Risk factors for episodic neck pain in workers: a 5-year prospective study of a general working population.

PURPOSE: Development of neck pain (NP) in workers has a multifactorial etiology and depends on both individual and workplace factors. The aim of this study was to investigate risk factors for episodic NP in a large diverse sample of active workers. METHODS: A prospective study based on the surveillance program implemented by the French Public Health Agency in the Loire Valley region. Between 2002 and 2005, 3710 workers were included. Between 2007 and 2010, 2332 workers responded to a follow-up questionnaire which assessed: (1) musculoskeletal symptoms (Nordic questionnaire) and (2) individual and work-related risk factors. Associations between episodic NP in 2007 (i.e., free subjects at baseline and who suffered at least 8 days during the preceding 12 months) and individual and work-related risk factors at baseline were studied using logistic regression modeling, stratified by sex. RESULTS: Among the 1510 workers (914 men, 596 women) still active at follow-up, 10.4% (8.4-12.4) of men and 14.6% (11.8-17.4) of women declared episodic NP. Among men, work pace dependence of guests or permanent hierarchical controls were risk factors of NP [OR = 1.8 (1.1-2.8) and OR = 2.1 (1.3-3.3), respectively]. Among women, the combination of sustained/repeated arm abduction with high physical perceived exertion was the strongest risk factor for NP [OR = 3.5 (1.7-7.2)]; age and paced work were also predictors for NP in women. CONCLUSIONS: NP results from complex relationships between individual and work-related variables. High physical workload, awkward postures, and poor organizational environment together with age differently predicted episodic NP according to the sex.

[Occupational asthma]. / Asthmes professionnels.

BACKGROUND: Occupational asthma (OA) is a frequent work-related disease in industrialised countries. It often leads to severe social and medical consequences. TWO TYPES OF OA: A distinction must be made between OA with a latency period, the origin of which is essentially allergic, and OA without a latency period or Reactive airways dysfunction syndrome (RADS), induced by acute inhalation of irritant substances. PREVALENCE: This is currently estimated as one case of asthma of occupational origin in one adult out of ten. In many cases its diagnosis is missed because it is not systematically searched for. REGARDING DIAGNOSIS: Diagnosis, initiated on the results of questioning, must be supported by immunological tests whenever possible and notably on functional respiratory explorations (longitudinal monitoring of peak flow or spirometry, repeated measurements of non-specific bronchial reactivity), which objectifies significant variations in the parameters measured and related to professional activity. Bronchial challenge tests specifically identify the causal agent, but such examinations are long, expensive, potentially dangerous and therefore cannot be used in routine. MANAGEMENT OF OA: Both social and medical, the management is aimed at stopping the exposure to the risk whilst protecting the person's employment. The declaration of occupational diseases is one of the principle measures of the medico-social care.