Can we distinguish the roles of demographic and temporal changes in the incidence and prevalence of musculoskeletal disorders? A systematic review

Bouziri, Hanifa; Descatha, Alexis; Dab, William; Jean, Kévin

doi:10.5271/sjweh.4018

Cited by 6 publications

(8 citation statements)

References 46 publications

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“…Second, it happens that for certain countries where the data was incomplete, calibration was used on neighbouring countries (this aspect was mainly observed for data from African countries). 5 Furthermore, this study does not allow to distinguish whether the differences in prevalence observed according to the type of MSD and the geographical location of the individuals are due to differences in risk which depend on the characteristics between the regions, such as genetic factors, or whether these differences in prevalence are due to risk factors such as occupational or environmental exposure factors. This work presents other limitations that could explain an underestimation of the prevalence and the real burden of MSD over time.…”

Section: Discussionmentioning

confidence: 98%

“…Among these variations, we can count the differences in definitions, in national income, reflecting the structure of employment and acting in part on cultural factors and pain tolerance, or even variations in medical density which may be used as an indicator of diagnostic capability and probability of detection 5 . Moreover, country treatment arsenal may also indirectly drive the country diagnostic capacity.…”

Section: Discussionmentioning

confidence: 99%

“…These aspects mean that the sensitivity and specificity of the indicators observed undoubtedly vary geographically due to the diversity of the characteristics of the countries and the profiles of the populations. Among these variations, we can count the differences in definitions, in national income, reflecting the structure of employment and acting in part on cultural factors and pain tolerance, or even variations in medical density which may be used as an indicator of diagnostic capability and probability of detection 5 . Moreover, country treatment arsenal may also indirectly drive the country diagnostic capacity.…”

Section: Discussionmentioning

confidence: 99%

“…However, evidence of past and current trends in the occurrence of MSD comes primarily from high-income countries, while evidence in the Global South remains scarce. 5 Several factors may drive the spatial and temporal distribution of MSD. First, several risk factors for MSD have been consistently identified, including occupational exposures such as biomechanical or psychosocial factors.…”

Section: Introductionmentioning

confidence: 99%

“…However, evidence of past and current trends in the occurrence of MSD comes primarily from high-income countries, while evidence in the Global South remains scarce. 5…”

Section: Introductionmentioning

confidence: 99%

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The spatio-temporal distribution of musculoskeletal disorders: results of the Global Burden of Disease in 204 countries and 21 subregions between 1990 and 2019

Bouziri

Descatha

Dab

et al. 2022

Preprint

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BackgroundMusculoskeletal disorders (MSD) represent the main contributor to disability worldwide. However, a global view of the geographic and temporal trends in the occurrence of MSD remains lacking. This study aimed to assess the spatio-temporal distribution of MSD from 1990 to 2019.MethodsWe used data from the 2019 Global Burden of Diseases (GBD) to analyse the prevalence of 6 work-related MSD defined medically or self-reported pain, over the 1990-2019 period. We mapped raw and age-standardized prevalence in over 204 countries. We also described the 2019 MSD prevalence by sub-regions, age, and sex. We assessed temporal trends in prevalence using Cochran-Armitage trend tests (CA). We also explored the correlation between national income level and medical density for each country with the MSD prevalence using multivariate regression.FindingsIn 2019, global raw prevalences of work-related MSD ranged from 0·56% [95% CI: 0·43-0·70] for hip osteoarthritis to 8·62% [95% CI: 7·62-9·74] for low back pain, with large variations across countries. The prevalence of MSD increased monotonically with age, except for neck pain which increase then remain stable or decreases after 45-50 years old. Globally, MSD prevalences increased with age in both men and women. Although the shapes of the age distributions were similar between men and women in all sub-regions, MSD prevalences were higher in women compared to men. Prevalences were higher in high vs. middle income countries for the 6 MSD. Over time, in most sub-regions, trends in raw prevalences of low back and neck pain increased significantly, whereas after controlling for age, a majority were no longer significant. Osteoarthritis raw prevalence increased in more than half of the sub-regions; however, after taking age into account, almost half of the trends remained significant or close to significance. Finally, on multivariate linear regressions, the World Bank income level and medical density for each country were positively correlated with the prevalences of MSD.InterpretationThe ageing of the population presumably drives the growing burden of MSD on a global scale, although other factors also play a role in the occurrence of these pathologies over time. Longitudinal data on a larger panel of MSD, considering occupational exposures over time, would allow better prevention of these pathologies.FundingsThe French National Institute for Science, Technology, and Management (Cnam) grant and the Health and Enterprises Chair (Cnam, Malakoff Humanis).Research in contextEvidence before this studyMusculoskeletal disorders (MSD) represent a major public health problem and the burden of morbidity is expected to increase considerably due to the overall ageing of the population. Several studies from the Global Burden of Disease (GBD) have shown that MSD are among the most disabling chronic non-communicable pathologies in the world. There are established links between many risk factors and MSD such as biomechanical and psychosocial factors, but very few studies have focused on the temporal trends of MSD and their geographical distribution. We searched PubMed and Google Scholar for articles of any language focusing on temporal trends in MSD, up to July 15, 2022. The search terms were: (“Musculoskeletal disorder*” OR “Musculoskeletal disease*”) AND (“temporal trends” OR “time trends” OR “over time”) AND (“incidence” OR “prevalence”)). Several articles described the global burden of specific MSD based on data from the GBD. However, these studies focused on a unique MSD, and did not describe global patterns of diseases. Additionally, a recent systematic review explored the role of aging and other risk factors in the time trends of MSD. This review highlighted the scarcity of evidence regarding time trends in the burden of MSD, especially beyond western countries. The surveys set up by the GBD allowed to quantify the prevalence of several pathologies, including MSD standardized by age, in the world, to be able to compare diseases and study their trends over time.Added value of this studyTo our knowledge, this study is the first to analyze the spatio-temporal distribution of global and regional MSD. It has been shown that the burden of MSD has tended to increase over the past 30 years. Regardless of the years and geographical locations studied, the prevalence of low back pain is by far the most widespread in the world. There is also a great diversity of prevalence between MSD and regions. Most MSD increased significantly over time but were explained by age. However, age was not sufficient to explain all the trends we report here. Especially, we observe a marked difference in the prevalence of MSD between countries in the global North vs. global South, which was not totally explained by differences in age structures. The prevalence of MSD is higher in high-income countries and with countries with high medical density.Implications of all the available evidenceIn a context of expected ageing of the active population, a better understand these pathologies, it is becoming urgent to better understand these pathologies to better prevent them. This study has therefore highlighted the relevance of broader surveillance of these pathologies, considering occupational exposure over time, with a view to developing effective policies for the management and prevention. Furthermore, the cause of the difference in MSD prevalence between the Global North and the Global South deserve further research.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, evidence of past and current trends in the occurrence of MSD comes primarily from high-income countries, while evidence in the Global South remains scarce. 5…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The spatio-temporal distribution of musculoskeletal disorders: results of the Global Burden of Disease in 204 countries and 21 subregions between 1990 and 2019

Bouziri

Descatha

Dab

et al. 2022

Preprint

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Assessing Ergonomics on IPS IMMA Family of Manikins

Vargas¹,

Cavatorta

Cibrario³

et al. 2023

Lecture Notes in Computer Science

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The development of working life expectancy without musculoskeletal diseases against the backdrop of extended working lives

Tetzlaff,

Epping,

Stahmeyer

et al. 2024

Sci Rep

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Musculoskeletal diseases (MSDs) are a major predictor of early retirement. Against the backdrop of the extension of working life, we investigated time trends and educational inequalities in years spent in the labour market free of MSD. Based on German statutory health insurance data (N = 3,405,673), total life years free of MSD (Healthy Life Expectancy, HLE) and years spent in the labour force free of MSD (Healthy Working Life Expectancy, HWLE) were estimated for three periods (2006–2008, 2011–2013, 2016–2018) using multistate analyses. Educational inequalities (8 to 11 vs. 12 or more years of schooling) are reported for 2011–2013. HLE decreased slightly over time in all genders. HWLE in women increased, while it remained rather constant in men. Over time, the share of years in the labour force spent free of MSD declined continuously. People with lower education had lower HLE and HWLE than individuals with higher education. With respect to musculoskeletal diseases, the increase in disease-free working life years cannot keep pace with the extension of working life, resulting in an increasing proportion of years spent in impaired musculoskeletal health in the labour market. Effective prevention strategies are needed, focusing especially on individuals with lower educational attainment.

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Can we distinguish the roles of demographic and temporal changes in the incidence and prevalence of musculoskeletal disorders? A systematic review

Cited by 6 publications

References 46 publications

The spatio-temporal distribution of musculoskeletal disorders: results of the Global Burden of Disease in 204 countries and 21 subregions between 1990 and 2019

The spatio-temporal distribution of musculoskeletal disorders: results of the Global Burden of Disease in 204 countries and 21 subregions between 1990 and 2019

Assessing Ergonomics on IPS IMMA Family of Manikins

The development of working life expectancy without musculoskeletal diseases against the backdrop of extended working lives

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