Social position modifies the association between severe shoulder/arm and knee/leg pain, and quality of life after retirement.
OBJECTIVE
Musculoskeletal disorders are extremely frequent and account for an important part of the global burden of disease. Risk factors for musculoskeletal disorders include sustained occupational exposure to physically demanding jobs. The effects of sustained occupational physical exposures on knee and shoulder pain are known to persist after retirement; also, several studies have shown a socio-economic gradient in health and quality-of-life outcomes, including for musculoskeletal pain. It is thus possible that prolonged occupational exposures affect workers differently in the long-term along a socio-economic gradient. This study was conducted to investigate whether the impacts of severe shoulder/arm and knee/leg pain on the quality of life of retired workers follow a socio-economic gradient.


METHODS
Data from the French GAZEL cohort study (n = 14,249) were used to compare the impacts of severe shoulder/arm and knee/leg pain separately on the SF-36, Nottingham Health Profile and limitations in activities of daily living measured in 2006 and 2007, between four groups of social position (measured in 1989). Analyses were made in 2014 with multiple linear and logistic regressions and stratified by sex.


RESULTS
For both pain sites, in men and women, there was a strong general tendency for the impacts of severe pain to be smaller among participants in higher social positions. Most important differences were related to pain and physical limitations.


CONCLUSIONS
These results suggest inequalities in the impacts of severe joint pain by socio-economic status. The source of these inequalities is still speculative and merits the scientific attention.
Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche FRQS du Centre hospitalier universitaire (CHU) de Québec, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Québec City, QC, G1S 4L8, Canada. clermont.dionne@uresp.ulaval.ca.|Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France. clermont.dionne@uresp.ulaval.ca.
Clermont E
CE
Dionne
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.
Annette
A
Leclerc
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.
Matthieu
M
Carton
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.|AP-HP, Occupational Health Unit/EMS (Samu92), University Hospital of West Suburb of Paris, Poincaré site, 92380, Garches, France.
Zakia
Z
Mediouni
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.
Marcel
M
Goldberg
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.
Marie
M
Zins
Population-Based Epidemiological Cohorts Unit, Inserm-UVSQ, UMS 011, 94807, Villejuif, France.|Université Versailles St-Quentin en Yvelines, 78035, Versailles, France.|AP-HP, Occupational Health Unit/EMS (Samu92), University Hospital of West Suburb of Paris, Poincaré site, 92380, Garches, France.
Alexis
A
Descatha
D000328:Adult; D001132:Arm; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007717:Knee; D007866:Leg; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology* / Q000523:psychology; D009784:Occupational Diseases / Q000209:etiology* / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects; D011788:Quality of Life; D012179:Retirement / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D012782:Shoulder; D020069:Shoulder Pain / Q000209:etiology / Q000523:psychology; D012923:Social Class; D013997:Time Factors
Knee pain; Quality of life; Retirement; Shoulder pain; Social inequalities