Work-related musculoskeletal disorders of the upper limbs (MSDs) are the first cause of occupational illness in France, as in Europe. A pilot network for epidemiological surveillance system of MSDs has been implemented in France's Loire Valley region to assess the prevalence of MSDs and their risk factors in the working population, namely the ageing workforce. The surveillance was based on a network of occupational physicians and used the recommendations of a group of European experts ('Saltsa Criteria document' consensus). Between 2002 and 2004, 3710 men and women (aged 20-59) representative of the regional workforce were randomly selected. Exposure to risk factors of MSDs was evaluated by the use of a self-administered questionnaire which aimed to assess bio-mechanical and psychosocial risk factors. With at least one of the six primary MSDs of the upper limbs having been clinically diagnosed using a rigorous protocol, the prevalence of clinically-diagnosed MSDs was high: about 11% of male and 15% of female workers suffered from at least one of the MSDs studied. After age fifty, about 19% of male and 27% of female workers suffered from at least one MSD and 4% of male and 6% of female workers from at least two disorders. Blue-collar workers were the most affected, regardless of age or gender, followed by office employees. Exposure to MSD risk factors of remained high after age fifty: 77% of male and 72% of female blue-collar workers were exposed to at least two MSD risk factors. The implications for the prevention of MSDs and job security of workers are discussed. The high prevalence of specific MSDs of the upper limb combined with a high exposure to risk factors of MSDs in ageing workers emphasizes the need to implement comprehensive prevention programs in most sectors to reduce the exposure to risk, the prevalence of MSDs and ensure the capacity to keep employees suffering from MSDs working, or at least to quickly return to work after recovery.