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Tjøsvoll SO, Steiro Fimland M, Gonzalez V, Seeberg TM, Holtermann A, Færevik H, Wiggen Ø. Physical Work Demands of Maintenance Workers on Onshore Petroleum Facilities in Norway: An Observational Study Utilizing Wearable Sensor Technology. Ann Work Expo Health 2023; 67:706-719. [PMID: 37171985 PMCID: PMC10324642 DOI: 10.1093/annweh/wxad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVES High physical work demands can cause musculoskeletal disorders and sick leave in petroleum workers. However, our knowledge of their physical work demands is scarce and based on self-report. The objective of our study is to work towards closing this knowledge gap by assessing the physical work demands of onshore petroleum maintenance workers using body-worn sensors. METHODS A total of 46 of 69 eligible maintenance workers (37 mechanics and 9 process technicians) from three onshore petroleum facilities in Norway filled in a questionnaire and diary and wore five accelerometers and a heart rate sensor for up to six consecutive workdays. Work-related physical activity and postures were classified using rule-based modelling in a modified version of the validated Acti4 software. RESULTS The onshore maintenance petroleum workers were working an average of 10 h a day and spent on average this time with 48% (SD = 16.5) sitting, 1% (SD = 2.8) lying down, 39% (SD = 16.2) in light physical activity, and 9% (SD = 3.8) in moderate to vigorous physical activity. During work hours while at feet, we found arm elevation ≥60° to be 11% (SD = 7.1) (68 min), and forward bending of the trunk ≥60° to be 2% (SD = 2.2) (14 min). The workers spent 2% (SD = 2.5) (12 minu) of the workhours kneeling. We observed a high inter-individual variation for all these work exposures. Moreover, 26% (12) of the workers conducted static standing for >30% of the workday, and 17% (8) spent more than half of the work hours >33% of their estimated maximal cardiovascular capacity. CONCLUSIONS While onshore maintenance petroleum workers on average spend about half of the workday sitting or lying down, the remaining worktime is spent with a rather high duration of arm elevation and forward bending. Quite high fraction of the workers spends much of the workhours in static standing and kneeling. We see a substantial variation in these work exposures between the workers. The findings indicate a need for preventive measures in how work is organized and performed.
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Affiliation(s)
- Svein O Tjøsvoll
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Hysnesveien 11, 7112 Hasselvika, Norway
| | - Victor Gonzalez
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Trine M Seeberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
| | - Hilde Færevik
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
| | - Øystein Wiggen
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
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Lind CM, Abtahi F, Forsman M. Wearable Motion Capture Devices for the Prevention of Work-Related Musculoskeletal Disorders in Ergonomics-An Overview of Current Applications, Challenges, and Future Opportunities. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094259. [PMID: 37177463 PMCID: PMC10181376 DOI: 10.3390/s23094259] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023]
Abstract
Work-related musculoskeletal disorders (WMSDs) are a major contributor to disability worldwide and substantial societal costs. The use of wearable motion capture instruments has a role in preventing WMSDs by contributing to improvements in exposure and risk assessment and potentially improved effectiveness in work technique training. Given the versatile potential for wearables, this article aims to provide an overview of their application related to the prevention of WMSDs of the trunk and upper limbs and discusses challenges for the technology to support prevention measures and future opportunities, including future research needs. The relevant literature was identified from a screening of recent systematic literature reviews and overviews, and more recent studies were identified by a literature search using the Web of Science platform. Wearable technology enables continuous measurements of multiple body segments of superior accuracy and precision compared to observational tools. The technology also enables real-time visualization of exposures, automatic analyses, and real-time feedback to the user. While miniaturization and improved usability and wearability can expand the use also to more occupational settings and increase use among occupational safety and health practitioners, several fundamental challenges remain to be resolved. The future opportunities of increased usage of wearable motion capture devices for the prevention of work-related musculoskeletal disorders may require more international collaborations for creating common standards for measurements, analyses, and exposure metrics, which can be related to epidemiologically based risk categories for work-related musculoskeletal disorders.
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Affiliation(s)
- Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden
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Tjøsvoll SO, Wiggen Ø, Gonzalez V, Seeberg TM, Elez Redzovic S, Frostad Liaset I, Holtermann A, Steiro Fimland M. Assessment of Physical Work Demands of Home Care Workers in Norway: An Observational Study Using Wearable Sensor Technology. Ann Work Expo Health 2022; 66:1187-1198. [PMID: 35959647 PMCID: PMC9664225 DOI: 10.1093/annweh/wxac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/24/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES High physical work demands are believed to be partly responsible for the high sickness absence among home care workers, but no studies have assessed their physical work demands using precise device-based measurements. Hence, the objective of this observational study was to assess physical work demands in home care, using wearable sensors. METHODS From six home care units in a large municipality in Norway, 114 of 195 eligible home care workers filled in a questionnaire, a diary about work hours, and wore five accelerometers, and a heart rate sensor for up to six consecutive workdays. RESULTS On average, the homecare workers spent 50% of the working hours sitting, 25.2% standing, 11.4% moving, 8.3% walking fast, 1.9% walking slow, 1.2% stair-climbing, 0.3% cycling, and 0.05% running. We found the following exposures to demanding postures: arm-elevation in an upright body position ≥30° was 36.7%, ≥60° was 4.1%, and ≥90°was 0.5%; forward trunk inclination in an upright body position ≥30° was 9.9%, ≥60° was 4%, and ≥90° was 1%; and for kneeling it was 0.8%. We found the average cardiovascular load (%heart rate reserve) during work to be 28%. There was considerable individual variation in these physical exposures at work. CONCLUSIONS This study presents precise information on various physical work demands of home care workers in Norway. Home care workers spent on average half the workday sitting and the remaining time in various occupational physical activities. Presently, few device-based exposure limits have been proposed for acceptable amounts of occupational physical exposures, but the level of arm-elevation, forward trunk inclination, and the considerable variation of physical workloads among home care workers, indicate that preventive measures should be taken.
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Affiliation(s)
| | - Øystein Wiggen
- Health Research, SINTEF DIGITAL, SINTEF AS, Trondheim, Norway
| | - Victor Gonzalez
- Smart Sensor Systems, SINTEF DIGITAL, SINTEF AS, Oslo, Norway
| | - Trine M Seeberg
- Smart Sensor Systems, SINTEF DIGITAL, SINTEF AS, Oslo, Norway
| | - Skender Elez Redzovic
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingeborg Frostad Liaset
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lerso Parkalle, Copenhagen, Denmark
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
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Gupta N, van Dongen JM, Holtermann A, van der Beek AJ, Stevens ML, Nørregaard Rasmussen CD. Cost-Effectiveness and Return-on-Investment of a Participatory Ergonomics Intervention Among Childcare Workers: An Economic Evaluation in a Randomized Controlled Trial. J Occup Environ Med 2022; 64:533-539. [PMID: 35143453 PMCID: PMC9275851 DOI: 10.1097/jom.0000000000002510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the cost-effectiveness and return-on-investment (ROI) of 20-week ergonomic intervention to reduce physical exertion at work compared with usual-practice among childcare workers. METHODS One hundred ninety workers from 16 institutions were cluster-(institute)-randomized to intervention (n = 96) and usual-practice (n = 94) group. The intervention group participated in three workshops to develop/implement action plans improving ergonomic conditions. The rating of physical exertion (RPE) was measured at baseline and 20-weeks. Employer-perspective-based costs of intervention, absenteeism, and presenteeism were estimated. RESULTS Although statistically non-significant, one-unit reduction in RPE was associated with saving of 592 EUR/worker. Per-EUR invested by the employer was associated with 1.6 EUR (95% CI: -3.1; 6.5) return in the intervention compared with usual practice. CONCLUSION The intervention tended to gain monetary benefit for the employer. The results should be replicated in larger populations for improved precision of economic evaluation estimates.Trial registration: ISRCTN10928313.
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Affiliation(s)
- Nidhi Gupta
- From the Department of Musculoskeletal Disorders and PhysicalWork Demands, The National Research Centre for the Working Environment, Copenhagen, Denmark (Dr Gupta, Dr Holtermann, Dr Stevens, Dr Rasmussen); Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute (Dr van Dongen); Department of Public and Occupational Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (Dr van der Beek)
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Laudanski AF, Buchman-Pearle JM, Acker SM. Quantifying high flexion postures in occupational childcare as they relate to the potential for increased risk of knee osteoarthritis. ERGONOMICS 2022; 65:253-264. [PMID: 34397308 DOI: 10.1080/00140139.2021.1969041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
High knee flexion postures, despite their association with increased incidences of osteoarthritis, are frequently adopted in occupational childcare. This study sought to define and quantify high flexion postures typically adopted in childcare to evaluate any increased likelihood of knee osteoarthritis development. Through video analysis of eighteen childcare workers caring for infant, toddler, and preschool-aged children, eight high knee flexion postures were identified and quantified by duration and frequency. An analysis of postural adoption by task was subsequently performed to determine which might pose the greatest risk for cumulative joint trauma. Childcare workers caring for children of all ages were found to adopt kneeling and seated postures for extended durations and at elevated frequencies, exceeding proposed thresholds for incidences of knee osteoarthritis development. Structured activities, playing, and feeding tasks demanded the greatest adoption of high flexion postures and should be evaluated to minimise the potential childcare-related risks of osteoarthritis. Practitioner summary: High knee flexion postures (kneeling, squatting, etc.) have been associated with increased incidences of knee injury yet are commonly adopted in childcare. Childcare workers' postures were examined through video analysis revealing that proposed adoption thresholds for knee health are commonly exceeded when caring for children of all ages. Abbreviations: OA: osteoarthritis; WSIB: workplace safety insurance board; CAD: Canadian Dollar; DK: dorsiflexed kneeling; PK: plantarflexed kneeling; SAK: single arm supported kneeling; DAK: double arm supported kneeling; FS: flatfoot squatting; HS: heels up squatting; FLRS: floor sitting; SS: side sitting or leaning; STLS: stool sitting; BR: bending and reaching.
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Affiliation(s)
- Annemarie F Laudanski
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Jessa M Buchman-Pearle
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Stacey M Acker
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
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Does Childcare Work Promote Cardiorespiratory Fitness and Health? A Cross-Sectional Study of Danish Childcare Workers Based on Accelerometry and Heart Rate Measurements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312496. [PMID: 34886220 PMCID: PMC8656773 DOI: 10.3390/ijerph182312496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022]
Abstract
Childcare workers are reported to have poor cardiorespiratory fitness and health. The Goldilocks Work Principle argues that productive work should be designed with the right composition, intensity and alternations of physical behaviors so that workers get fit and healthy. The purpose of this study was to investigate: (1) composition, (2) intensity and (3) alternations of physical behaviors during work and leisure among childcare workers. Data were collected using accelerometers and heart rate monitors over five workdays among 51 childcare workers at five Danish childcare institutions. Workers mainly spent their work time sedentary (43.0%), spent little time (0.7%) at sufficiently high cardiometabolic intensity to increase cardiorespiratory fitness and often alternated between physical behaviors (67.0% occurred in bouts of <5 min). These findings indicate that the workers have a composition of behaviors at work dominated by sedentary time, little time with high cardiometabolic intensity, and frequent alternations between behaviors. During leisure, workers spent more time sedentary (59.4%), more time at high cardiometabolic intensity (3.4%) and less time occurred in bouts <5 min (38.7%). We see a potential for promoting cardiorespiratory fitness and health of childcare workers by redesigning the way they play with the children, so that work time with high cardiometabolic intensity is increased.
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Fan X, Lind CM, Rhen IM, Forsman M. Effects of Sensor Types and Angular Velocity Computational Methods in Field Measurements of Occupational Upper Arm and Trunk Postures and Movements. SENSORS 2021; 21:s21165527. [PMID: 34450967 PMCID: PMC8401405 DOI: 10.3390/s21165527] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
Accelerometer-based inclinometers have dominated kinematic measurements in previous field studies, while the use of inertial measurement units that additionally include gyroscopes is rapidly increasing. Recent laboratory studies suggest that these two sensor types and the two commonly used angular velocity computational methods may produce substantially different results. The aim of this study was, therefore, to evaluate the effects of sensor types and angular velocity computational methods on the measures of work postures and movements in a real occupational setting. Half-workday recordings of arm and trunk postures, and movements from 38 warehouse workers were compared using two sensor types: accelerometers versus accelerometers with gyroscopes-and using two angular velocity computational methods, i.e., inclination velocity versus generalized velocity. The results showed an overall small difference (<2° and value independent) for posture percentiles between the two sensor types, but substantial differences in movement percentiles both between the sensor types and between the angular computational methods. For example, the group mean of the 50th percentiles were for accelerometers: 71°/s (generalized velocity) and 33°/s (inclination velocity)-and for accelerometers with gyroscopes: 31°/s (generalized velocity) and 16°/s (inclination velocity). The significant effects of sensor types and angular computational methods on angular velocity measures in field work are important in inter-study comparisons and in comparisons to recommended threshold limit values.
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Affiliation(s)
- Xuelong Fan
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
| | - Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Correspondence:
| | - Ida-Märta Rhen
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
- Department of Industrial and Materials Science, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
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Lerche AF, Vilhelmsen M, Schmidt KG, Kildedal R, Launbo N, Munch PK, Lidegaard M, Jacobsen SS, Rasmussen CL, Mathiassen SE, Straker L, Holtermann A. Can Childcare Work Be Designed to Promote High Intensity Physical Activity for Improved Fitness and Health? A Proof of Concept Study of the Goldilocks Principle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207419. [PMID: 33053791 PMCID: PMC7600739 DOI: 10.3390/ijerph17207419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
Childcare workers are reported to have high variation in physical activity during work hours, but also to sit for about half of the workday and have almost no high intensity physical activity (HIPA). No study has investigated if their work can be re-designed to introduce HIPA, thus promoting fitness and health according to the Goldilocks principle. This study investigated the feasibility of designing pedagogical games (‘Goldilocks-games’) intended to lead to more HIPA. Heart rate was measured in nineteen childcare workers during Goldilocks-games, and compared to measurements during a regular workday. Worker perceptions of feasibility, and researcher observations of contextual factors were also collected. The Goldilocks-games (33 min) elicited significantly more HIPA (18/33 min) compared to the most active period of equal length on a regular workday (0.5/33 min). Seventy-four-percent of the childcare workers reported that it was feasible to integrate the Goldilocks-games pedagogically, and seventy-two-percent could see themselves using them. Thus, we found it possible to re-design a work task in childcare according to the Goldilocks principle so that it leads to substantial time with HIPA. The sustainability of Goldilocks-games in childcare, and their effectiveness in improving fitness and health among childcare workers, needs to be tested in further studies.
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Affiliation(s)
- Anders Fritz Lerche
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence:
| | - Maja Vilhelmsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Kathrine Greby Schmidt
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Rasmus Kildedal
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Natja Launbo
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Mark Lidegaard
- Novo Nordisk Health & Safety, Novo Nordisk A/S, 2880 Bagsværd, Denmark;
| | - Sandra Schade Jacobsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Charlotte Lund Rasmussen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden;
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia;
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
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