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Dahlgren G, Liv P, Öhberg F, Slunga Järvholm L, Forsman M, Rehn B. Correlations between Ratings and Technical Measurements in Hand-Intensive Work. Bioengineering (Basel) 2023; 10:867. [PMID: 37508893 PMCID: PMC10376394 DOI: 10.3390/bioengineering10070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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Affiliation(s)
- Gunilla Dahlgren
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Radiation Physics, Department of Radiation Sciences, Umeå University, S-901 87 Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, S-141 57 Huddinge, Sweden
| | - Börje Rehn
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden
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Hoareau D, Fan X, Abtahi F, Yang L. Evaluation of In-Cloth versus On-Skin Sensors for Measuring Trunk and Upper Arm Postures and Movements. SENSORS (BASEL, SWITZERLAND) 2023; 23:3969. [PMID: 37112309 PMCID: PMC10142577 DOI: 10.3390/s23083969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
Smart workwear systems with embedded inertial measurement unit sensors are developed for convenient ergonomic risk assessment of occupational activities. However, its measurement accuracy can be affected by potential cloth artifacts, which have not been previously assessed. Therefore, it is crucial to evaluate the accuracy of sensors placed in the workwear systems for research and practice purposes. This study aimed to compare in-cloth and on-skin sensors for assessing upper arms and trunk postures and movements, with the on-skin sensors as the reference. Five simulated work tasks were performed by twelve subjects (seven women and five men). Results showed that the mean (±SD) absolute cloth-skin sensor differences of the median dominant arm elevation angle ranged between 1.2° (±1.4) and 4.1° (±3.5). For the median trunk flexion angle, the mean absolute cloth-skin sensor differences ranged between 2.7° (±1.7) and 3.7° (±3.9). Larger errors were observed for the 90th and 95th percentiles of inclination angles and inclination velocities. The performance depended on the tasks and was affected by individual factors, such as the fit of the clothes. Potential error compensation algorithms need to be investigated in future work. In conclusion, in-cloth sensors showed acceptable accuracy for measuring upper arm and trunk postures and movements on a group level. Considering the balance of accuracy, comfort, and usability, such a system can potentially be a practical tool for ergonomic assessment for researchers and practitioners.
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Affiliation(s)
- Damien Hoareau
- Department of Mechatronics, École Normale Supérieure de Rennes, 35170 Bruz, France
- Laboratoire SATIE, CNRS UMR 8029, École Normale Supérieure de Rennes, 35170 Bruz, France
| | - Xuelong Fan
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-171 77 Stockholm, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, SE-141 57 Huddinge, Sweden
| | - Liyun Yang
- Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, SE-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
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Wieczorek M, Verstappen SM, Putrik P, Gwinnutt JM, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda M, Guillemin F. Association of vocational interventions and work-related factors with disease and work outcomes in people with RMDs: A systematic review. Semin Arthritis Rheum 2023; 58:152135. [PMID: 36434893 DOI: 10.1016/j.semarthrit.2022.152135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A EULAR taskforce was convened to develop recommendations for lifestyle behaviours amongst people with rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on work-related factors and disease-specific outcomes for people with osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis (SSc) and gout. METHODS Two separate systematic literature reviews (SLRs) were conducted. The first identified SLRs, published between 01/2013 and 09/2018. The second identified original observational and intervention studies published before 05/2019. Manuscripts were included if they assessed the effects of vocational interventions on disease-specific outcomes (i.e. clinical outcomes, patient-reported outcomes, and work outcomes) or if they assessed the association between work-related factors and these outcomes. Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases were searched. RESULTS Two SLRs were identified including individuals with SSc and inflammatory arthritis. Subsequently, 23 original manuscripts were identified, with most of them (43.5%) including people with RA and no manuscripts on gout. Most observational studies evaluated the association between work-related factors and work outcomes while limited information was available on the impact of work on clinical outcomes. A few studies suggested that physically demanding jobs have a small detrimental effect on radiographic progression in axSpA and PsA. Intervention studies showed beneficial effects of vocational interventions for disease-specific outcomes, but with small effect sizes. CONCLUSION Many studies indicated that work participation is not likely to be detrimental and, in some cases, may be beneficial for RMD-specific outcomes and should therefore receive attention within healthcare consultations.
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Affiliation(s)
- Maud Wieczorek
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland
| | - Suzanne Mm Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology Department, "Sf Maria Hospital", "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland; University Clinic for Aging Medicine, City Hospital - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, United Kingdom
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria; Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria; Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Spain; Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department. Hospital Universitari Son Espases. Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia; Department of Internal Medicine University of East Sarajevo Medical Faculty Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Inserm, CHRU Nancy, Université de Lorraine, CIC-1433 Epidémiologie Clinique, Nancy, France
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Assessing physical workload among people with musculoskeletal disorders: validity and reliability of the physical workload questionnaire. BMC Musculoskelet Disord 2022; 23:282. [PMID: 35331205 PMCID: PMC8944019 DOI: 10.1186/s12891-022-05222-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Demands of physical work are related to musculoskeletal disorders, and hence, important to assess. The Physical Workload Questionnaire (PWQ) is based on 26 items related to physical workload. The PWQ has been translated into Norwegian, but its psychometric properties have not yet been tested. The aim of this study was to assess the validity and reliability of the PWQ among patients with musculoskeletal disorders. Methods A cross-sectional study with a test-retest design was conducted to assess construct validity (structural validity and hypothesis testing) and reliability (internal consistency and test-retest reliability) among employed patients with musculoskeletal disorders. Exploratory factor analysis was performed to assess the structural validity and number of items to be included in the Norwegian version of the PWQ. Hypothesis testing was assessed by 14 a priori hypotheses (“known” group, convergent and discriminant validity). Internal consistency was evaluated using Cronbach’s alpha and test-retest reliability by Intraclass Correlation Coefficient (ICC2.1), Standard Error of Measurement (SEMagreement) and Smallest Detectable Change (SDC95%ind). Results In total, 115 patients with a mean age (SD) of 46 (9) years were included, of which 48 were included in the reliability analyses. Exploratory factor analysis resulted in two subscales: “Heavy physical work” (15 items, range 0–100) and “Long-lasting postures and repetitive movements” (7 items, range 0–100). No floor or ceiling effects were seen in the subscales. Twelve of the 14 (85%) predefined hypotheses were confirmed. The internal consistency with Cronbach’s alpha was 0.94 and 0.85 on subscales 1 and 2, respectively. Test-retest reliability analyses demonstrated an ICC2.1 of 0.96 (95% CI 0.88, 0.98) and 0.92 (95% CI 0.81, 0.96), SEM of 6.9 and 10.0 and SDC95%ind of 19.2 and 27.7 of subscales 1 and 2, respectively. Conclusions The Norwegian version of the PWQ demonstrated good validity and reliability and can be used to evaluate physical workload in patients with musculoskeletal disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05222-y.
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Evaluation of a New Simplified Inertial Sensor Method against Electrogoniometer for Measuring Wrist Motion in Occupational Studies. SENSORS 2022; 22:s22041690. [PMID: 35214592 PMCID: PMC8874503 DOI: 10.3390/s22041690] [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: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/26/2022]
Abstract
Wrist velocity is an important risk factor for work-related musculoskeletal disorders in the elbow/hand, which is also difficult to assess by observation or self-reports. This study aimed to evaluate a new convenient and low-cost inertial measurement unit (IMU)-based method using gyroscope signals against an electrogoniometer for measuring wrist flexion velocity. Twelve participants performed standard wrist movements and simulated work tasks while equipped with both systems. Two computational algorithms for the IMU-based system, i.e., IMUnorm and IMUflex, were used. For wrist flexion/extension, the mean absolute errors (MAEs) of median wrist flexion velocity compared to the goniometer were <10.1°/s for IMUnorm and <4.1°/s for IMUflex. During wrist deviation and pronation/supination, all methods showed errors, where the IMUnorm method had the largest overestimations. For simulated work tasks, the IMUflex method had small bias and better accuracy than the IMUnorm method compared to the goniometer, with the MAEs of median wrist flexion velocity <5.8°/s. The results suggest that the IMU-based method can be considered as a convenient method to assess wrist motion for occupational studies or ergonomic evaluations for the design of workstations and tools by both researchers and practitioners, and the IMUflex method is preferred. Future studies need to examine algorithms to further improve the accuracy of the IMU-based method in tasks of larger variations, as well as easy calibration procedures.
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Öhberg F, Vänn M, Jonzén K, Edström U, Sundström N. Comparison between two mobile applications measuring shoulder elevation angle-A validity and feasibility study. Med Eng Phys 2021; 98:1-7. [PMID: 34848028 DOI: 10.1016/j.medengphy.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
Pain in the shoulder complex affects the working population where work with elevated arms is a risk factor. The aim of the present study was to compare a mobile application for measurements of arm elevation, ErgoExposure, against an existing mobile application, ErgoArmMeter, in a laboratory setting and to test the feasibility in a field trial. Eleven persons performed three tasks in the laboratory setting: static, dynamic, and simulated work tasks, where the applications were validated against an optical tracking system (OTS). Also, ErgoExposure was tested by a teacher in a real-world situation. Limits of agreement for the static task varied between -6.1° to 4.2° (ErgoExposure) and between -7.6° to 5.2° (ErgoArmMeter). The average root mean square difference for dynamic and simulated work tasks was 3.4° (ErgoExposure) and 7.7° (ErgoArmMeter). From the field trial, different work tasks produced distinct exposure variation analysis patterns. Both apps showed similar results compared to OTS, but ErgoExposure was more accurate than ErgoArmMeter.
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Affiliation(s)
- Fredrik Öhberg
- Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
| | - Mårten Vänn
- Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
| | - Karolina Jonzén
- Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
| | - Urban Edström
- Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
| | - Nina Sundström
- Dept. of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
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Osinuga A, Janssen B, Fethke NB, Story WT, Imaledo JA, Baker KK. Understanding Rural Women's Domestic Work Experiences (DWE) in Ibadan, Nigeria: Development of a Measurement Tool Using Confirmatory Factor Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111043. [PMID: 34769564 PMCID: PMC8582860 DOI: 10.3390/ijerph182111043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
Gender norms prescribe domestic labor as primarily a female's responsibility in developing countries. Many domestic tasks depend on access to water, so the physical, emotional, and time demands of domestic labor may be exacerbated for women living in water-insecure environments. We developed a set of domestic work experience (DWE) measures tailored to work in rural areas in developing countries, assessed rural Nigerian women's DWE, and examined relationships among the measures. Interviewer-administered survey data were collected between August and September from 256 women in four rural Nigerian communities. Latent factors of DWE were identified by analyzing survey items using confirmatory factor analysis. Pearson's correlation was used to examine relationships among latent factor scores, and multivariate linear regression models were used to determine if factor scores significantly differed across socio-demographic characteristics. The DWE measures consisted of latent factors of the physical domain (frequency of common domestic tasks, water sourcing and carriage, experience of water scarcity), the psychosocial domain (stress appraisal and demand-control), and the social domain (social support). Significant correlations were observed among the latent factors within and across domains. Results revealed the importance of measuring rural Nigerian women's DWE using multiple and contextual approaches rather than relying solely on one exposure measure. Multiple inter-related factors contributed to women's DWE. Water insecurity exacerbated the physical and emotional demands of domestic labor DWE varied across age categories and pregnancy status among rural Nigerian women.
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Affiliation(s)
- Abisola Osinuga
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
- Correspondence: ; Tel.: +1-3195126701
| | - Brandi Janssen
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
| | - Nathan B Fethke
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
| | - William T Story
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA;
| | - John A Imaledo
- Department of Health Promotion and Education, University of Ibadan, Ibadan 200212, Nigeria;
| | - Kelly K Baker
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA; (B.J.); (N.B.F.); (K.K.B.)
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Haraldsson P, Areskoug-Josefsson K, Rolander B, Strengbom E, Jonker D. Comparing the Structured Multidisciplinary work Evaluation Tool (SMET) questionnaire with technical measurements of physical workload in certified nursing assistants in a medical ward setting. APPLIED ERGONOMICS 2021; 96:103493. [PMID: 34116412 DOI: 10.1016/j.apergo.2021.103493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
The Certified Nursing Assistant (CNA) is an important part of the workforce in hospitals and nursing homes, whose work includes heavy and repetitive work tasks including patient manual handling. The Structured Multidisciplinary work Evaluation Tool (SMET) questionnaire is an Occupational Health Service method for evaluation of the work environment. The aim of this study is to compare the SMET questionnaire with technical measurements of physical workload in CNAs in a medical ward setting. 16 CNA's participated voluntarily to 8 h of measurements during one workday. Physical workload was measured with surface electromyography and inclinometers, and the work environment was evaluated with the SMET questionnaire during the same working day. Spearman's rho was used in the statistical correlation analysis between measurements. This study shows strong, statistically significant correlations between the items in the SMET questionnaire and measured physical workload, n CNAs.
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Affiliation(s)
- P Haraldsson
- Occupational Safety and Health Care, Region Jönköping County, Jönköping, Sweden; School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - K Areskoug-Josefsson
- School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden; Faculty of Health Studies, VID Specialized University, Sandnes, Norway; Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - B Rolander
- Futurum - Academy for Healthcare, Region Jönköping County, Jönköping, Sweden; School of Health and Welfare, Department of Behavioural Science and Social Work, Jönköping University, Jönköping, Sweden
| | - E Strengbom
- Occupational Safety and Health Care, Region Jönköping County, Jönköping, Sweden
| | - D Jonker
- Occupational Safety and Health Care, Region Jönköping County, Jönköping, Sweden; School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
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Lotter O, Lieb T, Molsner J, Breul V. Predictors for Clinical Outcomes Related to Upper Extremity Musculoskeletal Disorders in a Healthy Working Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179171. [PMID: 34501760 PMCID: PMC8430676 DOI: 10.3390/ijerph18179171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
A wide range of endpoints and methods of analysis can be observed in occupational health studies in the context of work-related musculoskeletal disorders (WMSDs). Comparison of study results is therefore difficult. We investigated the association between different clinical endpoints and the presence of upper extremity WMSDs in a healthy working population. Furthermore, the influence of socio-demographic, work-related, and individual predictors on different endpoints was examined. Two self-administered questionnaires were distributed to 70 workers and employees. In addition, a standardized physical examination and an industry test were performed in this cross-sectional study. Correlations between WMSDs and clinical endpoints were analyzed with the Spearman method and prediction ellipses. Multiple regression models were used to study the strength of associations with a pre-defined set of potential influencing factors. The prevalence of WMSDs was 56% (39/70). Disabilities of Arm, Shoulder, and Hand (DASH) score/pain under strain showed the strongest correlations with WMSDs. When analyzing the correlation between WMSDs and pre-selected predictors, none of the predictors could be identified as a risk factor. The DASH score remains a close candidate for best surrogate endpoint for WMSDs detection. Standardized analysis methods could improve the methodological quality of future occupational health studies.
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Affiliation(s)
- Oliver Lotter
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Academic District Hospital, Zeppelinstrasse 21, 78532 Tuttlingen, Germany
- Correspondence: ; Tel.: +49-7424-950-4491; Fax: +49-7424-950-4499
| | - Tobias Lieb
- Office for Occupational and Hand Therapy, Neuhauser Strasse 85, 78532 Tuttlingen, Germany;
| | - Jochen Molsner
- IAS-Group for Occupational Health Management, Koenigstrasse 6, 78532 Tuttlingen, Germany;
| | - Viktor Breul
- Department of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz, 78532 Tuttlingen, Germany;
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Rolander B, Forsman M, Ghafouri B, Abtahi F, Wåhlin C. Measurements and observations of movements at work for warehouse forklift truck operators. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1840-1848. [PMID: 34193025 DOI: 10.1080/10803548.2021.1943866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Inclinometry and video analyses can provide objective measures of physical workloads. The study aim was to measure and observe arm, back and head postures and movements among forklift truck operators (FLTOs) during a working day, analyzing differences between types of forklift trucks and to assess reported workload and health. Twenty-five male FLTOs in a high-level warehouse were randomly included. The data collected comprised technical measurements, video analyses of postures and movements, and a questionnaire measuring health, pain and workload. On average, the FLTOs rotated their head more than 45°, in total, 232 times/h. Video analysis revealed that FLTOs periodically drive the forklift truck sideways with the head rotated in the direction of travel, and in periods look upwards, in which the head is highly rotated and extended. Inclinometry and observations during the working day has the potential to be a valuable part of risk assessment promoting occupational safety and health.
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Affiliation(s)
- Bo Rolander
- School of Health and Welfare, Jönköping University, Sweden.,Futurum, Academy for Health and Care, Region Jönköping, Sweden
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institutet, Sweden.,Division of Ergonomics, KTH Royal Institute of Technology, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, KTH Royal Institute of Technology, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden.,Department of Clinical Physiology, Karolinska University Hospital Huddinge, Sweden
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Osinuga A, Hicks C, Ibitoye SE, Schweizer M, Fethke NB, Baker KK. A meta-analysis of the association between physical demands of domestic labor and back pain among women. BMC WOMENS HEALTH 2021; 21:150. [PMID: 33849504 PMCID: PMC8045256 DOI: 10.1186/s12905-021-01294-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
Background Back pain (BP) is among the most common musculoskeletal problems globally and is a leading contributor to disability among adults. Millions of women especially those in low-income settings, engage in strenuous domestic activities that may increase their risk of BP. The purpose of this meta-analysis was to estimate the association between physically demanding domestic labor (PDDL) which is characterized as intensity, frequency, duration of work and biomechanical risk factors of work and BP among women. Methods Five databases were searched for records published from January 1991 to March 2020; and results from 11studies were included in the meta-analysis. A random effects model and the generic inverse-variance method was used to estimate the pooled odds ratio (OR), 95% confidence interval (CI), and the degree of heterogeneity among studies (I2). Stratified and sensitivity analyses were conducted to identify the influence of outliers and identify the sources of heterogeneity. Results Exposure to high PDDL was significantly associated with BP (OR = 1.63; 95% CI 1.30, 2.04; I2 = 70%). The odds of back pain were highest among the following groups: women performing domestic labor in non-neutral postures (OR = 2.30; 95% CI = 1.75–3.04; I2 = 0%; N = 4 studies) and among women from low- and middle-income countries (OR = 1.98; 95% CI = 1.58–2.49; I2 = 29%; N = 5 studies). We found no evidence of publication bias (Egger’s test p-value = 0.15). Conclusions PDDL may significantly increase a woman’s risk of experiencing BP, but larger prospective studies are needed to further investigate the association. Presenting data on how domestic work affects the musculoskeletal health of women will be important in designing future interventions (behavioral, infrastructural, and ergonomic) that can reduce the burdens from domestic labor. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01294-5.
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Affiliation(s)
- Abisola Osinuga
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA.
| | - Chelsea Hicks
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Segun E Ibitoye
- Department of Health Promotion and Education, University of Ibadan, Ibadan, 200212, Nigeria
| | - Marin Schweizer
- Department of Epidemiology, University of Iowa, Iowa City, 52242, USA
| | - Nathan B Fethke
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
| | - Kelly K Baker
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, 52242, USA
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12
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Zare M, Norval M, Bodin J, Roquelaure Y. Differences between risk situations identified using a self-reported questionnaire and an observational method. Work 2021; 68:759-769. [PMID: 33612518 DOI: 10.3233/wor-203409] [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: 11/15/2022] Open
Abstract
BACKGROUND This study investigates work-related musculoskeletal disorders risk estimation by frequently as used as ergonomic methods in the field. OBJECTIVE To identify the difference in risk estimation by an in-house observational method and a self-reported questionnaire, and to evaluate the complementary aspects of these methods. METHODS A sample of 15 operators who worked on the assembly workstations was selected from a truck manufacturing plant. The risk assessment of these workstations (28 scenarios) was performed by the observational method and the self-reported questionnaire. The agreement between both methods to identify risk situations was measured with the weighted Kappa coefficient. RESULTS The observational method and the self-reported questionnaire deployed on the same activity estimated different risk situations. CONCLUSION This analysis does not reveal that one tool is more powerful than the other one, but shows the probability of different risk estimation. The complementary effect of each method might be considered for further investigation concerning musculoskeletal risk factors.
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Affiliation(s)
- Mohsen Zare
- ERCOSGroup (pole), Laboratory of ELLIAD-EA4661, UTBM-University of BourgogneFranche-Comté, France.,Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement ettravail - Research Institute for Environmental and Occupational Health), UMR S 1085, F-49000 Angers, France
| | - Maxime Norval
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement ettravail - Research Institute for Environmental and Occupational Health), UMR S 1085, F-49000 Angers, France
| | - Julie Bodin
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement ettravail - Research Institute for Environmental and Occupational Health), UMR S 1085, F-49000 Angers, France
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement ettravail - Research Institute for Environmental and Occupational Health), UMR S 1085, F-49000 Angers, France
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13
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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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14
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JEMINI (Job Exposure Matrix InterNatIonal) Initiative: a Utopian Possibility for Helping Occupational Exposure Assessment All Around the World? J Occup Environ Med 2020; 61:e320-e321. [PMID: 31090677 DOI: 10.1097/jom.0000000000001631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Yang L, Wang T, Weidner TK, Madura JA, Morrow MM, Hallbeck MS. Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery. Surg Endosc 2020; 35:6335-6343. [PMID: 33083930 DOI: 10.1007/s00464-020-08085-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/03/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Surgeon workload is significant both mentally and physically and may differ by procedure type. When comparing laparoscopic surgery and open surgery, studies have reported contrasting results on the physical and mental workload assessed. METHODS Wearable posture sensors and pre-/post-surgical questionnaires were employed to assess intraoperative workload and to identify risk factors for surgeons using objective and subjective measures. RESULTS Data from 49 cases (27 open and 22 laparoscopic surgeries performed by 13 male and 11 female surgeons) were assessed. More than half the surgeons reported a clinically relevant post-surgical fatigue score. The surgeons also self-reported a significant increase in pain for the neck, upper back, and lower back during/after surgery. Procedural time had significant impacts on fatigue, body part pain, and subjective (NASA-TLX) workload. The objectively assessed intraoperative work postures using wearable sensors showed a high musculoskeletal risk for neck and lower back based on their posture overall. Open surgeries had significantly larger neck angles (median [IQR]: 40 [28-47]°) compared with laparoscopic surgeries (median [IQR]: 23 [16-29]°), p < 0.001) and torso (median [IQR]: 17 [14-22]° vs. 13 [10-17]°, p = 0.006). CONCLUSION Surgeons reported significantly higher levels of fatigue and pain in the neck and lower back during or after performing a surgical case. Longer procedural time resulted in more self-rated fatigue, pain, and subjective workload. Open surgery had higher postural risk. Overall, surgeons spent a disturbingly high percentage of time during surgery in high-risk musculoskeletal postures, especially the neck. These results show that intraoperative postural risk is very high and that interventions are necessary to protect surgeon musculoskeletal health for optimal surgeon performance and career longevity.
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Affiliation(s)
- Liyun Yang
- Department of Health Sciences Research, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Ergonomics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Tianke Wang
- Department of Health Sciences Research, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Tiffany K Weidner
- Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Phoenix, AZ, USA
| | - James A Madura
- Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Melissa M Morrow
- Department of Health Sciences Research, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Susan Hallbeck
- Department of Health Sciences Research, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA. .,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. .,Department of Surgery, Mayo Clinic, Rochester, MN, USA.
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16
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Fadel M, Valter R, Quignette A, Descatha A. Usefulness of a job-exposure matrix 'MADE' as a decision tool for compensation of work-related musculoskeletal disorders. Eur J Public Health 2020; 29:868-870. [PMID: 30629239 DOI: 10.1093/eurpub/cky274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We aimed to assess the predictivity of the biomechanical job-exposure matrix 'MADE' using compensation data from the National Health Insurance for work-related disorders. Data were obtained from 2013 to 2015, area under curves (AUC), sensitivity, specificity and predictive values were calculated using compensation results as reference. We collected 163 128 cases data. AUC ranged from 0.64 for shoulders disorder to 0.82 for knee disorders. If two thresholds were considered, 28.7% of the sample fit under or over those. The matrix showed a fair predictivity. Such matrix cannot replace expertise but might be a tool used for improving compensation process.
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Affiliation(s)
- Marc Fadel
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France.,Versailles St-Quentin Univ UVSQ - Paris Saclay Univ, UMS 011, UMR-S 1168, Montigny-le-Bretonneux, France
| | - Remi Valter
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France.,Versailles St-Quentin Univ UVSQ - Paris Saclay Univ, UMS 011, UMR-S 1168, Montigny-le-Bretonneux, France
| | - Alexandre Quignette
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France.,Renault Flins, Service Médical, Aubergenville, France
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France.,Versailles St-Quentin Univ UVSQ - Paris Saclay Univ, UMS 011, UMR-S 1168, Montigny-le-Bretonneux, France.,Inserm, U1168 (VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.,Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, Angers, France
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17
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Zare M, Bodin J, Sagot JC, Roquelaure Y. Quantification of Exposure to Risk Postures in Truck Assembly Operators: Neck, Back, Arms and Wrists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176062. [PMID: 32825386 PMCID: PMC7503406 DOI: 10.3390/ijerph17176062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
The study assessed the proportion of time in risky postures for the main joints of the upper limbs in a truck assembly plant and explored the association with musculoskeletal symptoms. Fourteen workstations (13 individuals) of a truck assembly plant were selected, and seven sensors were placed on the body segments of the participants. The sensors included tri-axial accelerometers for the arms and back, inclinometers for the neck and electro-goniometry for quantifying flexion/extension of the right and left hands. The proportions of time in moderate awkward postures were high at all workstations. Neck and wrist excessive awkward postures were observed for most workstations. The average values of the 91st percentile for back flexion and right/left arm elevation were 25°, 62°, and 57°, respectively. The 91st and 9th percentile averages for neck flexion/extension were 35.9° and −4.7°, respectively. An insignificant relationship was found between the percentage of time spent in awkward upper limb posture and musculoskeletal symptoms. The findings provide objective and quantitative data about time exposure, variability, and potential risk factors in the real workplace. Quantitative measurements in the field provide objective data of the body postures and movements of tasks that can be helpful in the musculoskeletal disorders (MSDs) prevention program.
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Affiliation(s)
- Mohsen Zare
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-49000 Angers, France; (J.B.); (Y.R.)
- ERCOS Group (Pôle), Laboratory of ELLIAD-EA4661, UTBM-University of Bourgogne Franche-Comté, Belfort 90001, France;
- Correspondence: ; Tel.: +33-7-8772-2141
| | - Julie Bodin
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-49000 Angers, France; (J.B.); (Y.R.)
| | - Jean-Claude Sagot
- ERCOS Group (Pôle), Laboratory of ELLIAD-EA4661, UTBM-University of Bourgogne Franche-Comté, Belfort 90001, France;
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, F-49000 Angers, France; (J.B.); (Y.R.)
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18
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Norval M, Zare M, Brunet R, Coutarel F, Roquelaure Y. Contribution of situational operational leeway for ergonomic assessment in the evaluation of work situations. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2020. [DOI: 10.1080/1463922x.2020.1785039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Maxime Norval
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement et travail - Research Institute for Environmental and Occupational Health), Angers, France
| | - Mohsen Zare
- ERCOS Research Group (Pôle), Laboratory of ELLIAD-EA4661, UTBM-University of Bourgogne Franche-Comté, Belfort, France
| | - René Brunet
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement et travail - Research Institute for Environmental and Occupational Health), Angers, France
| | - Fabien Coutarel
- ACTÉ, University of Clermont-Auvergne, Clermont-Ferrand, France
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, Ehesp, Irset (Institut de recherche en santé, environnement et travail - Research Institute for Environmental and Occupational Health), Angers, France
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19
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Ngabirano L, Fadel M, Leclerc A, Evanoff BA, Dale AM, Roquelaure Y, Descatha A. Comparison Between a Job-Exposure Matrix (JEM) Score and Self-Reported Exposures for Carrying Heavy Loads Over the Working Lifetime in the CONSTANCES Cohort. Ann Work Expo Health 2020; 64:455-460. [PMID: 32105298 DOI: 10.1093/annweh/wxaa015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 01/27/2020] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Job-exposure matrices (JEMs) were developed to allow assessment of past work exposure for large population-based studies where better exposures data are unavailable. Few studies have directly compared biomechanical JEMs to self-administered questionnaires. We compared assessments of cumulative exposure to carrying heavy loads based on 'JEM Constances' to individually self-reported (SR) exposures. METHODS In the French CONSTANCES cohort at inception, past SR exposure to carrying heavy loads (ever/never and durations) and a detailed job history were available for 26 929 subjects. JEM Constances, an existing biomechanical JEM based on SR current exposures from 26 821 asymptomatic workers, was combined with job history to build a cumulative biomechanical exposure score. Using individual SR exposure as the reference, Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curves, sensitivity, and specificity were calculated. For both methods, associations with low back pain and knee pain were computed using multinomial logistic models. Additional analyses compared older (>10 years) to more recent (≤10 years) exposures. RESULTS AUCs ranged from 0.795 (0.789-0.800) when all periods were considered, to 0.826 (0.820-0.833) for more recent biomechanical exposure (≤10 years). Associations between carrying heavy loads and low back pain or knee pain were less strong using JEM assessment than individually SR exposure: for low back pain ORSR = 3.02 (2.79-3.26) versus ORJEM = 1.70 (1.59-1.82) and for knee pain ORSR = 2.27 (2.10-2.46) versus ORJEM = 1.64 (1.53-1.77). CONCLUSIONS JEM Constances' assessment of cumulative exposure of carrying heavy loads seems to be a useful method compared to a self-administrated questionnaire for large population-based studies where other methods are not available.
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Affiliation(s)
- Laure Ngabirano
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France.,Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France
| | - Marc Fadel
- Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France.,AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
| | - Annette Leclerc
- Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Angers cedex, France.,Versailles St-Quentin Univ, Paris Sud Univ, Paris Saclay Univ, Inserm, UMR 1168 UMS011, Villejuif cedex, France.,AP-HP, UVSQ, Unité Hospitalo-Universitaire de Santé professionnelle Hôpitaux Universitaires de Paris Ile-de-France Ouest, site Raymond Poincaré, Garches, France
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20
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Velasco Garrido M, Mette J, Mache S, Harth V, Preisser AM. Musculoskeletal pain among offshore wind industry workers: a cross-sectional study. Int Arch Occup Environ Health 2020; 93:899-909. [PMID: 32338301 PMCID: PMC7452945 DOI: 10.1007/s00420-020-01544-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/13/2020] [Indexed: 12/22/2022]
Abstract
Objective To assess whether there are differences in musculoskeletal pain among different types of occupations offshore and their relationship to ergonomic demands. Methods We conducted a web-based cross-sectional survey among workers from offshore wind energy companies operating within the German exclusive economic zone. We selected workers with regular offshore commitments and at least 28 days spent offshore in the past year (n = 268). Musculoskeletal pain was assessed using the Subjective Health Complaints inventory (SHC), which considers the past month. Results Of the 268 male participants eligible for analysis, 54% reported back pain 50.4% neck pain, 40.3% lower back pain, 35.5% shoulder, 23.3% arm and 22.1% leg pain, all of them during the past month. Compared to other offshore occupations, technicians reported more frequently arm (OR 3.13; 95% CI 1.58–6.19), back (OR 1.97; 95% CI 1.15–3.39), shoulder (OR 1.94; 95% CI 1.11–3.40) and neck pain (OR 1.89; 95% CI 1.11–3.22). After adjusting for age and nationality, lifting and carrying heavy loads were associated with all types of pain except leg pain. Overhead work, work in awkward postures, and the use of personal protection equipment and heavy tools was associated with shoulder, back and arm pain. Conclusions Our findings suggest that occupational health counselling, health promotion and preventive interventions of offshore wind energy workers needs to consider the specific tasks of the employee and be particularly tailored to the ergonomic needs of technicians.
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Affiliation(s)
- Marcial Velasco Garrido
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany.
| | - Janika Mette
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Alexandra M Preisser
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
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21
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Yang L, Money SR, Morrow MM, Lowndes BR, Weidner TK, Fortune E, Davila VJ, Meltzer AJ, Stone WM, Hallbeck MS. Impact of Procedure Type, Case Duration, and Adjunctive Equipment on Surgeon Intraoperative Musculoskeletal Discomfort. J Am Coll Surg 2020; 230:554-560. [PMID: 32220445 DOI: 10.1016/j.jamcollsurg.2019.12.035] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Surgeons are at high risk of developing musculoskeletal disorders. STUDY DESIGN This study was designed to identify risk factors and assess intraoperative physical stressors using subjective and objective measures, including type of procedure and equipment used. Wearable sensors and pre- and postoperation surveys were analyzed. RESULTS Data from 116 cases (34 male and 19 female surgeons) were collected across surgical specialties. Surgeons reported increased pain in the neck, upper, and lower back both during and after operations. High-stress intraoperative postures were also revealed by the real-time measurement in the neck and back. Surgical duration also impacted physical pain and fatigue. Open procedures had more stressful physical postures than laparoscopic procedures. Loupe usage negatively impacted neck postures. CONCLUSIONS This study highlights the fact that musculoskeletal disorders are common in surgeons and characterizes surgeons' intraoperative posture as well as surgeon pain and fatigue across specialties. Defining intraoperative ergonomic risk factors is of paramount importance to protect the well-being of the surgical workforce.
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Affiliation(s)
- Liyun Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Ergonomics, KTH Royal Institute of Technology, Stockholm, Sweden
| | | | - Melissa M Morrow
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Bethany R Lowndes
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE
| | | | - Emma Fortune
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | | | | | | | - M Susan Hallbeck
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Surgery, Mayo Clinic, Rochester, MN; Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
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22
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Gremark Simonsen J, Axmon A, Nordander C, Arvidsson I. Neck and upper extremity pain in sonographers - a longitudinal study. BMC Musculoskelet Disord 2020; 21:156. [PMID: 32164619 PMCID: PMC7069173 DOI: 10.1186/s12891-020-3096-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/hand pain at follow-up. Methods A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up. Results Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50–2.76], for neck/shoulders and (PR 3.45; CI 2.29–5.22) for elbows/hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05–1.49), a high mechanical exposure index (PR 1.66; CI 1.09–2.52), and adverse visual conditions (PR 1.24; CI 1.00–1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01–3.12), and a high mechanical exposure index (PR 2.0; CI 0.98–4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08–2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53–7.31). Conclusion Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.
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Affiliation(s)
- Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-223 81, Lund, Sweden.
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Lund University, SE-223 81, Lund, Sweden
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23
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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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24
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Maimaiti N, Wang J, Jin X, Wang S, Qin D, He L, Wang F, Zhang Z, Forsman M, Yang L, Yang Q, Wang H. Cervical musculoskeletal disorders and their relationships with personal and work-related factors among electronic assembly workers. JOURNAL OF SAFETY RESEARCH 2019; 71:79-85. [PMID: 31862047 DOI: 10.1016/j.jsr.2019.09.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 06/09/2019] [Accepted: 09/12/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Electronics assembly workers are reported to have a high prevalence of musculoskeletal disorders (MSDs). This study investigated the prevalence of cervical MSDs and the complex relationships between cervical MSDs and individual, physical, psychosocial factors among electronics assembly workers. METHODS In this cross-sectional survey, self-administered questionnaires from 700 workers in electronics manufacturing workshops were analysed. Information concerning musculoskeletal symptoms, personal and work-related factors was collected. Finally, the prevalence of cervical MSDs was computed for different subgroups, and the relationships with different factors were analyzed using logistic regression and structural equation modeling (SEM). RESULTS The total 12 month prevalence of cervical MSDs among the survey population was 29.4%. Variables of gender, job tenure, twisting head frequently, neck flexion/extension for long time and work required to be done quickly showed significant associations with MSDs in a multivariate logistic regression (P < 0.05). The SEM analysis showed moderate and significant correlations between postural load (γ = 0.279), gender (γ = 0.233) and cervical MSDs, while there were weak but significant correlations between vibration (γ = 0.024), work stress (γ = 0.126), job tenure (γ = 0.024) and cervical MSDs. Both work stress and vibration affected the MSDs indirectly through postural load. CONCLUSIONS The logistic regression results support previous general epidemiological MSD studies, and indicates that individual, physical, and psychosocial factors are related to cervical MSDs. The SEM provides a better approximation of the complexity of the relationship between risk factors and cervical MSDs. Improving awkward postures may be effective ways to control the influence of occupational stressors or vibration on MSDs. Practical Applications: The study is to improve prevention of MSDs among electronics assembly workers and promote their occupational health.
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Affiliation(s)
- Nazhakaiti Maimaiti
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Jingjing Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Xianning Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Shijuan Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Dongliang Qin
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Lihua He
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Fujiang Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Zhongbin Zhang
- China Academy of Safety Science and Technology, Beijing 100029, China
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
| | - Liyun Yang
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; Division of Ergonomics, KTH Royal Institute of Technology, 141 57 Huddinge, Sweden
| | - Qiuyue Yang
- National Research Center for Occupational Safety and Health, State Administration of Work Safety, Beijing 100191, China
| | - Haijiao Wang
- National Research Center for Occupational Safety and Health, State Administration of Work Safety, Beijing 100191, China
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25
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Palm P, Gupta N, Forsman M, Skotte J, Nordquist T, Holtermann A. Exposure to Upper Arm Elevation During Work Compared to Leisure Among 12 Different Occupations Measured with Triaxial Accelerometers. Ann Work Expo Health 2019; 62:689-698. [PMID: 29945157 PMCID: PMC6037214 DOI: 10.1093/annweh/wxy037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 06/21/2018] [Indexed: 01/15/2023] Open
Abstract
Regarding prevention of neck and shoulder pain (NSP), unsupported arm elevation is one factor that should be taken into account when performing work risk assessment. Triaxial accelerometers can be used to measure arm elevation over several days but it is not possible to differentiate between supported and unsupported arm elevation from accelerometers only. Supported arm elevation is more likely to exist during sitting than standing. The aim of the study was to evaluate the use of whole workday measurements of arm elevation with accelerometers to assess potentially harmful work exposure of arm elevation, by comparing arm elevation at work with arm elevation during leisure, in a population with diverse work tasks, and to assess how the exposure parameters were modified when upper arm elevation during sitting time was excluded. The participants, 197 workers belonging to 12 occupational groups with diverse work tasks, wore triaxial accelerometers on the dominant arm, hip, and back for 1–4 days to measure arm elevation and periods of sitting. None of the groups were found to have higher exposure to arm elevation during work compared to leisure. Even though some occupations where known to have work tasks that forced them to work with elevated arms to a large extent. A high proportion of arm elevation derived from sitting time, especially so during leisure. When arm elevation during sitting time was excluded from the analysis, arm elevation was significantly higher at work than during leisure among construction workers, garbage collectors, manufacturing workers, and domestic cleaners. Together this illustrates that it is not suitable to use whole workday measurments of arm elevation with accelerometer as a sole information source when assessing the risk for NSP due to arm elevation. Information on body posture can provide relevant contextual information in exposure assessments when it is known that the potential harmful exposure is performed in standing or walking.
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Affiliation(s)
- Peter Palm
- Department of Medical Sciences Occupational and Environmental Medicine, Dag Hammarsjköldsväg, Uppsala, Sweden.,Occupational and Environmental Medicine, Akademiska sjukhuset, Dag Hammarsjköldsväg, Uppsala, Sweden
| | - Nidhi Gupta
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Mikael Forsman
- IMM Institute of Environmnental Medicine, Nobels väg, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Solnavägen, Stockholm, Sweden
| | - Jørgen Skotte
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark
| | - Tobias Nordquist
- Department of Medical Sciences Occupational and Environmental Medicine, Dag Hammarsjköldsväg, Uppsala, Sweden
| | - Andreas Holtermann
- National Research Centre for the Working Environmnent, Lersø Parkallé, Copenhagen Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Odense, Campusvej, Odense, Denmark
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26
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Lund CB, Mikkelsen S, Thygesen LC, Hansson GÅ, Thomsen JF. Movements of the wrist and the risk of carpal tunnel syndrome: a nationwide cohort study using objective exposure measurements. Occup Environ Med 2019; 76:519-526. [PMID: 31189693 PMCID: PMC6703125 DOI: 10.1136/oemed-2018-105619] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/17/2019] [Accepted: 05/28/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We conducted a large cohort study to investigate the association between work-related wrist movements and carpal tunnel syndrome (CTS). METHODS Electro-goniometric measurements of wrist movements were performed for 30 jobs (eg, office work, child care, laundry work and slaughterhouse work). We measured wrist angular velocity, mean power frequency (MPF) and range of motion (ROM). We established a cohort of Danish citizens born 1940-1979 who held one of these jobs from age 18-80 years, using Danish national registers with annual employment information from 1992 to 2014. We updated the cohort by calendar year with job-specific and sex-specific means of measured exposures. Dates of a first diagnosis or operation because of CTS were retrieved from the Danish National Patient Register. The risk of CTS by quintiles of preceding exposure levels was assessed by adjusted incidence rate ratios (IRRadj) using Poisson regression models. RESULTS We found a clear exposure-response association between wrist angular velocity and CTS with an IRRadj of 2.31 (95% CI 2.09 to 2.56) when exposed to the highest level compared with the lowest. MPF also showed an exposure-response pattern, although less clear, with an IRRadj of 1.83 (1.68 to 1.98) for the highest compared with the lowest exposure level. ROM showed no clear pattern. Exposure-response patterns were different for men and women. CONCLUSIONS High levels of wrist movement were associated with an increased risk of CTS. Preventive strategies should be aimed at jobs with high levels of wrist movements such as cleaning, laundry work and slaughterhouse work.
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Affiliation(s)
- Christina Bach Lund
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Gert-Åke Hansson
- Occupational and Environmental Medicine, University and Regional Laboratories Region Scania, Lund, Sweden.,Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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27
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Solitaire C, Martin F. Troubles musculosquelettiques et risques psychosociaux dans une population de conducteurs ambulanciers hospitaliers. ARCH MAL PROF ENVIRO 2019. [DOI: 10.1016/j.admp.2019.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Balogh I, Arvidsson I, Björk J, Hansson GÅ, Ohlsson K, Skerfving S, Nordander C. Work-related neck and upper limb disorders - quantitative exposure-response relationships adjusted for personal characteristics and psychosocial conditions. BMC Musculoskelet Disord 2019; 20:139. [PMID: 30935374 PMCID: PMC6444852 DOI: 10.1186/s12891-019-2491-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/04/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We have previously reported quantitative exposure-response relationships between physical exposures recorded by technical methods, and complaints and diagnoses in the neck/shoulders, and the elbows/hands, based on group data. In the present study the number of workers was doubled, and information on individual factors, and psychosocial working conditions was used. Relationships between various kinds of exposure and response have been analysed in this larger and more detailed sample. METHODS The prevalence of complaints (Nordic Questionnaire) and diagnoses (clinical examination) were recorded in a number of occupational groups within which the participants had similar work tasks, 34 groups of female employees (N = 4733 women) and 17 groups of male employees (N = 1107 men). Age and other individual characteristics were recorded, as well as psychosocial work environment factors (job-content questionnaire) for most participants. Postures and velocities (inclinometry) of the head (N = 505) and right upper arm (N = 510), right wrist postures and velocities (electrogoniometry; N = 685), and muscular activity (electromyography; EMG) in the right trapezius muscle (N = 647) and forearm extensors (N = 396) were recorded in representative sub-groups. Exposure-response relationships between physical exposure and musculoskeletal disorders, adjusted for individual factors with Poisson regression were then calculated. The effect of introducing psychosocial conditions into the models was also assessed. RESULTS Associations were found between head velocity, trapezius activity, upper arm velocity, forearm extensor activity and wrist posture and velocity, and most neck/shoulder and elbow/hand complaints and diagnoses. Adjustment for age, other individual characteristics and psychosocial work conditions had only a limited effect on these associations. For example, the attributable fraction for tension neck syndrome among female workers with the highest quintile of trapezius activity was 58%, for carpal tunnel syndrome versus wrist velocity it was 92% in men in the highest exposure quintile. CONCLUSIONS Based on the findings, we propose threshold limit values for upper arm and wrist velocity.
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Affiliation(s)
- Istvan Balogh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Gert-Åke Hansson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Kerstina Ohlsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Staffan Skerfving
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81 Lund, Sweden
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29
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Green DR, Gerberich SG, Kim H, Ryan AD, McGovern PM, Church TR, Schwartz A, Arauz RF. Janitor workload and occupational injuries. Am J Ind Med 2019; 62:222-232. [PMID: 30675912 DOI: 10.1002/ajim.22940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study was designed to identify potential effects of workload and sleep on injury occurrence. METHODS Questionnaires were disseminated to janitors in the SEIU Local 26 union; 390 responded and provided information on workload, sleep, and injury outcomes. Quantitative measurements of workload and sleep were collected via FitBit devices from a subset of 58 janitors. Regression techniques were implemented to determine risk. RESULTS Thirty-seven percent reported increased workload over the study period Adjusted analyses indicated a significant effect of change in workload (RR: 1.94; 95%CI: 1.40-2.70) and sleep hours (RR: 2.21; 95%CI: 1.33-3.66) on occupational injury. Among those with sleep disturbances, injury risk was greater for those with less than five, versus more than five, days of moderate to vigorous physical activity; RR: 2.77; 95%CI: 1.16-6.59). CONCLUSIONS Increased workload and sleep disturbances increased the risk of injury, suggesting employers should address these factors to mitigate occupational injuries.
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Affiliation(s)
- Deirdre R. Green
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Susan G. Gerberich
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Hyun Kim
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Andrew D. Ryan
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Patricia M. McGovern
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Timothy R. Church
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Adam Schwartz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
| | - Rony F. Arauz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis Minnesota
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30
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Evanoff BA, Yung M, Buckner-Petty S, Andersen JH, Roquelaure Y, Descatha A, Dale AM. The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation. Occup Environ Med 2019; 76:398-406. [PMID: 30705110 PMCID: PMC6520135 DOI: 10.1136/oemed-2018-105287] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/28/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Abstract
Objectives Job exposure matrices (JEMs) can be constructed from expert-rated assessments, direct measurement and self-reports. This paper describes the construction of a general population JEM based on self-reported physical exposures, its ability to create homogeneous exposure groups (HEG) and the use of different exposure metrics to express job-level estimates. Methods The JEM was constructed from physical exposure data obtained from the Cohorte des consultants des Centres d’examens de santé (CONSTANCES). Using data from 35 526 eligible participants, the JEM consisted of 27 physical risk factors from 407 job codes. We determined whether the JEM created HEG by performing non-parametric multivariate analysis of variance (NPMANOVA). We compared three exposure metrics (mean, bias-corrected mean, median) by calculating within-job and between-job variances, and by residual plots between each metric and individual reported exposure. Results NPMANOVA showed significantly higher between-job than within-job variance among the 27 risk factors (F(253,21964)=61.33, p<0.0001, r2=41.1%). The bias-corrected mean produced more favourable HEG as we observed higher between-job variance and more explained variance than either means or medians. When compared with individual reported exposures, the bias-corrected mean led to near-zero mean differences and lower variance than other exposure metrics. Conclusions CONSTANCES JEM using self-reported data yielded HEGs, and can thus classify individual participants based on job title. The bias-corrected mean metric may better reflect the shape of the underlying exposure distribution. This JEM opens new possibilities for using unbiased exposure estimates to study the effects of workplace physical exposures on a variety of health conditions within a large general population study.
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Affiliation(s)
- Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Marcus Yung
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Skye Buckner-Petty
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Yves Roquelaure
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France
| | - Alexis Descatha
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France.,AP-HP, EMS (Samu92), Occupational Health Unit, Raymond Poincaré University Hospital, Garches, France.,INSERM, UMR 1168 UMS011, University of Versailles Saint-Quentin-en-Yvelines, Villejuif, France
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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31
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Descatha A, Despréaux T, Petit A, Bodin J, Andersen JH, Dale AM, Evanoff BA, Roquelaure Y. [Development of “MADE”, a French Job exposure matrix for evaluation of biomechanical exposure]. SANTE PUBLIQUE 2018; 30:333-337. [PMID: 30541262 DOI: 10.3917/spub.183.0333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE This paper presents the stages of development of an occupational biomechanical exposure matrix and preliminary reliability and validity indicators. METHODS The expertise-based job exposure matrix, called "MADE" (for "difficult physical conditions and job matrix"), was developed from the French and international classification of jobs for 17 biomechanical exposures. Three pairs of investigators independently rate the frequency and intensity of exposure of each job from 0 to 5; discordant scores within pairs (mean difference >20% for each biomechanical exposure considered) were discussed collectively. Reliability was assessed by the difference between the initial ratings, the number of revised jobs, and the correlation between the two classifications (with transcoding). Validity was studied by correlating variables similar to those from existing United States and Danish matrices. RESULTS The difference between the mean scores of the pairs was considered to be "fair" (less than one point). Of the 51 paired results studied (17 exposures - 3 pairs of investigators), four coefficients were found to be less than 0.6, and 14 were between 0.6 and 0.7. Forty-nine of the 1,169 job categories were reviewed. Correlation coefficients between the initial classification and transcoding were greater than 0.7. Correlation coefficients between the French, United States and Danish MEE variables were fair to good. CONCLUSION An expertise-based job exposure matrix with fairly reliable indicators has been developed, opening up the prospects to improve certain some fields of public health, at both national and international levels.
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32
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Dahlqvist C, Nordander C, Forsman M, Enquist H. Self-recordings of upper arm elevation during cleaning - comparison between analyses using a simplified reference posture and a standard reference posture. BMC Musculoskelet Disord 2018; 19:402. [PMID: 30442141 PMCID: PMC6238373 DOI: 10.1186/s12891-018-2328-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/29/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To reduce ergonomic risk factors in terms of awkward and constrained postures and high velocities, it is important to perform adequate risk assessments. Technical methods provide objective measures of physical workload. These methods have so far mainly been used by researchers. However, if written instructions how to apply the sensors and how to adopt the reference posture are provided, together with triaxial accelerometers, it may be possible for employees to record their own physical workload. The exposure in terms of e.g. upper arm elevations could then easily be assessed for all workers in a workplace. The main aims of this study were: 1) to compare analyses for self-recording of upper arm elevation during work using a simplified reference posture versus using a standard reference posture, and 2) to compare the two reference postures. METHODS Twenty-eight cleaners attached an accelerometer to their dominant upper arm and adopted a simplified reference according to a written instruction. They were thereafter instructed by a researcher to adopt a standard reference. Upper arm elevations were recorded for 2 or 3 days. Each recording was analysed twice; relative to the simplified reference posture and relative to the standard reference posture. The group means of the differences in recorded upper arm elevations between simplified and standard reference analyses were assessed using Wilcoxon signed ranks test. Furthermore, we calculated the group mean of the differences between the simplified reference posture and the standard reference posture. RESULTS For arm elevation during work (50th percentile), the group mean of the differences between the two analyses was 0.2° (range -7 - 10°). The group mean of the differences between the two references was 9° (range 1 - 21°). The subjects were able to follow the instructions in the protocol and performed self-recording of upper arm elevation and velocity. CONCLUSIONS The small difference between the two analyses indicates that recordings performed by employees themselves are comparable, on a group level, with those performed by researchers. Self-recordings in combination with action levels would provide employers with a method for risk assessment as a solid basis for prevention of work-related musculoskeletal disorders.
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Affiliation(s)
- Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Mikael Forsman
- Division of Ergonomics, KTH Royal Institute of Technology, SE-141 57 Huddinge, Sweden
| | - Henrik Enquist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
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Simonsen JG, Dahlqvist C, Enquist H, Nordander C, Axmon A, Arvidsson I. Assessments of Physical Workload in Sonography Tasks Using Inclinometry, Goniometry, and Electromyography. Saf Health Work 2018; 9:326-333. [PMID: 30370165 PMCID: PMC6130004 DOI: 10.1016/j.shaw.2017.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/13/2017] [Accepted: 08/26/2017] [Indexed: 02/01/2023] Open
Abstract
Background Echocardiography involves strenuous postures of the upper limbs. This study explored the physical workload in the neck and upper limbs in sonographers performing echocardiography, and the extent to which the workload differs from than in other work tasks (other sonographic examinations, and nonsonographic tasks). Methods The physical load was assessed by inclinometry, goniometry, and electromyography methods in 33 female sonographers during authentic work using three different echocardiography techniques and other work tasks. Results Echocardiography was characterized by low velocities of the head, arms, and wrists, and a low proportion of muscular resting time in the forearms, in the transducer limb, and the computer limb. The transducer limb was more elevated in one of the techniques, but this technique also involved a higher proportion of muscular resting time of the trapezius muscle. We also found a high proportion of awkward wrist postures in the transducer wrist in all three techniques; in one due to prolonged flexion, and in the others due to prolonged extension. Other work tasks were less static, and were performed with higher upper arm and wrist velocities. Conclusion None of the three echocardiography techniques was optimal concerning physical workload. Thus, to achieve more variation in physical load we recommend that the equipment be arranged so that the sonographer can alternate between two different techniques during the workday. We also propose alternation between echocardiography and nonsonographic tasks, in order to introduce variation in the physical workload. Clinical expertise should be used to achieve further improvements.
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Affiliation(s)
| | - Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Henrik Enquist
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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Huysmans MA, Eijckelhof BHW, Garza JLB, Coenen P, Blatter BM, Johnson PW, van Dieën JH, van der Beek AJ, Dennerlein JT. Predicting Forearm Physical Exposures During Computer Work Using Self-Reports, Software-Recorded Computer Usage Patterns, and Anthropometric and Workstation Measurements. Ann Work Expo Health 2018; 62:124-137. [PMID: 29186308 DOI: 10.1093/annweh/wxx092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 10/31/2017] [Indexed: 11/14/2022] Open
Abstract
Objectives Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms. The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self-reported factors, software-recorded computer usage patterns, and worksite measurements of anthropometrics and workstation set-up (full models); and (ii) a practical set of predicting variables, only including the self-reported factors and software-recorded computer usage patterns, that are relatively easy to assess (practical models). Methods Prediction models were build using data from a field study among 117 office workers who were symptom-free at the time of measurement. Arm-wrist-hand physical exposures were measured for approximately two hours while workers performed their own computer work. Each worker's anthropometry and workstation set-up were measured by an experimenter, computer usage patterns were recorded using software and self-reported factors (including individual factors, job characteristics, computer work behaviours, psychosocial factors, workstation set-up characteristics, and leisure-time activities) were collected by an online questionnaire. We determined the predictive quality of the models in terms of R2 and root mean squared (RMS) values and exposure classification agreement to low-, medium-, and high-exposure categories (in the practical model only). Results The full models had R2 values that ranged from 0.16 to 0.80, whereas for the practical models values ranged from 0.05 to 0.43. Interquartile ranges were not that different for the two models, indicating that only for some physical exposures the full models performed better. Relative RMS errors ranged between 5% and 19% for the full models, and between 10% and 19% for the practical model. When the predicted physical exposures were classified into low, medium, and high, classification agreement ranged from 26% to 71%. Conclusion The full prediction models, based on self-reported factors, software-recorded computer usage patterns, and additional measurements of anthropometrics and workstation set-up, show a better predictive quality as compared to the practical models based on self-reported factors and recorded computer usage patterns only. However, predictive quality varied largely across different arm-wrist-hand exposure parameters. Future exploration of the relation between predicted physical exposure and symptoms is therefore only recommended for physical exposures that can be reasonably well predicted.
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Affiliation(s)
- Maaike A Huysmans
- Department of Public and Occupational Health and Amsterdam Public Health research institute, VU University Medical Center, The Netherlands.,Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, The Netherlands
| | - Belinda H W Eijckelhof
- Department of Public and Occupational Health and Amsterdam Public Health research institute, VU University Medical Center, The Netherlands.,Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, The Netherlands
| | | | - Pieter Coenen
- Department of Public and Occupational Health and Amsterdam Public Health research institute, VU University Medical Center, The Netherlands.,School of Physiotherapy and Exercise Science, Curtin University, Australia
| | - Birgitte M Blatter
- Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, The Netherlands.,Netherlands Organisation for Applied Scientific Research, TNO, The Netherlands
| | - Peter W Johnson
- Department of Environmental and Occupational Health Sciences, University of Washington, USA
| | - Jaap H van Dieën
- Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, 'Vrije Universiteit' Amsterdam, Amsterdam Movement Sciences, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health and Amsterdam Public Health research institute, VU University Medical Center, The Netherlands.,Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, The Netherlands
| | - Jack T Dennerlein
- Department of Public and Occupational Health and Amsterdam Public Health research institute, VU University Medical Center, The Netherlands.,Department of Environmental Health, Harvard T. H. Chan School of Public Health, USA.,Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, USA
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Locks F, Gupta N, Hallman D, Birk Jørgensen M, Oliveira AB, Holtermann A. Association between objectively measured static standing and low back pain - a cross-sectional study among blue-collar workers. ERGONOMICS 2018; 61:1196-1207. [PMID: 29560812 DOI: 10.1080/00140139.2018.1455900] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Abstract
This study aims to investigate the cross-sectional association between objectively measured total time and temporal patterns of static standing (short bouts: 0-5 min; moderate bouts: >5-10 min; and long bouts: >10 min) during work and leisure and low back pain (LBP) among 698 blue-collar workers. Workers reported LBP on a 0-10 scale. The association between time spent on static standing and LBP was tested with linear regression. A positive association with LBP intensity was found for long bouts of static standing (β = 0.27) during total day (work + leisure), and total static standing time at leisure (β = 0.12). No significant associations were found for static standing during work and LBP intensity. These findings indicate that particularly long bouts of static standing over the entire day contribute to LBP in blue-collar workers. Practitioner Summary: The association between LBP and static standing time was investigated. This study indicates that prolonged time standing during total day and standing during leisure are positively associated with LBP among blue-collar workers. Therefore, practitioners should consider long periods of standing as a potential risk factor for LBP.
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Affiliation(s)
- Francisco Locks
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Nidhi Gupta
- b National Research Centre for the Working Environment , Copenhagen , Denmark
| | - David Hallman
- c Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research , University of Gävle , Gävle , Sweden
| | | | - Ana Beatriz Oliveira
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Andreas Holtermann
- b National Research Centre for the Working Environment , Copenhagen , Denmark
- d Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark
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Dale AM, Ekenga CC, Buckner-Petty S, Merlino L, Thiese MS, Bao S, Meyers AR, Harris-Adamson C, Kapellusch J, Eisen EA, Gerr F, Hegmann KT, Silverstein B, Garg A, Rempel D, Zeringue A, Evanoff BA. Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures. Occup Environ Med 2018; 75:501-506. [PMID: 29599164 PMCID: PMC6035491 DOI: 10.1136/oemed-2017-104744] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/07/2018] [Accepted: 03/12/2018] [Indexed: 11/19/2022]
Abstract
Background There is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures. Objective This study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O*NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study. Methods 2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O*NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O*NET. Results Both exposure methods found associations between incident CTS and exposures of force and repetition, with evidence of dose–response. Observed associations were similar across the two methods, with somewhat wider CIs for HRs calculated using the JEM method. Conclusion Exposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the ‘gold standard’ method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures.
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Affiliation(s)
- Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Christine C Ekenga
- George Warren Brown School, Washington University in Saint Louis, St Louis, Missouri, USA
| | - Skye Buckner-Petty
- Division of General Medical Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Linda Merlino
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
| | - Matthew S Thiese
- Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), University of Utah, Salt Lake City, Utah, USA
| | - Stephen Bao
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
| | - Alysha Rose Meyers
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Carisa Harris-Adamson
- Department of Environmental Health Sciences, University of California Berkeley, Berkeley, California, USA
| | - Jay Kapellusch
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Ellen A Eisen
- Department of Environmental Health Sciences, University of California Berkeley, Berkeley, California, USA
| | - Fred Gerr
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA
| | - Kurt T Hegmann
- Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), University of Utah, Salt Lake City, Utah, USA
| | - Barbara Silverstein
- Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
| | - Arun Garg
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - David Rempel
- Division of Occupational and Environmental Medicine, University of California at San Francisco, San Francisco, California, USA.,Department of Bioengineering, University of California Berkeley, Berkeley, California, USA
| | | | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
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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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Yang L, Grooten WJA, Forsman M. An iPhone application for upper arm posture and movement measurements. APPLIED ERGONOMICS 2017; 65:492-500. [PMID: 28274467 DOI: 10.1016/j.apergo.2017.02.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/28/2016] [Accepted: 02/16/2017] [Indexed: 05/27/2023]
Abstract
There is a need for objective methods for upper arm elevation measurements for accurate and convenient risk assessments. The aims of this study were (i) to compare a newly developed iOS application (iOS) for measuring upper arm elevation and angular velocity with a reference optical tracking system (OTS), and (ii) to compare the accuracy of the iOS incorporating a gyroscope and an accelerometer with using only an accelerometer, which is standard for inclinometry. The iOS-OTS limits of agreement for static postures (9 subjects) were -4.6° and 4.8°. All root mean square differences in arm swings and two simulated work tasks were <6.0°, and all mean correlation coefficients were >0.98. The mean absolute iOS-OTS difference of median angular velocity was <13.1°/s, which was significantly lower than only using an accelerometer (<43.5°/s). The accuracy of this iOS application compares well to that of today's research methods and it can be useful for practical upper arm measurements.
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Affiliation(s)
- Liyun Yang
- Unit of Ergonomics, School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden.
| | - Wilhelmus J A Grooten
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Zare M, Biau S, Brunet R, Roquelaure Y. Comparison of three methods for evaluation of work postures in a truck assembly plant. ERGONOMICS 2017; 60:1551-1563. [PMID: 28475477 DOI: 10.1080/00140139.2017.1314023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
This study compared the results of three risk assessment tools (self-reported questionnaire, observational tool, direct measurement method) for the upper limbs and back in a truck assembly plant at two cycle times (11 and 8 min). The weighted Kappa factor showed fair agreement between the observational and direct measurement method for the arm (0.39) and back (0.47). The weighted Kappa factor for these methods was poor for the neck (0) and wrist (0) but the observed proportional agreement (Po) was 0.78 for the neck and 0.83 for the wrist. The weighted Kappa factor between questionnaire and direct measurement showed poor or slight agreement (0) for different body segments in both cycle times. The results revealed moderate agreement between the observational tool and the direct measurement method, and poor agreement between the self-reported questionnaire and direct measurement. Practitioner Summary: This study provides risk exposure measurement by different common ergonomic methods in the field. The results help to develop valid measurements and improve exposure evaluation. Hence, the ergonomist/practitioners should apply the methods with caution, or at least knowing what the issues/errors are.
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Affiliation(s)
- Mohsen Zare
- a Equipe ERCOS-UTBM - Université de Bourgogne Franche-Comté , Belfort , France
| | - Sophie Biau
- a Equipe ERCOS-UTBM - Université de Bourgogne Franche-Comté , Belfort , France
- b French Institute of National Horse Riding School (IFCE) , Saumur , France
| | - Rene Brunet
- c INSERM, U1085, IRSET, ESTER Team, University of Angers , Angers , France
| | - Yves Roquelaure
- c INSERM, U1085, IRSET, ESTER Team, University of Angers , Angers , France
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Method for measuring tri-axial lumbar motion angles using wearable sheet stretch sensors. PLoS One 2017; 12:e0183651. [PMID: 29020053 PMCID: PMC5636072 DOI: 10.1371/journal.pone.0183651] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 08/08/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Body movements, such as trunk flexion and rotation, are risk factors for low back pain in occupational settings, especially in healthcare workers. Wearable motion capture systems are potentially useful to monitor lower back movement in healthcare workers to help avoid the risk factors. In this study, we propose a novel system using sheet stretch sensors and investigate the system validity for estimating lower back movement. METHODS Six volunteers (female:male = 1:1, mean age: 24.8 ± 4.0 years, height 166.7 ± 5.6 cm, weight 56.3 ± 7.6 kg) participated in test protocols that involved executing seven types of movements. The movements were three uniaxial trunk movements (i.e., trunk flexion-extension, trunk side-bending, and trunk rotation) and four multiaxial trunk movements (i.e., flexion + rotation, flexion + side-bending, side-bending + rotation, and moving around the cranial-caudal axis). Each trial lasted for approximately 30 s. Four stretch sensors were attached to each participant's lower back. The lumbar motion angles were estimated using simple linear regression analysis based on the stretch sensor outputs and compared with those obtained by the optical motion capture system. RESULTS The estimated lumbar motion angles showed a good correlation with the actual angles, with correlation values of r = 0.68 (SD = 0.35), r = 0.60 (SD = 0.19), and r = 0.72 (SD = 0.18) for the flexion-extension, side bending, and rotation movements, respectively (all P < 0.05). The estimation errors in all three directions were less than 3°. CONCLUSION The stretch sensors mounted on the back provided reasonable estimates of the lumbar motion angles. The novel motion capture system provided three directional angles without capture space limits. The wearable system possessed great potential to monitor the lower back movement in healthcare workers and helping prevent low back pain.
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Gyemi DL, van Wyk PM, Statham M, Casey J, Andrews DM. 3D peak and cumulative low back and shoulder loads and postures during greenhouse pepper harvesting using a video-based approach. Work 2017; 55:817-829. [PMID: 28059807 DOI: 10.3233/wor-162442] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In agricultural field work many tasks have been cited as high priority risk factors for the development of work-related musculoskeletal disorders (WRMDs). Although video-based biomechanical approaches have been effective in documenting the physical demands and risks associated with various occupational and non-occupational tasks, to date, this method has yet to be used to document jobs such as crop harvesting in a greenhouse environment. OBJECTIVE To document and assess the postural characteristics and 3D peak and cumulative low back and shoulder loads associated with greenhouse pepper harvesting using a video-based posture sampling approach. METHODS Nine male (28.2 (4.1) years) pepper harvesters from a greenhouse in Southwestern Ontario, Canada were videotaped during a normal shift. 3DMatch was used to document working trunk and shoulder postures, from which 3D peak and cumulative forces and moments were quantified. RESULTS On average, workers spent the majority of their time in neutral trunk postures (lateral bend: 99.1%; axial twist: 59.9%; flexion: 89.8%). Consistent results were found for the left and right shoulder, with the arms held in a neutral flexion posture 50% of the time or more. Four participants experienced peak L4/L5 compression forces (between 4116.3 N and 5937.0 N) which exceeded the NIOSH Action Limit (3400 N) during the cart pushing/pulling task, but remained below the threshold during picking. Mean cumulative L4/L5 extension and shoulder flexion moments ranged in magnitude from 18.5 Nm to 28.2 Nm, and between 19.4 Nm and 23.2 Nm, respectively, across all tasks. CONCLUSIONS The postural characteristics and biomechanical loads associated with greenhouse pepper harvesting were quantified with a video-based biomechanical approach. Further investigations of the physical risk factors for low back and shoulder musculoskeletal disorders is warranted in pepper harvesting, given the postures and loads documented in this study.
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Affiliation(s)
- Danielle L Gyemi
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - Paula M van Wyk
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - Melissa Statham
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
| | - Jeff Casey
- Occupational Health Clinics for Ontario Workers, Windsor, ON, Canada
| | - David M Andrews
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
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Nogueira HC, Silva LCDCB, Coury HJCG, Barbieri DF, Oliveira AB. Can experience modulate handler responses to boxes designed to decrease musculoskeletal load? ERGONOMICS 2017; 60:867-875. [PMID: 27482747 DOI: 10.1080/00140139.2016.1218942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Biomechanical load during the handling of commercial (cardboard box with and without cut out) and non-commercial boxes (cardboard box with a retreat on the bottom edges), on experienced compared to inexperienced subjects was evaluated. Thirty-seven inexperienced and 21 experienced workers handled all boxes at shoulder and ground levels. Biomechanical load on upper limb was investigated through posture and electromyography (EMG) recordings. Comfort and effort were assessed immediately after each handling. In general, experienced workers had low range of motion. On the other hand, EMG was similar between both groups, except when non-commercial boxes were handled in non-favourable heights. Comfort was higher when a non-commercial box was handled versus a commercial one, regardless of the group. Both groups had a lower biomechanical load when handling the non-commercial boxes compared to the commercial ones. However, experienced workers did not have the same advantage as inexperienced subjects when handling those new boxes. Practitioner Summary: Box designs favouring intuitive hand coupling and more efficient postures have potential to reduce the risk of upper-limb musculoskeletal disorders in inexperienced subjects. However, ergonomist has to deal with workers on different levels of experience. Results of this study can support the development of effective recommendations for the working context.
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Affiliation(s)
- Helen Cristina Nogueira
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Luciana Cristina da Cunha Bueno Silva
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Helenice Jane Cote Gil Coury
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Dechristian França Barbieri
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
| | - Ana Beatriz Oliveira
- a Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy , Federal University of São Carlos , São Carlos , Brazil
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Trunk kinematics and low back pain during pruning among vineyard workers-A field study at the Chateau Larose-Trintaudon. PLoS One 2017; 12:e0175126. [PMID: 28384277 PMCID: PMC5383154 DOI: 10.1371/journal.pone.0175126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/21/2017] [Indexed: 12/19/2022] Open
Abstract
The prevalence of low back disorders is dramatically high in viticulture. Field measurements that objectively quantify work exposure can provide information on the relationship between the adopted trunk postures and low back pain. The purposes of the present study were three-fold (1) to carry out a kinematics analysis of vineyard-workers’ pruning activity by extracting the duration of bending and rotation of the trunk, (2) to question separately the relationship between the duration of forward bending or trunk rotation with low back pain intensity and pressure pain sensitivity and (3) to question the relationship between the combined duration of forward bending and trunk rotation on low back pain intensity and pressure pain sensitivity. Fifteen vineyard-workers were asked to perform pruning activity for 12 minutes with a wireless triaxial accelerometer placed on their trunk. Kinematic analysis of the trunk showed that vineyard-workers spent more than 50% of the time with the trunk flexed greater than 30° and more than 20% with the trunk rotated greater than 10°. These results show that pruning activity lead to the adoption of forward bended and rotated trunk postures that could significantly increase the risk of work related musculoskeletal disorders in the low back. However, this result was mitigated by the observation of an absence of significant association between the duration of forward bending and trunk rotation with low back pain intensity or pressure pain sensitivity. Even if prospective field measurements and studies assessing the effects of low back pain confounders are needed, this field study provides new genuine information on trunk kinematics during pruning activity.
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Munch Nielsen C, Gupta N, Knudsen LE, Holtermann A. Association of objectively measured occupational walking and standing still with low back pain: a cross-sectional study. ERGONOMICS 2017; 60:118-126. [PMID: 26968200 DOI: 10.1080/00140139.2016.1164901] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES This cross-sectional study investigated the association of objectively measured walking and standing still time at work with low back pain (LBP) intensity among blue-collar workers. DESIGN A cross-sectional study. METHODS 187 workers attached two accelerometers for diurnal standing still and walking measurements, which were categorised using tertiles. Workers' self-reported LBP intensity (scale 0-9) was categorised into low (0-5) and high pain (6-9). RESULTS Of the 187 workers, 17% reported a high level of LBP. Results of the multi-adjusted logistic regression analysis demonstrated a negative association between walking and high LBP intensity (OR 0.24 CL 95% 0.07 to 0.79). The results between standing still and high LBP intensity were mixed and non-significant. CONCLUSION Blue-collar workers who walk more at work tend to have low LBP. These results should be verified using objective measures in a prospective design. Practitioner Summary: Most studies on the association of occupational walking and standing still with LBP have used poor self-reported measures. This study investigated the association of objectively measured time spent walking and standing still at work with LBP among blue-collar workers. A significant negative association between walking and LBP was found. However, because of the cross-sectional design, these results should be further investigated in prospective studies.
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Affiliation(s)
- Camilla Munch Nielsen
- a Department of Musculoskeletal Disorders and Physical Workload , National Research Centre for the Working Environment , Copenhagen Ø , Denmark
| | - Nidhi Gupta
- a Department of Musculoskeletal Disorders and Physical Workload , National Research Centre for the Working Environment , Copenhagen Ø , Denmark
| | - Lisbeth E Knudsen
- b Department of Public Health , University of Copenhagen , Copenhagen K , Denmark
| | - Andreas Holtermann
- a Department of Musculoskeletal Disorders and Physical Workload , National Research Centre for the Working Environment , Copenhagen Ø , Denmark
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Gremark Simonsen J, Axmon A, Nordander C, Arvidsson I. Neck and upper extremity pain in sonographers - Associations with occupational factors. APPLIED ERGONOMICS 2017; 58:245-253. [PMID: 27633219 DOI: 10.1016/j.apergo.2016.06.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 06/06/2023]
Abstract
Sonographers have a high risk of musculoskeletal disorders. This study explores the associations between working conditions and musculoskeletal pain based on the frequency and intensity of pain in the neck and upper extremities. A questionnaire was answered by 291 female sonographers. High prevalence of neck/shoulder pain was associated with eye complaints and headache related to work on the computer, dissatisfaction with the computer workstation, high mechanical exposure index (MEI) and high demands. The possibility to adjust the keyboard and chair, and adequately corrected eyesight were positive factors. High prevalence of elbow/hand pain was associated with performing echocardiography, computer-related eye complaints, high MEI and high job and sensory demands. In echocardiography, working with a straight wrist and holding the transducer with a two-handed grip or alternating hands was associated with a low prevalence of elbow/hand pain. Thus, further improvements in the working conditions are possible and are recommended.
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Affiliation(s)
- Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
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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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Gemark Simonsen J, Gard G. Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement. BMC Musculoskelet Disord 2016; 17:391. [PMID: 27628504 PMCID: PMC5024433 DOI: 10.1186/s12891-016-1245-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sonographers' perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers' perceptions of ergonomic problems at work, and their suggestions for improvement strategies. METHODS Twenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied. RESULTS The sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient's physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills. CONCLUSION Sonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable.
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Affiliation(s)
- Jenny Gemark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Gunvor Gard
- Department of Health Sciences, Faculty of Lund University, SE-221 00, Lund, Sweden.,and Department of Health Sciences, Luleå University of Technology, S-971 87, Luleå, Sweden
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Nordander C, Hansson GÅ, Ohlsson K, Arvidsson I, Balogh I, Strömberg U, Rittner R, Skerfving S. Exposure-response relationships for work-related neck and shoulder musculoskeletal disorders--Analyses of pooled uniform data sets. APPLIED ERGONOMICS 2016; 55:70-84. [PMID: 26995038 DOI: 10.1016/j.apergo.2016.01.010] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 01/07/2016] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
There is a lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal disorders in the neck and shoulders. We explored such relationships in pooled data from a series of our cross-sectional studies. We recorded the prevalence of complaints/discomfort (Nordic Questionnaire) and diagnoses (physical examination) in 33 groups (24 female and 9 male) within which the workers had similar work tasks (3141 workers, of which 817 were males). In representative sub-groups, we recorded postures and velocities of the head (N = 299) and right upper arm (inclinometry; N = 306), right wrist postures and velocities (electrogoniometry; N = 499), and muscular activity (electromyography) in the right trapezius muscle (N = 431) and forearm extensors (N = 206). We also assessed the psychosocial work environment (Job Content Questionnaire). Uni- and multivariate linear meta-regression analysis revealed several statistically significant group-wise associations. Neck disorders were associated with head inclination, upper arm elevation, muscle activity of the trapezius and forearm extensors and wrist posture and angular velocity. Right-side shoulder disorders were associated with head and upper arm velocity, activity in the trapezius and forearm extensor muscles and wrist posture and angular velocity. The psychosocial work environment (low job control, job strain and isostrain) was also associated with disorders. Women exhibited a higher prevalence of neck and shoulder complaints and tension neck syndrome than men, when adjusting for postures, velocities, muscular activity or psychosocial exposure. In conclusion, the analyses established quantitative exposure-response relationships between neck and shoulder disorders and objective measures of the physical workload on the arm. Such information can be used for risk assessment in different occupations/work tasks, to establish quantitative exposure limits, and for the evaluation of preventive measures.
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Affiliation(s)
- Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden.
| | - Gert-Åke Hansson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Kerstina Ohlsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Inger Arvidsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Istvan Balogh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Ulf Strömberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Ralf Rittner
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Staffan Skerfving
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
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Arvidsson I, Gremark Simonsen J, Dahlqvist C, Axmon A, Karlson B, Björk J, Nordander C. Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. BMC Musculoskelet Disord 2016; 17:35. [PMID: 26781760 PMCID: PMC4717636 DOI: 10.1186/s12891-016-0883-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 01/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is usually assumed that musculoskeletal pain is associated with both the physical workload and the psychosocial work environment, as well as with personal and lifestyle factors. This study aims to ascertain the prevalence of musculoskeletal pain in women with varying or different occupational exposures, and to explore the associations between musculoskeletal pain and the occupational and personal factors. METHODS A questionnaire on physical, psychosocial and individual factors was answered by 1591 women in five occupational groups with contrasting occupational exposures (teachers, anaesthetic, theatre, and assistant nurses, and sonographers). The outcome measure was musculoskeletal pain (in a new model based on frequency and intensity of complaints the preceding year) from the neck, shoulders, hands, lower back and feet. RESULTS Neck pain was equally frequent among teachers, assistant nurses and sonographers, and less frequent in anaesthetic and theatre nurses. The sonographers experienced the highest prevalence of shoulder pain, while the assistant nurses were the most affected in the wrists and hands, lower back, and feet. The teachers reported the highest scores in most of the psychosocial dimensions. The theatre nurses scored highest in strenuous work postures and movements (mechanical exposure index, MEI), and the assistant nurses in physical activity and lifting (physical exposure index, PHYI). Multivariable models in the total population showed that both the physical workload and the psychosocial work environment were associated with pain in all body regions, though different factors affected different regions. Pain in the neck, shoulders, hands and lower back was strongly associated with a high MEI and high job demands, while pain in the feet was associated with a high PHYI and a high BMI. A young age was associated with pain in the neck, and an older age was associated with pain in the hands and feet. Lack of time for personal recovery was associated with pain in the shoulders and lower back. CONCLUSIONS The occupational groups were affected differently and need different protective measures. For the teachers, the psychosocial work environment should be improved. The surgical staff and sonographers require measures to mitigate lifting and constrained postures.
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Affiliation(s)
- Inger Arvidsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Björn Karlson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
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Chiasson MÈ, Imbeau D, Major J, Aubry K, Delisle A. Influence of musculoskeletal pain on workers' ergonomic risk-factor assessments. APPLIED ERGONOMICS 2015; 49:1-7. [PMID: 25766416 DOI: 10.1016/j.apergo.2014.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 07/28/2014] [Accepted: 12/29/2014] [Indexed: 06/04/2023]
Abstract
This study compares the ergonomic risk-factor assessments of workers with and without musculoskeletal pain. A questionnaire on the musculoskeletal pain experienced in various body regions during the 12 months and seven days preceding the data collection was administered to 473 workers from three industrial sectors. The Ergonomic Workplace Analysis method, developed by the Finnish Institute of Occupational Health (FIOH), was then used by the workers and an ergonomics expert to assess the workstations. The ergonomic quality of the workstations and the need for change were also assessed by the expert and the workers at the workstation, using visual analog scales (VAS). Results show that the workers in this study were exposed to significant musculoskeletal disorder (MSD) risk factors, according to the FIOH assessment and the high percentages of reported pain. The results also show that those who reported pain in the seven days prior to the assessment evaluated their workstations more negatively than subjects who reported no pain, while the expert found no difference between the two groups' exposure to MSD risk factors.
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Affiliation(s)
- Marie-Ève Chiasson
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.
| | - Daniel Imbeau
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
| | - Judy Major
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
| | - Karine Aubry
- Department of Mathematics and Industrial Engineering, Polytechnique Montreal, Montreal, Quebec, Canada
| | - Alain Delisle
- Faculty of Physical Education and Sports, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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