title: Long-term effects of biomechanical exposure on severe shoulder pain in the Gazel cohort.
abstract: OBJECTIVE
  We aimed to assess whether the risk factors for severe shoulder pain, especially exposure to arm         elevation, were still relevant after a 12-year follow-up, even following retirement.
  
  
  METHODS
  All men participating in         the ARPEGE ancillary study of the GAZEL cohort (followed-up since 1989) and who answered the 1994 or 1995 general GAZEL         self-administered questionnaire were included. Weight and self-reported exposure (arm elevation >90° with and         without carrying loads) over the entire working life were collected at baseline (1994-1995). Shoulder pain and         its intensity were recorded in 1994-1995 and again in 2006. Shoulder pain was measured on an intensity or         discomfort 6-point scale in 1994-1995 and on an 8-point scale in 2006. Severe shoulder pain was defined as         point-rated higher than the mid-points (>3/6 in 1994-1995 and >4/8 in 2006) while moderate pain was lower         or equal to these thresholds.
  
  
  RESULTS
  At baseline, 1786 47-51-year-old men were included. In 1994-1995,         moderate pain was observed among 8.5% (N=151) of men and severe shoulder pain among 14.6% (N=261). Exposure to arm         elevation >90° while carrying loads was significantly associated with severe shoulder pain with >25 years of         exposure [adjusted odds ratio (OR         (adj)) 4.2, 95% confidence interval (95% CI) 1.7-10.5], taking into account age, sports, smoking habits,         history of shoulder trauma, and body mass index. In 2006, when most of the subjects had retired, 1482 men (83.0%)         answered the questionnaire, 17.3% of them with severe shoulder pain; the association between exposure to arm elevation         >90° while carrying loads and severe shoulder pain was still significant (ORadj 3.3, 95% CI 1.3-8.0), and         remained so when subjects with shoulder pain at baseline were excluded.
  
  
  CONCLUSIONS
  Among men, the effect of high         shoulder exposure (arm elevation >90° while carrying loads) during working life on severe shoulder pain remains         even after retirement. Extended surveillance and prevention should be offered to these workers.
authors.affiliation: Université de Versailles Saint Quentin-Inserm, Centre for Research in Epidemiology & Population Health, Population-Based Epidemiological Cohorts Research Platform, Villejuif, France. alexis.descatha@rpc.aphp.fr
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
authors.forename: Denis
authors.initials: D
authors.lastname: Teysseyre
authors.forename: Diane
authors.initials: D
authors.lastname: Cyr
authors.forename: Ellen
authors.initials: E
authors.lastname: Imbernon
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Chastang
authors.forename: Aurélia
authors.initials: A
authors.lastname: Plenet
authors.forename: Sébastien
authors.initials: S
authors.lastname: Bonenfant
authors.forename: Marie
authors.initials: M
authors.lastname: Zins
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
mesh_terms: D001696:Biomechanical Phenomena; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020069:Shoulder Pain / Q000503:physiopathology*; D011795:Surveys and Questionnaires