Upper extremity musculoskeletal disorders (UEMSD) are one of the most common and costly occupational health problems. We aimed to assess the population-attributable fraction (PAF) of personal and ...occupational risk factors associated with incident UEMSD in a working population.
From 2002 to 2005, a random sample of 3710 workers from the Pays de la Loire region in France, aged 20-59 were included by occupational physicians (OPs). Between 2007 and 2010, 1611 workers were re-examined by their OPs. Subjects free from UEMSD at baseline were included in this study (1275 workers, mean age: 38.2 years). Cox regression models with equal follow-up time and robust variance estimates were used to estimate age-adjusted and multivariable-adjusted relative risks (RRs) and their 95% confidence intervals (CIs). Based on multivariable models, PAF associated with each factor included in the models was estimated.
During the follow-up period, 143 (11%) cases of UEMSD were diagnosed. PAFs for factors associated with the incident UEMSD risk were 30% (7 to 51) for high physical exertion (RPE Borg scale ≥12), 12% (- 0.2 to 24) for low social support, 7% (- 3 to 17) for working with arms above shoulder level (≥2 h/day), 20% (12 to 28) for age group ≥45, 13% (3 to 22) for the age group 35-44, and 12% (0.3 to 24) for female gender.
Our study suggests that an important fraction of UEMSD can be attributed to occupational exposures after the contributions of personal and other work-related factors are considered. In terms of public health, our findings are in agreement with the ergonomic literature postulating that a high proportion of UEMSD are preventable through modifying workplace risk factors. Such information is useful to help public health practitioners and policy makers implement programs of prevention of UEMSD in the working population.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BACKGROUND: Increased consumption of dietary fiber is widely recommended to maintain or improve health, but knowledge of the relation between dietary fiber sources and cardiovascular disease risk ...factors is limited. OBJECTIVE: We examined the relation between the source or type of dietary fiber intake and cardiovascular disease risk factors in a cohort of adult men and women. DESIGN: In a cross-sectional study, quintiles of fiber intake were determined from dietary records, separately for 2532 men and 3429 women. Age- and multivariate-controlled logistic models investigated the odds ratios of abnormal markers for quintiles 2-5 of fiber intake compared with the lowest quintile. RESULTS: The highest total dietary fiber and nonsoluble dietary fiber intakes were associated with a significantly (P < 0.05) lower risk of overweight and elevated waist-to-hip ratio, blood pressure, plasma apolipoprotein (apo) B, apo B:apo A-I, cholesterol, triacylglycerols, and homocysteine. Soluble dietary fiber was less effective. Fiber from cereals was associated with a lower body mass index, blood pressure, and homocysteine concentration; fiber from vegetables with a lower blood pressure and homocysteine concentration; and fiber from fruit with a lower waist-to-hip ratio and blood pressure. Fiber from dried fruit or nuts and seeds was associated with a lower body mass index, waist-to-hip ratio, and fasting apo B and glucose concentrations. Fiber from pulses had no specific effect. CONCLUSION: Dietary fiber intake is inversely correlated with several cardiovascular disease risk factors in both sexes, which supports its protective role against cardiovascular disease and recommendations for its increased consumption.
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CMK, GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective This study aimed to estimate the proportion and number of incident upper-extremity musculoskeletal disorders (UEMSD) cases attributable to occupational risk factors in a working population. ...Methods Between 2002-2005, occupational physicians randomly selected 3710 workers, aged 20-59, from the Pays de la Loire (PdL) region. All participants underwent a standardized clinical examination. Between 2007-2010, 1611 workers were re-examined. This study included 1246 workers who were free of six main clinically diagnosed UEMSD at baseline but were diagnosed with at least one of these UEMSD at follow-up 59% of men, mean age: 38 (standard deviation 8.6) years. Relative risks and population-attributable fractions (PAF) were calculated using Cox multivariable models with equal follow-up time and robust variance. The total number of incident UEMSD in the PdL region was estimated after adjustment of the sample weights using 2007 census data. The estimated number of potentially avoidable UEMSD was calculated by multiplying PAF by the total number of incident UEMSD in PdL. Results At follow-up, 139 new cases of UEMSD (11% of the study sample) were diagnosed. This represented an estimated 129 320 incident cases in the PdL in 2007. Following adjustment for personal factors, 26 381 (20.4% of all incident UEMSD) were attributable to high physical exertion, 16 682 (12.9%) to low social support, and 8535 (6.6%) to working with arms above shoulder level. Conclusions A large number and important proportion of incident UEMSD may be preventable by reducing work exposures to physical exertion and working with arms above shoulder level as well as improving social support from co-workers/supervisors.
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BFBNIB, NMLJ, NUK, ODKLJ, PNG, UL, UM, UPUK
Longitudinal studies on physical activity patterns around retirement age are scarce and provide divergent findings. Little is known about changes in sedentary behaviour in this context. Our aim was ...to investigate relationships between retirement and 3-year changes in leisure-time physical activity (LTPA) patterns and sedentary behaviour in middle-aged French adults.
Past-year LTPA and sedentary behaviour (watching television) were assessed in 1998 and 2001 using the Modifiable Activity Questionnaire on participants in the SU.VI.MAX (Supplementation with Antioxidants and Minerals) study. A total of 698 men and 691 women aged 45-64 were included in this analysis. Comparisons were made between subjects who had retired between 1998 and 2001 and those who continued to work, using the Chi-square test, Student t-test, Wilcoxon rank test or covariance analysis where appropriate.
20.1% of men and 15.6% of women retired during follow-up. The baseline LTPA level was similar between subjects who retired during follow-up and those who continued to work. Mean LTPA increased by about 2 h/week in men and women who had retired, whereas no change was observed in employed persons. The positive change in LTPA following retirement was mainly related to an increase in activities of moderate intensity, such as walking. Retirement did not modify the ranking of the most frequently performed LTPAs, but the number of participants and the duration increased through retirement. In men, the increase in time spent watching TV was more than twice as high in retirees as in workers (+40.5 vs. +15.0 min/day, P < 0.0001). The same tendency was observed among women, but was borderline non-significant (+33.5 vs. +19.9 min/day, P = 0.05). In women, retirees who increased their walking duration by 2 h/week or more also decreased time spent watching TV by 11.5 min/day.
Retirement was associated with both an increase in LTPAs and in time spent watching TV, suggesting that retirement is an important period not only for promoting physical activity, but also for limiting sedentary behaviour.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
There are few data on the relationship between health-related quality of life (HRQoL) and leisure time physical activity (LTPA) in the general population. We investigated the relationships of meeting ...public health recommendations (PHR) for moderate and vigorous physical activity with HRQoL in French adult subjects.
LTPA and HRQoL were assessed in 1998 in 2333 men and 3321 women from the SU.VI.MAX. cohort using the French versions of the Modifiable Activity Questionnaire (MAQ) and the SF-36 questionnaire, respectively. Relationship between LTPA and HRQoL was assessed using analysis of variance.
Results from multivariate analysis showed that meeting physical activity recommended levels was associated with higher HRQoL scores (except in Bodily pain dimension for women): differences in mean HRQoL scores between subjects meeting or not PHR ranged from 2.4 (Mental health) to 4.5 (Vitality) and from 2.2 (Bodily pain) to 5.7 (Vitality) for women and men, respectively.
Subjects meeting PHR for physical activity had better HRQoL than those who did not. Our data suggest that 30′ of moderate LTPA per day on a regular basis may be beneficial on HRQoL. Higher intensity LTPA is associated with greater HRQoL. This emphasizes the importance to promote at least moderate physical activity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
BACKGROUND/AIMSAs a module of a standard ultrasound imaging device, acoustic radiation force impulse (ARFI) is a new technology for liver stiffness evaluation (LSE). We aimed to evaluate accuracy, ...feasibility, reproducibility, and training effect of ARFI for liver fibrosis evaluation.
METHODSOne hundred and one patients with chronic liver disease had LSE by Fibroscan and ARFI. LSE by ARFI was performed in the two liver lobes by two operatorsan expert and a novice. Correlation and agreement were evaluated by the Pearson (Rp) and intraclass (Ric) correlation coefficients. The independent reference for liver fibrosis was fibrosis blood tests.
RESULTSARFI results, ranging from 0.7 to 4.6 m/s, were well correlated with Fibroscan results (Rp=0.76). Fibroscan had a significantly higher area under the receiver operating characteristic curve (AUROC) than ARFI for the perprotocol diagnosis of significant fibrosis0.890±0.034 versus 0.795±0.047 (P=0.04). However, LSE failure occurred in zero patients using ARFI versus six patients using Fibroscan (P=0.03). Thus, on an intention-to-diagnose basis, Fibroscan and ARFI AUROCs for the diagnosis of significant fibrosis were not different0.791±0.049 versus 0.793±0.046 (P=0.98). Interobserver agreement was very good (Ric=0.84) and excellent for ARFI interquartile range (IQR)≤0.30 (Ric=0.91). Indeed, agreement was independently predicted only by ARFI IQR, but not by LSE result as earlier observed for Fibroscan. ARFI AUROC was 0.876±0.057 in patients with ARFI IQR ratio≤0.30, and Fibroscan AUROC was 0.912±0.034 in patients with Fibroscan IQR ratio less than 0.21 (P=0.59). Intersite ARFI agreement between the two liver lobes was fair (Ric=0.60). There was no training effect for LSE by ARFI.
CONCLUSIONARFI is highly feasible and reproducible, and provides diagnostic accuracy similar to Fibroscan. This new device seems noteworthy for the widespread noninvasive diagnosis of liver fibrosis.
OBJECTIVE: To study the relationships of time spent in sedentary occupations with the National Cholesterol Education Program-defined metabolic syndrome (MS), taking into account the habitual level of ...physical activity (PA). RESEARCH METHODS AND PROCEDURES: This was a cross-sectional analysis in 1902 men and 1932 women 50 to 69 years of age participating in the French Supplementation with Antioxidant Vitamins and Minerals study. We assessed past-year PA, television watching or computer use, and reading during leisure with the Modifiable Activity Questionnaire. Subjects who performed at least 150 min/wk of moderate-intensity PA (3 to 6 metabolic equivalent tasks) or 60 min/wk of vigorous PA (>6 metabolic equivalent tasks) were considered as meeting recommended levels. RESULTS: The frequency of most MS components increased with time spent in front of a screen and decreased with increasing PA levels. The likelihood to have MS, adjusted for age, education, and smoking, was decreased by one-third in subjects meeting moderate PA guidelines and by two-thirds in subjects meeting vigorous PA recommendations odds ratio (95% CI), 0.34 (0.17 to 0.66) in women, 0.44 (0.28 to 0.68) in men compared with those with insufficient PA. Independently of PA levels, time spent in front of a screen was positively associated with the likelihood to have the MS in women odds ratio (95% CI), 3.30 (2.04 to 5.34), whereas in both sexes, no association was found with time spent reading. DISCUSSION: The relationship of the MS with a sedentary lifestyle differs according to sex and type of sedentary occupation. These results suggest the need to assess selected indicators of sedentary behavior in preventive programs.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Estimation of dietary intake of polyphenols is difficult, due to limited availability of food composition data and bias inherent to dietary assessment methods. The aim of the present study was to ...evaluate the associations between the intake of polyphenol-rich foods and the urinary excretion of several phenolic compounds and therefore explore whether these phenolic compounds could be used as a biomarker of intake. Fifty-three participants of the SU.VI.MAX study (a randomised primary-prevention trial evaluating the effect of daily antioxidant supplementation on chronic diseases) collected a 24h urine and a spot urine sample and filled a dietary record during a 2d period. Thirteen polyphenols and metabolites, chlorogenic acid, caffeic acid, m-coumaric acid, gallic acid, 4-o-methylgallic acid, quercetin, isorhamnetin, kaempferol, hesperetin, naringenin, phloretin, enterolactone and enterodiol, were measured using HPLC–electrospray ionisation–MS–MS. In spot samples apple consumption was positively correlated to phloretin, grapefruit consumption to naringenin, orange to hesperetin, citrus fruit consumption to both naringenin and hesperetin, with r coefficients ranging from 0·31 to 0·57 (p<0·05). The combination of fruits and/or fruit juices was positively correlated to gallic acid and 4-o-methylgallic acid, isorhamnetin, kaempferol, hesperetin, naringenin and phloretin (r 0·24–0·44, p<0·05). Coffee consumption was positively correlated to caffeic and chlorogenic acids (r 0·29 and 0·63, p<0·05 respectively). Black tea and wine consumption were positively correlated with gallic and 4-o-methylgallic acids (r 0·37–0·54, p<0·001). The present results suggest that several polyphenols measured in a spot urine sample can be used as biomarkers of polyphenol-rich food intake.
A high consumption of flavonoids may lower cardiovascular risk through their antioxidant capacity. This study evaluated the relation between consumption of foods rich in flavonoids and estimated ...cardiovascular risk. A cross-sectional analysis was performed in 1286 women and 1005 men of the SU.VI.MAX Study (an 8-y trial evaluating the effect of antioxidant supplementation on the incidence of major chronic diseases). Dietary intakes were estimated using six 24-h dietary records collected during the year between the clinical measurement of blood pressure, weight and height and the biological measurement of total serum cholesterol and fasting plasma glucose. The relation between flavonoid rich food consumption and cardiovascular risk factors was evaluated with analyses of covariance and the effect on cardiovascular risk with logistic regression analyses. In women, flavonoid-rich food consumption was inversely related to systolic blood pressure (P = 0.005). No relation between risk factors and flavonoid-rich food consumption was seen in men. Women in the highest tertile of flavonoid-rich food consumption were at lower risk for cardiovascular disease odds ratio (OR): 0.31; 95%CI: 0.14, 0.68, whereas a positive tendency was seen in men (OR: 1.38; 95%CI: 0.96, 2.00). These results indicate that in women, a high consumption of flavonoid-rich foods may prevent cardiovascular disease.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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