Descriptive Study on Musculoskeletal Disorders Among “Fromagers” (Workers of Cheese Shops) and Their Risk Factors

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To the Editor:
Occupational disorders related to cheese exposure have been recognized from many years.1 It has been indicated that cheese factory workers might suffer from lung and cutaneous disorders related to their working conditions.2–5 Musculoskeletal disorders have also been described in this industry but never in the special context of retailing.6,7
France is recognized worldwide for its cheese industry, and on the presence of small cheese shops in most cities. The owner, called the “artisan crémier-fromager” or more frequently “fromager,” is in charge of refining, cutting, preparing, and selling the many types of cheese. Our aim is, using data from a broad survey of the musculoskeletal disorders in various food retailers, to describe a sample of 461 “fromagers” and compare them to 4620 grocers.
The average age of the “fromagers” was 44.5 years (20 to 82 years), they were women (68.8%, n = 317). Severe or disabling musculoskeletal disorders affected 46.2% (n = 213), including musculoskeletal disorders of the hand/wrist, which accounted for 11.1% (n = 51) of these workers, significantly higher than for the grocers (P = 0.035). “Fromagers” were more exposed to polyvalent activities, trunk flexion, repetitive gesture, and cold temperatures (and less frequently to pallet unloading and difficult clients, Table 1). Among “fromager,” pallet unloading (though less frequent than grocers) and repetitive gesture were the main physical constraint significantly associated with the presence of severe or disabling musculoskeletal disorders of the hands after adjustment (odds ratio 2.4 [1.3;4.6]).
This study in a large French sample of this particular working condition highlights the need for prevention at the collective level of musculoskeletal disorders. “Fromagers” have high level of musculoskeletal pain in hands. Repetitive tasks of cutting and wrapping for cheese preparations, and bad trunk postures in cold environments seem the main risk factors of musculoskeletal pain. The cross-sectional design using phones survey is a major limitation and no causation is possible without longitudinal study. Nevertheless, the large sample and use of a standardized questionnaire by trained health professionals contributes to the validity of the information gathered.
The results of the study lead to collective information for “fromagers” in France or in countries with a specific retail industry of small shops. Other studies can be envisaged involving assessment observed exposures, as well as a precise diagnosis, for intervention purposes.
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