676 How can we explain gender differences in work-related upper limb symptoms? a cross-sectional study with irish manual therapists

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Abstract

Introduction

Female workers commonly show higher prevalence of work-related upper limb disorders (WRULD) than males. Explanations include higher vulnerability to physical and psychosocial work risks, differential exposure to risks and higher muscle activity relative to capacity; research is inconclusive. Objectives were to (1) determine gender-specific WRULD prevalence in Irish Physical Therapists, Athletic Therapists and Physiotherapists, (2) test gender differences in work exposures and in exertion that may explain WRULD disparities, (3) compare whether women’s musculoskeletal health was more affected by physical and psychosocial exposures.

Methods

347 hospital-based and self-employed Irish Chartered Physiotherapists, Physical and Athletic Therapists (cluster and random sampling), 114 men and 233 women, completed the Nordic Questionnaire (neck, shoulder, elbows, wrist, finger, thumb symptoms), the Copenhagen Psychosocial Questionnaire (demands, tempo, influence, predictability, social support), physical exposures (repetitive movements, postures, Borg exertion scale). Age-adjusted prevalence odds ratios (POR) of WRULS comparing genders, gender-stratified logistic regression with confounder adjustment.

Result

82% experienced WRULD in at least one body site without significant difference between women (84%) and men (80%) (POR=1.3; 0.7–2.3), with significantly higher prevalence in women for shoulder (56% vs 35%) (POR=1.7, 1.2–2.7) and neck (58% vs 44%) (POR=2.3; 1.4–3.7). Physical exposures and exertion did not differ by gender. Exertion due to repetitive thumb, arm and wrist movements was more strongly associated with neck and shoulder symptoms in women than in men. Women reported significantly higher tempo and emotional demands, there was no difference in quantitative demands, predictability, influence and social support. The magnitude of associations between psychosocial exposures and WRULDs were similar in gender-stratified analyses.

Discussion

Women may be more exposed to certain psychosocial risks and may be more vulnerable to physical exertion. Gender-specific risk assessment for the prevention of WRULS is paramount. Prevention for health care workers in hand-intensive occupations is warranted given the high ULD prevalence in both genders.

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