Shoulder disorders and postural stress in automobile assembly work

Objectives A case-referent study was conducted in an automobile assembly pl ant to evaluate the risk of shoulder disorders associated with nonneutral p ostures. Methods The cases were workers who reported shoulder pain to the plant clin ic during a 10-month period and met symptom criteria (pain frequency or dur ation in the past year) in an interview; more than one-half also had positi ve findings in a physical examination. The referents were randomly selected workers who were free of shoulder disorders according to the clinic record s, the interview, and the physical examination. For each of the 79 cases an d 124 referents, 1 job was analyzed for postural and biomechanical demands by an analyst blinded to the case-referent status. Results Forty-one percent of the subjects flexed or abducted the right arm "severely" (above 90 degrees) during the job cycle, and 35% did so with the left arm. The peak torques at the shoulder were rather low. Shoulder disor ders were associated with severe flexion or abduction of the left [odds rat io (OR) 3.2, 95% confidence interval (95% CI) 1.5-6.5] and the right (OR 2. 3, 95% CI 1.2-4.8) shoulder. The risk increased as the proportion of the wo rk cycle exposed increased. The relationships were similar for the cases wi th and without physical findings. Use of hand-held tools increased the risk and also modified the association with postural stress, although the joint exposure distributions limited full analysis of this finding. Conclusions The findings support the conclusion that severe shoulder flexio n or abduction, especially for 10% or more of the work cycle, is predictive of chronic or recurrent shoulder disorders.