Occup Environ Med 2000;57:433-442 ( July )

Review

Occupational risk factors for shoulder pain: a systematic review Daniëlle A W M van der Windt^a, Elaine Thomas^b, Daniel P Pope^b, Andrea F de Winter^a, Gary J Macfarlane^c, Lex M Bouter^a, Alan J Silman^b

^a Institute for Research in Extramural Medicine, Vrije Universiteit, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands, ^b ARC Epidemiology Unit, School of Epidemiology and Health Sciences, University of Manchester, UK, ^c Unit of Chronic Disease Epidemiology

Correspondence to: Dr Daniëlle van der Windt dawm.van_der_windt.emgo{at}med.vu.nl

Accepted 10 March 2000

OBJECTIVESTo systematically evaluate the available evidence on occupational risk factors of shoulder pain.
METHODSRelevant reports were identified by a systematic search of Medline, Embase, Psychlit, Cinahl, and Current Contents. The quality of the methods of all selected publications was assessed by two independent reviewers using a standardised checklist. Details were extracted on the study population, exposures (physical load and psychosocial work environment), and results for the association between exposure variables and shoulder pain.
RESULTS29 Studies were included in the review; three case-control studies and 26 cross sectional designs. The median method score was 60% of the maximum attainable score. Potential risk factors related to physical load and included heavy work load, awkward postures, repetitive movements, vibration, and duration of employment. Consistent findings were found for repetitive movements, vibration, and duration of employment (odds ratio (OR) 1.4-46 in studies with method scores  60%). Nearly all studies that assessed psychosocial risk factors reported at least one positive association with shoulder pain, but the results were not consistent across studies for either high psychological demands, poor control at work, poor social support, or job dissatisfaction. Studies with a method score 60% reported ORs between 1.3 and 4.0. Substantial heterogeneity across studies for methods used for exposure assessment and data analysis impeded statistical pooling of results.
CONCLUSIONSIt seems likely that shoulder pain is the result of many factors, including physical load and the psychosocial work environment. The available evidence was not consistent across studies, however, and the associations were generally not strong. Future longitudinal research should evaluate the relative importance of each individual risk factor and the role of potential confounding variablessuch as exposure during leisure timeto set priorities for the prevention of shoulder pain in occupational settings.


Keywords: systematic review; shoulder pain; risk factors

---

© 2000 by Occupational and Environmental Medicine
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Pehkonen, I, Miranda, H, Haukka, E, Luukkonen, R, Takala, E-P, Ketola, R, Leino-Arjas, P, Riihimaki, H, Viikari-Juntura, E (2009). Prospective study on shoulder symptoms among kitchen workers in relation to self-perceived and observed work load. Occup. Environ. Med. 66: 416-423 [Abstract] [Full Text]  
• Macfarlane, G J, Pallewatte, N, Paudyal, P, Blyth, F M, Coggon, D, Crombez, G, Linton, S, Leino-Arjas, P, Silman, A J, Smeets, R J, van der Windt, D (2009). Evaluation of work-related psychosocial factors and regional musculoskeletal pain: results from a EULAR Task Force. Ann Rheum Dis 68: 885-891 [Abstract] [Full Text]  
• Reilingh, M. L., Kuijpers, T., Tanja-Harfterkamp, A. M., van der Windt, D. A. (2008). Course and prognosis of shoulder symptoms in general practice. Rheumatology (Oxford) 47: 724-730 [Abstract] [Full Text]  
• Miranda, H, Punnett, L, Viikari-Juntura, E, Heliovaara, M, Knekt, P (2008). Physical work and chronic shoulder disorder. Results of a prospective population-based study. Ann Rheum Dis 67: 218-223 [Abstract] [Full Text]  
• Sanderson, S., Tatt, I. D, Higgins, J. P. (2007). Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol 36: 666-676 [Abstract] [Full Text]  
• Bonzini, M., Coggon, D., Palmer, K. T (2007). Risk of prematurity, low birthweight and pre-eclampsia in relation to working hours and physical activities: a systematic review. Occup. Environ. Med. 64: 228-243 [Abstract] [Full Text]  
• IJmker, S, Huysmans, M A, Blatter, B M, van der Beek, A J, van Mechelen, W, Bongers, P M (2007). Should office workers spend fewer hours at their computer? A systematic review of the literature. Occup. Environ. Med. 64: 211-222 [Abstract] [Full Text]  
• Leijon, O., Lindberg, P., Josephson, M., Wiktorin, C. (2007). Different working and living conditions and their associations with persistent neck/shoulder and/or low back disorders. Occup. Environ. Med. 64: 115-121 [Abstract] [Full Text]  
• Hayden, J. A., Cote, P., Bombardier, C. (2006). Evaluation of the quality of prognosis studies in systematic reviews.. ANN INTERN MED 144: 427-437 [Abstract] [Full Text]  
• Bragge, P., Bialocerkowski, A., McMeeken, J. (2006). A systematic review of prevalence and risk factors associated with playing-related musculoskeletal disorders in pianists. Occup Med (Lond) 56: 28-38 [Abstract] [Full Text]  
• Harkness, E. F., Macfarlane, G. J., Silman, A. J., McBeth, J. (2005). Is musculoskeletal pain more common now than 40 years ago?: two population-based cross-sectional studies. Rheumatology (Oxford) 44: 890-895 [Abstract] [Full Text]  
• Miranda, H., Viikari-Juntura, E., Heistaro, S., Heliovaara, M., Riihimaki, H. (2005). A Population Study on Differences in the Determinants of a Specific Shoulder Disorder versus Nonspecific Shoulder Pain without Clinical Findings. Am J Epidemiol 161: 847-855 [Abstract] [Full Text]  
• Chen, W Q, Yu, I T-S, Wong, T W (2005). Impact of occupational stress and other psychosocial factors on musculoskeletal pain among Chinese offshore oil installation workers. Occup. Environ. Med. 62: 251-256 [Abstract] [Full Text]  
• Aittomaki, A, Lahelma, E, Roos, E, Leino-Arjas, P, Martikainen, P (2005). Gender differences in the association of age with physical workload and functioning. Occup. Environ. Med. 62: 95-100 [Abstract] [Full Text]  
• Bot, S D M, Terwee, C B, van der Windt, D A W M, Feleus, A, Bierma-Zeinstra, S M, Knol, D L, Bouter, L M, Dekker, J (2004). Internal consistency and validity of a new physical workload questionnaire. Occup. Environ. Med. 61: 980-986 [Abstract] [Full Text]  
• Svendsen, S W, Bonde, J P, Mathiassen, S E, Stengaard-Pedersen, K, Frich, L H (2004). Work related shoulder disorders: quantitative exposure-response relations with reference to arm posture. Occup. Environ. Med. 61: 844-853 [Abstract] [Full Text]  
• Leclerc, A, Chastang, J-F, Niedhammer, I, Landre, M-F, Roquelaure, Y (2004). Incidence of shoulder pain in repetitive work. Occup. Environ. Med. 61: 39-44 [Abstract] [Full Text]  
• Harkness, E F, Macfarlane, G J, Nahit, E S, Silman, A J, McBeth, J (2003). Mechanical and psychosocial factors predict new onset shoulder pain: a prospective cohort study of newly employed workers. Occup. Environ. Med. 60: 850-857 [Abstract] [Full Text]  
• Bos, J, Kuijer, P P F M, Frings-Dresen, M H W (2002). Definition and assessment of specific occupational demands concerning lifting, pushing, and pulling based on a systematic literature search. Occup. Environ. Med. 59: 800-806 [Abstract] [Full Text]  
• Hoozemans, M J M, van der Beek, A J, Frings-Dresen, M H W, van der Woude, L H V, van Dijk, F J H (2002). Pushing and pulling in association with low back and shoulder complaints. Occup. Environ. Med. 59: 696-702 [Abstract] [Full Text]  
• Cassou, B, Derriennic, F, Monfort, C, Norton, J, Touranchet, A (2002). Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France. Occup. Environ. Med. 59: 537-544 [Abstract] [Full Text]  
• Miranda, H, Viikari-Juntura, E, Martikainen, R, Takala, E-P, Riihimaki, H (2001). A prospective study of work related factors and physical exercise as predictors of shoulder pain. Occup. Environ. Med. 58: 528-534 [Abstract] [Full Text]  
• Torp, S., Riise, T., Moen, B. E (2001). The Impact of Social and Organizational Factors on Workers' Coping With Musculoskeletal Symptoms. ptjournal 81: 1328-1338 [Abstract] [Full Text]  
• , P. (2001). The cost of shoulder pain at. BMJ 322: 64-65 [Full Text]