Main Article Content
Criteria; occupational disease; musculoskeletal system
Background: Criteria for diagnosis and compensation of occupational musculoskeletal diseases varies widely between countries as demonstrated by the large differences between countries with comparable economics and social systems (for example, within the European Union). Several countries have a list of occupational diseases and sometimes these lists include diagnostic and attribution criteria, but these criteria are usually not very specific, and they may also be very different. Objectives: The aim of this paper is to explicitly define what are the information needed for an evidence-based diagnosis and attribution of an occupational musculoskeletal disease. Methods: Based on the general framework of evidence-based medicine, a review is presented of the information required to define: - when a musculoskeletal disease is present, according to the best available techniques; - how to define a relevant exposure to biomechanical risk factors, according to the best available techniques. Results: Criteria are presented to combine information regarding the diagnosis of a musculoskeletal disease and exposure to biomechanical risk factors for an evidence-based attribution of the disease to the occupational exposure. The criteria use a probabilistic model that combine epidemiologic and medical findings, workplace exposure assessment, and non-occupational factors evaluation. Discussion: The use of the proposed criteria may improve the process of diagnosis and attribution of an occupational musculoskeletal disease. In addition, it makes possible to associate a probability rank to the attribution and, ultimately, it may improve the overall quality of the decisional process of the occupational physician.
2. GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1923-1994
3. AMA Style Insider. Condition, Disease, Disorder. Accessible at: https://amastyleinsider.com/2011/11/21/condition-disease-disorder/
4. Expert committee on Identification and control of work-related diseases. Identification and control of work-related diseases: report of a WHO expert committee. WHO Technical Report Series 714, 1985. Accessible at: https://apps.who.int/iris/bitstream/handle/10665/40176/WHO_TRS_714.pdf?sequence=1&isAllowed=y
5. Fan X, Straube S: Reporting on work-related low back pain: data sources, discrepancies and the art of discovering truths.
Pain Manag 2016; 6:553-559
6. Hagberg M, Violante FS, Bonfiglioli R, et al: Prevention of musculoskeletal disorders in workers: classification and health surveillance - statements of the Scientific Committee on Musculoskeletal Disorders of the International Commission on Occupational Health. BMC Musculoskelet Disord 2012;13:109
7. Rempel D, Evanoff B, Amadio PC, et al: Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health 1998; 88:1447-1451
8. Verbeek J: When work is related to disease, what established evidence for a causal relation?
Saf Health Work 2012; 3:110-6. 2
9. Boschman JS, Brand T, Frings-Dresen MH, van der Molen HF: Improving the assessment of occupational diseases by occupational physicians.Occup Med (Lond) 2017; 67 :13-19
10. Greaves WW, Das R, McKenzie JG, et al: Work-Relatedness. J Occup Environ Med 2018; 60: e640-e646
11. Alonso-Coello P, Schünemann HJ, Moberg J, et al (GRADE Working Group): GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ 2016 Jun 28;353:i2016
12. Strömberg T, Dahlin LB, Brun A, Lundborg G: Structural nerve changes at wrist level in workers exposed to vibration. Occup Environ Med. 1997; 54:307-311
13. Palmer K, Walker-Bone K, Linaker C, et al: The Southampton examination schedule for the diagnosis of musculoskeletal disorders of the upper limb. Ann Rheum Di. 2000; 59:5-11
14. Hegmann KT, Thiese MS, Wood EM, et al: Impacts of differences in epidemiological case definitions on prevalence for upper-extremity musculoskeletal disorders. Hum Factors 2014; 56:191-202
15. Walker HK, Hall WD, Hurst JW (editors): Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Accesible at: https://www.ncbi.nlm.nih.gov/books/NBK201/
16. Hermans J, Luime JJ, Meuffels DE, et al: Does this patient with shoulder pain have rotator cuff disease? The Rational Clinical Examination systematic review. JAMA 2013; 310:837-347
17. Verbeek J, Mischke C, Robinson R, et al: Occupational exposure to knee loading and the risk of osteoarthritis of the knee: A systematic review and dose-response meta-analysis. Saf Health Work 2017; 8:130-142
18. Alonso-Coello P, Oxman AD, Moberg J, et al (GRADE Working Group): GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ. 2016 30;353:i2089
19. Van der Molen HF, Foresti C, Daams JG, et al: Work-related factors for specific shoulder disorders: a systematic review and meta-analysis. Occup Environ Med 2017; 74:745-755
20. Kuijer PPFM, Verbeek JH, Seidler A, et al: Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis. Neurology 2018; 91:558-564
21. Verbeek J, Burdorf A: National variations in back pain: ecological fallacy or cultural differences? Scand J Work Environ Health. 2014; 40:1-3
22. Althubaiti A: Information bias in health research: definition, pitfalls, and adjustment methods.
J Multidiscip Healthc 2016; 9:211-217
23. Sackett DL: The rational clinical examination. A primer on the precision and accuracy of the clinical examination. JAMA 1992; 267:2638-2644
24. Wright C, Smith B, Wright S, et al: Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity. Obstet Med 2014; 7:90-94