Name: The Shoulder JEM

The JEM consists of two parts, a purely expert rated part and a calibrated part, where technical measurements in a selection of occupations are included to calibrate the expert ratings.

Reference:

Expert ratings:

1) Dalbøge, A. Frost, P. Andersen, J.H. Svendsen, S.W. Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study. Occup. Environ. Med.2014. 71(11),750-756.

2) Svendsen, S.W. Dalbøge, A. Andersen, J.H. Thomsen, J.F. Frost, P. Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures: a longitudinal study. Scand. J. Work Environ. Health. 2013. 39 (6),568-577.

Technical measurements:

3) Dalbøge, A, Hansson GA, Andersen JH, Svendsen SW. Upper arm elevation and repetitive shoulder movements: a general population job exposure matrix based on expert ratings and technical measurements (in press).

Contact information:  Annett Dalbøge. Danish Ramazzini Centre, Department of Occupational Environmental Medicine. Aarhus University Hospital, Nørrebrogade 44, Bygning 2C, Aarhus C, Denmark. Email: anetaner@rm.dk.

Access: To obtain access to data follow the application procedure on this site. You will find an overview of the access posibilies to the JEM  here  Hent dokument.

Exposure:

Expert ratings:

1) upper arm elevation >90°, 2) repetitive shoulder movements, 3) forceful shoulder exertions, 4) use of hand-arm vibrations tools, 5) lifting/carrying >20 kg, 6) pushing or pulling >50 kg and 7) computer use, 8) shoulder load 9) total shoulder score.

 Technical measurements:

1) upper arm elevation >90°, 2) repetitive shoulder movements.

Coverage: All occupational titles in the DISCO-88 system.

Job title and industry classification system: DISCO-88.

Calendar period: 1993-current date

Measures of exposure:

Expert ratings:

1) Upper arm elevation >90°: duration (% time, continuous, mean)

2) Repetitive shoulder movements: duration (% time, continuous, mean) and frequency (0-2, categorical, median)

3) Forceful shoulder exertions: intensity (score: 0-4, categorical, mean)

4) Use of hand-arm vibrations tool: duration (% time, continuous, mean) and intensity (0-2, categorical, median)

5) Lifting/carrying > 20 kg: duration (% time, continuous, mean) and frequency (continuous, mean)

6) Pushing or pulling >50 kg duration:  (% time, continuous, mean) and frequency (continuous, mean)

7) Computer use: duration (% time, mean)

8) Shoulder load (0-2, categorical, mean)

9) Total shoulder score (0-10, categorical, mean)

Technical measurements:

1) Upper arm elevation >90°: duration (% time, mean)

2) Repetitive shoulder movements: duration (angular velocity, median, 10th and 90th percentiles)

Uncertainty in exposure measures: None included.

Demographic dimensions: None included.

Exposure variable Definition
Upper arm elevation Upper arm elevation >90° was defined as working with one or both elbows above shoulder height.
Repetitive shoulder movements Repetitive shoulder movements were defined as at least 4 movements of the upper arm per minute continuously for at least 30 minutes with a range of movement of at least 30°. Repetitive shoulder movements were categorised according to their frequency as either moderately repetitive work (4-<15 movements per minute) or highly repetitive work (≥15 movements per minute).
Force
  Forceful shoulder exertions Forceful shoulder exertions were defined as the mean shoulder force requirement for the entire work day using Moore & Garg’s intensity of exertion in relation to a standard 35-year-old male trade worker using a 5-point force-score scale (0=light, 1=somewhat hard, 2=hard, 3=very hard, 4=near maximal).

 

  Lifting/carrying Lifting/carrying loads was defined as manually lifting or carrying an object of ≥10 kg (including lifting of humans). The frequency of lifting/carrying objects was defined as the mean number of lifts per hour when performing work which entails lifting/carrying.

 

  Pushing/pulling Pushing/pulling was defined as manually pushing or pulling an object of ≥50 kg. The frequency of pushing/pulling objects was defined as the mean number of pushing/pulling manoeuvres per hour when performing work which entails pushing/pulling.

 

HAV Exposure to HAV was defined as working with a hand-held vibrating tool the following acceleration groups: <3, ≥3–10, and >10 m/s2.
Computer use Computer use was simply defined as using a computer.
Total shoulder score The total shoulder score was defined as the overall shoulder exposure based on all above mentioned exposures, which is considered to have an internal effect on the rotator cuff (scored 0-10).
HAV, hand-arm vibration.

 

 Exposure assessment methods
Exposure variables Dimension Scale Expert ratings
Number of job groups 172
Upper arm elevation
     Upper arm elevation >90° Duration Continuous Yes
     Upper arm elevation >60° Duration Continuous No
     Upper arm elevation 90th percentile (°) Intensity Continuous No
     Upper arm elevation 99th percentile (°)

 

Intensity Continuous No
Repetitive shoulder movements
     Repetitive shoulder movements Duration Continuous Yes
     Repetitive shoulder movements Frequency Categories (1-3) Yes
     Median upper arm angular velocity (°/s)

 

Intensity Continuous No
Force
     Forceful shoulder exertion Intensity Continuous  Yes
     Lifting/carrying >10 kg Duration Continuous Yes
     Lifting/carrying >10 kg Frequency Continuous Yes
     Pushing/pulling >50 kg Duration Continuous Yes
     Pushing/pulling >50 kg

 

Frequency Continuous Yes
HAV
     HAV Duration Continuous Yes
     HAV acceleration group Intensity Categories (1-3) Yes
Computer use Duration Continuous Yes
Total shoulder score Intensity Continuous Yes
HAV, hand-arm vibration. * Borg scale (CR10). ** Self-reported exposures estimates were not used in the dissertation. Duration = hours