title: Prospective study on shoulder symptoms among kitchen workers in relation to self-perceived and observed work load.
abstract: OBJECTIVE
  To study the occurrence of shoulder symptoms among professional kitchen workers, and whether reduction in self-perceived and observed physical work load decreases future symptoms.
  
  
  METHODS
  In this prospective study conducted in 2002-2005 in municipal kitchens in Finland, changes during a 1-year follow-up in the physical strenuousness of work tasks were self-assessed by 376 female workers (substudy I). Changes in exposure to manual lifting and awkward upper arm posture during the follow-up were also observed by experts in 69 kitchens with 183 workers (substudy II). Information on shoulder symptoms was collected with questionnaires at baseline and at follow-up. The risk of shoulder symptoms at follow-up related to changes in exposure was estimated with logistic regression.
  
  
  RESULTS
  The 3-month prevalence of shoulder pain was 34% at baseline and 41% at follow-up. Reduction during follow-up in work tasks perceived as the most strenuous physically (ie, receiving and storing raw food) led to a significantly reduced risk of future shoulder pain with an adjusted odds ratio (OR) of 0.41 (95% CI 0.17 to 0.98) and trouble caused by the pain with an OR of 0.34 (0.14 to 0.83). The observed reduction in lifting was also associated with a lower risk for future shoulder symptoms.
  
  
  CONCLUSIONS
  Reduction in lifting showed beneficial protective effects on the shoulder. Although more risk factor and intervention studies are needed to estimate the health impacts of kitchen work, special attention should be paid to work tasks that include lifting when assessing risk and designing preventive measures.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland. irmeli.pehkonen@ttl.fi
authors.forename: I
authors.initials: I
authors.lastname: Pehkonen
authors.forename: H
authors.initials: H
authors.lastname: Miranda
authors.forename: E
authors.initials: E
authors.lastname: Haukka
authors.forename: R
authors.initials: R
authors.lastname: Luukkonen
authors.forename: E-P
authors.initials: EP
authors.lastname: Takala
authors.forename: R
authors.initials: R
authors.lastname: Ketola
authors.forename: P
authors.initials: P
authors.lastname: Leino-Arjas
authors.forename: H
authors.initials: H
authors.lastname: Riihimäki
authors.forename: E
authors.initials: E
authors.lastname: Viikari-Juntura
mesh_terms: D000328:Adult; D016021:Epidemiologic Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D011633:Public Facilities / Q000706:statistics & numerical data; D020069:Shoulder Pain / Q000453:epidemiology*; D014937:Work / Q000502:physiology*; D055815:Young Adult