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首页> 外文期刊>Occupational and environmental medicine >Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis
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Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis

机译：特定肩部障碍的与工作相关的危险因素：系统审查和荟萃分析

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The objective of this systematic review and metaanalysis is to examine which work-related risk factors are associated with specific soft tissue shoulder disorders. We searched the electronic databases of Medline and Embase for articles published between 2009 and 24 March 2016 and included the references of a systematic review performed for the period before 2009. Primary cross-sectional and longitudinal studies were included when outcome data were described in terms of clinically assessed soft tissue shoulder disorders and at least two levels of work-related exposure were mentioned (exposed vs less or non-exposed). Two authors independently selected studies, extracted data and assessed study quality. For longitudinal studies, we performed meta-analyses and used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the evidence for the associations between risk factors and the onset of shoulder disorders. Twenty-seven studies met the inclusion criteria. In total, 16 300 patients with specific soft tissue shoulder disorders from a population of 2 413 722 workers from Denmark, Finland, France, Germany and Poland were included in the meta-analysis of one case-control and six prospective cohort studies. This meta-analysis revealed moderate evidence for associations between shoulder disorders and arm-hand elevation (OR=1.9, 95% CI 1.47 to 2.47) and shoulder load (OR=2.0, 95% CI 1.90 to 2.10) and low to very low evidence for hand force exertion (OR=1.5, 95% CI 1.25 to 1.87), hand-arm vibration (OR=1.3, 95% CI 1.01 to 1.77), psychosocial job demands (OR=1.1, 95% CI 1.01 to 1.25) and working together with temporary workers (OR=2.2, 95% CI 1.2 to 4.2). Low-quality evidence for no associations was found for arm repetition, social support, decision latitude, job control and job security. Moderate evidence was found that arm-hand elevation and shoulder load double the risk of specific shoulder disorders. Low to very-low-quality evidence was found for an association between hand force exertion, handarm vibration, psychosocial job demands and working together with temporary workers and the incidence of specific shoulder disorders.
机译：该系统审查和元分析的目的是检查哪些有关的有关的危险因素与特定的软组织肩部障碍有关。我们搜索了2009年3月24日至2016年3月24日发表的文章的电子数据库，并包括在2009年之前进行的系统审查的参考。当结果数据描述时，包括初级横截面和纵向研究临床评估的软组织肩部疾病和至少有两种水平的与工作相关的接触（暴露在较少或未暴露）。两位作者独立选择研究，提取数据和评估的研究质量。对于纵向研究，我们进行了荟萃分析和使用年级（建议，评估，开发和评估等级），以评估风险因素与肩部障碍发作之间的协会的证据。二十七项研究符合纳入标准。总共有16种300例特异性软组织肩部患者来自丹麦，芬兰，法国，德国和波兰的2413名722名工人的患者被列入一个病例控制和六个前瞻性队列研究的荟萃分析中。该荟萃分析显示了肩部障碍和手臂抬高（或= 1.9,95％CI 1.47至2.47）和肩部载荷（或= 2.0,95％CI 1.90至2.10）和低证据证据的适度证据对于手力劳累（或= 1.5,95％CI 1.25至1.87），手臂振动（或= 1.3,95％CI 1.01至1.77），心理社会工作要求（或= 1.1,95％CI 1.01至1.25）和与临时工人（或= 2.2,95％CI 1.2至4.2）一起工作。没有找到任何协会的低质量证据，用于ARM重复，社会支持，决策纬度，求职和工作保障。发现适度的证据是，手臂抬高和肩部载荷的风险是特定肩部障碍的风险。在手力劳累，手工振动，心理社会工作需求和临时工和特定肩部障碍的发病率和特定肩部障碍的发病率之间存在低于非常低质量的证据。

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