Hulshof, Carel T JPega, FrankNeupane, SubasColosio, ClaudioDaams, Joost GKc, PrakashKuijer, Paul P F MMandic-Rajcevic, StefanMasci, Federicavan der Molen, Henk FNygård, Clas-HåkanOakman, JodiProper, Karin IFrings-Dresen, Monique H W2021-02-262021-02-262021-02-023354691910.1016/j.envint.2020.106349http://hdl.handle.net/10029/624705In total eight studies (4 cohort studies and 4 case control studies) met the inclusion criteria, comprising a total of 2,378,729 participants (1,157,943 females and 1,220,786 males) in 6 countries in 3 WHO regions (Europe, Eastern Mediterranean and Western Pacific). The exposure was measured using self-reports in most studies and with a job exposure matrix in one study and outcome was generally assessed with physician diagnostic records or administrative health data. Across included studies, risk of bias was generally moderate. Compared with no or low exposure (<2 h per day), any occupational exposure to ergonomic risk factors increased the risk of acquiring MSD (odds ratio (OR) 1.76, 95% confidence interval [CI] 1.14 to 2.72, 4 studies, 2,376,592 participants, I2 70%); and increased the risk of acquiring OA of knee or hip (OR 2.20, 95% CI 1.42 to 3.40, 3 studies, 1,354 participants, I2 13%); Subgroup analysis for MSD found evidence for differences by sex, but indicated a difference in study type, where OR was higher among study participants in a case control study compared to study participants in cohort studies.enCopyright © 2021 World Health Organization. Published by Elsevier Ltd.. All rights reserved.Ergonomic risk factorsGlobal burden of diseaseOccupational exposureOsteoarthritisOther musculoskeletal diseasesSystematic reviewArticle1873-6750Environ Int 2021; 150:106349