OCCUPATIONAL FACTORS RELATED TO SHOULDER PAIN AND DISABILITY

Objectives--To determine, in a population based study, the influence o f occupational factors on the occurrence of shoulder pain and disabili ty. Methods--A random sample of patients was selected from the registe r of a general practice in the Greater Manchester area of the United K ingdom. Information was collected by a posted questionnaire with speci fic enquiries about symptoms in the shoulder region and related disabi lity. A lifetime occupational history was obtained including physical exposures, working conditions, and psychosocial aspects of each workpl ace. Analysis has been conducted as a case-control study, comparing oc cupational exposures at the time of onset of symptoms in those with sh oulder pain and disability with corresponding occupational exposures i n those without shoulder pain and disability. Results--An increased ri sk of shoulder pain and disability in men was associated with carrying weights on one shoulder (relative risk (RR) 5.5, 95% confidence inter val (95% CI) 1.8 to 17), whereas those who reported working with hands above shoulder level, using wrists or arms in a repetitive way, or st retching down to reach below knee level had about twice the risk of sh oulder pain and disability. Men working frequently in very cold or dam p conditions had a fourfold and sixfold risk respectively of shoulder pain and disability. Reporting of shoulder pain and disability was als o more common among men and women who reported that their work caused a lot of stress (RR 1.9, 95% CI 0.9 to 4.1) or was very monotonous (RR 2.7, 95% CI 1.3 to 5.4). The relations between physical exposures, wo rking conditions, and psychosocial factors were independent. Conclusio ns--This population based study has shown that physical activities car ried out at work, the physical conditions under which the work is cond ucted, psychosocial aspects of work, or the working environment are al l independently related to the occurrence of shoulder symptoms and dis ability, emphasising the multifactorial nature of this condition.