Associations between single and combined occupational mechanical exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study

OBJECTIVE: This study aimed to evaluate whether the risk of surgery for subacromial impingement syndrome (SIS) increases with the number of combined occupational mechanical exposures compared with single exposure. METHODS: We reanalyzed data from a register-based cohort study of the entire Danish wo...

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Main Authors: Annett Dalbøge (Author), Poul Frost (Author), Johan Hviid Andersen (Author), Susanne Wulff Svendsen (Author)
Format: Book
Published: Nordic Association of Occupational Safety and Health (NOROSH), 2022-09-01T00:00:00Z.
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Summary:OBJECTIVE: This study aimed to evaluate whether the risk of surgery for subacromial impingement syndrome (SIS) increases with the number of combined occupational mechanical exposures compared with single exposure. METHODS: We reanalyzed data from a register-based cohort study of the entire Danish working population (N=2 374 403) with 14 118 events of surgery for SIS (2003-2008). Exposure information in 10-year windows was obtained by combining occupational codes with a job exposure matrix. For single and combined mechanical exposures, we created three exposure variables of the number of years with specific exposure intensities with or without co-existing mechanical exposures. We used logistic regression as survival analysis. RESULTS: We found exposure-response relations for duration and intensity of each single mechanical exposure except for repetition. The single effect of arm elevation >90º reached a maximum adjusted odds ratio (OR_adj) of 1.7 [95% confidence interval (CI) 1.5-2.0], which increased to 1.8 (95% CI 1.5-2.0), 2.0 (95% CI 1.9-2.2), and 2.2 (95% CI 2.0-2.5) when combined with repetition, force, and both. When combining repetition with arm elevation >90º, force, and both, OR_adj increased from 1.5 (95% CI 1.3-1.8) to 2.1 (95% CI 1.8-2.4), 2.5 (95% CI 2.4-2.9), and 2.7 (95% CI 2.4-3.0). For force, OR_adj increased from 2.5 (95% CI 2.1-2.9) to 2.6 (95% CI 2.3-2.8), 2.8 (95% CI 2.4-3.2), and 3.0 (95% CI 2.6-3.4). CONCLUSION: We found an increased risk of surgery for SIS with the number of combined exposures; the risk was especially pronounced when the combined exposures included force.
Item Description:0355-3140
1795-990X
10.5271/sjweh.4032