AJ Beek Van der

EF Harkeness

G Baril-Gingras

M. H. W. Frings-Dresen

M. J. M. Hoozemans

MJ Hoozemans

P. P. F. M. Kuijer

PP Kuijer

RE Hughes

English

PubMed

Springer - Publisher Connector

LETTER TO THE EDITOR
Tendon lesions in the shoulder: tear and wear without push
and pull?
P. P. F. M. Kuijer • M. J. M. Hoozemans •
M. H. W. Frings-Dresen
Received: 21 April 2011 / Accepted: 8 June 2011 / Published online: 22 June 2011
 The Author(s) 2011. This article is published with open access at Springerlink.com
First of all, we would like to complement Siedler and his
colleagues for their innovative case–control study in
patients with clinically established tendon lesions of the m.
supraspinatus in order to verify a pathological dose–
response relation for work-related risk factors of shoulder
complaints, taking into account personal and sport-related
confounders (Seidler et al. 2011).
We were surprised to read that lifting and carrying was
considered as a potential risk factor or confounder and not
pushing and pulling. As far as we know, there is no epi-
demiological evidence for an association between lifting
and carrying and shoulder symptoms. However, several
studies reported significant associations between pushing
and pulling and shoulder symptoms (Van der Beek et al.
1993; Hughes et al. 1997; Hoozemans et al. 2002a, b;
Harkeness et al. 2003; Smedley et al. 2003). Not taking
into account pushing and pulling as a potential risk factor
or confounder may partly explain the observed differences
in odds ratio’s (ORs) between exposure in terms of occu-
pational groups (Table 2; Seidler et al. 2011) and in terms
of strenuous activities (Table 3; Seidler et al. 2011). For
instance, for construction workers, packers and physically
exposed service workers (f.i. nurses and refuse collectors),
Seidler et al. (2011) observed significant adjusted ORs of
2.5, 5.0 and 1.9, respectively. These ORs are somewhat
higher than for lifting and carrying, which may be caused
by the fact that jobs that consist of manual materials han-
dling often include pushing and pulling besides lifting and
carrying (Baril-Gingras and Lortie 1995). For comparable
jobs, Hoozemans et al. (2002a) reported significant prev-
alence rate ratios (PRRs) for shoulder symptoms between
2.2 and 4.9 for self-reported and observed exposure to
pushing and pulling in their 1-year prospective cohort
study among 829 workers. In this study, the PRRs were
adjusted for working above shoulder level and lifting and
carrying. These findings are supported by biomechanical
studies on contact forces at the glenohumeral joint in jobs
like service workers in distribution (Hoozemans et al.
2004) and refuse collectors (Kuijer et al. 2003). Therefore,
we strongly recommend taking into account pushing and
pulling when evaluating manual materials handling, espe-
cially in relation to shoulder symptoms (Kuijer et al. 2007).
Open Access This article is distributed under the terms of the
Creative Commons Attribution Noncommercial License which per-
mits any noncommercial use, distribution, and reproduction in any
medium, provided the original author(s) and source are credited.
References
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P. P. F. M. Kuijer (&)  M. H. W. Frings-Dresen
Coronel Institute of Occupational Health, Netherlands Center
for Occupational Diseases, Academic Medical Center,
University of Amsterdam, Amsterdam, The Netherlands
e-mail: p.p.kuijer@amc.uva.nl
M. J. M. Hoozemans
Faculty of Human Movement Sciences, Research Institute
MOVE, VU University, Amsterdam, The Netherlands
123
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123


Tendon lesions in the shoulder: tear and wear without push and pull?

Crossref

Kuijer, P.P.F.M.

Hoozemans, M.J.M.

Frings-Dresen, M.H.

NARCIS 

Kuijer, P. P. F. M.

Hoozemans, M. J. M.

Frings-Dresen, M. H. W.

VU Research Portal

Dijk FJ (2002a) Low-back and shoulder complaints among workers with pushing and pulling tasks.

Ind Med 32:66–75 Kuijer PP, Hoozemans MJ, Kingma I et al (2003) Effect of a redesigned two-wheeled container for refuse collecting on mechanical loading of low back and shoulders.

Risk factors for incident neck and shoulder pain in hospital nurses.

The handling of objects other than boxes: univariate analysis of handling techniques in a large transport company.

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Tendon lesions in the shoulder: tear and wear without push and pull?

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