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Psychosocial Factors Related to Lateral and Medial Epicondylitis: Results From Pooled Study Analyses

Thiese, Matthew S. PhD, MSPH; Hegmann, Kurt T. MD, MPH; Kapellusch, Jay PhD; Merryweather, Andrew PhD; Bao, Stephen PhD; Silverstein, Barbara PhD; Tang, Ruoliang PhD; Garg, Arun PhD

Journal of Occupational and Environmental Medicine: June 2016 - Volume 58 - Issue 6 - p 588–593
doi: 10.1097/JOM.0000000000000701
Original Articles

Objective: The goal is to assess the relationships between psychosocial factors and both medial and lateral epicondylitis after adjustment for personal and job physical exposures.

Methods: One thousand eight hundred twenty-four participants were included in pooled analyses. Ten psychosocial factors were assessed.

Results: One hundred twenty-one (6.6%) and 34 (1.9%) participants have lateral and medial epicondylitis, respectively. Nine psychosocial factors assessed had significant trends or associations with lateral epicondylitis, the largest of which was between physical exhaustion after work and lateral epicondylitis with and odds ratio of 7.04 (95% confidence interval = 2.02 to 24.51). Eight psychosocial factors had significant trends or relationships with medial epicondylitis, with the largest being between mental exhaustion after work with an odds ratio of 6.51 (95% confidence interval = 1.57 to 27.04).

Conclusions: The breadth and strength of these associations after adjustment for confounding factors demonstrate meaningful relationships that need to be further investigated in prospective analyses.

Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), University of Utah, Salt Lake City (Drs Thiese, Hegmann); Center for Ergonomics, University of Wisconsin-Milwaukee (Drs Kapellusch, Tang, Garg); Department of Mechanical Engineering, University of Utah, Salt Lake City (Dr Merryweather); and Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia (Drs Bao, Silverstein).

Address correspondence to: Matthew S. Thiese, PhD, MSPH, Rocky Mountain Center for Occupational & Environment Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, 391 Chipeta Way, Suite C, Salt Lake City, UT 84108 (

This research has been approved by the relevant Institutional Review Boards.

This study was funded, in part, by grants from the National Institute for Occupational Safety and Health (NIOSH/CDC) R01-OH009712, NIOSH Education and Research Center training grant T42/CCT810426-10.

No coauthor reported a direct financial interest in the results of the research supporting this article. The authors declare that they have no conflict of interest.

Copyright © 2016 by the American College of Occupational and Environmental Medicine