Occupational mechanical exposures as risk factor for shoulder osteoarthritis: a systematic review.

IF 1.8 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Annals Of Work Exposures and Health Pub Date : 2024-09-04 DOI:10.1093/annweh/wxae063

Ea Helene Korsgaard Thorsen, Annett Dalbøge, Nicholas Hovgaard, Johan Hviid Andersen, Alexander Jahn

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Abstract

Objectives: The aim of this systematic review was to study the association between occupational mechanical exposures and shoulder osteoarthritis (OA).

Methods: A protocol was registered in PROSPERO. Four databases were systematically searched based on PECOS criteria. Outcome was defined as shoulder OA (acromioclavicular (AC) and/or glenohumeral OA) and exposure as occupational mechanical exposures (vibration, upper arm elevation, force, lifting, repetition, and combined mechanical exposures). We included epidemiological studies estimating the prevalence of shoulder OA or the association between occupational mechanical exposures and shoulder OA. Two researchers independently screened articles, performed data extraction, and assessed the risk of bias and level of evidence using GRADE.

Results: A total of 1642 articles were screened, of which 7 met the inclusion criteria. Four studies were assessed as having a high risk of bias, 1 with a moderate risk, and 2 with a low risk. Based on job titles, higher prevalence estimates (2.9% to 61.8%) were found in exposed job groups. For all occupational mechanical exposures, exposure-response relations were found in relation to AC OA. For vibration, the odds ratio (OR) ranged between 1.7 and 3.1 in the highest exposure groups, while the ORs for upper arm-elevation, force, lifting, repetition, and combined mechanical exposures ranged between 0.5 to 2.2, 1.3 to 1.8, 7.3 to 10.3, 2.4, and 2.2 to 2.9. Low or very low level of evidence was found for all exposures.

Conclusions: This systematic review found an indication of an association between occupational mechanical exposures and shoulder OA, especially AC OA. However, the level of evidence varied between low and very low. High-quality studies assessing the association and differentiating between the specific shoulder joints are highly warranted.

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作为肩关节骨关节炎风险因素的职业机械接触：系统综述。

目的：本系统综述旨在研究职业性机械接触与肩关节骨关节炎（OA）之间的关系：本系统综述旨在研究职业性机械接触与肩关节骨性关节炎（OA）之间的关系：方法：在 PROSPERO 上注册了一项研究方案。根据 PECOS 标准对四个数据库进行了系统检索。结果定义为肩关节 OA（肩锁关节和/或盂肱关节 OA），暴露定义为职业机械暴露（振动、上臂抬高、用力、提举、重复和综合机械暴露）。我们纳入了估计肩部 OA 患病率或职业机械接触与肩部 OA 之间关系的流行病学研究。两名研究人员独立筛选文章，进行数据提取，并使用 GRADE 评估偏倚风险和证据等级：共筛选出 1642 篇文章，其中 7 篇符合纳入标准。经评估，4 项研究存在高偏倚风险，1 项存在中度风险，2 项存在低风险。根据职称，暴露职业组的患病率估计值较高（2.9% 至 61.8%）。在所有职业性机械接触中，都发现了与交流性踝关节损伤有关的接触-反应关系。对于振动，最高暴露组的几率比（OR）介于 1.7 和 3.1 之间，而上臂抬高、用力、提升、重复和综合机械暴露的几率比介于 0.5 和 2.2 之间、1.3 和 1.8 之间、7.3 和 10.3 之间、2.4 和 2.2 和 2.9 之间。所有暴露的证据水平都较低或很低：本系统综述发现，有迹象表明职业性机械接触与肩部 OA（尤其是 AC OA）之间存在关联。然而，证据水平介于较低和极低之间。我们非常有必要开展高质量的研究，评估两者之间的关联，并对特定的肩关节进行区分。

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来源期刊

Annals Of Work Exposures and Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.60

自引率

19.20%

发文量

期刊介绍： About the Journal Annals of Work Exposures and Health is dedicated to presenting advances in exposure science supporting the recognition, quantification, and control of exposures at work, and epidemiological studies on their effects on human health and well-being. A key question we apply to submission is, "Is this paper going to help readers better understand, quantify, and control conditions at work that adversely or positively affect health and well-being?" We are interested in high quality scientific research addressing: the quantification of work exposures, including chemical, biological, physical, biomechanical, and psychosocial, and the elements of work organization giving rise to such exposures; the relationship between these exposures and the acute and chronic health consequences for those exposed and their families and communities; populations at special risk of work-related exposures including women, under-represented minorities, immigrants, and other vulnerable groups such as temporary, contingent and informal sector workers; the effectiveness of interventions addressing exposure and risk including production technologies, work process engineering, and personal protective systems; policies and management approaches to reduce risk and improve health and well-being among workers, their families or communities; methodologies and mechanisms that underlie the quantification and/or control of exposure and risk. There is heavy pressure on space in the journal, and the above interests mean that we do not usually publish papers that simply report local conditions without generalizable results. We are also unlikely to publish reports on human health and well-being without information on the work exposure characteristics giving rise to the effects. We particularly welcome contributions from scientists based in, or addressing conditions in, developing economies that fall within the above scope.