Associations of screen work with neck and upper extremity symptoms: A systematic review with meta-analysis

Objectives It has often been suggested that screen work (ie, work on desktop, laptop, notebook or tablet computers) is a risk factor for neck and upper extremity symptoms. However, an up-to-date overview and quantification of evidence are lacking. We aimed to systematically review the association of exposure to screen work with neck and upper extremity symptoms from prospective studies. Methods An electronic database search (PubMed, Embase, Cinahl and Scopus) for prospective studies on the association of exposure to screen work and musculoskeletal symptoms was conducted. Studies were synthesised regarding extracted data and risk of bias, and meta-analyses were conducted. Results After screening 3423 unique references, 19 articles from 12 studies (with 18 538 participants) were included for the current review, with the most recent exposure assessment reported in 2005. Studies described duration and input frequency of screen work (ie, computer, keyboard and mouse use, assessed using self-reports or software recordings) and musculoskeletal symptoms (ie, self-reported neck/shoulder and distal upper extremity symptoms and diagnosed carpal tunnel syndrome [CTS]). Although there was overall an increased occurrence of musculoskeletal symptoms with larger exposure to screen work (relative risk: 1.11 [1.03 1.19]), findings were rather inconsistent with weaker (and statistically non-significant) risks when screen work was assessed by software recording (1.05 [0.91 1.21]) compared to with self-report (1.14 [1.03 1.19]). Conclusions We found an increased risk of musculoskeletal symptoms with screen work. However, the evidence is heterogeneous, and it is striking that it lacks information from contemporary screen work using laptop, notebook or tablet computers.