Occupational Stress as a Possible Risk Factor for Rotator Cuff Damage - Systematic Review and Meta-analysis.

Area of Science:

• Occupational Medicine
• Orthopedics
• Public Health

Background:

• Rotator cuff lesions are increasingly recognized as potential occupational diseases.
• Factors such as long-term overhead work, repetitive motions, hand-arm vibration, and heavy lifting are implicated.
• Germany's Federal Ministry of Labour and Social Affairs (BMAS) recommended recognizing these lesions as occupational in 2021.

Purpose of the Study:

• To systematically review and analyze the correlation between specific occupational risk factors and rotator cuff lesions.
• To determine the influence of overhead work, repetitive movements, hand-arm vibration, and heavy lifting on rotator cuff disease development.

Main Methods:

• A systematic literature review was conducted across PubMed, Cochrane, and Web-of-Science databases.
• 13 studies were included in a meta-analysis after reviewing 58 full-text papers.
• The analysis focused on occupational shoulder load and associated shoulder disorders.

Main Results:

• All four examined risk factors (overhead work, repetitive movements, hand-arm vibration, heavy lifting) showed a significant association with rotator cuff lesions.
• Overhead work (OR 2.23) and repetitive movements (OR 2.17) demonstrated the strongest dose-response relationships.
• Hand-arm vibration (OR 1.59) and heavy lifting (OR 1.57) also showed significant associations.

Conclusions:

• While significant associations were found for all risk factors, the current evidence is limited.
• A low number of high-quality studies and insufficient pathophysiological explanations hinder the establishment of a reliable correlation.
• Further research with robust study designs is necessary to confirm the link between these occupational activities and rotator cuff disease.