{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:02:49Z","timestamp":1777669369457,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T00:00:00Z","timestamp":1624147200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hum Factors"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This prospective study assessed the risk of developing rotator cuff syndrome (RCS) with separate or specific combinations of biomechanical exposures measures, controlling for individual confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Compared with other musculoskeletal disorders, rates of work-related shoulder musculoskeletal disorders have been declining more slowly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted up to 2 years of individual, annual assessments of covariates, exposures, and health outcomes for 393 U.S. manufacturing and healthcare workers without RCS at baseline. Task-level biomechanical exposures assessed exposure to forceful exertions (level, exertion rates, duty cycles), vibration, and upper arm postures (flexion, abduction). Hazard ratios (HRs) were calculated with Cox proportional hazard models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed 39 incident RCS cases in 694 person-years (incidence rate = 5.62 per 100 person-years). Adjusting for confounders, we found increased risk of incident RCS associated with forceful hand exertions per minute for three upper arm posture tertiles: flexion \u226545\u00b0 (\u226528.2% time, HR = 1.11, CI [1.01, 1.22]), abduction \u226530\u00b0 (11.9\u201321.2%-time, HR = 1.18, CI [1.04, 1.34]), and abduction &gt;60\u00b0 (\u22654.8% time, HR = 1.16, CI [1.04, 1.29]). We failed to observe statistically significant effects for other interactions or any separate measures of biomechanical exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the importance of assessing combinations of exposure to forceful repetition and upper arm elevation when developing interventions for preventing RCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Application<\/jats:title>\n                    <jats:p>Based on these results, interventions that reduce exposure to forceful repetition (i.e., lower force levels and\/or slower exertion rates) may reduce the risk of RCS, especially when upper arm elevation cannot be avoided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00187208211022122","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T12:28:53Z","timestamp":1624192133000},"page":"419-434","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Work-Related Risk Factors for Rotator Cuff Syndrome in a Prospective Study of Manufacturing and Healthcare Workers"],"prefix":"10.1177","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6402-0145","authenticated-orcid":false,"given":"Alysha R.","family":"Meyers","sequence":"first","affiliation":[{"name":"National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA"}]},{"given":"Steven J.","family":"Wurzelbacher","sequence":"additional","affiliation":[{"name":"National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA"}]},{"given":"Edward F.","family":"Krieg","sequence":"additional","affiliation":[{"name":"National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA"}]},{"given":"Jessica G.","family":"Ramsey","sequence":"additional","affiliation":[{"name":"National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA"}]},{"given":"Kenneth","family":"Crombie","sequence":"additional","affiliation":[{"name":"Federal Department of Agriculture, Rockville, Maryland, USA"}]},{"given":"Annette L.","family":"Christianson","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Ohio, USA"}]},{"given":"Lian","family":"Luo","sequence":"additional","affiliation":[{"name":"ATTAIN, LLC, Cincinnati, Ohio, USA"}]},{"given":"Susan","family":"Burt","sequence":"additional","affiliation":[{"name":"formerly National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA"}]}],"member":"179","published-online":{"date-parts":[[2021,6,20]]},"reference":[{"key":"bibr1-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31821d0879"},{"key":"bibr2-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1080\/00140130701458230"},{"key":"bibr3-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1080\/00140130500520214"},{"key":"bibr4-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1016\/j.apergo.2008.01.013"},{"key":"bibr5-00187208211022122","unstructured":"Bernard B. 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U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health; DHHS (NIOSH) Publication No. 97-141. http:\/\/www.cdc.gov\/niosh\/docs\/97-141\/"},{"key":"bibr42-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-816713-7.00020-9"},{"key":"bibr6-00187208211022122","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3285"},{"key":"bibr7-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198205000-00012"},{"key":"bibr8-00187208211022122","volume-title":"Nonfatal cases involving days away from work: selected characteristics by special combinations, All U.S., All workers, Private industry, (2011-2017) [Custom tabulation by body park for musculoskeletal disorders]","author":"Bureau of Labor Statistics","year":"2019"},{"key":"bibr9-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2010.063677"},{"key":"bibr10-00187208211022122","volume-title":"[Poster presentation]. 16th World Congress on Ergonomics (IEA2006), Maastricht, The Netherlands.","author":"Burt S.","year":"2006"},{"key":"bibr11-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2012-101287"},{"key":"bibr43-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1179\/1743288X15Y.0000000009"},{"key":"bibr12-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2014-102161"},{"key":"bibr13-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2017-104511"},{"key":"bibr14-00187208211022122","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-019-01485-6"},{"key":"bibr44-00187208211022122","author":"Dickerson C. 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