Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: A meta‐analysis

Abstract

In the past 10 years there has been growing awareness among occupational health professionals worldwide of the large burden of illness associated with musculoskeletal disorders of the neck and upper limbs. It has been suggested that these disorders are associated with highly repetitive work and are due, at least in part, to ergonomic factors. This review examines the epidemiologic evidence of the relationship between workplace ergonomic factors such as repetition, force, static muscle loading, and extreme joint position and the development of muscle, tendon, and nerve entrapment disorders of the neck and upper limbs of exposed workers. An extensive search for relevant studies was undertaken. Of 54 potentially relevant studies identified, three met the a priori inclusion criteria. The validity of these studies was assessed, and one study was found to have major flaws. Criteria to demonstrate causality were also applied and were met in the most rigorously conducted study. When the results of these studies are compared and aggregated where appropriate, they provide strong evidence of a causal relationship between repetitive, forceful work and the development of musculoskeletal disorders of the tendons and tendon sheaths in the hands and wrists and nerve entrapment of the median nerve at the carpal tunnel. The comparison of exposed to controls for hand/wrist tendinitis gives an unadjusted common odds ratio of 9.1 (95% CI 4.9-16.2). The adjusted odds ratio for carpal tunnel syndrome is 15.5 (95% CI 1.7-141.5) based on the most rigorous study.

Physical load during work and leisure time as risk factors for back pain

“…A description of these 2 lists is given in the appendix. These lists were adapted from criteria lists used in systematic reviews of randomized controlled trials on treatment (1 6) and criteria lists used in other reviews of observational studies (20,21).…”

Role of physical load factors in carpal tunnel syndrome

“…In the 1990s, several reviews have appeared in the literature, especially on epidemiologic studies (6)(7)(8)(9)(10)(11). Because of the high number of epidemiologic reviews, and only a few reviews on experimental studies, especially reviews with any attempt to link the physical loads to possible pathomechanisms (12), we chose to approach the role of physical load factors in CTS with a broad spectrum of studies.…”

Postural load on the personnel of a Costa Rican university and implications for occupational health

“…For this study we have avoided common methodological mistakes, by following the recommendations of Guillén (2006), Hagberg (2007), and Westgaard (2010), so we are confident to recommend urgent changes (Stock 2007) in attitudes, processes and jobs in these departments.…”

“…This is especially important when it affected the tendons and tendon sheaths in hands and wrists (causing carpal tunnel syndrome, Stock 2007), because hundreds of millions of people use computer keyboards daily. For example, in the United States of America, muscle-skeletal disorders that result from inadequate working conditions, went from 21% to 56% over a ten year period, occupying one of the first places in occupational diseases (Montiel et al 2006).…”