Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire
From: BMC Musculoskeletal Disorders 2007, 8:68
Complaints of Arm Neck and Shoulder represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling complaints of arm neck and shoulder and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of complaints of arm neck and shoulder in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints.
To examine potential workplace risk factors for the presence of complaints of arm neck and shoulder, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of complaints of arm neck and shoulder in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability).
Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document complaints of arm neck and shoulder among computer workers in the Netherlands.
Complaints of arm, neck and shoulder complaints of arm neck and shoulder were recognized in the early seventies as an important cause of work disability. They were introduced as “occupational cramps” or “occupational myalgia” and suspected of being associated with numerous occupations and work activities. The rapid development of information technology has entailed changes in working life during the recent decades. It is estimated that more than half of the working population in Western societies currently use personal computers at work. Additionally, the relative time spent in front of the computer and the use of a computer mouse has increased rapidly over the years. It is likely that these developments may have contributed to the increasing burden of complaints of arm neck and shoulder.
The results showed higher prevalence of neck and shoulder complaints in the study population compared to arm, elbow and hand complaints. This matter is rather debatable in the literature since some reviews, which focus on muscle activity during computer use, suggest a stronger relationship between computer use and complaints of the hand and arm, than to complaints of the neck and shoulders. On the other hand, there are also studies indicating that neck or shoulder complaints are more common than other complaints in the upper extremity in computer workers. Job characteristics, such as high quantitative job demands, having little influence on one’s work situation, and limited rest break opportunities have been found as predictors of neck pain. One should cautiously postulate that certain risk factors are more related to the presence of neck and shoulder pain than to wrist and hand pain. However, the majority of the available literature either investigates a variety of symptoms (frequency, intensity) and/or one body region or the used concepts are rather broadly defined which complicates making a meaningful comparison of the results presented in the literature. However, the correlations between risk factor scales and complaints of arm neck and shoulder are to be investigated and presented in a separate manuscript.
Furthermore, musculoskeletal complaints and neck and shoulder complaints in particular, were more common among women than among men. Even though women and men were working in the same institute and had the same job titles. Another study confirmed our findings, showing the prevalence of symptoms in the neck and upper extremities per year to be 51% among men and 72% among women. A possible explanation for this gender related difference is that women apparently do not always perform tasks with the same physical requirements or work organization as men. The European Foundation for the Improvement of Living and Working Conditions indicated that women tended to perform more repetitive work on average, whereas men were less likely to sit for prolonged periods compared to women (refer). Furthermore, women are more often exposed to additional stress from unpaid work such as housekeeping and child care.
Neck and shoulder complaints are reported more frequently than complaints in any of the other upper body regions. Further, women had higher 12 months prevalence rates of upper extremity musculoskeletal complaints than men. The tested questionnaire, i.e. the MUEQ, has satisfactory reliability and internal consistency when used to document complaints of arm neck and shoulder among computer office workers in the Netherlands.
This questionnaire can be used as a screening inventory for occupational health services to identify worker groups in which a more thorough ergonomic analysis is indicated.
We tested the psychometric properties of the questionnaire in employees without severe musculoskeletal complaints. Further evaluation of the psychometric properties of the questionnaire studies in other populations may therefore be useful. The question whether the scales identified by the factor analyses are indeed risk factors for the development of complaints of arm neck and shoulder in computer workers needs to be addressed in well designed prospective cohort studies.
