Theoretical Impact of Workplace-Based Primary Prevention of Lumbar Disc Surgery in a French Region: A Pilot Study

Abstract

Background: Lumbar disc-related disorders are a main cause of work-related osteo-articular morbidity. Lumbar disc surgery (LDS) has been chosen as sentinel event for the epidemiological surveillance of these disorders since LDS can be identified in the medical databases from public and private hospitals. Objective: To assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or workrelated risk factors for LDS. Methods: Cases of LDS were assessed using hospital discharge records for persons aged 20-64 in 2007-8 in the French Pays de la Loire region. We estimated the number of work-related cases of LDS (WR-LDS) in high-risk industry sectors. Three theoretical scenarios of workplace-based primary prevention have been simulated: a mono-component work-centered intervention reducing the incidence of WR-LDS by 10%, and two multicomponent global interventions reducing the incidence of all cases of LDS by 5% and 10% by targeting personal and occupational risk factors. Results: Four high-risk sectors were identified, amounting to 277 [216-352] cases, of which 98 [37-175] were WR-LDS: construction and information & communication for men; wholesale & retail trade and accommodation & food service activities for women. AFE was limited for each industry sector, 30%, 50%, 33% and 55%, respectively. Conclusions: Prevention scenarios combining actions on personal and occupational risk factors would be the most effective, compared to prevention focused only on occupational risk factors. Implementing actions of promotion of health at work would be necessary in addition of actions on occupational risks.