Longitudinal evidence for the association between work-related physical exposures and neck and/or shoulder complaints: a systematic review

Abstract

Background

Most existing reviews focus on evidence for the association between neck and/or shoulder complaints and physical exposures at the workplace gathered from cross-sectional studies. In comparison, this review summarizes existing evidence from longitudinal studies only.

Methods

A systematic literature research was conducted in Medline and EMBASE (1975–2009), and all studies were scanned by at least two researchers according to strict inclusion criteria. Levels of evidence were assigned according to the number of studies reporting similar findings, and according to the methodological quality of the included studies.

Results

Altogether 21 longitudinal studies (19 high-quality studies) met the inclusion criteria and were included in this review. In comparison with former reviews, we found strong evidence for an association between shoulder complaints and manual material handling (MMH) (range between Odds Ratio (OR) 1.4 and 4.9), vibration (range between OR 1.6 and OR 2.5), trunk flexion or rotation (range between OR 1.8 and OR 5.1), and working with hands above shoulder level (range between OR 1.1 and OR 1.8). Apart from that, the included studies confirmed existing knowledge on the association between physical exposures at the workplace and neck and/or shoulder complaints.

Conclusions

This analysis of longitudinal studies allowed for new evidence with regard to four cause-effect chains between physical exposures at work and the development of shoulder, neck and neck/shoulder complaints. As outcome variables varied greatly among the included studies, harmonization in studies on musculoskeletal research is desirable.

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The authors declare that they have no conflict of interest.

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Correspondence to Elke Ochsmann.

Appendix of methodological assessment

Appendix of methodological assessment

A:

Positive if age, gender, and profession were clearly defined.

B:

Positive if either inclusion or exclusion criteria for the baseline population were presented.

C:

Positive if the total number of participants was ≥60% on the last point of follow-up compared with the number of participants at baseline.

D:

Positive if demographic/clinical information information (patient/disease characteristics such as age, sex and other potential prognostic predictors) was presented for those lost to follow-up/drop-outs.

E:

Positive if the follow-up period was at least 3 months.

F:

Positive if clinical diagnosis (e. g., rotator cuff syndrome) was assessed.

G:

Positive if standardized questionnaires at baseline and at follow-up were applied for outcome measurement.

H:

Positive if objective outcome measurements were applied (clinical examination, clinical tests, X-ray).

I:

Positive if standardized questionnaires at baseline and at follow-up were applied for psychosocial risk factors.

J:

Positive if standardized questionnaires at baseline and follow-up were applied for physical risk factors.

K:

Positive if objective assessment of physical exposure was conducted (video analysis, weight definition).

L:

Positive if the data presentation fit to the stated method.

M:

Positive if univariate/multivariate models were presented in terms of relative risks, rate ratios, odds ratios or hazard ratios.

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Mayer, J., Kraus, T. & Ochsmann, E. Longitudinal evidence for the association between work-related physical exposures and neck and/or shoulder complaints: a systematic review. Int Arch Occup Environ Health 85, 587–603 (2012). https://doi.org/10.1007/s00420-011-0701-0

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Keywords

  • Neck disorders
  • Shoulder disorders
  • Exposure
  • Evidence