Table 1

Definition and assessment of exposure and outcomes for studies included concerning risk factors (n=15)

Outcome (prevalence*; incidence†)Exposure
Author (reference)DefinitionAssessmentDefinitionAssessment
Frost et al 32
CS
Shoulder tendonitis: self-reported shoulder pain in combination with pain at resisted abduction, impingement pain and tenderness of the greater humeral tubercle*Questionnaire, physical examinationRepetitive hand-arm movements (yes/no); frequency of shoulder movements, low: 1–14 movements/min, high: 15–36 movements/min; force requirements, low: <10% of MVC (1 on 1–5 scale), high: >10% of MVC (2–5 on 1–5 scale); micropauses in shoulder flexion (% of task), ≤80% of cycle time without pauses, >80% of cycle time without pausesObservation by plant walk-through, video recordings, self-reported task distribution
Svendsen et al 33
CS
Supraspinatus tendonitis: increased signal intensity on T2-weighted images in two planes or focal areas of tendon discontinuity with T2 bright fluid signal or focal complete discontinuity of tendon fibres from articular to bursal surfaces or complete discontinuity of the tendon with atrophy of the muscle*MRILifetime upper arm elevation >90° (months); lifetime shoulder force requirements (low/medium/high)Inclinometer measurement, torque index
Svendsen et al 34
CS
Supraspinatus tendonitis: at least one sign of indirect tenderness (painful arc test positive, pain provoked by isometric abduction, Jobe’s test positive) and at least one sign of direct tenderness (Hawkins’s test positive, abduction internal rotation test positive)*Physical examinationUpper elevation above 90° (% of working hours); job demands; job control; social supportInclinometer measurement, questionnaire
Miranda et al 6
CS
Rotator cuff tendinitis: history of pain in the rotator cuff region lasting for ≥3 months, pain during the month preceding the examination and pain in the rotator cuff region upon ≥1 resisted active movements: abduction of the arm (supraspinatus), external rotation of the arm (infraspinatus, teres minor) and internal rotation of the arm (subscapularis) or painful arc of shoulder abduction*Physical examinationFrequent lifting, ≥5 kg, >2 times/min, >2 hours/day (year); heavy lifting, >20 kg, >10 times/day (year); working with hand above shoulder, ≥1 hour/day (year); work requiring high hand force, ≥1 hour/day (year); work requiring repetitive motion hand/wrist, ≥2 hours/day (year); working with a vibrating tool, ≥2 hours/day (year); job demandsInterview, questionnaire
Sutinen et al 27
Cohort
RCS: typical history of painful arch and intermittent pain and pronounced tenderness locally in the shoulder region were diagnostic or, in addition, at least one of the signs: painful arch test during elevation, pain in resisted abduction or resisted external rotation†Questionnaire, physical examinationLifelong vibration energy (m2/s4) hdMeasurements on chainsaw
Silverstein et al 35
CS
RCS: shoulder pain or burning in past 12 months occurring ≥3 times or lasting >1 week, and shoulder pain or burning present in the previous 7 days, and no traumatic injury onset, and resisted shoulder abduction, external rotation, internal rotation, or a ‘painful arc,’ and no history of acute trauma to the shoulder or rheumatoid arthritis*Questionnaire, physical examinationUpper arm flexion and duty cycles of forceful exertion (%time): forceful exertion, pinch grip force ≥8.9 n (0.9 kg) or lifting objects weight, power grip or push/pull forces ≥44.1 n (4.5 kg); upper arm flexion and pinch grip force (% time): pinch grip force ≥8.9 n; decision latitude (low/high); job satisfaction (low/high); job security (low/high)Observation on-site and videotaped, questionnaire
Nordander et al 36
CS
Supraspinatus tendonitis: shoulder pain; local tenderness over the tendon insertion; pain at resisted isometric abduction
Infraspinatus tendonitis: shoulder pain; local tenderness over the tendon insertion; pain at resisted isometric outward rotation
Bicipital tendonitis: shoulder pain; local tenderness over the tendon(s); pain at resisted isometric elevation of the arm (straight and elevated 90°) and/or resisted isometric flexion of the elbow (flexed 90° and hand supinated)*
Questionnaire, physical examinationHead inclination (1st, 50th, 90th percentiles); head angular velocity (50th percentile); upper arm elevation (50th, 90th percentiles) and velocity (50th percentile); trapezius and forearm extensor muscles activity (10th, 90th percentiles); wrist flexion (10th, 50th, 90th percentiles) and angular velocity (50th percentiles); job demand (high/low); job control (high/low); job strain (high demand/low control); isostrain (job strain/low job support)Direct measurement, job content questionnaire
Seidler et al 21
CC
Supraspinatus lesion: shoulder pain and radiographic tears†Interview, MRILifting and carrying loads ≥20 kg in hours; work above shoulder level in hours; handheld vibration in years on jobQuestionnaire
Bodin et al 28 CohortRCS: intermittent pain in shoulder region worsened by active elevation movement of upper arm currently or for ≥4 days during preceding 7 days and ≥1 of following shoulder test positive: resisted shoulder abduction; external or internal rotation; resisted elbow flexion; painful arc on active upper arm test†Questionnaire, physical examinationPerceived physical exertion (scale 6–20; high=man: ≥15, women: ≥14); repeated and sustained posture with arms above shoulder level (≥2 hours/day); coworker support (median score) JCQ; work with temporary workers; work organisationQuestionnaire
Grzywacz et al 22
CS
RCS: pain with resisted abduction, internal rotation, external rotation or forward flexion of the shoulder, tenderness to palpation over the bicipital groove or lateral shoulder†*Interview, physical examinationJob control (three items from ‘seldom-never’ coded 1 to ‘almost always’ coded 4); psychological demand (four items from ‘seldom-never’ coded 1 to ‘almost always’ coded 4); heavy load (12 items from ‘seldom-never’ coded 1 to ‘almost always’ coded 4); awkward posture and repeated movements (six items from ‘seldom-never’ coded 1 to ‘almost always’ coded 4); abusive supervision (three items from ‘strongly disagree’ coded 1 to ‘strongly agree’ coded 4); poor safety commitment (yes/no)Questionnaire
Herin et al 29 CohortIncident chronic shoulder: shoulder pain present for at least 6 months (duration of current episode or intermittent complaints over the last 6 months) and presenting positive clinical signs (active or passive functional limitations, stiffness, tenderness)†Interview, physical examinationConsiderable physical effort; physical effort with tools; carrying heavy loads; long, difficult working positions and awkward posture; precise movements and repetitive work; considerable vibrations and exposure to jolts; low decision latitude; high psychological demandsQuestionnaire supervised by physician
Bugajska et al 30 CohortRotator cuff tendinitis: positive results of at least one of the provocation tests; Nordic musculoskeletal questionnaire†Questionnaire, physical examinationDecision latitude (no/yes); mental job demands (no/yes); job insecurity (no/yes); social support (no/yes); physical job demand (no/yes)JCQ
Svendsen et al 31 CohortSubacromial impingement syndrome: first-time surgery ICD-10: M19 or M75.1–M75.9†Medical registryForce (5-point force scale; 0=light and 4=near maximal); upper arm elevation >90°; repetitive movements (moderate: ≥4 to <15 movements of upper arm per minute, high: ≥15/min); shoulder load (high: ≥1 of force score ≥3, arm elevation >90° ≥1 hour/day, highly repetitive work ≥0.5 hour/day, moderate repetitive work ≥4 hours/day/medium: if highly repetitive work <0.5 hour/day and ≥1 of force score >1.5 <3, arm elevation >90° >0.5 to <1 hour/day, moderately repetitive work ≥2 to <4 hours/day/low: force score ≤1.5, arm elevation >90° <0.5 hour/day, moderate repetitive work <2 hours/day); job demands (high/low); job control (high/low); social support (no, from leaders and colleagues, leaders only, colleagues only)Job exposure matrix, questionnaire
Dalbøge et al 2 CohortSubacromial impingement syndrome first-time surgery ICD-10: M19 or M75.1–M75.9)†Medical registryJob exposure matrix assessments of years of arm elevation (>90°), repetitiveness, force and acceleration (HAV), shoulder load by five specialists in occupational medicineRegistries (years), expert assessment, job exposure matrix
Nordander et al 37
CS
Bicipital or supraspinatus; infraspinatus*Questionnaire, physical examinationHead inclination (1st, 50th, 90th percentiles); head angular velocity (50th percentile); upper arm elevation (50th, 90th percentiles) and velocity (50th percentile); trapezius and forearm extensor muscles activity (10th, 90th percentiles); wrist flexion (10th, 50th, 90th percentiles) and angular velocity (50th percentile); job demand (high/low), job control (high/low), job strain (high demand/low control), isostrain (job strain/low job support)Direct measurement, job content questionnaire
  • *(n=8).

  • †(n=7).

  • CC, case control; CS, cross-sectional study; HAV, hand-arm vibration; ICD, International Classification of Diseases; JCQ, Job Content Questionnaire; MVC, maximum voluntary contraction; RCS, rotator cuff syndrome.