Pre-employment examination for low back risk in workers exposed to manual handling of loads: French guidelines.
BACKGROUND
Low back pain (LBP) is a major cause of sickness absence and disability in the working population, and the pre-employment examination should insure that worker's state of health is compatible with the requirements of proposed job. This paper summarizes the main recommendations of the good practice guidelines of the French Society of Occupational Medicine for pre-employment examination in workers exposed to manual handling of loads apart from pre-employment test.


METHODS
The recommendations were developed according to the Clinical Practice Guidelines proposed by the French National Health Authority and based on a systematic search of the literature 1990-2012 in several databases. The guidelines were written and reviewed by two multidisciplinary committees. On the basis of the level of evidence in the literature, the proposed guidelines are classified as grade A, B, C or expert consensus.


RESULTS
The main recommendations of these guidelines are as follows: (1) medical contraindications alone should not exclude employment in a job associated with a low back risk on the basis of a history of "simple" nonspecific LBP; (2) the relevance of examining a previous history of LBP, which is the best predictor of future LBP due to the recurrent nature of LBP.


CONCLUSIONS
These guidelines correspond to a constant concern with prevention of occupational risk. Primarily intended for occupational physicians, they are also intended for general practitioners who carry out pre-employment examinations in many countries and are likely to be increasingly faced with this type of situation because of the combination of increasing work constraints with ageing of the workforce.
Faculty of Medicine of Angers, Laboratory of Ergonomics and Epidemiology in Occupational Health, LUNAM University, Angers, France. aupetit@chu-angers.fr.|Occupational Health Department, University Hospital of Angers, Angers, France. aupetit@chu-angers.fr.|Centre de consultations de pathologie professionnelle, CHU Angers, 4 rue Larrey, 49933, Angers Cedex 9, France. aupetit@chu-angers.fr.
A
A
Petit
Intercompany Health Committee of Loiret, Orléans, France. s.rousseau@cihl45.com.
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S
Rousseau
Faculty of Medicine of Angers, Laboratory of Ergonomics and Epidemiology in Occupational Health, LUNAM University, Angers, France. jean-francois.huez@univ-angers.fr.|Department of Family Practice, Faculty of Medicine of Angers, Angers, France. jean-francois.huez@univ-angers.fr.
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JF
Huez
Department of Occupational Medicine and Health Education, University of Liège, Liège, Belgium. ph.mairiaux@ulg.ac.be.
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P
Mairiaux
Faculty of Medicine of Angers, Laboratory of Ergonomics and Epidemiology in Occupational Health, LUNAM University, Angers, France. yvroquelaure@chu-angers.fr.|Occupational Health Department, University Hospital of Angers, Angers, France. yvroquelaure@chu-angers.fr.
Y
Y
Roquelaure
D004651:Employment / Q000592:standards*; D005602:France; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000517:prevention & control; D009784:Occupational Diseases / Q000209:etiology* / Q000517:prevention & control; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D014938:Work Capacity Evaluation; D016526:Workload / Q000592:standards
Guidelines; Low back pain; Low back risk; Manual handling of loads; Pre-employment; Recommendations