Musculoskeletal disorders and workplace factors. A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back.
This critical review of the epidemiologic literature identified a number of specific physical exposures which are strongly associated with specific upper extremity and low back musculoskeletal system disorders (MSDs) when exposures are intense, prolonged, and particularly when workers are exposed to several risk factors simultaneously. Such knowledge would have application in preventive programs in a number of diverse work settings. Specific topics addressed in this review included neck musculoskeletal disorders and the evidence for work relatedness including the impacts of repetition, force, posture, vibration, and the role of confounders; evidence for work relatedness in shoulder musculoskeletal disorders; elbow disorders; hand/wrist disorders including carpal tunnel syndrome, hand/wrist tendinitis, and hand/arm vibration syndrome; low back musculoskeletal disorders with attention given to heavy physical work, lifting and forceful movements, bending and twisting into awkward postures, whole body vibration, and static work postures; and the relationship between work related musculoskeletal disorders and psychosocial factors. Strong evidence was found for increased risk of work related MSDs for some body parts.