TY - JOUR
T1 - Work-relatedness of lateral epicondylitis
T2 - Systematic review including meta-analysis and GRADE work-relatedness of lateral epicondylitis
AU - Bretschneider, S Fransje
AU - Los, Felicia S
AU - Eygendaal, Denise
AU - Kuijer, P Paul F M
AU - van der Molen, Henk F
N1 - Funding Information: Grant sponsor: the Ministry of Social Affairs and Employment, the Netherlands. Grant number: 5100‐26151 Publisher Copyright: © 2021 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals LLC.
PY - 2022/1
Y1 - 2022/1
N2 - Background: Lateral epicondylitis (LE) is a highly prevalent musculoskeletal disorder in workers, often associated with physically demanding work. Knowledge of work-relatedness of LE is crucial to develop appropriate preventive measures. This study investigates the prospective association between work-related physical risk factors and LE. Methods: A systematic literature review was conducted in MedLine using PubMed from January 1, 2010 until February 16, 2021. Published reports were included if: (1) LE was clinically assessed, (2) exposure to work-related physical risk factors was assessed, and (3) associations between LE and work-related physical risk factors were reported in prospective studies. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. Results: In total, 318 workers with LE from a population of 5036 workers in five studies were included. Meta-analyses revealed high-quality evidence for associations between LE and a Strain Index (SI) score >5.1 (odds ratio [OR]: 1.75, 95% confidence interval (CI): 1.11–2.78) and moderate-quality evidence for forearm rotation >4 h/day or forearm rotation ≥45° for ≥45% time (OR: 1.85, 95% CI: 1.10–3.10). Gripping, flexion and extension of the wrist, and repetitive movements showed no significant associations with LE. Conclusion: High-quality evidence was found indicating that a higher SI increased the risk of LE. Moderate-quality evidence was found for an association between forearm rotation and LE. No associations were found between other physical risk factors and LE. Primary preventive interventions should focus on a reduction of the SI and of high forearm rotation in work.
AB - Background: Lateral epicondylitis (LE) is a highly prevalent musculoskeletal disorder in workers, often associated with physically demanding work. Knowledge of work-relatedness of LE is crucial to develop appropriate preventive measures. This study investigates the prospective association between work-related physical risk factors and LE. Methods: A systematic literature review was conducted in MedLine using PubMed from January 1, 2010 until February 16, 2021. Published reports were included if: (1) LE was clinically assessed, (2) exposure to work-related physical risk factors was assessed, and (3) associations between LE and work-related physical risk factors were reported in prospective studies. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. Results: In total, 318 workers with LE from a population of 5036 workers in five studies were included. Meta-analyses revealed high-quality evidence for associations between LE and a Strain Index (SI) score >5.1 (odds ratio [OR]: 1.75, 95% confidence interval (CI): 1.11–2.78) and moderate-quality evidence for forearm rotation >4 h/day or forearm rotation ≥45° for ≥45% time (OR: 1.85, 95% CI: 1.10–3.10). Gripping, flexion and extension of the wrist, and repetitive movements showed no significant associations with LE. Conclusion: High-quality evidence was found indicating that a higher SI increased the risk of LE. Moderate-quality evidence was found for an association between forearm rotation and LE. No associations were found between other physical risk factors and LE. Primary preventive interventions should focus on a reduction of the SI and of high forearm rotation in work.
KW - elbow tendinopathy
KW - lateral epicondylitis
KW - occupational disease
KW - occupational exposures
KW - occupational physician
KW - physical risk factors
KW - prevention
KW - tennis elbow
KW - workers' health
UR - http://www.scopus.com/inward/record.url?scp=85117384658&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ajim.23303
DO - https://doi.org/10.1002/ajim.23303
M3 - Review article
C2 - 34674287
SN - 0271-3586
VL - 65
SP - 41
EP - 50
JO - American journal of industrial medicine
JF - American journal of industrial medicine
IS - 1
ER -