Musculoskeletal conditions are a major burden on individuals, health systems, and social care systems, with indirect costs being predominant. This burden has been recognized by the United Nations and WHO, by endorsing the Bone and Joint Decade 2000-2010. This paper describes the burden of four major musculoskeletal conditions: osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain. Osteoarthritis, which is characterized by loss of joint cartilage that leads to pain and loss of function primarily in the knees and hips, affects 9.6% of men and 18% of women aged > 60 years. Increases in life expectancy and ageing populations are expected to make osteoarthritis the fourth leading cause of disability by the year 2020. Joint replacement surgery, where available, provides effective relief. Rheumatoid arthritis is an inflammatory condition that usually affects multiple joints. It affects 0.3-1.0% of the general population and is more prevalent among women and in developed countries. Persistent inflammation leads to joint destruction, but the disease can be controlled with drugs. The incidence may be on the decline, but the increase in the number of older people in some regions makes it difficult to estimate future prevalence. Osteoporosis, which is characterized by low bone mass and microarchitectural deterioration, is a major risk factor for fractures of the hip, vertebrae, and distal forearm. Hip fracture is the most detrimental fracture, being associated with 20% mortality and 50% permanent loss in function. Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4-33% of the population at any given point. Cultural factors greatly influence the prevalence and prognosis of low back pain.

/pdf/burden-of-major-musculoskeletal-conditions-1xayk0ikb2.pdf

Burden of major musculoskeletal conditions

1. Place animal in induction chamber and anesthetize the mouse and ensure sedation. 2. Once the animal is sedated, move it to a nose cone for hair removal using cream. Only apply cream to the area of the chest that will be utilized for imaging. Once the hair is removed, wipe area with wet gauze to ensure all hair is removed. 3. Move the animal to the imaging platform and tape its paws to the ECG lead plates and insert rectal probe. Body temperature should be maintained at 36-37°C. During imaging, reduce anesthesia to maintain proper heart rate. If the animal shows signs of being awake, use a higher concentration of anesthetic.

人唾液天疱疮抗原的纯化

Background National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective of this study was to determine whether the prevalence of chronic LBP and the demographic, health-related, and health care–seeking characteristics of individuals with the condition have changed over the last 14 years. Methods A cross-sectional, telephone survey of a representative sample of North Carolina households was conducted in 1992 and repeated in 2006. A total of 4437 households were contacted in 1992 and 5357 households in 2006 to identify noninstitutionalized adults 21 years or older with chronic (>3 months), impairing LBP or neck pain that limits daily activities. These individuals were interviewed in more detail about their health and health care seeking. Results The prevalence of chronic, impairing LBP rose significantly over the 14-year interval, from 3.9% (95% confidence interval [CI], 3.4%-4.4%) in 1992 to 10.2% (95% CI, 9.3%-11.0%) in 2006. Increases were seen for all adult age strata, in men and women, and in white and black races. Symptom severity and general health were similar for both years. The proportion of individuals who sought care from a health care provider in the past year increased from 73.1% (95% CI, 65.2%-79.8%) to 84.0% (95% CI, 80.8%-86.8%), while the mean number of visits to all health care providers were similar (19.5 [1992] vs 19.4 [2006]). Conclusions The prevalence of chronic, impairing LBP has risen significantly in North Carolina, with continuing high levels of disability and health care use. A substantial portion of the rise in LBP care costs over the past 2 decades may be related to this rising prevalence.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/414769/ioi80169_251_258.pdf

The rising prevalence of chronic low back pain.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673611606107.pdf

Non-specific low back pain

1.1. History
Formaldehyde was described in the year 1855 by the Russian scientist Alexander Michailowitsch Butlerow. The technical synthesis by dehydration of methanol was achieved in 1867 by the German chemist August Wilhelm von Hofmann. The versatility that makes it suitable for use in various industrial applications was soon discovered, and the compound was one of the first to be indexed by Chemical Abstracts Service (CAS). In 1944, Walker published the first edition of his classic work Formaldehyde.(1) Between 1900 and 1930, formaldehyde-based resins became important adhesives for wood and wood composites. The first commercial particle board was produced during World War II in Bremen, Germany. Since 1950, particle board has become an attractive alternative to solid wood for the manufacturing of furniture. Particle board and other wood-based panels were subsequently also used for the construction of housing. Adverse health effects from exposure to formaldehyde in prefabricated houses, especially irritation of the eyes and upper airways, were first reported in the mid-1960s. Formaldehyde emissions from particle boards bonded with urea formaldehyde resin were soon identified as the cause of the complaints. As a consequence, a guideline value of 0.1 ppm was proposed in 1977 by the former German Federal Agency of Health to limit human exposure in dwellings. Criteria for the limitation and regulation of formaldehyde emissions from wood-based materials were established in 1981 in Germany and Denmark. The first regulations followed in the United States in 1985 or thereabouts. In Germany and the United States, large-scale test chambers were used for the evaluation of emissions. Although the chamber method is very reliable, it is also time-consuming and expensive. This meant there was a strong demand for simple laboratory test methods.(2)

Formaldehyde in the Indoor Environment

Objective: To determine the prevalence, interrelation, and impact of musculoskeletal disorders of the upper limb in the general population. Methods: A total of 9,696 randomly selected adults of working age were surveyed in a 2-stage cross-sectional study involving a screening questionnaire and a standardized physical examination in symptomatic subjects. Age- and sex-specific prevalence rates were estimated for several musculoskeletal disorders and for nonspecific pain in the upper limbs. The overlap and impact on daily activities and healthcare utilization were explored. Results: Among 6,038 first-stage responders, 3,152 reported upper limb symptoms and 1,960 were subsequently examined. Of subjects with pain, 44.8% had 1 or more specific soft-tissue disorders. Site-specific prevalence rates were as follows: shoulder tendinitis 4.5% among men and 6.1% among women; adhesive capsulitis 8.2% among men and 10.1% among women; lateral epicondylitis 1.3% among men and 1.1% among women; de Quervain's disease 0.5% among men and 1.3% among women; other tenosynovitis of the hand or wrist, 1.1% among men and 2.2% among women. Specific disorders tended to cluster (P Conclusion: Upper limb pain is common in the general population and is often associated with physical signs suggestive of specific upper-limb disorders. These disorders have a substantial impact on physical function and use of health care.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.20535

Prevalence and impact of musculoskeletal disorders of the upper limb in the general population

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 98: Painting, Firefighting and Shiftwork. International Agency for Research on Cancer

Objectives To assess occupational risk factors for carpal tunnel syndrome (CTS), we conducted a systematic literature review. Methods We identified relevant primary research from two major reviews in the 1990s and supplemented this material by a systematic search of the MEDLINE and EMBASE biomedical databases from the start of the electronic record to 1 January 2005. Reports were obtained and their bibliographies checked for other relevant publications. From each paper, we abstracted a standardized set of information on study populations, exposure contrasts and estimates of effect. Results Altogether, we summarized 38 primary reports, with analyses based either on a comparison of job titles (22) or of physical activities in the job (13) or both (3). We found reasonable evidence that regular and prolonged use of hand-held vibratory tools increases the risk of CTS >2-fold and found substantial evidence for similar or even higher risks from prolonged and highly repetitious flexion and extension of the wrist, especially when allied with a forceful grip. The balance of evidence on keyboard and computer work did not indicate an important association with CTS. Discussion Although the papers that we considered had limitations, a substantial and coherent body of evidence supports preventive policies aimed at avoiding highly repetitive wrist–hand work. There is a case for extending social security compensation for CTS in the United Kingdom to cover work of this kind.

/pdf/carpal-tunnel-syndrome-and-its-relation-to-occupation-a-na3nyjggjl.pdf

Carpal tunnel syndrome and its relation to occupation: a systematic literature review

Farming is a physically arduous occupation and this places farm workers at potential risk of musculoskeletal disorders such as osteoarthritis (OA) of the hip and knee, low back pain (LBP), neck and upper limb complaints, and hand-arm vibration syndrome (HAVS). This review considers the epidemiological evidence concerning such risks. The strongest evidence relates to OA of the hip, for which the public health impact is likely to be considerable. There is also weaker, but suggestive evidence that farmers more often have knee OA and LBP than workers in occupations with fewer physical demands. Tractor drivers, in particular, seem to have more LBP. Relatively little information exists on the risks of soft tissue rheumatism in the limbs and neck. For some outcomes, the link with occupational risk factors (such as heavy loading of joints and whole-body vibration) is sufficient to suggest the course that future prevention should take, but for several outcomes more research is first needed.

/pdf/musculoskeletal-disorders-in-farmers-and-farm-workers-4x9qaw9xj5.pdf

Musculoskeletal disorders in farmers and farm workers.

Objectives: To explore the relation between smoking habits and regional pain in the general population. 

Methods: A questionnaire was mailed to 21 201 adults, aged 16–64 years, selected at random from the registers of 34 British general practices, and to 993 members of the armed services, randomly selected from pay records. Questions were asked about pain in the low back, neck, and upper and lower limbs during the past 12 months; smoking habits; physical activities at work; headaches; and tiredness or stress. Associations were examined by logistic regression and expressed as prevalence ratios (PRs). 

Results: Questionnaires were completed by 12 907 (58%) subjects, including 6513 who had smoked at some time, among whom 3184 were current smokers. Smoking habits were related to age, social class, report of headaches, tiredness or stress, and manual activities at work. After adjustment for potential confounders, current and ex-smokers had higher risks than lifetime non-smokers for pain at all of the sites considered. This was especially so for pain reported as preventing normal activities (with PRs up to 1.6 in current v never smokers). Similar associations were found in both sexes, and when analysis was restricted to non-manual workers. 

Conclusions: There is an association between smoking and report of regional pain, which is apparent even in ex-smokers. This could arise from a pharmacological effect of tobacco smoke (for example, on neurological processing of sensory information or nutrition of peripheral tissues); another possibility is that people with a low threshold for reporting pain and disability are more likely to take up and continue smoking.

https://ard.bmj.com/content/annrheumdis/62/1/33.full.pdf

Keith T Palmer

Papers

Prevalence and impact of musculoskeletal disorders of the upper limb in the general population

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 98: Painting, Firefighting and Shiftwork. International Agency for Research on Cancer

Carpal tunnel syndrome and its relation to occupation: a systematic literature review

Musculoskeletal disorders in farmers and farm workers.

Smoking and musculoskeletal disorders: findings from a British national survey