Self-reported physical exposure association with medial and lateral epicondylitis incidence in a large longitudinal study

• Published in: Occupational and environmental medicine (London, England) Vol. 70; no. 9; pp. 670 - 673
• Main Authors: Descatha, Alexis, Dale, Ann Marie, Jaegers, Lisa, Herquelot, Eléonore, Evanoff, Bradley
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.09.2013; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Age Distribution; Bending; Biological and medical sciences; Cohort Studies; Cross-sectional studies; Cumulative Trauma Disorders - complications; Cumulative Trauma Disorders - diagnosis; Diseases of the osteoarticular system; Disorders; Elbow; Employment; epicondylitis; Female; Follow-Up Studies; Forearm; Humans; Incidence; Juxtaarticular diseases. Extraarticular rhumatism; Longitudinal Studies; Male; Medical sciences; Men; Middle Aged; Musculoskeletal diseases; Obesity; observational study; occupational; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Diseases - physiopathology; Occupational exposure; Occupational medicine; Occupations; Pain; Physical examinations; Population studies; Public health. Hygiene-occupational medicine; Questionnaires; rick factor; Risk Assessment; Self Report; Self reports; Sex Distribution; SHORT REPORT; Tennis Elbow - epidemiology; Tennis Elbow - etiology; Tennis Elbow - physiopathology; Time Factors; United States; Variables; Women; Workers; Workplace; Wrist; United States; North America; America; United States > US; Juxtaarticular disease; Human; Self evaluation; Follow up study; Diseases of the osteoarticular system; Occupational exposure; Epidemiology; Occupational medicine; Epicondylitis; Incidence; epicondylitis; occupational; rick factor; observational study
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2012-101341

Introduction Although previous studies have related occupational exposure and epicondylitis, the evidence is moderate and mostly based on cross-sectional studies. Suspected physical exposures were tested over a 3-year period in a large longitudinal cohort study of workers in the USA. Method In a population-based study including a variety of industries, 1107 newly employed workers were examined; only workers without elbow symptoms at baseline were included. Baseline questionnaires collected information on personal characteristics and self-reported physical work exposures and psychosocial measures for the current or most recent job at 6 months. Epicondylitis (lateral and medial) was the main outcome, assessed at 36 months based on symptoms and physical examination (palpation or provocation test). Logistic models included the most relevant associated variables. Results Of 699 workers tested after 36 months who did not have elbow symptoms at baseline, 48 suffered from medial or lateral epicondylitis (6.9%), with 34 cases of lateral epicondylitis (4.9%), 30 cases of medial epicondylitis (4.3%) and 16 workers who had both. After adjusting for age, lack of social support and obesity, consistent associations were observed between self-reported wrist bending/twisting and forearm twisting/rotating/screwing motion and future cases of medial or lateral epicondylitis (ORs 2.8 (1.2 to 6.2) and 3.6 (1.2 to 11.0) in men and women, respectively). Conclusions Self-reported physical exposures that implicate repetitive and extensive/prolonged wrist bend/twisting and forearm movements were associated with incident cases of lateral and medial epicondylitis in a large longitudinal study, although other studies are needed to better specify the exposures involved.