Musculoskeletal disorders among female dental personnel--clinical examination and a 5-year follow-up study of symptoms.
OBJECTIVE
To explore the natural course of musculoskeletal disorders during a 5-year period among dental personnel, to survey findings and diagnoses according to a standardized protocol, and to compare and evaluate different methods for the detection of musculoskeletal disorders in a population.


METHODS
In a 5-year follow-up study, dental personnel (n = 90) and referents (n = 30) were studied. The Nordic questionnaire (years 0 and 5), the present pain rating according to the Borg category ratio scale, and physical examination (year 5) were used.


RESULTS
In year 0 the prevalence of symptoms in the shoulders, the wrists/hands, and, unexpectedly, the hips was higher in the dental personnel as compared with the referents. Furthermore, those (16%) who had left the dental profession during the observation period showed a higher prevalence of and, often, combined symptoms from several body regions in year 0 than did those who stayed. Dental personnel who remained in the profession tended to have an increased risk of developing more symptoms in the shoulders and the elbows/wrists/hands in year 5 as compared with year 0 and at year 5 were in more pain and had received more diagnoses for the neck/shoulder region relative to the referents. Furthermore, there was a considerable variation in symptoms during the follow-up period. The sensitivity of the pain rating and of the Nordic questionnaire in detecting musculoskeletal disorders was high for the neck and shoulders but was not as high for the elbow, wrists/hands, or hips. The association was better for diagnoses than for findings. The opposite patterns were observed for specificity.


CONCLUSIONS
Dental personnel had an increased risk of developing musculoskeletal disorders as verified by symptoms and diagnoses and more painful or persistent conditions. This led to a selection out of work. The questionnaire and the present pain rating gave a relatively good picture of the prevalence of musculoskeletal disorders arising from the neck, shoulders, and hips and would be useful as screening tools. Their sensitivity in detecting disorders was higher for diagnoses than for findings. However, these methods were not as sensitive for disorders involving the elbows/wrists/hands. Physical examinations gave more detailed information.
Akesson
I
I
Department of Occupational and Environmental Medicine, University Hospital, S-221 85 Lund, Sweden.
Johnsson
B
B
Rylander
L
L
Moritz
U
U
Skerfving
S
S
D000328:Adult; D016022:Case-Control Studies; D003726:Dental Assistants / Q000706:statistics & numerical data*; D003756:Dental Hygienists / Q000706:statistics & numerical data*; D003815:Dentists / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000503:physiopathology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D015995:Prevalence; D012306:Risk; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology