I disordini muscolo-scheletrici nella pratica ambulatoriale di medicina del lavoro

Musculoskeletal disorders are very common among the working population, and often present difficult problems to the occupational physician, regarding both the possible casual relationship with the job, and the judgement on work fitness. We examined, during the last five years, 1808 patients who asked medical assistance for suspected work-related health problems. In 367 (19.74% of total; 239 males, 128 females; mean age 47 years, range 24-68), at least one musculoskeletal disorder was found: 331 required a change of the previous tasks. The most frequent diagnosis were lumbosacral spondilopathy, rotator cuff syndrome, and carpal tunnel syndrome. A causal link with the occupation was identified in 36 (17 males and 19 females) patients. These cases were reported to the Judicial Authority as work-reated musculoskeletal disorders (WRMDs), and referred to the Italian Workers’ Compensation Authority. Our case record indicate that musculoskeletal disorders are a major cause for specialistic help request in the occupational medical practice, affecting work capability in the large majority of cases. The lumbosacral spine and the upper limb are the anatomical sites most frequently involved. The occupation is often implicated in the causation of the disease: the recognition of these cases is important in relation to medicolegal issues and occupational-related compensation claims.