Epidemiological surveillance of lumbar disc surgery in 2007-2008 in the general population from the Pays de la Loire region, France

Purposes Lumbar disc-related disorders are a main cause of work-related osteo-articular morbidity [1]. To implement a system for epidemiological surveillance of these disorders, lumbar disc surgery (LDS) was chosen as sentinel event. LDS was identified in the medical databases from public and private hospitals. The aim of this study was to describe the association between LDS and industry sectors and occupational categories, and to evaluate their contribution to the occurrence of LDS. Methods Epidemiological surveillance of LDS in the general population was set up at the centres for spinal surgery in the Pays de la Loire region. This surveillance system for LDS was implemented in the five areas of the Pays de la Loire region (West Central France), using the 2007-2008 hospital databases. Inpatients were included if they: - were aged from 20 to 64 years; - lived in this region; - had undergone LDS in 2007 and 2008 in the participating centres. Medical and work histories were obtained by postal questionnaire. The Centres databases identified 3,150 inpatients, without age limits. Association between LDS and industry sectors (or occupational categories) was estimated by age-adjusted relative risk (RRa). The contribution of the industry sectors (or occupational categories) to the occurrence of LDS was quantified with the population attributable fraction of risk (PAF). Results 1,860 exploitable questionnaires (909 men and 761 women, 66.5% response rate) had been obtained. The industry sectors associated with higher risks of LDS were the construction and transportation sectors in men. In women, 6 industry sectors were exposed to higher risk of LDS (Table). This suggests that between 1 and 7% of LDS cases occurring in the whole population might be avoided by reducing the risk excess in these industry sectors. The occupational categories at high risk of LDS were the technicians and intermediate occupations for both genders, blue-collar workers for men (RRa=2.1 [1.8-2.4], PAF=25 [21-30]) and lower grade white-collar workers for women (RRa=2.0 [1.8-2.4], PAF=25 [20-30]). Conclusions This surveillance system of LDS can identify occupations and industries at risk. The results suggested that 1 to 5% of LDS cases might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industry sectors