Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital Herning, Herning, Denmark.
PLoS One. 2011 May 12;6(5):e19691. doi: 10.1371/journal.pone.0019691.
BACKGROUND: To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. METHODOLOGY/PRINCIPAL FINDINGS: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. CONCLUSIONS/SIGNIFICANCE: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.
背景:总结评估计算机工作与腕管综合征(CTS)或上肢肌肉骨骼疾病(UEMSD)之间因果关系的系统评价,或报告计算机使用者/办公室工作人员干预研究的系统评价。
方法/主要发现:在 1999 年至 2010 年期间,在 PubMed、Embase、CINAHL 和 Web of Science 上搜索了综述。内容领域专家提供了其他出版物。主要作者使用专门设计的表格提取所有数据,而两位作者使用 AMSTAR 推荐的标准准则评估综述的质量;意见分歧通过讨论解决。对纳入综述中证据综合的质量进行了定性评估,评估了每个结果和干预措施的质量。共确定了 1349 个综述标题,检索了 47 篇综述以评估全文相关性,并最终纳入了 17 篇相关且质量足够的综述。这 17 篇综述的重点和严格程度差异很大。有 3 篇关于腕管综合征危险因素的综述被评为中等至高质量,8 篇关于 UEMSDs 危险因素的综述从低到中等/高质量不等,6 篇关于干预研究的综述为中等至高质量。计算机使用作为 CTS 危险因素的证据质量不足,而计算机使用与 UEMSDs 之间的证据质量为中度,关于疼痛投诉,对于特定肌肉骨骼疾病的证据则有限。从干预研究综述中,无法给出强有力的循证建议。
结论/意义:计算机使用与疼痛投诉有关,但仍不清楚这种关联是否具有因果关系。特定疾病或病症的证据有限。尚未记录到有效的干预措施。
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