Medical Faculty, Institute of Occupational and Social Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
Int Arch Occup Environ Health. 2013 May;86(4):375-95. doi: 10.1007/s00420-013-0848-y. Epub 2013 Apr 3.
To systematically analyse evidence on the incremental effect of work-related psychosocial risk factors on the development of neck and shoulder disorders, as reported in longitudinal studies.
A systematic literature search was conducted in three data bases (MEDLINE, EMBASE, and PsychINFO) until May 2009. The quality assessment leading to a methodological quality score of the included studies was conducted by two independent reviewers using a standardised checklist. Criteria for the evaluation of evidence were established. Heterogeneity analyses were conducted.
Altogether 18 prospective longitudinal studies were included in the analysis. Potential psychosocial risk factors were mainly based on the job demand control (support) model by Karasek (1998). Study results were too heterogeneous to deduce pooled risk estimates. But the weight of evidence was strong for an incremental effect of job demands, job control, social support, and job strain, on the development of neck and/or shoulder disorders.
While we found evidence for an incremental effect of different psychosocial work factors (in addition to the effect of physical job factors), these results have to be interpreted carefully in order to support the notion that psychological factors can have an independent causal influence on the development of musculoskeletal disorders. Nevertheless, our findings are important for the development of preventive strategies, as they stress the need for preventive approaches that tackle both physical and psychosocial factors. Future research is warranted to consolidate and strengthen the results of this review.
系统分析工作相关心理社会危险因素对颈肩疾病发展的增量影响的证据，这些证据来自于纵向研究。
在三个数据库（MEDLINE、EMBASE 和 PsychINFO）中进行了系统的文献检索，检索时间截至 2009 年 5 月。两名独立的评审员使用标准化的清单对纳入研究的质量评估进行了方法学质量评分。为评估证据制定了标准。进行了异质性分析。
总共分析了 18 项前瞻性纵向研究。潜在的心理社会危险因素主要基于 Karasek（1998）的工作需求控制（支持）模型。研究结果的异质性太大，无法推断出汇总的风险估计。但是，有强有力的证据表明，工作需求、工作控制、社会支持和工作压力对颈和/或肩疾病的发展具有增量效应。
虽然我们发现了不同心理社会工作因素（除了物理工作因素的影响之外）的增量效应的证据，但这些结果需要谨慎解释，以支持心理因素对肌肉骨骼疾病发展具有独立因果影响的观点。尽管如此，我们的研究结果对于预防策略的制定非常重要，因为它们强调了需要采取针对身体和心理社会因素的预防方法。未来的研究是必要的，以巩固和加强本综述的结果。
