Psychosocial work conditions, perceived stress, perceived muscular tension, and neck/shoulder symptoms among medical secretaries

How are sex-gender differences in chair-and-desk-based postural variability explained? A scoping review

BACKGROUND

Desk-work-related musculoskeletal pain is more prevalent among female workers than male workers. This may be contributed to by sex and/or gender differences in postural variability however, the mechanisms underpinning these differences are poorly understood. This review investigates whether desk-based postural variability studies investigate sex-gender differences and, how they explain the mechanisms behind these differences.

METHODS

A scoping review was conducted with four databases (PubMed, Embase, Scopus and ProQuest) searched in June and July 2023. Studies investigating postural variability among desk-based workers were included and a narrative approach used to synthesise results.

RESULTS

15 studies were included. Only four reported on sex-gender differences. None collected psychological or social information to explore reasons for sex-gender differences.

CONCLUSION

The mechanisms behind postural variability differences between sexes and genders are complex and multifactorial. Studies largely do not consider sex and gender and do not collect the information necessary to explain their results.

Injury by design: A thematic networks and system dynamics analysis of work-related musculoskeletal disorders in tram drivers

Tram driving is a safety critical task where work-related musculoskeletal disorders (WRMSDs) and injuries are associated with interacting occupational design factors over time. These interactions then carry implications for workforce retention, public safety, workplace relations and supports. To better understand such interactions, this study used thematic networks and system dynamics (causal loop diagrams) analysis with the aim to unearth a global theme underscoring occurrence of WRMSDs, and describe the factors influencing the system dynamics of WRMSD occurrence in tram drivers. Building on earlier work focused on occupational participation, secondary analysis of driver interviews (n = 13) and driving observations (n = 11) produced thematic network and causal loop models of risk factors that highlighted an Injury by Design problem structure as a global theme. Research targeting organisational culture, human factors, and design standards is needed to minimise WRMSDs risk in tram drivers.

Risk factors for shoulder disorders among French workers: prospective cohort study

Objectives

Shoulder disorders are common in the working population. This longitudinal study aimed to explore the relationships between personal factors and occupational organisational, psychosocial, and biomechanical factors and the incidence of shoulder disorders.

Methods

A total of 3710 workers in the Pays de la Loire region (Loire Valley area, France) were randomly included by their occupational physician in the Cosali cohort between 2002 and 2005. All workers completed a self-administered questionnaire about personal factors and work exposure, and using a standardised physical examination, occupational physicians diagnosed shoulder disorders. Between 2007 and 2010, 1611 workers were re-examined by their occupational physician. The 1,320 workers free of shoulder disorders at baseline were studied. A conceptual model was developed in which relationships between organisational, psychosocial, biomechanical, and personal factors at baseline and the incidence of shoulder disorders were assumed. Structural equation modelling was used to test the model.

Results

Shoulder disorders were directly associated with biomechanical factors and age but not with psychosocial factors. However, skill discretion and psychological demand influenced shoulder disorders indirectly through biomechanical factors. Exposure to a work pace dependent on an automatic rate and to a work pace dependent on customers’ demands were associated with biomechanical and psychosocial factors, but not directly to shoulder disorders.

Conclusions

This study identified the complex direct and indirect relationships between occupational factors and shoulder disorders. Our data confirmed our conceptual causation model: organisational and psychosocial factors were associated with biomechanical factors, while biomechanical factors were associated with the incidence of shoulder disorders.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-022-01853-9.

Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach

This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), psychosocial (job strain model), biomechanical (Borg's rating perceived exertion, wrist bending, pinching, and hand-transmitted vibrations), and personal factors at baseline. Symptomatic CTS risk was directly increased by biomechanical factors (standardized coefficient = 0.19, P = 0.011), female gender (0.25, P < 0.001), and age (0.15, P = 0.042). No psychosocial factors had a direct impact on CTS, but decision authority and skill discretion had an indirect impact by influencing biomechanical exposure. Exposure to machine-paced work had an indirect impact on increasing CTS, either by raising biomechanical exposure (0.19, P < 0.001) or by lowering decision authority (-0.18, P < 0.001) and skill discretion (-0.20, P < 0.001), which in turn increased biomechanical exposure. Similar complex relationships were observed between risk factors and CTS defined by a more strict case definition. Biomechanical exposure had a direct impact on CTS, while organizational factors and psychosocial factors had an indirect impact on CTS. The findings support conceptual models linking work organization to CTS.

Development of Conceptual Models to Guide Public Health Research, Practice, and Policy: Synthesizing Traditional and Contemporary Paradigms

This applied paper is intended to serve as a "how to" guide for public health researchers, practitioners, and policy makers who are interested in building conceptual models to convey their ideas to diverse audiences. Conceptual models can provide a visual representation of specific research questions. They also can show key components of programs, practices, and policies designed to promote health. Conceptual models may provide improved guidance for prevention and intervention efforts if they are based on frameworks that integrate social ecological and biological influences on health and incorporate health equity and social justice principles. To enhance understanding and utilization of this guide, we provide examples of conceptual models developed by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. PLUS is a transdisciplinary U.S. scientific network established by the National Institutes of Health in 2015 to promote bladder health and prevent lower urinary tract symptoms, an emerging public health and prevention priority. The PLUS Research Consortium is developing conceptual models to guide its prevention research agenda. Research findings may in turn influence future public health practices and policies. This guide can assist others in framing diverse public health and prevention science issues in innovative, potentially transformative ways.

Shoulder pain among male industrial workers: Validation of a conceptual model in two independent French working populations

This study aims to validate a conceptual model for shoulder pain risk factors in two independent samples of male industrial workers: the Cosali cohort (n = 334) and one pharmaceutical company (n = 487). Direct and indirect relationships between work organization factors (automatic speed of a machine or movement of a product and work pace dependent on customers' demand), psychosocial factors (Job strain model), biomechanical factors (working with abducted arms, working with arms at or above shoulder level, and perceived physical exertion), perceived stress, and shoulder pain were explored using structural equation models. Shoulder pain was positively associated with biomechanical exposure in both samples, and with perceived stress only in the pharmaceutical preparation manufacturer, while factors related to work organization and psychosocial factors had indirect impacts on the risk of chronic shoulder pain in both samples. The results provide a deeper understanding of the complex relationships between workplace risk factors and shoulder pain.

The prevention of musculoskeletal complaints: long-term effect of a work-related psychosocial coaching intervention compared to physiotherapy alone-a randomized controlled trial

PURPOSE

Research shows that psychosocial factors play a significant role in the emergence of musculoskeletal complaints (MSC). The aim of this study was to determine the long-term effects on unspecific MSC by a combined physiotherapy and coaching intervention compared to physiotherapy alone. The coaching intervention focussed on enabling better strategies for coping with work stressors.

METHODS

The participants of a previous randomized controlled intervention were invited to participate again in a third follow-up survey 22 months after the end of the intervention. In 2014, 65 nurses completed a 10-week personalised physiotherapy. Additionally, the intervention group (n = 33) passed five individual coaching sessions, plus an opening and closing session. 44 nurses (IG: n = 24; CG: n = 20) passed again a physical examination as well as another questionnaire assessment in 2016. The primary outcome was MSC, secondary outcomes were work ability and work-related well-being. Due to missing data, multiple imputations were conducted using the mice package in R. Data were analysed by ANOVA with two-way repeated measures, t tests for independent samples and Chi-squared tests.

RESULTS

In respect of MSC, stronger improvement of movement in the vertebral column was observed in the IG compared to the CG. No differences between the IG and CG regarding other long-term effects were observed.

CONCLUSIONS

The results suggest that the combined intervention of work-related coaching and physiotherapy had only a marginally stronger long-term effect with respect to MSC than physiotherapy alone.

Impact of near work on perceived stress according to working hours: The Korea National Health and Nutrition Examination Survey VI (2013-2015)

The purpose of this study was to investigate the relationships among working hours, near work time, and perceived stress. In total, data of 3,776 workers from the Korea National Health and Nutrition Examination Survey VI were examined. The workers’ working hours per week, daily near work time, and complaints of perceived stress were analyzed in conjunction with other sociodemographic and occupation-related variables. Multivariate logistic analysis found that workers with 3 and ≥4 hours of near work were more likely to report high perceived stress than were the reference group who had <1 hour per day of near work, with odds ratios (ORs) (95% confidence intervals [CIs]) of 1.34 (1.01–1.78) and 1.94 (1.53–2.46), respectively. Additionally, those working 50 and more hours a week were more likely to report high perceived stress with ORs of 1.51 (1.19–1.90) and 1.88 (1.42–2.48), respectively. When stratified by working hours, workers with daily near work time of ≥4 hours were more likely to report high perceived stress with ORs of 2.21 (1.45–3.37), 2.27 (1.30–3.97), and 3.47 (1.80–6.69), among the workers with 40–49, 50–59, and ≥60 weekly working hours, respectively. Workers with greater near work time are at risk for high perceived stress. Moreover, this risk was found to be higher among workers with longer working hours. Therefore, work cycle modification and reductions in near work time are necessary to prevent stress-related health outcomes.

Risk Factors for Shoulder Pain in a Cohort of French Workers: A Structural Equation Model

Shoulder pain is common in the working population and causes loss of productivity, high economic costs, and long absences. Simultaneous evaluation of the complex relationships between work organization (e.g., work pace, application of quality standards), psychosocial and physical risk factors, stress, and shoulder pain is rare. The aim of this study was to explore the direct and indirect relationships between workplace risk factors, perceived stress, and occurrence of shoulder pain in workers of the Cohorte des Salariés Ligériens study. A total of 3,710 workers in a French region were randomly selected for inclusion between 2002 and 2005. They completed a self-administered questionnaire about musculoskeletal symptoms, individual factors, and exposure to work constraints. In 2007, they responded to a follow-up questionnaire. The study sample comprised 1,400 workers free of shoulder pain at baseline. Structural equation models were used. For both sexes, exposure to factors related to work organization had an effect on physical and psychosocial risk factors. Psychological demand was the only psychosocial constraint that increased perceived stress. Shoulder pain was influenced directly by physical risk factors for both sexes and by perceived stress for men. In view of their distal action, work organization is an important target for strategies to prevent shoulder pain in the working population.

Inhibiting the Physiological Stress Effects of a Sustained Attention Task on Shoulder Muscle Activity

Objective: The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. Background: The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing operators often monitor automated process for long periods of their work shift. Prolonged monitoring work requires sustained attention, which is a cognitive process that humans are typically poor at and find stressful. As sustained attention becomes an increasing requirement of manufacturing operators’ job content, the resulting stress experienced could contribute to the onset of many health problems, including work related musculoskeletal disorders (WRMSDs). Methods: The SART attention test was completed by a group of participants before and after a breathing intervention exercise. The effects of the abdominal breathing intervention on breathing rate, upper trapezius muscle activity and end-tidal CO₂ were evaluated. Results: The breathing intervention reduced the moderation effect of end-tidal CO₂ on upper trapezius muscle activity. Conclusions: Abdominal breathing could be a useful technique in reducing the effects of sustained attention work on muscular activity. Application: This research can be applied to highly-automated manufacturing industries, where prolonged monitoring of work is widespread and could, in its role as a stressor, be a potential contributor to WRMSDs.

Psychosocial work aspects, stress and musculoskeletal pain among musicians. A systematic review in search of correlates and predictors of playing-related pain

BACKGROUND

Musicians face numerous psychosocial and physical demands at work resulting in high prevalence of musculoskeletal problems. Unlike physical risks, little is known about psychosocial work factors influencing such health problems in this particular group.

OBJECTIVE

The paper aimed to identify psychosocial work demands resulting in musculoskeletal problems among musicians.

METHODS

A systematic review was undertaken to find data linking psychosocial work demands or stress with musculoskeletal disorders among musicians.

RESULTS

The exploration of databases resulted in nine research studies linking psychosocial aspects of work or stress with musculoskeletal problems among musicians. The analyzed studies linked psychosocial aspects with musculoskeletal problems in three ways - showing proportions of people indicating particular causes of pain, indicating correlations between these variables or performing regression analysis showing psychosocial predictors of musculoskeletal pain.

CONCLUSIONS

Only a few studies have undertaken the issue of psychosocial risk factors for musculoskeletal problems among musicians. The results revealed that some psychosocial aspects of work, e.g. long hours at work, work content, high job demands, low control/influence, lack of social support, were related to musculoskeletal pain, however, the methods and results were inconsistent. The extant studies employed variety of definitions of psychosocial aspects that hindered the possibility for consistent conclusions. Basing on those conclusions, future directions were offered.

Perceived stress at work is associated with attenuated DHEA-S response during acute psychosocial stress

BACKGROUND

Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) have been suggested to play a protective role during acute psychosocial stress, because they act as antagonists to the effects of the stress hormone cortisol. This study aims to investigate whether prolonged psychosocial stress, measured as perceived stress at work during the past week, is related to the capacity to produce DHEA and DHEA-S during acute psychosocial stress. It also aims to investigate whether prolonged perceived stress affects the balance between production of cortisol and DHEA-S during acute psychosocial stress.

METHOD

Thirty-six healthy subjects (19 men and 17 women, mean age 37 years, SD 5 years), were included. Perceived stress at work during the past week was measured by using the Stress-Energy (SE) Questionnaire. The participants were divided into three groups based on their mean scores; Low stress, Medium stress and High stress. The participants underwent the Trier Social Stress Test (TSST) and blood samples were collected before, directly after the stress test, and after 30 min of recovery. General Linear Models were used to investigate if the Medium stress group and the High stress group differ regarding stress response compared to the Low stress group.

RESULTS

Higher perceived stress at work was associated with attenuated DHEA-S response during acute psychosocial stress. Furthermore, the ratio between the cortisol production and the DHEA-S production during the acute stress test were higher in individuals reporting higher perceived stress at work compared to individuals reporting low perceived stress at work. There was no statistical difference in DHEA response between the groups.

CONCLUSIONS

This study shows that prolonged stress, measured as perceived stress at work during the past week, seems to negatively affect the capacity to produce DHEA-S during acute stress. Given the protective functions of DHEA-S, attenuated DHEA-S production during acute stress may lead to higher risk for adverse effects on psychological and physiological health, particularly if stress exposure continues.

Perceived stress at work is associated with lower levels of DHEA-S

BACKGROUND

It is known that long-term psychosocial stress may cause or contribute to different diseases and symptoms and accelerate aging. One of the consequences of prolonged psychosocial stress may be a negative effect on the levels of dehydroepiandrosterone (DHEA) and its sulphated metabolite dehydroepiandrosterone sulphate (DHEA-S). The aim of this study is to investigate whether levels of DHEA and DHEA-S differ in individuals who report perceived stress at work compared to individuals who report no perceived stress at work.

METHODS

Morning fasting DHEA-S and DHEA levels were measured in serum in a non-stressed group (n = 40) and a stressed group (n = 41). DHEA and DHEA-S levels were compared between the groups using ANCOVA, controlling for age.

RESULTS

The mean DHEA-S levels were 23% lower in the subjects who reported stress at work compared to the non-stressed group. Statistical analysis (ANCOVA) showed a significant difference in DHEA-S levels between the groups (p = 0.010). There was no difference in DHEA level between the groups.

CONCLUSIONS

This study indicates that stressed individual have markedly lower levels of DHEA-S. Given the important and beneficial functions of DHEA and DHEA-S, lower levels of DHEA-S may constitute one link between psychosocial stress, ill health and accelerated ageing.