Repetitive and forceful movements of the hand as predictors of treatment for pain in the distal upper extremities.

OBJECTIVE: To investigate repetitive movements and the use of hand force as causes of treatment for distal upper extremities musculoskeletal disorders METHODS: A cohort of 202 747 workers in a pension health scheme from 2005 to 2017 in one of 17 jobs (eg, office work, carpentry, cleaning) was formed. Representative electro-goniometric measurements of wrist angular velocity as a measure for repetition and expert-rated use of hand force were used in a job exposure matrix (JEM). Job titles were retrieved from the Danish registers. Outcome was first treatment in the distal upper extremities. In a Poisson regression model, incidence rate ratios (IRRs) of treatment were adjusted for age, calendar-year, diagnosis of rheumatoid arthritis and arm fractures. In further analyses, wrist velocity or hand force was added. RESULTS: In men, wrist velocity had an IRR of 1.48 (95% CI 1.15 to 1.91) when the highest exposure level was compared with the lowest but with no clear exposure-response pattern. The effect became insignificant when adjusted for hand force. Hand force had an IRR of 2.65 (95% CI 2.13 to 3.29) for the highest versus the lowest exposure with an exposure-response pattern, which remained after adjustment for wrist velocity. Among women, no increased risk was found for hand force, while wrist velocity showed a significantly protective association with treatment. CONCLUSIONS: In men, occupational exposure to hand force more than doubled the risk of seeking treatment. The results for exposure to repetition were less clear. In women, we could not find any indications of an increased risk neither for force nor for repetition.

Risk of pain in the neck and shoulders and job change among hairdressers: a combined questionnaire and register-based Danish prospective cohort study.

OBJECTIVE: To investigate whether intensity of work as a hairdresser was associated with treatments for pain, and if musculoskeletal pain was associated with leaving the hairdressing trade. METHODS: We formed two cohorts of hairdressers covered in the PensionDanmark Health Scheme (PDHS). Cohort 1 consisted of 1304 active hairdressers in 2009. Self-reported weekly haircuts were used as work intensity measure and treatments for pain in the neck and shoulders in PDHS were used as outcome. We used a Cox regression model with robust sandwich estimates adjusted for age, sex, employment status and prior treatment < 1 year before July 2009. Cohort 2 consisted of all hairdressers ever covered in the PDHS from 2006 to 2016 (n = 11,162). Exposure were treatments in PDHS within the last year. Outcome was leaving the trade within the following year. Adjustments were made for sex, calendar-year and age in Cox regression models. RESULTS: The adjusted hazard ratio of treatments in PDHS compared to the lowest work intensity was 0.95 (95% CI 0.58-1.55) and 0.74 (0.43-1.29) for medium and highest intensity, respectively. The risk of leaving the trade was lower, HR 0.80 (0.72-0.90) among hairdressers with treatments in PDHS within the last year, mainly driven by hairdressers aged < 56 years. CONCLUSION: We found no association between intensity of work as a hairdresser, measured as self-reported weekly haircuts, and treatments for pain in PDHS. Furthermore, we found a protective effect of treatments in the PDHS within the last year on risk of leaving the trade.