The association between occupational mechanical exposures and low-back and lower-body musculoskeletal disorders: an overview of systematic reviews.

Authors

Alexander Jahn, Claus Kjærgaard, Bradley Evanoff, Frederik Kronvold Nielsen, Alexis Descatha, Johan Hviid Andersen, Annett Dalbøge

Published in

Annals of work exposures and health. Volume 70. Issue 5. Jun 03, 2026.

Abstract

The aim of this systematic overview was to summarize and synthesize systematic reviews (SRs) with meta-analyses of the association between occupational mechanical exposures and low-back and lower-body musculoskeletal disorders (MSDs).
A protocol was registered in PROSPERO and a systematic literature search was conducted in PubMed, Web of Science, Embase, and CINAHL. Systematic reviews were considered eligible if they included occupational mechanical exposures and provided weighted measures of association in relation to specific MSDs. Data were extracted from each SR, including databases searched, exposure, outcome, effect estimates, and quality of evidence of the association. The methodological quality of each SR was assessed using AMSTAR 2.
The screening of 1,756 articles resulted in the inclusion of 17 SRs with meta-analyses covering 7 MSDs: chronic low back pain (n = 1), lumbar spine degeneration (n = 2), lumbosacral radiculopathy (n = 1), hip osteoarthritis (n = 7), inguinal hernia (n = 1), meniscal lesions (n = 1), knee osteoarthritis (n = 4), and knee and/or hip osteoarthritis (n = 1). Methodological quality assessment using the AMSTAR 2 tool revealed high confidence in 5 SRs, while 4 were rated as low and 8 as critically low confidence. The weighted odds ratios (OR) from the meta-analyses generally ranged between 1.3 and 2.8, although substantial heterogeneity was observed. Among the included SRs, 50% graded the certainty of evidence, and among these 60% graded it as low or very low.
This overview demonstrates that most occupational mechanical exposures show directionally consistent associations (OR >1) with an increased risk of developing lower-body MSDs. However, as the quality of evidence was generally graded as low, the true effect may be substantially different from the reported estimates. Future research should prioritize prospective studies and objective exposure assessments to strengthen the quality of evidence.

PMID:
42329800
Bibliographic data and abstract were imported from PubMed on 23 Jun 2026.

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