Documents van der Wal, G. 3 results

"OBJECTIVE
To study the relation between neck pain and work related neck flexion, neck rotation, and sitting.
METHODS
A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured exposure data (video recordings) of neck flexion, neck rotation, and sitting posture. Neck pain was assessed by a questionnaire. Adjustments were made for various physical factors that were related or not related to work, psychosocial factors, and individual characteristics.
RESULTS
A significant positive relation was found between the percentage of the working time in a sitting position and neck pain, implying an increased risk of neck pain for workers who were sitting for more than 95% of the working time (crude relative risk (RR) 2.01, 95% confidence interval (95% CI) 1.04 to 3.88; adjusted RR 2.34, 95% CI 1.05 to 5.21). A trend for a positive relation between neck flexion and neck pain was found, suggesting an increased risk of neck pain for people working with the neck at a minimum of 20° of flexion for more than 70% of the working time (crude RR 2.01, 95% CI 0.98 to 4.11; adjusted RR 1.63, 95% CI 0.70 to 3.82). No clear relation was found between neck rotation and neck pain.
CONCLUSION
Sitting at work for more than 95% of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain. No clear relation was found between neck rotation and neck pain."

Background Neck pain, which is assumed to be a multifactorial disease, is a major problem in modern society. Methods To identify the most important psychosocial risk factors for neck pain, a systematic review of the literature was carried out. The methodological quality of all studies in the review was assessed. Four levels of evidence were defined to assess the strength of evidence for potential risk factors for neck pain (strong, moderate, some or inconclusive evidence). Results Some evidence was found for a positive relationship between neck pain and high quantitative job demands, low social (coworker) support, low job control, high and low skill discretion and low job satisfaction. Inconclusive evidence was found for high job strain, low supervisor support, conflicts at work, low job security, and limited rest break opportunities. Conclusions The procedure of the assessment of the methodological quality and the rating system applied to distinguish between high- and low-score studies, had a considerable influence on the level of evidence, indicating that changes in this procedure may have a major impact on the overall conclusions of this review.

"To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22 cross-sectional studies, 2 prospective cohort studies, and 1 case-referent study were eligible for determining the level of evidence. The results showed some evidence for a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk. A sensitivity analysis was carried out excluding 3 items of the quality list, the importance of which seemed doubtful. On the basis of this sensitivity analysis, it was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors: neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand-arm vibration, and workplace design."