Recent studies on occupational risk factors for soft tissue disorders of the shoulder region were reviewed. The problem of work related shoulder pain was considered. Shoulder pain resulting from soft tissue cumulative trauma ranks second in clinical frequency to low back and neck pain as occupationally related musculoskeletal disorders. The prevalence of shoulder pain across a wide range of occupations has been found to range from 4 to 42%. Problems associated with investigating occupational risk factors for soft tissue shoulder disorders were discussed. The types and clinical characteristics of soft tissue shoulder disorders were described. These included tendon related disorders, muscular shoulder pain, nerve related disorders, neurovascular disorders, and occupational cervicobrachial disorder. Tendon related disorders constituted a general category that included rotator cuff tendinitis, calcific tendinitis, bicipital tendinitis, tendon tear, and bursitis. Nerve and neurovascular disorders usually involved inflammation or compression of the suprascapular nerve. Occupational cervicobrachial disorder was a symptom complex located primarily in the shoulder and neck region. Epidemiological, field, and laboratory studies of risk factors for occupational shoulder pain were discussed. These have indicated that awkward or static postures, heavy physical labor, direct load bearing, repetitive arm movements, working with the arms held above the shoulders, and lack of rest breaks are significant risk factors for shoulder pain. Personal risk factors include female sex, job dissatisfaction, age, social factors such as having a sick spouse, having children and working a shift different from that of the spouse, and participating in sports activities such as swimming, tennis, and baseball pitching. Shoulder pain has been shown to be related to elevated electromyographic (EMG) activity and changes in EMG level and median spectral frequency of the trapezius muscle. Suggested engineering and administrative controls for reducing occupational risk factors for soft tissue shoulder disorders were discussed.
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