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Pushing and pulling in association with low back and shoulder complaints
M J M Hoozemans1, A J van der Beek, M H W Frings-Dresen
1Coronel Institute for Occupational and Environmental Health, AmCOGG Amsterdam Centre for Research into Health and Health Care, Academic Medical Centre/University of Amsterdam, PO Box 22700, Netherlands.
Occupational and Environmental Medicine
|October 3, 2002
Summary
Workplace pushing and pulling significantly increase the risk of shoulder complaints, showing a clear dose-response relationship. Low back complaints were also associated with higher exposure, particularly for severe cases.
Area of Science:
- Occupational Health
- Ergonomics
- Musculoskeletal Disorders
Background:
- Repetitive physical tasks like pushing and pulling are common in many industries.
- These activities are suspected contributors to musculoskeletal complaints, particularly in the low back and shoulders.
- Understanding the dose-response relationship is crucial for effective workplace interventions.
Purpose of the Study:
- To investigate the association between occupational exposure to pushing/pulling tasks and the prevalence of low back and shoulder complaints.
- To explore the dose-response relationship between exposure levels and the severity of these complaints.
- To assess the influence of psychosocial factors on these associations.
Main Methods:
- A cross-sectional questionnaire survey was conducted among 434 workers with pushing/pulling tasks and 188 reference workers.
- Exposure levels were categorized into medium and high, with a reference group.
- Prevalence of low back and shoulder complaints (trouble, pain intensity, disability) was assessed over 12 months using validated questionnaires; prevalence rate ratios (PRs) were calculated.
Main Results:
- The 12-month prevalence of low back complaints was similar across exposure groups, but high exposure was linked to increased risk compared to the reference group.
- A clear dose-response relationship was observed for all dimensions of shoulder complaints, with high exposure significantly increasing risk (PRs 2.09-6.37).
- Psychosocial factors confounded the association for pain intensity and disability, but not for trouble.
Conclusions:
- Occupational pushing and pulling exposure demonstrates a significant dose-response relationship with shoulder complaints.
- While less consistent, pushing/pulling exposure is associated with low back complaints, especially in more severe cases.
- Work-related psychosocial factors likely modulate the association between physical exposures and pain outcomes.