Lateral epicondylitis: new evidence for work relatedness.

Lateral epicondylitis is one of the most common upper-limb usculoskeletal disorders in general practice [1] and in working opulation [2] with an estimated incidence ranging from 0.3–1.1 er 100 person-years [3]. Its description by Runge in 1873 and ajor in 1883 as “Lawn-tennis elbow” was due to its association ith the biomechanical injuries in this sport [4]. Recent systemtic reviews concluded that there was moderate evidence of an ssociation between epicondylitis and occupational exposure to orceful and repetitive hand activities [5,6]. However, the evidence or this association was primarily based on cross-sectional studies. s there was only one prospective study available [7], the causality f the reported association between occupational exposure and the ccurrence of lateral epicondylitis has been debated [6]. Three large, longitudinal studies on musculoskeletal disorders ere recently completed which address the issues of workplace xposures and risk for lateral epicondylalgia with greater preciion. In this paper, we have summarized these studies and drawn onclusions from their findings. All three studies were published in 2013; two were conducted n the United States, and one in Europe [8–10]. Lateral epicondylalia is the term used for outcome since each study used a standard efinition for possible epicondylitis that included specific sympoms and/or physical examination manoeuvre [11,12] (Table 1). In he French Cosali study (Principal investigator Y. Roquelaure), 3710 orkers, representative of the workforce, were identified by 83 ccupational physicians; the cohort included 1394 workers withut elbow pain who were followed on average for 5.5 years [8]. he incidence of lateral epicondylalgia was 1.0/100 person-years. elf-reported high physical exertion (Borg20 rating > 13) combined ith reported elbow flexion and extension, or with extreme wrist ending for > 2 h/day, was associated with lateral epicondylalgia ith an estimated relative risk of 3.2 in men (95% confidence nterval [1.5–6.4]) and 3.3 [1.4–7.6] in women. The PrediCTS study Principal investigator B. Evanoff) included 1107 newly employed