Consequences of musculoskeletal disorders on occupational events: a life-long perspective from a national survey.

INTRODUCTION: Musculoskeletal disorders (MSDs) are among the most frequent causes of disability, with potentially important consequences. Our objective was to investigate from a lifelong perspective the factors associated with these consequences, including permanent withdrawal from the workforce, focusing especially on factors at the start of working life.
METHODS: The data come from the SIP national survey (Santé et Histoire Professionnelle, health and occupational history). Three groups of subjects were compared with multinomial logistic models: group 1 (G1), who had MSDs that caused an important event in their working life; group 2, who had MSDs without any such consequence; and group 3 (G3), who had no MSD.
RESULTS: In multivariate models, MSDs with consequences on occupational events were strongly associated with a low educational level for both sexes, and with some working conditions. In the comparison G1/G3, the odds-ratio (OR) for "no diploma" compared to "university level" was 4.41 and the confidence interval (95 % CI) 2.31-8.40 for men. For women the OR was 2.02 (95 % CI 1.32, 3.10). Group 2's educational level was between G1 and G3, closer to G3. For men, another risk factor was a first job in construction or farming (OR = 2.95 for construction, 2.23 for farming, comparison G1/G3). Comparisons focusing on "permanent withdrawal from the workforce" yielded similar results.
CONCLUSIONS: Associations between occupational history and health are complex; the results strongly suggest that factors at the beginning of working life, including level of education, have important delayed consequences, especially for workers with health disorders such as MDSs. In order to reduce the frequency of negative consequences, a better knowledge on causal mechanisms would be needed.