van der Molen HF, et al. – The goal of this paper was to identify which work–related risk factors were associated with specific soft tissue shoulder disorders. The data revealed Low-quality evidence with regard to the absence of associations for arm repetition, social support, decision latitude, job control and job security. Moderate evidence revealed that arm–hand elevation and shoulder load doubled the risk of specific shoulder disorders. Low to very–low–quality evidence was discovered with regard to the link between hand force exertion, hand–arm vibration, psychosocial job demands and working together with temporary workers and the incidence of specific shoulder disorders.

Methods

• Data was extracted from the Medline and Embase for articles published between 2009 and 24 March 2016.
• It 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 elucidated with regard to clinically assessed soft tissue shoulder disorders.
• A minimum of 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, meta-analyses were carried out and this study used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) for examining the evidence for the link between risk factors and the onset of shoulder disorders.
• Twenty-seven studies met the inclusion criteria.
• The enrollees included 16300 patients with specific soft tissue shoulder disorders from a population of 2413722 workers from Denmark, Finland, France, Germany and Poland.

Results

• Moderate evidence was obtained 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).
• Low to very low evidence was yielded 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).