van Rijn Rogier M, Huisstede Bionka M A, Koes Bart W, Burdorf Alex
Department of General Practice, Erasmus MC, Rotterdam, The Netherlands.
Rheumatology (Oxford). 2009 May;48(5):528-36. doi: 10.1093/rheumatology/kep013. Epub 2009 Feb 17.
To assess the exposure-response relationships between work-related physical and psychosocial factors and lateral epicondylitis, medial epicondylitis, cubital tunnel syndrome and radial tunnel syndrome in occupational populations.
A systematic review of the literature was conducted on the associations between type of work, physical load and psychosocial aspects at work and the occurrence of specific elbow disorders. Associations between work factors and these elbow disorders were expressed in quantitative measures: odds ratio (OR) or relative risk (RR).
Handling tools >1 kg (ORs of 2.1-3.0), handling loads >20 kg at least 10 times/day (OR 2.6) and repetitive movements >2 h/day (ORs of 2.8-4.7) were associated with lateral epicondylitis. Psychosocial factors associated with lateral epicondylitis were low job control (OR 2.2) and low social support (OR 1.8). Handling loads >5 kg (2 times/min at minimum of 2 h/day), handling loads >20 kg at least 10 times/day, high hand grip forces for >1 h/day, repetitive movements for >2 h/day (ORs of 2.2-3.6) and working with vibrating tools >2 h/day (OR 2.2) were associated with medial epicondylitis. The occurrence of cubital tunnel syndrome was associated with the factor 'holding a tool in position' (OR 3.53). Handling loads >1 kg (OR 9.0; 95% CI 1.4, 56.9), static work of the hand during the majority of the cycle time (OR 5.9) and full extension (0-45 degrees ) of the elbow (OR 4.9) were associated with radial tunnel syndrome.
Several physical and psychosocial factors at work may result in an increased occurrence of specific disorders at the elbow.
评估职业人群中与工作相关的身体和心理社会因素与外侧上髁炎、内侧上髁炎、肘管综合征和桡管综合征之间的暴露-反应关系。
对工作类型、工作中的身体负荷和心理社会方面与特定肘部疾病发生之间的关联进行了文献系统综述。工作因素与这些肘部疾病之间的关联以定量指标表示：比值比（OR）或相对风险（RR）。
搬运重量>1 kg的工具（OR为2.1 - 3.0）、每天至少10次搬运重量>20 kg的物品（OR 2.6）以及每天重复动作>2小时（OR为2.8 - 4.7）与外侧上髁炎相关。与外侧上髁炎相关的心理社会因素是工作控制感低（OR 2.2）和社会支持低（OR 1.8）。搬运重量>5 kg（每天至少2小时，每分钟2次）、每天至少10次搬运重量>20 kg的物品、每天手部高强度握力>1小时、每天重复动作>2小时（OR为2.2 - 3.6）以及每天使用振动工具>2小时（OR 2.2）与内侧上髁炎相关。肘管综合征的发生与“将工具固定在一个位置”这一因素相关（OR 3.53）。搬运重量>1 kg（OR 9.0；95%可信区间1.4, 56.9）、在大部分循环时间内手部进行静态工作（OR 5.9）以及肘部完全伸展（0 - 45度）（OR 4.9）与桡管综合征相关。
工作中的多种身体和心理社会因素可能导致肘部特定疾病的发生率增加。
