title: Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis.
abstract: In view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work.
  
  
  
  Using the key words "lateral epicondylitis" AND "occupational" AND ("cohort" OR "longitudinal," OR "incidence") without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Données de Santé Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]).
  
  
  
  From 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q = 1.4, P > 0.05). Funnel plots and Egger's test did not suggest major publication bias.
  
  
  
  The results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.
authors.affiliation: AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, and Versailles St-Quentin University, INSERM, Villejuif, France. alexis.descatha@inserm.fr.
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
authors.affiliation: AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Albo
authors.affiliation: Versailles St-Quentin University, INSERM; Versailles St-Quentin University, INSERM, Villejuif, France.
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
authors.affiliation: Versailles St-Quentin University, INSERM; Versailles St-Quentin University, INSERM, Villejuif, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Carton
authors.affiliation: Versailles St-Quentin University, INSERM, Villejuif, and AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Godeau
authors.affiliation: LUNAM Université and Université d'Angers, Angers, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.affiliation: LUNAM Université and Université d'Angers, Angers, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Petit
authors.affiliation: Versailles St-Quentin University, INSERM, Villejuif, and INRS, Vandœuvre-lès-Nancy, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Aublet-Cuvelier
mesh_terms: D000328:Adult; D004550:Elbow; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013716:Tennis Elbow / Q000453:epidemiology / Q000209:etiology*; D014953:Wrist