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October/November 2014 (vol. 11/3)
Pushing and pulling
There is strong evidence, with consistent findings, that jobs involving pushing and pulling increase the risk of occupational shoulder symptoms, according to this systematic review. Two cross-sectional studies, one case–control study and four prospective cohort studies, together covering more than 8,000 participants, met inclusion criteria. There is moderate evidence – defined here as ‘consistent findings in at least two prospective cohort studies with low risk of bias and effect sizes in the same direction’ – that high exposure to occupational pushing and pulling are associated with neck/shoulder symptoms, but insufficient or conflicting evidence for a link with upper-arm, elbow, forearm, wrist or hand symptoms. Exposure levels were often defined in the included studies in terms of frequency of pushing/pulling tasks as well as load mass and duration.
Hoozemans MJM, Knelange EB et al. Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies. Occupational and Environmental Medicine 2014; online first: doi: 10.1136/oemed-2013-101837.
Occupational Health at Work October/November 2014 (vol. 11/3) pp44