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. 2001 Mar;58(3):200–207. doi: 10.1136/oem.58.3.200

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

G Ariens 1, P Bongers 1, M Douwes 1, M Miedema 1, W Hoogendoorn 1, G van der Wal 1, L Bouter 1, W van Mechelen 1
PMCID: PMC1740110  PMID: 11171934

Abstract

OBJECTIVE—To study the relation between neck pain and work related neck flexion, neck rotation, and sitting.
METHODS—A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured exposure data (video recordings) of neck flexion, neck rotation, and sitting posture. Neck pain was assessed by a questionnaire. Adjustments were made for various physical factors that were related or not related to work, psychosocial factors, and individual characteristics.
RESULTS—A significant positive relation was found between the percentage of the working time in a sitting position and neck pain, implying an increased risk of neck pain for workers who were sitting for more than 95% of the working time (crude relative risk (RR) 2.01, 95% confidence interval (95% CI) 1.04 to 3.88; adjusted RR 2.34, 95% CI 1.05 to 5.21). A trend for a positive relation between neck flexion and neck pain was found, suggesting an increased risk of neck pain for people working with the neck at a minimum of 20° of flexion for more than 70% of the working time (crude RR 2.01, 95% CI 0.98 to 4.11; adjusted RR 1.63, 95% CI 0.70 to 3.82). No clear relation was found between neck rotation and neck pain.
CONCLUSION—Sitting at work for more than 95% of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain. No clear relation was found between neck rotation and neck pain.


Keywords: neck pain; physical risk factors; longitudinal cohort study

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Selected References

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  1. Ariëns G. A., van Mechelen W., Bongers P. M., Bouter L. M., van der Wal G. Physical risk factors for neck pain. Scand J Work Environ Health. 2000 Feb;26(1):7–19. doi: 10.5271/sjweh.504. [DOI] [PubMed] [Google Scholar]
  2. Copeland K. T., Checkoway H., McMichael A. J., Holbrook R. H. Bias due to misclassification in the estimation of relative risk. Am J Epidemiol. 1977 May;105(5):488–495. doi: 10.1093/oxfordjournals.aje.a112408. [DOI] [PubMed] [Google Scholar]
  3. Dartigues J. F., Henry P., Puymirat E., Commenges D., Peytour P., Gagnon M. Prevalence and risk factors of recurrent cervical pain syndrome in a working population. Neuroepidemiology. 1988;7(2):99–105. doi: 10.1159/000110141. [DOI] [PubMed] [Google Scholar]
  4. Godin G., Jobin J., Bouillon J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health. 1986 Sep-Oct;77(5):359–362. [PubMed] [Google Scholar]
  5. Ignatius Y. T., Yee T. Y., Yan L. T. Self reported musculoskeletal problems amongst typist and possible risk factors. J Hum Ergol (Tokyo) 1993 Dec;22(2):83–93. [PubMed] [Google Scholar]
  6. Kamwendo K., Linton S. J., Moritz U. Neck and shoulder disorders in medical secretaries. Part I. Pain prevalence and risk factors. Scand J Rehabil Med. 1991;23(3):127–133. [PubMed] [Google Scholar]
  7. Kuorinka I., Jonsson B., Kilbom A., Vinterberg H., Biering-Sørensen F., Andersson G., Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987 Sep;18(3):233–237. doi: 10.1016/0003-6870(87)90010-x. [DOI] [PubMed] [Google Scholar]
  8. Lee J. Odds ratio or relative risk for cross-sectional data? Int J Epidemiol. 1994 Feb;23(1):201–203. doi: 10.1093/ije/23.1.201. [DOI] [PubMed] [Google Scholar]
  9. Musson Y., Burdorf A., van Drimmelen D. Exposure to shock and vibration and symptoms in workers using impact power tools. Ann Occup Hyg. 1989;33(1):85–96. doi: 10.1093/annhyg/33.1.85. [DOI] [PubMed] [Google Scholar]
  10. Skov T., Borg V., Orhede E. Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople. Occup Environ Med. 1996 May;53(5):351–356. doi: 10.1136/oem.53.5.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Stock S. R. Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: a meta-analysis. Am J Ind Med. 1991;19(1):87–107. doi: 10.1002/ajim.4700190111. [DOI] [PubMed] [Google Scholar]
  12. Theorell T., Schüldt C., Ekholm J., Michélsen H. Physical strength and endurance in relation to perceived psychosocial work environment, sleep disturbance and coping strategies in men. Stockholm MUSIC I (MUsculo-Skeletal Intervention Centre) Study Group, Stockholm. Scand J Rehabil Med. 1995 Jun;27(2):67–71. [PubMed] [Google Scholar]
  13. Thompson M. L., Myers J. E., Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med. 1998 Apr;55(4):272–277. doi: 10.1136/oem.55.4.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. de Jonge J., Reuvers M. M., Houtman I. L., Bongers P. M., Kompier M. A. Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence: baseline results from SMASH. Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health. J Occup Health Psychol. 2000 Apr;5(2):256–268. doi: 10.1037//1076-8998.5.2.256. [DOI] [PubMed] [Google Scholar]

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