title: The CADEUS study: burden of nonsteroidal anti-inflammatory drug (NSAID) utilization for musculoskeletal disorders in blue collar workers.
abstract: OBJECTIVE
  The aim of this study was to compare patterns of utilization of NSAIDs for musculoskeletal disorders (MSD) by occupation in a general employed population.
  
  
  METHODS
  This was a secondary analysis of the CADEUS cohort study on 5651 actively employed patients, who submitted at least one claim for the reimbursement of a NSAID dispensation for a MSD between August 2003 and July 2004, in the French National Healthcare Insurance database. Questionnaires were sent to prescribing physicians to obtain diagnoses and the medical history, and to patients for their occupation, height and weight and smoking status. Multivariate logistic regression was used to study the determinants of a heavy use of NSAIDs defined as 'over four dispensations in one year with less than two months between any two'.
  
  
  RESULTS
  Factors associated with heavy use of NSAIDs were age (Odds ratio (OR): 1.8 (ten years), 95% confidence interval (CI): 1.6-1.9), osteoarthritis (versus back pain) (OR: 1.8, 95% CI: 1.5-2.1), body mass index (superior to 30) (OR: 1.8, 95% CI: 1.5-2.2), and occupation (blue collar versus white collar workers) (OR: 1.4, 95% CI: 1.2-1.6). Blue collar workers also had a 20% higher prevalence of 5-year history of dyspepsia. No difference was observed between sexes or in the use of COX-2 selective inhibitors between occupations.
  
  
  CONCLUSIONS
  Factors associated with occupational constraints that contribute to the severity of MSDs, may explain the heavier use of NSAIDs among blue collar workers in spite of a concurrent and past medical history of adverse reactions to this type of medication.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. rossignol@santepub-mtl.qc.ca
authors.forename: Michel
authors.initials: M
authors.lastname: Rossignol
authors.forename: Abdelilah
authors.initials: A
authors.lastname: Abouelfath
authors.forename: Regis
authors.initials: R
authors.lastname: Lassalle
authors.forename: Yvon
authors.initials: Y
authors.lastname: Merlière
authors.forename: Cécile
authors.initials: C
authors.lastname: Droz
authors.forename: Bernard
authors.initials: B
authors.lastname: Bégaud
authors.forename: Fanny
authors.initials: F
authors.lastname: Depont
authors.forename: Yola
authors.initials: Y
authors.lastname: Moride
authors.forename: Patrick
authors.initials: P
authors.lastname: Blin
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Annie
authors.initials: A
authors.lastname: Fourrier-Réglat
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D017723:Drug Utilization Review; D004812:Epidemiologic Methods; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy*; D009784:Occupational Diseases / Q000188:drug therapy* / Q000453:epidemiology; D009790:Occupations; D055656:Prescriptions; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal