Does an Exercise Intervention Improving Aerobic Capacity Among Construction Workers Also Improve Musculoskeletal Pain, Work Ability, Productivity, Perceived Physical Exertion, and Sick Leave?: A Randomized Controlled Trial

Effectiveness of a Goldilocks work intervention to promote musculoskeletal health among industrial workers - A cluster randomized controlled trial

INTRODUCTION

Industrial workers with physically demanding work have increased risk of musculoskeletal pain. The present 12-week Goldilocks Work intervention aimed to organize work among industrial workers to comprise a 'just right' ergonomic balance of physical behaviors (i.e., sit, stand and active) intended to promote musculoskeletal health. The paper investigates the effectiveness of the intervention in reducing low back pain after work.

METHODS

83 workers across 28 workteams in a biotech organization were recruited. Workteams were randomly allocated to receive the intervention or work as usual (control). Intervention workteams implemented the Goldilocks Work planning tool to organize their work tasks towards a predefined 'just right' ergonomic balance (i.e., composition of 60% sitting, 30% standing, 10% active work and hourly task alternation). The primary outcome was low back pain intensity. Secondary outcomes were bodily pain, fatigue, physical exertion, productivity and energy after work measured in the survey, and composition and alternations of physical behaviors measured using wearable sensors.

RESULTS

The intervention was delivered almost as planned, with good quality and high adherence among most workteams. However, the intervention did not change physical behaviors towards the intended 'just right' ergonomic balance. No significant reduction in low back pain (0.07, CI 95%: -0.68; 0.82), bodily pain (0.10, CI 95%: -0.57; 0.76), tiredness (-0.53, CI 95%: -1.24; 0.19), physical exertion (-0.18, CI 95%: -0.83; 0.48), or improvement in energy (0.39, CI 95%: -1.02; 0.23) or productivity (-0.03, CI 95%: -0.77; 0.72) were found.

CONCLUSION

This Goldilocks Work intervention did not promote musculoskeletal health among industrial workers and did not change physical behaviors as intended. Thus, more research is needed into implementation strategies to change physical behaviors during productive work towards an evidence-based 'just right' ergonomic balance.

Association between physical fitness and perceived work ability among Finnish population: a cross-sectional study

OBJECTIVE

This cross-sectional study aims to examine association between different components of physical fitness and perceived work ability among working age population.

METHODS

The population-based study sample included 2050 participants aged 18-74 from the Finnish national Health 2011 study. Physical fitness was assessed by the single leg stand test, the modified push-up test, the vertical jump test and the six-minute walk test, and perceived work ability was assessed via interview. Logistic regression was used for examining the associations between physical fitness and work ability.

RESULTS

After adjusting for potential confounders (age, sex, marital status, educational level, work characteristics, total physical activity, daily smoking, BMI and number of diseases), odds ratios indicated that good work ability was more likely among those who had better balance in single leg stand test (OR = 1.54; 95% CI 1.07-2.24), and who belonged in the high fitness thirds in six-minute walking test (OR = 2.08; 95% CI 1.24-3.49) and in vertical jump test (OR = 2.51; 95% CI 1.23-5.12) compared to lowest third. Moreover, moderate (OR = 1.76; 95% CI 1.02-3.05) to high fitness (OR = 2.87; 95% CI 1.40-5.92) in modified push-up test increased the likelihood of good work ability compared to lowest third.

CONCLUSION

These study results indicate that good musculoskeletal as well as cardiorespiratory fitness are associated with better perceived work ability. Promoting physical fitness in individual and societal level may be potential targets for maintaining good work ability in working age population.

A Scoping Review of Interventions to Improve Occupational Safety and Health of Construction Workers

OBJECTIVE

This review comprehensively examines interventions which sought to improve the occupational safety and/or health of construction workers. Factors that explain the (in)effectiveness of interventions were also summarized.

DATA SOURCE

This review consisted of a search using two electronic databases, PubMed and Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

Targeted workers in the construction industry; had at least one primary outcome that aimed to improve occupational safety and/or health; were published between January 01, 1990 and December 01, 2019; and were written in English.

DATA EXTRACTION AND SYNTHESIS

Two researchers independently carried out the process of reviewing the titles, abstracts and full texts, and extracted all data. If there were differences, discussions were held until a consensus was reached.

RESULTS

A total of 1297 articles were retrieved and 24 were selected for final evaluation. Seventeen studies reported significant intervention effects, while 7 found their primary outcome not significantly improved.

CONCLUSION

Future research should place more effort on interventions aimed at improving both occupational safety and health outcomes in an integrated manner, with environmental interventions that accompany behavioral interventions at the individual level. Besides, additional effort is also needed to ensure the involvement of relevant stakeholders in designing the intervention, avoiding contamination effects (through cluster randomization), optimizing the "dosage" of intervention, and improving measurement of outcomes.

Investigating Associations Between Physical Activity and Presenteeism - A Scoping Review

OBJECTIVE

The aim of this study is to scope the literature on what is currently known between physical activity and presenteeism.

DATA SOURCE

A search strategy was conducting in six scientific databases.

STUDY INCLUSION AND EXCLUSION CRITERIA

Studies written in English about the relation between physical activity and presenteeism were considered for inclusion.

DATA EXTRACTION

Data on definitions and measurement of presenteeism and physical activity were extracted.

DATA SYNTHESIS

The data is categorized according to the understanding of presenteeism of the studies to give a better idea of how this phenomenon is studied in relation to physical activity.

RESULTS

After screening 9773 titles and abstracts and 269 full-text articles, 57 unique articles fulfilled our eligibility criteria. The majority of the articles were published since 2010 and originated predominantly in the United States. Most studies (70%) define presenteeism as lost productivity due to health problems, according to the American line of research, whereas 19% of the studies define it as "working while ill" which refers to the European line of research. The studies that reflected the American school of thought tends to report more results that supported their hypothesis (i.e., that more physical activity is associated with less presenteeism).

CONCLUSION

This review has highlighted the homogeneity in how presenteeism is conceptualized and measured in studies included in our sample. Research on physical activity and presenteeism should be expanded across various disciplines in social sciences to respond to the needs that many researchers have expressed to promote healthier organizations.

A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function

INTRODUCTION

Firefighting is a high-risk job with a high prevalence of work-related musculoskeletal disorders (WMSDs). The aim of his study was to determine the prevalence of WMSDs, estimate the likelihood of subsequent disorders, and investigate the effect of NASM-based training protocol on firefighters function.

METHOD

First, prevalence and region of WMSDs in all 524 male Isfahan firefighters were determined by Medical-history-questionnaire. Then, functional movement screen (FMS) separated firefighters to the 2-dimension FMS score (FMSCS≤14 or FMSCS>14) to show at risk firefighters. Finally, 40 Participants with both FMSCS≤14 and common WMSDs randomly assigned to either an intervention (IG) (n = 20) or control (CG) (n = 20) group. The IG received NASM-based training, while the CG engaged in daily activities. Outcomes included movement efficiency during landing error scoring system-real time, Y balance, single-leg squat, and deep squat, which were assessed in pretest and posttest.

RESULTS

The prevalence of disorders was 52.1%, which lower limb, back, upper limb, and neck were the highest prevalence respectively. Only lower limb and back disorders could identify individuals at disorder risk with a likelihood of 89% and 71%, sequentially. Also, movement performance significantly improved in all functional tests in IG relative to CG.

CONCLUSIONS

Considering high disorder rate in firefighters, the value of our study lies in alleging a systematic model periodically to reduce WMSDs and risk of subsequent disorders. Not only our model determined the prevalence of WMSDs, but it also identified those who are at risk. In addition, our model represents exercise therapy as a solution.

Treatment of Upper Crossed Syndrome: A Narrative Systematic Review

BACKGROUND AND OBJECTIVES

Upper crossed syndrome (UCS) is a common musculoskeletal condition that is characterized by tightness and weakness of the muscles of the neck, shoulders, and upper back. The aim of this current study is to summarize and provide an overview of the treatment in patients with UCS.

MATERIALS AND METHODS

A MEDLINE (PubMed), Cochrane library, Embase, Scopus, and Web of Science database search was conducted for English-language articles about upper crossed syndrome that were published until 19 January 2023. To identify potentially relevant articles, the following key search phrases were combined: "upper crossed syndrome", "upper cross syndrome", "diagnosis", and "treatment". A total of 233 articles were identified. After reading the titles and abstracts and assessing their eligibility based on the full-text articles, 11 articles were finally included in this review. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for the randomized controlled trials (RCTs) and the non-randomized clinical trial (non-RCT), respectively.

RESULTS

Among eleven studies that investigated the effect of treatment programs for UCS, five studies compared the therapeutic effect of exercise programs with controls, whereas six compared different rehabilitative treatment strategies, such as the muscle energy technique, soft-tissue mobilization, and stretching exercises. In addition, regarding the study design, ten studies were RCTs and only one study was a prospective observational study.

CONCLUSIONS

Treatment programs including various types of exercises and techniques to correct an abnormal posture and restore neuromuscular imbalances are effective for decreasing pain and improving neck disabilities and postural deviations in patients with UCS.

Measuring, Analyzing, and Presenting Work Productivity Loss in Randomized Controlled Trials: A Scoping Review

OBJECTIVES

This study aimed to conduct a scoping review of randomized controlled trials (RCTs) and investigate which work productivity loss outcomes were measured in these RCTs, how each outcome was measured and analyzed, and how the results for each outcome were presented.

METHODS

A systematic search was conducted from January 2010 to April 2020 from 2 databases: PubMed and Cochrane Central Register of Controlled Trials. Data on country, study population, disease focus, sample size, work productivity loss outcomes measured (absenteeism, presenteeism, employment status changes), and methods used to measure, report, and analyze each work productivity loss outcome were extracted and analyzed.

RESULTS

We found 435 studies measuring absenteeism or presenteeism, of which 155 studies (35.6%) measured both absenteeism and presenteeism and were included in our final review. Only 9 studies also measured employment status changes. The most used questionnaire was the Work Productivity and Activity Impairment Questionnaire. The analysis of absenteeism and presenteeism data was mostly done using regression models (n = 98, n = 98, respectively) for which a normal distribution was assumed (n = 77, n = 89, respectively). Absenteeism results were most often presented in time whereas presenteeism was commonly presented using a percent scale or score.

CONCLUSIONS

There is a lack of consensus on how to measure, analyze, and present work productivity loss outcomes in RCTs published in the past 10 years. The diversity of measurement, analysis, and presentation methods used in RCTs may make comparability challenging. There is a need for guidelines providing recommendations to standardize the comprehensiveness and the appropriateness of methods used to measure, analyze, and report work productivity loss in RCTs.

Importance of frequency and intensity of strength training for work ability among physical therapists

The aim of the study was to evaluate the association between frequency and intensity of strength training participation and work ability among physical therapists (PTs). The Work Ability Index questionnaire (WAI) and a questionnaire about participation in strength training during leisure time were administered to a sample of Spanish PTs. In addition, participants provided information on gender, age, body mass index, education, substance use, working experience and working hours per week. The odds for having excellent WAI (score 44-49) as a function of intensity or frequency of strength training participation were determined using binary logistic regression controlled for various confounders. Data from 981 PTs were analysed. High-intensity strength training (> 80% 1 RM) showed strong associations with excellent WAI (odds ratio = 9.7; 95% confidence interval, 2.9-31.6). In addition, performing strength training more than 3 times per week was associated with excellent WAI (odds ratio = 1.79; 95% confidence interval, 1.24-2.59), however, no significant associations were found with lower levels of frequency and intensities. High-intensity strength training 3 times per week is associated with excellent WAI among PTs. Training programs meeting these features may importantly contribute to maintain or improve WAI.

Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial

Objective

To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS).

Methods

We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up].

Results

ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group.

Conclusion

Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home.

Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study

Background

Acute musculoskeletal (MSK) pain is very common and associated with impaired productivity and high economic burden. Access to timely and personalized, evidence-based care is key to improve outcomes while reducing healthcare expenditure. Digital interventions can facilitate access and ensure care scalability.

Objective

Present the feasibility and results of a fully remote digital care program (DCP) for acute MSK conditions affecting several body areas.

Methods

Interventional single-arm study of individuals applying for digital care programs for acute MSK pain. Primary outcome was the mean change between baseline and end-of-program in self-reported Numerical Pain Rating Scale (NPRS) score and secondary outcomes were change in analgesic consumption, intention to undergo surgery, anxiety (GAD-7), depression (PHQ-9), fear-avoidance beliefs (FABQ-PA), work productivity (WPAI-GH) and engagement.

Results

Three hundred forty-three patients started the program, of which 300 (87.5%) completed the program. Latent growth curve analysis (LGCA) revealed that changes in NPRS between baseline and end-of-program were both statistically (p < 0.001) and clinically significant: 64.3% reduction (mean − 2.9 points). Marked improvements were also noted in all secondary outcomes: 82% reduction in medication intake, 63% reduction in surgery intent, 40% in fear-avoidance beliefs, 54% in anxiety, 58% in depression and 79% recovery in overall productivity. All outcomes had steeper improvements in the first 4 weeks, which paralleled higher engagement in this period (3.6 vs 3.2 overall weekly sessions, p < 0.001). Mean patient satisfaction score was 8.7/10 (SD 1.26).

Strengths and limitations

This is the first longitudinal study demonstrating the feasibility of a DCP for patients with acute MSK conditions involving several body areas. Major strengths of this study are the large sample size, the wide range of MSK conditions studied, the breadth of outcomes measured, and the very high retention rate and adherence level. The major limitation regards to the absence of a control group.

Conclusions

We observed very high completion and engagement rates, as well as clinically relevant changes in all health-related outcomes and productivity recovery. We believe this DCP holds great potential in the delivery of effective and scalable MSK care.

Trial registration

NCT, NCT04092946. Registered 17/09/2019;

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04891-5.

Online supervised versus workplace corrective exercises for upper crossed syndrome: a protocol for a randomized controlled trial

Background and objective

Musculoskeletal disorders (MSDs) including upper crossed syndrome (UCS) are considered as the leading cause of work-related issues worldwide among office workers. Therefore, the present study aims to evaluate the effect of workplace-based versus online-supervised home-based corrective exercises among office workers with UCS.

Methods and design

To this end, 45 subjects within the age range of 30–45 years are randomly assigned to three groups in the present parallel-group, randomized control trial using a pretest-posttest design. These groups include the subjects who receive online-supervised exercise and workplace exercise containing three sessions of intervention for 8 weeks and the control group receives no intervention while performing routine activities. The primary outcome variables are neck-shoulder pain (NSP) and consequent sick leave due to NSP, followed by alignment, workability, and the surface electromyography of upper, middle, and lower trapezius (UT, MT, and LT), sternocleidomastoid (SCM), and serratus anterior (SA) as the secondary variables.

Discussion

The present study seeks to assess the effect of workplace versus online-supervised corrective exercise interventions among 45 office workers suffering from UCS. It is expected to improve and reduce the related symptoms including postural malalignment and imbalance muscles after 8 weeks of corrective exercises. If effective, the findings may lead to adherence and work performance among the office workers, and individuals subjected to UCS can use the benefits of an online-supervised intervention. In addition, the findings may be useful in different workplaces as the evidence for employers to benefit from the reduction in the related costs and side effects of work-related neck/shoulder disorders including work disability, productivity loss, time expense, social insurance, work absenteeism, and treatment costs. Finally, clinicians and corrective exercise therapists can consider it as a clinical based-evidence intervention for their further actions.

Trial registration

Iranian Registry of Clinical Trials IRCT20200729048249N1. Registered on 5 October 2020 (https://en.irct.ir/user/trial/49992/view)

Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists

Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of restricted work, unemployment, and work disability. The primary purpose of this clinical practice guideline (CPG) is to systematically review available scientific evidence and provide a set of evidence-based recommendations for effective physical therapy evaluation, treatment, and management of individuals experiencing limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):CPG1-CPG102. doi:10.2519/jospt.2021.0303.

Workplace interventions that aim to improve employee health and well-being in male-dominated industries: a systematic review

The published evidence on whether workplace health and well-being interventions are as effective in male-dominated industries compared with mixed-gender environments has not been synthesised. We performed a systematic review of workplace interventions aimed at improving employee health and well-being in male-dominated industries. We searched Web of Knowledge, PubMed, Medline, Cochrane Database and Web of Science for articles describing workplace interventions in male-dominated industries that address employee health and well-being. The primary outcome was to determine the effectiveness of the intervention and the process evaluation (intervention delivery and adherence). To assess the quality of evidence, Cochrane Collaboration’s Risk of Bias Tool was used. Due to the heterogeneity of reported outcomes, meta-analysis was performed for only some outcomes and a narrative synthesis with albatross plots was presented. After full-text screening, 35 studies met the eligibility criteria. Thirty-two studies delivered the intervention face-to-face, while two were delivered via internet and one using postal mail. Intervention adherence ranged from 50% to 97%, dependent on mode of delivery and industry. 17 studies were considered low risk of bias. Albatross plots indicated some evidence of positive associations, particularly for interventions focusing on musculoskeletal disorders. There was little evidence of intervention effect on body mass index and systolic or diastolic blood pressure. Limited to moderate evidence of beneficial effects was found for workplace health and well-being interventions conducted within male-dominated industries. Such interventions in the workplace can be effective, despite a different culture in male-dominated compared with mixed industries, but are dependent on delivery, industry and outcome. CRD42019161283.

Effectiveness of combined aerobic exercise and neck-specific exercise compared to neck-specific exercise alone on work ability in neck pain patients: a secondary analysis of data from a randomized controlled trial

OBJECTIVE

To compare the effect of combined aerobic exercise (AE) and neck-specific exercise to neck-specific exercise alone on the work ability of individuals complaining of neck pain.

METHOD

Secondary analysis of data from a previous randomized controlled trial was conducted to compare AE and neck-specific exercise (AE group, n = 69) to neck-specific exercise alone (control group, n = 70). The Work Ability Index (WAI) was administered after the 6-week intervention, and Global Rating of Change (GROC) was assessed after the 6-week intervention and at 12- and 24-week follow-ups.

RESULTS

Repeated-measure analyses of variance between groups indicated a significant time × group interaction on the GROC at 12- and 24-week follow-ups. The AE group showed better improvement on the GROC (mean ± SD) from 6 to 24 weeks than controls: 4.7(± 0.12) to 5.3 (± 0.13) vs. 4.4 (± 0.13) to 4.1(± 0.13), respectively, (P < 0.001). There was a significant group × time interaction on the WAI (P < 0.001): the AE group showed better improvement (mean ± SD) from baseline to 6-weeks than controls: 34.9 (± 4.4) to 39.2 (± 3.6) vs. 34.4 (± 4.9) to 35.8 (± 4.9), respectively, (P < 0.001). Work ability of participants with poor/moderate baseline scores improved more (P < 0.001) than those with good/excellent baseline scores (P = 0.48).

CONCLUSIONS

Combining moderate AE and neck-specific exercise improved the work ability of patients with NP more than neck-specific exercise alone. The combination should be recommended in health promotion programs, particularly for workers with low baseline work ability.

CLINICAL TRIAL

Registered at ClinicalTrial.gov: NCT02451267; date of registration: 21 May 2015. https://clinicaltrials.gov/ct2/home.

Investigating associations between physical activity and presenteeism: a scoping review protocol

INTRODUCTION

Considering that physical activity plays a key role in the health of workers, a growing number of researchers are studying its relationship with various workplace outcomes, such as presenteeism. Numerous scientists recognise the relevance of further studying this relationship in order to improve our understanding of it. However, studies about the association between physical activity and presenteeism show some discrepancy in the results obtained. Disparity in the way of measuring presenteeism makes it even more challenging to compare results. In addition, it remains difficult to determine the optimal frequency, intensity, duration and type of physical activity to increase the productivity benefits of physical activity. In light of these issues, clarification through a scoping review of the literature on the subject is warranted.

METHOD AND ANALYSIS

A search strategy will be conducted in six scientific databases: MEDLINE, CINAHL, PsycINFO, ABI Inform Global, Web of Science and Business Source Premier. A screening process by two independent reviewers will lead to study selection. Quantitative and qualitative studies written in English about the relation between physical activity and presenteeism will be considered for inclusion. Data on the definition and measurement of presenteeism as well as the measurement of physical activity will be extracted. Additional data will be extracted to provide a descriptive overview of studies that have examined the relationship between presenteeism and physical activity.

ETHICS AND DISSEMINATION

As this study will be based only on published studies, ethics approval is not required. Through the manner in which the included studies will be presented (categorised by their approach to presenteeism), this scoping review has the potential to improve our understanding of some of the inconsistencies observed in the literature. This review can also identify gaps in the existing evidence base and lead to new avenues of research.

A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work

Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752 ).

Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial

Background

To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations.

Methods

We randomized 265 healthy, sedentary, middle-aged women (45–65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO_2peak) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7–36 points, n = 83), good (WAI 2, 37–43 points, n = 136) and excellent (WAI 3, 44–49 points, n = 46) WAI subgroups.

Results

Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3 ± 5.0 to 39.8 ± 4.9 points) but not in the CG (39.4 ± 4.7 to 39.3 ± 4.9 points), with a significant difference between groups (p < 0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0 ± 2.9 to 36.6 ± 4.8 points, p < 0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2 ± 2.1 to, 40.4 ± 3.7 points) and excellent (WAI 3, 45.6 ± 1.5 to 45.7 ± 1.8 points) subgroup.

Conclusions

A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals.

Trial registration

German Clinical Trails Register Identifier: DRKS00005159. Registered 25 September 2013.

Effectiveness of Workplace Interventions for Improving Absenteeism, Productivity, and Work Ability of Employees: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

To determine the effectiveness of workplace interventions and the most effective methodological design for the improvement of employee productivity, work ability, and absenteeism. A meta-analysis of randomized controlled trials (RCTs) of workplace interventions was conducted (PROSPERO, CRD42018094083). The PubMed, Scopus, PsycINFO, and Cochrane databases were searched. RCTs from 2000 to 2017 and with employees (18-65 years) were selected. Then, intervention characteristics and work-related outcomes data were extracted. A total of 47 RCTs were included in the systematic review, and 19 RCTs (11 absenteeism, 7 productivity, and 5 work ability) were included in the meta-analysis. The meta-analysis showed that the effectiveness of workplace interventions for absenteeism was -1.56 (95% CI, -2.67 to -0.44) and -2.65 (95% CI, -4.49 to -0.81) considering only moderate quality RCTs. In contrast, only a few studies of workplace interventions for productivity and work ability were included, which was insufficient for determining the effectiveness and best design for improving these work outcomes. The workplace is an interesting environment to reduce absenteeism, and individualized and counseling interventions with <10 sessions/total were the most effective workplace intervention methodological design for reducing the absenteeism of employees. Future high-quality RCTs that also consider health risks should be implemented to strengthen the results.

Education as a strategy for managing occupational-related musculoskeletal pain: a scoping review

BACKGROUND

Musculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and individualised advice could be essential and effective for managing persistent MSK pain.

OBJECTIVE

The objective of this scoping review was to map the existing educational resources for work-related MSK (WRMSK) pain, and the effects of implementing educational strategies in the workplace on managing WRMSK pain.

METHODS

This scoping review assessed original studies that implemented and assessed education as a strategy to manage WMSK pain. Literature search strategies were developed using thesaurus headings (ie, MeSH and CINAHL headings) and free-text search including words related to MSK in an occupational setting. The search was carried out in PubMed, CINAHL, Cochrane Library and Web of Science in the period 12-14 February 2019.

RESULTS

A total of 19 peer-reviewed articles were included and the study design, aim and outcomes were summarised. Of the 19 peer-reviewed articles, 10 randomised controlled trial (RCT) studies assessed the influence of education on work-related MSK pain. Many studies provided a limited description of the education material and assessed/used different methods of delivery. A majority of studies concluded education positively influences work-related MSK pain. Further, some studies reported additive effects of physical activity or ergonomic adjustments.

CONCLUSIONS

There is a gap in knowledge regarding the best content and delivery of education of material in the workplace. Although beneficial outcomes were reported, more RCT studies are required to determine the effects of education material as compared with other interventions, such as exercise or behavioural therapy.

Exercise alone and exercise combined with education both prevent episodes of low back pain and related absenteeism: systematic review and network meta-analysis of randomised controlled trials (RCTs) aimed at preventing back pain

OBJECTIVES

We aimed to investigate which prevention strategies for low back pain (LBP) are most effective.

DESIGN

We completed a Bayesian network meta-analysis to summarise the comparative effectiveness of LBP prevention strategies. The primary outcomes were an episode of LBP and LBP-associated work absenteeism represented as ORs with associated 95% credibility intervals (CrIs). We ranked all prevention strategies with surface under the cumulative ranking curve (SUCRA) analysis.

DATA SOURCES

PubMed, EMBASE and CENTRAL databases were searched along with manual searches of retrieved articles. We only included randomised controlled trials (RCTs) that reported an episode of LBP and/or LBP-associated work absenteeism evaluating LBP prevention strategies were included.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Data were independently extracted by two investigators, and RCT quality was assessed using the Cochrane Risk of Bias tool.

RESULTS AND SUMMARY

Forty RCTs were included. Exercise combined with education (OR: 0.59, CrI: 0.41 to 0.82) and exercise alone (OR: 0.59, CrI: 0.36 to 0.92) both prevented LBP episodes; exercise combined with education and education alone both had large areas under the curve (SUCRA: 81.3 and 79.4, respectively). Additionally, exercise (OR: 0.04, CrI: 0.00 to 0.34) prevented LBP-associated work absenteeism, with exercise and the combination of exercise and education ranking highest (SUCRA: 99.0 and 60.2, respectively).

CONCLUSIONS

Exercise alone and exercise combined with education can prevent episodes of LBP and LBP-related absenteeism.

TRIAL REGISTRATION NUMBER

PROSPERO 42017056884.

Physical-work ability and chronic musculoskeletal complaints are related to leisure-time physical activity: Cross-sectional study among manual workers aged 50–70 years

Aims: To investigate the associations between both high- and low-intensity leisure-time physical activity on physical-work ability and chronic musculoskeletal complaints among manual workers aged 50–70 years. Methods: In this cross-sectional study, 1763 manual workers (mean age 57.1, SD ± 4.7 years) replied to questions about leisure-time physical activity, physical-work ability, chronic musculoskeletal complaints as well as health and lifestyle factors. Ordinal and binomial logistic regression models were constructed to assess the influence of the duration of both low- and high-intensity physical activity on physical-work ability and chronic musculoskeletal complaints, respectively. Models were adjusted for gender, age, smoking, alcohol intake, body mass index, physical-work demand, work experience, chronic disease and, regarding physical-work ability, also for chronic musculoskeletal complaints. Results: A statistically significant association between greater physical-work ability and high-intensity physical activity was found for workers engaged in 3–4 h/wk and ⩾ 5 h/wk (OR 1.59, 95% CI 1.15–2.19 and OR 1.56, 95% CI 1.10–2.22, respectively). For both high- and low-intensity physical activity, a duration of 3–4 h/wk was associated with lower odds of reporting chronic musculoskeletal complaints in the knees (OR 0.65, 95% CI 0.42–1.00 and OR 0.61, 95% CI 0.38–0.99, respectively). Conclusions: Engaging in ⩾ 3 h/wk of high-intensity leisure-time physical activity was associated with greater physical-work ability among manual workers aged 50–70 years. Both high- and low-intensity physical activity related to lower odds of having chronic musculoskeletal complaints in the knees.

Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials

The aim of this systematic review and meta-analysis was to assess the effect of exercise in population-based interventions to prevent low back pain (LBP) and associated disability. Comprehensive literature searches were conducted in multiple databases, including PubMed, Embase, and the Cochrane Library, from their inception through June 2017. Thirteen randomized controlled trials (RCTs) and 3 nonrandomized controlled trials (NRCTs) qualified for the meta-analysis. Exercise alone reduced the risk of LBP by 33% (risk ratio = 0.67, 95% confidence interval: 0.53, 0.85; I2 = 23%, 8 RCTs, n = 1,634), and exercise combined with education reduced it by 27% (risk ratio = 0.73, 95% confidence interval: 0.59, 0.91; I2 = 6%, 6 trials, n = 1,381). The severity of LBP and disability from LBP were also lower in exercise groups than in control groups. Moreover, results were not changed by excluding the NRCTs or adjusting for publication bias. Few trials assessed health-care consultation or sick leave for LBP, and meta-analyses did not show statistically significant protective effects of exercise on those outcomes. Exercise reduces the risk of LBP and associated disability, and a combination of strengthening with either stretching or aerobic exercises performed 2-3 times per week can reasonably be recommended for prevention of LBP in the general population.

Is fatigue after work a barrier for leisure-time physical activity? Cross-sectional study among 10,000 adults from the general working population

Aim: In spite of the many health-related benefits of regular physical activity, fatiguing work may be a barrier to performing leisure-time physical activity. This study investigates the association between work-related fatigue and the duration of low- and high-intensity leisure-time physical activity in workers with sedentary and physically demanding jobs. Methods: From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners from the general working population ( N=10,427) replied to questions about work-related fatigue (predictor) and duration of low- and high-intensity leisure-time physical activity (outcome). Associations were modelled using general linear models controlling for various confounders. Results: Among workers with physically demanding jobs, higher levels of work-related fatigue were associated with gradually lower levels of leisure-time physical activity – for low, moderate and high levels of work-related fatigue the duration of high-intensity leisure-time physical activity was 133 (95% confidence interval (CI) 127–178), 134 (95% CI 109–160) and 113 (95% CI 86–140) min per week, respectively (trend test p<0.001). The duration of high-intensity leisure-time physical activity was lower among older workers (≥50 years) compared to younger workers (<50 years) (132 ± 126 vs 168 ± 150 min per week) ( p<0.0001). Conclusions: The duration of high-intensity leisure-time physical activity gradually decreases with increased work-related fatigue in workers with physically demanding jobs. Older workers perform less high-intensity physical activity than younger workers. Workplaces should consider initiatives to allow workers with physically demanding jobs and older workers to perform physical exercise during working hours and thereby increase physical capacity to meet the job demands.

Association between V̇O2max, handgrip strength, and musculoskeletal pain among construction and health care workers

Background

Construction and health care workers have a high prevalence of musculoskeletal disorders, and they are assumed to have physically demanding jobs. Profession- and gender-specific associations between individual capacity and musculoskeletal pain have not been sufficiently investigated. The main aim of this study was to examine the association between individual capacity (maximal oxygen uptake (V̇O_2max) and handgrip strength) and musculoskeletal pain among construction and health care workers.

Methods

This cross-sectional study examined 137 construction and health care workers (58 women and 79 men) with a mean age of 41.8 years (standard deviation 12). Aerobic capacity was indirectly assessed by the Åstrand cycle test, and strength was assessed by a handgrip test. Musculoskeletal pain was described by total pain, divided into neck, shoulder, and low back pain, during the last 12 months, and it was dichotomized in below or above 30 days. Logistic regression was used to analyse the associations between V̇O_2max, strength, and musculoskeletal pain in the total study sample and separately for construction and health care workers. Analyses were adjusted for age, gender, body mass index (BMI), and selected mechanical and psychosocial factors.

Results

Every second participant (51.8%) reported pain in either neck, shoulders or low back for more than 30 days during the last 12 months. Among the health care workers, a small but significant association was found between a high V̇O_2max, high handgrip strength, and a low level of musculoskeletal pain. No association was found for the construction workers.

Conclusions

An association between V̇O_2max, handgrip strength, and musculoskeletal pain was found for health care workers but not for construction workers. These results indicate that activities promoting individual capacity may reduce musculoskeletal pain for health care workers.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4173-3) contains supplementary material, which is available to authorized users.

Factors affecting pain relief in response to physical exercise interventions among healthcare workers

The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain.

Sickness Presenteeism Among Health Care Workers and the Effect of BMI, Cardiorespiratory Fitness, and Muscle Strength

OBJECTIVES

The primary objective of this study was to assess the relationship between sickness presenteeism and body mass index (BMI), cardiorespiratory fitness (CRF), and maximal voluntary contraction (MVC).

METHODS

Female health care workers (n = 139) were analyzed cross-sectional as well as longitudinal after 3 and 12-month follow-up. Sickness presenteeism was assessed as a summed score using validated questions from three questionnaires: Health and Work Performance Questionnaire, Work Ability Index, and Quantity and Quality Method. CRF was assessed by a maximal cycling test and MVC from four muscle groups.

RESULTS

Significant relationships were found between sickness presenteeism and BMI as well as MVC both cross-sectional and as changes over 3 months. Participants with BMI more than 30  kg/m had significantly higher sickness presenteeism than those with BMI less than 25  kg/m.

CONCLUSIONS

This study suggests that actions that decrease BMI and increase MVC decrease the amount of sickness presenteeism.

High Job Demands, Job Strain, and Iso-Strain are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up

OBJECTIVE

To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations.

METHODS

Respondents (n = 11,729), given to complete a questionnaire in 2004 to 2006, were followed up approximately 5 years for sick leave spells due to mental disorders, using national registry data. Data were analyzed using logistic regression, and conditional logistic regression for twin pairs discordant for sick leave (cotwin control).

RESULTS

High job demands, job strain, and iso-strain were independent risk factors for sick leave due to mental disorders. Familial factors seem to be of importance in the associations between job support, smoking, a combination of unhealthy behaviors and sick leave.

CONCLUSIONS

Improving the psychosocial work environment may be effective in preventing sick leave due to mental disorders.

Occupational and leisure-time physical activity and workload among construction workers - a randomized control study

BACKGROUND

There is a lack of quantification of occupational physical activity (OPA) and leisure time physical activity (LTPA) among construction workers.

OBJECTIVES

To describe physical activity energy expenditure (PAEE), physical workload, and the effect of a PA-intervention among construction workers.

METHODS

Sixty-seven Construction workers self-reported their physical activity (PA), had PA assessed directly (PAEE), and observed OPA using the tool "Posture, Activity, Tools and Handling." The PA-intervention (Intervention; n = 29, Controls; n = 24) included 3x20-min training/week for 12 weeks.

RESULTS

Baseline median OPA was 5036 MET-min/week and LTPA 2842 MET-min/week, p < 0.01. OPA directly recorded was (mean ± SE): 56.6 ± 3.2 J/kg/min and LTPA was: 35.7 ± 2.2 J/kg/min (p < 0.001). Manual material handling was performed for ≥ 25% of working time by more than 50% of the participants. Post-intervention, the training group reduced overall PAEE compared to the control group but not specifically during work.

CONCLUSIONS

OPA was within the maximum recommended level of 1/3 proposed in consensus guidelines but did not decrease with PA-intervention.

The effect on work ability of a tailored ergonomic learning program

BACKGROUND

The physical working conditions and the musculoskeletal health of industrial workers have an effect on their work ability.

OBJECTIVE

The paper evaluates the effectiveness of an ergonomic learning program focused on the development of low strain working techniques. The project is evaluated in regard to its capacity to improve and sustain the work ability of industrial workers with high physical work demands.

METHOD

249 employees at an industrial work site were followed over 2½ years. About one third of the employees were selected into differentiated courses according to the severity of musculoskeletal disorders. The reference group consisted of the departments that did not participate. The project was evaluated by using questionnaires and interviews.

RESULTS

The evaluation of the project only showed minor, non-significant increases in the work ability of the group of employees participating in the most intensive activities. Self- reported productivity increased in all departments, with the largest improvement found among the employees in the department, where everyone participated in a course (8.6% , p = 0.003).

CONCLUSIONS

Work ability is composed of many different factors, physiological, physical as well as psycho-social and this may explain the only limited results even of the extensive project activities in the present study. However, the evaluation indicated that job rotation in combination with more healthy work methods could sustain the work ability of employees with more severe musculoskeletal disorders.

Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial

BACKGROUND

Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers.

METHODS

Two hundred female healthcare workers (Age: 42.0, BMI: 24.1, work ability index [WAI]: 43.1) from 18 departments at three Danish hospitals participated (Copenhagen, Denmark, Aug 2013-Jan 2014). Participants were randomly allocated at the cluster level to 10 weeks of: 1) workplace physical exercise (WORK) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI.

RESULTS

Significant group by time interaction was observed for WAI (p < 0.05). WAI at follow-up was 1.1 (0.3 to 1.8) higher in WORK compared with HOME corresponding to a small effect size (Cohens'd = 0.24). Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in HOME. Of the seven items of WAI, item 2 (work ability in relation to the demands of the job) and item 5 (sickness absence during the past year) were improved in WORK compared with HOME (P < 0.05).

CONCLUSIONS

Performing physical exercise together with colleagues at the workplace prevents deterioration of work ability among female healthcare workers.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov NCT01921764 . Registered 10 August 2013.

Physical activity levels at work and outside of work among commercial construction workers

OBJECTIVE

Characterize the number of minutes of moderate and vigorous physical activities at work and outside of work during seven consecutive days, in a sample of 55 commercial construction workers.

METHODS

Workers wore accelerometers during work and outside-of-work hours for seven consecutive days and completed brief survey at the seventh day of data collection.

RESULTS

From the directly measured physical activity, the average number per participant of moderate minutes of occupational physical activity and physical activity outside of work obtained in short bouts were 243 minutes (65%) and 130 minutes (35%), respectively. Directly measured minutes of vigorous occupational physical activity were significant and positively correlated with self-reported fatigue.

CONCLUSIONS

Among commercial construction workers, physical activity from work contributes significantly, approximately two thirds, toward a worker's total amount of weekly minutes of moderate physical activity.

Physical exercise at the workplace reduces perceived physical exertion during healthcare work: cluster randomized controlled trial

BACKGROUND

High physical exertion during work is a risk factor for musculoskeletal pain and long-term sickness absence. Physical exertion (RPE) reflects the balance between physical work demands and physical capacity of the individual. Thus, increasing the physical capacity through physical exercise may decrease physical exertion during work. This study investigates the effect of workplace-based versus home-based physical exercise on physical exertion during work (WRPE) among healthcare workers.

METHODS

200 female healthcare workers (age: 42.0, body mass index: 24.1, average pain intensity: 3.1 on a scale of 0 to 10, average WRPE: 3.6 on a scale of 0 to 10) from 18 departments at three participating hospitals. Participants were randomly allocated at the cluster level to 10 weeks of: (1) workplace physical exercise (WORK) performed in groups during working hours for 5×10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (2) home-based physical exercise (HOME) performed during leisure time for 5×10 minutes per week. Physical exertion was assessed at baseline and at 10-week follow-up.

RESULTS

2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. Physical exertion was reduced more in WORK than HOME (p<0.01). Between-group differences in physical exertion at follow-up (WORK vs. HOME) was -0.5 points (95% CI -0.8 to -0.2). Within-group effect size (Cohen's d) in WORK and HOME was 0.43 and 0.13, respectively.

CONCLUSIONS

Physical exercise performed at the workplace appears more effective than home-based exercise in reducing physical exertion during daily work tasks in healthcare workers.

A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial

Background

Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers.

Methods/Design

A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period.

Discussion

This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability.

Improved fitness after a workbased physical exercise program

Purpose

– The purpose of this paper is to investigate the effects on fitness outcomes of a work-based physical exercise (PE) intervention among women working in older people’s care. In addition, effects on productivity-related outcomes including work ability and sickness absence were studied.

Design/methodology/approach

– Employees participated in a one-year intervention involving two one-hour weekly mandatory PE sessions. The intervention (n=13) was compared to referents (n=12). Fitness tests and self-reports on work ability and sickness absence were obtained before the intervention (T1), six months into the intervention and after 12 months.

Findings

– Fitness test scores (corrected for age and weight) increased significantly over time in the intervention group but not among referents. Perceived exertion decreased significantly in the intervention group and increased significantly among referents. For self-rated work ability and sickness absence, no significant time or group differences emerged.

Research limitations/implications

– Further research on larger groups of women is needed to delineate the effects of PE on self-rated productivity and performance.

Practical implications

– Work-based PE programs can improve fitness among women in older people’s care.

Social implications

– With previous research having primarily focussed on men, this study shows that women in blue-collar jobs also may benefit from taking part in work-based PE programs.

Originality/value

– This paper makes an important contribution through its focus on the effects of a work-based PE program on fitness and possible relations to productivity, among employed women.

Loss of heat acclimation and time to re-establish acclimation

Acclimation in a hot environment is one potent means to decrease the heat strain of work in a hot environment. However, with diminished heat exposure, positive adaptations of acclimation may be lost. This rate of loss is equivocal and, once established, could be used to prescribe the time for re-acclimation. The purpose of this study was to determine the rate of loss of heat acclimation over a period of 6 weeks and determine the time needed for re-acclimation after 2 weeks and 4 weeks of de-acclimation in ten healthy participants. All participants first underwent an initial acclimation period (a 3-day plateau in Tre was used to signify acclimation). Based on the mean time to acclimate in Phase 1 (mean time to acclimate = 6.1 ± 1.4 days), the loss of acclimation was mapped and participants were randomly assigned to one of two groups: one that underwent one 2-hr heat exposure at 1, 3, and 5 weeks post-acclimation, and one that underwent one 2-hr heat exposure session at 2,4, and 6 weeks. Complete loss of acclimation occurred in 6 weeks and, as expected, work HR and Tre increased with increasing time away from the heat (p<0.05). Based on the time for total loss of acclimation from Phase 1, participants in Phase 2 (n = 8) first underwent acclimation. Then, after either a 2-week or 4-week absence from the heat, participants returned to the laboratory for re-acclimation. While not statistically significant yet practically significant (p = 0.18; one-tailed confidence interval), average days for re-acclimation in the 2-week group tended to be fewer than in the 4-week group (days for re-acclimation = 3.8 ± 1.2 and 5.3 ± 1.9, respectively). Based on these general trends, for occupational settings, a re-acclimation period of 4 days is recommended after 2 weeks absence from the heat, 5 days for 4 weeks absence from the heat, and complete acclimation (6 days) after 6 weeks absence or more from the heat.

Are elderly construction workers sufficiently fit for heavy manual labour?

This study analysed the work ability of elderly construction workers. Forty male construction workers, 20 young (age < 33 yrs) and 20 senior (age>44 yrs) workers, were tested regarding aerobic power (VO2max) and muscle strength. The aerobic demand of a number of tasks in construction work was measured and compared with the workers' aerobic power. VO2max was higher for the young, and they performed better on most muscle strength tests. The measurements showed that about half of the senior workers had to use more than 30% of their maximum oxygen uptake on some tasks. In conclusion, because elderly construction workers decline in physical fitness, they are more exposed to overload when performing heavy manual work than are their younger peers. Increasing their individual fitness or adjusting their workload may be important for staying in the workforce for such workers.

PRACTITIONER SUMMARY

Construction workers must occasionally perform strenuous work tasks that may endanger their safety. This was more often the case for elderly workers investigated here. Elderly workers should therefore be particularly observant of their physical fitness, and should possibly train during leisure time to improve their fitness.

Short- and Long-term Effects of a Physical Exercise Intervention on Work Ability and Work Strain in Symptomatic Menopausal Women

BACKGROUND

Physical exercise during leisure time is known to increase physical capacity; however, the long-term effects on work ability and work strain are inconclusive. The aim of this study was to investigate the effects of a 6-month physical exercise program on work ability and work strain after 6 months and 30 months, among women with menopausal symptoms at baseline.

METHODS

A questionnaire including questions on work ability and work strain was mailed in the beginning, at 6 months and after 30 months after the intervention to occupationally active women participating in a randomized controlled study on physical exercise and quality of life. The intervention included aerobic exercise training 4 times per week, 50 minutes per session. Work ability was measured with the Work Ability Index (WAI) and with questions about physical and mental work strain.

RESULTS

Women aged 47-62 years (N = 89) who were occupationally active at baseline were included in the analyses. The increase in WAI from baseline to the end of the exercise intervention (6 months) was statistically significantly greater among the intervention group than among the control group (regression coefficient 2.08; 95% confidence interval 0.71-3.46). The difference between the groups persisted for 30 months. No significant short- or long-term effects on physical and mental work strain were found.

CONCLUSION

A 6-month physical exercise intervention among symptomatic menopausal women had positive short-term as well as long-term effects on work ability.

Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study

OBJECTIVE

To examine access to health programs at workplace as a determinant of presenteeism among adults.

METHODS

Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders.

RESULTS

Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions.

CONCLUSIONS

This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

Construction workers working in musculoskeletal pain and engaging in leisure-time physical activity: Findings from a mixed-methods pilot study

BACKGROUND

While exercise has been shown to be beneficial for some musculoskeletal pain conditions, construction workers who are regularly burdened with musculoskeletal pain may engage less in leisure-time physical activity (LTPA) due to pain. In a small pilot study, we investigate how musculoskeletal pain may influence participation in LTPA among construction workers.

METHODS

A sequential explanatory mixed-methods design was employed using a jobsite-based survey (n = 43) among workers at two commercial construction sites and one focus group (n = 5).

RESULTS

Over 93% of these construction workers reported engaging in LTPA and 70% reported musculoskeletal pain. Fifty-seven percent of workers who met either moderate or vigorous LTPA guidelines reported lower extremity pain (i.e., ankle, knee) compared with 21% of those who did not engage in either LTPA (P = 0.04). Focus group analyses indicate that workers felt they already get significant physical activity out of their job because they are "moving all the time and not sitting behind a desk." Workers also felt they "have no choice but to work through pain and discomfort [as the worker] needs to do anything to get the job done."

CONCLUSION

Pilot study findings suggest that construction workers not only engage in either moderate or vigorous LTPA despite musculoskeletal pain but workers in pain engage in more LTPA than construction workers without pain.

Face validity of the single work ability item: comparison with objectively measured heart rate reserve over several days

Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74) aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD)” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005), but not among females (R = 0.11, P = 0.431). In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI) = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16), and a significant interaction between work ability, %HRR and gender was observed (P = 0.03). Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated.