title: Shoulder disorders and postural stress in automobile assembly work.
abstract: OBJECTIVE
  A case-referent study was conducted in an automobile assembly plant to evaluate the risk of shoulder disorders associated with nonneutral postures.
  
  
  METHODS
  The cases were workers who reported shoulder pain to the plant clinic during a 10-month period and met symptom criteria (pain frequency or duration in the past year) in an interview; more than one-half also had positive findings in a physical examination. The referents were randomly selected workers who were free of shoulder disorders according to the clinic records, the interview, and the physical examination. For each of the 79 cases and 124 referents, 1 job was analyzed for postural and biomechanical demands by an analyst blinded to the case-referent status.
  
  
  RESULTS
  Forty-one percent of the subjects flexed or abducted the right arm "severely" (above 90 degrees) during the job cycle, and 35% did so with the left arm. The peak torques at the shoulder were rather low. Shoulder disorders were associated with severe flexion or abduction of the left [odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.5-6.5] and the right (OR 2.3, 95% CI 1.2-4.8) shoulder. The risk increased as the proportion of the work cycle exposed increased. The relationships were similar for the cases with and without physical findings. Use of hand-held tools increased the risk and also modified the association with postural stress, although the joint exposure distributions limited full analysis of this finding.
  
  
  CONCLUSIONS
  The findings support the conclusion that severe shoulder flexion or abduction, especially for 10% or more of the work cycle, is predictive of chronic or recurrent shoulder disorders.
authors.affiliation: Center for Ergonomics, The University of Michigan, Ann Arbor, Michigan, United States. Laura_Punnett@UML.EDU
authors.forename: L
authors.initials: L
authors.lastname: Punnett
authors.forename: L J
authors.initials: LJ
authors.lastname: Fine
authors.forename: W M
authors.initials: WM
authors.lastname: Keyserling
authors.forename: G D
authors.initials: GD
authors.lastname: Herrin
authors.forename: D B
authors.initials: DB
authors.lastname: Chaffin
mesh_terms: D000328:Adult; D001336:Automobiles; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D006804:Ergonomics; D005260:Female; D006801:Humans; D015994:Incidence; D007587:Job Description; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology*; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology*; D011187:Posture; D012307:Risk Factors; D020069:Shoulder Pain / Q000209:etiology*