Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures: a longitudinal study

Svendsen, Susanne Wulff; Dalbøge, Annett; Andersen, Johan Hviid; Thomsen, Jane Frølund; Frost, Poul

doi:10.5271/sjweh.3374

Cited by 45 publications

(86 citation statements)

References 26 publications

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“…Furthermore, we estimated individual cumulative exposures without recall bias by linking registered D-ISCO 88 codes with an independent JEM, which has shown high predictive validity in a recent study of surgery for SIS 18. The experts did not have information on the distribution of surgery for SIS across occupational titles, but from their previous research, they did have information on the prevalence of clinically diagnosed SIS for a few of the occupational titles represented in the JEM (eg, slaughterhouse workers and house painters).…”

Section: Discussionmentioning

confidence: 99%

“…We conducted a nationwide cohort study using data from Danish registers, that is, the Civil Registration System (CRS),28 the Supplementary Pension Fund Register,29 the Employment Classification Module (ECM)30 and the National Patient Register (NPR),31 together with a job exposure matrix (JEM) based on experts’ ratings of occupational shoulder exposures 18…”

Section: Methodsmentioning

confidence: 99%

“…For each year from 1993 and onwards, we allocated exposure measures to the cohort members by connecting their D-ISCO 88 codes with a JEM. The JEM was developed for a number of studies concerning SIS (including this study); its construction has been described previously 18. In brief, we excluded rare or obsolete occupational titles from the 2227 different occupational titles in D-ISCO 88 and divided the remaining 2042 titles into 172 groups of jobs with expected homogeneous shoulder exposures.…”

Section: Methodsmentioning

confidence: 99%

“…No job group was rated in the highest acceleration group. We also constructed a joint shoulder load variable, which represented forceful work, upper arm elevation >90° and repetitive shoulder movements, either individually or in different combinations 18. Shoulder load was scored 0 (low exposure), 1 (medium exposure) or 2 (high exposure), and one shoulder-load-year was defined as having a shoulder load score of 1 for 1 year.…”

Section: Methodsmentioning

confidence: 99%

“…Whether work-related cases of clinically diagnosed SIS have characteristics that lead to surgery has only been addressed in one study,18 which suggested so. If a relationship between occupational shoulder exposures and surgery for SIS can be corroborated, this will provide a further incentive for prevention by reducing occupational shoulder exposures.…”

Section: Introductionmentioning

confidence: 99%

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Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study

et al. 2014

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ObjectivesThe primary aim was to examine exposureresponse relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sexspecific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. Methods We conducted a nationwide register study of all persons born in Denmark (1933Denmark ( -1977, who had at least 5 years of full-time employment. In the follow-up period (2003)(2004)(2005)(2006)(2007)(2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. Results The adjusted OR (OR adj ) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The OR adj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Conclusions Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study

et al. 2014

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Reliability and validity of expert assessments of hand‐wrist physical exposures

Mikkelsen

Petersen

et al. 2021

American J Industrial Med

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Background: General population job-exposure matrices (JEMs) based on expert assessments of physical exposures may be valuable tools for studying occupationrelated musculoskeletal disorders. Wrist-hand JEMs are few and the reliability and validity of expert assessments of wrist-hand exposures is uncertain.Methods: We examined intra-and inter-rater reliability of ratings of five experts of hand-wrist repetition, deviation, force, vibration, and computer work in 33 jobs selected to represent a large exposure variation. The validity of ratings of handwrist repetition was examined by comparison with electro-goniometer measurements of wrist angular velocity and mean power frequency (MPF), and the validity of hand-wrist deviation by comparison with goniometer measurements of range of motion (ROM).Results: Intra-rater test-retest and inter-rater Spearman correlation coefficients controlling for rater effects, varied between 0.70 and 0.87. Corresponding kappa statistics of overall agreement showed similar high values, except for wrist deviation (kappa = 0.50). Regression analyses showed strong positive associations between expert assessments of repetition and goniometer measurements of wrist angular velocity (R 2 = 0.56, p < 0.0001) and MPF (R 2 = 0.37, p < 0.0003), while expert ratings of wrist deviation showed a weak statistically nonsignificant association with goniometer measurements of ROM (R 2 = 0.032, p = 0.34). Conclusion:The reliability of expert assessments of wrist-hand physical exposures was high. Compared to goniometer measurements, the validity of assessments of wrist-hand repetition was also high, but it was low for assessments of wrist-hand deviation. The results are encouraging for establishing a hand-wrist JEM, but the results for wrist deviation emphasize that expert assessments should be validated against objective measurements.

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Investigating the multifactorial etiology of supraspinatus tendon tears

Lawrence,

Soliman,

Dalbøge

et al. 2023

Journal Orthopaedic Research

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The purpose of this study was to develop a multivariable model to determine the extent to which a combination of etiological factors is associated with supraspinatus tendon tears. Fifty‐four asymptomatic individuals (55 ± 4 years) underwent testing of their dominant shoulder. Diagnostic ultrasound was used to assess for a supraspinatus tendon tear. The etiological factors investigated included demographics (age and sex), tendon impingement during shoulder motion (via biplane videoradiography), glenohumeral morphology (via computed tomography imaging), family history of a tear (via self‐report), occupational shoulder exposure (via shoulder job exposure matrix), and athletic exposure (via self‐report). Univariate relationships between etiological predictors and supraspinatus tears were assessed using logistic regression and odds ratios (ORs), while multivariable relationships were assessed using classification and regression tree analysis. Thirteen participants (24.1%) had evidence of a supraspinatus tear. Individuals with a tear had a higher critical shoulder angle (OR 1.2, p = 0.028) and acromial index (OR 1.2, p = 0.016) than individuals without a tear. The multivariable model suggested that a tear in this cohort can be explained with acceptable accuracy (AUROC = 0.731) by the interaction between acromial index and shoulder occupational exposure: a tear is more likely in individuals with a high acromial index (p < 0.001), and in individuals with a low acromial index and high occupational exposure (p < 0.001). The combination of an individual's glenohumeral morphology (acromial index) and occupational shoulder exposure may be important in the development of supraspinatus tears.

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Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures: a longitudinal study

Abstract: The impact of occupational biomechanical shoulder exposures on risk of surgery for subacromial impingement syndrome (SIS) is unknown. Shoulder load increased the risk of surgery for SIS. Neck-shoulder complaints combined with high shoulder load conveyed the highest risk.Affiliation:

Cited by 45 publications

References 26 publications

Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study

Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study

Reliability and validity of expert assessments of hand‐wrist physical exposures

Investigating the multifactorial etiology of supraspinatus tendon tears

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