Extended report
Association of occupational physical demands and psychosocial
working environment with disabling shoulder pain
D P Popea, A J Silmana, N M Cherryb, C Pritcharda, G J Macfarlanea c
a Arthritis Research
Campaign Epidemiology Unit, School of Epidemiology and Health Sciences,
The University of Manchester, Stopford Building, Oxford Road,
Manchester M13 9PT, UK, b Centre for Occupational and Environmental
Health, School of Epidemiology and Health Sciences, The University of
Manchester, c Unit of Chronic
Disease Epidemiology, School of Epidemiology and Health Sciences, The
University of Manchester
Correspondence to: Dr D Pope, Department of Public Health, The University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, UK danpope{at}liverpool.ac.uk
Accepted for publication 9 February
2001
OBJECTIVE
To estimate
the individual and combined associations of physical and psychosocial
working environment with disabling shoulder pain and to identify groups
at "high risk" for shoulder pain.
METHODSA cross
sectional survey was conducted at five manual occupational settings in
south Manchester, United Kingdom (n=775, 83%).
RESULTSBoth the
duration of occupational physical demands (working postures, manual
handling activities, and repetitive arm movements) and psychosocial
working environment (psychological demands and lack of opportunity to
learn new skills) were found to be significantly associated with
shoulder pain. Three occupational factors identified a high risk group
for shoulder pain: duration of lifting with one hand (prevalence rate
ratio (PRR) (highest third) 2.0, 95% confidence interval (CI) 1.4 to
2.8), duration of working above shoulder level (PRR (highest third)
2.2, 95% CI 1.5 to 3.3), and whether employees found their work
stressful (PRR (highest third) 1.4, 95% CI 1.0 to 2.1). In addition, a
measure of psychological distress (General Health Questionnaire (GHQ)
score) was found to identify a group at high risk for shoulder pain
(PRR (highest third) 1.9, 95% CI 1.3 to 2.9). In employees exposed to
three or more of these factors, 79% (23/29) reported shoulder pain
compared with only 16% (56/353) of those not exposed to any.
CONCLUSIONThis study
has identified a variety of occupational physical demands and
psychosocial factors associated with shoulder pain. It has also
identified groups of employees at a "high risk" for shoulder pain
by their exposure to both physical and psychosocial factors.
© 2001 by Annals of the Rheumatic Diseases
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