Work-related upper quadrant musculoskeletal disorders in midwives, nurses and physicians: A systematic review of risk factors and functional consequences

Applied Ergonomics

Volumn 43, Issue 3, 2012, Pages 455-467

  Long, Maryann H ^a   Johnston, Venerina ^a   Bogossian, Fiona ^a  

^a UNIVERSITY OF QUEENSLAND   (Australia)

Author keywords

Health personnel; Musculoskeletal system injuries; Risk factors

Indexed keywords

DISEASES; ERGONOMICS; HEALTH; HEALTH RISKS; MUSCULOSKELETAL SYSTEM; NURSING; OBSTETRICS; SEARCH ENGINES;

ACTIVITIES OF DAILY LIVING; ELECTRONIC DATABASE; MUSCULOSKELETAL DISORDERS; MUSCULOSKELETAL SYSTEM/INJURIES; PREVENTIVE STRATEGIES; PRIMARY HEALTHCARE; RISK FACTORS; WORK-RELATED MUSCULOSKELETAL DISORDERS;

OCCUPATIONAL RISKS;

DISEASE ASSOCIATION; EVIDENCE BASED MEDICINE; HUMAN; MIDWIFE; MUSCULOSKELETAL DISEASE; NURSE; OCCUPATIONAL DISEASE; OCCUPATIONAL EXPOSURE; OUTCOME ASSESSMENT; PHYSICIAN; PROSPECTIVE STUDY; QUALITY CONTROL; REVIEW; RISK ASSESSMENT; RISK FACTOR; SYSTEMATIC REVIEW; WORK SCHEDULE;

EID: 84855864811     PISSN: 00036870     EISSN: 18729126     Source Type: Journal    
DOI: 10.1016/j.apergo.2011.07.002     Document Type: Review

References (79)

1. Alexopoulos E.C., Burdorf A., Kalokerinou A. Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals. Int. Arch. Occup. Environ. Health 2003, 76:289-294.
2. Australian Institute of Health and Welfare Nursing and midwifery labour force 2007 Retrieved from, 7 December 2009. http://www.aihw.gov.au/publications/index.cfm/title/10724-detailed_tables.
3. Bogduk N. The anatomy and pathophysiology of neck pain. Phys. Med. Rehabil. Clin. N. Am. 2003, 14:455.
4. Bongers P.M., de Winter C.R., Kompier M.A., Hildebrandt V.H. Psychosocial factors at work and musculoskeletal disease. Scand. J. Work. Environ. Health 1993, 19:297-312.
5. Bongers P.M., Ijmker S., van den Heuvel S., Blatter B.M. Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors (Part I) and effective interventions from a biobehavioural perspective (Part II). J.Occup. Rehabil. 2006, 16:279-302.
6. Bongers P.M., Kremer A.M., ter Laak J. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. Am. J. Ind. Med. 2002, 41:315-342.
7. Bos E., Krol B., van der Star L., Groothoff J. Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists. Int. Arch. Occup. Environ. Health 2007, 80:198-206.
8. Bru E., Mykletun R.J., Svebak S. Neuroticism, extraversion, anxiety and type A behaviour as mediators of neck, shoulder and lower back pain in female hospital staff. Pers. Individ. Dif. 1993, 15:485-492.
9. Bru E., Mykletun R.J., Svebak S. Work-related stress and musculoskeletal pain among female hospital staff. Work Stress 1996, 10:309-321.
10. Camerino D., Cesana G.C., Molteni G., De Vito G., Evaristi C., Latocca R. Job strain and musculoskeletal disorders of Italian nurses. Occup. Ergon. 2001, 2:215-223.
11. Cameron S.J., Armstrong-Stassen M., Kane D., Moro F.B. Musculoskeletal problems experienced by older nurses in hospital settings. Nurs. Forum (Auckl.) 2008, 43:103-114.
12. Canadian Association of Midwives Annual report/rapport annuel Retrieved from, 30 May 2010. http://www.canadianmidwives.org/annual-reports.html.
13. Canadian Institute for Health Information Canada's health care providers, 2007 Retrieved from, 30 May 2010. http://www.cihi.ca/cihiweb/dispPage.jsp%3Fcw_page%3DAR_35_E.
14. Canadian Institute for Health Information RN demographic statistics 2007 Retrieved from, 3 October 2009. http://secure.cihi.ca/cihiweb/dispPage.jsp%3Fcw_page%3Dstatistics_results_topic_nurses_e.
15. Canadian Institute for Health Information Percentage distribution of midwives by 10-year age groups and selected provinces/territories, 2006 Retrieved from, 30 May 2010. http://secure.cihi.ca/cihiweb/dispPage.jsp%3Fcw_page%3Dhpdb_midwives_e.
16. Carayon P., Smith M.J., Haims M.C. Work organization, job stress, and work-related musculoskeletal disorders. Hum. Factors 1999, 41:644-663.
17. Choobineh A., Rajaeefard A., Neghab M. Association between perceived demands and musculoskeletal disorders among hospital nurses of Shiraz University of Medical Sciences: a questionnaire survey. Int. J. Occup. Saf. Ergon. 2006, 12:409-416.
18. Cole D.C., Rivilis I. Individual factors and musculoskeletal disorders: a framework for their consideration. J.Electromyogr. Kinesiol. 2004, 14:121-127.
19. Côté P., van der Velde G., Cassidy J.D., Carroll L.J., Hogg-Johnson S., Holm L.W., Carragee E.J., Haldeman S., Nordin M., Hurwitz E.L., Guzman J., Peloso P.M. The burden and determinants of neck pain in workers. Spine 2008, 33:S60-S74.
20. Curtis P., Ball L., Kirkham M. Bullying and horizontal violence: cultural or individual phenomena?. Br. J. Midwifery 2006, 14:218-221.
21. Curtis P., Ball L., Kirkham M. Ceasing to practise midwifery: working life and employment choices. Br. J. Midwifery 2006, 14:336-338.
22. Devereux J.J., Vlachonikolis I.G., Buckle P.W. Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb. Occup. Environ. Med. 2002, 59:269-277.
23. Estryn-Behar M., van der Heijden B.I.J.M., Fry C., Hasselhorn H.-M. Longitudinal analysis of personal and work-related factors associated with turnover among nurses. Nurs. Res. 2010, 59:166-177.
24. Feuerstein M., Shaw W.S., Nicholas R.A., Huang G.D. From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders. J.Electromyogr. Kinesiol. 2004, 14:171-178.
25. Fochsen G., Josephson M., Hagberg M., Toomingas A., Lagerström M. Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel. Occup. Environ. Med. 2006, 63:198-201.
26. Gaynor L., Gallasch T., Yorkston E., Stewart S., Bogossian F., Fairweather C., Foley D., Nutter H., Thompson J., Stewart L., Anastasi J., Kelly J., Barnes L., Glover P., Turner C. The future nursing workforce in Australia: baseline data for a prospective study of the profile, attrition rates, and graduate outcomes in a contemporary cohort of undergraduates. Aust. J. Adv. Nurs. 2011, 25:11-20.
27. Geiger-Brown J., Trinkoff A.M., Nielsen K., Lirtmunlikaporn S., Brady B., Vasquez E.I. Nurses' perception of their work environment, health, and well-being: a qualitative perspective. AAOHN J. 2004, 52:16-22.
28. Gerein N., Green A., Pearson S. The implications of shortages of health professionals for maternal health in sub-Saharan Africa. Reprod. Health Matters 2006, 14:40-50.
29. Gershon R.R.M., Stone P.W., Zeltser M., Faucett J., MacDavitt K., Chou S.-S. Organizational climate and nurse health outcomes in the United States: a systematic review. Ind. Health 2007, 45:622-636.
30. Grzywacz J.G., Frone M.R., Brewer C.S., Kovner C.T. Quantifying work-family conflict among registered nurses. Res. Nurs. Health 2006, 29:414-426.
31. Hartvigsen J., Lings S., Leboeuf-Yde C., Bakketeig L. Psychosocial factors at work in relation to low back pain and consequences of low back pain: a systematic, critical review of prospective cohort studies Retrieved from, 3 May 2011. http://www.occenvmed.com/cgi/content/full/61/1/e2.
32. Haufler A.J., Feuerstein M., Huang G.D. Job stress, upper extremity pain and functional limitations in symptomatic computer users. Am. J. Ind. Med. 2000, 38:507-515.
33. Hignett S. Manual handling risks in midwifery: identification of risk factors. Br. J. Midwifery 1996, 4:590-596.
34. Hignett S., Fray M., Rossi M.A., Tamminen-Peter L., Hermann S., Lomi C., Dockrell S., Cotrim T., Cantineau J.B., Johnsson C. Implementation of the Manual Handling Directive in the healthcare industry in the European Union for patient handling tasks. Int. J. Ind. Ergon. 2007, 37:415-423.
35. Hildebrandt V.H., Bongers P.M., Dul J., van Dijk F.J., Kemper H.C. The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int. Arch. Occup. Environ. Health 2000, 73:507-518.
36. Johnston V., Jull G., Jimmieson N., Souvlis T. Interactive effects from self-reported physical and psychosocial factors in the workplace on neck pain and disability in female office workers. Ergonomics 2010, 53:502-513.
37. Josephson M., Lagerström M., Hagberg M., Wigaeus Hjelm E. Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period. Occup. Environ. Med. 1997, 54:681-685.
38. Karasek R.A., Theorell T. Healthy Work: Stress, Productivity and the Reconstruction of Working Life 1990, Basic Books, New York.
39. Kennedy C.A., Amick B.C., Dennerlein J.T., Brewer S., Catli S., Williams R., Serra C., Gerr F., Irvin E., Mahood Q., Franzblau A., Van Eerd D., Evanoff B., Rempel D. Systematic review of the role of occupational health and safety interventions in the prevention of upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims, and lost time. J.Occup. Rehabil. 2010, 20:127-162.
40. Knardahl S. Psychological and social factors at work: contribution to musculoskeletal disorders and disabilities. G.Ital. Med. Lav. Ergon. 2005, 27:65-73.
41. Kuorinka I., Jonsson B., Kilbom A., Vinterberg H., Biering-Sorensen F., Andersson G., Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl. Ergon. 1987, 18:233-237.
42. Larsson B., Søgaard K., Rosendal L. Work related neck-shoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Pract. Res. Clin. Rheumatol. 2007, 21:447-463.
43. Lim J., Bogossian F., Ahern K. Stress and coping in Australian nurses: a systematic review. Int. Nurs. Rev. 2010, 57:22-31.
44. Lipscomb J., Trinkoff A., Brady B., Geiger-Brown J. Health care system changes and reported musculoskeletal disorders among registered nurses. Am. J. Public Health 2004, 94:1431-1435.
45. Lipscomb J., Trinkoff A.M., Geiger-Brown J., Brady B. Work-schedule characteristics and reported musculoskeletal disorders of registered nurses. Scand. J. Work. Environ. Health 2002, 28:394-401.
46. Long, M.H., Bogossian, F.E., Johnston, V. Are work-related neck-shoulder musculoskeletal disorders prevalent in midwives, nurses and physicians? A systematic review, submitted for publication.
47. Lorusso A., Bruno S., L'Abbate N. Areview of low back pain and musculoskeletal disorders among Italian nursing personnel. Ind. Health 2007, 45:637-644.
48. Magnago T., Lisboa M., Griep R., Kirchhof A., Guido L. Psychosocial aspects of work and musculoskeletal disorders in nursing workers. Rev. Lat. Am. Enfermagem 2010, 18:429-435.
49. Mehrdad R., Dennerlein J.T., Haghighat M., Aminian O. Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses. Am. J. Ind. Med. 2010, 53:1032-1039.
50. Messing K. Ergonomic studies provide information about occupational exposure differences between women and men. J.Am. Med. Womens Assoc. 2000, 55:72-75.
51. Moher D., Liberati A., Tetzlaff J., Altman D.G. Preferred reporting items for systematic reviews and meta-analyses. Ann. Intern. Med. 2009, 151:264-269.
52. National League for Nursing Percentage of basic RN students and US college students* over age 30 by program type: 2003, 2005, 2007, and 2009 Retrieved from, 11 May 2011. http://www.nln.org/research/slides/topic_nursing_stud_demographics.htm.
53. Nicholas R.A., Feuerstein M., Suchday S. Workstyle and upper extremity symptoms: a biobehavioral perspective. J.Occup. Environ. Med. 2005, 47:352-361.
54. Nursing and Midwifery Council Statistical analysis of the Register 1 April 2007 to 31 March 2008 Retrieved from, 29 October 2009. http://www.nmc-uk.org/aDisplayDocument.aspx%3FDocumentID%3D5730.
55. Owen B. Preventing injuries using an ergonomic approach. AORN J. 2000, 72:1031-1036.
56. Panel on Musculoskeletal Disorders and the Workplace Answers to questions posed by Congress. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities 2001, 431-438. National Academy Press, Washington, DC.
57. Panel on Musculoskeletal Disorders and the Workplace Chapter 4: Epidemiologic evidence. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities 2001, 85-183. National Academy Press, Washington, DC.
58. Panel on Musculoskeletal Disorders and the Workplace Executive summary. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities 2001, 1-13. National Academy Press, Washington, DC.
59. Punnett L., Bergqvist U. Musculoskeletal disorders in visual display unit work: gender and work demands. Occup. Med. 1999, 14:113.
60. Royal College of Nursing Nursing our future Retrieved from, 11 May 2011. http://www.rcn.org.uk/development/publications/publicationsA-Z-N.
61. See S., Ginzburg R. Skeletal muscle relaxants. Pharmacotherapy 2008, 28:207-213.
62. Sherehiy B., Karwowski W., Marek T. Relationship between risk factors and musculoskeletal disorders in the nursing profession: a systematic review. Occup. Ergon. 2004, 4:241-279.
63. Smedley J., Inskip H., Trevelyan F., Buckle P., Cooper C., Coggon D. Risk factors for incident neck and shoulder pain in hospital nurses. Occup. Environ. Med. 2003, 60:864-869.
64. Smith D.R., Mihashi M., Adachi Y., Koga H., Ishitake T. Adetailed analysis of musculoskeletal disorder risk factors among Japanese nurses. J. Safety Res. 2006, 37:195-200.
65. Smith D.R., Wei N., Zhang Y.J., Wang R.S. Musculoskeletal complaints and psychosocial risk factors among physicians in mainland China. Int. J. Ind. Ergon. 2006, 36:599-603.
66. Smith D.R., Wei N., Zhao L., Wang R.S. Musculoskeletal complaints and psychosocial risk factors among Chinese hospital nurses. Occup. Med. (Lond.) 2004, 54:579-582.
67. Staal J.B., de Bie R.A., Hendriks E.J. Aetiology and management of work-related upper extremity disorders. Best Pract. Res. Clin. Rheumatol. 2007, 21:123-133.
68. Stone P.W., Du Y.L., Gershon R.R.M. Organizational climate and occupational health outcomes in hospital nurses. J.Occup. Environ. Med. 2007, 49:50-58.
69. Stone P.W., Gershon R.R.M. Nurse work environments and occupational safety in intensive care units. Policy Polit. Nurs. Pract. 2006, 7:240-247.
70. Sveinsdóttir H., Biering P., Ramel A. Occupational stress, job satisfaction, and working environment among Icelandic nurses: a cross-sectional questionnaire survey. Int. J. Nurs. Stud. 2006, 43:875-889.
71. Szeto G.P.Y., Ho P., Ting A.C.W., Poon J.T.C., Cheng S.W.K., Tsang R.C.C. Work-related musculoskeletal symptoms in surgeons. J.Occup. Rehabil. 2009, 19:175-184.
72. The Manual Handling Operations Regulations 1992 No. 2793 Retrieved from, 11 July 2010. http://www.opsi.gov.uk/si/si1992/uksi_19922793_en_1.htm.
73. Treaster D.E., Burr D. Gender differences in prevalence of upper extremity musculoskeletal disorders. Ergonomics 2004, 47:495-526.
74. Trinkoff A.M., Le R., Geiger-Brown J., Lipscomb J., Lang G. Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses. Am. J. Ind. Med. 2006, 49:964-971.
75. Trinkoff A.M., Lipscomb J.A., Geiger-Brown J., Brady B. Musculoskeletal problems of the neck, shoulder, and back and functional consequences in nurses. Am. J. Ind. Med. 2002, 41:170-178.
76. Trinkoff A.M., Lipscomb J.A., Geiger-Brown J., Storr C.L., Brady B.A. Perceived physical demands and reported musculoskeletal problems in registered nurses. Am. J. Prev. Med. 2003, 24:270-275.
77. van den Heuvel S.G., Heinrich J., Jans M.P., van der Beek A.J., Bongers P.M. The effect of physical activity in leisure time on neck and upper limb symptoms. Prev. Med. 2005, 41:260-267.
78. Yassi A., Gilbert M., Cvitkovich Y. Trends in injuries, illnesses, and policies in Canadian healthcare workplaces. Can. J. Public Health 2005, 96:333-339.
79. Yeung S.S., Genaidy A., Deddens J., Sauter S. The relationship between protective and risk characteristics of acting and experienced workload, and musculoskeletal disorder cases among nurses. J. Safety Res. 2005, 36:85-95.