Self-reported versus expert-assessed work-relatedness of pain in the neck, shoulder, and arm.
OBJECTIVE
The aim of this study was to compare self-reported work-relatedness of neck-shoulder and arm pain with experts' assessments based on specific criteria.


METHODS
A sample of 217 employed participants in the Oslo Health Study 2000-2001, aged 30, 40, and 45 years, who reported neck-shoulder or arm pain in the past month, underwent a health examination. A criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders was used to -establish clinical diagnoses and assess the work-relatedness of pain with respect to the subject's present job. We measured agreement between the participants and experts on whether pain was related to work as observed agreement, positive and negative specific agreement, and kappa.


RESULTS
A major proportion of the cases were assessed as work-related, somewhat more frequently by self-report than when assessed by experts (80% versus 65% for neck-shoulder pain, and 78% versus 72% for arm pain, respectively). However, there was considerable disagreement as to which cases were work-related. The experts disagreed more frequently in cases that were reported as non-work-related (particularly for neck-shoulder pain and cases reported by men). Positive specific agreement was fairly high (76-85% in the total population), while negative specific agreement was lower (37-51%). Kappa values were also low (0.16-0.34).


CONCLUSIONS
Compared with expert assessment, self-reporting did not seem to particularly exaggerate work-relatedness. Nevertheless, there was considerable disagreement, especially on cases assessed as non-work--related. However, agreement will depend on the case definitions and the criteria for work-relatedness used both by the participants and the experts.
National Institute of Occupational Health, PO Box 8149 Dep, N-0033 Oslo, Norway. ism@stami.no
Ingrid Sivesind
IS
Mehlum
Kaj Bo
KB
Veiersted
Morten
M
Waersted
Ebba
E
Wergeland
Helge
H
Kjuus
D000328:Adult; D001134:Arm Injuries / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000453:epidemiology; D019547:Neck Pain / Q000175:diagnosis / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D015588:Observer Variation; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement; D015995:Prevalence; D020069:Shoulder Pain / Q000175:diagnosis / Q000453:epidemiology