Latin Questionnaire: a threshold strategy for anamnestic screening of occupational musculoskeletal disorders through specific reference groups

INTRODUCTION: Health surveillance programs conducted for both individual workers and working populations as a whole are managed by occupational health physicians and focus on disorders and diseases caused by biomechanical overload, primarily for preventive purposes. OBJECTIVES: The purpose of the paper is to update an anamnestic protocol for studying musculoskeletal disorders after more than 40 years experience of its application. The updated version has been re-named the Latin Questionnaire. The protocol enables preliminary epidemiological evaluation, by comparing results of exposed populations to those from a reference population, thanks to the introduction of a severity threshold, a concept lacking in similar questionnaires. METHODS: The Latin Questionnaire is based on symptoms of discomfort, pain, and paraesthesia. Each symptom is described in terms of location, duration, number of episodes, irradiation, and treatment. The model covers present symptoms during the previous 12 months and is designed to identify positive anamnestic cases (when positive according to the threshold), cases with minor disorders, and negative cases for conditions involving the spine and upper and lower limbs. RESULTS: The updated anamnestic model was validated again through the collaborative effort involving 37 physicians from 14 Latin countries. To enable comparisons with exposed populations, an updated reference population (4,000 unexposed workers) is presented, evaluating the percentages of subjects positive according to thresholds for spine and upper and lower limbs and the incidence of acute lower back pain, broken down by gender and age groups. Examples of application of the questionnaire are also presented. CONCLUSIONS: The Latin Questionnaire, which has also been implemented in digital form (free download), allows selection of significant anamnestic cases compared to cases with minor disorders. This strategy is indispensable for correctly conducting preliminary epidemiological studies. Example applications confirm the presence of significant differences between the percentages of subjects with positive thresholds in exposed compared to reference groups, with surpluses proportional to their levels of biomechanical overload.