[Evidence based prevention and upper limb work-related musculoskeletal disorders]

To evaluate interventions for primary prevention of Upper limb Work-related Musculoskeletal Disorders (UWMSD) we conducted a literature search from the biomedical database Medline and the Cochrane Collaboration Occupational Health Field. A total of 41 studies were selected: the majority investigated the effect of interventions among office workers, few involved industrial workplaces. Studies were characterized by a wide range of interventions (engineering, administrative, ergonomic training) and methodological heterogeneity (in the study design and outcome measures). Only four studies examine interventions for the prevention of specific outcomes (Carpal Tunnel Syndrome and Hand Arm Vibration Syndrome). At present, the multidimensional approach of interventions and the poor outcome definitions hamper the isolation of the potentially effective component of the intervention. Future intervention studies should be based on well defined risk assessment and outcome measures, rigorous and long-term study design. Only strong levels of evidence could be the base of policy recommendations.