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Koch M, Forsman M, Enquist H, Baare Olsen H, Søgaard K, Sjøgaard G, Østensvik T, Nilsen P, Andersen LL, Due Jacobsen M, Brandt M, Westgaard R, Mork PJ, Fan X, Wærsted M, Veiersted KB. Frequency of breaks, amount of muscular rest, and sustained muscle activity related to neck pain in a pooled dataset. PLoS One 2024; 19:e0297859. [PMID: 38917191 PMCID: PMC11198897 DOI: 10.1371/journal.pone.0297859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/10/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Neck pain remains a persistent challenge in modern society and is frequently encountered across a wide range of occupations, particularly those involving repetitive and monotonous tasks. It might be expected that patterns of trapezius muscle activity at work, characterized by few breaks and prolonged periods of sustained muscle activity, are linked to neck pain. However, previous cross-sectional studies have generally failed to establish a definitive association. While some longitudinal studies have suggested that extended periods of heightened muscle activity could be a risk factor for neck pain, these findings often relied on limited participant numbers or specific professional groups. This study aimed to investigate the relationship between trapezius muscle activity and neck pain by pooling data from seven Scandinavian research institutes encompassing a diverse range of occupational backgrounds. METHODS Electromyographic (EMG) data for the upper trapezius muscle, collected during working hours, were coupled with questionnaire responses pertaining to neck pain, individual characteristics, and potential confounding variables for a total of 731 subjects. Additionally, longitudinal data from 258 subjects were available. The various EMG datasets were consolidated into a standardized format, and efforts were made to harmonize inquiries about neck pain. Regression analyses, adjusting for sex and height, were conducted to explore the associations between muscle activity variables and neck pain. An exposure index was devised to quantify the cumulative neck load experienced during working hours and to differentiate between various occupational categories. RESULTS The cross-sectional data displayed a distinct pattern characterized by positive associations for brief periods of sustained muscle activity (SUMA) and negative associations for prolonged SUMA-periods and neck pain. The longitudinal data exhibited a contrasting trend, although it was not as pronounced as the cross-sectional findings. When employing the exposure index, notable differences in cumulative muscle load emerged among occupational groups, and positive associations with longitudinal neck pain were identified. DISCUSSION The results suggest that individuals with neck pain experience higher cumulative workloads and extended periods of muscle activity over the long term. In the short term, they appear to compensate by taking frequent short breaks, resulting in a lower cumulative workload. Regardless of their occupation, it is crucial to distribute work breaks throughout the workday to ensure that the cumulative load remains manageable.
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Affiliation(s)
- Markus Koch
- National Institute of Occupational Health, Research Group for Work Psychology and Physiology, Oslo, Norway
| | - Mikael Forsman
- Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Henrik Enquist
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Henrik Baare Olsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Petter Nilsen
- Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Musculoskeletal Disorders and Physical Workload, Copenhagen, Denmark
| | - Markus Due Jacobsen
- National Research Centre for the Working Environment, Musculoskeletal Disorders and Physical Workload, Copenhagen, Denmark
| | - Mikkel Brandt
- National Research Centre for the Working Environment, Musculoskeletal Disorders and Physical Workload, Copenhagen, Denmark
| | - Rolf Westgaard
- Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xuelong Fan
- Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Morten Wærsted
- National Institute of Occupational Health, Research Group for Work Psychology and Physiology, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, Research Group for Work Psychology and Physiology, Oslo, Norway
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Ding Z, Xiong Z, Ouyang Y. A Bibliometric Analysis of Neuroscience Tools Use in Construction Health and Safety Management. SENSORS (BASEL, SWITZERLAND) 2023; 23:9522. [PMID: 38067895 PMCID: PMC10708774 DOI: 10.3390/s23239522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/29/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
Despite longstanding traditional construction health and safety management (CHSM) methods, the construction industry continues to face persistent challenges in this field. Neuroscience tools offer potential advantages in addressing these safety and health issues by providing objective data to indicate subjects' cognition and behavior. The application of neuroscience tools in the CHSM has received much attention in the construction research community, but comprehensive statistics on the application of neuroscience tools to CHSM is lacking to provide insights for the later scholars. Therefore, this study applied bibliometric analysis to examine the current state of neuroscience tools use in CHSM. The development phases; the most productive journals, regions, and institutions; influential scholars and articles; author collaboration; reference co-citation; and application domains of the tools were identified. It revealed four application domains: monitoring the safety status of construction workers, enhancing the construction hazard recognition ability, reducing work-related musculoskeletal disorders of construction workers, and integrating neuroscience tools with artificial intelligence techniques in enhancing occupational safety and health, where magnetoencephalography (EMG), electroencephalography (EEG), eye-tracking, and electrodermal activity (EDA) are four predominant neuroscience tools. It also shows a growing interest in integrating the neuroscience tools with artificial intelligence techniques to address the safety and health issues. In addition, future studies are suggested to facilitate the applications of these tools in construction workplaces by narrowing the gaps between experimental settings and real situations, enhancing the quality of data collected by neuroscience tools and performance of data processing algorithms, and overcoming user resistance in tools adoption.
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Affiliation(s)
- Zhikun Ding
- Key Laboratory of Coastal Urban Resilient Infrastructures (Shenzhen University), Ministry of Education, Shenzhen 518060, China
- Guangdong Laboratory of Artificial Intelligence and Digital Economy (SZ), Shenzhen 518060, China
- Sino-Australia Joint Research Center in BIM and Smart Construction, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Green, Efficient and Intelligent Construction of Underground Metro Station, Shenzhen University, Shenzhen 518060, China
| | - Zhaoyang Xiong
- Guangdong Laboratory of Artificial Intelligence and Digital Economy (SZ), Shenzhen 518060, China
- Sino-Australia Joint Research Center in BIM and Smart Construction, Shenzhen University, Shenzhen 518060, China
| | - Yewei Ouyang
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong, China
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Abebe GK, Melkie KA, Alamaw AW, Zemariam AB, Workneh BS. Perceived work-ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022. BMC Public Health 2023; 23:1460. [PMID: 37525203 PMCID: PMC10391903 DOI: 10.1186/s12889-023-16386-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Nurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability. AIMS OF THE STUDY The aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022. METHODS A multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess' the presence of association between dependent and independent variables. RESULTS The findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses' level of work ability, p-value < 0.05. CONCLUSIONS In this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses.
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Affiliation(s)
- Gebremeskel Kibret Abebe
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Kibret Asimare Melkie
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addis Wondmagegn Alamaw
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Atia DT, Elsayed NI, Abdelmonem AF, Mahmoud SMS, Mahmoud MMM, Mohamed KES, Turky KTY, Rashad UM, Abdel Karim AE. Prevalence of Musculoskeletal Disorders among General and Technical Secondary School Students in Egypt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1465. [PMID: 36674223 PMCID: PMC9859266 DOI: 10.3390/ijerph20021465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 06/01/2023]
Abstract
(1) Background: Children spend a lot of time within schools. The school setting generally has many ergonomic hazards and reinforced behavior patterns which put children at greater risk of environmental hazards than adults during their critical developmental stages. (2) Objective: The aim of the current study was to investigate the prevalence of musculoskeletal disorders (MSDs) and detect spinal deformities amongst general and technical secondary school students. (3) Methods: A total of 418 students from the second grade of secondary school in Shaquira governorate, Egypt participated in this cross-sectional study. Each student in the study was screened via Nordic Musculoskeletal Questionnaire (NMQ) and had their upper limb posture measured via RULA (Rapid Upper Limb assessment), and the deviation in their thoracic curve was measured using a scoliometer. (4) Results: There was a prevalence of MSDs amongst students as there were 69.7% of general school students and 83.8% of the technical school students suffering from MSDs with a statistically significant difference between both technical and general school students in RULA score and musculoskeletal complaints, whereas there were non-statistical differences in the scoliometer scale in both general and technical education students. (5) Conclusions: Musculoskeletal problems are prevalent among Egyptian secondary school students, with higher prevalence between technical school students. Therefore, preventive measures and strategies are recommended to overcome the future complications of these musculoskeletal disorders.
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Affiliation(s)
- Doaa Tammam Atia
- Faculty of Physical Therapy, Heliopolis University, Cairo 11785, Egypt
- National Institute of Neuromotor System, General Organization for Teaching Hospitals and Institutes, Cairo 11697, Egypt
| | | | | | | | | | | | | | - Usama M. Rashad
- Faculty of Physical Therapy, Galala University, Suez 43111, Egypt
| | - Amel E. Abdel Karim
- College of Physical Therapy, Misr University for Science and Technology, 6th of October City 12585, Egypt
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An Exploratory Study on the Physical Activity Health Paradox-Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052751. [PMID: 35270444 PMCID: PMC8910306 DOI: 10.3390/ijerph19052751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 12/04/2022]
Abstract
Using a novel approach, this exploratory study investigated whether the physical activity (PA) paradox extends to cardiovascular load and musculoskeletal pain. At baseline, 1–2 days of 24 h heart rate was assessed in 72 workers from construction and healthcare. Workers then reported pain intensity in 9 body regions (scale 0–3) every 6 months for two years. The 2 year average of musculoskeletal pain (sum of 9 pain scores; scale 0–27) was regressed on time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e., ≥20 %HRR, ≥30 %HRR, and ≥40 %HRR, using a novel ilr structure in compositional data analysis. Analyses were stratified for several important variables. Workers spending more time in physical activity at work had higher pain, while workers with more time in physical activity during leisure had less pain (i.e., the PA paradox), but none of the associations were statistically significant. Higher aerobic capacity and lower body mass index lowered the pain score among those with higher physical activity at work. This exploratory study suggests that the PA paradox may apply to musculoskeletal pain and future studies with larger sample sizes and additional exposure analyses are needed to explain why this occurs.
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Effectiveness of Augmented Reality in Stroke Rehabilitation: A Meta-Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12041848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Augmented reality (AR)-based rehabilitation shows potential to improve upper and lower limb function after stroke. This study aims to review the effect of AR technology in the recovery of the upper and lower limb function in stroke patients. Published randomized controlled trials and observational investigations with adult stroke patients were retrieved from five electronic databases to analyze the effect of the AR systems in improving motor function and balance and gait function for stroke patients. The treatment effect was estimated by standardized mean difference (SMD) and 95% confidence interval (CI) using a random effect model for motor function outcomes at the body structure and function, body activity and participation level of the International Classification of Functioning, and balance and gait outcomes. In total, 13 investigations (9 for the upper limb and 4 for the lower limb) were identified. AR demonstrated a significant influence on the upper limb function (SMD = 0.657; 95% CI, 0.287 to 1.026; p = 0.000) and the lower limb function (SMD = 0.52; 95% CI, 0.039 to 1.001; p = 0.034). The present analysis suggests that AR applications could offer options for increasing treatment intensity and promoting motor recovery after a stroke. This approach can be used with the conventional rehabilitation methods as a new intervention for recovering upper and lower limb function.
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Tugba Y, Andsoy II. Musculoskeletal System Disorders among Surgical Nurses Related to Health Industry in Northwestern Turkey: A Cross-sectional Study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2119-2124. [PMID: 34266370 DOI: 10.1080/10803548.2021.1956797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction. Nurses may encounter musculoskeletal disorders (MSDs) and pain episodes stemming from regular exposure to health industry risk factors.Aim. To determine prevalence of MSDs and its associated factors among Turkish surgical nurses.Methods. A cross-sectional design which used a self-administered questionnaire surveys was employed with 169 surgical nurses. The survey included an individual data questionnaire, and Nordic Musculoskeletal Questionnaire- Extended (NMQ-E).Results. 88.8 %of the surgical nurses had musculoskeletal system disorders, and most experienced these problems were related health industry. The interventions causing physical strain in the participants were identified as constant standing up, patient care, carrying heavy loads, sudden movements, patient transfer, and pulling-pushing practices. It was found that the nurses used coping methods including walking, exercising, receiving physiotherapist support, pilates and yoga. The most frequently encountered problems were in the back region. A significant relationship was found between musculoskeletal system problems and the clinic of work, years of work, age, and gender (p < 0.05).Conclusions. Nurses experience musculoskeletal problems related to health industry. It is crucial to determine the real causes of musculoskeletal problems and take appropriate preventive measures to improve workplace ergonomics.
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Affiliation(s)
- Yilmaz Tugba
- Karabuk University Teaching and Training Hospital, Karabuk-Turkey, 78050 E-mail: ; Phone: 00905069389391
| | - Isil Isik Andsoy
- Karabuk University, Health Sciences Faculty, Nursing Department, Karabuk- Turkey E mail: ; Phone: 00905326417803
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Cao Z, Chen T, Cao Y. Effect of Occupational Health and Safety Training for Chinese Construction Workers Based on the CHAID Decision Tree. Front Public Health 2021; 9:623441. [PMID: 34095047 PMCID: PMC8175887 DOI: 10.3389/fpubh.2021.623441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Occupational health and safety (OHS) training is an important way to prevent construction safety risks. However, the effectiveness of OHS training in China is questionable. In this study, the CHAID (chi-squared automatic interaction detection) decision tree, chi-square analysis, and correlation analysis were used to explore the main, secondary, weak, unrelated, and expectation factors affecting the effectiveness of training. It is the first to put forward the "five-factor method" of training effectiveness. It is found that training effectiveness is positively correlated with job responsibilities, OHS training, and job satisfaction. It is also significantly related to job certificate, training time, training method, and working time. However, the effectiveness of training has nothing to do with personal age, marital status, educational level, job type, and whether or not they have experienced industrial accidents. And the workers on site expect the enterprise to provide security and opportunities such as physical safety, training and learning, and future career development. The results show that OHS system training should be strengthened in the construction industry, and classified training should be carried out according to post responsibility, training methods, job satisfaction, and working hours.
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Affiliation(s)
- Zhonghong Cao
- School of Accounting, Wuhan Qingchuan University, Wuhan, China
| | - Tao Chen
- School of Management, Wuhan University of Science and Technology, Wuhan, China
| | - Yuqing Cao
- School of Physics, Huazhong University of Science and Technology, Wuhan, China
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Lunde LK, Merkus S, Koch M, Knardahl S, Wærsted M, Veiersted KB. Associations of objectively measured total duration and maximum bout length of standing at work with lower-extremity pain intensity: a 2-year follow-up of construction and healthcare workers. BMC Musculoskelet Disord 2021; 22:43. [PMID: 33413254 PMCID: PMC7791765 DOI: 10.1186/s12891-020-03868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022] Open
Abstract
Background Musculoskeletal disorders are among the major reasons for years lived with disability. Approximately one third of the European working population report lower-extremity discomfort and many attribute these discomforts to work-related factors. Employees in the healthcare and construction sectors reports high levels of lower-extremity pain and commonly relate the pain to their profession. These workers spend a large part of their workday standing. Periods of prolonged standing is suggested to increase lower-extremity symptoms, but this cannot be concluded on, since limited evidence is available from longitudinal studies using objective measures. This study aimed to determine possible associations between objectively measured total duration and maximum bout length of static- and dynamic standing at work and lower-extremity pain intensity (LEPi) among Norwegian construction- and healthcare workers. Methods One-hundred and twenty-three construction and healthcare workers wore two accelerometers for up to four consecutive days, to establish standing behavior at baseline. The participants reported LEPi (Likert scale 0–9) for the preceding 4 weeks at baseline and after 6, 12, 18, and 24 months. We investigated associations between standing at work and average and change in LEPi using linear mixed models with significance level p ≤ 0.05. Results Total duration of static- and dynamic standing showed weak associations with average LEPi, for the total sample and for construction workers. Maximum bout of static- and dynamic standing was associated with average LEPi in construction workers, but not in healthcare workers. Furthermore, we found no associations between standing and change in LEPi over the 2-year follow-up in any of our analyses. Conclusions This study indicate that objectively measured standing is associated with average LEPi over 2-years follow-up in construction workers, and that maximal bout of standing have a stronger association to LEPi than total duration. For every 10 min added to the maximal length of continuous standing during an average workday, we found approximately one unit increase in pain on a 0–9 scale. The lack of significant findings in analyses on healthcare workers suggest that the association between standing and LEPi depend on work-tasks, gender and/or other sector-specific factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-020-03868-0.
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Affiliation(s)
- Lars-Kristian Lunde
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway.
| | - Suzanne Merkus
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Stein Knardahl
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Morten Wærsted
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, P.O. Box 5330, Majorstuen, 0304, Oslo, Norway
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Can a metric combining arm elevation and trapezius muscle activity predict neck/shoulder pain? A prospective cohort study in construction and healthcare. Int Arch Occup Environ Health 2020; 94:647-658. [PMID: 33278002 PMCID: PMC8068682 DOI: 10.1007/s00420-020-01610-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/09/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine whether a composite metric of arm elevation and trapezius activity (i.e. neck/shoulder load) is more strongly associated with the 2-year course of neck and shoulder pain intensity (NSPi) among construction and healthcare workers than each exposure separately. METHODS Dominant arm elevation and upper trapezius muscle activity were estimated in construction and healthcare employees (n = 118) at baseline, using accelerometry and normalized surface electromyography (%MVE), respectively. At baseline and every 6 months for 2 years, workers reported NSPi (score 0-3). Compositions of working time were determined for arm elevation (< 30°; 30-60°; > 60°), trapezius activity (< 0.5%; 0.5-7.0%; > 7.0%MVE), and a composite metric "neck/shoulder load" (restitution, low, medium, and high load). Associations between each of these three compositions and the 2-year course of NSPi were determined using linear mixed models. RESULTS Associations between exposure compositions and the course of NSPi were all weak and in general uncertain. Time spent in 0.5-7.0%MVE showed the largest and most certain association with changes in NSPi during follow-up (β = - 0.13; p = 0.037; corresponding to a -0.01 change in NPSi every 6 months). Among pain-free workers at baseline, medium (β = - 0.23; p = 0.039) and high (β = 0.15; p = 0.031) neck/shoulder load contributed the most to explaining changes in NSPi. CONCLUSION The composite metric of neck/shoulder load did not show a stronger association with the course of NSPi than arm elevation or trapezius activity alone in the entire population, while some indications of a stronger association were found among those who were pain-free at baseline.
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Rypicz Ł, Karniej P, Witczak I, Kołcz A. Evaluation of the occurrence of work-related musculoskeletal pain among anesthesiology, intensive care, and surgical nurses: An observational and descriptive study. Nurs Health Sci 2020; 22:1056-1064. [PMID: 32767424 PMCID: PMC7754151 DOI: 10.1111/nhs.12767] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022]
Abstract
Clinical nurses can encounter musculoskeletal pain episodes stemming from regular exposure to workplace risk factors that contribute to overloads. This study aimed to evaluate the occurrence and location of work-related musculoskeletal pain among Polish nurses. An observational and descriptive survey study was conducted among 136 nurses working in the anesthesiology, intensive care, and surgery units. An extended version of the Nordic Musculoskeletal Questionnaire was used to investigate musculoskeletal pain. Only 8% of the participating nurses experienced no musculoskeletal pain, while 85% suffered from pain in more than one location. The lower back (67%), upper back (59%), and neck (66%) were the most common pain locations. In summary, nurses experienced multiple musculoskeletal pain episodes, occurring most frequently in the spinal region (lower and upper back and neck). It is crucial to determine the real causes of musculoskeletal pain and to take appropriate preventive measures to improve workplace ergonomics.
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Affiliation(s)
- Łukasz Rypicz
- Department of Health Care Economics and QualityWroclaw Medical UniversityWroclawPoland
| | - Piotr Karniej
- Department of Organisation and ManagementWroclaw Medical UniversityWroclawPoland
| | - Izabela Witczak
- Department of Health Care Economics and QualityWroclaw Medical UniversityWroclawPoland
| | - Anna Kołcz
- Laboratory of Ergonomics and Biomedical MonitoringWroclaw Medical UniversityWroclawPoland
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Soares CO, Pereira BF, Pereira Gomes MV, Marcondes LP, de Campos Gomes F, de Melo-Neto JS. Preventive factors against work-related musculoskeletal disorders: narrative review. Rev Bras Med Trab 2020; 17:415-430. [PMID: 32368676 DOI: 10.5327/z1679443520190360] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 09/05/2019] [Indexed: 11/05/2022] Open
Abstract
Musculoskeletal disorders (MSDs) are major causes of morbidity among workers. They comprise several signs and symptoms, as e.g. pain, paresthesia, fatigue and limited range of motion, which can be related to work tasks. Workplace-related factors include physical, psychological, social and biomechanical hazards. The main kinetic factors associated with MSDs include repetitive movements, exerting excessive force, awkward postures, compression and mechanical vibration. Accurate knowledge of epidemiological aspects, evaluation of ergonomic hazards and musculoskeletal symptoms, and workplace exercise may help reduce the occurrence of MSDs. The aim of the present review is to analyze the applicability of preventive strategies against MSDs among workers. We performed a narrative review based on a survey of databases PubMed and BIREME and included studies published in English, Spanish or Portuguese. We found that workplace exercise is beneficial for both employers and workers. Risk analysis of MSDs is essential for early identification of occupational hazards and to prevent health consequences and costs associated with absenteeism.
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Affiliation(s)
| | | | | | - Laís Passos Marcondes
- Physical Therapy, Centro Universitário de Rio Preto - São José do Rio Preto (SP), Brazil
| | - Fabiana de Campos Gomes
- Health Sciences, Faculdade de Medicina de São José do Rio Preto - São José do Rio Preto (SP), Brazil
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Lunde LK, Koch M, Merkus SL, Knardahl S, Wærsted M, Veiersted KB. Associations of objectively measured forward bending at work with low-back pain intensity: a 2-year follow-up of construction and healthcare workers. Occup Environ Med 2020; 76:660-667. [PMID: 31413188 PMCID: PMC6824615 DOI: 10.1136/oemed-2019-105861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/26/2019] [Accepted: 07/06/2019] [Indexed: 12/05/2022]
Abstract
Objectives This study aimed to determine possible associations between objectively measured forward bending at work (FBW) and low-back pain intensity (LBPi) among Norwegian construction and healthcare workers. Methods One-hundred and twenty-five workers wore two accelerometers for 3–4 consecutive days, during work and leisure to establish duration of ≥30° and ≥60° forward bending. The participating workers reported LBPi (0–3) at the time of objective measurements and after 6, 12, 18 and 24 months. We investigated associations using linear mixed models with significance level p≤0.05 and presented results per 100 min. Results The duration of ≥30° and ≥60° FBW was not associated with average LBPi during follow-up, neither for the total sample nor stratified on work sector. Furthermore, analyses on all workers and on construction workers only found no significant association between ≥30° or ≥60° FBW and change in LBPi over the 2-year follow-up. For healthcare workers we found a consistent significant association between the duration of ≥30° FBW at baseline and the change in LBPi during follow-up, but this was not found for ≥60° FBW. Conclusions This study suggests that objectively measured duration of FBW in minutes is not associated with average levels of, or change in LBPi in construction workers over a 2-year period. In healthcare workers, exposure to ≥30° FBW was associated with change in LBPi, while we did not find this for ≥60° FBW. Results may indicate that the associations between FWB and LBP vary depending on type of work tasks, gender or sector-specific factors.
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Affiliation(s)
- Lars-Kristian Lunde
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Markus Koch
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Suzanne Lerato Merkus
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Morten Wærsted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Kaj Bo Veiersted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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Kołcz A, Główka N, Kowal M, Paprocka-Borowicz M. Baropodometric evaluation of foot load distribution during gait in the group of professionally active nurses. J Occup Health 2019; 62:e12102. [PMID: 31837089 PMCID: PMC6970405 DOI: 10.1002/1348-9585.12102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/25/2019] [Accepted: 11/06/2019] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses. METHODS The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait. RESULTS We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045). CONCLUSIONS Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses' work productivity.
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Affiliation(s)
- Anna Kołcz
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Główka
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Kowal
- Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland
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Abstract
Literature shows an increasing interest for the development of augmented reality (AR) applications in several fields, including rehabilitation. Current studies show the need for new rehabilitation tools for upper extremity, since traditional interventions are less effective than in other body regions. This review aims at: Studying to what extent AR applications are used in shoulder rehabilitation, examining wearable/non-wearable technologies employed, and investigating the evidence supporting AR effectiveness. Nine AR systems were identified and analyzed in terms of: Tracking methods, visualization technologies, integrated feedback, rehabilitation setting, and clinical evaluation. Our findings show that all these systems utilize vision-based registration, mainly with wearable marker-based tracking, and spatial displays. No system uses head-mounted displays, and only one system (11%) integrates a wearable interface (for tactile feedback). Three systems (33%) provide only visual feedback; 66% present visual-audio feedback, and only 33% of these provide visual-audio feedback, 22% visual-audio with biofeedback, and 11% visual-audio with haptic feedback. Moreover, several systems (44%) are designed primarily for home settings. Three systems (33%) have been successfully evaluated in clinical trials with more than 10 patients, showing advantages over traditional rehabilitation methods. Further clinical studies are needed to generalize the obtained findings, supporting the effectiveness of the AR applications.
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Merkus SL, Lunde LK, Koch M, Wærsted M, Knardahl S, Veiersted KB. Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare. Int Arch Occup Environ Health 2018; 92:295-307. [PMID: 30443711 PMCID: PMC6420471 DOI: 10.1007/s00420-018-1377-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/29/2018] [Indexed: 01/22/2023]
Abstract
Purpose To assess age-related differences in physical capacity, occupational physical demands, and relative physical strain at a group level, and the balance between capacity and demands at an individual level, for construction and healthcare workers. Methods Shoulder strength, back strength, and aerobic capacity were assessed among construction (n = 62) and healthcare workers (n = 64). During a full working day, accelerometers estimated upper-arm elevation, trunk flexion, and occupational physical activity as indicators of occupational physical demands. Simultaneously, normalised surface electromyography (%sEMGmax) of the upper trapezius and erector spinae muscles, and normalised electrocardiography (percentage heart rate reserve (%HRR)) estimated relative physical strain. Differences between younger (≤ 44 years) and older (≥ 45 years) workers, as well as the moderating effect of age on the associations between capacity and demands, were analysed per sector. Results Compared to younger workers, older workers had similar strength and lower aerobic capacity; older construction workers had similar demands while older healthcare workers had higher demands. Compared to younger workers, older employees had unfavourable muscle activity patterns; %HRR had a tendency to be lower for older construction workers and higher for older healthcare workers. Among construction workers, age moderated the associations between shoulder strength and arm elevation (p = 0.021), and between aerobic capacity and occupational physical activity (p = 0.040). Age did not moderate these associations among healthcare workers. Conclusions In both sectors, the level of occupational physical demands and the higher relative physical strain in older employees require addressing to promote sustainable work participation among an aging population. Electronic supplementary material The online version of this article (10.1007/s00420-018-1377-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Suzanne L Merkus
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway.
| | - Lars-Kristian Lunde
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Morten Wærsted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Stein Knardahl
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
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Association of objectively measured arm inclination with shoulder pain: A 6-month follow-up prospective study of construction and health care workers. PLoS One 2017; 12:e0188372. [PMID: 29176761 PMCID: PMC5703553 DOI: 10.1371/journal.pone.0188372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 10/30/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim was to determine the association of occupational arm inclination with shoulder pain in construction and health care workers. METHODS Arm inclination relative to the vertical was measured with an accelerometer placed on the dominant upper arm for up to four full days at baseline in 62 construction workers and 63 health care workers. The pain intensity in the shoulder and mechanical and psychosocial work factors were measured by self-reports at baseline and prospectively after 6 months. The associations between exposures and shoulder pain were analyzed with multilevel mixed-effects linear regressions. RESULTS For the total study population working with the dominant arm at inclinations > 30° and >120° was associated with lower levels of shoulder pain both cross-sectionally and after 6 months. Associations were attenuated when adjusting for individual and social factors, psychological state, and exposure during leisure time, especially for the high inclination levels. Analyses, only including subjects with no pain at baseline revealed no significant associations. While stratified analysis showed negative associations in the construction worker group, there were no significant association in health care workers. Compared to the number of hypotheses tested, the number of significant findings was low. Adjustment by Bonferroni-correction made almost all findings insignificant. CONCLUSIONS All analyses reflected a negative association between arm inclination and shoulder pain, but few analyses showed these associations to be statistically significant. If there is a relationship between arm inclination and shoulder pain, these findings could indicate that pain-avoidance may modify how workers perform their tasks.
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Moberg LL, Lunde LK, Koch M, Tveter AT, Veiersted KB. Association between V̇O 2max, handgrip strength, and musculoskeletal pain among construction and health care workers. BMC Public Health 2017; 17:272. [PMID: 28320356 PMCID: PMC5359892 DOI: 10.1186/s12889-017-4173-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 03/04/2017] [Indexed: 11/17/2022] Open
Abstract
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 (V̇O2max) 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 V̇O2max, 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 V̇O2max, high handgrip strength, and a low level of musculoskeletal pain. No association was found for the construction workers. Conclusions An association between V̇O2max, 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.
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Affiliation(s)
- Lene Lehmann Moberg
- National Institute of Occupational Health, PO Box 8149 Dep, 0033, Oslo, Norway.,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PO Box 4, St. Olavsplass, 0130, Oslo, Norway
| | - Lars-Kristian Lunde
- National Institute of Occupational Health, PO Box 8149 Dep, 0033, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, PO Box 8149 Dep, 0033, Oslo, Norway
| | - Anne Therese Tveter
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PO Box 4, St. Olavsplass, 0130, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, PO Box 8149 Dep, 0033, Oslo, Norway.
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The Impact of Physical Work Demands on Need for Recovery, Employment Status, Retirement Intentions, and Ability to Extend Working Careers: A Longitudinal Study Among Older Workers. J Occup Environ Med 2017; 58:e140-51. [PMID: 27058492 DOI: 10.1097/jom.0000000000000687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Prospectively investigating whether different approaches of physical work demands are associated with need for recovery (NFR), employment status, retirement intentions, and ability to prolong working life among older employees from the industry and health care sector. METHODS A subsample from the Maastricht Cohort Study was studied (n = 1126). Poisson, Cox, and logistic regression analyses were performed to investigate outcomes. RESULTS Perceiving physical work demands as strenuous was associated with higher NFR. Continuous physical strain was associated with being out of employment 4 years later. Employees with the highest amount of physical work demands perceived they were less able to prolong working life, although no significant associations between physical work demands and retirement intentions were found. CONCLUSIONS Overall, physical work demands were associated with adverse outcomes, with divergent insights for the different approaches of physical work demands.
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Gupta N, Christiansen CS, Hanisch C, Bay H, Burr H, Holtermann A. Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time. BMJ Open 2017; 7:e013251. [PMID: 28093433 PMCID: PMC5253534 DOI: 10.1136/bmjopen-2016-013251] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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 investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time. METHODS 183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1-4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time. RESULTS Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to -139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers. CONCLUSIONS This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Christiana Hanisch
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr, Berlin, Germany
| | - Hans Bay
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr, Berlin, Germany
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Gyo C, Boll M, Brüggmann D, Klingelhöfer D, Quarcoo D, Groneberg DA. Imbalances in the German public health system - numbers of state-certified occupational physicians and relation to socioeconomic data. J Occup Med Toxicol 2016; 11:47. [PMID: 27752276 PMCID: PMC5062824 DOI: 10.1186/s12995-016-0136-3] [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: 02/02/2016] [Accepted: 09/24/2016] [Indexed: 11/10/2022] Open
Abstract
Background State-certified occupational physicians who work as civil servants in the Federal Republic of Germany are key players in the German Public Health system. They control i.e. the legal compliance in occupational health and participate in the occupational disease procedures. Despite the role model function of the German Public health system for many developing countries, this area of Public health is debated to have been hampered in the past years by a disregard concerning structural developments. Methods Different databases were screened for occupational health benchmarks. Obtained data were compared to socioeconomic data and indices were calculated. Results The overall numbers of State-certified occupational physicians decreased in Germany between 1992 and 2012 from 136 to 86 (63 %). On the single state level, the ratios of State-certified occupational physicians per 1 Mio. working population ranged from 8 for the state of Saarland to 0.8 for the state of North Rhine Westphalia. A general difference was found for old versus new German states. Also, large differences were present for the ratios of State-certified occupational physicians per 106 employees towards public debt per capita (€) and the ratios of State-certified occupational physicians per Gross Domestic Product (GDP) in the 16 German states in 2012. Conclusions In striking contrast to the WHO document on the Occupational safety and health (OSH) system that states in its executive summary that the human and institutional capacities of the German occupational health system are very strong in both quantity and quality, we here show extreme imbalances present at the single state levels that developed over the past 20 years. With a regard to the increasing complexity of the economic system a reversal of this trend should be demanded.
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Affiliation(s)
- Christoph Gyo
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Michael Boll
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Dörthe Brüggmann
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Doris Klingelhöfer
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David Quarcoo
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David A Groneberg
- The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, School of Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
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Koch M, Lunde LK, Gjulem T, Knardahl S, Veiersted KB. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work. PLoS One 2016; 11:e0162881. [PMID: 27649499 PMCID: PMC5029916 DOI: 10.1371/journal.pone.0162881] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/30/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Methods Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3–4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). Results All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Conclusions Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks.
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Affiliation(s)
- Markus Koch
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
- * E-mail:
| | - Lars-Kristian Lunde
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Tonje Gjulem
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Kaj Bo Veiersted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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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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