Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

doi:10.1136/oemed-2017-104511

Cited by 29 publications

(77 citation statements)

References 24 publications

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“…Occupations involving a high intensity of force and upper arm elevation >90° were associated with increased rates of surgery for subacromial pain in a recent Danish study. 22 We were not able to obtain an expert evaluation of work load in the included patients. Work was classified as manual if the patient reported to be engaged in daily manual work at the work place.…”

Section: Predictors and Clinical Datamentioning

confidence: 99%

Sick leave and return to work after surgery for type II SLAP lesions of the shoulder: a secondary analysis of a randomised sham-controlled study

et al. 2020

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ObjectivesTo compare days on sick leave and assess predictors of return to work following shoulder surgery.DesignA secondary analysis of a randomised controlled trial.SettingOrthopaedic department.Participants114 patients with type II superior labral tear from anterior to posterior of the shoulder.InterventionsLabral repair, biceps tenodesis or sham surgery.Outcome measuresSick leave was obtained from national registers for the last year before and 2 years following surgery. Total and shoulder related number of days on sick leave were obtained, using international diagnostic codes. We applied the difference-in-difference approach to compare the differences in the change in mean work days on sick leave between groups over time, backwards logistic regression and lasso regression to evaluate predictors.ResultsMean total number of work days on sick leave during the 2 years after surgery was 148 (range 0–460) days. More than 80% of the sick leave days were taken by 22% of the patients. Days on sick leave classified as shoulder-related constituted 80% of the total. In all three treatment groups, the mean total number of days on sick leave doubled the year after surgery. Sham surgery and labral repair had fewer postoperative sickness absence days compared with biceps tenodesis but differences were not significant when adjusted for days of sick leave the year before surgery. Predictors of return to work at 2 years analysed by logistic regression were no sick leave (OR 8.0, 95% CI 2.4 to 26.0) and moderate symptoms of anxiety or depression (OR 0.16, 95% CI 0.05 to 0.5) at inclusion. Similar results were obtained by lasso regression but manual work was an additional predictor.ConclusionsChange in mean work days on sick leave comparing sham surgery, labral repair and biceps tenodesis, was not significantly different. Sick leave, symptoms of anxiety and depression, and manual work at inclusion predicted work status 2 years after surgery.Trial registration numberNCT00586742.

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Section: Predictors and Clinical Datamentioning

confidence: 99%

Sick leave and return to work after surgery for type II SLAP lesions of the shoulder: a secondary analysis of a randomised sham-controlled study

et al. 2020

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“…Work with the arms elevated >90° estimates were assessed using the Shoulder JEM, which is based on expert ratings by five Danish occupational health physicians with a minimum of 10 years of experience (29)(30)(31)(32). The expert rated estimates of time spent working with the arms elevated >90° (hours/day) have been validated against technical measurements (13).…”

Section: Assessment Of Occupational Exposure Intensitiesmentioning

confidence: 99%

Influence of errors in job codes on job exposure matrix-based exposure assessment in the register-based occupational cohort DOC*X

Petersen

Em²,

Sw³

et al. 2019

Scand J Work Environ Health

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We found substantial agreement between job-exposure-matrix-derived exposure estimates according to DISCO-88 codes based on self-reported job-titles and registered in the Danish Occupational Cohort with eXposure data (DOC*X), with respect to airborne, mechanical, and physical exposures. Substantial agreement was also found between the two sets of DISCO-88 codes. The results are promising with respect to future studies based on the DOC*X.

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“…The primary outcome is work with the arm elevated > 60˚ (minutes/day) according to Axivity measurements shortly after EOI. This outcome was chosen based on the available evidence that work with elevated arms (assessed in various ways) is associated with an increased risk of shoulder complaints and SIS [5,7,8,10] and because we think that this measure will be more responsive to change than minutes/day with the arm elevated > 90˚, which has been quite well studied [10][11][12][13][14], but occurs to a limited extent in some of the included occupations. The timing was chosen because we expect that most work modifications will occur within the intervention period and because we want to use the 2nd measurement feedback to motivate the participants for further work modifications.…”

Section: In Relation To Hypothesis IImentioning

confidence: 99%

“…High occupational shoulder exposures are even associated with an approximately doubled risk of surgery for SIS [11][12][13], and when combined with shoulder complaints, a more than five-fold increase in risk of later surgery has been reported [14]. Based on these findings, persons with shoulder complaints and high occupational shoulder exposures seem an obvious target group for secondary prevention efforts.…”

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confidence: 94%

“…The pamphlet, developed by AD in collaboration with PF, SWS, and SDC, focuses on work with elevated arms, repetitive shoulder movements, and forceful shoulder exertions. It is based on previous assessments of occupational shoulder exposures[29], exposure-response relationships with shoulder disorders[11][12][13][14], and years of experience from work as occupational health physicians (PF and SWS) and as a health and safety consultant (SDC).Assessment of occupational shoulder exposures based on:Technical measurements of postures and movements performed using an Axivity (AX3) accelerometer[46] processed to yield minutes/day with the arms elevated > 30˚, > 60˚, and > 90˚, and median angular velocity (˚/s) (as a measure of repetition) during work. Axivity measurements are performed on the more affected shoulder (right shoulder in case of similar symptoms).…”

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confidence: 99%

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Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)

Trøstrup

Mikkelsen

Frost

et al. 2019

Preprint

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Background: In Denmark, exercise therapy in combination with work modifications is the first choice treatment for persons with shoulder complaints and high occupational shoulder exposures. To obtain this treatment they must visit several healthcare providers, which makes usual care fragmented and uncoordinated. Therefore, we developed a new intervention which unifies the expertise that is needed. The main hypotheses are that a group-based Shoulder-Café intervention will more effectively reduce (I) shoulder complaints and (II) occupational shoulder exposures than an individual-based Shoulder-Guidance intervention (active control – enhanced usual care). Methods: A cluster-randomised trial is conducted including 120 employees with high occupational shoulder exposures. Companies (clusters) are randomised to either Shoulder-Café or Shoulder-Guidance with a 1:1 allocation ratio. Participants are 18–65 years old and have an Oxford Shoulder Score (OSS) ≤ 40. Both interventions include a home-based shoulder exercise programme, assessment of shoulder exposures by technical measurements and self-report, and general information on how to reduce shoulder exposures. The Shoulder-Café course also includes three café meetings with physiotherapist-supervised exercises, clinical shoulder evaluation, education on shoulder anatomy, workplace-oriented counselling, and an opportunity for a workplace visit by a health and safety consultant. The primary outcomes are the OSS at 6 month follow-up (hypothesis I), and the mean number of minutes/day with the arm elevated > 60° shortly after end of intervention (hypothesis II). We will use mixed model analysis that allows for company clustering, and data will be analysed according to the intention-to-treat principle. Discussion: Persons with shoulder complaints and high occupational shoulder exposures are an obvious target group for secondary prevention efforts. We developed the Shoulder-Café to reduce shoulder complaints and shoulder exposures while unifying the expertise that is needed to evaluate and treat shoulder complaints. If the intervention is effective, it would warrant widespread implementation. Trial registration: The trial was registered at Clinicaltrials.gov on 18 May 2017 (ID: NCT03159910).

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Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows

Abstract: We found indications of safe exposure intensities for repetition. Any intensities of force and upper arm elevation >90° above minimal implied an increased risk across 10-year exposure time windows. No independent associations were found for HAV.

Cited by 29 publications

References 24 publications

Sick leave and return to work after surgery for type II SLAP lesions of the shoulder: a secondary analysis of a randomised sham-controlled study

Sick leave and return to work after surgery for type II SLAP lesions of the shoulder: a secondary analysis of a randomised sham-controlled study

Influence of errors in job codes on job exposure matrix-based exposure assessment in the register-based occupational cohort DOC*X

Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)

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