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It was estimated that there were over 313 million non-fatal occupational accidents worldwide in 2010. In order to reduce occupational accident rate, it is necessary to determine its associated factors. Musculoskeletal symptoms have been shown: to act as a mediating factor between ergonomic conditions and occupational accidents; to be associated with perceived risk of injury; and to increase the probability of accidents. Therefore, the aim of this study was to investigate whether self-reports of musculoskeletal symptoms were associated with occupational accidents occurrence.A hospital-based case control study was conducted among workers aged 17–59 years and residing in Botucatu, Brazil. The study included cases of occupational accidents that required hospitalisation. Controls were patients who suffered a non-work-related accident. Altogether, 80 cases and 125 controls were included. Self-reports of musculoskeletal symptoms were obtained using the Nordic Musculoskeletal Questionnaire, while a standardised questionnaire was used to assess socio-demographic factors. Frequency statistics and logistic regression were conducted to analyse the data.The highest musculoskeletal symptoms prevalence was for the low back, followed by shoulders and the upper back. Self-reports of upper back musculoskeletal symptoms in the last 7 days and the occurrence of occupational accidents were associated (OR=3.670, 95% CI: 1.503 to 8.963).According to our results, musculoskeletal symptoms in the upper back do predict occupational accidents. However, we believe that further studies, with a method of musculoskeletal symptoms assessment capable of discriminating between serious and minor complaints, are necessary to determine whether self-reports of musculoskeletal symptoms in other regions are also associated with the occurrence of occupational accidents.