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Associations of screen work with neck and upper extremity symptoms: a systematic review with meta-analysis
  1. Pieter Coenen1,
  2. Henk F van der Molen2,
  3. Alex Burdorf3,
  4. Maaike A Huysmans1,
  5. Leon Straker4,
  6. Monique HW Frings-Dresen2,
  7. Allard J van der Beek1
  1. 1 Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  2. 2 Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
  3. 3 Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
  4. 4 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  1. Correspondence to Dr Pieter Coenen, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands; p.coenen{at}


Objectives It has often been suggested that screen work (ie, work on desktop, laptop, notebook or tablet computers) is a risk factor for neck and upper extremity symptoms. However, an up-to-date overview and quantification of evidence are lacking. We aimed to systematically review the association of exposure to screen work with neck and upper extremity symptoms from prospective studies.

Methods An electronic database search (PubMed, Embase, Cinahl and Scopus) for prospective studies on the association of exposure to screen work and musculoskeletal symptoms was conducted. Studies were synthesised regarding extracted data and risk of bias, and meta-analyses were conducted.

Results After screening 3423 unique references, 19 articles from 12 studies (with 18 538 participants) were included for the current review, with the most recent exposure assessment reported in 2005. Studies described duration and input frequency of screen work (ie, computer, keyboard and mouse use, assessed using self-reports or software recordings) and musculoskeletal symptoms (ie, self-reported neck/shoulder and distal upper extremity symptoms and diagnosed carpal tunnel syndrome [CTS]). Although there was overall an increased occurrence of musculoskeletal symptoms with larger exposure to screen work (relative risk: 1.11 [1.03 1.19]), findings were rather inconsistent with weaker (and statistically non-significant) risks when screen work was assessed by software recording (1.05 [0.91 1.21]) compared to with self-report (1.14 [1.03 1.19]).

Conclusions We found an increased risk of musculoskeletal symptoms with screen work. However, the evidence is heterogeneous, and it is striking that it lacks information from contemporary screen work using laptop, notebook or tablet computers.

  • screen work
  • computer use
  • musculoskeletal
  • systematic review
  • meta-analysis

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  • Contributors All authors were involved in study conception and design, drafting the article and/or critically revising it for important intellectual content, and all authors approved the final version to be submitted for publication. PC and HFvdM: study selection, data extraction and methodological quality assessment. PC: conducted the analyses (with the help of HFvdM and AJvdB) and prepared a draft manuscript. AJvdB: study guarantor.

  • Funding The study has partly been funded by the Amsterdam Public Health Research Institute.

  • Competing interests None declared.

  • Ethics approval As this is a systematic review, no ethical approval is required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional data are provided in the supplementary files.

  • Patient consent for publication Not required.