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Introduction: In Germany, the following occupational disease 2117 can be recognized since this year: “Lesion of the rotator cuff of the shoulder due to long-term and intensive exposure from over-shoulder work, repetitive movements in the shoulder joint, exertion due to lifting loads or hand-arm vibrations”. The scientific justification was published in 2021. In a meta-review of systematic reviews, we examined whether additional evidence has emerged since then.

Methods: We searched Medline and EMBASE for systematic reviews on the association between occupational exposure caused by over-shoulder work, repetitive movements in the shoulder joint, lifting loads and hand-arm vibration, and rotator cuff lesions published between 2021 and 2024. The screening of titles, abstracts and full texts were performed independently by two authors. The quality assessment using AMSTAR 2 and ROBIS, and data extraction was done by one author and controlled by another author. Additionally, one author screened the reference lists of included studies for further relevant systematic reviews and performed citation tracking in Google Scholar using three key studies related to our research question.

Results: 1,782 documents were found for the title and abstract screening, and three systematic reviews met our inclusion criteria. The study by Diener et al. 2024 confirmed the new occupational disease. The publication by Curti et al. 2023 found moderate evidence of a causal relationship between combined occupational exposures to over-shoulder work and forceful movements and the risk of shoulder tendinopathy, but not for individual exposures. In the study by Versloot et al. 2024, the strongest evidence emerged for the association between arm elevation, repetitive shoulder movements, shoulder force application and hand-arm vibrations with the risk of impingement syndrome and shoulder tendinopathy. Inconsistent results have been found for the association between mechanical exposure from force application, repetitive movements and hand-arm vibration with rotator cuff syndrome. Examination of the underlying primary studies revealed that this conclusion is untenable. The quality of the three systematic reviews was low. A total of nine primary studies were included in these systematic reviews that were not cited in the scientific justification for the occupational disease 2117. Only one of these nine studies (Dalbøge et al. 2020) was of high quality and confirmed the occupational disease 2117. We are also aware of another high-quality study (Lewis et al. 2023), which was not included in any of the three systematic reviews, which also confirms the occupational disease 2117.

Discussion: Our meta-review confirms the association between occupational exposures and lesions of the rotator cuff of the shoulder.

Conclusion: Lesions of the rotator cuff of the shoulder should generally be accepted as occupational disease.