Work above shoulder level and shoulder complaints: a systematic review
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REVIEW
Work above shoulder level and shoulder complaints: a systematic review Morten Wærsted1 · Markus Koch1 · Kaj Bo Veiersted1 Received: 20 June 2019 / Accepted: 9 May 2020 © The Author(s) 2020
Abstract Objective To investigate the association and the exposure–response relationship between work above shoulder height and shoulder pain or disorders. Methods A systematic search was performed in Medline, Embase, and Health and Safety Science Abstracts. Included were articles with prospective cohort, case–control, cross-sectional, or intervention study designs. Quality assessment was based on an evaluation scheme adjusted to study design and normalized to 100%. The cut-off for sufficient quality to include articles was above 40% and cut-off for high-quality articles was above 50% of maximal score. The level of strength of evidence for an association between exposure and effect was assessed according to the GRADE guidelines. Results Thirty-four articles were included. Articles that document large effects (higher risk estimates; OR ≥ 2) have higher quality score, include analyses of severe arm elevation, more often use clinical outcome, and report an exposure–response relationship compared to studies reporting lower risk estimates. The studies that reported large effects were all significant. An exposure–response relationship was found in many high-quality studies when relating exposure intensity of arm elevation (level of arm elevation, amplitude) as well as duration of arm elevation, especially > 90°. Conclusion We conclude on a limited evidence for an association between arm elevation at work and shoulder disorders. Severe arm elevation with elbows above shoulder level (i.e., > 90°) shows a moderate evidence for an association with shoulder disorders. Keywords Systematic review · Work-related musculoskeletal disorders · Shoulder pain · Arm elevation
Introduction Shoulder pain or disorders are a widespread in the general population. In a systematic review, Luime and co-workers found prevalence rates for 1-month prevalence of shoulder pain ranging from 19 to 31%, 5–47% for 1-year prevalence, and 7–67% for lifetime prevalence (Luime et al. 2004a). In a study conducted in Sweden, the estimated costs per patient seeking primary health care with shoulder pain were in average €326 for healthcare and €1743 for sick leave during a Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00420-020-01551-4) contains supplementary material, which is available to authorized users. * Morten Wærsted [email protected] 1
National Institute of Occupational Health, Gydas vei 8, Majorstuen, PO Box 5330, 0304 Oslo, Norway
period of 6 months (Virta et al. 2012). For patients with higher need for medical care, the total costs increased dramatically (€8528). With a focus on the high socioeconomic burden and individual’s health and work ability, a reduction in occurrence and severity of musculoskeletal disorders are wanted. Previous reviews have shown a positive association between work wit
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