RT Journal Article
SR Electronic
T1 Repetitive and forceful movements of the hand as predictors of treatment for pain in the distal upper extremities
JF Occupational and Environmental Medicine
JO Occup Environ Med
FD BMJ Publishing Group Ltd
SP 55
OP 62
DO 10.1136/oemed-2021-107543
VO 79
IS 1
A1 Jonathan Aavang Petersen
A1 Charlotte Brauer
A1 Lau Caspar Thygesen
A1 Esben Meulengracht Flachs
A1 Christina Bach Lund
A1 Jane Frølund Thomsen
YR 2022
UL http://oem.bmj.com/content/79/1/55.abstract
AB Objective To investigate repetitive movements and the use of hand force as causes of treatment for distal upper extremities musculoskeletal disordersMethods A cohort of 202 747 workers in a pension health scheme from 2005 to 2017 in one of 17 jobs (eg, office work, carpentry, cleaning) was formed. Representative electro-goniometric measurements of wrist angular velocity as a measure for repetition and expert-rated use of hand force were used in a job exposure matrix (JEM). Job titles were retrieved from the Danish registers. Outcome was first treatment in the distal upper extremities. In a Poisson regression model, incidence rate ratios (IRRs) of treatment were adjusted for age, calendar-year, diagnosis of rheumatoid arthritis and arm fractures. In further analyses, wrist velocity or hand force was added.Results In men, wrist velocity had an IRR of 1.48 (95% CI 1.15 to 1.91) when the highest exposure level was compared with the lowest but with no clear exposure-response pattern. The effect became insignificant when adjusted for hand force. Hand force had an IRR of 2.65 (95% CI 2.13 to 3.29) for the highest versus the lowest exposure with an exposure-response pattern, which remained after adjustment for wrist velocity. Among women, no increased risk was found for hand force, while wrist velocity showed a significantly protective association with treatment.Conclusions In men, occupational exposure to hand force more than doubled the risk of seeking treatment. The results for exposure to repetition were less clear. In women, we could not find any indications of an increased risk neither for force nor for repetition.Data from the JEM are available upon reasonable request. Data from the Danish national registers are available through online access at Statistics Denmark under standard conditions.