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Meta-Analysis
. 2018 Sep 18;91(12):558-564.
doi: 10.1212/01.wnl.0000544322.26939.09. Epub 2018 Aug 17.

Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis

P Paul F M Kuijer  1 , Jos H Verbeek  2 , Andreas Seidler  2 , Rolf Ellegast  2 , Carel T J Hulshof  2 , Monique H W Frings-Dresen  2 , Henk F Van der Molen  2
Affiliations
Meta-Analysis

Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis

P Paul F M Kuijer et al. Neurology. .

Abstract

Objective: Clinicians need to know whether lumbosacral radiculopathy syndrome (LRS) can be attributed to work. This review describes what work-related risk factors are associated with LRS.

Methods: A systematic review was performed in PubMed and Embase. Inclusion criteria were that LRS was diagnosed by a clinician and workers exposed to work-related risk factors were compared to workers less or not exposed. A quality assessment and a meta-analysis were performed, including a dose-response analysis.

Results: The search resulted in 7,350 references and 24 studies that fulfilled the inclusion criteria: 19 studies were rated as having a high risk of bias and 5 as having a low risk of bias. The median number of LRS patients per study were 209 (interquartile range 124-504) and the total number of participants was 10,142. The meta-analysis revealed significant associations with heavy physically demanding work (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.48-2.79), bending or twisting of the trunk (OR 2.43, 95% CI 1.67-3.55), and lifting and carrying in combination with bending or twisting of the trunk (OR 2.84, 95% CI 2.18-3.69). No significant associations were found for professional driving (OR 1.46, 95% CI 0.90-2.35) or sitting (OR 1.08, 95% CI 0.49-2.38). A dose-response relation was present per 5 years of exposure for bending (OR 1.12, 95% CI 1.04-1.20), lifting (OR 1.08, 95% CI 1.02-1.14) and the combination of bending and lifting (OR 1.14, 95% CI 1.01-1.29).

Conclusions: Moderate to high-quality evidence is available that LRS can be classified as a work-related disease depending on the level of exposure to bending of the trunk or lifting and carrying. Professional driving and sitting were not significantly associated with LRS.

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Figures

Figure 1
Figure 1. Flow chart of the included studies
Figure 2
Figure 2. Risk of lumbosacral radiculopathy syndrome due to bending and twisting of the trunk based on low risk of bias studies (green dot +) and high risk of bias studies (red dot −)
CI = confidence interval; MH = Mantel-Haenszel.
Figure 3
Figure 3. Dose-response relation between the risk of lumbosacral radiculopathy syndrome (odds ratio, including 95% confidence interval) and number of years bending 20 degrees at least 1 hour a day and lifting 5 kg during 2 hours per work day or 20 kg 10 times per work based on 3 studies,,
See this image and copyright information in PMC

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