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A main cause for absence from work worldwide is musculoskeletal disorders (MSDs).1 2 Occupations that are physically strenuous have a particularly high MSD prevalence.3 Causes of occupational MSDs include poor fitness and poor health habits, but a considerable proportion of MSDs is considered to be caused by physical work exposures.4 Therefore, implementation of initiatives to reduce physical work exposures and consequently MSDs is needed. Substitution and engineering controls are in the top of the ‘hierarchy of control’ aiming to protect workers from exposures. However, when it is not feasible for workplaces to substitute or implement engineering controls to reduce exposures, administrative controls may be used. Job rotation has been recommended as an administrative control.5 Two recent published reviews conclude that there is currently inconsistent evidence for positive or negative effects of job rotation on MSDs and even indicated that it may increase their prevalence. Large variations and low quality in study designs (mainly cross-sectional studies), variations in outcomes, and insufficient description of the job rotation programme contribute to the mixed results. No high-quality methodological study designed to examine job rotation programmes was included in the reviews.6 7 Comper et al make an important contribution towards filling this …
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