title: The influence of work-related exposures on the prognosis of neck/shoulder pain.
abstract: To determine associations between work-related exposures and the prognosis of self-reported neck/shoulder pain. This prospective cohort study was based on 803 working subjects who reported neck/shoulder pain at baseline. The proportion of subjects who 5-6 years later were symptom-free was calculated. Data concerning work-related biomechanical, psychosocial, and organizational exposures were collected at baseline. The Cox regression analyses were used to calculate the relative chances (RC) of being symptom-free at the end of the study for single exposures, and also for up to three simultaneous work-related exposures. Adjustments were made for sex and age. Only 36% of the subjects were symptom-free 5-6 years later. The relative chance for being symptom-free at the end of the study was 1.32 (95% CI = 0.99-1.74) for subjects who were exposed to sitting > or =75% of the working time and 1.53 (95% CI = 1.02-2.29) for subjects who were exposed to job strain, i.e., the combination of high demands and low decision latitude. The relative chance of being symptom-free at the end of the study was 0.61 (95% CI = 0.40-0.94) for subjects with at least two out of three simultaneous biomechanical exposures at work; manual handling, working with the hands above shoulder level, and working with vibrating tools. In a heterogeneous population with moderate nonspecific neck/shoulder pain, sedentary work enhanced the chance of being symptom-free 5-6 years later, whereas simultaneous exposures to at least two of manual handling, working with hands above shoulder level and working with vibrating tools were associated with a lower chance of being symptom-free at the end of the study. This could imply that subjects with neck/shoulder pain should avoid such simultaneous exposures.
authors.affiliation: Department of Public Health Sciences, Division of Occupational Medicine, Karolinska Institutet, Norrbacka, 171 76, Stockholm, Sweden. Wim.Grooten@ki.se
authors.forename: Wilhelmus Johannes Andreas
authors.initials: WJ
authors.lastname: Grooten
authors.forename: Marie
authors.initials: M
authors.lastname: Mulder
authors.forename: Malin
authors.initials: M
authors.lastname: Josephson
authors.forename: Lars
authors.initials: L
authors.lastname: Alfredsson
authors.forename: Christina
authors.initials: C
authors.lastname: Wiktorin
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015331:Cohort Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology* / Q000503:physiopathology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D009790:Occupations / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000453:epidemiology* / Q000503:physiopathology; D013548:Sweden / Q000453:epidemiology; D014937:Work / Q000706:statistics & numerical data