Zusammenhang zwischen beruflichen Belastungen und Läsionen der Rotatorenmanschette der Schulter
摘要
In a meta-review of systematic reviews the association between occupational burdens of above-shoulder work, repetitive movements in the shoulder joint, heavy lifting and hand-arm vibration and rotator cuff lesions of the shoulder was examined. The Medline and EMBASE databases were used to search for systematic reviews on this topic published between 2021 and 2024, and 3 systematic reviews were included. The systematic review by Diener et al. 2024 confirmed the occupational disease 2117. The systematic review by Curti et al. 2023 found moderate evidence of a causal relationship between combined occupational exposures to above-shoulder work and forceful movements and the risk of shoulder tendinopathy but not for individual burdens. In the systematic review by Versloot et al. 2024, the strongest evidence emerged for the association between arm elevation, repetitive shoulder movements, shoulder force application and hand-arm vibrations with the risk of impingement syndrome and shoulder tendinopathy. Inconsistent results were found for the association between mechanical stress from force application, body posture, repetitive movements and hand-arm vibration with the risk of rotator cuff syndrome. Examination of the underlying primary studies included by Versloot et al. 2024 revealed that this conclusion is untenable. The quality of the 3 systematic reviews was low because all showed significant risk of bias in the assessment with AMSTAR 2 and ROBIS. A total of 9 primary studies were included in these systematic reviews that were not cited in the scientific justification for the occupational disease 2117. Only 1 of these 9 studies (Dalbøge et al. 2020) was of high quality and confirmed the occupational disease 2117. We are also aware of another high-quality study (Lewis et al. 2023), which was not included in any of the 3 systematic reviews, which also confirms the occupational disease 2117.