Predictors of work-related repetitive strain injuries in a population cohort

Work-related musculoskeletal disorders among physical therapists in Taiwan

Work-related musculoskeletal disorders (WMSD) refer to musculoskeletal injuries caused by the occupation. Physical therapists (PTs) suffer from a high risk of WMSD despite their extensive knowledge in ergometrics and injury prevention. This study aims to discover the incidence and prevalence of WMSD among PTs using Taiwan's nationwide claims database. The trend of annual patients seeking rehabilitation and the prevalence of WMSD among PTs were presented. The age- and gender-specific incidence of WMSD were also calculated. The prevalence of WMSD in PTs varied from 6.1% to 75.2%, and the incidence ranged from 6.1 to 29.1 per 100 person-years during 1997 and 2012. For those aged ≤30 years, the incidence was higher in females than males (incidence rate ratio  = 1.08, 95% confidence interval [CI]: 1.02-1.14, P = .011), whereas for those aged from 31 to40 years, females had lower incidence of WMSD than males (incidence rate ratio  = 0.88, 95% CI: 0.80-0.96, P = .007). The patients/PTs ratio was higher (270.56-337.74) in 1998 and 2004 to 2007 and became stable (245.93-252.82) in 2008 to 2012, correlating with a rise in the WMSD prevalence in 1999 to 2007 and a steady prevalence after 2008 (63.5%-66.3%) in PTs. In conclusion, the risk of WMSD among PTs was positively correlated to the frequency of patients seeking rehabilitation service. In addition, age and gender were important risk factors for developing WMSD among PTs.

Comparison of spinal column alignment and autonomic nervous activity using the intersegmental tenderness test in the segment above

[Purpose] The thoracolumbar supraspinous intersegmental tenderness test (ITT) in the segment above was performed to compare spinal alignment and autonomic activity in the presence or absence of pain. [Participants and Methods] Thirty young males were grouped into Th1–4 (Cardiopulmonary visceral nerves), Th5–9 (Large visceral nerve), and Th10–12 (Small visceral nerve) by ITT for the presence of pain. Measurements of the spinal alignment and autonomic function were performed. [Results] Those with ITT pain had a significantly lower range of motion in the sagittal plane at Th12, Th12–L1, and L2–3 and in the frontal plane at Th1–2, Th4–5, Th6–7, and L3–4 than those in the no pain group. On autonomic function tests, the pain group had significantly lower Total Power, LF (Low Frequency), and CVRR (Coefficient of variation of R-R interval). [Conclusion] In ITT, patients with pain at Th5–9 have a mixture of reduced sagittal tilt angle and autonomic hypofunction of the adjacent upper and lower thoracic to lumbar vertebrae.

Effect of Workplace Violence on Turnover Intention: The Mediating Roles of Job Control, Psychological Demands, and Social Support

Exposing nursing staff to workplace violence workplace violence (WV) affects their psychological, emotional, and physical health; engenders increased workload; affects the medical reciprocity between nurses and patients; and ultimately leads to staff turnover intention. To preventing WV, development of intervention strategies and WV prevention measures are crucial. This study discusses the mediating effect of job control, psychological needs, and social support on WV and turnover intention. Through this discussion, this study aims to aid medical institutions in reducing their nursing staff turnover rate and to provide a reference for hospital management and decision making. A cross-sectional research method was adopted and conducted quantitative research to prove the complexity of the relationship between WV and turnover intention. Participants comprised clinical nurses working in 2 regional teaching hospital in central Taiwan. A total of 268 questionnaires were distributed, and 213 completed questionnaires were returned. Of the returned questionnaires, 198 contained valid responses, yielding a response rate of 73.9%. Our results demonstrated the mechanisms through which psychological demands and social support mediate the relationship between WV and turnover intention. This study determined the mediating effects of psychological demands and social support. The results expand the findings of previous research and demonstrate the complexity of the relationship between WV and turnover intention. Hospitals should formulate effective mechanisms for preventing and addressing incidents of WV, improve their ability to address and regulate violent incidents in clinics, reduce the psychological pressure exerted on employees, and establish communication channels for social support.

Local heating of trigger points reduces neck and plantar fascia pain

BACKGROUND

Heating the skin and muscles is a commonly accepted method of pain relief and a modality to increase relaxation in muscles and increase tissue blood flow.

OBJECTIVE

The purpose of the present study was to examine the effect of local heat applied to trigger points and to determine if there was pain relief in the neck and plantar fascia.

METHODS

Forty adults were divided into 2 different groups according to their pain; twenty subjects had plantar foot pain and the other 20 had nonspecific neck pain. The 20 subjects in each group were randomly subdivided into a heat and a sham group. Sensitivity to pressure was measured with an algometer. A stopwatch was given to the subject and started when either the heat patch or placebo was applied. Heat cells were applied at trigger points on the pain area.

RESULTS

Subjective pain significantly decreased in both sham and heat group patients with neck pain (p< 0.05), however, the change was greater in the heat group and there was a significant difference between the heat and sham groups (p= 0.002, d= 0.81). For the plantar pain group, a significant decrease in subjective pain was found in the heat group but not in the sham group. Pressure pain threshold significantly decreased in the heat group patients both with neck and plantar pain but for the sham group there was an increase in the pressure after sham treatment. Pain relief during the intervention was also significantly different between the heat and sham group in both patients with neck and plantar pain.

CONCLUSION

The effect of local heat on trigger points of the body on pain relief was significantly better in the heat groups than in the sham groups. This finding is significant because using heat on trigger points could be an alternative to dry needling performed by healthcare professionals. This modality can be alternative for home use and avoids opioids.

Do Differences in Work Disability Duration Between Men and Women Vary by Province in Canada?

Purpose Research has shown that there are important sex and gender-based differences in the work disability duration of men and women. This research is often limited to single jurisdictions, using different outcome measures, and therefore has limited generalisability of findings. This study examined if differences between work disability of men and women differed by province and by duration of work disability. Methods Cohorts of injured workers in the Canadian provinces of British Columbia (BC), Manitoba (MB) and Ontario (ON) were analysed using workers' compensation data for work-related injuries occurring between 2007 and 2011. Work disability duration was measured using cumulative days in receipt of disability benefits paid during one-year post-injury. Poisson models with restricted cubic splines tested whether differences between men and women in the likelihood of transitioning off disability benefits varied by duration of work disability in each province, adjusting for confounders. Results Men transitioned off disability benefits faster than women for claim durations of up to two to four months, after which women transitioned off disability benefits faster until ten months. Differences between men and women were consistent across all jurisdictions. For claims longer than ten months, men transitioned off work disability benefits faster than women in BC and ON, but there were no significant differences between men and women in MB. Conclusions Differences in the work disability duration between men and women vary by province and duration of work disability. Claims management processes need to be sensitive to differences that men and women face and the timing of interventions.

Work demand, stress and work-related musculoskeletal disorders among emergency workers

Purpose

The demanding nature of firefighting exposes firefighters to unprecedented work stress and work-related musculoskeletal disorders (WMSDs). Even though relationships among work demand, work stress and WMSDs have been examined, the mediating role of work stress in the relationship between work demand and WMSDs requires more attention, particularly among emergency workers. The purpose of this paper is to therefore assess the mediation role of firefighters’ work stress in the pathway of work demand and WMSDs.

Design/methodology/approach

A quantitative research design was used. Convenient sampling was employed to select 320 firefighters from the Greater Accra region of Ghana. Data were analyzed using descriptive, correlation and regression.

Findings

The findings revealed that work demand and stress significantly affect WMSDs. Also, work demand has a significant positive effect on work stress. It was further found that work stress partially mediates the relationship between work demand and WMSDs.

Research limitations/implications

The usage of cross-sectional data limits the strength of causality and observation of changes within units of observation over time, hence the need to use longitudinal data in future studies.

Originality/value

The novelty of this study lies in the revelation of the influence of stress in the pathway of work demand and WMSDs among emergency professionals, using an African lens.

Comparison of the kinematics and kinetics of shoulder exercises performed with constant and elastic resistance

Background

Internal and external rotation exercises of the shoulder are frequently performed to avoid injury and pain. Knowledge about the motion and loadings of the upper extremities during these exercises is crucial for the development of optimal training recommendations. However, a comparison of the angles and corresponding moments in the upper extremities that are achieved during internal and external rotation exercises for the shoulder by using different resistance types has not yet been performed. Therefore, the aim of the study was to examine upper extremity kinetics and kinematics in 3D of the internal and external rotation exercises.

Methods

The kinematics and kinetics of 12 participants while they performed 10 different exercises with a constant and with an elastic external load corresponding to 2% body mass was assessed. The motion of the upper extremities was recorded three-dimensionally with a motion capture system, using a newly developed marker set and joint coordinate systems with 28 markers. The applied external load was measured with a load cell placed in series with the external resistance, and moments were calculated using an inverse dynamics approach.

Results

The range of motion and the joint loading was highly dependent on the exercises. The range of motion in the glenohumeral joint did not differ significantly between the two resistance types, whereas internal/external rotation moments were significantly higher with constant resistance than those with elastic resistance.

Conclusions

Larger or lower moments can, therefore, be achieved through selection of the appropriate resistance type, while the range of motion can be altered through the selection of exercise type. Therefore, the loading motion patterns identified in this study can help to choose suitable shoulder exercises dependent on the training objective.

Electronic supplementary material

The online version of this article (10.1186/s13102-018-0111-7) contains supplementary material, which is available to authorized users.

Repeated High Rate Facet Capsular Stretch at Strains That are Below the Pain Threshold Induces Pain and Spinal Inflammation With Decreased Ligament Strength in the Rat

Repeated loading of ligamentous tissues during repetitive occupational and physical tasks even within physiological ranges of motion has been implicated in the development of pain and joint instability. The pathophysiological mechanisms of pain after repetitive joint loading are not understood. Within the cervical spine, excessive stretch of the facet joint and its capsular ligament has been implicated in the development of pain. Although a single facet joint distraction (FJD) at magnitudes simulating physiologic strains is insufficient to induce pain, it is unknown whether repeated stretching of the facet joint and ligament may produce pain. This study evaluated if repeated loading of the facet at physiologic nonpainful strains alters the capsular ligament's mechanical response and induces pain. Male rats underwent either two subthreshold facet joint distractions (STFJDs) or sham surgeries each separated by 2 days. Pain was measured before the procedure and for 7 days; capsular mechanics were measured during each distraction and under tension at tissue failure. Spinal glial activation was also assessed to probe potential pathophysiologic mechanisms responsible for pain. Capsular displacement significantly increased (p = 0.019) and capsular stiffness decreased (p = 0.008) during the second distraction compared to the first. Pain was also induced after the second distraction and was sustained at day 7 (p < 0.048). Repeated loading weakened the capsular ligament with lower vertebral displacement (p = 0.041) and peak force (p = 0.014) at tissue rupture. Spinal glial activation was also induced after repeated loading. Together, these mechanical, physiological, and neurological findings demonstrate that repeated loading of the facet joint even within physiologic ranges of motion can be sufficient to induce pain, spinal inflammation, and alter capsular mechanics similar to a more injurious loading exposure.

The Relationship between Firefighters' Work Demand and Work-related Musculoskeletal Disorders: The Moderating Role of Task Characteristics

Background

Emergency workers such as firefighters are cataloged within the most demanding and injurious professions globally. Considering the health and safety implications in firefighting, a lot of research needs to be conducted to examine how firefighters' task characteristics and their work demand influence the development of work-related musculoskeletal disorders (WMSDs). This study therefore examines how the task characteristics of firefighters moderates the relationship between their work demand and the development of WMSDs.

Methods

Convenient sampling was employed to select 320 firefighters in the Greater Accra region of Ghana. Data were analyzed using descriptive statistics, correlation, and regression.

Results

The findings revealed that work demand and task characteristics have significant positive effects on WMSDs. Again, the task characteristics of firefighters moderates the relationship between their work demand and WMSDs.

Conclusion

Since the study shows that task characteristics influences the relationship between work demand and WMSDs, it is vital for managers to constantly modify the nature of tasks performed by and work demand of emergency workers to minimize the development of WMSDs and other industrial health complications.

Use of low level of continuous heat and Ibuprofen as an adjunct to physical therapy improves pain relief, range of motion and the compliance for home exercise in patients with nonspecific neck pain: A randomized controlled trial

BACKGROUND

It has been well documented at heat reduces pain and increases healing by increasing blood flow in tissue.

OBJECTIVE

The purpose of this study was to see if the use of low level continuous heat (LLCH) and Ibuprofen used as a home therapy between physical therapy sessions at a clinic resulted in better therapy outcomes in people with chronic neck pain.

METHODS

Ninety-two patients with chronic nonspecific neck pain were randomly divided into 4 groups; LLCH group, LLCH with Ibuprofen (IP) group, sham LLCH with sham IP group, and controls. All subjects underwent 45 minutes of conventional physical therapy twice a week for 2 weeks. the neck disability index (NDI), subjective pain, range of motion (ROM), strength of the neck, and home exercise compliance were measured.

RESULTS

Both LLCH and IP significantly reduced pain and NDI score, and increased ROM (p< 0.01). Home exercise compliance in LLCH and LLCH with IP group was significantly higher than the placebo and control groups (p < 0.05).

CONCUSION

The use of LLCH alone and LLCH with IP as an adjunct to conventional physical therapy for chronic neck pain significantly improved pain attenuation and it causes greater compliance for home.

Job stress and burnout: A comparative study of senior and head nurses in China

Senior nurses can suffer from high job stress and burnout, which can lead to negative patient outcomes and higher turnover rates; however, few studies have examined this topic. We recruited 224 head and senior nurses from September to December 2015 using convenience and cluster sampling, to compare job stress and burnout levels between the two groups. The Nurse Job Stressors Inventory and Maslach Burnout Inventory scales were used to evaluate job stress and burnout, respectively. Results indicated that job stress scores significantly differed between head and senior nurses. The highest scoring subscales in both groups were time allocation and workload problems. Scores for the three burnout dimensions also significantly differed between the groups. Positive correlations between job stress and burnout were stronger among senior nurses than head nurses. Burnout may be higher among senior nurses given head nurses' potential for greater perceived job control. Our findings suggest that measures need to be taken to reduce burnout and turnover rates among senior nurses.

Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment

Background

Though previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health. With especially job insecurity reflecting a contemporary health risk for the employed, a systematic review was performed to assess if insecure employment can be as detrimental for health as unemployment, and to determine whether these associations vary according to different health measures and among men and women.

Methods

The literature search was conducted in the databases Medline, Embase and PsychInfo. In order to allow a more accurate comparison between the two risk factors, studies were included if the data for job insecurity and unemployment was ascertained from the same sample, and contained a quantitative analysis for both exposures towards one (or more) health outcome(s).

Results

Out of 375 articles, in total, 13 studies were included in the systematic review. In 24 analyses contrasting the health-related associations between job insecurity and unemployment, 16 statistically significant associations were found for each exposure. According to the different health outcomes used, job insecurity and unemployment were strongly related to mental health, whereas job insecurity was more strongly associated with somatic symptoms. Unemployment showed stronger relations with worse general health and mortality. In 4 out of 16 gender-stratified analyses, significant associations between job insecurity/unemployment and health were found for men but not for women. Beyond that, associations were significant or insignificant in both gender groups.

Conclusions

Though there were moderate differences across the health outcomes, overall, it was found that job insecurity can pose a comparable threat to health than unemployment. Policy interventions should therefore not only consider health risks posed by unemployment, but should also aim at the reduction of insecure employment.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2313-1) contains supplementary material, which is available to authorized users.

Constant negotiating: managing work-related musculoskeletal disorders while remaining at the workplace

We used grounded theory to explore processes and strategies used by workers affected by work-related musculoskeletal disorders (WMSDs) while they remained in the workplace, and we developed a theory to describe the overall process. Participants included 25 workers affected by WMSDs who were currently employed in various workplaces in Newfoundland and Labrador, Canada. The theoretical model has five main phases: (a) becoming concerned, (b) getting medical help, (c) dealing with the workplace, (d) making adjustments to lifestyle, and (e) taking charge, each with separate subphases. Constant negotiating was the core variable that explained the overall process, with workers engaged in negotiations with others in occupational, health, and social contexts. Using a two-dimensional figure, we illustrate the negotiation strategies workers used. We discuss implications for health care, workplaces, education, and research for creating a culture of understanding and respect for injured workers who wish to remain working after developing WMSDs.

The association between nonstandard work and occupational injury in Korea

BACKGROUND

The number of workers who died due to occupational injury in Korea as of 2007 was 1,383. The aim of this study was to identify whether there were any differences in the risk of occupational injury between nonstandard workers (temporary workers and/or subcontract workers) and regular workers.

METHODS

1,576 injured workers, selected from National Health Insurance and National Workers' Compensation Insurance, were interviewed via telephone survey using standardized questionnaires in 2007. The control group was 1,500 workers matched for age, gender, and severity of injury. A multivariate logistic regression model was used to analyze the association between the type of nonstandard work and occupational injury.

RESULTS

Nonstandard temporary workers were more likely to be injured than regular workers even if other related factors of occupational injury were statistically adjusted (adjusted odds ratio, OR 2.87, 95% confidence interval 2.37-3.49).

CONCLUSIONS

The reason why the risks of nonstandard workers are higher than those of regular workers is that nonstandard workers are placed in poor working conditions.

Research opportunities using administrative databases and existing surveys for new knowledge in occupational health and safety in Canada, Quebec, Ontario and British Columbia

In Canada, many datasets are initially collected for purposes other than occupational health and safety (OHS) research. These include administrative health care billing records, pharmaceutical records, vital statistics, provincial cancer registries and workers' compensation claims data. In addition, many national and provincial health surveys, while not focused specifically on occupational health and safety, collect data on the health status and health determinants of populations, and such data can be used for investigating OHS issues among Canadian workers. This paper provides examples of the use of administrative and survey data for OHS research projects from the provinces of Quebec, Ontario and British Columbia to illustrate the potential of such data. These three provinces have a long history of using administrative and survey data for OHS research and have developed capacity in this regard for improving access to data, for linkage of records across databases and for developing methods to answer OHS questions. As research using these data sources expands, a consistent understanding within the work and health research community must be forged concerning the strengths and limitations of these data resources and their comparability.

Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies

OBJECTIVE

This systematic review was designed and conducted in an effort to evaluate the evidence currently available for the many suggested risk factors for work-related musculoskeletal disorders.

METHODS

To identify pertinent literature we searched four electronic databases (Cinahl, Embase, Medline, and The Cochrane Library). The search strategies combined terms for musculoskeletal disorders, work, and risk factors. Only case-control or cohort studies were included.

RESULTS

A total of 1,761 non-duplicated articles were identified and screened, and 63 studies were reviewed and integrated in this article. The risk factors identified for the development of work-related musculoskeletal disorders were divided and organized according to the affected body part, type of risk factor (biomechanical, psychosocial, or individual) and level of evidence (strong, reasonable, or insufficient evidence).

CONCLUSIONS

Risk factors with at least reasonable evidence of a causal relationship for the development of work-related musculoskeletal disorders include: heavy physical work, smoking, high body mass index, high psychosocial work demands, and the presence of co-morbidities. The most commonly reported biomechanical risk factors with at least reasonable evidence for causing WMSD include excessive repetition, awkward postures, and heavy lifting. Additional high methodological quality studies are needed to further understand and provide stronger evidence of the causal relationship between risk factors and work-related musculoskeletal disorders. The information provided in this article may be useful to healthcare providers, researchers, and ergonomists interested on risk identification and design of interventions to reduce the rates of work-related musculoskeletal disorders.

Risks associated with tendinitis: effects from demographic, socioeconomic, and psychological status among Brazilian workers

BACKGROUND

Self-reported tendinitis/tenosynovitis was evaluated by gender, age group, skin color, family income, and educational and psychological status.

METHODS

!The study was carried out in a representative sample of formally contracted Brazilian workers from a household survey. A total of 54,660 participants were included. Occupations were stratified according to estimated prevalences of self-reported injuries. Non-conditional logistic regression was performed, and all variables were analyzed in two occupational groups.

RESULTS

The overall prevalence rate of tendinitis/tenosynovitis was 3.1%: 5.5% in high-prevalence occupations (n = 10,726); and 2.5% in low-prevalence occupations (n = 43,934). White female workers between the ages of 45 and 64 years and at a higher socioeconomic level were more likely to report tendinitis/tenosynovitis regardless of their occupational category. An adjusted OR = 3.59 [95% CI: 3.15--4.09] was found between tendinitis/tenosynovitis and psychological status.

CONCLUSION

Among formally contracted Brazilian workers, higher income can imply greater physical and psychological demands that, regardless of occupational stratum, increase the risk of tendinitis/tenosynovitis.

Predictors of upper extremity symptoms and functional impairment among workers employed for 6 months in a new job

BACKGROUND

We sought to identify personal and work-related predictors of upper extremity symptoms and related functional impairment among 1,108 workers employed for 6 months in a new job.

METHODS

We collected data at baseline and 6-month follow-up using self-administered questionnaires. Multivariate logistic regression models were created for each outcome variable. Predictors included personal risk factors, physical work exposures and psychosocial factors.

RESULTS

Independent predictors for upper extremity symptoms at 6-month follow-up were age, Caucasian race, female gender, baseline history of UE symptoms, and job tasks involving wrist bending or forceful gripping. Independent predictors for functional impairment were baseline history and severity of UE symptoms, wrist bending, and social support.

CONCLUSIONS

Both personal and work-related factors were independent predictors of upper extremity symptoms and functional impairment in this working population. We found different risk factors for symptoms than for functional impairment related to symptoms.

Is workstyle a mediating factor for pain in the upper extremity over time?

INTRODUCTION

Upper extremity musculoskeletal disorders influence workers' quality of life. Workstyle may be one factor to deal with in workers with pain in the upper extremity. The objective of this study was to determine if workstyle is a mediating factor for upper extremity pain in a changing work environment of office workers over time.

METHODS

Office workers with upper extremity pain filled out a Workstyle questionnaire (WSF) at baseline (n = 110). After 8 and 12 months follow-up assessment took place. Participants were divided into a good and an adverse workstyle group at baseline. The presence of upper extremity pain in both groups was calculated and relative risks were determined. Chi-square tests were used.

RESULTS

Eight months after baseline, 80% of the adverse and 45% of the good workstyle group reported pain. The relative risk (RR) of having upper extremity pain for the adverse compared to the good workstyle group was 1.8 (95% CI 1.08-2.86) (P = 0.055). Twelve months after baseline, upper extremity pain was more often presented in the adverse workstyle compared to the good workstyle group (RR = 3.0, (95% CI 1.76-5.11), P = 0.003). Twelve months after baseline, 100% of the adverse workstyle group and 33% of the good workstyle group reported pain in the upper extremity.

CONCLUSION

Workstyle seems to be a mediating factor for upper extremity pain in office workers in a changing work environment. It is recommended to assess workstyle among office workers with upper extremity pain, and to include workstyle behaviour in treatments.

Characterization of women's occupational musculoskeletal exposures

Although women are often characterized as having "safe" occupations, they are at risk of experiencing occupational musculoskeletal injuries. This cross-sectional study examined the health status, occupations, and job tasks of a random sample of working women (N = 123) to characterize their risk of occupational injury. The women had been employed, most full-time, in the 12 months prior to administration of the telephone survey. The women tended to cluster into two types of occupational exposures. Overall, the women rated their health as excellent. However, those with diagnosed musculoskeletal disorders had significantly worse scores on two scales of the Short Form Health Survey than those without musculoskeletal disorders. Women are exposed to occupational musculoskeletal stressors that increase their risk of experiencing musculoskeletal injuries.

Repetitive strain injury

Repetitive strain injury remains a controversial topic. The term repetitive strain injury includes specific disorders such as carpal tunnel syndrome, cubital tunnel syndrome, Guyon canal syndrome, lateral epicondylitis, and tendonitis of the wrist or hand. The diagnosis is usually made on the basis of history and clinical examination. Large high-quality studies using newer imaging techniques, such as MRI and ultrasonography are few. Consequently, the role of such imaging in diagnosis of upper limb disorders remains unclear. In many cases, no specific diagnosis can be established and complaints are labelled as non-specific. Little is known about the effectiveness of treatment options for upper limb disorders. Strong evidence for any intervention is scarce and the effect, if any, is mainly short-term pain relief. Exercise is beneficial for non-specific upper limb disorders. Immobilising hand braces and open carpal tunnel surgery release are beneficial for carpal tunnel syndrome, and topical and oral non-steroidal anti-inflammatory drugs, and corticosteroid injections are helpful for lateral epicondylitis. Exercise is probably beneficial for neck pain, as are corticosteroid injections and exercise for shoulder pain. Although upper limb disorders occur frequently in the working population, most trials have not exclusively included a working population or assessed effects on work-related outcomes. Further high-quality trials should aim to include sufficient sample sizes, working populations, and work-related outcomes.

The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers

BACKGROUND

The combined effect of socioeconomic, organizational, psychosocial, and physical factors on work-related musculoskeletal disorders (WRMSDs) were studied in a heterogeneous, socioeconomically diverse sample (cases and their matched referents) of hospital workers.

METHODS

Cases were defined by a new acute or cumulative work-related musculoskeletal injury; referents were matched by job group, shift length, or at random. Information was obtained through telephone interviews and on-site ergonomics observation. Questionnaire items included sociodemographic variables, lost work time, work effectiveness, health status, pain/disability, and psychosocial working conditions using Effort Reward Imbalance (ERI) and Demand-Control (DC) models. Two multivariate models were tested: Model 1 included occupation as a predictor; Model 2 included education-income as a predictor.

RESULTS

Cases reported greater pain, disability, lost time, and decreased work effectiveness than the referents. Model 1 was statistically significant for neck/upper extremity injury (Chi-square = 19.3, P = 0.01), back/lower extremity injury (Chi-square = 14.0, P = 0.05), and all injuries combined (Chi-square = 25.4, P = 0.001). "Other Clinical" occupations (34% mental health workers) had the highest risk of injury (OR 4.5: 95%CI, 1.7-12.1) for all injuries. The ERI ratio was a significant predictor for neck and upper extremity (OR 1.5: 95%CI, 1.1-1.9) and all injuries (OR 1.3; 95%CI, 1.04-1.5), per SD change in score.

CONCLUSIONS

In this study, the risk of WRMSDs was more strongly influenced by specific psychosocial and physical job-related exposures than by broad socioeconomic factors such as education and income.

Work-related repetitive strain injury and leisure-time physical activity

OBJECTIVE

To investigate the relationship between leisure-time physical activity and work-related repetitive strain injury (RSI), adjusted for sociodemographic characteristics and work-related physical and stress factors.

METHODS

The data source was the 2003 Canadian Community Health Survey, a national cross-sectional survey of 134,072 respondents. The analysis was limited to a sample of the survey population reporting full-time work during the past 12 months (n = 58,622). The outcome of interest was work-related RSI of the upper body. Multiple logistic regression was used to examine the relationship between the outcome and leisure-time physical activity level, adjusted for sociodemographic, health, and occupational characteristics. The potential effect of leisure-time physical activity with a high upper-body load was investigated in a secondary analysis.

RESULTS

The prevalence of upper-body work-related RSI was 5.9% in the Canadian population in 2003. An active lifestyle during leisure time was associated with a lower prevalence of work-related upper-body RSI (odds ratio 0.84, 99% confidence interval 0.75-0.95), after adjustment for work physical demands and other covariates. Female sex, obesity, smoking, age, work-related stress, and work physical demands were associated with RSI. In the secondary analysis, we did not find that participating in leisure-time activities with a high upper-body load was a risk factor for RSI.

CONCLUSION

Our study results indicate that being physically active during leisure time is associated with a decreased risk of upper-body occupational RSI, adding another potential health benefit to participation in leisure-time physical activity.

The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study

Background

Work-related neck and upper limb pain has mainly been studied in specific occupational groups, and little is known about its impact in the general population. The objectives of this study were to estimate the prevalence and population impact of work-related neck and upper limb pain.

Methods

A cross-sectional survey was conducted of 10 000 adults in North Staffordshire, UK, in which there is a common local manual industry. The primary outcome measure was presence or absence of neck and upper limb pain. Participants were asked to give details of up to five recent jobs, and to report exposure to six work activities involving the neck or upper limbs. Psychosocial measures included job control, demand and support. Odds ratios (ORs) and population attributable fractions were calculated for these risk factors.

Results

The age-standardized one-month period prevalence of neck and upper limb pain was 44%. There were significant independent associations between neck and upper limb pain and: repeated lifting of heavy objects (OR = 1.4); prolonged bending of neck (OR = 2.0); working with arms at/above shoulder height (OR = 1.3); little job control (OR = 1.6); and little supervisor support (OR = 1.3). The population attributable fractions were 0.24 (24%) for exposure to work activities and 0.12 (12%) for exposure to psychosocial factors.

Conclusion

Neck and upper limb pain is associated with both physical and psychosocial factors in the work environment. Inferences of cause-and-effect from cross-sectional studies must be made with caution; nonetheless, our findings suggest that modification of the work environment might prevent up to one in three of cases of neck and upper limb pain in the general population, depending on current exposures to occupational risk.