Abstract
ObjectivesThe aim was to determine the association of occupational arm inclination with shoulder pain in construction and health care workers.MethodsArm inclination relative to the vertical was measured with an accelerometer placed on the dominant upper arm for up to four full days at baseline in 62 construction workers and 63 health care workers. The pain intensity in the shoulder and mechanical and psychosocial work factors were measured by self-reports at baseline and prospectively after 6 months. The associations between exposures and shoulder pain were analyzed with multilevel mixed-effects linear regressions.ResultsFor the total study population working with the dominant arm at inclinations > 30° and >120° was associated with lower levels of shoulder pain both cross-sectionally and after 6 months. Associations were attenuated when adjusting for individual and social factors, psychological state, and exposure during leisure time, especially for the high inclination levels. Analyses, only including subjects with no pain at baseline revealed no significant associations. While stratified analysis showed negative associations in the construction worker group, there were no significant association in health care workers. Compared to the number of hypotheses tested, the number of significant findings was low. Adjustment by Bonferroni-correction made almost all findings insignificant.ConclusionsAll analyses reflected a negative association between arm inclination and shoulder pain, but few analyses showed these associations to be statistically significant. If there is a relationship between arm inclination and shoulder pain, these findings could indicate that pain-avoidance may modify how workers perform their tasks.
Highlights
Shoulder pain is a major concern in Western society [1]
For the total study population working with the dominant arm at inclinations > 30 ̊ and >120 ̊ was associated with lower levels of shoulder pain both cross-sectionally and after 6 months
All analyses reflected a negative association between arm inclination and shoulder pain, but few analyses showed these associations to be statistically significant
Summary
Shoulder pain is a major concern in Western society [1]. The one-month prevalence of shoulder pain in the general population ranges from 19% to 31% and the lifetime prevalence from 7% to 67% [1]. A recent systematic review [7] identified seven high-quality studies with prospective designs based on subjective reports of mechanical exposures at work, that all found positive associations between work with hands above shoulder level and shoulder pain [8,9,10,11,12,13,14]. Self-reports of some mechanical exposures at work have inadequate validity. Correlations between objectively measured data and self-reports are relatively low [17]. Bias in self-reported measurements might be caused by recall bias or insufficient memory, interpretation of questions, pain [17,18,19], perception of other work factors, or psychosocial factors [20]. Objective measurements of exposures are recommended to provide valid assessments of exposure [18]
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