Occupational mechanical exposures and upper-body musculoskeletal disorders: an overview of systematic reviews

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Weighted odds ratios generally ranged between 1.5 and 3.0

• Primary Outcome: Association between occupational mechanical exposures and upper-body musculoskeletal disorders

• Nnt Or Sensitivity: Odds ratios suggest 50-200% increased risk of upper-body musculoskeletal disorders with occupational mechanical exposures

• Confidence Interval: Not reported in abstract

Clinical Application

Findings support workplace ergonomic interventions and risk assessment protocols already established in many industries Relevant to Safe Work Australia guidelines and WorkCover claims. Supports existing workplace health and safety regulations under Work Health and Safety Act 2011. May inform RACGP occupational health assessments and return-to-work protocols Workers in physically demanding occupations with repetitive motion, force application, vibration exposure, or awkward postures

Abstract

OBJECTIVES: The aim was to provide a comprehensive overview of systematic reviews with meta-analyses of the association between occupational mechanical exposures and upper-body musculoskeletal disorders. METHODS: A systematic literature search was conducted in PubMed, Web of Science, Embase, and CINAHL. Systematic reviews were considered eligible if they included occupational mechanical exposures and provided weighted measures of association in relation to specific musculoskeletal disorders. From each systematic review, data on eg databases searched, exposure, outcome, effect estimates, and quality of evidence of the association were extracted. The methodological quality of each systematic review was assessed using AMSTAR 2. RESULTS: The screening of 1,756 articles resulted in the inclusion of 17 systematic reviews with meta-analysis covering 6 musculoskeletal disorders: subacromial pain syndrome (n = 3), lateral epicondylitis (n = 2), carpal tunnel syndrome (n = 7), Dupuytren's disease (n = 4), hand-arm vibration syndrome (n = 1), and hand osteoarthritis (n = 1). The weighted odds ratios from the meta-analyses generally ranged between 1.5 and 3.0. Approximately 35% of the included systematic reviews assessed the quality of evidence of the association, and among these, 48% graded the evidence as being low to very low. CONCLUSIONS: In general, this overview found an increased risk associated with most mechanical exposures in relation to specific upper-body musculoskeletal disorders. However, grading of evidence quality was rarely applied, and when present, showed substantial variability. Future research related to primary studies should prioritise high-quality prospective studies and objective exposure assessments, and systematic reviews would benefit from standardised methodologies and improved reporting transparency to further strengthen the evidence quality.

References

1. 1.Jahn, A., Kjærgaard, C., Descatha, A., Evanoff, B., Andersen, J. H., & Dalbøge, A. (2026). Occupational mechanical exposures and upper-body musculoskeletal disorders: an overview of systematic reviews. Annals of Work Exposures and Health. https://doi.org/10.1093/annweh/wxag030