Occupational demands associated with rotator cuff disease surgery in the UK Biobank

Elizabeth Yanik, Jay Keener, Martin Stevens, Karen Walker-Bone, Ann Marie Dale, Yinjiao Ma, Graham Colditz, Rick Wright, Nancy Saccone, Nitin Jain, Bradley Evanoff

Research output: Contribution to journalArticlepeer-review


Objectives Physically-demanding occupations may increase rotator cuff disease (RCD) risk and need for surgery. We linked a job-exposure matrix (JEM) to the UK Biobank cohort study to measure physical occupational exposures and estimate associations with RCD surgery.

Methods Jobs and UK Standard Occupational Classification (SOC) codes were recorded during the UK Biobank verbal interview. Lifetime job histories were captured through a web-based survey. UK SOC codes were linked to a JEM based on the US O*NET database. O*NET-based scores [static strength, dynamic strength, general physical activities, handling/moving objects (range=1–7), time spent using hands, whole body vibration, and cramped/awkward positions (range=1–5)] were assigned to jobs. RCD surgeries were identified through linked national hospital inpatient records. Multivariable Cox regression was used to calculate hazard ratios (HR) as estimates of associations with RCD surgery. Among those with lifetime job histories, associations were estimated for duration of time with greatest exposure (top quartile of exposure).

Results Of 277 808 people reporting jobs, 1997 (0.7%) had an inpatient RCD surgery. After adjusting for age, sex, race, education, area deprivation, and body mass index, all O*NET variables considered were associated with RCD surgery (HR per point increase range=1.10–1.45, all P<0.005). A total of 100 929 people reported lifetime job histories, in which greater exposures were significantly associated with RCD surgery after >10 years of work (eg, HR for 11–20 versus 0 years with static strength score ≥4 = 2.06, 95% confidence interval 1.39–3.04).

Conclusions Workplace physical demands are an important risk factor for RCD surgery, particularly for workers with more than a decade of exposure.
Original languageEnglish
JournalScandinavian Journal of Work, Environment & Health
Early online date13 Oct 2022
Publication statusE-pub ahead of print - 13 Oct 2022


  • job exposure matrix
  • occupational health


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