title: Does obesity modify the relationship between exposure to occupational factors and musculoskeletal pain in men? Results from the GAZEL cohort study.
abstract: OBJECTIVE
  To analyze relationships between physical occupational exposures, post-retirement shoulder/knee pain, and obesity.
  
  
  METHODS
  9 415 male participants (aged 63-73 in 2012) from the French GAZEL cohort answered self-administered questionnaires in 2006 and 2012. Occupational exposures retrospectively assessed in 2006 included arm elevation and squatting (never, <10 years, ≥10 years). "Severe" shoulder and knee pain were defined as ≥5 on an 8-point scale. BMI was self-reported.
  
  
  RESULTS
  Mean BMI was 26.59 kg/m2 +/-3.5 in 2012. Long-term occupational exposure to arm elevation and squatting predicted severe shoulder and knee pain after retirement. Obesity (BMI≥30 kg/m2) was a risk factor for severe shoulder pain (adjusted OR 1.28; 95% CI 1.03, 1.90). Overweight (adjusted OR 1.71; 1.28,2.29) and obesity (adjusted OR 3.21; 1.90,5.41) were risk factors for severe knee pain. In stratified models, associations between long-term squatting and severe knee pain varied by BMI.
  
  
  CONCLUSIONS
  Obesity plays a role in relationships between occupational exposures and musculoskeletal pain. Further prospective studies should use BMI in analyses of musculoskeletal pain and occupational factors, and continue to clarify this relationship.
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France; Harvard College, Cambridge, MA, United States of America.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Evanoff
authors.affiliation: Harvard Center for Population and Development Studies, Cambridge, MA, United States of America.
authors.forename: Erika L
authors.initials: EL
authors.lastname: Sabbath
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Carton
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France; Department of Nutrition, Assistance Publique-Hopitaux de Paris, Ambroise Paré University Hospital, Boulogne-Billancourt, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Zins
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France.
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
authors.affiliation: Univ Versailles St-Quentin, Versailles, France; UMS 011 Population-based Epidemiologic Cohorts Unit Inserm, Villejuif, France; Occupational Health Unit/EMS (Samu92), AP-HP, University hospital of Poincaré, Garches, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
mesh_terms: D000368:Aged; D015331:Cohort Studies; D006801:Humans; D007717:Knee / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D059352:Musculoskeletal Pain / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D009784:Occupational Diseases / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012782:Shoulder / Q000473:pathology