Introduction: Spondylosis is a prevalent degenerative condition that can affect any spine region. Commonly associated with physically demanding activities, it is one of the most frequent causes of worker’s compensation claims. However, the relationships between specific occupational exposures and the clinical diagnosis of spondylosis are not clear. Therefore, the aim of this review was to identify and review studies reporting on occupational risk factors for the development of spondylosis in physically demanding occupations.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and methods detailed in a protocol published in advance, a search of seven databases was performed. The eligibility criteria were developed to identify factors that increase the risk of developing spondylosis in physically demanding settings. Included studies were critically appraised with specific tools for each type of study design to assess their methodological quality, and a narrative synthesis of the findings was completed.
Results: Six articles were included. Workers who carried load on the head, compared to those who did not, had higher prevalence of cervical spondylosis. Workers engaged in mentally demanding work, compared to those in ‘physical-based’ occupations (OR 1.65, 95% CI 1.22-2.25), male workers exposed to vibration (OR 1.60, 95% CI 1.05-2.45), and workers younger than 30 years of age who worked in the same posture for a period ranging from 1 to 2.9 hours per day (OR 12.52, 95% CI 1.60-97.85) were at increased risk of cervical spondylosis. Working for more than five years in ‘heavy manual labour’ was reported to increase the prevalence of thoracic spondylosis compared to individuals working in ‘physically light work’. The risk of lumbar spondylosis was found to be higher in carpenters, machine drivers, workers in agricultural, forestry, and fishery industries, and in female workers who lifted weights of more than 10kg at least once a week. In tactical populations, enlisted personnel and those in the army are at increased risk of developing lumbar spondylosis.
Discussion: Findings of this review suggest that physically demanding occupations are associated with an increased risk of developing spondylosis. Specifically, occupations and occupational tasks associated with vibration, lifting weights, and maintaining the same posture for extended periods appear to increase the risk of developing spondylosis. However, these findings are mainly based on cross-sectional studies; therefore, results should be interpreted with caution. Further research is warranted to explore the topic.
Impact: Physically demanding occupations were found to be at increased risk of developing spondylosis. Additionally, vibration, lifting weights, and maintaining the same posture for extended periods appear to increase the risk of developing spondylosis.
Conflict of interest statement:
This research was funded by the Department of Veterans’ Affairs.