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Jackson, J. A., Olsson, D., Burdorf, A., Punnett, L., Järvholm, B. & Wahlström, J. (2019). Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers. Occupational and Environmental Medicine, 76(5), 326-331
Open this publication in new window or tab >>Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers
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2019 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, no 5, p. 326-331Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period.

METHODS: A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships.

RESULTS: The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00).

CONCLUSIONS: Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
elbow flexion/extension, hand tools, hand-arm vibration, job exposure matrix, nerve entrapment, neuropathy, repetitive, static work, upper extremity load
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-157109 (URN)10.1136/oemed-2018-105311 (DOI)30850390 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-07-11Bibliographically approved
Lewis, C. A., Jackson, J., Liv, P. & Wahlström, J. (2019). Occupational biomechanical risk factors for surgical treatment of subacromial impingement syndrome (SIS) in a 16-year prospective study among male construction workers. In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices. Paper presented at PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September, 2019 (pp. 165-165).
Open this publication in new window or tab >>Occupational biomechanical risk factors for surgical treatment of subacromial impingement syndrome (SIS) in a 16-year prospective study among male construction workers
2019 (English)In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices, 2019, p. 165-165Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: Shoulder disorders are common in the general population, with an annual prevalence up to over 40% per 1000 person-years. One common disorder is subacromial impingement syndrome (SIS), where a narrowing in the subacromial space causes compression of the tendons or bursa by the surrounding tissues. When conservative treatments are not effective, surgical treatments is often the alternative. The aim of the current study was to assess the association between occupational biomechanical exposures and the occurrence of surgically treated SIS in a large construction worker cohort over a 16-year follow-up period. 

Methods: A cohort of 280 747 male construction workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively (1987-2016) for SIS. SIS case status was defined by primary surgical treatment of diagnosis codes M75.1, M75.4, 726B, or 726C (ICD 10 and Swedish ICD 9 code systems), with data from the Swedish national registry for in- and out-patient surgery records. A job exposure matrix (JEM) was developed and biomechanical exposure estimates were assigned according to job title. Poisson regression models adjusted for age, BMI, smoking and a surgical time factor were used to estimate the relative risks (incidence rate ratios) of surgical treatment for SIS for each biomechanical factor.

Results: There were 1381 cases in the cohort, which corresponded to an incidence rate of surgically treated SIS over the 16-year observation period of 46 cases per 100,000 person years. Increased risk for surgically treated SIS was shown for working with elevated arms (RR=1.27, 95% CI=1.02-1.58), heavy upper arm loads (RR=1.75, 95% CI=1.48-2.08), high grip force (RR=1.64, 95% CI=1.40-1.93), working with hand tools (RR=1.46, 95% CI=1.26-1.70), working with hand tools in a fixed posture (RR=1.28, 95% CI=1.14-1.44), and working with hand-arm vibration (RR=1.30, 95% CI=1.09-1.55).

Conclusions: Working with elevated arms, high arm load, high grip force and vibrating handheld tools may increase the risk for SIS.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163186 (URN)
Conference
PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September, 2019
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-11Bibliographically approved
Jackson, J. A., Olsson, D., Punnett, L., Burdorf, A., Järvholm, B. & Wahlström, J. (2019). Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers. Scandinavian Journal of Work, Environment and Health, 45(1), 63-72
Open this publication in new window or tab >>Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 1, p. 63-72Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE).

Methods: A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971–1993) were examined prospectively over a 13-year case ascertainment period (2001–2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register.

Results: There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18–1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers.

Conclusion: Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.

Place, publisher, year, edition, pages
Nordic Association of Occupational Safety and Health (NOROSH), 2019
Keywords
biomechanical, biomechanical risk factor, construction worker, cubital tunnel syndrome, elbow, elbow extension, grip force, hand tool, hand-arm vibration, HAV, JEM, job-exposure matrix, male construction worker, neuropathy, occupational biomechanical risk factor, prospective study, repetitive, risk factor, static work, ulnar nerve entrapment, upper-arm load
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152108 (URN)10.5271/sjweh.3757 (DOI)000466176700007 ()30132781 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01016
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2019-05-17Bibliographically approved
Jackson, J., Liv, P. & Wahlström, J. (2019). Occupational risk factors for hospitalization due to cervical disc disorder in a 29-year prospective study of Swedish male construction workers. In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices. Paper presented at PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September, 2019 (pp. 168-168).
Open this publication in new window or tab >>Occupational risk factors for hospitalization due to cervical disc disorder in a 29-year prospective study of Swedish male construction workers
2019 (English)In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices, 2019, p. 168-168Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: The aim of this study was to assess the associations between individual and occupational exposure factors and hospitalization for cervical disc disorder (CDD).

Methods: CDD was examined prospectively in a cohort of 278 319 Swedish male construction workers who participated in a national health surveillance program (1971-1993). Job title, smoking status, age, height, and weight were recorded on examination. Case data were obtained through linkage with the Swedish national in-patient hospital registry for the period 1987 – 2016; case status was defined by primary diagnosis code M50.0 (ICD-10) or 722.0, 722.4, or 722.7 (ICD-9). A job exposure matrix was developed and occupational exposure estimates were assigned by job title. Self-reported estimates of pain/discomfort from a subset of 87 500 workers were also linked to the database. Poisson regression models were used to estimate the relative risks (RR) for the biomechanical and self-reported factors with adjustment for smoking status, age, BMI and surgical time period.

Results: There were 562 cases of hospitalization for CDD; the incidence rate was 8.0 cases per 100 000 during the 29-year follow-up period. Smoking status, age, BMI and height were all associated with increased risk (RR 1.21-3.16). Occupational exposure to static work in non-neutral or extreme neck postures, and time spent in awkward postures showed the highest associations with CDD hospitalization (RR = 1.62 – 2.10). Upper arm load and time with arms above shoulders were also associated with increased risk (RR = 1.50 – 1.58). Workers who reported experiencing pain ‘often’ or ‘very often’ during the previous year for any of the neck, shoulder or upper back regions had a 3-fold increase in risk relative to workers reporting no pain.

Conclusions: Occupational non-neutral neck posture was associated with increased risk of hospitalization for CDD. Our data also suggest an exposure-response relationship for self-reported neck pain/discomfort and risk of hospitalization for CDD.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163185 (URN)
Conference
PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September, 2019
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved
Wahlström, J., Liv, P. & Jackson, J. (2019). Occupational risk factors for surgically treated carpal tunnel syndrome: a prospective cohort study of 220,610 Swedish construction workers. In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices. Paper presented at PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September 2019 (pp. 141-141).
Open this publication in new window or tab >>Occupational risk factors for surgically treated carpal tunnel syndrome: a prospective cohort study of 220,610 Swedish construction workers
2019 (English)In: PREMUS 2019: 10th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders: From research to evidence based sustainable interventions and practices, 2019, p. 141-141Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: Carpal tunnel syndrome (CTS) is the most common upper extremity nerve entrapment syndrome . The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated CTS in construction workers over a 16-year follow-up.

Methods: A cohort of 220 610 male construction workers who participated in a national occupational health surveillance program (1971–1992) were examined prospectively (2001–2016) for surgically treated CTS. Cases were determined via a linkage with the Swedish Hospital Outpatient Register. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group using a job exposure matrix (JEM) developed for the study. Poisson regression models were used to assess the relative risks for each biomechanical exposure. Relative risks were adjusted for age, surgical time period, BMI, and smoking status at first examination.

Results: There were 4048 cases of surgically treated CTS within the cohort which represented an incidence rate of 134 cases per 100 000 person years. Workers exposed to medium and high forceful handgrip factors had relative risks of 1.3 (95% CI 1.16-1.38) and 1.6 (95% CI 1.50-1.77), respectively, of undergoing surgical treatment for CTS compared to low exposed workers. Workers exposed to medium and high exposure to hand-arm vibration had relative risks of 1.3 (95% CI 1.19-1.34) and 1.2 (95% CI 1.07-1.28), respectively, of undergoing surgical treatment for CTS compared to low exposed workers.

Conclusions: In conclusion, forceful hand-grip work and exposure to hand-arm vibration increased the risk for surgically treated carpal tunnel syndrome.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163184 (URN)
Conference
PREMUS 2019 10th International Scientific Conference on the Prevention of Work-Related Muscoluskeletal Disorders, Bologna, Italy, 2-5 September 2019
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2939-0236

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