title: Towards exposure limits for working postures and musculoskeletal symptoms - a prospective cohort study.
abstract: Occupational postures are considered to be an important group of risk factors for musculoskeletal pain. However, the exposure-outcome association is not clear yet. Therefore, we aimed to determine the exposure-outcome association of working postures and musculoskeletal symptoms. Also, we aimed to establish exposure limits for working postures. In a prospective cohort study among 789 workers, intensity, frequency and duration of postures were assessed at baseline using observations. Musculoskeletal pain was assessed cross-sectionally and longitudinally and associations of postures and pain were addressed using logistic regression analyses. Cut-off points were estimated based on ROC-curve analyses. Associations were found for kneeling/crouching and low-back pain, neck flexion and rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain. The results provide insight into exposure-outcome relations between working postures and musculoskeletal symptoms as well as evidence-based working posture exposure limits that can be used in future guidelines and risk assessment tools. Practitioner Summary: Our study gives insight into exposure-outcome associations of working postures and musculoskeletal symptoms (kneeling/crouching and low-back pain, neck flexion/rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain). Results furthermore deliver evidence-based postural exposure limits that can be used in guidelines and risk assessments.
authors.affiliation: a School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia.|b Faculty of Human Movement Sciences, Research Institute MOVE , VU University Amsterdam , Amsterdam , The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Coenen
authors.affiliation: c TNO , Leiden , The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Douwes
authors.affiliation: c TNO , Leiden , The Netherlands.
authors.forename: Swenneke
authors.initials: S
authors.lastname: van den Heuvel
authors.affiliation: c TNO , Leiden , The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Bosch
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000453:epidemiology / Q000517:prevention & control; D009426:Netherlands; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Exposure assessment; musculoskeletal pain; occupational health; work postures