Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands.
Occup Environ Med. 2019 Jul;76(7):502-509. doi: 10.1136/oemed-2018-105553. Epub 2019 Mar 20.
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.
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.
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]).
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.
人们常认为屏幕作业（即台式机、笔记本电脑、笔记本或平板电脑上的工作）是导致颈部和上肢症状的危险因素。然而，目前缺乏对这方面证据的全面概述和评估。本研究旨在系统地回顾前瞻性研究中与屏幕作业暴露相关的颈部和上肢症状的关联。
通过电子数据库（PubMed、Embase、Cinahl 和 Scopus）搜索关于屏幕作业暴露与肌肉骨骼症状关联的前瞻性研究。对提取的数据和偏倚风险进行综合分析，并进行荟萃分析。
在筛选了 3423 篇独特的参考文献后，有 19 篇文章（来自 12 项研究，涉及 18538 名参与者）被纳入本次综述，其中最近的暴露评估报告于 2005 年。这些研究描述了屏幕作业的持续时间和输入频率（即计算机、键盘和鼠标使用，使用自我报告或软件记录进行评估）以及肌肉骨骼症状（即自我报告的颈部/肩部和远端上肢症状以及确诊的腕管综合征[CTS]）。尽管总体而言，屏幕作业暴露量越大，肌肉骨骼症状的发生率越高（相对风险：1.11[1.03-1.19]），但当使用软件记录（1.05[0.91-1.21]）评估屏幕作业时，风险相对较弱（且统计学上不显著），而当使用自我报告（1.14[1.03-1.19]）评估时，风险则较高。
我们发现屏幕作业与肌肉骨骼症状的风险增加有关。然而，证据存在异质性，令人惊讶的是，它缺乏使用笔记本电脑、笔记本或平板电脑进行当代屏幕作业的信息。
