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Epidemiology of musculoskeleteal disorders

Epidemiology of musculoskeleteal disorders. Prof.Dr.Selma KARABEY. C ondition : A state of health ,a state of readiness or physical fitness , a disease or physical ailment . Disorder: An ailment that affects the function of mind or body .

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Epidemiology of musculoskeleteal disorders

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  1. Epidemiology of musculoskeletealdisorders Prof.Dr.Selma KARABEY

  2. Condition: A state of health,a state of readiness or physical fitness, a disease or physical ailment. • Disorder: An ailment that affects the function of mind or body. • Disease: The failure of an organism to adequately or appropriately counteractstresses or stimuli, which can be biological, behavioral, or environmental,resulting in sickness or disability.

  3. 1 M00–M99 – Diseases of the musculoskeletal system and connective tissue • 1.1 (M00–M25) Arthropathies • 1.1.1 (M00–M03) Infectious arthropathies • 1.1.2 (M05–M14) Inflammatory polyarthropathies • 1.1.3 (M15–M19) Arthrosis • 1.1.4 (M20–M25) Other joint disorders • 1.2 (M30–M36) Systemic connective tissue disorders • 1.3 (M40–M54) Dorsopathies • 1.3.1 (M40–M43) Deforming dorsopathies • 1.3.2 (M45–M49) Spondylopathies • 1.3.3 (M50–M54) Other dorsopathies • 1.4 (M60–M79) Soft tissue disorders • 1.4.1 (M60–M63) Disorders of muscles • 1.4.2 (M65–M68) Disorders of synovium and tendon • 1.4.3 (M70–M79) Other soft tissue disorders • 1.5 (M80–M90) Osteopathies • 1.6 (M91–M94) Chondropathies • 1.7 (M95–M99) Other disorders of the musculoskeletal system and connective tissue

  4. Prevalence of SelectMedical Conditions in the U.S.Population • Musculoskeletal conditions (MSC) are the most common cause of severe long term pain anddisability, • lead to significant healthcare and social support costs, • as a majorcause of work absence and incapacity • they have a significant economic cost through lost productivity.

  5. Prevalence of SelectMedical Conditions in the U.S. Population • The prevalence of many MSC and their associated disability increases with • ageing, • obesityand • lack of physical activity.

  6. Prevalence of SelectMedical Conditions in the U.S. Population • MSCs werereported by 110.34 million adults in the U.S.in 2008 in the National Health InterviewSurvey (NHIS) • (½ of persons aged 18 and over of the estimated 2008population) • The rate of chronic MSCs found in the adult population is 60%greater than that of chronic circulatory conditions, • more than twice that of all chronic respiratoryconditions.

  7. Prevalence of SelectMedical Conditions in the U.S. Population • Amongfemales, 53 in every 100 in the population reportmusculoskeletal conditions; • among males therate is 45 per 100, a slight increase in recent years.

  8. Prevalence of SelectMedical Conditions in the EU Population • In a 2007 EU survey,22% of the population currently had, or had experienced long-term muscle, bone andjoint problems such as rheumatism and arthritis. • The most common musculoskeletal pain experienced is back pain; • pain is the mostprominent symptom in most people with arthritis • and is the most important determinant of disability in patients with osteoarthritis.

  9. Turkey health statistics • The distribution of disease orhealth problems in individuals aged 15 years and over, in Turkey: 1)Hypertension; 8.7% in males, 17.6% in females, 13.2% in both total 2)Lumbar region of musculoskeletal problems(low back pain, herniateddisc):9.6% in males, 15.9% in females,12.8% in both total 3) Rheumatoiddisease(RA):5.3% in males, 12.7% in females, 9.1% in both total 6) Arthritis(OA, arthrosis, degenerativejointdisease): 3.6% in males, 9.4% in females, 6.5% in both total 7) Neckregion of musculoskeletalproblems( neckpain, herniateddisc):3.1% in males, 8.8% in females, 6% in both total Turkey health statistics yearbook 2012

  10. Turkey health statistics • Thedistribution of thediseaseorhealthproblemsthataredeterminedbythephysicianin individuals aged 15 years and over, in Turkey: 1) Lumbar region of musculoskeletal problems(low back pain, herniated disc):8% inmales, 13.8% in females, 10.9% in both total 3) Rheumatoiddisease(RA): 4.25% in males,11.4% in females,7.9% in both total 5) Arthritis(OA, arthrosis, degenerative joint disease):3.1% in males, 8.8% in females, 6% in both total 8) Neck region of musculoskeletal problems( neck pain, herniated disc):4.2% in males, 5.4% in females, 4.8% in both total Turkey health statistics yearbook 2012

  11. TÜİK Ölüm Nedeni İstatistikleri, 2013

  12. The Eurobarometer Report on Health in the EU • Activity restrictingmusculoskeletalpain: • 32% of all respondents • 44% of those 55 years and over said that in the preceding weekthey experienced • Muscle, • joint, • neck • back pain which affected their daily activities.

  13. The Eurobarometer Report on Health in the EU • Women were more likely than men to experience this pain (37% vs. 27%). • Countries reporting particularly high levels of reduced activities due to pain were Finland(44%) and Lithuania (42%). • The lowest proportions reporting activity reducing pain were Ireland (18%) and Portugal (21%).

  14. MSC related mortality • Osteoarthritis and rheumatoid arthritis are associated withincreased mortality due to an increased risk of co-morbidities and the adverse effects ofmedication. • Mortality rates are up to 20-24% in the first year after a hip fracture and thegreater risk of dying may persist for at least 5 years afterwards

  15. Determinants of MusculoskeletalHealth

  16. Turk and Okifuji 1997, Statistisches Bundesamt 1998, Schneider et al. 2005

  17. Turk and Okifuji 1997, Statistisches Bundesamt 1998, Schneider et al. 2005

  18. Turk and Okifuji 1997, Statistisches Bundesamt 1998, Schneider et al. 2005

  19. Age • Eurostat projections indicate that while the total population of the EU-25 will fall onlyslightly by 2050, the age structure will change dramatically. • By 2050, the EU will have 48million less people of aged 15- to 64-year-olds and 58 million more people aged 65 andover.

  20. Obesity • Obesity is associated with a range of disablingconditions inadults • there is evidence that childhood obesity can have a significant effect on achild’s musculoskeletal system (Anandacoomarasamy et al 2008, Shiri et al 2010, Tsiros etal 2011). • Obesity rates vary substantially across the EU with the lowest adult rate inRomania,the highest in the UK. • Across all EU countries the prevalence of obesity ishigher in women than men (OECD 2010).

  21. Physical activity and exercise • Physical activity is essential for good musculoskeletal health. • It can increase bone densityin adolescents, • maintain it in adults and slow its decline in old age. • The average proportion of people in the EU 27 who say they never do any exercise or do sovery rarely is 24%. • However this varies widely from 51% in Lithuania to 14% in Germany.

  22. Diet and nutrition An adequate intake of calcium and Vitamin D is essential for bone formation and themaintenance of musculoskeletal health. Inadequate vitamin D can cause rickets, osteoporosis in adults, osteomalacia. The European Male Ageingstudy (McBeth 2010) indicated that musculoskeletal pain is associated with very low levels of Vitamin D in men. Vitamin D inadequacy is particularly common among patients with osteoporosis.

  23. Alcohol • Consumption of alcohol is related to over 60 medical conditions, including the increasedrisk of some skeletal conditions, such as fractures and muscle diseases (Anderson &Baumberg, 2006) • There is some evidence that women with low levels of alcohol intakehave higher bone density than women with higher levels of alcohol intake (Lu et al 2010) • Moderate alcohol consumption may decrease the risk for RA and RA progression(Lu et al 2010).

  24. Smoking • Smoking is a well-established environmental risk factor for the development of rheumatoidarthritis (RA). • There is evidence of an overall negative association betweensmoking and osteoarthritis. • Europe smoking prevalence is higher amongmen than women. • The overall prevalence of smoking is higher among younger people thanolder generations. • Deprivation, including poverty and lower educational levels are relatedto higher rates of smoking in the population. (ASPECT, 2004).

  25. Work type • MSDs are the single largestcategory of work-related illness, representing athird or more of all registered occupational diseases inthe United States, the Nordic countries, and Japan. • Numerous surveys of working populationshave reported upper extremity symptom prevalences of20 to 30% or even higher.

  26. Changing lifestyles and the prevention ofmusculoskeletalconditions • Lifestyles to optimise musculoskeletal health include: • Physical activity to maintain physical fitness • Maintaining an ideal weight • A balanced diet that meets the recommended daily allowance for calcium andvitamin D • The avoidance of smoking • The balanced use of alcohol and avoidance of alcohol abuse

  27. Put Pain in Its Place • How to Get Osteoarthritis Pain Under Control • Put Pain in Its Place gives you the tools to manage your Osteoarthritis (OA) pain and live better. Developed by the experts you trust at the Arthritis Foundation in conjunction with the National Council on Aging and sponsored by Ferring Pharmaceuticals, Inc., this program will help you: • Understand OA, its causes and how to treat it • Learn self-management strategies to prevent and relieve pain • Get inspired to take action and get your pain under control • Find out about effective and safe exercises from the Arthritis Foundation Exercise Program

  28. About the Program • Move More, Feel Great! • Life With Arthritis empowers people with both arthritis and diabetes to incorporate physical activity and healthy eating into their daily routine. Developed in partnership with the American Diabetes Association, this informative two-hour class will help people: • Understand the relationship between arthritis and diabetes and what that means for their health • Learn how to incorporate exercise and good eating habits into their everday life • Find out about safe, effective physical activity programs that can be done individually or in a group setting

  29. Secondary Fracture Prevention Programs • In the U.S., Kaiser Permanente’s Healthy Bones program has reduced the expected hip fracture rate by 38 percent since 1998 Geisinger Health System achieved $7.8 million in cost savings over five years. • The FLS (Fracture Liaison Service) model of care is a tested, effective way to improve patient outcomes, decrease health care costs and improve provider quality measure compliance. • FLS programs coordinate post-fracture care through a FLS coordinator (a nurse practitioner, physician’s assistant, nurse or other health professional) who ensures that individuals who suffer a fracture receive appropriate diagnosis, treatment and support

  30. ‘School Milk’ Programs in the World • In more than 80 countries around the worldthe School Milk project was implemented, in different periods. • Netherlands, Denmark, Czech Republic, China, Portugal and Sweden are the most successful of them.

  31. ‘School Milk’ Programs in Turkey • 7 million 200 thousand 144 million cans of milk were distributed to students32 thousand 500 schoolsin Turkey ,in 2011-2012 Academic Year. • 296 million cans of milkwere distributedto6 million 172 thousand 692 master classes and elementary school studentsin Turkey, in 2012-2013 AcedemicYear. • From 10 February 2014, 303 million boxes,in reliable, 200 mL healthy packaging, fat, plain UHT milk will be distributedto 6 million 330 thousand 215 students,3 days a week (Monday, Wednesday, Friday)

  32. References and Web Sources • The Burden of Musculoskeletal Diseases in the United States, • http://www.boneandjointburden.org/ • Musculoskeletal Health in EuropeReport v5.0 • http://www.eumusc.net/mwginternal/de5fs23hu73ds/progress?id=qzA6pLxKYU • TURKEY BURDEN OF DISEASESTUDY2004 • http://ekutuphane.tusak.gov.tr/kitaplar/turkey_burden_of_disease_study.pdf • T.C Sağlık Bakanlığı, Sağlık İstatistikleri Yıllığı 2012 • Oxford Textbook of Public Health, Musculoskeletal Diseases, Roger Detels, Robert Beaglehole, Mary Ann Lansang, Martin Gulliford, 2009 • Dictionary ofpublic healthpromotionand education,Terms and Concepts,NaomıN . Modeste, Teri S .Tamayose,2004 • Musculoskeletal Disorders andWorkplace FactorsA Critical Review of Epidemiologic Evidence forWork-Related Musculoskeletal Disorders of the Neck,Upper Extremity, and Low Back, Edited by:Bruce P. Bernard,1997

  33. References and Web Sources • Impact of musculoskeletal disorders and social determinants on health inconstruction workers, Sameer Valsangkar, K. Surendranath Sai, Int J Biol Med Res. 2012; 3(2):1727-1730 • Work-related musculoskeletal disorders: the epidemiologic evidenceand the debateLaura Punnett , David H. Wegman,Journal of Electromyography and Kinesiology 14 (2004) 13–23, • Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-studyH.S.J. Picavet, J.S.A.G. Schouten, Pain 102 (2003) 167–178 • http://www.sciencedirect.com/science/article/pii/S030439590200372X# • Arthritis Foundation • http://www.arthritis.org/resources/community-programs/educational-programs • Centers for Diseases Control and Prevention • http://www.cdc.gov/injury/stateprograms/index.html

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