Original article

Scand J Work Environ Health 2013;39(6):568-577    pdf full text

doi:10.5271/sjweh.3374

Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures: a longitudinal study

by Svendsen SW, Dalbøge A, Andersen JH, Thomsen JF, Frost P

Objectives The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures.

Methods The study was based on the Musculoskeletal Research Database at the Danish Ramazzini Centre. We linked baseline questionnaire information from 1993–2004 on neck-shoulder complaints, job titles, psychosocial work factors, body mass index, and smoking with register information on first-time surgery for SIS from 1996–2008. Biomechanical exposure measures were obtained from a job exposure matrix based on expert judgment. We applied multivariable Cox regression.

Results During 280 125 person-years of follow-up among 37 402 persons, 557 first-time operations for SIS occurred. Crude surgery rates increased from 1.1 to 2.5 per 1000 person-years with increasing shoulder load. Using no neck-shoulder complaints and low shoulder load at baseline as a reference, no neck-shoulder complaints and high shoulder load showed an adjusted hazard ratio (HRadj) of 2.55 [95% confidence interval (95% CI) 1.59–4.09], while neck-shoulder complaints in combination with high shoulder load showed an HRadj of 4.52 (95% CI 2.87–7.13). Subanalyses based on 18 856 persons showed an HRadj of 5.40 (95% CI 2.88–10.11) for complaints located specifically in the shoulder in combination with high shoulder load.

Conclusions Based on these findings, persons with neck-shoulder and especially shoulder complaints in combination with high shoulder load seem an obvious target group for interventions aimed at reducing exposures to prevent surgery for SIS.

This article refers to the following texts of the Journal: 2004;30(5):399-409  2007;33(3):165-191  2009;35(1):19-36  2010;36(3):189-201  2011;37(6):502-511  2012;38(5):436-446
The following article refers to this text: 2016;42(6):481-489