Quelles conséquences pour la santé ?
Réponse de l'INRS à une question posée par un médecin du travail.
L'utilisation de ces écrans de petite taille est de plus en plus répandue. Elle peut être source de contrainte posturale et de fatigue visuelle.
Source : http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.QR%2079
Improved work safety or shifting of care?
INTRODUCTION: Construction workers are at high risk of work-related musculoskeletal back disorders, and research suggests medical care and costs associated with these conditions may be covered by sources other than workers' compensation (WC). Little is known about the back injury experience and care seeking behavior among drywall installers, a high-risk workgroup regularly exposed to repetitive activities, awkward postures, and handling heavy building materials. METHODS: Among a cohort of 24,830 Washington State union carpenters (1989-2008), including 5,073 drywall installers, we identified WC claims, visits for health care covered through union-provided health insurance and time at risk. Rates of work-related overexertion back injuries (defined using WC claims data) and health care utilization for musculoskeletal back disorders covered by private health insurance were examined and contrasted over time and by worker characteristics, stratified by type of work (drywall installation, other carpentry). RESULTS: Drywall installers' work-related overexertion back injury rates exceeded those of other carpenters (adjusted IRR 1.63, 95% CI 1.48-1.78). For both carpentry groups, rates declined significantly over time. In contrast, rates of private healthcare utilization for musculoskeletal back disorders were similar for drywall installers compared to other carpenters; they increased over time (after the mid-1990s), with increasing years in the union, and with increasing numbers of work-related overexertion back injuries. CONCLUSIONS: Observed declines over time in the rate of work-related overexertion back injury, as based on WC claims data, is encouraging. However, results add to the growing literature suggesting care for work-related conditions may be being sought outside of the WC system.
Source : Schoenfisch AL, Lipscomb HJ, Marshall SW, Casteel C, Richardson DB, Brookhart MA, Cameron W. Am. J. Ind. Med. 2013.
OBJECTIVES: To estimate the contribution of preexisting chronic conditions on age differences in health care expenditures for the management of work-related musculoskeletal injuries in British Columbia. METHODS: A secondary analysis of workers' compensation claims submitted over the 5-year period between January 1, 2002 and December 31, 2006 (N=55,827 claims among men and 32,141 claims among women). Path models examined the relationships between age and health care expenditures, and the extent to which age differences in health care expenditures were mediated by preexisting chronic conditions. Models were adjusted for individual, injury, occupational, and industrial covariates. RESULTS: The relationship between age and health care expenditures differed for men and women, with a stronger age gradient observed among men. Preexisting osteoarthritis and coronary heart disease were associated with elevated health care expenditures among men and women. Diabetes was associated with elevated health care expenditures among men only, and depression was associated with elevated health care expenditures among women only. The percentage of the age effect on health care expenditures that was mediated through preexisting chronic conditions increased from 12.4% among 25-34-year-old men (compared with 15-24 y) to 26.6% among 55+-year-old men; and 14.6% among 25-34-year-old women to 35.9% among women 55 and older. CONCLUSIONS: The results of this study demonstrate that differences in preexisting chronic conditions have an impact on the relationship between older age and greater health care expenditures after a work-related musculoskeletal injury. The differing prevalence of preexisting osteoarthritis, coronary heart disease, and to a lesser extent diabetes (among men) and depression (among women) across age groups explain a nontrivial proportion of the age effect in health care expenditures after injury. However, approximately two thirds or more of the age effect in health care expenditures remains unexplained.
Source : Smith PM, Bielecky A, Ibrahim S, Mustard C, Scott-Marshall H, Saunders R, Beaton D. Med. Care. 2013.
The case of MSDs in the EU
With many EU member states set to see 50% of their population diagnosed with an MSD by 2030, this report warns that this growing problem cannot be ignored and must be urgently addressed.
MSDs are the leading cause of sickness absence across the EU -44 million workers have MSDs – including back pain and strains of the neck, shoulder and arms.
This costs up to €240bn annually in lost productivity and sickness absence, representing up to 2% of GDP across the EU. The report calls on EU member states to coordinate action between government departments, employers and clinicians to tackle this problem and save billions while transforming the lives of those affected by such devastating conditions.
Source : https://osha.europa.eu/en/news/fit-for-work-europe
Objective: The American College of Occupational and Environmental Medicine has updated the treatment guidelines in its Elbow Disorders chapter through revision processes begun in 2006. This abbreviated version of that chapter highlights some of the evidence and recommendations developed.
Methods: Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 108 high- or moderate-quality trials were identified for elbow disorders.
Results: Guidance has been developed for 13 major diagnoses and includes 270 specific recommendations.
Conclusion: Quality evidence is now available to guide treatment for elbow disorders, particularly for lateral epicondylalgia.
Source :Hegmann, Kurt T. MD, MPH; Hoffman, Harold E. MD; Belcourt, Roger M. MD, MPH; Byrne, Kevin MD, MPH; Glass, Lee MD, JD; Melhorn, J. Mark MD; Richman, Jack MD; Zinni, Phillip III DO; Thiese, Matthew S. PhD, MSPH; Ott, Ulrike PhDc, MSPH; Tokita, Kylee BS; Passey, Deborah Gwenevere MS; Effiong, Atim Cecelia MPH; Robbins, Riann Bree BS; Ording, Julie A. MPH. Journal of Occupational & Environmental Medicine. November 2013, Volume 55, Issue 11, p. 1365–1374.
Objective: To examine the relationship of musculoskeletal pain and depressive symptoms, occurring alone or both together, with self-rated current work ability and thoughts of early retirement.
Methods: In a nationally representative sample drawn in 2000–2001, we studied actively working subjects aged 30 to 64 years (n = 4009).
Results: Musculoskeletal pain was associated with moderate/poor physical work ability (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI], 2.0 to 4.2) and mental work ability (OR = 1.6; 95% CI, 1.2 to 2.2). Depressive symptoms were associated with moderate/poor mental work ability only (adjusted OR = 4.2; 95% CI, 2.3 to 7.9). Moreover, only musculoskeletal pain was associated with thoughts of early retirement (OR = 1.4; 95% CI, 1.1 to 1.8). There was an interaction between musculoskeletal pain and depressive symptoms regarding physical work ability and thoughts of early retirement.
Conclusion: Co-occurrence of musculoskeletal pain and depressive symptoms is strongly related to poor self-rated physical work ability.
Source : Shiri, Rahman PhD; Kaila-Kangas, Leena PhD; Ahola, Kirsi PhD; Kivekäs, Teija PhD; Viikari-Juntura, Eira PhD; Heliövaara, Markku PhD; Miranda, Helena PhD; Leino-Arjas, Päivi PhD. Journal of Occupational & Environmental Medicine, November 2013, Volume 55, Issue 11, p 1281–1285.
Dans le cadre d’une nouvelle approche de formation, l’Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) lance un outil d’aide à la planification pour une manutention manuelle plus sécuritaire. À partir de la Grille d’évaluation des situations de manutention, des chercheurs ont conçu ce nouvel outil qui a été testé par des intervenants en santé et en sécurité du travail pour en faciliter l’usage. Son utilisation permet de mieux comprendre les situations de manutention et de planifier des transformations et des activités de formation adaptées au contexte de travail.
Connaître et agir
À l’aide de cinq fiches, les intervenants pourront 1) identifier les problèmes associés à certains postes ou à des tâches de manutention; 2) déterminer qu’elles sont les situations qui doivent être transformées et celles qui nécessitent une formation; 3) comprendre les caractéristiques de chacune des situations retenues afin de pouvoir mieux planifier les transformations et la formation; 4) déterminer, pour chaque situation, les aspects à améliorer et 5) organiser la formation, en consignant les informations à prendre en compte et à transmettre au formateur pour la planification de la formation et du suivi.
Source : http://www.irsst.qc.ca/-publication-irsst-outil-aide-planification-manutention-manuelle-securitaire-rf-782.html?utm_source=SendBlaster&utm_medium=email&utm_term=2013%2D11%2Dnov%2Dinofirsst%2Dfr&utm_content=2013%2D11%2Dnov%2Dinofirsst%2Dfr&utm_campaign=2013%2D11%2Dnov%2Dinofirsst%2Dfr
A path analysis approach
Objectives: This study aims to examine the extent to which a greater prevalence of pre-existing chronic conditions among older workers explains why older age is associated with longer duration of sickness absence (SA) following a musculoskeletal work-related injury in British Columbia.
Methods: A secondary analysis of workers' compensation claims in British Columbia over three time periods (1997–1998; 2001–2002, and 2005–2006), the study comprised 102 997 and 53 882 claims among men and women, respectively. Path models examined the relationships between age and days of absence and the relative contribution of eight different pre-existing chronic conditions (osteoarthritis, rheumatoid arthritis, hypertension, coronary heart disease, diabetes, thyroid conditions, hearing problems, and depression) to this relationship. Models were adjusted for individual, injury, occupational, and industrial covariates.
Results: The relationship between age and length of SA was stronger for men than women. A statistically significant indirect effect was present between older age, diabetes, and longer days of SA among both men and women. Indirect effects between age and days of SA were also present through osteoarthritis, among men but not women, and coronary heart disease, among women but not men. Depression was associated with longer duration of SA but was most prevalent among middle-aged claimants. Approximately 70–78% of the effect of age on days of SA remained unexplained after accounting for pre-existing conditions.
Conclusions: Pre-existing chronic conditions, specifically diabetes, osteoarthritis and coronary heart disease, represent important factors that explain why older age is associated with more days of SA following a musculoskeletal injury. Given the increasing prevalence of chronic conditions among labor market participants (and subsequently injured workers) moderate reductions in age differences in SA could be gained by better understanding the mechanisms linking these conditions to longer durations of SA.
Source : Smith P, Bielecky A, Ibrahim S, Mustard C, Saunders R, Beaton D, Koehoorn M, McLeod C, Scott-Marshall H, Hogg-Johnson S. Scand J Work Environ Health. 2013.
Le secteur de l'agroalimentaire en France est, depuis de nombreuses années, l'un des plus exposés aux risques de lombalgies et de troubles musculosquelettiques. De nombreuses entreprises se sont lancées dans des réflexions sur les postes, les tâches et l'organisation du travail, analyses ergonomiques, travail au froid… Retour sur les constats et les pistes d'actions explorés par le réseau Assurance maladie Risques professionnels.
Source : Travail & Sécurité, octobre 2013.
Objectives: This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk.
Methods: Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those with without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk.
Results: Among 123 jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93).
Conclusion: Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented.
Source : Cantley LF, Taiwo OA, Galusha D, Barbour R, Slade MD, Tessier-Sherman B, Cullen MR. Scand J Work Environ Health.
Direct measurement of hand forces during assessment of manual materials handling is infeasible in most field studies and some laboratory studies (e.g., during patient handling). Therefore, this study proposed and evaluated the performance of a novel hand force estimation method based on ground reaction forces (GRFs) and body segment accelerations. Ten male subjects performed a manual lifting/carrying task while an optoelectronic motion tracking system measured 3D full body kinematics, a force plate measured 3D GRFs and an instrumented box measured 3D hand forces. The estimated 3D hand forces were calculated by taking the measured GRF vector and subtracting the force vectors due to weight and acceleration of all body segments. Root-mean-square difference (RMSD) between estimated and measured hand forces ranged from 11 to 27N. When ignoring the segment accelerations (just subtracting body weight from the GRFs), the hand force estimation errors were much higher, with RMSDs ranging from 21 to 101N. Future studies should verify the performance of the proposed hand force estimation method when using an ambulatory field measurement system.
Source : http://www.jbiomech.com/article/S0021-9290(13)00355-2/abstract?rss=yes
Ce blog créé par la Carsat Alsace Moselle rassemble des données utiles sur le syndrome du canal carpien (symptômes, origines...) ainsi que des ressources pour détecter et prévenir ce trouble musculosquelettique.
Source : http://blogs.carsat-am.fr/spip.php?rubrique49
BACKGROUND: Manual material handling has been attributed as a major risk to human musculoskeletal system. Workers postural stability in these tasks is influenced by holding method, time and weight being handled. OBJECTIVES: The study attempts to investigate postural balance in five different commonly adopted load handling methods amongst female volunteers. METHODS: 10 women subjects performed manual material handling tasks by lifting 9 kg load in five different ways. Lifting tasks included (1) Upfront in palms (2) on head (3) sideways (left) (4) sideways (right) and (5) in bag at back. Normalized electromyography signals (back and leg) and center of pressure displacements parameters were investigated as measures of postural control. RESULT: An increase in the medio-lateral and anterio-posterior center of pressure displacements and activity of back muscles was reported when subjects lifted the weight directionally. CONCLUSION: There was a significant influence of load position on center of pressure displacements and muscle activity and thereby on postural stability.
Source : Pranab Nag, Anjali Nag, Heer Vyas, Priyanka Shah. Work: A Journal of Prevention, Assessment and Rehabilitation.
Dans ce numéro, intitulé « TMS et facteurs psychosociaux », la prévention des risques sera abordée dans une approche globale de la santé au travail. Les TMS sont sans cesse en augmentation dans un contexte de travail marqué par l'intensification, le cumul des contraintes et des évolutions rapides des métiers. Le partage de connaissances et de compétences entre chercheurs et praticiens, issus de plusieurs disciplines, est nécessaire pour faire progresser l'étiologie et les méthodes d'intervention. En centrant le point de vue sur l'activité de travail, le lecteur pourra enrichir ses connaissances sur les TMS et les facteurs psychosociaux. Il trouvera au travers d'exemples empiriques des moyens d'améliorer la prévention par la combinaison de méthodes visant à développer l'évaluation des déterminants des risques ainsi que l'intervention sur la conception de l'organisation du travail et de la pluridisciplinarité.
Source : http://pistes.revues.org/
Objective This study aims to investigate whether associations of psychological risk factors with the incidence and persistence of disabling musculoskeletal pain differ from those for non-disabling musculoskeletal pain. Methods As part of the international Cultural and Psychosocial Influences in Disability (CUPID) study, 1105 Spanish nurses and office workers were asked at baseline about health beliefs concerning pain, mental health, and somatizing tendency. Musculoskeletal pain in the past months at ten anatomical sites (back, neck, and left and right shoulder, elbow, wrist/hand, and knee) was ascertained at baseline and one year later. Pain was classed as disabling if it made one or more specified everyday activities difficult or impossible. Multilevel multinomial logistic regression modeling was used to explore associations of baseline risk factors with pain outcomes at follow-up, conditioned on pain status at baseline. Results A total of 971 participants (87.9%) completed follow-up. Among anatomical sites that were pain-free at baseline, the development of disabling musculoskeletal pain was predicted by pessimistic beliefs about pain prognosis [odds ratio (OR) 1.5, 95% confidence interval (95% CI) 1.0–2.1], poor mental health (OR 2.0, 95% CI 1.3–3.0), and somatizing tendency (OR 4.0, 95% CI 2.5–6.4). Adverse beliefs about prognosis were also associated with the transition from non-disabling to disabling musculoskeletal pain (OR 3.7, 95% CI 1.1–12.5) and the persistence of disabling musculoskeletal pain (OR 2.5, 95% CI 1.2–5.5), which was already present at baseline. Associations with non-disabling musculoskeletal pain were weaker and less consistent. Conclusion Our findings suggest that established psychological risk factors relate principally to the disability that arises from musculoskeletal pain.
Vargas-Prada S, Martínez JM, Coggon D, Delclos G, Benavides FG, Serra C. Scand J Work Environ Health Online-first -article. http://dx.doi.org/10.5271/sjweh.3377
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