Psychosocial work stressors as antecedents of musculoskeletal problems: a systematic review and meta-analysis of stability-adjusted longitudinal studies

Although the relationship between psychosocial workplace conditions and musculoskeletal problems has been extensively studied, the causal impact of psychosocial workplace factors in the development of musculoskeletal problems remains unclear. The purpose of the present study was to conduct a systematic review of baseline-adjusted prospective longitudinal studies estimating the lagged effect of psychosocial risk factors on musculoskeletal problems in industrialized work settings. A literature review was conducted by searching the MEDLINE, EMBASE, and PsychINFO databases dated until August 2009. The authors classified studies into categories of psychological work stressors and musculoskeletal problems. Available effect sizes were converted to odds ratios (OR). ORs were then pooled for each stressor-problem relationship using a random-effects model. Additionally, the possibility of publication bias was assessed with the Duval and Tweedie nonparametric "trim and fill" procedure. In total, 50 primary studies fulfilled inclusion criteria. Within these studies at least five effect sizes were available for 23 of the 45 possible psychosocial work stress-musculoskeletal problems relationships, leaving 9 psychosocial variables and four musculoskeletal problem areas for analyses. Of these 23 relationships, pooled OR estimates were positive and significant ranging from 1.15 to 1.66 with the largest pooled OR estimating the relationship between highly monotonous work and lower back pain. The lagged effect of low social support on lower limb problems was the only effect size for which the statistical test for bias was significant. Most psychosocial stressors had small but significant lagged effects on the development of musculoskeletal problems. Thus, organizational interventions to minimize these stressors may be promising in reducing one risk factor for the development of employee musculoskeletal problems.