Facteurs personnels et professionnels associés aux lombalgies en population générale au travail en France

Low Back Pain and Upper-Extremity Musculoskeletal Disorders in French Postal Workers Driving Light-Duty Vehicles for Mail and Parcel Delivery

Occupational driving of light-duty vehicles (LDVs) became increasingly important in parcel delivery faced with the explosive growth of e-commerce. Since musculoskeletal disorders (MSDs) represent the most reported driving-related health problem, we aimed to analyze the risk of low back pain (LBP) and upper-extremity musculoskeletal disorders (UEMSDs) associated with driving LDVs for parcel delivery. In 306 postal workers exposed to driving and 100 unexposed workers, information on occupational driving, physical/psychosocial constraints, and work organization were collected via a questionnaire. MSDs were assessed using the Nordic Questionnaire, 14 additional questions regarding LBP, and a standardized clinical examination for UEMSDs. Statistical modeling consisted of multivariable logistic regression for UEMSDs and the item response theory approach for LBP. UEMSDs were associated with the distance of rural rounds and inversely associated with urban/mixed delivery rounds. Handling heavy loads was associated with LBP, and high physical demands during delivery rounds were related to MSDs. Karasek dimensions and mobbing actions were associated with MSDs. Work recognition, driving training, using an automatic gearbox, and the utilization of additional staff during peak periods were inversely associated with MSDs. Our results suggest that the distance driven in rural settings and high physical demands were associated with MSDs, while some organizational factors could protect from MSDs.

Relationship between psychosocial factors at work and incidence of perceived health problems in the GERICOTS cohort

BACKGROUND

The objective of this study was to investigate the relationship between the incidence of health problems and the psychosocial work environment in a French occupational cohort.

METHODS

Among the 2062 employees in the North of France who participated in the GERICOTS survey between 1999 and 2004, 1154 subjects who kept the same full-time shift in the same firm during the study period (797 men and 357 women) were included. Job strain was assessed using Karasek's model--the strain profile (high psychological demand and low decision latitude) and the iso-strain profile (strain profile and low social support)--and Siegrist's model, Effort-Reward Imbalance (ERI) (high effort and low rewards). Perceived health status was assessed using the four dimensions of the Nottingham Health Profile (emotional reactions, sleep, social isolation, pain). The results are given by the odds ratio adjusted for age, occupational category, and size of firm.

RESULTS

At baseline, higher prevalence of health problems was found in workers with job strain, e.g., between emotional reactions and iso-strain for men, OR=3.50 (2.19-5.60) and for women, 2.64 (1.39-5.04) or between sleep disorders and ERI for men, OR=2.41 (1.71-3.40) and for women, OR=2.41 (1.39-4.20). Longitudinal analysis showed a significant relationship between incidence of health problems and level of job strain in 1999, e.g., between sleep disorder incidence and strain profile, OR=1.89 (1.16-3.06) and ERI, OR=2.20 (1.43-3.38).

CONCLUSION

These results show a significant relationship between perceived health and job stress in 1999 but also between incidence of health problems between 1999 and 2004 and job strain in 1999.