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Quel indicateur pertinent pour la surveillance épidémiologique et la prévention des troubles musculo-squelettiques en lien avec le travail ? : application à la lombalgie

Abstract : This thesis proposes to review the available indicators for the epidemiological surveillance of work-related low back pain, including compensation data of occupational diseases and data from the pilot surveillance system for musculoskeletal disorders in the Pays de la Loire region.The proportion of cases of lumbar disc surgery (used as sentinel event of low back pain) attributable to occupational activity was particularly high among blue-collar workers of both genders and lower-grade female white-collar workers. Low back pain is a complex phenomenon and cannot be monitored using a single indicator. Compensation data, despite their limitations, give results comparable to other data sources and don’t require specific gathering. Cohorts’ data, based on a standardized questionnaire, are necessary for international comparisons. Finally, surgical data from private and public hospitals databases provide the finest information, if they are completed with occupational data. However, this is a mixed indicator of morbidity and care. It shows large local disparities in a region, encouraging the development of differentiated prevention programs.In addition to these three indicators, it would be interesting to add a disability or incapacity indicator in the surveillance system to better target prevention programs according to occupational exclusion which is an important dimension in terms of social impact for people and cost for the society.
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Natacha Fouquet. Quel indicateur pertinent pour la surveillance épidémiologique et la prévention des troubles musculo-squelettiques en lien avec le travail ? : application à la lombalgie. Santé publique et épidémiologie. Université d'Angers, 2016. Français. ⟨NNT : 2016ANGE0044⟩. ⟨tel-01768848⟩

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