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

Abstract

Purpose In September 2021, the Federal Ministry of Labour and Social Affairs in Germany (BMAS) recommended recognising rotator cuff lesions caused by occupational long-term overhead work, repetitive movements, hand-arm-vibration and carrying and lifting heavy loads as an occupational disease. To gain a more detailed understanding of the correlation between occupational risk factors and lesions of the rotator cuff, a systematic literature review was carried out to determine their influence on the development of rotator cuff disease.

Material and Method A systematic literature review was used to search in the databases PubMed, Cochrane and Web-of-Science for papers dealing with occupational shoulder load and associated shoulder disorders. The influence of overhead work, repetitive movements, hand-arm-vibrations and carrying and lifting heavy loads were examined.

Results 58 studies were read in full text, of which 13 papers were included in the meta-analysis. In all risk factors, a significant association can be found with the strongest dose-response relationship in “overhead work” and “repetitive movements”: overhead work: 2.23 (95% CI 1.98–2.52), repetitive movements: 2.17 (95% CI 1.92–2.46), hand-arm-vibration: 1.59 (95% CI 1.13–2.23), carrying and lifting heavy loads: 1.57 (95% CI 1.15–2.15).

Conclusion Although a significant effect could be shown in our study for all the four risk factors examined, due to the low number of studies with high-quality study design and insufficient pathophysiological explanation for the development of a rotator cuff disease in these mechanical activities, no reliable correlation can currently be established.

Keywords

shoulder - rotator cuff - rotator cuff disease - occupation - occupational load

Publication History

Received: 01 June 2022

Accepted after revision: 26 September 2022

Article published online:
06 December 2022

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