Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: A systematic review update.

This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.

Protocol for an observational study of working conditions and musculoskeletal health in Swedish online retail warehousing from the perspective of sex/gender and place of birth.

European and International sustainable development agendas aim to reduce inequalities in working conditions and work-related health, yet disparate occupational health outcomes are evident between both men and women and domestic- and foreign-born workers. In Sweden, major growth in online retail warehousing has increased occupational opportunities for foreign-born workers. The rapid change has left research lagging on working conditions, i.e., employment conditions, facility design, work organisation, physical and psychosocial work environment conditions, and their effects on worker health. Further, no known studies have considered patterns of inequality related to these factors. The overall aim of this study is to describe working conditions and musculoskeletal health in online retail warehousing, determine the extent to which differences exist related to sex/gender and place of birth (as a proxy for race/ethnicity), and examine factors at the organisational and individual levels to understand why any differences exist. Three online retail warehouses, each employing 50-150 operations workers performing receiving, order picking, order packing and dispatching tasks will be recruited. Warehouses will, to the extent possible, differ in their extent of digital technology use. Employment conditions, facility design (including digital tool use), work organisation, physical and psychosocial work environment conditions and worker health will be assessed by survey, interview and technical measurements. Analysis of quantitative data stratified by sex and place of birth will consider the extent to which inequalities exist. Focus group interviews with operations employees and in-depth interviews with managers, union and health and safety representatives will be conducted to assess how employee working conditions and musculoskeletal health are related to inequality regimes of sex/gender and/or race/ethnicity in organisational processes and practices in online retail warehousing. The study is pre-registered with the Open Science Framework. This study will describe working conditions and health in online retail warehouse workers and consider the extent to which patterns of inequality exist based on sex/gender and place of birth.

Physical and psychosocial work-related exposures and the incidence of carpal tunnel syndrome: A systematic review of prospective studies.

This systematic review summarizes the evidence on associations between physical and psychosocial work-related exposures and the development of carpal tunnel syndrome (CTS). Relevant databases were searched up to January 2020 for cohort studies reporting associations between work-related physical or psychosocial risk factors and the incidence of CTS. Two independent reviewers selected eligible studies, extracted relevant data, and assessed risk of bias (RoB). We identified fourteen articles for inclusion which reported data from nine cohort studies. Eight reported associations between physical exposure and the incidence of CTS and five reported associations between psychosocial exposures and the incidence of CTS. Quality items were generally rated as unclear or low RoB. Work-related physical exposure factors including high levels of repetition, velocity, and a combination of multiple physical exposures were associated with an increased risk of developing CTS. No other consistent associations were observed for physical or psychosocial exposures at work and CTS incidence.

Assessing the efficacy of a job rotation for improving occupational physical and psychosocial work environment, musculoskeletal health, social equality, production quality and resilience at a commercial laundromat: protocol for a longitudinal case study.

INTRODUCTION: Job rotation is a work organisation strategy used to reduce work-related exposures and musculoskeletal complaints, yet evidence for the efficacy of the approach is weak. Mismatch between job rotation and company needs, lack of full implementation, lack of exposure variation in included tasks and failure to assess variation may underlie inconclusive research findings to date. The study aims to develop a job rotation with company stakeholders, perform a process evaluation of the implementation, and determine the extent to which the intervention improves the physical and psychosocial work environment, indicators of health, gender and social equality among workers and production quality and resilience. METHODS AND ANALYSIS: Approximately 60 production workers at a Swedish commercial laundromat will be recruited. Physical and psychosocial work environment conditions, health, productivity and gender and social equality will be assessed pre and post intervention, using surveys, accelerometers, heart rate, electromyography and focus groups. A task-based exposure matrix will be constructed, and exposure variation estimated at the level of the individual worker pre and post intervention. An implementation process evaluation will be conducted. Job rotation efficacy will be assessed in terms of improvement in work environment conditions, health, gender and social inequality, and production quality and resilience. This study will provide novel information on the effects of the job rotation on physical and psychosocial work environment conditions, production quality and rate, health and gender and social inequality among blue-collar workers in a highly multicultural workplace. ETHICS AND DISSEMINATION: The study received approval from the Swedish Ethical Review Authority (reference number 2019-00228). The results of the project will be shared directly with the employees, managers and union representatives from the participating company, other relevant labour market stakeholders and with researchers at national and international conferences and via scientific publication. TRIAL REGISTRATION NUMBER: The study is preregistered with the Open Science Framework (https://osf.io/zmdc8/).

Exposure to hand-arm vibrations in the workplace and the occurrence of hand-arm vibration syndrome, Dupuytren's contracture, and hypothenar hammer syndrome: a systematic review and meta-analysis.

This study provides an overview of the relationships between exposure to work-related hand-arm vibration and the occurrence of pre-defined disorders of the hands. We searched Medline, Embase, Web of Science, Cochrane Central, and PsycINFO for cross-sectional and longitudinal studies on the association between work-related vibration exposure and the occurrence of hand-arm vibration syndrome (including vibration-induced white finger), Dupuytren's contracture, or hypothenar hammer syndrome. We used a 16-item checklist for assessing the risk of bias. We present results narratively, and we conducted random effects meta-analyses if possible. We included 10 studies with more than 24,381 participants. Our results showed statistically significant associations between the exposure to hand-arm vibrations and the occurrence of the selected disorders, with pooled odds ratios ranging between 1.35 (95% CI: 1.28 to 2.80) and 3.43 (95% CI: 2.10 to 5.59). Considerable between-study heterogeneity was observed. Our analyses show that exposure to vibrating tools at work is associated with an increased risk for the occurrence of selected disorders of the hands. Due to the majority of studies being cross-sectional, no firm conclusion is possible regarding causal relationships between vibration exposure and disorder occurrence. Future research should specifically address whether reducing exposure to hand-held vibrating tools at work reduces the incidence of the disorders of the hands investigated in this systematic review.

A Systematic Review of Work Organization, Work Environment, and Employment Conditions in Warehousing in Relation to Gender and Race/Ethnicity.

OBJECTIVES: Studies in the goods supply chain in areas outside of warehousing show evidence of gender and racial/ethnic inequalities in working conditions (i.e. in work organization, work environment, and employment conditions). This review aimed to identify, summarize, and discuss research focused on inequality in warehousing and its effects on warehouse working conditions. In the review, racial/ethnic inequality includes inequality related to country of birth and (im)migration status. METHODS: We performed a systematic search in the Scopus and Web of Science databases to identify warehouse studies that addressed working conditions and (in)equality at a workplace level. Screening of records was performed using the Rayyan systematic review tool. Risk of bias was assessed according to established methods and checklists. RESULTS: Database searches yielded 4910 articles. After title-abstract-keyword and full-text screenings, 21 articles were included. Results showed inequality based on gender and race/ethnicity in both work organization (different tasks were performed by different groups of employees), work environment conditions (physical and psychosocial aspects differed), and employment conditions (disparate employment types and incomes between groups of employees). Health differences, as a possible result of unequal working conditions, were evident between different racial/ethnic groups of employees. A hierarchy that included both gender and race/ethnicity was found, with (im)migrant and racialized women positioned at the bottom. CONCLUSIONS: We found evidence that gender and race/ethnicity influenced work organization, work environment conditions, and employment conditions. Evidence was found for an intersection between gender and race/ethnicity. To improve working conditions, and subsequently occupational health, we encourage researchers to simultaneously consider gender and race/ethnicity factors at work, and to consider both why inequality is present and how it impacts working conditions in future studies of warehousing, particularly in online retailing.

Surgery for subacromial impingement syndrome and occupational biomechanical risk factors in a 16-year prospective study among male construction workers.

OBJECTIVE: The aim of this study was to assess the association between occupational biomechanical exposures and the occurrence of surgical treatment for subacromial impingement syndrome (SIS). METHODS: A cohort of 220 295 male constructions workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively over a 16-year follow-up period (2001-2016) for surgically treated SIS. Worker job title, smoking status, height, weight, and age were registered on health examination. Job titles were mapped to 21 occupational groups based on tasks and training. A job exposure matrix (JEM) was developed with exposure estimates for each occupational group. Surgical cases were determined through linkage with the Swedish national in- and outpatient registers. Poisson regression was used to assess the relative risks (RR) for each biomechanical exposure. RESULTS: The total incidence rate of surgically treated SIS over the 16-year observation period was 201.1 cases per 100 000 person-years. Increased risk was evident for workers exposed to upper-extremity loading (push/pull/lift) (RR 1.45-2.30), high hand grip force (RR 1.47-2.23), using handheld tools (RR 1.52-2.09), frequent work with hands above shoulders (RR 1.62-2.11), static work (RR 1.77-2.26), and hand-arm vibration (RR 1.78-2.13). There was an increased risk for SIS surgery for all occupational groups (construction trades) compared with white-collar workers (RR 1.56-2.61). CONCLUSIONS: Occupational upper-extremity load and posture exposures were associated with increased risk for surgical treatment of SIS, which underlines the need for reducing workplace exposures and early symptom detection in highly exposed occupational groups.

Physical and psychosocial work-related exposures and the occurrence of disorders of the elbow: A systematic review.

This systematic review updates a previous systematic review on work-related physical and psychosocial risk factors for elbow disorders. Medline, Embase, Web of Science, Cochrane Central and PsycINFO were searched for studies on associations between work-related physical or psychosocial risk factors and the occurrence of elbow disorders. Two independent reviewers selected eligible studies and assessed risk of bias (RoB). Results of studies were synthesized narratively. We identified 17 new studies and lateral epicondylitis was the most studied disorder (13 studies). Five studies had a prospective cohort design, eight were cross-sectional and four were case-control. Only one study had no items rated as high RoB. Combined physical exposure indicators (e.g. physical exertion combined with elbow movement) were associated with the occurrence of lateral epicondylitis. No other consistent associations were observed for other physical and psychosocial exposures. These results prevent strong conclusions regarding associations between work-related exposures, and the occurrence of elbow disorders.

Risk factors for surgically treated cervical spondylosis in male construction workers: a 20-year prospective study.

BACKGROUND CONTEXT: Degenerative changes due to cervical spondylosis (CS) can detrimentally affect work ability and quality of life yet understanding of how physical exposure affects disease progression is limited. PURPOSE: To assess the associations between occupational physical exposures and occurrence of surgically treated cervical spondylosis (ST-CS) and early exit from the labor market via disability pension. STUDY DESIGN/SETTING: Prospective register study with 20 years follow-up period. PATIENT SAMPLE: Swedish construction workers participating in a national health surveillance project conducted between 1971 and 1993. OUTCOME MEASURES: Surgically treated cervical spondylosis (ST-CS) and early labor market exit at a minimum rate of 25% time on disability pension. METHODS: Associations between occupational physical exposures (job exposure matrix) and subsequent ST-CS (National Hospital in-patient register) and early labor market exit via disability pension (Swedish Social Insurance Agency register) were assessed in a cohort of male construction workers (n=237,699). RESULTS: A total of 1381 ST-CS cases were present and a 20 years incidence rate of 35.1 cases per 100,000 person years (95% confidence interval (CI) 33.2-36.9). Increased relative risk (RR) for ST-CS was found for workers exposed to non-neutral (RR 1.40, 95% CI 1.15-1.69), and awkward neck postures (1.52, 1.19-1.95), working with the hands above shoulder height (1.30, 1.06-1.60), and high upper extremity loading (1.35, 1.15-1.59). Increased risk was also present for workers who reported frequent neck (3.06, 2.18-4.30) and upper back (3.84, 2.57-5.73) pain in the 12 months prior to survey. Among workers with elevated arm exposure, higher risk was seen in those who also had more frequent neck pain. ST-CS cases took early retirement more often (41.3%) and at a younger age (53 years) than the total study cohort (14.8% and 56 years of age, respectively). CONCLUSIONS: Occupational exposure to non-neutral neck postures, work with hands above shoulders and high loads born through the upper extremities increased the risk for ST-CS and early retirement due to disability. Decreasing postural and load exposure is salient for primary, secondary, and tertiary prevention of CS. Neck pain was shown to be a prognostic factor for ST-CS, which stresses the importance of acting early and taking preventative action to reduce workplace exposure, and the need for systematic medical check-ups within primary or occupational care to mitigate disease progression and early labour market exit due to disability.

Selective dependence on IL-7 for antigen-specific CD8 T cell responses during airway influenza infection.

Interleukin-7 (IL-7) is a cytokine known for its importance in T cell development and survival. How IL-7 shapes CD8 T cell responses during an acute viral infection is less understood. We had previously shown that IL-7 signaling deficient mice have reduced accumulation of influenza-specific CD8 T cells following influenza infection. We sought to determine whether IL-7 affects early CD8 T cell expansion in the mediastinal lymph node and effector function in the lungs. Using IL-7Rα signaling deficient mice, we show that IL-7 is required for a normal sized mediastinal lymph node and the early clonal expansion of influenza-specific CD8 T cells therein. We show that IL-7 plays a cell-intrinsic role in the accumulation of NP366-374 and PA224-233-specific CD8 T cells in the lymph node. We also found that IL-7 shapes terminal differentiation, degranulation and cytokine production to a greater extent in PA224-233-specific than NP366-374-specific CD8 T cells. We further demonstrate that IL-7 is induced in the lung tissue by viral infection and we characterize multiple cellular sources that contribute to IL-7 production. Our findings on IL-7 and its effects on lower respiratory diseases will be important for expanding the utility of therapeutics that are currently available.

Loss of NFE2L3 protects against inflammation-induced colorectal cancer through modulation of the tumor microenvironment.

We investigated the role of the NFE2L3 transcription factor in inflammation-induced colorectal cancer. Our studies revealed that Nfe2l3-/- mice exhibit significantly less inflammation in the colon, reduced tumor size and numbers, and skewed localization of tumors with a more pronounced decrease of tumors in the distal colon. CIBERSORT analysis of RNA-seq data from normal and tumor tissue predicted a reduction in mast cells in Nfe2l3-/- animals, which was confirmed by toluidine blue staining. Concomitantly, the transcript levels of Il33 and Rab27a, both important regulators of mast cells, were reduced and increased, respectively, in the colorectal tumors of Nfe2l3-/- mice. Furthermore, we validated NFE2L3 binding to the regulatory sequences of the IL33 and RAB27A loci in human colorectal carcinoma cells. Using digital spatial profiling, we found that Nfe2l3-/- mice presented elevated FOXP3 and immune checkpoint markers CTLA4, TIM3, and LAG3, suggesting an increase in Treg counts. Staining for CD3 and FOXP3 confirmed a significant increase in immunosuppressive Tregs in the colon of Nfe2l3-/- animals. Also, Human Microbiome Project (HMP2) data showed that NFE2L3 transcript levels are higher in the rectum of ulcerative colitis patients. The observed changes in the tumor microenvironment provide new insights into the molecular differences regarding colon cancer sidedness. This may be exploited for the treatment of early-onset colorectal cancer as this emerging subtype primarily displays distal/left-sided tumors.

Consistent individual motor variability traits demonstrated by females performing a long-cycle assembly task under conditions differing in temporal organisation.

Research suggests an association between motor variability (MV) during repetitive work and work-related musculoskeletal disorders (MSDs). However, whether MV is a consistent individual trait, even across working conditions or tasks, remains unknown. This study assessed whether individual MV traits were consistent during complex work performed under different temporal conditions. Fifteen women performed cyclic assembly under four conditions differing in pace and organisation (line-type, batch-type). MV of trapezius muscle activity and upper arm elevation was quantified and partitioned into variance components. For all MV metrics, a non-zero between-subjects variance was found, indicating consistent individual MV traits across conditions. Variance between subjects was higher for electromyography (EMG) MV metrics compared with kinematic metrics. Our results showed individuals exhibited consistent MV traits across working conditions differing in pace and production process. Further research is needed to understand whether MV is an individual predictive factor for MSD onset or progression.

Calibration of Self-Reported Time Spent Sitting, Standing and Walking among Office Workers: A Compositional Data Analysis.

We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-effective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers.

OBJECTIVES: The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period. METHODS: A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships. RESULTS: The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00). CONCLUSIONS: Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.

Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers.

Objectives The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE). Methods A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively over a 13-year case ascertainment period (2001-2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register. Results There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18-1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers. Conclusion Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.

Precision based guidelines for sub-maximal normalisation task selection for trunk extensor EMG.

AIM: The object of this study was to quantify the contribution of sub-maximal normalisation to the overall variance of exposure parameters describing erector spinae (ES) activity, and to provide guidelines for task selection which minimize methodological variance. METHODS: ES EMG was measured from three locations (T9, L1 and L5 levels) on fifteen men performing a manual materials handling task in the laboratory on three separate days. Four repeats of each of eleven sub-maximal normalisation tasks (eight static, three dynamic) were collected, work data were normalised to each task and repeat, and exposure parameters calculated. The unique contribution of normalisation to the overall variance was determined for each task and exposure parameter using variance component analyses. Normalisation tasks were scored according to their relative contributions to the overall variance and coefficients of variation. RESULTS: A prone task, similar to the Biering-Sørensen test posture, was the most repeatable for all electrode locations and across all exposure parameters. Thoracic level normalisation typically showed poorer repeatability than lumbar normalisation. DISCUSSION: To maximize measurement precision, we recommend that future ES EMG studies employing sub-maximal normalisation utilise said prone task. An alternate normalisation task specific to thoracic level ES muscles may be warranted.

Full-Shift Trunk and Upper Arm Postures and Movements Among Aircraft Baggage Handlers.

OBJECTIVES: The present study assessed full-shift trunk and upper arm postural exposure amplitudes, frequencies, and durations among Swedish airport baggage handlers and aimed to determine whether exposures differ between workers at the ramp (loading and unloading aircraft) and baggage sorting areas. METHODS: Trunk and upper arm postures were measured using inclinometers during three full work shifts on each of 27 male baggage handlers working at a large Swedish airport. Sixteen of the baggage handlers worked on the ramp and 11 in the sorting area. Variables summarizing postures and movements were calculated, and mean values and variance components between subjects and within subject (between days) were estimated using restricted maximum likelihood algorithms in a one-way random effect model. RESULTS: In total, data from 79 full shifts (651h) were collected with a mean recording time of 495min per shift (range 319-632). On average, baggage handlers worked with the right and left arm elevated >60° for 6.4% and 6.3% of the total workday, respectively. The 90th percentile trunk forward projection (FP) was 34.1°, and the 50th percentile trunk movement velocity was 8° s(-1). For most trunk (FP) and upper arm exposure variables, between-subject variability was considerable, suggesting that the flight baggage handlers were not a homogeneously exposed group. A notable between-days variability pointed to the contents of the job differing on different days. Peak exposures (>90°) were higher for ramp workers than for sorting area workers (trunk 0.6% ramp versus 0.3% sorting; right arm 1.3% ramp versus 0.7% sorting). CONCLUSIONS: Trunk and upper arm postures and movements among flight baggage handlers measured by inclinometry were similar to those found in other jobs comprising manual material handling, known to be associated with increased risks for musculoskeletal disorders. The results showed that full-shift trunk (FP) and, to some extent, peak arm exposures were higher for ramp workers compared with sorting workers.

Observer performance in estimating upper arm elevation angles under ideal viewing conditions when assisted by posture matching software.

Selecting a suitable body posture measurement method requires performance indices of candidate tools. Such data are lacking for observational assessments made at a high degree of resolution. The aim of this study was to determine the performance (bias and between- and within-observer variance) of novice observers estimating upper arm elevation postures assisted by posture matching software to the nearest degree from still images taken under ideal conditions. Estimates were minimally biased from true angles: the mean error across observers was less than 2°. Variance between observers was minimal. Considerable variance within observers, however, underlined the risk of relying on single observations. Observers were more proficient at estimating 0° and 90° postures, and less proficient at 60°. Thus, under ideal visual conditions observers, on average, proved proficient at high resolution posture estimates; further investigation is required to determine how non-optimal image conditions, as would be expected from occupational data, impact proficiency.

Is what you see what you get? Standard inclinometry of set upper arm elevation angles.

Previous research suggests inclinometers (INC) underestimate upper arm elevation. This study was designed to quantify possible bias in occupationally relevant postures, and test whether INC performance could be improved using calibration. Participants were meticulously positioned in set arm flexion and abduction angles between 0° and 150°. Different subject-specific and group-level regression models comprising linear and quadratic components describing the relationship between set and INC-registered elevation were developed using subsets of data, and validated using additional data. INC measured arm elevation showed a downward bias, particularly above 60°. INC data adjusted using the regression models were superior to unadjusted data; a subject-specific, two-point calibration based on measurements at 0° and 90° gave results closest to the 'true' set angles. Thus, inclinometer measured arm elevation data required calibration to arrive at 'true' elevation angles. Calibration to a common measurement scale should be considered when comparing arm elevation data collected using different methods.