Risk Factors For Neck Pain Research Articles

Are there health effects of harassment in the workplace? A gender-sensitive study of the relationships between work and neck pain

The aim of this study was to identify workplace physical and psychosocial risk factors for neck pain among male and female workers and, in particular, to study the relationship between neck pain and intimidation and sexual harassment in the workplace in a representative sample of the Quebec working population. The study sample included 5405 men and 3987 women. In multiple logistic regression analyses, when taking into account individual and other workplace factors, neck pain was significantly associated with intimidation at work among both male (odds ratio (OR) 1.4 (1.01–1.8)) and female workers (OR 1.3 (1.01–1.8)). Among female workers, neck pain was alsosignificantly associated with unwanted sexual attention (OR 1.6 (1.1–2.4)). If confirmed in prospective studies, these results suggest that interventions to prevent harassment in the workplace may help reduce musculoskeletal disorders in the workplace and that workplace programmes to reduce harassment in the workplace should include prevention of sexual harassment. Practitioner Summary: While taking into account relevant personal factors and previously identified workplace physical and psychosocial risk factors, this gender-based study identifies new work exposures associated with neck pain that have not previously been studied, including unwanted sexual attention, intimidation and difficult or tense situations with the public.

Changes in Head and Neck Posture Using an Office Chair With and Without Lumbar Roll Support

A repeated measures observational study. To investigate change in sagittal alignment of head and neck posture in response to adjustments of an office chair with and without a lumbar roll in situ. Forward head posture has been identified as a risk factor for neck pain, and there is evidence to show that ergonomic correction in sitting may reduce the incidence of pain. The effect placement of a lumbar roll has on cervical spine posture has not been previously investigated experimentally but rather, is assumed to have a positive influence on head and neck posture. Thirty healthy male participants (18-30 years) were photographed while registered in the natural head resting position in each of 4 sitting positions with and without a lumbar roll in situ. Two positions incorporated adjustments to the back rest and 1 to the seat pan of the office chair. The craniovertebral (CV) angle, as a determinant of head and neck posture was measured from the set of digitized photographs obtained for each participant. Comparisons between the CV angle in all postural registrations were made using a mixed model analysis adjusted for multiple comparisons. Of the positions examined, significant differences in the mean CV angles were found with the backrest of the chair at 100 degrees and at 110 degrees (P < 0.001). With the lumbar roll in situ and the backrest position at 110 degrees , there was a significant increase in the mean CV compared with the angle without the lumbar roll in situ (2.32 degrees , 95% confidence interval: 1.31-3.33; P < 0.001). The degree of angulation of the backrest support of an office chair plus the addition of lumbar roll support are the 2 most important factors to be taken into account when considering seating factors likely to favorably change head and neck postural alignment, at least in asymptomatic subjects.

Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study

Neck pain is more prevalent in office workers than in the general community. To date, findings from prospective studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up. The aim of this research was to prospectively evaluate a range of risk factors for neck pain in office workers, using validated and reliable objective measures as well as attain an estimate of 1-year incidence. We assembled a cohort of 53 office workers without neck pain and measured individual, physical, workplace and psychological factors at baseline. We followed participants for 1 year to measure the incidence of neck pain. We achieved 100% participant follow-up. Cox regression analysis was applied to examine the relationship between the putative risk factors and the cumulative incidence of neck pain. The 1-year incidence proportion of neck pain in Australian office workers was estimated in this study to be 0.49 (95% CI 0.36-0.62). Predictors of neck pain with moderate to large effect sizes were female gender (HR: 3.07; 95% CI: 1.18-7.99) and high psychological stress (HR: 1.64; 95% CI: 0.66-4.07). Protective factors included increased mobility of the cervical spine (HR: 0.44; 95% CI: 0.19-1.05) and frequent exercise (HR: 0.64; 95% CI: 0.27-1.51). These results reveal that neck pain is common in Australian office workers and that there are risk factors that are potentially modifiable.

The Burden and Determinants of Neck Pain in the General Population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. Summary of Background Data The evidence on burden and determinants of neck has not previously been summarized. Methods The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. Results We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing. Conclusion Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.

The Burden and Determinants of Neck Pain in Workers: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Study Design Systematic review and best evidence synthesis. Objectives To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research. Summary of Background Data Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research. Methods We systematically searched Medline for literature published from 1980–2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis. Results One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Québec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers' ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers. Conclusion Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

Prevalence and Risk Factors of Neck Pain in Military Office Workers

An extensive cross-sectional questionnaire was used to estimate the prevalence of neck pain and to identify risk factors (short term to long term) in the occurrence of neck pain in military office workers. Two standardized scales (Neck Disability Index and Tampa Scale for Kinesiophobia) allowed assessment of the impact of neck pain on the person's life and the pain-related fear avoidance. A total of 629 completed questionnaires were evaluated which revealed the following: lifetime prevalence (78%), week prevalence (53%), point prevalence (59%), year prevalence (65%) (once-only, 19%; regular, 51%; long term, 15%; never, 7%). The results of this study provided support for the role of physical and psychosocial job characteristics in the etiology of neck pain in military office workers.

The Burden and Determinants of Neck Pain in the General Population

Best evidence synthesis. To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. The evidence on burden and determinants of neck has not previously been summarized. The Bone and Joint Decade 2000−2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing. Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.

The Burden and Determinants of Neck Pain in Workers

Systematic review and best evidence synthesis. To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research. Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research. We systematically searched Medline for literature published from 1980–2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis. One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Quebec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers’ ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers. Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders

Scott Haldeman, DC, MD, PhD,1 Linda Carroll, PhD,2 J. David Cassidy, DC, PhD, DrMedSc,3 Jon Schubert, CMA,4 and Ake Nygren, DDS, MD, DrMedSc5 1Department of Neurology, University of California, Irvine, CA; Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA 2Department of Public Health Sciences, and Alberta Center for Injury Control and Research, School of Public Health, University of Alberta, Canada 3Department of Public Health Sciences, Faculty of Medicine, University of Toronto an Division of Health Outcomes and Research, Toronto Western Research Institute, University Health Network, Toronto, Canada 4CEO–SGI, Regina, Saskatchewan, Canada 5Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Karolinska Institutet, Stockholm, Sweden

The Burden and Determinants of Neck Pain in the General Population

Best evidence synthesis. To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. The evidence on burden and determinants of neck has not previously been summarized. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to the burden and determinants of neck pain in the general population. Incidence ranged from 0.055 per 1000 person years (disc herniation with radiculopathy) to 213 per 1000 persons (self-reported neck pain). Incidence of neck injuries during competitive sports ranged from 0.02 to 21 per 1000 exposures. The 12-month prevalence of pain typically ranged between 30% and 50%; the 12-month prevalence of activity-limiting pain was 1.7% to 11.5%. Neck pain was more prevalent among women and prevalence peaked in middle age. Risk factors for neck pain included genetics, poor psychological health, and exposure to tobacco. Disc degeneration was not identified as a risk factor. The use of sporting gear (helmets, face shields) to prevent other types of injury was not associated with increased neck injuries in bicycling, hockey, or skiing. Neck pain is common. Nonmodifiable risk factors for neck pain included age, gender, and genetics. Modifiable factors included smoking, exposure to tobacco, and psychological health. Disc degeneration was not identified as a risk factor. Future research should concentrate on longitudinal designs exploring preventive strategies and modifiable risk factors for neck pain.

The Burden and Determinants of Neck Pain in Workers

Systematic review and best evidence synthesis. To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research. Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research. We systematically searched Medline for literature published from 1980-2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis. One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Québec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers' ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers. Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

Individual and work related risk factors for neck pain among office workers: a cross sectional study

Work related neck disorders are common problems in office workers, especially among those who are intensive computer users. It is generally agreed that the etiology of work related neck disorders is multidimensional which is associated with, and influenced by, a complex array of individual, physical and psychosocial factors. The aim of the current study was to estimate the one-year prevalence of neck pain among office workers and to determine which physical, psychological and individual factors are associated with these prevalences. Five hundred and twelve office workers were studied. Information was collected by an online questionnaire. Self-reported neck pain during the preceding 12 months was regarded as a dependent variable, whereas different individual, work-related physical and psychosocial factors were studied as independent variables. The 12 month prevalences of neck pain in office workers was 45.5%. Multivariate analysis revealed that women had an almost two-fold risk compared with men (OR = 1.95, 95% CI 1.22-3.13). The odds ratio for age indicates that persons older than 30 years have 2.61 times more chance of having neck pain than younger individuals (OR = 2.61, 95% CI 1.32-3.47). Being physically active decreases the likelihood of having neck pain (OR = 1.85, 95% CI 1.14-2.99). Significant associations were found between neck pain and often holding the neck in a forward bent posture for a prolonged time (OR = 2.01, 95% CI 1.20-3.38), often sitting for a prolonged time (OR = 2.06, 95% CI 1.17-3.62) and often making the same movements per minute (OR = 1.63, 95% CI 1.02-2.60). Mental tiredness at the end of the workday (OR = 2.05, 95% CI 1.29-3.26) and shortage of personnel (OR = 1.71, 95% CI 1.06-2.76) are significantly associated with neck pain. The results of this study indicate that physical and psychosocial work factors, as well as individual variables, are associated with the frequency of neck pain. These association patterns suggest also opportunities for intervention strategies in order to stimulate an ergonomic work place setting and increase a positive psychosocial work environment.

Risk factors for neck pain in office workers: a prospective study

BackgroundPersisting neck pain is common in society. It has been reported that the prevalence of neck pain in office workers is much higher than in the general population. The costs to the worker, employer and society associated with work-related neck pain are known to be considerable and are escalating. The factors that place office workers at greater risk of developing neck pain are not understood. The aim of this study is to investigate the incidence and risk factors of work-related neck pain in Australian office workers.Methods/designWe will conduct a prospective cohort study. A cohort of office workers without neck pain will be followed over a 12 month period, after baseline measurement of potential risk factors. The categories of risk factors being evaluated are physical (cervical spine posture, range of movement, muscle endurance and exercise frequency), demographic (age, sex), work environment (sitting duration, frequency of breaks) and psychosocial (psychological distress and psychosocial work factors). Cox regression analysis will be used to identify risk factors associated with work-related neck pain, and will be expressed as hazard ratios with 95% confidence intervals. The data will also enable the incidence of neck pain in this population to be estimated.DiscussionIn addition to clarifying the magnitude of this occupational health problem these data could inform policy in workplaces and provide the basis for primary prevention of neck pain in office workers, targeting the identified risk factors.

The Prevalence of and Risk Factors for Neck Pain and Upper Limb Pain among Secondary School Teachers in Hong Kong

To investigate the prevalence and occupational risk factors of neck and upper limb disorders among secondary school teachers. One hundred secondary schools in Hong Kong were randomly chosen. Every full-time teacher received a questionnaire and a letter describing the purpose of the study. Questionnaires were collected 1 to 3 weeks later. Among 3,100 secondary school teachers, the lifelong prevalence of neck pain and upper limb pain was 69.3% (2091/3018) and 35.8% (1088/3042) respectively. The lifelong cumulative incidence of both neck and upper limb pain was 31.6% (938/2966). Multiple logistic regression analysis showed that gender, age and working in head down posture were identified as risk factors for neck and upper limb pain. High workload, low colleague support and high anxiety were found to be significant on affecting the neck pain and upper limb pain developed after becoming teachers. Neck pain and upper limb pain were highly prevalent in secondary school teachers in Hong Kong. Gender, age, head down posture and some psychological factors were found to be significant risk factors.

A study on the prevalence of and risk factors for neck pain in secondary school teachers

Neck pain is common in the general population, and is costly in terms of treatment, individual suffering and time lost due to work absenteeism. Many studies have investigated the relationship between neck pain and occupation. Medical secretaries, factory workers, office workers and university academic staff have been found to be at risk. Three domains of risk factors have been identified that contribute to occupation-related neck pain: individual factors (age, gender and length of employment), physical factors (working with computer or visual display unit, working posture and duration) and psychosocial factors (job stress, job satisfaction, work demand and colleague support). This cross-sectional study was conducted in an attempt to explore the effects of these risk factors among secondary school teachers.

A study on the prevalence of and risk factors for neck pain among university academic staff in Hong Kong.

The 1-year prevalence of neck pain and possible risk factors among university academic staff were investigated. Self-administered questionnaires were distributed to all the full-time academic staff in one of the universities in Hong Kong. The 1-year prevalence of neck pain was investigated. The relationship between individual factors, job nature, psychosocial factors, and neck pain were also analyzed. The 1-year prevalence of neck pain among after being an academic staff was 46.7%. A significant association was found between gender and neck pain (p = 0.02). The percentage of female academic staff with neck pain (62%) was higher than that in male staff (38%). This matched the results of other studies, which demonstrated that neck pain was more prevalent in women. There was a significant association between head posture during computer processing and neck pain (p = 0.02). Among those with neck pain during computer processing, 60.5% had a forward head posture. However, a low correlation between psychosocial factors and neck pain was demonstrated (r = 0.343). Academic staff in tertiary institutions could be considered as a high-risk group of job-related neck pain.

High quantitative job demands and low coworker support as risk factors for neck pain: results of a prospective cohort study.

A 3-year prospective cohort study among 1334 workers was conducted. To determine whether the work-related psychosocial factors of quantitative job demands, conflicting job demands, skill discretion, decision authority, supervisor support, coworker support, and job security are risk factors for neck pain. Among the various risk factors for neck pain, work-related psychosocial factors play a major role. Previous studies on risk factors for neck pain often had a cross-sectional design, and did not take both physical and psychosocial factors into account. At baseline, data on work-related psychosocial factors were collected by means of a questionnaire. During the 3-year follow-up period, data on the occurrence of neck pain were collected by means of postal questionnaires. Individuals without neck pain at baseline were selected for the analyses. Cox regression analysis was applied to examine the relation between the work-related psychosocial factors and the cumulative incidence of neck pain. Adjustments were made for various physical factors and individual characteristics. The analysis included 977 patients. Altogether, 141 workers (14.4%) reported that they had experienced neck pain at least once during the 3-year follow-up period. The relation of neck pain to high quantitative job demands (relative risk [RR], 2.14; 95% confidence interval [CI], 1.28-3.58) and low coworker support (RR, 2.43; 95% CI, 1.11-5.29) was statistically significant. An increased risk was found for low decision authority in relation to neck pain (RR, 1.60; 95% CI, 0.74-3.45), but this relation was not statistically significant. High quantitative job demands and low coworker support are independent risk factors for neck pain. There are indications that another risk factor for neck pain is low decision authority.

Risk factors for neck pain: a longitudinal study in the general population

The objective of the study was to examine the 1-year cumulative incidence of episodic neck pain and to explore its associations with individual risk factors, including a history of previous neck injury. A baseline cross-sectional survey of an adult general population sample made up of all 7669 adults aged 18–75 years, registered with two family practices in South Manchester, United Kingdom, identified the study population of adults with no current neck pain. This study population was surveyed again 12 months later to identify all those who had experienced neck pain during the follow-up period. At follow-up, cumulative 1-year episode incidence of neck pain was estimated at 17.9% (95% confidence interval 16.0–19.7%). Incidence was independent of age, but was more common in women. A history of previous neck injury at baseline was a significant risk factor for subsequent neck pain in the follow-up year (risk ratio 1.7, 95% confidence interval 1.2–2.5), independent of gender and psychological status. Other independent baseline risk factors for subsequent neck pain included number of children, poor self-assessed health, poor psychological status and a past history of low back pain. We have carried out a prospective study in a general population sample and demonstrated that established risk factors for chronic pain predict future episodes of neck pain, and shown that in addition a history of neck injury is an independent and distinct risk factor. This finding may have major public health and medicolegal implications.

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

As the work load has been shifting from heavy manufacturing to office work, neck disorders are increasing. However, most of the current cervical spine biomechanical models were created to simulate crash situations. Therefore, the biomechanics of cervical spine during daily living and occupational activities remain unknown. In this effort, cervical spine biomechanical models were systematically reviewed based upon different features including approach, biomechanical properties, and validation methods.The objective of this review was to systematically categorize cervical spine models and compare the underlying logic in order to identify voids in the literature.Twenty-two models met our selection criteria and revealed several trends: 1) The multi-body dynamics modeling approach, equipped for simulating impact situations were the most common technique; 2) Straight muscle lines of action, inverse dynamic/optimization muscle force calculation, Hill-type muscle model with only active component were typically used in the majority of neck models; and 3) Several models have attempted to validate their results by comparing their approach with previous studies, but mostly were unable to provide task-specific validation.EMG-driven dynamic model for simulating occupational activities, with accurate muscle geometry and force representation, and person- or task-specific validation of the model would be necessary to improve model fidelity.

Psychosocial risk factors for neck pain: a systematic review.

Neck pain, which is assumed to be a multifactorial disease, is a major problem in modern society. To identify the most important psychosocial risk factors for neck pain, a systematic review of the literature was carried out. The methodological quality of all studies in the review was assessed. Four levels of evidence were defined to assess the strength of evidence for potential risk factors for neck pain (strong, moderate, some or inconclusive evidence). Some evidence was found for a positive relationship between neck pain and high quantitative job demands, low social (coworker) support, low job control, high and low skill discretion and low job satisfaction. Inconclusive evidence was found for high job strain, low supervisor support, conflicts at work, low job security, and limited rest break opportunities. The procedure of the assessment of the methodological quality and the rating system applied to distinguish between high- and low-score studies, had a considerable influence on the level of evidence, indicating that changes in this procedure may have a major impact on the overall conclusions of this review.