title: Job strain and neck-shoulder symptoms: a prevalence study of women and men white-collar workers.
abstract: BACKGROUND
  Neck-shoulder symptoms are frequent among workers. Psychosocial factors at work have been associated with neck-shoulder symptoms, but few studies have examined job strain, the combined effect of high psychological demands (PD) and low decision latitude (DL).
  
  
  OBJECTIVE
  To examine the association between psychosocial factors at work and the prevalence of self-reported neck-shoulder symptoms among white-collar workers.
  
  
  METHODS
  In a cross-sectional study of 1543 white-collar workers, PD and DL at work were measured with Karasek's questionnaire. Prevalent cases were workers for whom neck-shoulder symptoms were present for >or=3 days during the previous 7 days and for whom pain intensity was greater than half the visual analogue scale. Gender and social support at work were evaluated as potential effect modifiers.
  
  
  RESULTS
  Workers exposed to high job strain had a higher prevalence of neck-shoulder symptoms [adjusted prevalence ratio (PR): 1.54, 95% confidence interval (CI): 1.00-2.37]. No modifying effect of gender was observed in this association. The effect of job strain was stronger in workers with low social support (adjusted PR: 1.84, 95% CI: 0.92-3.68). These associations tended to be stronger and/or more precise when using alternative exposures and case definition. Namely, a stronger job strain effect was observed when a tertile cut-off was used to classify exposure (adjusted PR: 2.47, 95% CI: 1.15-5.32).
  
  
  CONCLUSIONS
  These results suggest that primary prevention of neck-shoulder symptoms among white-collar workers should consider the exposure to job strain, especially when workers are exposed to low social support at work.
authors.affiliation: Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Hôpital du Saint-Sacrement, 1050 chemin Sainte-Foy, Québec, G1S 4L8, Canada. ileroux@uresp.ulaval.ca
authors.forename: Isabelle
authors.initials: I
authors.lastname: Leroux
authors.forename: Chantal
authors.initials: C
authors.lastname: Brisson
authors.forename: Sylvie
authors.initials: S
authors.lastname: Montreuil
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D020069:Shoulder Pain / Q000453:epidemiology / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*