Association of occupational physical demands and psychosocial working environment with disabling shoulder pain

Objective-To estimate the individual and combined associations of physical and psychosocial working environment with disabling shoulder pain and to id entify groups at "high risk" for shoulder pain. Methods-A cross sectional survey was conducted at five manual occupational settings in south Manchester, United Kingdom (n=775, 83%). Results-Both the duration of occupational physical demands (working posture s, manual handling activities, and repetitive arm movements) and psychosoci al working environment (psychological demands and lack of opportunity to le arn new skills) were found to be significantly associated with shoulder pai n. Three occupational factors identified a high risk group for shoulder pai n: duration of lifting with one hand (prevalence rate ratio (PRR) (highest third) 2.0, 95% confidence interval (CI) 1.4 to 2.8), duration of working a bove shoulder level (PRR (highest third) 2.2, 95% Cl 1.5 to 3.3), and wheth er employees found their work stressful (PRR (highest third) 1.4, 95% Cl 1. 0 to 2.1). In addition, a measure of psychological distress (General Health Questionnaire (GHQ) score) was found to identify a group at high risk for shoulder pain (PRR (highest third) 1.9, 95% Cl 1.3 to 2.9). In employees ex posed to three or more of these factors, 79% (23/29) reported shoulder pain compared with only 16% (56/353) of those not exposed to any. Conclusion-This study has identified a variety of occupational physical dem ands and psychosocial factors associated with shoulder pain. It has also id entified groups of employees at a "high risk" for shoulder pain by their ex posure to both physical and psychosocial factors.