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Scandinavian Journal of Work,... May 2010Our aim was to provide a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the occurrence of... (Review)
Review
OBJECTIVE
Our aim was to provide a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the occurrence of specific shoulder disorders in occupational populations.
METHODS
A systematic review of the literature was conducted on the associations between type of work, physical load factors, and psychosocial aspects at work, on the one hand, and the occurrence of tendinitis of the biceps tendon, rotator cuff tears, subacromial impingement syndrome (SIS), and suprascapular nerve compression, on the other hand. Associations between work factors and shoulder disorders were expressed in quantitative measures as odds ratio (OR) or relative risk (RR).
RESULTS
The occurrence of SIS was associated with force requirements >10% maximal voluntary contraction (MVC), lifting >20 kg >10 times/day, and high-level of hand force >1 hour/day (OR 2.8-4.2). Repetitive movements of the shoulder, repetitive motion of the hand/wrist >2 hours/day, hand-arm vibration, and working with hand above shoulder level showed an association with SIS (OR 1.04-4.7) as did upper-arm flexion > or =45 degrees > or =15% of time (OR 2.43) and duty cycle of forceful exertions > or =9% time or duty cycle of forceful pinch >0% of time (OR 2.66). High psychosocial job demand was also associated with SIS (OR 1.5-3.19). Jobs in the fish processing industry had the highest risk for both tendinitis of the biceps tendon as well as SIS (OR 2.28 and 3.38, respectively). Work in a slaughterhouse and as a betel pepper leaf culler were associated with the occurrence of SIS only (OR 5.27 and 4.68, respectively). None of the included articles described the association between job title/risk factors and the occurrence of rotator cuff tears or suprascapular nerve compression.
CONCLUSIONS
Highly repetitive work, forceful exertion in work, awkward postures, and high psychosocial job demand are associated with the occurrence of SIS.
Topics: Accidents, Occupational; Cumulative Trauma Disorders; Humans; Occupational Diseases; Occupational Exposure; Shoulder; Shoulder Injuries; Shoulder Joint; Stress, Psychological; Weight-Bearing
PubMed: 20094690
DOI: 10.5271/sjweh.2895 -
Scandinavian Journal of Work,... Jun 2007This paper systematically reviews the work-relatedness of neck-shoulder disorders with associated physical findings. (Review)
Review
OBJECTIVES
This paper systematically reviews the work-relatedness of neck-shoulder disorders with associated physical findings.
METHODS
Studies incorporating a physical examination were focused upon. Four detailed reviews were searched, and a systematic search of the MEDLINE, Embase BIDS, and Psychinfo databases was conducted until May 2006, the key words for the outcome and various occupational exposures being combined. The quality of each paper was rated by criteria related to study design, power, sampling methods, response rate, potential for bias, or confounding, and approaches to the assessment of exposure outcome. Weight was given to studies with objective exposure-response information.
RESULTS
Twenty-one relevant reports (four prospective) were found. Most considered the outcome neck pain with palpation tenderness (tension neck syndrome) or mixed neck-shoulder disorder (predominantly tension neck syndrome). Most investigations shared common limitations--small sample size, potential for confounding, incomplete blinding, and crude exposure assessment. The overall quality of the information was rated as excellent for only two reports. Exposures included repetitive work (14 studies), static loading (12 studies), neck flexion (7 studies), force (5 studies), and occupational psychosocial factors (7 studies). Moderate evidence was found for a causal relation for repetition at the shoulder and for neck flexion allied with repetition. Limited evidence was found for hand-wrist repetition, neck flexion with respect to static loading and force in the absence of repetition, and high job demands, low control, low job support and job strain.
CONCLUSION
There is some evidence that neck pain with palpation tenderness is causally related to workplace exposures. However, evidence is lacking on the validity, clinical course, and functional importance of this diagnostic entity.
Topics: Chronic Disease; Cumulative Trauma Disorders; Humans; Industry; Neck Pain; Occupations; Risk Factors
PubMed: 17572827
DOI: 10.5271/sjweh.1134