: duty cycle; GH: glenohumeral angle; HT: humerothoracic angle; LM: lateral/medial; MAE: maximum acceptable effort; MAF: maximum acceptable force; MAS: manual arm strength; MVC: maximum voluntary contraction; N: newton; OCRA: occupational repetitive action; R: reach distance; RMS: root means square; RULA: rapid upper limb assessment; SF: scale factor; SI: superior/inferior; ST: scapulothoracic angle; T: thoracicKEY POINTSA new design tool is introduced that estimates maximum acceptable hand forces for specific locations above the shoulder.This above-shoulder tool is based on a 50th percentile female anthropometry and 25th percentile female manual arm strength.These base strengths are multiplied by scaling factors that adjust for subacromial impingement and fatigue.The tool was shown to be robust based on sensitivity analysis.
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Affiliation(s)
- David Rempel
- Department of Bioengineering, University of California, Berkeley, CA, USA
| | - Jim Potvin
- McMaster University, Hamilton, ON, Canada
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Green CK, Scanaliato JP, Dunn JC, Rosner RS, Parnes N. Rates of Return to Manual Labor After Arthroscopic Rotator Cuff Repair. Am J Sports Med 2022; 50:2227-2233. [PMID: 35604344 DOI: 10.1177/03635465221097102] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rotator cuff tears represent a significant cause of shoulder pain and dysfunction in the United States. The development of these injuries is associated with older patient age and higher levels of physical activity; however, data regarding the rate of return to work after arthroscopic rotator cuff repair in patients older than 50 years of age who have physically strenuous jobs is inconclusive. PURPOSE/HYPOTHESIS The purpose of this study was to report short term outcomes and return to work rates after arthroscopic rotator cuff repair in a cohort of patients aged 50 to 60 years working in manual labor jobs. It was hypothesized that arthroscopic rotator cuff repair would result in good functional outcomes for these patients and allow for return to work rates in excess of 80%. STUDY DESIGN Case series; Level of evidence, 4. METHODS Preoperative and final evaluations including the pain visual analog scale (VAS), the Single Assessment Numeric Evaluation (SANE), and the American Shoulder and Elbow Surgeons (ASES) Shoulder Score were collected. A total of 73 patients were screened for inclusion. Nineteen patients were outside of the inclusion age range, 2 underwent exclusionary concomitant procedures, and 4 patients were lost to follow up, leaving a total of 48 patients with a mean follow up of 34.02 months (range, 24-67 months) available for analysis. None of the patients were involved in a workers' compensation claim. Subgroup analysis was performed to determine if arm dominance or tear size affected surgical outcomes or return to work rates. RESULTS After arthroscopic rotator cuff repair, 43 of 48 patients (89.6%) were able to return to manual labor positions. Tears were classified using the Southern California Orthopaedic Institute Classification at the time of repair as massive (C4) in 9 patients (18.75%), large (C3) in 13 patients (27.08%), medium (C2) in 21 patients (43.75%), and small (C1) in 5 patients (10.42%). At latest follow up, the mean VAS decreased from 8.0 ± 1.81 to 0.46 ± 1.20, the average SANE increased from 47.50 ± 18.59 to 91.88 ± 12.30, and the average ASES score improved from 39.58 ± 10.71 to 93.44 ± 11.97 (P < .0001). Outcomes did not differ between patients who underwent surgery on their dominant shoulder and those who underwent surgery on their nondominant shoulder. The overall postoperative complication rate was 8.33%. CONCLUSION Arthroscopic rotator cuff repair portended favorable outcomes and high rates of return to work in this cohort of manual laborers, with 89.6% of patients able to return to work.
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Affiliation(s)
- Clare K Green
- George Washington University School of Medicine, Washington, DC
| | - John P Scanaliato
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA
| | - John C Dunn
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA
| | - Rachel S Rosner
- Department of Orthopaedic Surgery, Carthage Area Hospital, Carthage, New York, USA
| | - Nata Parnes
- Department of Orthopaedic Surgery, Carthage Area Hospital, Carthage, New York, USA.,Department of Orthopaedic Surgery, Claxton-Hepburn Medical Center, Ogdensburg, New York, USA
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Pichené‐Houard A, Paysant J, Claudon L, Paris N, Michel B, Jacquot A, Martinet N, Sirveaux F, Wild P. Predictive factors for the duration until return to work after surgery for work-related rotator cuff syndrome: A prospective study of 92 workers. Am J Ind Med 2021; 64:1028-1039. [PMID: 34541681 DOI: 10.1002/ajim.23293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Return to work (RTW) after surgery for a work-related rotator cuff disorder (WRRCD) is often difficult. The study's purpose was to identify preoperative factors predicting RTW. METHODS Ninety-two workers with a WRRCD were identified by four surgeons. Before surgery, the workers completed a series of standardized questionnaires related to working conditions, health, and health beliefs. They were followed up prospectively for 20 months. Statistical analysis was based on single and multiple-factor Cox models of the duration of absence from the time of surgery until RTW. RESULTS The median age at inclusion was 49 years (27-62), with 52 women included (57%). Sixty-one subjects (66%) were employed in highly physically demanding jobs. Forty-two (46%) stayed at work until their surgery, whereas preoperative sick leave exceeded 100 days in 20 subjects (21%). Twenty months after surgery, 14 were still not back at work. For the other participants, the mean duration until RTW was 225 days (SD 156). In the fully adjusted model, variables that were significantly predictive of the duration until RTW were: work physical demand levels, preoperative sick leave, the number of body parts causing pain or discomfort in the last 12 months, self-assessed 2-year workability, and the Readiness for RTW (RRTW) Scale. CONCLUSIONS Several physical, psychological, and work-related factors, easily recorded, can be identified preoperatively. They may be predictive of delayed return, loss of employment, or employability as a result of shoulder surgery.
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Affiliation(s)
- Anne Pichené‐Houard
- Institut National de Recherche et de Sécurité (INRS) Vandoeuvre‐lès‐Nancy Cedex France
| | - Jean Paysant
- Institut Régional de Réadaptation Centre Louis Pierquin, UGECAM du Nord‐Est Nancy France
| | - Laurent Claudon
- Institut National de Recherche et de Sécurité (INRS) Vandoeuvre‐lès‐Nancy Cedex France
| | | | - Blaise Michel
- Clinique Louis Pasteur Service de chirurgie orthopédique Essey‐lès‐ Nancy France
| | - Adrien Jacquot
- Clinique Louis Pasteur Service de chirurgie orthopédique Essey‐lès‐ Nancy France
- Centre Chirurgical Emile Gallé Centre Hospitalier Régional Universitaire de Nancy Nancy France
| | - Noël Martinet
- Institut Régional de Réadaptation Centre Louis Pierquin, UGECAM du Nord‐Est Nancy France
| | - François Sirveaux
- Centre Chirurgical Emile Gallé Centre Hospitalier Régional Universitaire de Nancy Nancy France
| | - Pascal Wild
- Institut National de Recherche et de Sécurité (INRS) Vandoeuvre‐lès‐Nancy Cedex France
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Ngabirano L, Fadel M, Leclerc A, Evanoff BA, Dale AM, d'Errico A, Roquelaure Y, Descatha A. Association between physical limitations and working life exposure to carrying heavy loads assessed using a job-exposure matrix: CONSTANCES cohort. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:243-247. [PMID: 32935642 DOI: 10.1080/19338244.2020.1819184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Decline in physical performance with age varies among workers. We studied the association between lifetime exposure to carrying heavy loads and limitations in climbing stairs. METHODS We used data from the French CONSTANCES study. A biomechanical Job-Exposure Matrix (JEM) was combined with lifetime job histories to build a cumulative exposure score, and compared with reported limitations in climbing stairs using robust Poisson models, stratified by sex and educational level. RESULTS Of the 26,255 subjects, 618 men and 1,080 women reported difficulties in climbing stairs; this outcome was associated with cumulative exposure to carrying heavy loads: adjusted PR= 2.17 (1.75-2.73) for men, 1.50 (1.30-1.74) for women. The association was primarily seen among less educated subjects. CONCLUSION Cumulative work exposure to carrying heavy loads across the working life was associated with physical limitations in climbing stairs among the less educated in both genders.
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Affiliation(s)
- Laure Ngabirano
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, CAPTV CDC, Angers, France
- Versailles St-Quentin Univ, Paris Saclay Univ, Inserm, U1018, UMS011, Villejuif, France
| | - Marc Fadel
- Versailles St-Quentin Univ, Paris Saclay Univ, Inserm, U1018, UMS011, Villejuif, France
- AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
| | - Annette Leclerc
- Versailles St-Quentin Univ, Paris Saclay Univ, Inserm, U1018, UMS011, Villejuif, France
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Angelo d'Errico
- Local Health Unit TO3, Epidemiology Department - Piedmont Region, Italy
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, CAPTV CDC, Angers, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, CAPTV CDC, Angers, France
- Versailles St-Quentin Univ, Paris Saclay Univ, Inserm, U1018, UMS011, Villejuif, France
- AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
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Occupational differences in disability retirement due to a shoulder lesion: do work-related factors matter? Int Arch Occup Environ Health 2020; 93:983-993. [PMID: 32367197 PMCID: PMC7519916 DOI: 10.1007/s00420-020-01549-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/24/2020] [Indexed: 11/03/2022]
Abstract
Objective To identify occupations with a high risk of disability retirement due to a shoulder lesion and to examine the effect of physical and psychosocial work-related factors on occupational differences in disability retirement. Methods We followed Finnish wage earners aged 30–59 years (n = 1,135,654) from 2005 to 2014 for full disability retirement due to a shoulder lesion. The work-related exposures were assessed with job exposure matrices. We calculated age-adjusted incidence rates and hazard ratios to test for the association between occupation and disability retirement due to a shoulder lesion. We also examined the contribution of work-related exposures to the excess risk of disability retirement. Results As compared to professionals, the age-adjusted risk of disability retirement was increased among men in all occupational groups except managers and customer service clerks and among women in several occupational groups. Adjustment for education attenuated the occupational differences considerably, particularly among women. The physical work-related factors fully explained the excess risk of disability retirement due to a shoulder lesion among male finance and sales associate professionals and administrative secretaries as well as among agricultural and fishery workers. In women, the physical work-related factors fully explained the excess risk among construction workers, electricians and plumbers. For both genders, the contribution of psychosocial factors to excess risk of disability retirement was modest and seen for monotonous work only. Conclusions A reduction of the level of physical work load factors as well as monotonousness of work has a potential to prevent work disability due to a shoulder lesion. Electronic supplementary material The online version of this article (10.1007/s00420-020-01549-y) contains supplementary material, which is available to authorized users.
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Ngabirano L, Fadel M, Leclerc A, Evanoff BA, Dale AM, Roquelaure Y, Descatha A. Comparison Between a Job-Exposure Matrix (JEM) Score and Self-Reported Exposures for Carrying Heavy Loads Over the Working Lifetime in the CONSTANCES Cohort. Ann Work Expo Health 2020; 64:455-460. [PMID: 32105298 DOI: 10.1093/annweh/wxaa015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 01/27/2020] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Job-exposure matrices (JEMs) were developed to allow assessment of past work exposure for large population-based studies where better exposures data are unavailable. Few studies have directly compared biomechanical JEMs to self-administered questionnaires. We compared assessments of cumulative exposure to carrying heavy loads based on 'JEM Constances' to individually self-reported (SR) exposures. METHODS In the French CONSTANCES cohort at inception, past SR exposure to carrying heavy loads (ever/never and durations) and a detailed job history were available for 26 929 subjects. JEM Constances, an existing biomechanical JEM based on SR current exposures from 26 821 asymptomatic workers, was combined with job history to build a cumulative biomechanical exposure score. Using individual SR exposure as the reference, Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curves, sensitivity, and specificity were calculated. For both methods, associations with low back pain and knee pain were computed using multinomial logistic models. Additional analyses compared older (>10 years) to more recent (≤10 years) exposures. RESULTS AUCs ranged from 0.795 (0.789-0.800) when all periods were considered, to 0.826 (0.820-0.833) for more recent biomechanical exposure (≤10 years). Associations between carrying heavy loads and low back pain or knee pain were less strong using JEM assessment than individually SR exposure: for low back pain ORSR = 3.02 (2.79-3.26) versus ORJEM = 1.70 (1.59-1.82) and for knee pain ORSR = 2.27 (2.10-2.46) versus ORJEM = 1.64 (1.53-1.77). CONCLUSIONS JEM Constances' assessment of cumulative exposure of carrying heavy loads seems to be a useful method compared to a self-administrated questionnaire for large population-based studies where other methods are not available.
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Affiliation(s)
- Laure Ngabirano
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France.,Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France
| | - Marc Fadel
- Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France.,AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
| | - Annette Leclerc
- Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France.,Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France.,AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
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Seidler A, Romero Starke K, Freiberg A, Hegewald J, Nienhaus A, Bolm-Audorff U. Dose-Response Relationship between Physical Workload and Specific Shoulder Diseases-A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041243. [PMID: 32075183 PMCID: PMC7068556 DOI: 10.3390/ijerph17041243] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022]
Abstract
Several epidemiological studies have found an association between shoulder-loaded work activities and specific shoulder diseases. No study has derived the dose-response relationship and resulting doubling dose, important for the recognition of occupational diseases. This systematic review is an update of the van der Molen et al. (2017) review. Based on its methodologies, we identified new studies published up to November 2018. The dose-response relationship between physical occupational demands (hands at/above shoulder level, repetitive movements, forceful work, hand-arm vibrations) and specific shoulder diseases (defined as ICD-10 M 75.1-5: rotator cuff syndrome, bicipital tendinitis, calcific tendinitis, impingement, and bursitis) was derived. No evidence for sex-specific differences in the dose-response relationship was found. If there were at least two studies with comparable exposures, a meta-analysis was carried out. The pooled analysis resulted in a 21% risk increase (95% CI 4–41%) per 1000 h of work with hands above shoulder level. A meta-analysis was not possible for other occupational burdens due to the low number of studies and differing exposure measurements; an estimate of the doubling dose was made based on the cohort study of Dalbøge et al. (2014). To conclude, the present systematic review with meta-analysis contributes to knowledge of the level of exposure at which specific shoulder diseases—particularly rotator cuff lesions—should be recognized as an occupational disease.
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Affiliation(s)
- Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (K.R.S.); (A.F.); (J.H.)
- Correspondence: ; Tel.: +49-351-3177-441
| | - Karla Romero Starke
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (K.R.S.); (A.F.); (J.H.)
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (K.R.S.); (A.F.); (J.H.)
| | - Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (K.R.S.); (A.F.); (J.H.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Public Health and Hazardous Substances, Statutory Accident Insurance and Prevention in the Health and Welfare Services, 22089 Hamburg, Germany;
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Ulrich Bolm-Audorff
- Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, 65197 Wiesbaden, Germany;
- Institute and Outpatient Clinic for Occupational and Social Medicine, University Medical Center Gießen, Justus-Liebig-University, 35392 Gießen, Germany
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