Job strain and neck-shoulder symptoms: A prevalence study of women and men white-collar workers

Abstract

Background: Neck-shoulder symptoms are frequent among workers. Psychosocial factors at work have been associated with neck-shoulder symptoms, but few studies have examined job strain, the combined effect of high psychological demands (PD) and low decision latitude (DL). Aims: To examine the association between psychosocial factors at work and the prevalence of self-reported neck-shoulder symptoms among white-collar workers. Methods: In a cross-sectional study of 1543 white-collar workers, PD and DL at work were measured with Karasek's questionnaire. Prevalent cases were workers for whom neck-shoulder symptoms were present for ≥3 days during the previous 7 days and for whom pain intensity was greater than half the visual analogue scale. Gender and social support at work were evaluated as potential effect modifiers. Results: Workers exposed to high job strain had a higher prevalence of neck-shoulder symptoms [adjusted prevalence ratio (PR): 1.54, 95% confidence interval (CI): 1.00-2.37]. No modifying effect of gender was observed in this association. The effect of job strain was stronger in workers with low social support (adjusted PR: 1.84, 95% CI: 0.92-3.68). These associations tended to be stronger and/or more precise when using alternative exposures and case definition. Namely, a stronger job strain effect was observed when a tertile cut-off was used to classify exposure (adjusted PR: 2.47, 95% CI: 1.15-5.32). Conclusion: These results suggest that primary prevention of neck-shoulder symptoms among white-collar workers should consider the exposure to job strain, especially when workers are exposed to low social support at work. © 2006 Oxford University Press.