Social and psychological factors influenced the course of arm, neck and shoulder complaints

OBJECTIVE: To investigate the clinical course and prognostic factors of complaints of arm, neck, and shoulder. STUDY DESIGN AND SETTING: A prospective cohort study in physical therapy practice. Participating physiotherapists recruited new consulters with musculoskeletal complaints of the neck and/or upper extremities. Participants filled in questionnaires at baseline, 3 months, and 6 months. The main outcome measure was the persistence of complaints over 6-month follow-up. Possible predictors like social and psychological factors, physical factors, and complaint specific factors were tested in univariate and multivariate logistic regression analyses for repeated measurements. RESULTS: Of the 624 participants at baseline 543 (87%) returned at least one follow-up questionnaire. At 6-month follow-up, 40% had persisting pain and discomfort. Somatization, kinesiophobia, catastrophizing, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months in the total population. In those with paid work (77%), catastrophizing, low decision authority at work, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months. CONCLUSION: 40% of the participants had persisting pain and discomfort after 6 months and mainly social and psychological factors played a role in this course.     

Prognostic factors for musculoskeletal sickness absence and return to work among welders and metal workers

OBJECTIVES: To analyse factors that determine the occurrence of sickness absence due to musculoskeletal problems and the time it takes to return to work. METHODS: A longitudinal study with two year follow up was conducted among 283 male welders and metal workers. The survey started with a standardised interview on the occurrence of musculoskeletal complaints. 61 (22%) workers were lost to follow up. Data on sickness absence among 222 workers during the follow up were collected from absence records and self reports. Regression analysis based on proportional hazards models was applied to identify risk factors for the occurrence and duration of sickness absence due to various musculoskeletal complaints. RESULTS: During the follow up 51% of the workers attributed at least one period of sickness absence to musculoskeletal complaints which accounted for 44% of all work days lost. A history of back pain was not associated with sickness absence for back pain, partly because subjects with back pain were more likely to be lost to follow up. Neck or shoulder pain and pain of the upper extremities contributed significantly to neck or shoulder absence (relative risk (RR) 3.35; 95% confidence interval (95% CI) 1.73 to 6.47) and to upper extremities absence (RR 2.29; 95% CI 1.17 to 4.46), respectively. Company and job title were also significant predictors for sickness absence due to these musculoskeletal complaints. Absence with musculoskeletal complaints was not associated with age, height, body mass index, smoking, and duration of employment. Return to work after neck or shoulder absence was worse among metal workers than welders (RR 2.12; 95% CI 1.08 to 4.17). Return to work after lower extremities absence was strongly influenced by visiting a physician (RR 11.31; 95% CI 2.94 to 43.46) and by musculoskeletal comorbidity (RR 2.81; 95% CI 1.18 to 6.73). CONCLUSIONS: Complaints of the neck or shoulder and upper extremities in the 12 months before the study were associated with sickness absence for these complaints during the follow up. Workers with absence due to pain from back, neck or shoulder, upper extremities, or lower extremities were at higher risk of subsequent sickness absence in the next year.

 

     

The prevalence of musculoskeletal complaints among women in Tijuana, Mexico: sociodemographic and occupational risk factors

The authors interviewed an age- and occupation-stratified sample of 466 women, aged 18-40, from 12 Tijuana neighborhoods, about sociodemographic characteristics, work and reproductive history, and musculoskeletal complaints. A total of 29.8% reported experiencing aches or pain in the low back, 38.3% in the upper back, 26.4% in the neck/shoulders, 18.2% in the hand/wrist, and 28.3% in the legs in the preceding year. Both sociodemographic and occupational factors were associated with these complaints. Very low educational attainment, having substandard housing, being the head of household, and being a migrant were each associated with an increased prevalence of one or more musculoskeletal complaints. In general, working outside the home increased the risk of musculoskeletal complaints. Compared with women who had not worked in the preceding 30-month period, those working in the maquiladora had 40-90% higher risks of upper back, neck/shoulder, and hand/wrist pain. Compared with women working outside the maquiladora, maquiladora women workers had 20% higher risks of low back, upper back, and neck/shoulder complaints. More detailed studies of the incidences of musculoskeletal disorders and of specific etiologic risk factors within the maquiladora industry are warranted. Future studies should concurrently evaluate sociodemographic risk factors.     

Upper body quadrant pain in bus drivers

The aims of this study were to evaluate the prevalence of upper body quadrant pain among Israeli professional urban bus drivers and to evaluate the association between individual, ergonomic, and psychosocial risk factors and occurrence of neck pain. Three hundred and eighty-four male urban bus drivers were consecutively enrolled in the study. Data pertaining to work-related ergonomic and psychosocial stress factors were collected. The 12-month prevalence of neck pain was 21.2%, followed by shoulder: 14.7%, upper back: 8.3%, elbow: 3.0%, and wrist: 3.0% pain. Prevalence of neck pain was associated with uncomfortable seats (odds ratio; OR [95% confidence interval; CI]: 2.2 [1.2-4.3], back support (2.3 [1.2-4.2]), and steering wheel (2.2 [1.1-4.5]). Drivers with neck pain reported significantly higher prevalence of pain in the upper back (OR [95% CI]: 5.9 [2.7-12.9]), shoulders (8.1 [4.3-15.3]), and wrists (7.0 [2.0-21.8]) compared to drivers without neck pain. Work-related organizational stress factors were not associated with neck pain prevalence.     

Musculoskeletal complaints among Italian X-ray technologists

The aim of this study was to determine the prevalence of musculoskeletal complaints among X-ray technologists and to examine their relationship with physical and psychosocial factors. A cross-sectional study was performed in 2006 among 203 X-ray technologists working in 13 hospitals in the Apulia region of southern Italy. A questionnaire was used to collect data on personal characteristics, physical workload, psychosocial aspects, and the presence of musculoskeletal symptoms in the neck, shoulders, low back, hand/wrist and legs. Univariate analyses and multiple logistic regression analyses were then performed. The prevalence of complaints at any body site in the previous 12 months was 67%. Low back pain was the most commonly reported symptom (59.6%), followed by shoulder (21.2%), neck (19.7%), leg (13.8%) and hand/wrist pain (12.3%). Age was associated with low back pain, while high physical workload was associated with symptoms in the neck, low back and hand/wrist. High job demands were associated with neck and shoulder pain. Overall, our study suggests high prevalence rates of musculoskeletal complaints may exist among Italian X-ray technologists. Physical workload, psychosocial and individual factors appear to be important risk factors for musculoskeletal disorders within this occupational group.     

The Prevalence of Musculoskeletal Complaints among Women in Tijuana,Mexico: Sociodemographic and Occupational Risk Factors

Abstract

The authors interviewed an age- and occupation-stratified sample of 466 women, aged 18–40, from 12 Tijuana neighborhoods, about sociodemographic characteristics, work and reproductive history, and musculoskeletal complaints. A total of 29.8% reported experiencing aches or pain in the low back, 38.3% in the upper back, 26.4% in the neck/shoulders, 18.2% in the hand/wrist, and 28.3% in the legs in the preceding year. Both sociodemographic and occupational factors were associated with these complaints. Very low educational attainment, having substandard housing, being the head of household, and being a migrant were each associated with an increased prevalence of one or more musculoskeletal complaints. In general, working outside the home increased the risk of musculoskeletal complaints. Compared with women who had not worked in the preceding 30-month period, those working in the maquiladora had 40–90% higher risks of upper back, neck/shoulder, and hand/wrist pain. Compared with women working outside the maquiladora, maquiladora women workers had 20% higher risks of low back, upper back, and neck/shoulder complaints. More detailed studies of the incidences of musculoskeletal disorders and of specific etiologic risk factors within the maquiladora industry are warranted. Future studies should concurrently evaluate sociodemographic risk factors.     

Managing shoulder pain in general practice--the value of academic detailing

After low back pain and neck pain, shoulder pain is the third musculoskeletal reason for presentation to general practice, with a self reported prevalence of 16-26%. Approximately 1% of the adult population is expected to visit a general practitioner annually for shoulder pain. Shoulder complaints are more common in women and despite the fact that 50% of acute shoulder pain resolves in 8-10 weeks, many patients present with the anticipation of being referred for imaging.     

Occupational cervicobrachial disorder (OCD) of nursery school teachers based on subjective symptoms related to OCD

To clarify the association of occupational cervicobrachial disorder (OCD), with labor conditions, and personal situation, a questionnaire study was conducted among nursery school teachers. The questionnaire was composed of subjective symptoms related to OCD (neck, shoulder, back and arm stiffness/pain), labor conditions, and whether or not the teacher had a child of her own under the age of two. Data of 793 subjects were analyzed. The results were as follows: The mean age and working period of 793 subjects were 27.6 (+/- 4.9) and 5.5 (+/- 3.2) years, respectively. Of them, 38.5% complained of right shoulder stiffness every day during the prior month, 26.5% neck stiffness, 18.8% arm stiffness, 9.6% back pain, 7.8% shoulder pain and 3.9% arm pain. The complaint rates on the left side were similar to those on the right side. The complaint rates of these subjective symptoms increased with the duration of the working period. The complaint rates of shoulder, neck and arm stiffness increased earlier than those of back stiffness, shoulder or arm pain. The complaint rates of these symptoms were highest among teachers in charge of children less than one-year-old and those in charge of four-year olds. Teachers in charge of three-year-old children had the lowest complaint rates. Subjects complaining of neck, shoulder and arm stiffness on every day worked under less favorable conditions than those without such complaints. When subjects having no children of their own under the age of two were matched in their ages and length of work history with those who have such children, the complaint rates of the two groups did not differ statistically for any of the subjective symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)     

Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals

OBJECTIVES: To investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of the lower back, neck and shoulders. METHODS: In this cross-sectional study a questionnaire survey was carried out among 351 nursing personnel (response 84%) in six general hospitals in Athens, Greece. A questionnaire was used on physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence. In logistic regression analysis odds ratios (ORs) were estimated for all relevant risk factors. RESULTS: Self-reported factors of physical load were associated with the occurrence of back pain (OR=1.85), neck pain (OR=1.88), and shoulder pain (OR=1.87) but these factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.47 and 4.13 for two and three musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, or sickness absence was observed. A perceived moderate general health was also a risk factor, and strongest associations were observed for sickness absence due to back pain (OR=2.03), neck pain (OR=8.31), and shoulder pain (OR=6.84). CONCLUSIONS: The handling of physical loads among nurses seems to put them at risk for the occurrence of musculoskeletal disorders. The development of these complaints into chronic complaints and associated sickness absence is strongly determined by perceived general health and almost not associated with work-related physical and psychosocial risk factors. When the influence of work-related risk factors on musculoskeletal health is being investigated, the general health status of individual workers should be taken into account.     

The association between exposure to a rear-end collision and future neck or shoulder pain: a cohort study

Neck pain is the most frequently reported feature in connection with whiplash injury, but it is also a common complaint in the general population. Therefore it is crucial to include an unexposed comparison group when evaluating the association between neck pain and a previous motor vehicle crash (MVC). To determine whether exposure to a rear-end collision, without or with whiplash injury, is associated with future neck or shoulder pain, a cohort study was conducted. The study population consisted of persons covered by traffic insurance at one of the largest insurance companies in Sweden. Claim reports were collected from the period November 1987 to April 1988. Drivers exposed to a rear-end collision were divided into two subgroups, without reported whiplash injury (n = 204) and with reported whiplash injury (n = 232). Two comparison groups, unexposed to MVCs, consisting of 1599 and 2089 persons, were selected with consideration taken to the age and gender distribution in the exposed subgroups. A questionnaire concerning neck or shoulder pain and other subjective health complaints was mailed to all the study subjects at follow-up in 1994, 7 years after the rear-end collision. The relative risk of neck or shoulder pain at follow-up was 1.3 (95% CI 0.8-2.0) in the exposed subjects without whiplash injury compared with the unexposed. The corresponding relative risk in subjects with whiplash injury was 2.7 (95% CI 2.1-3. 5). We conclude that there is no increased risk of future neck or shoulder pain in drivers who did not report whiplash injury in connection with a rear-end collision 7 years earlier. In drivers with reported whiplash injury, the risk of neck or shoulder pain 7 years after the collision was increased nearly three-fold compared with that in unexposed subjects.     

Factors associated with medical care-seeking due to low-back pain in scaffolders

BACKGROUND: Few studies have demonstrated the consequences of having back pain and the mechanisms underlying decisions to seek medical care. This study aimed to assess the prevalence of back pain and other musculoskeletal complaints and to identify factors that determine specific type of care-seeking due to back pain among scaffolders. METHODS: A cross-sectional study was conducted among 323 scaffolders. A questionnaire was used to collect data on musculoskeletal complaints and type of medical care sought. Logistic regression analysis was performed to study the risk factors for care-seeking for LBP, estimating Prevalence Ratios (PR) as a measure of association. RESULTS: The prevalence of musculoskeletal complaints was high. Severe back pain was reported by 28% of the scaffolders, LBP with sciatic pain by 23%, with sickness absence by 21%, with disability by 21%, and chronic back pain by 14%. Back pain was often accompanied by complaints of neck, shoulder, or knee. A general practitioner was sought by 44% of the workers with LBP, a physiotherapist by 22%, an occupational physician by 20%, and a specialist by 11%. The nature and severity of back pain seemed to determine the decision to visit the GP. Irradiating pain and sickness absence were the strongest predictors for seeking medical care and being referred to a specialist or physiotherapist. CONCLUSION: The particular definition of back pain and the selection process of workers with LBP may partly determine the findings on work-related risk factors and health care utilization.     

Pushing and pulling in association with low back and shoulder complaints

Aims: To examine the association between exposure to pushing/pulling at work and low back and shoulder complaints. Methods: A cross sectional questionnaire survey was carried out among 434 workers from several companies with mainly pushing/pulling tasks. From the same companies 188 workers without physically demanding tasks served as reference. The questionnaire was used to assess the exposure to pushing/pulling and other physical risk factors for low back and shoulder complaints. Mean scores at company level were used to classify groups into medium and high exposed to pushing/pulling and a reference group. Psychosocial factors at work were also assessed. Several pain related questionnaires were used to assess the 12 month prevalence of low back and shoulder complaints in three dimensions: trouble (ache, pain, discomfort), pain intensity, and disability. Prevalence rate ratios (PRs) were calculated using Cox''s proportional hazards regression analysis. Results: The 12 month prevalence of low back complaints was almost equal for all three groups. The prevalence of shoulder complaints increased with an increase in exposure level. Adjusted PRs showed that the high exposed group had an increased risk for low back complaints compared to the reference group. For all dimensions of shoulder complaints a clear tendency towards a dose–response relation was observed. The high exposed group had significant PRs for shoulder complaints, ranging from 2.09 to 6.37. Generally, psychosocial factors had a confounding effect for pain intensity and disability, but not for trouble. Conclusions: For shoulder complaints a dose–response relation was observed for exposure to pushing/pulling. Low back complaints were less consistently associated with pushing/pulling. Stronger associations were observed for more severe cases of low back and shoulder complaints. It is hypothesised that work related psychosocial factors affect these associations.     

Prevalence and comparative troublesomeness by age of musculoskeletal pain in different body locations

BACKGROUND: Chronic pain has large health care costs and a major impact on the health of those affected. Few studies have also considered the severity of pain in different parts of the body across all age groups. OBJECTIVES: To measure the prevalence and troublesomeness of musculoskeletal pain in different body locations and age groups, in a consistent manner, without using location specific health outcome measures. METHODS: A cross-sectional postal survey of 4049 adults registered with 16 MRC General Practice Research Framework practices. Frequency of chronic pain overall and troublesome pain by location and age was calculated. Logistic regression was undertaken to explore the relationship between chronic pain and demographic factors. RESULTS: We received 2504 replies; response rate 60%. The prevalence of chronic pain was 41%. The prevalence of chronic pain rose from 23% in 18-24 year olds reaching a peak of 50% in 55-64 year olds. Troublesome pain over the last 4 weeks was commonest in the lower back (25%), neck (18%), knee (17%) and shoulder (17%). Troublesome wrist, elbow, shoulder, neck and lower back pain were most prevalent in the 45- to 64-year-age groups. Troublesome hip/thigh, knee and ankle/foot pain were most prevalent in those aged 75 or more. CONCLUSIONS: Great efforts have been made to develop and test treatments for low back pain. Our findings suggest that the overall prevalence of troublesome neck, knee and shoulder pain approaches that of troublesome low back pain and that similar efforts may be required to improve the management these pains.     

Low-back and shoulder complaints among workers with pushing and pulling tasks

OBJECTIVES: Low-back and shoulder complaints were examined in relation to self-reported and objectively assessed exposure to work-related pushing and pulling. METHODS: Workers from several companies (eg, nursing homes and flower auctions) with pushing and pulling tasks and, as reference, workers without physically demanding tasks were invited to participate. Altogether 829 workers initially received a questionnaire, of whom 459 responded both initially and after 1 year of follow-up. Initially, self-reported exposure to pushing and pulling was assessed by questionnaire. Furthermore, a representative sample of 131 workers was observed at work using TRAC (task recording and analysis on computer) to assess exposure to pushing and pulling objectively. For exposure to pushing and pulling, the workers were classified into a reference group and medium and high exposure groups. Initially and in the follow-up, the 12-month prevalence of low-back and shoulder complaints was assessed. Complaints reported in the follow-up were separately used as dependent variables to calculate prevalence rate ratios (PR) in a Cox's proportional hazard regression analysis. RESULTS: The adjusted PR values were not significant for low-back complaints. For shoulder complaints, both the medium and high exposure groups showed significant adjusted PR values for self-reported exposure and observed duration of pushing and pulling when compared with the reference group (PR range 2.18-4.86). For the observed frequency of pushing and pulling, only the medium exposure group showed a significant PR, of 3.95. CONCLUSIONS: The findings suggest a rather strong relationship between pushing and pulling and shoulder complaints. The evidence for a relationship between pushing and pulling and low-back complaints is limited.     

Work Related Risk Factors for Neck, Shoulder and Arms Complaints: A Cohort Study Among Dutch Computer Office Workers

Introduction This study aims to investigate the relationship between work-related physical and psychosocial characteristics and complaints of the neck, shoulder and forearm/hands. Methods Data were used from a prospective Dutch cohort study among computer office workers with a follow-up period of 2 years. The study was conducted among 264 computer users. Physical and psychosocial risk factors were tested to predict the occurrence of neck, shoulder and forearm/hands complaints. Bivariate and multivariable logistic regression was used to identify the association between risk factors and outcome variables. Results The 2 year follow-up prevalence rates with 95% CI for neck complaints were 0.31 (0.28–0.37), for shoulder complaints 0.33 (0.27–0.39) and for forearm/hands complaints 0.21 (0.14–0.28). Four main predictors for the occurrence of neck and shoulder complaints were identified: (1) Irregular head and body posture [OR: 1.1 (1.0–1.2) P = 0.04]; (2) task difficulty (job demands) [OR: 1.2 (1.0–1.5) P = 0.01]; (3) number of working hours/day with the computer [OR: 1.20 (1.0–1.4) P = 0.03]; and (4) having had a previous history of complaints [OR: 7.2 (3.8–13.2) P = 0.01]. Two predictors were identified for forearm/hands complaints: time pressure (job demands) [OR: 1.20 (1.0–1.4) P = 0.03] and having had a previous history of complaints [OR: 7.1 (3.5–14.1) P = 0.06]. Conclusion This longitudinal study suggests that risk factors of upper musculoskeletal complaints in computer workers consist of a mixture of physical and psychosocial characteristics.     

Prevalence and occupational associations of neck pain in the British population

OBJECTIVES: This study determined the prevalence of neck pain and its relation to occupation and occupational activities in the general population. METHODS: A questionnaire was mailed to 21 201 subjects aged 16-64 years, randomly selected from the patient registers of general practices in England, Scotland, and Wales, and to 993 subjects randomly selected from pay records of the armed services. Information was collected on occupation, workplace physical activities, neck pain in the past week and year, headaches, and feelings of tiredness or stress. Associations were explored by logistic regression, the resultant odds ratios being converted to prevalence ratios (PR). RESULTS: Among 12907 respondents, 4348 and 2528 reported neck pain in past year (1421 with pain interfering with normal activities) and week, respectively. Symptoms were the most prevalent among male construction workers [past week and year 24% and 38% (pain interfering with activities 11%), respectively], followed by nurses, armed services members, and the unemployed. Generally the age-standardized prevalence of neck pain varied little by occupation. Work with arms above the shoulders for >1 hours/day was associated with a significant excess of symptoms [PR 1.3-1.7 (women) and 1.2-1.4 (men)], but no associations existed for typing, lifting, vibratory tool use, or professional driving. Stronger neck-pain associations were found with frequent headaches (PR 2.3-2.8) and frequent tiredness or stress (PR 2.2-2.5) than with occupational activities. CONCLUSIONS: The data provide evidence against a strong association between neck pain and the examined occupational physical activities. They suggest that psychosocial factors may be more important.     

A comparative analysis on musculoskeletal disorders between Greek and Dutch nursing personnel

Objective: To analyse cross-cultural differences between Greek and Dutch nursing personnel in association with the risk factors and occurrence and consequences (absenteeism and medical care seeking) of musculoskeletal disorders. Methods: This study was based on questionnaire surveys among 393 nurses and caregivers in nursing homes and homes for the elderly in The Netherlands and among 351 nurses in general hospitals in Athens, Greece. Logistic regression analysis was used to analyse associations between physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence and medical care seeking. Results: Greek nurses reported significantly more back complaints in the past 12 months (75 vs. 62%) than the Dutch workers, but chronicity (11 vs. 12%) and sickness absence (17 vs. 15%) of these complaints did not differ. Similar differences were observed for neck complaints but not for shoulder complaints. Most Greek nurses with back complaints visited a medical specialist (40%) while Dutch nurses and caregivers sought care through a general practitioner (33%). Multivariate analyses showed that in both countries strenuous back postures (ORs 1.9 and 1.9) and especially a moderate general health (ORs 4.3 and 2.9) were the significant risk factors for back pain. Conclusions: In both countries similar risk factors were associated with the occurrence of low-back pain. Cross-national differences were less important for the risk factors and musculoskeletal complaints than for the consequences of these complaints and for medical care seeking.     

A population study on differences in the determinants of a specific shoulder disorder versus nonspecific shoulder pain without clinical findings

Musculoskeletal pain frequently occurs without particular clinical findings. Pain per se may be determined by factors other than those indicating a clinical disorder. The authors examined the prevalence and determinants of clinically diagnosed chronic rotator cuff tendinitis and self-reported nonspecific shoulder pain. The Health 2000 survey, carried out in 2000-2001 in Finland, included a nationally representative sample of 8,028 persons aged 30 years or more. In the present study, analyses were restricted to subjects aged 30-64 years who had held a job during the preceding 12 months. The prevalences of chronic rotator cuff tendinitis and nonspecific shoulder pain were 2.0% (78 of 3,909 subjects) and 12% (410 of 3,525 subjects), respectively. Nonspecific pain was related to burnout (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4, 2.2), depression (among women, the adjusted OR was 1.8 (95% CI: 1.1, 2.9) for mild depression and 3.0 (95% CI: 1.6, 5.6) for severe depression), and inability to express one's feelings (alexithymia) (adjusted OR = 1.6, 95% CI: 1.1, 2.5). However, these factors were not associated with chronic rotator cuff tendinitis, determinants of which were work-related cumulative loading on the shoulder, age, and insulin-dependent diabetes mellitus (adjusted OR = 8.8, 95% CI: 1.9, 40.3). The determinants of specific musculoskeletal disorders differ from those of subjective complaints without clinical findings. Such complaints may be indicators of adverse psychological and psychosocial factors rather than the presence of an underlying pathologic condition.     

Subjective complaints in orthopedists and general surgeons

The aim of this study was to investigate the prevalence of subjective complaints among two groups of health care personnel. Using a mail questionnaire, 63 male orthopedists and 78 male general surgeons were asked to respond to questions on their subjective musculoskeletal complaints as well as their age, occupational career, and daily working time. In the final analysis, 54 orthopedists and 63 general surgeons who were aged 59 years and had worked for at least 5 years in clinical practice were considered. The mean age was 43.3 (SD 7.6) years for the orthopedists and 41.8 (SD 9.5) years for the general surgeons. Their mean employment time was 18.1 (SD 8.9) years and 16.6 (SD 9.5) years, respectively. The average working time per day was 9.5 h. In general, the orthopedists had a higher prevalence of subjective complaints than the general surgeons. Problems in the shoulders and lower back were the most frequently reported complaints, followed by neck problems. There were significant differences (P < 0.05) between the two groups regarding stiffness in the shoulders, stiffness in the lower back, pain in the neck, and numbness in the fingers. When subjective complaints were compared between the junior (employment time: < 20 years) and senior (employment time: 20 years) staff, the junior orthopedists had significantly higher prevalence rates for stiffness in the shoulders, pain in the neck, and stiffness in the lower back. This subgroup had significantly higher odds ratios (ORs) for some subjective complaints as compared to the junior surgeons, e.g., pain in the neck [OR = 6.19, 95% confidence interval (95% Cl) 1.91–20.04], shoulder stiffness (OR = 3.75, 95% Cl 1.36–10.31), pain in the shoulders (OR = 4.41, 95% Cl 3.64–4.70), and stiffness in the lower back (OR = 4.93, 95% Cl 1.74–13.94). It was concluded that ergonomic intervention to improve the working environment is imperative. In addition to ergonomic factors, consideration might also be given to psychological factors with a view to reducing the risk of subjective complaints among these subjects.     

Work-related risk factors for the incidence and recurrence of shoulder and neck complaints among nursing-home and elderly-care workers

OBJECTIVES: This study assessed the differences and similarities in the incidence and recurrence of shoulder and neck complaints with respect to work-related physical, psychosocial, and personal risk factors. METHODS: A prospective cohort study was carried out among 769 workers of nursing homes and homes for the elderly. At baseline, a questionnaire was used to collect data on personal characteristics, physical workload, psychosocial workload, and the presence of shoulder and neck complaints. After 1 and 2 years, follow-up data were collected on shoulder and neck complaints. Generalized estimation equations were used for analyzing risk factors for the participants with at least one follow-up measurement available (N=556, 72%). RESULTS: In the multivariate model, adjusted for age and gender, obesity [odds ratio (OR) 2.12, 95% confidence interval (95%CI) 1.23-3.65] was related to the incidence of shoulder complaints. The incidence of neck complaints was increased for obesity (OR 1.81, 95% CI 1.07-3.05), work in awkward postures (OR 1.76, 95% CI 1.11-2.78), and poor or fair general health (OR 1.53, 95% CI 1.02-2.31). The recurrence of both shoulder and neck complaints was associated with chronic complaints at baseline (shoulder: OR 1.91, 95% 1.36-2.67; neck: OR 1.71, 95% 1.14-2.55) but not with work-related risk factors. CONCLUSIONS: The results suggest that there are differences in risk factors for the incidence and recurrence of shoulder and neck complaints.