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Occupational lifting, carrying, pushing, pulling loads and risk of surgery for subacromial impingement syndrome: a register-based cohort study
  1. Bjørn Riddervold1,
  2. Johan Hviid Andersen2,
  3. Annett Dalbøge1,3
  1. 1Department of Environmental and Occupational Medicine, Aarhus University, Aarhus, Denmark
  2. 2Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland – University Research Clinic, Herning, Denmark
  3. 3Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  1. Correspondence to Annett Dalbøge, Aarhus University Department of Environmental and Occupational Medicine, Aarhus, Denmark; anetaner{at}


Aim The aim was to examine exposure–response relations between surgery for subacromial impingement syndrome (SIS) and intensities of lifting/carrying and pushing/pulling loads during a 10-year time window.

Methods We conducted a register-based cohort study (2003–2008), comprising persons born in Denmark (1933–1977) with ≥5 years of work experience (N=2 374 403). Information on surgery for SIS was retrieved from the Danish National Patient Register (N=14 188). Occupational mechanical exposures comprising lifting/carrying loads ≥10 kg and pushing/pulling loads ≥50 kg were assessed by combining individual register-based job codes with our expert-based Shoulder job exposure matrix. We created three intensity-specific exposure duration variables by dividing the intensity for lifting/carrying and pushing/pulling loads into three categories (low, medium and high), and summed up number of years in each exposure category for a 10-year time window. The associations were analysed using logistic regression technique equivalent to discrete survival analysis.

Results The adjusted OR (ORadj) increased with both exposure duration and intensity of lifting/carrying and pushing/pulling. For lifting/carrying, the ORadj reached a maximum of 1.78 (95% CI 1.66 to 1.89), 2.52 (95% CI 2.32 to 2.74) and 2.96 (95% CI 2.53 to 3.47) after 10 years of exposures for the three exposure intensities. For pushing/pulling, maximum ORadj was 1.44 (95% CI 1.31 to 1.58), 1.68 (95% CI 1.58 to 1.79) and 1.72 (95% CI 1.50 to 2.00), respectively.

Conclusion We found exposure–response relations for lifting/carrying and pushing/pulling across the 10-year time window. The risk was especially pronounced for lifting/carrying compared with pushing/pulling. We did not find indications of safe exposure intensities.

  • musculoskeletal system
  • upper extremity
  • public health

Data availability statement

No data are available.

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  • Contributors BR performed the analyses and drafted the paper in close collaboration with AD and JHA. All authors have reviewed the paper for important intellectual content, approved the final version of the manuscript and took responsibility for the integrity of the work as a whole. AD is responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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