Musculoskeletal disorders (MSD) represent a major public health issue, affecting more then 40 million European workers in 2017. The overall aging of the working population is expected to increase the ...burden of disease, but temporal changes in exposures or diagnosis may also drive the global trends in MSD. We therefore conducted a systematic review to summarize the evidence on the role of demographic and temporal changes in the occurrence of MSD.
We conducted a systematic review of articles reporting temporal trends in MSD in the general working-age population. Only articles controlling for age in the analysis were included. The risk of bias was assessed. The main indicators extracted were age-controlled time trends in MSD incidence or prevalence.
Among 966 articles, 16 fulfilled the inclusion criteria, representing 23 results according to the indicators extracted. No study was found with a high risk of bias. Results presenting time trends in prevalence were found in 12 studies and incidence in 11. After controlling for age, the reported temporal trends varied, mostly between non-monotonic changes (N=12/23) and increases (N=10/23). One article also highlighted an increase among women and non-monotonic changes among men (N=1/23). Several factors other than aging were suggested to explain temporal trends in MSD, mainly trends in obesity, changing occupational exposures, and cultural factors regarding pain tolerance.
This review shows that different kind of factors in addition to aging may contribute to varying or increasing trends in MSD. This review also highlighted the scarcity of evidence regarding time trends in the burden of MSD and their underlying causes.
Abstract
Freshwater sports expose practitioners to pathogens in the water environment and may result in infection. In French Brittany, these infections are particularly worrying, especially since ...2016 with an increase in the incidence of leptospirosis reaching 1 case per 100,000 inhabitants, which represents the highest incidence observed since 1920. We aimed to estimate the prevalence of infectious diseases related to freshwater sports practice and to identify the factors associated with these infections among freshwater sports licensees in Brittany, France. From March 18, 2019, to May 8, 2019, we interviewed freshwater sports licensees (online study) and club presidents and instructors (phone study) in Brittany. Licensee participants were 18 years old or more and practiced at least one freshwater sport in one of the 79 Brittany clubs. We used logistic regression models to study the association between our variables of interest and potential risk factors. In total, 551 licensees (20.3% of the total number of licensees) and 38 clubs (48.1%) were surveyed. Among the licensees, 29 (5.3%) reported being diagnosed with leptospirosis, of which 12 (41.3%) occurred in the last 5 years. The most reported symptoms were skin irritation/itchy skin (24.3%) and 39 individuals (7.1%) reported at least one hospitalization in their lifetime for a disease related to freshwater sports. The occurrence of leptospirosis was negatively associated with boarding from a pontoon (odds ratio (OR)=0.20, 95% confidence interval (95% CI) 0.06–0.56), practicing for less than 4 years (OR=0.17, 95% CI 0.04–0.56) compared to more than 10 years, and the occurrence of leptospirosis was positively associated with taking a soapy shower after practice (OR=4.38, 95% CI 1.90–10.51). Eskimo roll was positively associated with the occurrence of otitis and conjunctivitis (OR=3.22, 95% CI 1.82–6.03), and skin irritation/itchy skin (OR=1.66, 95% CI 0.99–2.84). Otitis, conjunctivitis, and skin irritation/itchy skin are the most commonly reported freshwater sport-related diseases in French Brittany. Despite a good level of knowledge of prevention measures, their implementation by licensees and clubs remains low. Further studies are needed to identify practices associated with infectious risk in freshwater sports.
Background
Musculoskeletal disorders (MSDs) affect nearly 40 million European workers in 2017. Since age constitutes an important risk factor for MSDs, the overall aging of the working population is ...expected to influence the burden of disease. However, factors other than aging that may explain global trends in MSDs are unknown. We conducted a systematic review to summarise the evidence on the role of demographic and temporal changes in the occurrence of MSDs.
Methods
Following the PRISMA guidelines, we searched Pubmed, ScienceDirect and Web of Science over the 1990-2020 period for articles reporting temporal trends in MSDs incidence or prevalence in the general working-age population. We only included articles controlling for age in the analysis. To assure the quality of the articles, the bias risk was assessed using the RoB-SPEO tool. The main indicators we extracted were age-controlled time trends in MSDs incidence or prevalence.
Results
Among 966 articles, 16 fulfilled the inclusion criteria, representing 23 results according to the indicators extracted. No study was found with high risk of bias. Nine used a definition of MSDs based on pain and 14 based on repercussions on work or social life. Twelve results presented time trends in prevalence and 11 in incidence. After controlling for age, temporal trends in MSDs presented some heterogeneity. Indeed, 10 results documented increases and 12 reported non-monotonic changes. Only one result reported a decreasing trend in MSDs incidence. Several factors other than aging were suggested to explain temporal trends in MSDs, mainly trends in obesity, changing occupational exposures and cultural factors in tolerance to pain.
Conclusions
This review shows that factors additional to aging of the working population may contribute to varying or increasing trends in MSDs. Results also highlight the scarcity of available evidence on time trends in MSDs burden and their underlying causes.
Key messages
Despite a scarcity of evidence, our results suggest that factors additional to aging of the working population may contribute to varying or increasing trends in MSDs.
Several factors other than aging were suggested to explain temporal trends in MSDs, mainly trends in obesity, changing occupational exposures and cultural factors in tolerance to pain.
Objectives
This study aimed to globally assess the prevalence and distribution of primary-origin musculoskeletal disorders (MSDs) from 1990 to 2019 to better understand their temporal trends.
Methods
...Using data from the 2019 Global Burden of Diseases, prevalence rates of six primary-origin MSDs were analysed across subregions, age groups and genders. Raw and age-standardised prevalence were mapped for over 204 countries. Cochran-Armitage trend tests evaluated temporal prevalence trends. The correlation between MSDs prevalence, national income levels and medical density was explored.
Results
In 2019, global MSDs prevalence varied significantly among countries. Hip osteoarthritis had a prevalence of 0.56% (95% CI: 0.43% to 0.70%), while low back pain was 8.62% (95% CI: 7.62% to 9.74%). Most MSDs exhibited an increasing prevalence with age, except for neck pain, which stabilised or decreased after age 45–50. Women generally had higher prevalence rates across all age groups. High-income countries consistently showed higher prevalence rates compared with middle and low-income countries. Over time, most subregions experienced a significant increase in MSD prevalence. However, after adjusting for age, the temporal trends for back and neck pain became non-significant, except for hip osteoarthritis, where half of the subregions remained significant. Multiple linear regressions revealed positive correlation between MSD prevalence and both national income level and medical density.
Conclusion
The global burden of MSDs is increasing due to population ageing, but other factors should be considered. Longitudinal studies with a wider range of MSDs and additional risk factors are needed for improved prevention strategies.
ObjectivesTo quantify the burden of COVID-19-related sick leave during the first pandemic wave in France, accounting for sick leaves due to symptomatic COVID-19 (‘symptomatic sick leaves’) and those ...due to close contact with COVID-19 cases (‘contact sick leaves’).MethodsWe combined data from a national demographic database, an occupational health survey, a social behaviour survey and a dynamic SARS-CoV-2 transmission model. Sick leave incidence from 1 March 2020 to 31 May 2020 was estimated by summing daily probabilities of symptomatic and contact sick leaves, stratified by age and administrative region.ResultsThere were an estimated 1.70M COVID-19-related sick leaves among France’s 40M working-age adults during the first pandemic wave, including 0.42M due to COVID-19 symptoms and 1.28M due to COVID-19 contacts. There was great geographical variation, with peak daily sick leave incidence ranging from 230 in Corse (Corsica) to 33 000 in Île-de-France (the greater Paris region), and greatest overall burden in regions of north-eastern France. Regional sick leave burden was generally proportional to local COVID-19 prevalence, but age-adjusted employment rates and contact behaviours also contributed. For instance, 37% of symptomatic infections occurred in Île-de-France, but 45% of sick leaves. Middle-aged workers bore disproportionately high sick leave burden, owing predominantly to greater incidence of contact sick leaves.ConclusionsFrance was heavily impacted by sick leave during the first pandemic wave, with COVID-19 contacts accounting for approximately three-quarters of COVID-19-related sick leaves. In the absence of representative sick leave registry data, local demography, employment patterns, epidemiological trends and contact behaviours can be synthesised to quantify sick leave burden and, in turn, predict economic consequences of infectious disease epidemics.
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