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Alkosha HM, Mohammed MIR, Amen MM. Risk Assessment and Prevalence of Work-Related Musculoskeletal Disorders Among Cranial and Spinal Neurosurgeons. World Neurosurg 2023; 176:e151-e161. [PMID: 37178909 DOI: 10.1016/j.wneu.2023.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To assess the risk and prevalence of work-related musculoskeletal disorders (WMSDs) in spine and cranial surgeons. METHODS A cross-sectional analytic study composed of a risk assessment and a questionnaire-based survey was conducted. The risk assessment for WMSDs was performed on young volunteer neurosurgeons using the Rapid Entire Body Assessment tool. The survey-based questionnaire was distributed using the Google Forms software among the relevant official WhatsApp groups of the Egyptian Society of Neurological Surgeons and the Egyptian Spine Association. RESULTS Thirteen volunteers with a median service of 8 years were assessed for the risk of WMSDs, showing moderate to very high risk of WMSDs, with a Risk Index >1 for all assessed postures. A total of 232 respondents completed the questionnaire, 74% of whom reported WMSD symptoms. Pain was experienced by most (96%), with neck pain being the most common (62.8%), followed by low back pain (56.0%), shoulder pain (44.5%), and wrist/finger pain (43.9%). Pain was experienced for 1-3 years by most respondents; however, most did not reduce their case volume, seek medical advice, or stop working when they experienced pain. The survey showed shortage in the literature studying ergonomics, calling for more ergonomic education and furnishing of working environment of neurosurgeons. CONCLUSIONS WMSDs are prevalent among neurosurgeons, affecting their ability to work. Ergonomics need further awareness, education, and interventions to reduce WMSDs, especially neck and low back pain, which proved to substantially interfere with work ability.
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Affiliation(s)
- Hazem M Alkosha
- Department of Neurosurgery, Mansoura University, Dakahlia, Egypt.
| | | | - Mohamed M Amen
- Department of Neurosurgery, Mansoura University, Dakahlia, Egypt
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Tang R, Kapellusch JM, Hegmann KT, Thiese MS, Wang I, Merryweather AS. Evaluating Different Measures of Low Back Pain Among U.S. Manual Materials Handling Workers: Comparisons of Demographic, Psychosocial, and Job Physical Exposure. HUMAN FACTORS 2022; 64:973-996. [PMID: 33300376 DOI: 10.1177/0018720820971101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine differences in demographic, psychosocial, and job physical exposure risk factors between multiple low back pain (LBP) outcomes in a prospective cohort of industrial workers. BACKGROUND LBP remains a leading cause of lost industrial productivity. Different case definitions involving pain (general LBP), medication use (M-LBP), seeking healthcare (H-LBP), and lost time (L-LBP) are often used to study LBP outcomes. However, the relationship between these outcomes remains unclear. METHOD Demographic, health status, psychosocial, and job physical exposure risk factors were quantified for 635 incident-eligible industrial workers. Incident cases of LBP outcomes and pain symptoms were quantified and compared across the four outcomes. RESULTS Differences in age, gender, medical history, and LBP history were found between the four outcomes. Most incident-eligible workers (67%) suffered an LBP outcome during follow-up. Cases decreased from 420 for LBP (25.4 cases/100 person-years) to 303 for M-LBP (22.0 cases/100 person-years), to 151 for H-LBP (15.6 cases/100 person-years), and finally to 56 for L-LBP (8.7 cases/100 person-years). Conversely, pain intensity and duration increased from LBP to H-LBP. However, pain duration was relatively lower for L-LBP than for H-LBP. CONCLUSION Patterns of cases, pain intensity, and pain duration suggest the influence of the four outcomes. However, few differences in apparent risk factors were observed between the outcomes. Further research is needed to establish consistent case definitions. APPLICATION Knowledge of patterns between different LBP outcomes can improve interpretation of research and guide future research and intervention studies in industry.
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Affiliation(s)
- Ruoliang Tang
- 12530 Sichuan University-Pittsburgh Institute, Chengdu, China
- 14751 University of Wisconsin-Milwaukee, USA
| | | | | | | | - Inga Wang
- 14751 University of Wisconsin-Milwaukee, USA
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Park JH, Srinivasan D. The effects of prolonged sitting, standing, and an alternating sit-stand pattern on trunk mechanical stiffness, trunk muscle activation and low back discomfort. ERGONOMICS 2021; 64:983-994. [PMID: 33565921 DOI: 10.1080/00140139.2021.1886333] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Sit-stand desks continue to be a popular intervention for office work. While previous studies have reported changes in subjective measures, there is limited understanding of how sit-stand work differs from prolonged sitting or standing work, from a biomechanical standpoint. The objective of this study was to investigate the effects of prolonged sitting, prolonged standing, and a sit-stand paradigm on changes in trunk stiffness, low back discomfort, and trunk muscle activation. Twelve healthy participants performed 2 h of computer-based tasks in each protocol, on three different days. The sit-stand protocol was associated with a significant increase in trunk stiffness and a decrease in muscle activation of lumbar multifidus and longissimus thoracis pars thoracis, compared to both prolonged sitting and standing. Both sitting and standing were associated with increased low back discomfort. These findings may be worth exploring in more detail, for why alternating sit-stand patterns may help alleviate low back pain. Practitioner summary: We explored changes in objective and subjective measures related to low back discomfort following prolonged sitting, standing, and alternating sit-stand patterns. Alternating sit-stand pattern was associated with increased trunk stiffness and decreased back muscle activity. Hence, sit-stand desks may have benefits in terms of preventing/mitigating low back pain. Abbreviations: DOF: degree of freedom; EMG: electromyogram; ILL: iliocostalis lumborum pars lumborum; LTL: longissimus thoracis pars lumborum; LTT: longissimus thoracis pars thoracis; LBP: low back pain; LM: lumbar multifidus; MVEs: maximum isometric voluntary exertions; RANOVA: repeated-measure analysis of variance; RMS: root mean square.
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Affiliation(s)
- Jang-Ho Park
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Divya Srinivasan
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA, USA
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Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey. Acta Neurochir (Wien) 2021; 163:1541-1552. [PMID: 33594483 PMCID: PMC8116287 DOI: 10.1007/s00701-021-04722-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/14/2021] [Indexed: 02/07/2023]
Abstract
Background Work-related musculoskeletal disorders (WMSDs) affect a significant percentage of the neurosurgical workforce. The aim of the current questionnaire-based study was to examine the prevalence of WMSDs amongst neurosurgeons, identify risk factors, and study the views of neurosurgeons regarding ergonomics. Methods From June to August 2020, members of the “European Association of Neurosurgical Societies,” the “Neurosurgery Research Listserv,” and the “Latin American Federation of Neurosurgical Societies” were asked to complete an electronic questionnaire on the topics of WMSDs and ergonomics. Results A total of 409 neurosurgeons responded to the survey, with a 4.7 male to female ratio. Most of the surgeons worked in Europe (76.9%) in academic public hospitals. The vast majority of the participants (87.9%) had experienced WMSDs, mainly affecting the shoulder, neck, and back muscles. The most common operations performed by the participants were “Craniotomy for convexity/intrinsic tumors” (24.1%) and “Open lumbar basic spine” (24.1%). Neurosurgeons agreed that ergonomics is an underexposed area in the neurosurgical field (84.8%) and that more resources should be spend (87.3%) and training curricula changes should be made (78.3%) in order to alleviate the burden of WMSDs on neurosurgeons. Univariate analysis did not reveal any associations between the development of WMSDs and age, gender, tenure, average duration of operation, operating time per week, type of operation, and surgical approach. Conclusions The problem of WMSDs ought to be more closely addressed and managed by the neurosurgical community. More studies ought to be designed to investigate specific ergonomic parameters in order to formulate practice recommendations. Supplementary Information The online version contains supplementary material available at 10.1007/s00701-021-04722-5.
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Fang N, Zhang C, Lv J. Effects of Vertical Lifting Distance on Upper-Body Muscle Fatigue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105468. [PMID: 34065333 PMCID: PMC8160884 DOI: 10.3390/ijerph18105468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 11/26/2022]
Abstract
Manual material handling (MMH) is commonly demanded in the manufacturing industry. Occupational muscle fatigue of the arm, shoulder, and back, which arise from MMH tasks, can cause work absences and low efficiency. The available literature presents the lack of the fatigue comparison between targeted muscles, on the same part or on different parts. The main aim of the present study was to evaluate and compare the fatigue of upper-body muscles during repetitive bending tasks, an experiment involving 12 male subjects has been conducted to simulate material handling during furniture board drilling. The vertical lifting distance was chosen to be the single independent variable, and the three levels were 0, 250, and 500 mm. Surface electromyography (sEMG) was used to measure the muscle fatigue of the biceps brachii, upper trapezius, and multifidus, while the sEMG parameters, including the normalized electromyographic amplitude (Normalized EA) and mean power frequency (MPF), of the target muscles were analyzed. The experimental results reveal that during the manual handling tasks, the biceps brachii was the most relaxed muscle, contributing the least muscle tension, while the multifidus was the most easily fatigued muscle. Furthermore, the EMG MPF fatigue threshold (MPFFT) of multifidus muscle tension was tested to estimate its maximum workload in the long-term muscle contraction. In conclusion, bending angle should be maintained to a small range or bending should even be avoided during material-handling tasks.
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Affiliation(s)
- Nianli Fang
- Key Laboratory of Advanced Manufacturing Technology of the Ministry of Education, Guizhou University, Guiyang 550025, China;
| | - Chang Zhang
- School of Mechanical Engineering, Southeast University, Nanjing 211189, China
- Correspondence: (C.Z.); (J.L.)
| | - Jian Lv
- Key Laboratory of Advanced Manufacturing Technology of the Ministry of Education, Guizhou University, Guiyang 550025, China;
- Correspondence: (C.Z.); (J.L.)
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Back pain occurrence and treatment-seeking behavior among nurses: the role of work-related emotional burden. Qual Life Res 2020; 29:1301-1310. [PMID: 31900762 DOI: 10.1007/s11136-019-02405-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To assess the association of back pain and treatment-seeking behavior for such pain with work-related emotional burden (regret about care), regret coping strategies, and physical burden among newly practicing nurses. METHODS We used data from the Impact of Care-related Regret Upon Sleep (ICARUS) cohort collected between 05.2017 and 07.2018 using web-based surveys (weekly for measures of emotional burden, physical burden and coping strategies, and monthly for back pain and seeking care). We investigated immediate associations and temporal influences between burdens and back pain with linear mixed models and cross-lagged Bayesian models, respectively. Coefficients were standardized to allow comparison between burdens. Logistic regression was used to examine the association of burdens with seeking care. RESULTS Among 105 nurses with an average follow-up of 3 months, 80 reported at least one episode of back pain. Neither physical nor emotional burdens had an immediate association with back pain. However, number of days with back pain in a given month was associated with an increase in both burdens during the previous month, with similar degrees of association (emotional: b = 0.24, physical: b = 0.21). Decision to seek treatment was associated with an increase in back pain frequency (OR 1.12, p = 0.04) and intensity (OR 1.80, p = 0.002) and a decrease in emotional burden (OR 0.95, p = 0.03). Coping strategies were associated neither with the occurrence of back pain nor with care-seeking. CONCLUSION While both emotional and physical burdens were associated with increased frequency of back pain the following month, emotional burden additionally showed a negative association with the decision to seek care.
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Wang MH, Chen YL, Chiou WK. Using the OVAKO working posture analysis system in cleaning occupations. Work 2019; 64:613-621. [PMID: 31658093 DOI: 10.3233/wor-193022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cleaning workers experience severe musculoskeletal symptoms. OBJECTIVE The objective of this paper was to examine musculoskeletal symptoms in cleaners of different heights to evaluate the effects of height on working postures in the work environment (schools). METHODS We used a three-stage method including using the Nordic Musculoskeletal Questionnaire (NMQ) to evaluate musculoskeletal symptoms, a task analysis to confirm typical cleaning tasks, and the OVAKO Working Posture Assessment System (OWAS) for posture analysis. Multinomial logistic regression was performed to evaluate the adjusted effects of individual characteristics on painful body regions, using individuals without any pain as the reference category. RESULTS This study found that the prevalence of musculoskeletal symptoms is very high for cleaners, especially in the shoulders, elbows, and lower back. Odds ratios for the accumulation of two or more risk factors were higher among men and were inversely associated with national economic indicators. The relatively high prevalence of musculoskeletal symptoms may stem from the multiple operations involved in cleaning tasks, such as trash collecting, floor mopping, toilet cleaning, and mirror polishing. Workers of different heights had differential work loadings for different tasks. CONCLUSIONS This paper proposes recommendations for job adaptations and occupational safety training. Cleaners of different heights execute the typical tasks via different postures, and awkward postures often result in musculoskeletal symptoms. Cleaners should be provided with specific tools and training regarding working postures on the basis of height. These findings can be used as a reference for related operation designs and task improvements to ensure correct tool usage and safer working postures during cleaning.
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Affiliation(s)
- Ming-Hsu Wang
- Center for General Education, Affiliated with College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan, R.O.C
| | - Yi-Lang Chen
- Department of Industrial Engineering and Management, Ming Chi University of Technology, New Taipei, Taiwan, R.O.C
| | - Wen-Ko Chiou
- Department of Industrial Design, College of Management, Chang Gung University, affiliated with Division of Metabolism, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan, R.O.C
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Monnier A, Larsson H, Nero H, Djupsjöbacka M, Äng BO. A longitudinal observational study of back pain incidence, risk factors and occupational physical activity in Swedish marine trainees. BMJ Open 2019; 9:e025150. [PMID: 31092646 PMCID: PMC6530317 DOI: 10.1136/bmjopen-2018-025150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course. DESIGN Prospective observational cohort study with weekly follow-ups. PARTICIPANTS Fifty-three SwAF marines entering the training course. OUTCOMES Incident of LBP and its related effect on work-ability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports. RESULTS During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate of 13.5 (95% CI 10.4 to 17.8) and 6.3 (95% CI 4.2 to 10.0) episodes per 1000 person-days, respectively. Previous back pain and shorter body height (≤1.80 m) emerged as independent risks for LBP (HR 2.5, 95% CI 1.4 to 4.3; HR 2.0, 95% CI 1.2 to 3.3, respectively), as well as for LBP that limited work ability (HR 3.6, 95% CI 1.4 to 8.9; HR 4.5, 95% CI 2.0 to 10.0, respectively). Furthermore, managing fewer than four pull-ups emerged as a risk for LBP (HR 1.9, 95% CI 1.2 to 3.0), while physical training of fewer than three sessions per week emerged as a risk for LBP that limited work ability (HR 3.0, 95% CI 1.2 to 7.4). More than 80% of the work time measured was spent performing low levels of ambulation, however, combat equipment (≥17.5 kg) was carried for more than half of the work time. CONCLUSIONS Incidents of LBP are common in SwAF marines' early careers. The link between LBP and previous pain as well as low levels of exercise highlights the need for preventive actions early on in a marine's career. The role of body height on LBP needs further investigation, including its relationship with body-worn equipment, before it can effectively contribute to LBP prevention.
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Affiliation(s)
- Andreas Monnier
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Swedish Armed Forces, Military Academy Karlberg, Stockholm, Sweden
| | - Helena Larsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Swedish Armed Forces, Headquarters, Medical Services, Stockholm, Sweden
| | - Håkan Nero
- Department of Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden
| | - Mats Djupsjöbacka
- Centre for Musculoskeletal Research, Department of Occupational Health Science and Psychology, University of Gävle, Gävle, Sweden
| | - Björn O Äng
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Center for Clinical Research, Uppsala University, Falun, Sweden
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Abstract
Acute low back pain, defined as less than 6 weeks in duration, does not require imaging in the absence of "red flags" that may indicate a cause, such as fracture, infection, or malignancy. When imaging is indicated, it is important to rule out a host of abnormalities that may be responsible for the pain and any associated symptoms. A common mnemonic VINDICATE can help ensure a thorough consideration of the possible causes.
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Affiliation(s)
- Scott M Johnson
- Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East, Room 1A71, Salt Lake City, UT 84132, USA
| | - Lubdha M Shah
- Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East, Room 1A71, Salt Lake City, UT 84132, USA.
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Tebyetekerwa M, Akankwasa NT, Marriam I. The Current Working Conditions in Ugandan Apparel Assembly Plants. Saf Health Work 2017; 8:378-385. [PMID: 29276637 PMCID: PMC5715488 DOI: 10.1016/j.shaw.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/09/2017] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required. METHODS A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work. RESULTS The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies. CONCLUSION The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.
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Affiliation(s)
- Mike Tebyetekerwa
- College of Material Science and Engineering, Donghua University, Shanghai, PR China
- Faculty of Science, Kyambogo University, Kampala, Uganda
| | - Nicholus Tayari Akankwasa
- Faculty of Science, Kyambogo University, Kampala, Uganda
- College of Textile Science and Engineering, Donghua University, Shanghai, PR China
| | - Ifra Marriam
- College of Textile Science and Engineering, Donghua University, Shanghai, PR China
- College of Textile Engineering, Mehran University of Engineering and Technology, Jamshoro, Pakistan
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Assessment of the Psychosocial Work Environment among Health Care Workers and Its Association with Work and Socioeconomic Status. ARCHIVES OF NEUROSCIENCE 2017. [DOI: 10.5812/archneurosci.13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Waldenström MÅ, Theorell T, Ahlberg G, Josephson M, Nise P, Waldenström K, VingÅrd E. Assessment of psychological and social current working conditions in epidemiological studies: experiences from the MUSIC-Norrtälje study. Scand J Public Health 2016. [DOI: 10.1177/14034948020300020301] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The aim of this study was to present, evaluate and propose a tool for the assessment of psychosocial working conditions in epidemiological studies. A referent group of the large epidemiological study, the MUSIC-Norrtälje study of musculoskeletal disorders, was used. The respondents were 950 working persons (585 female and 365 male). Method: Self-administered questionnaire and personal interview were used. The responses were subjected to factor analysis. The resulting model had components generated from the demand-control-support model and action theory. Result: The result supported the use of different aspects of psychological job demands. The interview data seemed to be more related to factual exposure and the questionnaire data more to individual perception. The usefulness of the model was supported by associations between the model and psychosomatic symptoms and sleep disturbances. Conclusion : A combination of interview and questionnaire increases the possibility of interpreting the association between working conditions and health and may provide a more effective basis for interventions.
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Affiliation(s)
| | - Töres Theorell
- National Swedish Institute for Psychosocial Factors and Health
| | | | - Malin Josephson
- Section for Personal Injury Prevention, Karolinska Institute, Stockholm, Sweden
| | - Patrik Nise
- Deparement of Occupational Health, Stockholm County Council
| | | | - Eva VingÅrd
- Section for Personal Injury Prevention, Karolinska Institute, Stockholm, Sweden
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Monnier A, Larsson H, Djupsjöbacka M, Brodin LÅ, Äng BO. Musculoskeletal pain and limitations in work ability in Swedish marines: a cross-sectional survey of prevalence and associated factors. BMJ Open 2015; 5:e007943. [PMID: 26443649 PMCID: PMC4606426 DOI: 10.1136/bmjopen-2015-007943] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of self-rated musculoskeletal pain and pain limiting work ability in Swedish Armed Forces (SAF) marines, and to study factors potentially associated with pain limiting work ability for the most prevalent pain regions reported. DESIGN Population-based, cross-sectional survey. PARTICIPANTS There were 272 SAF marines from the main marine battalion in Sweden included in the study. OUTCOMES Self-assessed musculoskeletal pain and pain limiting the marines' work ability within a 6-month period, as obtained from structured questionnaires. The association of individual, health and work-related factors with musculoskeletal pain limiting work ability was systematically regressed with multiple logistic models, estimating OR and 95% CI. RESULTS Musculoskeletal pain and pain limiting work ability were most common in the back, at 46% and 20%, and lower extremities at 51% and 29%, respectively. Physical training ≤1 day/week (OR 5.3, 95% CI 1.7 to 16.8); body height ≤1.80 m (OR 5.0, 95% CI 1.6 to 15.1) and ≥1.86 m (OR 4.4, 95% CI 1.4 to 14.1); computer work 1/4 of the working day (OR 3.2, 95% CI 1.0 to 10.0) and ≥1/2 (OR 3.3, 95% CI 1.1 to 10.1) of the working day were independently associated with back pain limiting work ability. None of the studied variables emerged significantly associated with such pain for the lower extremities. CONCLUSIONS Our findings show that musculoskeletal pain and resultant limitations in work ability are common in SAF marines. Low frequency of physical training emerged independently associated with back pain limiting work ability. This suggests that marines performing physical training 1 day per week or less are suitable candidates for further medical evaluation and secondary preventive actions. While also associated, body height and computer work need further exploration as underlying mechanisms for back pain limiting work ability. Further prospective studies are necessary to clarify the direction of causality.
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Affiliation(s)
- Andreas Monnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Swedish Armed Forces, Regional Medical Service Mälardalen, Berga, Sweden
| | - Helena Larsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Swedish Armed Forces, HR Centre, Stockholm, Sweden
| | - Mats Djupsjöbacka
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Lars-Åke Brodin
- Department of Medical Engineering, School of Technology and Health, KTH Royal Institute of Technology, Huddinge, Sweden
| | - Björn O Äng
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm, Sweden
- Centre for Clinical Research Dalarna, Falun, Sweden
- Karolinska University Hospital, Stockholm, Sweden
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Manchikanti L, Singh V, Falco FJE, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation 2015; 17 Suppl 2:3-10. [PMID: 25395111 DOI: 10.1111/ner.12018] [Citation(s) in RCA: 328] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 11/07/2012] [Accepted: 11/25/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Low back pain affects many individuals. It has profound effects on well-being and is often the cause of significant physical and psychological health impairments. Low back pain also affects work performance and social responsibilities, such as family life, and is increasingly a major factor in escalating health-care costs. A global review of the prevalence of low back pain in the adult general population has shown its point prevalence to be approximately 12%, with a one-month prevalence of 23%, a one-year prevalence of 38%, and a lifetime prevalence of approximately 40%. Furthermore, as the population ages over the coming decades, the number of individuals with low back pain is likely to increase substantially. This comprehensive review is undertaken to assess the increasing prevalence of low back pain and the influence of comorbid factors, along with escalating costs. MATERIALS AND METHODS A narrative review with literature assessment. RESULTS In the USA, low back pain and related costs are escalating. Based on the available literature, it appears that the prevalence of low back pain continues to increase, along with numerous modalities and their application in managing low back pain. Comorbid factors with psychological disorders and multiple medical problems, including obesity, smoking, lack of exercise, increasing age, and lifestyle factors, are considered as risk factors for low back pain. CONCLUSION Although it has been alleged that low back pain resolves in approximately 80% to 90% of patients in about six weeks, irrespective of the administration or type of treatment, with only 5% to 10% of patients developing persistent back pain, this concept has been frequently questioned as the condition tends to relapse and most patients experience multiple episodes years after the initial attack.
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Affiliation(s)
- Laxmaiah Manchikanti
- Pain Management Center of Paducah, Paducah, KY, USA; University of Louisville, Louisville, KY, USA
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Ramond-Roquin A, Bodin J, Serazin C, Parot-Schinkel E, Ha C, Richard I, Petit Le Manach A, Fouquet N, Roquelaure Y. Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees. Spine J 2015; 15:559-69. [PMID: 23856655 DOI: 10.1016/j.spinee.2013.05.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 02/12/2013] [Accepted: 05/22/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) is a major public health problem, with a considerable impact on workers. PURPOSE To model the risk of LBP in the male general working population. STUDY DESIGN/SETTING Repeated cross-sectional surveys in a wide occupational setting. PATIENT SAMPLE A random sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002, and 1,313 of these (60.8%) participated in a second survey in 2007. OUTCOME MEASURE The self-reported prevalence of LBP during the previous week in the second survey. METHODS Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey. The association between these potential risk factors and the prevalence of later LBP (in the second survey) was studied, using multistep logistic regression models. RESULTS Three hundred ninety-four men reported LBP in the second survey (prevalence 30.0%). The final multivariate model highlighted four risk factors: frequent bending (odds ratio [OR], 1.45, 95% confidence interval [CI], 1.07-1.97 for bending forward only; and OR, 2.13, 95% CI, 1.52-3.00 for bending both forward and sideways), driving industrial vehicles (OR, 1.35; 95% CI, 1.00-1.81), working more hours than officially planned (OR, 1.38; 95% CI, 1.05-1.81), and reported low support from supervisors (OR, 1.35; 95% CI, 1.02-1.79). CONCLUSIONS These results emphasize that biomechanical factors remain worth considering, even when psychosocial factors are taken into account, and provide a significant contribution to preventive strategies.
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Affiliation(s)
- Aline Ramond-Roquin
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Department of General Practice, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France.
| | - Julie Bodin
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France
| | - Céline Serazin
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France
| | - Elsa Parot-Schinkel
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Clinical Research Centre, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cédex, France
| | - Catherine Ha
- Department of Occupational Health, French Institute for Public Health Surveillance, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Isabelle Richard
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Regional Centre for Rehabilitation of Angers, rue des Capucins, B.P. 40329, 49103 Angers Cedex 02, France
| | - Audrey Petit Le Manach
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Department of Occupational Health, Faculty of Medicine, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cédex, France
| | - Natacha Fouquet
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Department of Occupational Health, French Institute for Public Health Surveillance, 12 rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
| | - Yves Roquelaure
- Laboratory of Ergonomics and Epidemiology in Occupational Health, Faculty of Medicine, University of Angers, Rue Haute de Reculée, 49045 Angers Cedex 01, France; Department of Occupational Health, Faculty of Medicine, University Hospital of Angers, 4, rue Larrey, 49933 Angers Cédex, France
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Gupta N, Christiansen CS, Hallman DM, Korshøj M, Carneiro IG, Holtermann A. Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study. PLoS One 2015; 10:e0121159. [PMID: 25806808 PMCID: PMC4373888 DOI: 10.1371/journal.pone.0121159] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 02/06/2015] [Indexed: 11/19/2022] Open
Abstract
Background Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis. Objectives To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers. Methods Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤5) or high (>5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time). Results The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR=1.43, 95%CI=1.15-1.77, P=0.01). Similar results were obtained for leisure-time sitting (OR=1.45, 95%CI=1.10-1.91, P=0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR=1.34, 95%CI 0.99-1.82, P=0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR=3.31, 95%CI=1.18-9.28, P=0.03), leisure (OR=5.31, 95%CI=1.57-17.90, P=0.01), and occupational (OR=3.26, 95%CI=0.89-11.98, P=0.08) periods, referencing those with low sitting time. Conclusion Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended.
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Affiliation(s)
- Nidhi Gupta
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
- * E-mail:
| | | | - David M. Hallman
- Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Mette Korshøj
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Isabella Gomes Carneiro
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, Copenhagen, Denmark
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Abstract
This chapter discusses mechanical stressors that are believed to be associated with work-related musculoskeletal disorders. It starts with an introduction to work-related musculoskeletal disorders (particularly those with high incidences in workplaces, such as disorders of low back, neck/shoulder, hand/wrist, elbow, and knee) in high-risk industries, and those mechanical stressors (such as high forces, awkward postures, high repetitions, excessive contact stress, and harmful human vibrations) in workplaces that are responsible for these disorders. Quantification methods of these mechanical stressors are then discussed. Although various quantification methods such as self-report, observational technique, and direct measurement are discussed, details are focused on many of those well-published observational techniques used by practitioners to assess risk levels of these mechanical stressors in jobs. These methods can quantify job mechanical stressors and provide risk level indications that can be used by practitioners to facilitate their decision making. These methods can also be used to evaluate the improvements of ergonomics interventions by comparing the risk levels quantitatively before and after the interventions.
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Reeuwijk KG, Robroek SJW, Hakkaart L, Burdorf A. How work impairments and reduced work ability are associated with health care use in workers with musculoskeletal disorders, cardiovascular disorders or mental disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:631-639. [PMID: 24390780 PMCID: PMC4229647 DOI: 10.1007/s10926-013-9492-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of this study was to explore how work impairments and work ability are associated with health care use by workers with musculoskeletal disorders (MSD), cardiovascular disorders (CVD), or mental disorders (MD). METHODS In this cross-sectional study, subjects with MSD (n = 2,074), CVD (n = 714), and MD (n = 443) were selected among health care workers in 12 Dutch organizations. Using an online questionnaire, data were collected on individual characteristics, health behaviors, work impairments, work ability, and consultation of a general practitioner (GP), physiotherapist, specialist, or psychologist in the past year. Univariate and multivariate logistic regression analyses were performed to explore the associations of work impairments and work ability with health care use. RESULTS Lower work ability was associated with a higher likelihood of consulting any health care provider among workers with common disorders (OR 1.05-1.45). Among workers with MSD work impairments increased the likelihood of consulting a GP (OR 1.55), specialist (OR 2.05), and physical therapist (OR 1.98). Among workers with CVD work impairments increased the likelihood of consulting a specialist (OR 1.94) and physical therapist (OR 2.73). Among workers with MD work impairments increased the likelihood of consulting a specialist (OR 1.79) and psychologist (OR 1.82). CONCLUSION Work impairments and reduced work ability were associated with health care use among workers with MSD, CVD, or MD. These findings suggest that addressing work-related problems in workers with common disorders may contribute in reducing health care needs.
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Affiliation(s)
- Kerstin G. Reeuwijk
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Suzan J. W. Robroek
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Leona Hakkaart
- Institute of Health Policy and Management (iBMG), Institute for Medical Technology Assessment, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Garg A, Kapellusch JM, Hegmann KT, Moore JS, Boda S, Bhoyar P, Thiese MS, Merryweather A, Deckow-Schaefer G, Bloswick D, Malloy EJ. The NIOSH lifting equation and low-back pain, Part 2: Association with seeking care in the backworks prospective cohort study. HUMAN FACTORS 2014; 56:44-57. [PMID: 24669542 DOI: 10.1177/0018720813491284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between the revised NIOSH lifting equation (RNLE) and risk of seeking care for low-back pain (SC-LBP). BACKGROUND The RNLE is commonly used to quantify low-back physical stressors from lifting/lowering of loads in workplaces. There is no prospective study on relationship between RNLE and SC-LBP. METHOD A cohort of 258 incident-eligible workers from 30 diverse facilities was followed for up to 4.5 years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, hobbies, and current low-back pain were obtained at baseline. The cohort was followed monthly to ascertain SC-LBP and quarterly to determine changes in physical exposure. Associations between SC-LBP and both the peak lifting index (PLI) and peak composite lifting index (PCLI) were tested in multivariate models using proportional hazards regression. RESULTS SC-LBP lifetime prevalence at baseline was 31.9%, and there were 24 incident cases during follow-up. Factors predicting SC-LBP included job physical exposure (PLI and PCLI), history of low-back pain, age, female gender, and lower body mass index. In adjusted models, risk (hazard ratio [HR]) increased per unit increase in PLI and PCLI (p = .03 and .02, and maximum HR = 23.0 and 21.9, respectively). Whereas PCLI suggested a continuous increase in risk with an increase in PCLI, the PLI showed elevated, though somewhat reduced, risk at higher exposures (HR = 14.9 at PLI = 6). CONCLUSION Job physical stressors are associated with increased risk of SC-LBP. Data suggest that both the PLI and PCLI are useful metrics for estimating exposure to job physical stressors.
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Steenbeek R. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study. BMC Health Serv Res 2012; 12:294. [PMID: 22938384 PMCID: PMC3444386 DOI: 10.1186/1472-6963-12-294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 08/03/2012] [Indexed: 12/02/2022] Open
Abstract
Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were collected in a longitudinal two-wave study (n = 2305 workers). The outcome measures were visits (yes/no and frequency) to a general practitioner (GP), a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. Results In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance) was the only work characteristic associated with more care-seeking (GP). For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency), high levels of decision latitude (GP frequency) and high levels of social support by the supervisor (medical specialist). Other work characteristics led to more care-seeking: high levels of engagement (GP), full time work (GP frequency) and experiencing a work handicap (physical therapist). Conclusions We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. The association between work characteristics and later medical care-seeking differed between health care providers and between men and women. If we aim at reducing health care costs for workers by preventing unnecessary or inefficient care, it is important to reduce the number of workers that report that health complaints impede their work performance. The supervisor could provide more social support, closely monitor workload in combination with work pressure and decision latitude, and when possible help to adjust working conditions. Health care providers could reduce medical costs by taking the work relatedness of health complaints into account and act accordingly, by decreasing the time to referral and waiting lists, and by providing appropriate care and avoiding unnecessary or harmful care.
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Affiliation(s)
- Romy Steenbeek
- TNO Work and Health, PO Box 718,, 2130, AS, Hoofddorp, The Netherlands.
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Arsalani N, Fallahi-Khoshknab M, Josephson M, Lagerstrom M. Iranian nursing staff's self-reported general and mental health related to working conditions and family situation. Int Nurs Rev 2012; 59:416-23. [PMID: 22897195 DOI: 10.1111/j.1466-7657.2012.00987.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is increasing global evidence that today's work environment results in higher risk of adverse health among nursing staff than among other professions. AIM To investigate self-reported general and mental health among Iranian nursing staff, and associations with organizational, physical and psychosocial working conditions and family situation. METHODS 520 nursing personnel from 10 university hospitals in Tehran participated in this cross-sectional study. Data were collected using a validated questionnaire in the Persian language, containing the Copenhagen Psychosocial Questionnaire, physical items from the Nurse Early eXit Study and two scales relating to general health and mental health from the Short Form-36. The Chi-square test with P<0.05 and logistic regression were used to analyse data. RESULTS Three out of four nursing staff reported overtime work. The self-reported general and mental health rates of participants were poor/fair (38%, 41%), good (44%, 39%) and very good/excellent (18%, 20%), respectively. Family demands were associated with general health but were not associated with mental health. Adverse physical and psychosocial work conditions gave an elevated odds ratio for poor health. CONCLUSION Poor general and mental health was associated with adverse working conditions and family demands. Physical and psychosocial working conditions of nursing personnel should be improved. Social facilities such as daycare for children and care for the elderly should be available during work shifts to help Iranian nurses play their family roles.
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Affiliation(s)
- N Arsalani
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
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Griffith LE, Shannon HS, Wells RP, Walter SD, Cole DC, Côté P, Frank J, Hogg-Johnson S, Langlois LE. Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health 2011; 102:309-18. [PMID: 22390445 DOI: 10.2105/ajph.2011.300343] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We used individual participant data from multiple studies to conduct a comprehensive meta-analysis of mechanical exposures in the workplace and low back pain. METHODS We conducted a systematic literature search and contacted an author of each study to request their individual participant data. Because outcome definitions and exposure measures were not uniform across studies, we conducted 2 substudies: (1) to identify sets of outcome definitions that could be combined in a meta-analysis and (2) to develop methods to translate mechanical exposure onto a common metric. We used generalized estimating equation regression to analyze the data. RESULTS The odds ratios (ORs) for posture exposures ranged from 1.1 to 2.0. Force exposure ORs ranged from 1.4 to 2.1. The magnitudes of the ORs differed according to the definition of low back pain, and heterogeneity was associated with both study-level and individual-level characteristics. CONCLUSIONS We found small to moderate ORs for the association of mechanical exposures and low back pain, although the relationships were complex. The presence of individual-level OR modifiers in such an area can be best understood by conducting a meta-analysis of individual participant data.
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Affiliation(s)
- Lauren E Griffith
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
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Arsalani N, Fallahi-Khoshknab M, Ghaffari M, Josephson M, Lagerstrom M. Adaptation of questionnaire measuring working conditions and health problems among Iranian nursing personnel. Asian Nurs Res (Korean Soc Nurs Sci) 2011; 5:177-82. [PMID: 25030367 DOI: 10.1016/j.anr.2011.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 08/28/2011] [Accepted: 08/31/2011] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To adapt a questionnaire in the Persian language measuring working conditions and health problems among nursing personnel. A further aim was to test the validity and reliability of the questionnaire. METHODS The adapted questionnaire was based on three well-established questionnaires. Physical working conditions items were from Nurse Early Exit Study. Psychosocial working conditions scales were included from Copenhagen Psychosocial Questionnaire which contains two scales on general and mental health as well. The Nordic Musculoskeletal Questionnaire was the origin of the musculoskeletal disorders questions. During the culture adaptation process, an expert panel method was used. To achieve equivalence between the sources and target version, some changes were made by the expert panel. Then the questionnaire was examined in the field for face validity and construct validity (n = 92) among Iranian nursing personnel from two hospitals. Construct validity was assessed using a priori hypothesized correlations of the outcomes with exposures. Finally the adaptation process was completed by reliability assessment using Cronbach's alpha and Intra-class Correlation Coefficient (ICC). RESULTS The construct validity result was the correlation of the health outcome with the work-related exposure (physical rs = .71 and psychosocial rs = .66). In the reliability assessment, Cronbach's alpha and ICC were .60 and .70 respectively. CONCLUSION The findings show that the adapted questionnaire has an acceptable conceptual structure and provides reliable information from the nursing profession. Consequently, the questionnaire is applicable to work situation studies among nurses and other health care workers.
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Affiliation(s)
- Narges Arsalani
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | | | - Mostafa Ghaffari
- Occupational Medicine Research Center of Tehran University of medical sciences and health services. Researcher, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Malin Josephson
- Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Monica Lagerstrom
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Low back pain in Hispanic residential carpenters. J Chiropr Med 2011; 6:2-14. [PMID: 19674688 DOI: 10.1016/j.jcme.2007.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2006] [Accepted: 12/01/2006] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a leading cause of lost work time and has been recognized as America's number one workplace safety challenge. Low back pain is occurring at epidemic proportions among construction workers, and minority populations have been underinvestigated for risk of back injury. This project investigated the multiple potential risk factors for occupational LBP among Hispanic residential carpenters. METHODS This investigation evaluated 241 Hispanic residential framing carpenters. Data for this study were collected using a 91-question survey. End points of interest included point, annual, and lifetime prevalence of LBP. RESULTS Nineteen percent of respondents reported they had an episode of LBP in their lifetime. CONCLUSIONS Hispanic residential carpenters reported less than expected prevalence of LBP compared with non-Hispanic counterparts in the same trade and location. Job tasks and personal and workplace risk factors, including psychological and morphological characteristics, affect the prevalence of LBP among Hispanic framing carpenters.
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Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L. Physical activity and low back pain: a systematic review of recent literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20:826-45. [PMID: 21221663 DOI: 10.1007/s00586-010-1680-7] [Citation(s) in RCA: 215] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 12/07/2010] [Accepted: 12/22/2010] [Indexed: 12/16/2022]
Abstract
The objective of the study is to systematically evaluate the available evidence on the association between physical activity (i.e. occupational load and non-occupational physical activities) and low back pain (LBP). A systematic approach was used to explore the literature between 1999 and 2009. Studies were selected for inclusion following a comprehensive search of Medline, Embase and CINAHL. The methodological quality of each study was assessed. Studies were considered to be of 'high quality' if they met the cut-off criterion of 60% of the maximum available quality score. Thirty-six cohort or case-control studies were retrieved. Heavy workload and the accumulation of loads or frequency of lifts were moderate to strong risk factors for LBP. Strong associations were found for flexed, rotated and the awkward positions of the lumbar spine. Inconsistent results were found for leisure time physical activities, sports and physical exercise. Studies focusing on daily habitual physical activities (e.g. domestic activities and commuting) in association with LBP are lacking. In conclusion, the occurrence of LBP is related to the nature and intensity of the physical activities undertaken. However, physical activities can be subdivided into separate types and intensities and the ultimate physical load is the sum of all these activities. This makes it difficult to designate one particular activity as the cause of LBP.
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Affiliation(s)
- Hans Heneweer
- Research Department Lifestyle and Health, University of Applied Sciences, PO Box 85182, 3508 AD Utrecht, The Netherlands.
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Mathiassen SE, Paquet V. The ability of limited exposure sampling to detect effects of interventions that reduce the occurrence of pronounced trunk inclination. APPLIED ERGONOMICS 2010; 41:295-304. [PMID: 19793578 DOI: 10.1016/j.apergo.2009.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Revised: 06/23/2009] [Accepted: 08/03/2009] [Indexed: 05/28/2023]
Abstract
Ergonomics interventions often focus on reducing exposure in those parts of the job having the highest exposure levels, while leaving other parts unattended. A successful intervention will thus change the form of the job exposure distribution. This disqualifies standard methods for assessing the ability of various exposure measurement strategies to correctly detect an intervention's effect on the overall job exposure of an individual worker, in particular for the safety or ergonomics practitioner who with limited resources can only collect a few measurements. This study used a non-parametric simulation procedure to evaluate the relationship between the number of measurements collected during a self-paced manufacturing job undergoing ergonomics interventions of varying effectiveness, and the probability of correctly determining whether and to which extent the interventions reduced the overall occurrence of pronounced trunk inclination, defined as an inclination of at least 20 degrees . Sixteen video-recordings taken at random times on multiple days for each of three workers were used to estimate the time distribution of each worker's exposure to pronounced trunk inclination. Nine hypothetical ergonomics intervention scenarios were simulated, in which the occurrence of pronounced trunk inclination in the upper 1/8, 1/4, and 1/2 of the job exposure distribution was reduced by 10%, 30% and 50%. Ten exposure measurement strategies were explored, collecting from one to ten pre- and post-intervention exposure samples from an individual worker. For each worker, intervention scenario and sampling strategy, data were bootstrapped from the measured (pre-intervention) and simulated (post-intervention) exposure distributions to generate empirical distributions of the estimated intervention effect. Results showed that for the one to three intervention scenarios that had the greatest effect on the overall occurrence of trunk inclination in the job, one to four pre- and post-intervention measurements, depending on worker, were sufficient to reach an 80% probability of detecting that the intervention did, indeed, have an effect. However, even for the intervention scenario that had the greatest effect on job exposure, seven or more samples were needed for two of the three workers to obtain a probability larger than 50% of estimating the magnitude of the intervention effect to within +/-50% of its true size. For almost all interventions affecting 1/8 or 1/4 of the job, limited exposure sampling led to low probabilities of detecting any intervention effect, let alone its correct size.
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Studnek JR, Crawford JM, Wilkins JR, Pennell ML. Back problems among emergency medical services professionals: the LEADS health and wellness follow-up study. Am J Ind Med 2010; 53:12-22. [PMID: 19943318 DOI: 10.1002/ajim.20783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Describe work-life and demographic characteristics associated with reporting recent back pain, and estimate back pain severity among Emergency Medical Services (EMS) professionals. METHODS A 58-item postal questionnaire was used to collect relevant health and wellness information from a national sample of EMS professionals. The outcome variables were self-reported pain in the back or legs, and severity of recent back pain as indicated by the Aberdeen Back Pain Scale (ABPS). RESULTS There were 470/930 (50.5%) participants who reported one or more days of pain in the back or legs over a 2-week period. The variables most strongly associated with recent back pain and pain severity were prior back problems, self-reported health, and job satisfaction. CONCLUSION This study indicated that work-life, health, and demographic characteristics of EMS professionals were associated with reporting recent back pain.
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Affiliation(s)
- Jonathan R Studnek
- The National Registry of Emergency Medical Technicians, Columbus, Ohio, USA.
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Tissot F, Messing K, Stock S. Studying the relationship between low back pain and working postures among those who stand and those who sit most of the working day. ERGONOMICS 2009; 52:1402-1418. [PMID: 19851907 DOI: 10.1080/00140130903141204] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A relationship between low back pain (LBP) and prolonged standing or prolonged sitting at work has not been clearly shown, despite its biological plausibility. Because sitting and standing postures vary as to duration and freedom to alternate postures, and standing postures vary as to mobility, associations between specific working postures and LBP were explored using multiple logistic regression. Associations between work factors and self-reported LBP during the previous 12 months that interfered with usual activities were examined among 4493 standing workers and 3237 sitting workers interviewed in the 1998 Quebec Health and Social Survey; 24.5% reported significant LBP. Since the same conditions can correspond to different physiological demands for sitting compared with standing workers, analyses were performed separately for the two groups. Standing without freedom to sit was associated with LBP. Different occupational physical and psychosocial factors were associated with LBP in sitting compared with standing populations.
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Affiliation(s)
- F Tissot
- Centre for the Study of Biological Interactions in Human Health, CINBIOSE, University of Quebec at Montreal, Canada.
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Knaepen K, Cumps E, Zinzen E, Meeusen R. Low-back problems in recreational self-contained underwater breathing apparatus divers: prevalence and specific risk factors. ERGONOMICS 2009; 52:461-473. [PMID: 19401898 DOI: 10.1080/00140130802707766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Low-back problems (LBP) are one of the most common musculoskeletal disorders in the general population, with reported lifetime prevalences of 50% to 80%. Also, certain sports participants (e.g. gymnasts, alpine skiers, runners) are at risk of LBP and its repercussions. This epidemiological study was undertaken to examine the lifetime and 1-year prevalence of LBP among recreational Flemish self-contained breathing apparatus (scuba) divers and to identify general and sport-specific risk factors associated with the occurrence of LBP. A retrospective self-assessment questionnaire was developed and assessed for validity and reliability, to gather data concerning demographics, LBP prevalence and associated risk factors and injuries among active scuba divers. A total of 181 recreational scuba divers (men: n = 138, mean age 40.3 +/- 12.8 years; women: n = 43, mean age 35.0 +/- 10.9 years) from 10 randomly selected internationally recognised scuba diving clubs participated in the study. Lifetime and 1-year prevalence of LBP among recreational Flemish scuba divers were 55.8% and 50.3%, respectively. General risk factors for LBP were found to include prior history of LBP, structural abnormalities, heavy workload, pregnancy and parturition, general fatigue and bending forwards and backwards. Scuba divers suffering from LBP generally had a significantly higher dive certificate than those without LBP (p = 0.007). Symptomatic scuba divers also used significantly more weights on their weight belts during indoor training (p = 0.003) and during outdoor dives with a dry suit (p = 0.044) as compared to asymptomatic scuba divers. In scuba diving, reliable sport-specific risk factors for LBP were found to be scarce. Further biomechanical research is required to point out whether or not scuba diving characteristics actually contribute to LBP.
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Affiliation(s)
- K Knaepen
- Department of Movement Education and Sports Training, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium.
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Sedentary lifestyle as a risk factor for low back pain: a systematic review. Int Arch Occup Environ Health 2009; 82:797-806. [DOI: 10.1007/s00420-009-0410-0] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2008] [Accepted: 02/22/2009] [Indexed: 10/21/2022]
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Aittomäki A, Lahelma E, Rahkonen O, Leino-Arjas P, Martikainen P. Job decision latitude as a potential modifier of the contribution of physical workload to poor functioning in middle-aged employees. Int Arch Occup Environ Health 2008; 81:975-82. [PMID: 18327604 DOI: 10.1007/s00420-007-0291-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 12/05/2007] [Indexed: 11/26/2022]
Abstract
OBJECTIVES It was hypothesised that job decision latitude may alleviate the detrimental health effect of physical workload. The objective was to test whether job decision latitude modifies the effect of physically demanding work on poor physical functioning, and whether the effects of physically demanding work and job decision latitude are dependent on occupational social class. METHODS Data were derived from the Helsinki Health Study baseline questionnaire survey. The participants were employees of the City of Helsinki, Finland, aged 40-60 years. Functioning was measured by Short Form 36 physical component summary. Logistic regression models were used to analyse the data. RESULTS The hypothesised modification of the effect of physical demands at work on physical functioning by job decision latitude could not be demonstrated. The expected interaction effect was observed only for the semi-professional class, and interaction of physical demands, decision latitude and occupational social class was not statistically significant. Furthermore, the effects of physically demanding work as well as low decision latitude were of similar magnitude in all the occupational social classes. CONCLUSIONS The results suggest that for the majority of employees the effect of physical workload on physical functioning is independent of job decision latitude or occupational social class in general. Control over work conditions is unlikely to reduce difficulties to cope with physical demands, when the actual physical tasks are not changed.
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Affiliation(s)
- Akseli Aittomäki
- Department of Public Health, University of Helsinki, Helsinki, Finland.
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Ghaffari M, Alipour A, Farshad AA, Jensen I, Josephson M, Vingard E. Effect of psychosocial factors on low back pain in industrial workers. Occup Med (Lond) 2008; 58:341-7. [DOI: 10.1093/occmed/kqn006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Plouvier S, Renahy E, Chastang JF, Bonenfant S, Leclerc A. Biomechanical strains and low back disorders: quantifying the effects of the number of years of exposure on various types of pain. Occup Environ Med 2007; 65:268-74. [PMID: 17928384 DOI: 10.1136/oem.2007.036095] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the effects of duration of exposure to biomechanical strains on various types of low back pain (LBP). METHODS The population study was a random sample from the GAZEL cohort. Durations of exposure to selected biomechanical strains during subjects' working lifetime and potential confounders were assessed in 1996 by self-administered questionnaires. Data on LBP in the previous 12 months were collected in 2001. Relations between various dimensions of LBP and durations of exposure to the biomechanical strains were analysed with multivariate regression models. Polytomous models were built to determine whether some biomechanical strains were specifically associated with some types of LBP. RESULTS Analyses were performed separately for men (n = 2218) and women (n = 383). Significant associations were observed (ORs reported are those for 20 years of exposure) between LBP and durations of driving and bending/twisting for men (OR 1.24 and 1.37 respectively); LBP for more than 30 days and duration of exposure to bending/twisting for men and women (OR 2.20 and 2.00 respectively) and duration of driving for women (OR 3.15); LBP radiating to the leg and duration of driving for men (OR 1.43) and bending/twisting for women (OR 1.95); LBP radiating below the knee and duration of exposure to pulling/pushing/carrying for men (OR 1.88). Bending/twisting in both men and women, and driving for women appeared to be stronger risk factors for LBP for more than 30 days. Pulling/pushing/carrying heavy loads appeared to be a risk factor specific for LBP radiating below the knee for men. CONCLUSION This study suggests that exposure to biomechanical strains has long-term effects and a dose-response relation with duration of exposure and specific effects for some types of LBP.
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Affiliation(s)
- S Plouvier
- INSERM, U 687 Hopital National Saint Maurice, 14 rue de val d'Osne, 94410 Saint-Maurice, France.
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van Vuuren B, Zinzen E, van Heerden HJ, Becker PJ, Meeusen R. Work and family support systems and the prevalence of lower back problems in a South African steel industry. JOURNAL OF OCCUPATIONAL REHABILITATION 2007; 17:409-21. [PMID: 17636456 DOI: 10.1007/s10926-007-9092-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Accepted: 06/15/2007] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Back complaints are a common in society. METHODS An analytical cross-sectional epidemiological study was carried out among 366 steel plant workers to examine the prevalence and association between lower back problems (LBP) and family and workplace related psychosocial risk factors. RESULTS Using inclusive and stringent definitions for LBP, point prevalence was 35.8% and 15.3%, respectively. Logistic regression analyses indicated significant adjusted odd ratios (OR) for negative perceptions of workplace support (2.32; CI 1.09-4.92), unexpected events (2.58; CI 1.19-5.59) and working under time pressures and deadlines (2.83; CI 1.24-6.48). A significant protective association was found for control over the order and pace of working tasks (OR 0.30; CI 0.14-0.63). A significant univariate association was further found between LBP and negative perceptions of family (1.97; CI 1.06-3.68) support. CONCLUSION These findings suggest that workers who feel more in control on the job and who have good family and workplace support systems in tact are less likely to experience LBP. Supervisors are therefore encouraged to develop appropriate support and organizational systems which may be an inexpensive, but potentially beneficial, means of reducing worker stress and LBP.
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Affiliation(s)
- Bernard van Vuuren
- Department of Biokinetics, Sport and Leisure Sciences, LC de Villiers Sport Centre, University of Pretoria, South Street, Hatfield, Pretoria 0002, South Africa.
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Alipour A, Ghaffari M, Jensen I, Shariati B, Vingard E. Reliability and validity study of Persian modified version of MUSIC (musculoskeletal intervention center) - Norrtalje questionnaire. BMC Musculoskelet Disord 2007; 8:88. [PMID: 17764557 PMCID: PMC2078587 DOI: 10.1186/1471-2474-8-88] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 08/31/2007] [Indexed: 11/18/2022] Open
Abstract
Background Musculoskeletal disorders (MSDs) are a major health problem in the world. Self-reported questionnaires are a known method for estimating the prevalence of MSDs among the population. One of the studies concerning MSDs and their relation to work-related physical and psychosocial factors, as well as non-work-related factors, is the MUSIC-Norrtalje study in Sweden. In this study, the research group developed a questionnaire, which has been validated during its development process and is now considered a well-known instrument. The aim of this study is to validate the Persian version of this questionnaire. Methods The first step was to establish two expert panel groups in Iran and Sweden. The Focus Group Discussion (FGD) method was used to detect questionnaire face and content validity. To detect questionnaire reliability, we used the test-retest method. Results Except for two items, all other questions that respondents had problems with in the focus group (20 of 297), had unclear translations; the ambiguity was related to the stem of the questions and the predicted answers were clear for the participants. The concepts of 'household/spare time' and 'physical activity in the workplace' were not understood by the participants of FGD; this has been solved by adding further descriptions to these phrases in the translation. In the test-retest study, the reliability coefficient was relatively high in most items (only 5 items out of 297 had an ICC or kappa below 0.7). Conclusion The findings from the present study provide evidence that the Persian version of the MUSIC questionnaire is a reliable and valid instrument.
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Affiliation(s)
- Akbar Alipour
- Department of Clinical Neuroscience, Section for Personal Injury, Karolinska Institutet, Sweden
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Mostafa Ghaffari
- Department of Public Health Science, Karolinska Institutet, Sweden
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Irene Jensen
- Department of Clinical Neuroscience, Section for Personal Injury, Karolinska Institutet, Sweden
| | - Batoul Shariati
- Department of Community Medicine, Tehran University of Medical Science, Iran
| | - Eva Vingard
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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Grooten WJA, Mulder M, Josephson M, Alfredsson L, Wiktorin C. The influence of work-related exposures on the prognosis of neck/shoulder pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2007; 16:2083-91. [PMID: 17721712 PMCID: PMC2140127 DOI: 10.1007/s00586-007-0481-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Revised: 06/29/2007] [Accepted: 08/02/2007] [Indexed: 11/25/2022]
Abstract
To determine associations between work-related exposures and the prognosis of self-reported neck/shoulder pain. This prospective cohort study was based on 803 working subjects who reported neck/shoulder pain at baseline. The proportion of subjects who 5-6 years later were symptom-free was calculated. Data concerning work-related biomechanical, psychosocial, and organizational exposures were collected at baseline. The Cox regression analyses were used to calculate the relative chances (RC) of being symptom-free at the end of the study for single exposures, and also for up to three simultaneous work-related exposures. Adjustments were made for sex and age. Only 36% of the subjects were symptom-free 5-6 years later. The relative chance for being symptom-free at the end of the study was 1.32 (95% CI = 0.99-1.74) for subjects who were exposed to sitting > or =75% of the working time and 1.53 (95% CI = 1.02-2.29) for subjects who were exposed to job strain, i.e., the combination of high demands and low decision latitude. The relative chance of being symptom-free at the end of the study was 0.61 (95% CI = 0.40-0.94) for subjects with at least two out of three simultaneous biomechanical exposures at work; manual handling, working with the hands above shoulder level, and working with vibrating tools. In a heterogeneous population with moderate nonspecific neck/shoulder pain, sedentary work enhanced the chance of being symptom-free 5-6 years later, whereas simultaneous exposures to at least two of manual handling, working with hands above shoulder level and working with vibrating tools were associated with a lower chance of being symptom-free at the end of the study. This could imply that subjects with neck/shoulder pain should avoid such simultaneous exposures.
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Skillgate E, Vingård E, Josephson M, Theorell T, Alfredsson L. Life events and the risk of low back and neck/shoulder pain of the kind people are seeking care for: results from the MUSIC-Norrtalje case-control study. J Epidemiol Community Health 2007; 61:356-61. [PMID: 17372298 PMCID: PMC2652947 DOI: 10.1136/jech.2006.049411] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To expand the knowledge about the occurrence of life events, and how they affect the risk of low back and neck/shoulder pain. DESIGN A population-based case-control study. SETTING Men and women 20-59-years old, living in and not working outside the municipality of Norrtälje, Sweden, from November 1993 to November 1997. PARTICIPANTS Cases (n = 1,148) were defined as all subjects from the study base who sought healthcare for a new episode of low back and/or neck/shoulder pain by any of the care givers in the municipality. Controls (n = 1,700) were selected as a stratified random sample from the study base, considering sex and age. Study subjects were interviewed about life events and critical life changes. Critical life changes were defined as events that brought about a marked psychosocial change. Odds ratios (ORs) associated with different numbers of life events or critical life changes were calculated. RESULTS Having experienced at least two life events during the preceding 5 years was associated with an increased risk of neck/shoulder pain (OR = 1.6, 95% CI 1.1 to 2.4). At least two critical life changes were associated with an increased risk of neck/shoulder pain (OR = 1.9, 95% CI 1.3 to 2.7). In general, no associations were observed in relation to risk of low back pain. CONCLUSION Life events and critical life changes are of importance for the risk of neck/shoulder pain of the kind that people are seeking care for. The study provides useful information for clinical practice and for future aetiological research on neck/shoulder pain.
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Affiliation(s)
- Eva Skillgate
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
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Leijon O, Lindberg P, Josephson M, Wiktorin C. Different working and living conditions and their associations with persistent neck/shoulder and/or low back disorders. Occup Environ Med 2006; 64:115-21. [PMID: 17043074 PMCID: PMC2078443 DOI: 10.1136/oem.2006.029603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate whether different combinations of working and living conditions are associated with the risk for persistent neck/shoulder and/or low back disorders. The underlying purpose of this contextual approach was to identify target groups for primary/secondary prevention. METHODS In a baseline study, 11 groups with different working and living conditions were identified by cluster analysis. In this study, these 11 groups were followed up by a postal questionnaire 5 years after baseline (response rate 82%, n = 1095). RESULTS Five of the groups--the onerous human services job, the free agent, the family burden, the mentally stretched and the physically strained groups--had an increased risk for persistent disorders (OR 2.38-2.70). Four of these groups had rather sex-specific working and living conditions. CONCLUSIONS The results support the hypothesis that different combinations of working and living conditions may increase the risk for persistent neck/shoulder and/or low back disorders to different degrees. Sex-specific working and living conditions increased the risk for women as well as for men, irrespective of whether the conditions were specific to women or men.
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Affiliation(s)
- Ola Leijon
- Division of Occupational Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Abstract
OBJECTIVES In comparison with men, women have a healthier lifestyle, are more rarely overweight, have less stressful occupations, or are not employed outside the home. The "gender pain bias" is the fact that women nevertheless have a higher prevalence of back pain. This paper looks at the possible underlying reasons for this as yet unexplained gender difference, using Stokols' socioecological health model as a basis. METHODS The first National Health Survey for the Federal Republic of Germany was carried out from October 1997 to March 1999. It comprised a representative total sample of 5315 persons between the ages of 20 and 64. The participants took part in a medical examination and answered a self-report form. chi test and logistic regression analyses were used to investigate correlations between self-reported low back pain and gender-specific biopsychobehavioral and sociophysical environmental factors. RESULTS Seven-day back pain prevalence in the Federal Republic of Germany is 32% for men and 40% for women. Prevalences are significantly higher for overweight subjects, persons with a marked somatization tendency or a low level of social support, physically inactive individuals, smokers, elderly subjects, the nonemployed, "blue collar workers" and lower socioeconomic groups. From a multivariate perspective, however, none of these factors reduces (and hence sufficiently explains) the gender difference. Factoring in the gender-specific somatization tendency reduces the odds ratios of women versus men from 1.42 to 1.23. DISCUSSION In view of the gender difference in pain prevalence, which remains stable despite a multivariate perspective, there is clearly a need for more research into the reasons underlying the gender difference. We believe that future studies should look at rarely investigated constructs such as "sex role expectancies," "anxiety," "ethnicity," and "family history" and take anatomic differences in muscle strength into account.
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Affiliation(s)
- Sven Schneider
- Pain Therapy, Department of Orthopedic Surgery, University of Heidelberg, Heidelberg, Germany.
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Plass AMC, Timmermans DRM, van der Wal G. Does stimulating self-care increase self-care behaviour for minor illnesses of Dutch and Turkish inhabitants of a deprived area in The Netherlands? PATIENT EDUCATION AND COUNSELING 2006; 63:97-103. [PMID: 16242295 DOI: 10.1016/j.pec.2005.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2005] [Revised: 08/25/2005] [Accepted: 09/04/2005] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The aim of the present study was to examine whether self-care behaviour increases after a self-care stimulating intervention that proved to be successful in reducing care-seeking behaviour for minor illnesses of Turkish and Dutch inhabitants of a deprived area in the Netherlands, and to see whether there are cultural differences. METHOD This longitudinal study was based on a "pre-test/post-test one group" design. Data were collected during three structured face-to-face interviews: before the intervention, and 6 months and 1 year after the intervention, in which GPs personally handed out booklets to their patients containing guidelines on the management of 12 minor illnesses. RESULTS The number of self-reported self-care actions did not increase. In contrast to the Dutch, the Turkish participants reported a decrease in the number of self-care actions, their attitude towards self-care became more negative, and they perceived less control. CONCLUSION Apparently, a reduction in formal health care utilisation is not engendered by an increase in self-care behaviour. In order to make sure that interventions like these will have the intended effect, more research is needed, particularly among non-western populations. PRACTICE IMPLICATIONS In developing future healthcare-reducing interventions, one should be aware of possible unwanted side effects in non-western populations.
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Affiliation(s)
- Anne Marie C Plass
- Department of Public and Occupational Health, VU University Medical Center Amsterdam, The Netherlands.
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Eriksen HR, Ihlebaek C, Jansen JP, Burdorf A. The relations between psychosocial factors at work and health status among workers in home care organizations. Int J Behav Med 2006; 13:183-92. [PMID: 17078768 DOI: 10.1207/s15327558ijbm1303_1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A considerable proportion of sickness absence and disability pension is caused by subjective health complaints, especially low back pain (LBP). In recent years focus has been on psychosocial characteristics of work as potential risk factors. The aim of this study is to examine the relations between psychosocial work aspects and subjective health complaints, LBP, and need for recovery. A total of 779 employees working in home care participated in a cross-sectional study. Higher psychological demands were associated with subjective health complaints and need for recovery. However, decision authority, skill discretion, and the 2 aspects of social support did not seem to be important factors. Higher psychological demands do not seem to be associated with severity of LBP, but does show an association with sick leave.
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Affiliation(s)
- Hege R Eriksen
- Department of Education and Public Health, University of Bergen and Unifob Health, Norway.
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Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Nouwen A, Larocque I, Demers E. Determinants of "return to work in good health" among workers with back pain who consult in primary care settings: a 2-year prospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:641-55. [PMID: 16868783 PMCID: PMC2213556 DOI: 10.1007/s00586-006-0180-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Revised: 04/13/2006] [Accepted: 06/15/2006] [Indexed: 10/24/2022]
Abstract
Many factors have been linked to return to work after a back pain episode, but our understanding of this phenomenon is limited and cross-sectional dichotomous indices of return to work are not valid measures of this construct. To describe the course of "return to work in good health" (RWGH--a composite index of back pain outcome) among workers who consulted in primary care settings for back pain and identify its determinants, a 2-year prospective study was conducted. Subjects (n = 1,007, 68.4%) were workers who consulted in primary care settings of the Quebec City area for a nonspecific back pain. They completed five telephone interviews over 2 years (follow-up = 86%). Analyses linking baseline variables with 2-year outcome were conducted with polytomous logistic regression. The proportion of "success" in RWGH increased from 18% at 6 weeks to 57% at 2 years. In women, persistent pain, pain radiating to extremities, increasing job seniority, not having a unionized job, feeling that the physician did listen carefully and increasing fear-avoidance beliefs towards work and activity were determinants of "failure" in RWGH. In men, decreasing age, cigarette smoking, poor self-reported health status, pain in the thoracic area, previous back surgeries, a non-compensated injury, high pain levels, belief that job is below qualifications, likelihood of losing job, job status, satisfaction with health services and fear-avoidance beliefs towards work were all significant. RWGH among workers with back pain receives multiple influences, especially among men. In both genders, however, fear-avoidance beliefs about work are associated with failure and high self-efficacy is associated with success.
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Affiliation(s)
- Clermont E Dionne
- Unité de recherche en santé des populations, Centre de recherche du CHA de Québec, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Quebec City, QC, Canada, G1S 4L8.
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Ghaffari M, Alipour A, Jensen I, Farshad AA, Vingard E. Low back pain among Iranian industrial workers. Occup Med (Lond) 2006; 56:455-60. [PMID: 16837536 DOI: 10.1093/occmed/kql062] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most epidemiological data concerning low back pain (LBP) are from high-income countries and there is very little information about LBP in the working population in developing countries. OBJECTIVES To determine the prevalence of LBP in Iranian industrial workers. To explore associations between LBP and physical and psychosocial factors at work, as well as lifestyle factors. METHODS Cross-sectional study of the largest car-manufacturing group in Iran. The prevalence of LBP, work exposures and lifestyle factors were recorded using the standardized Nordic questionnaire for analysis of musculoskeletal symptoms. Demographic data and lifestyle factors (age, sex, education, weight, work experience, smoking and fitness training) were also collected. RESULTS Of the 18,031 employees, 78% participated. The majority of subjects in this study population were young males (<30 years) and a small proportion was female (4%). The 1-year prevalence of self-reported LBP in this Iranian industrial population was 21% (20% males and 27% females). The prevalence rate of absence due to LBP was 5% per annum. The multiple logistic regression models indicated that the following remained risk indicators for LBP in the previous 12 months: increasing age, no regular exercise, heavy lifting, repetitive work and monotonous work. CONCLUSION LPB is a common problem in the working population even in a developing country. Age and gender as well as certain work-related physical and psychosocial factors influenced the prevalence of LBP but the differences between different categories of workers were small.
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Affiliation(s)
- Mostafa Ghaffari
- Karolinska Institute-Public Health, PO Box 12718, Stockholm 112 94, Stockholm, Sweden.
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Mariconda M, Galasso O, Imbimbo L, Lotti G, Milano C. Relationship between alterations of the lumbar spine, visualized with magnetic resonance imaging, and occupational variables. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:255-66. [PMID: 16835739 PMCID: PMC2200682 DOI: 10.1007/s00586-005-0036-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Revised: 09/06/2005] [Accepted: 11/30/2005] [Indexed: 10/24/2022]
Abstract
Although the effect of physical workload on the occurrence of low back pain (LBP) has been extensively investigated, few quantitative studies have examined the morphological changes visualized via magnetic resonance imaging (MRI) in relation to occupational variables. The relationship between the severity of some abnormalities such as lumbar spinal stenosis or spondylolisthesis and physical or psychosocial occupational risk factors has not been investigated previously. In this cross-sectional study patients fulfilled the following inclusion criteria: (1) long-standing (minimum 1-year) LBP radiating down the leg (or not); (2) age more than 40 years; (3) willingness to undergo an MRI of the lumbar spine; and (4) ability to speak Italian. Primary objective of the study was to investigate the association between occupational exposure and morphological MRI findings, while controlling for the individual risk factors for LBP. Secondarily, we looked at the influence of this exposure and the degenerative changes in the lumbar spine on clinical symptoms and the related disability. Lumbar MRI scans from 120 symptomatic patients were supplemented by the results of structured interviews, which provided personal, medical, and occupational histories. All occupational factors were arranged on scales of increasing exposure, whereas pain and disability were assessed using ad hoc validated questionnaires. Evidence of intervertebral disc narrowing or herniation and the occurrence and severity of spinal stenosis and spondylolisthesis was obtained from the MRI scans and a summative degenerative score was then calculated. We detected a direct association between increasing age and the global amount of degenerative change, the severity of intervertebral disc height loss, the number of narrowed discs, stenosis, the number of stenotic levels, and spondylolisthesis. Physical occupational exposure was not associated with the presence of lumbar disc degeneration and narrowing per se, but a higher degree of such an exposure was directly associated with a higher degree of degeneration (P=0.017). Spondylolistesis and stenosis were positively related to heavy workload (P=0.014) and the manual handling of materials (P=0.023), respectively. Psychosocial occupational discomfort was directly associated to stenosis (P=0.041) and number of stenotic levels (P=0.019). A heavier job workload was the only occupational factor positively related to the degree of disability at the multivariate analysis (P=0.002). Total amount of degeneration in the lumbar spine directly influenced pain duration (P=0.011) and degree of disability (P=0.050). These results suggest that caution should be exercised when symptomatic subjects with evidence of degenerative changes on MRI scans engage in strenuous physical labor.
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Schneider S, Mohnen SM, Schiltenwolf M, Rau C. Comorbidity of low back pain: representative outcomes of a national health study in the Federal Republic of Germany. Eur J Pain 2006; 11:387-97. [PMID: 16793296 DOI: 10.1016/j.ejpain.2006.05.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Revised: 05/08/2006] [Accepted: 05/10/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Unlike other biopsychosocial risk factors, the role of comorbidity in low back pain is largely unknown. AIMS The purpose is (1) to generate prevalence data on back pain in the total adult population and (2) to identify the most common physical comorbidities in subjects with back pain. This paper also (3) analyses the gender-specific and age-specific comorbidity structure. METHODS The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence and the associated comorbidities. The net sample comprises a total of 7124 Germans aged 18-79. RESULTS One in three Germans (34%) experienced back pain during the seven days prior to being interviewed. The one-year prevalence rate is 59%. All the morbidities investigated by us are more common in subjects with back pain than in individuals without back pain. The most common comorbidities associated with back pain are musculoskeletal disorders like rheumatoid arthritis, osteoarthritis and osteoporosis, followed by cardiovascular and cerebrovascular disease. CONCLUSIONS The present study investigating 31 physical diseases is the most extensive analysis to date on the topic of back pain and comorbidity. This is an attempt to cast light on the tangled relationships involved in developing and coping with back pain. In view of the large percentage of unspecific back pain, we believe it is important for physicians treating back pain to extend their history and diagnostic analysis skills to embrace comorbidities related to the back pain.
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Affiliation(s)
- Sven Schneider
- Stiftung Orthopädische Universitätsklinik Heidelberg, Forschungsgruppe Epidemiologie und Biometrie, Schlierbacher Landstrasse 200, D-69118 Heidelberg, Germany.
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Nyman T, Grooten WJA, Wiktorin C, Liwing J, Norrman L. Sickness absence and concurrent low back and neck-shoulder pain: results from the MUSIC-Norrtälje study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:631-8. [PMID: 16741741 PMCID: PMC2213552 DOI: 10.1007/s00586-006-0152-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2005] [Revised: 05/02/2006] [Accepted: 05/09/2006] [Indexed: 10/24/2022]
Abstract
In Sweden, musculoskeletal disorders, in particular low back disorders (LBD) and neck-shoulder disorders (NSD) constitute by far the most common disorders, causing sick leave and early retirement. Studies that compare sickness absence in individuals with LBD and individuals with NSD are lacking. Moreover, it is likely that having concurrent complaints from the low back region and the neck-shoulder region could influence sickness absence. The purpose of the present study was to explore potential differences in sickness absence and in long-term sickness absence during a 5-year period, 1995-2001, among individuals with (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. The present study was based on 817 subjects from the MUSIC-Norrtälje study, whom were working at baseline and whom at both baseline and follow-up reported LBD and/or NSD. Three groups were identified based on pain and pain-related disability at both baseline and follow-up: (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. Subjects who did not give consistent answers at both the baseline and follow-up occasions were assigned a fourth group: (4) migrating LBD/NSD. Two outcomes were analysed: (1) prevalence of sickness absence, and (2) long-term sickness absence among those with sickness absence days. Logistic regression analysis was used to calculate odds ratios (OR) for sickness absence in the different disorder groups, taking into account confounding factors such as gender, age and other non-musculoskeletal-related disorders. In the group concurrent LBD and NSD, 59% had been sickness absent between baseline and follow up, compared to 42% in the group solely LBD, 41% in the group solely NSD, and 46% in the group migrating LBD/NSD. No difference in sickness absence was found between the group solely LBD compared to the group solely NSD [OR 0.65 (0.36-1.17)]. The adjusted OR for sickness absence in the group concurrent LBD and NSD compared to subjects with solely LBD or solely NSD was [OR 1.69 (1.14-2.51)]. The adjusted OR for having long-term sickness absence was 2.48 (95% CI = 1.32-4.66) for the group concurrent LBD and NSD. In the present study, having concurrent LBD and NSD were associated with a higher risk for sickness absence and also long-term sickness absence. This suggests that, when research on sickness absence and return to work after a period of LBD or NSD is performed, it is important to take into consideration any concurrent pain from the other spinal region. The study also implies that spinal co-morbidity is an important factor to be considered by clinicians and occupational health providers in planning treatment, or in prevention of these disorders.
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Affiliation(s)
- Teresia Nyman
- Department of Occupational and Environmental Health, Stockholm County Council, Norrbacka, 171 76, Stockholm, Sweden.
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Lis AM, Black KM, Korn H, Nordin M. Association between sitting and occupational LBP. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:283-98. [PMID: 16736200 PMCID: PMC2200681 DOI: 10.1007/s00586-006-0143-7] [Citation(s) in RCA: 258] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2005] [Accepted: 03/31/2005] [Indexed: 11/24/2022]
Abstract
Low back pain (LBP) has been identified as one of the most costly disorders among the worldwide working population. Sitting has been associated with risk of developing LBP. The purpose of this literature review is to assemble and describe evidence of research on the association between sitting and the presence of LBP. The systematic literature review was restricted to those occupations that require sitting for more than half of working time and where workers have physical co-exposure factors such as whole body vibration (WBV) and/or awkward postures. Twenty-five studies were carefully selected and critically reviewed, and a model was developed to describe the relationships between these factors. Sitting alone was not associated with the risk of developing LBP. However, when the co-exposure factors of WBV and awkward postures were added to the analysis, the risk of LBP increased fourfold. The occupational group that showed the strongest association with LBP was Helicopter Pilots (OR=9.0, 90% CI 4.9-16.4). For all studied occupations, the odds ratio (OR) increased when WBV and/or awkward postures were analyzed as co-exposure factors. WBV while sitting was also independently associated with non-specific LBP and sciatica. Vibration dose, as well as vibration magnitude and duration of exposure, were associated with LBP in all occupations. Exposure duration was associated with LBP to a greater extent than vibration magnitude. However, for the presence of sciatica, this difference was not found. Awkward posture was also independently associated with the presence of LBP and/or sciatica. The risk effect of prolonged sitting increased significantly when the factors of WBV and awkward postures were combined. Sitting by itself does not increase the risk of LBP. However, sitting for more than half a workday, in combination with WBV and/or awkward postures, does increase the likelihood of having LBP and/or sciatica, and it is the combination of those risk factors, which leads to the greatest increase in LBP.
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Affiliation(s)
- Angela Maria Lis
- Occupational and Industrial Orthopaedic Center, New York, NY, USA.
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Schneider S, Lipinski S, Schiltenwolf M. Occupations associated with a high risk of self-reported back pain: representative outcomes of a back pain prevalence study in the Federal Republic of Germany. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 15:821-33. [PMID: 16432750 PMCID: PMC3489435 DOI: 10.1007/s00586-005-1015-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Revised: 07/01/2005] [Accepted: 07/31/2005] [Indexed: 01/29/2023]
Abstract
Given the increasing medical and economic implications of back pain, occupation-specific prevalence data may provide important pointers for preventive programmes targeted at promoting preventive behaviour and improving conditions. The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence by occupational category. The net sample comprises a total of 3,488 earners aged 18-69. One in three earners in the Federal Republic of Germany (34%) experienced back pain during the 7 days prior to being interviewed. The 1-year prevalence rate is 60%. Occupational categories associated with a lower-than-average back pain prevalence are highly qualified professionals, senior management, and production occupations associated with a comparatively low degree of manual labour. In contrast, an above-average prevalence was identified for occupations associated with physically strenuous work involving one-sided postures, moving, carrying and holding heavy weights, and work typically performed in poor conditions or bad weather. Our data demonstrates significant inter-occupational differences in terms of self-reported back pain. The results underline the importance of measures to promote preventive behaviour and improve the working conditions of those in low-skill manual labour occupations.
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Affiliation(s)
- Sven Schneider
- Section Neuroorthopaedics, Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany.
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Videman T, Ojajärvi A, Riihimäki H, Troup JDG. Low back pain among nurses: a follow-up beginning at entry to the nursing school. Spine (Phila Pa 1976) 2005; 30:2334-41. [PMID: 16227898 DOI: 10.1097/01.brs.0000182107.14355.ca] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective cohort. OBJECTIVES To investigate the prevalence of back pain from entering the nursing school through 5 years in nursing and the determinants and modifiers of back pain and disability. SUMMARY OF BACKGROUND DATA Physical loading, psychologic characteristics, and several other factors have been associated with back pain at work in earlier studies. Because of the lack of the prework entry morbidity data, the nature of the associations between these exposures and the symptoms is unclear. That previous back pain is a predictor of later pain underlines the importance to have pre-employment data in investigations of the role of exposures at work. METHODS Female nursing students (n = 174) were followed for 7.5 years. Data on constitutional and behavioral factors, occupational exposures, and back-related symptoms and disability were collected. Back pain was grouped into "sciatic," "sudden," or "other" and related disability. RESULTS The lifetime cumulative prevalence of back pain increased from 31% at entry to nursing school to 72% at the end of the school and further to 82% after 5 years as a nurse. The 1-year prevalence of any back pain was 54% for the first year in nursing school, 57% for the first year as a nurse, and 64% for the fifth year as a nurse. In multivariate analyses, other back pain and related disability as a nurse were associated with back pain history at the entry to nursing school (odds ratio, 7.1; 95% confidence interval, 1.5-34; and 3.6; 1.2-11, respectively), and working in twisted/bent positions (odds ratio, 6.2; 95% confidence interval, 1.7-23; and 7.5; 2.9-20, respectively). Sudden back pain was not associated with any of the studied risk factors. Sciatic back pain was associated only with working positions (odds ratio, 6.9; 95% confidence interval, 2.1-23). CONCLUSIONS Lifetime prevalence of back pain increased sharply during nursing school but slowly after that. Back pain at entering the nursing school was a predictor for back-related pain and disability. Self- reported occupational physical work load was associated with back pain and related disability. The nature of the association is unclear, but it is likely that back pain is exacerbated during nursing.
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Vindigni D, Walker BF, Jamison JR, Da Costa C, Parkinson L, Blunden S. Low back pain risk factors in a large rural Australian Aboriginal community. An opportunity for managing co-morbidities? CHIROPRACTIC & OSTEOPATHY 2005; 13:21. [PMID: 16197555 PMCID: PMC1277832 DOI: 10.1186/1746-1340-13-21] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Accepted: 09/30/2005] [Indexed: 01/04/2023]
Abstract
BACKGROUND Low back pain (LBP) is the most prevalent musculo-skeletal condition in rural and remote Australian Aboriginal communities. Smoking, physical inactivity and obesity are also prevalent amongst Indigenous people contributing to lifestyle diseases and concurrently to the high burden of low back pain. OBJECTIVES This paper aims to examine the association between LBP and modifiable risk factors in a large rural Indigenous community as a basis for informing a musculo-skeletal and related health promotion program. METHODS A community Advisory Group (CAG) comprising Elders, Aboriginal Health Workers, academics, nurses, a general practitioner and chiropractors assisted in the development of measures to assess self-reported musculo-skeletal conditions including LBP risk factors. The Kempsey survey included a community-based survey administered by Aboriginal Health Workers followed by a clinical assessment conducted by chiropractors. RESULTS Age and gender characteristics of this Indigenous sample (n = 189) were comparable to those reported in previous Australian Bureau of Statistics (ABS) studies of the broader Indigenous population. A history of traumatic events was highly prevalent in the community, as were occupational risk factors. Thirty-four percent of participants reported a previous history of LBP. Sporting injuries were associated with multiple musculo-skeletal conditions, including LBP. Those reporting high levels of pain were often overweight or obese and obesity was associated with self-reported low back strain. Common barriers to medical management of LBP included an attitude of being able to cope with pain, poor health, and the lack of affordable and appropriate health care services. Though many of the modifiable risk factors known to be associated with LBP were highly prevalent in this study, none of these were statistically associated with LBP. CONCLUSION Addressing particular modifiable risk factors associated with LBP such as smoking, physical inactivity and obesity may also present a wider opportunity to prevent and manage the high burden of illness imposed by co-morbidities such as heart disease and type-2 diabetes.
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Affiliation(s)
- Dein Vindigni
- Private practice of chiropractic, 12 David Street, Lalor, Victoria, 3075, Australia
| | - Bruce F Walker
- School of Medicine, James Cook University, Townsville, Queensland, Australia
| | | | - Cliff Da Costa
- School of Mathematical & Geospatial Sciences, RMIT University, Melbourne, Australia
| | - Lynne Parkinson
- Centre for Research and Education in Ageing, Faculty of Health, The University of Newcastle, New South Wales, Australia
| | - Steve Blunden
- Chief Executive Officer, Durri Aboriginal Corporation Medical Service, Kempsey, New South Wales, Australia
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