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Korshøj M, Møller A, Siersma V, Lund R, Hougaard CØ, Mortensen OS, Allesøe K. Relationship between cumulative exposure to occupational lifting throughout working life and risk of ischemic heart disease in men and women. The Copenhagen Aging and Midlife Biobank. Ann Work Expo Health 2024; 68:109-121. [PMID: 38142405 PMCID: PMC10877461 DOI: 10.1093/annweh/wxad077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023] Open
Abstract
Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009-2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05-2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06-1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18-2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88-1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85-1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81-1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen.
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Affiliation(s)
- Mette Korshøj
- Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital, Gl. Ringstedvej 4B, 4300 Holbæk, Denmark
| | - Anne Møller
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, build. 24 Q, 1353 Copenhagen K, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, build. 24 Q, 1353 Copenhagen K, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, build. 24 Q, 1353 Copenhagen K, Denmark
- Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Panum, building 7.2 & 7.3, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
| | - Charlotte Ø Hougaard
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, build. 24 Q, 1353 Copenhagen K, Denmark
| | - Ole S Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital, Gl. Ringstedvej 4B, 4300 Holbæk, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, build. 24 Q, 1353 Copenhagen K, Denmark
| | - Karen Allesøe
- Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital, Gl. Ringstedvej 4B, 4300 Holbæk, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
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Sedeh FB, Michaelsdóttir TE, Mortensen OS, Jemec GE, Ibler KS. Design and validation of pictograms and educational video clips to improve the knowledge of skin care and protection: Comprehension and recall among professional hospital cleaners. Contact Dermatitis 2023; 89:250-258. [PMID: 37579775 DOI: 10.1111/cod.14395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023]
Abstract
INTRODUCTION Insufficient knowledge about protection and care of the skin among Danish hospital cleaners, particularly immigrant cleaners, is guessed to be a widespread issue that can increase the likelihood of them developing occupational hand eczema (OHE). This study aimed to design and validate 10 pictograms and 10 short video clips showing recommendations for skin care that would help prevent OHE among professional cleaners. METHODS Ten pictograms and 10 short, educational video clips, based on standard, recommended information were developed in collaboration with a medical illustrator and a video director. The materials were validated in a two-step process that included bus drivers (primary validation) and professional cleaners (secondary validation). RESULTS During the primary validation, 5 of the 10 pictograms (50%) were comprehended correctly by at least 85%. Those that were misinterpreted, were modified and retested several times until they were understood correctly by at least 85%. During the secondary validation, all 10 pictograms achieved acceptable levels of comprehension among professional cleaners. All the video clips were comprehended correctly by both bus drivers and cleaners. CONCLUSION Ten easy-to-understand pictograms and 10 educational video clips for cleaners about the prevention of OHE have been designed and validated.
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Affiliation(s)
- Farnam B Sedeh
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Thórunn E Michaelsdóttir
- Department of Clinical Physiology, Nuclear Medicine, and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ole S Mortensen
- Department of Occupational and Social Medicine, Holbaek University Hospital, Holbaek, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gregor E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
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Kæmpe KR, Mortensen OS. The distribution of diagnoses in a population of individuals on long-term sick leave. Dan Med J 2021; 68:A06200429. [PMID: 33543700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the distribution of International Classification of Primary Care, second edition, (ICPC-2) diagnoses in a population of individuals on long-term sick leave. Furthermore, we wanted to test if the number of diagnoses varied between assessors. METHODS The study population was comprised of people on sick leave aged 18-65 years attending rehabilitation appointments in Region Zealand in the period from 1 March to 31 August 2018. Five general practitioners assigned between one and three ICPC-2 diagnoses per subject. It was investigated whether there was independence between the doctors collecting the data. RESULTS A total of 29 diagnostic categories were established, and the three most common conditions were back pain (9.8%), musculoskeletal disorders (8.6%) and depression (7.5%). During the data collection period, a primary ICPC-2 diagnosis was made in 743 subjects, a secondary diagnosis in 371 subjects (49.9%) and a tertiary diagnosis in 101 subjects (13.6%). No significant differences were found between the number of ICPC-2 diagnoses made by the five doctors (p = 0.49). CONCLUSIONS The most common diagnoses were back conditions, musculoskeletal disorders and depression, and half of the study population had at least two diagnoses. The study shows that health professionals can assign ICPC-2 diagnoses for individuals on sick leave during rehabilitation sessions. This will give the municipalities the necessary knowledge to systematically track the development of diagnoses in order to plan individualised interventions. FUNDING none. TRIAL REGISTRATION not relevant.
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Stevens ML, Crowley P, Rasmussen CL, Hallman DM, Mortensen OS, Nygård CH, Holtermann A. Accelerometer-Measured Physical Activity at Work and Need for Recovery: A Compositional Analysis of Cross-sectional Data. Ann Work Expo Health 2021; 64:138-151. [PMID: 31879769 PMCID: PMC7031076 DOI: 10.1093/annweh/wxz095] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 11/08/2019] [Accepted: 12/03/2019] [Indexed: 11/28/2022] Open
Abstract
Objectives Previous research has shown strong associations between occupational physical activity (OPA) and need for recovery (NFR). However this research has only utilized self-reported measures of OPA which may be biased. Thus, there is a need for investigating if the previously documented association between self-reported OPA and NFR can be found when using technical measures of OPA. There is also the need to investigate whether older workers are particularly susceptible to increased NFR, since age-related declines in physical capacity mean that it is likely these workers will have a higher NFR for a given physical activity. The aim of this study was to investigate the association between technically measured OPA and NFR, and whether this relationship is modified by age. Methods This study utilized data from the Danish Physical Activity Cohort with Objective Measurements cohort—comprising Danish workers (n = 840) from the cleaning, manufacturing, and transportation sectors. OPA was measured by accelerometers attached to the thigh and upper back for at least one work day and classified into four physical behaviour categories (sedentary, standing, light, or moderate/vigorous). NFR was measured using a shortened version of the Danish NFR scale. Analysis was conducted using linear regression and isotemporal substitution analyses for compositional data. Results The overall association between OPA and NFR was statistically significant in the unadjusted model (P < 0.001), but not when adjusted for age, sex, occupation, and shift work (P = 0.166). Isotemporal substitution showed small but significant reductions in NFR when increasing sedentary time relative to other behaviours (adjusted: ΔNFR = −0.010 [−0.019; −0.001]). There were no significant interactions between age and OPA (P = 0.409). Conclusions This study found significant associations between OPA and NFR, but the effect sizes were small. Reallocating 30 min to sedentary behaviours from other behaviours was associated with a reduced NFR, but the effect size may not be practically relevant. Moreover, no clear modifying effects of age were identified.
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Affiliation(s)
- Matthew L Stevens
- Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Patrick Crowley
- Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Charlotte L Rasmussen
- Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - David M Hallman
- Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Ole S Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.,Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, The National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Sveistrup J, Mortensen OS, Rosenschöld PM, Engelholm SA, Petersen PM. Employment and sick leave in patients with prostate cancer before, during and after radiotherapy. Scand J Urol 2016; 50:164-9. [PMID: 26754420 DOI: 10.3109/21681805.2015.1119190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine employment outcomes after radiotherapy (RT) for prostate cancer (PCa). MATERIALS AND METHODS The Danish DREAM database contains information about social benefits paid to Danish citizens. Data are recorded prospectively every week. From the database, it is possible to assess whether a patient is working, on sick leave or retired at a certain time. Data on 417 Danish citizens treated with RT for PCa at Rigshospitalet, Copenhagen, between 1 January 2005 and 1 May 2010 were obtained from the database. The data were collected during a 2 year period from 1 year before RT to 1 year after RT. RESULTS Among patients of working age, 75% were still available for work 1 year after RT. The degree of sick leave increased almost continuously in the year before the start of RT and reached a maximum of 56% during RT. After RT it gradually declined. There was no significant difference between the number of patients on sick leave 1 year after RT compared to 1 year before RT (p = 0.23). Patients spent a significantly higher number of weeks on sick leave in the year after the start of RT compared to the year before RT (p = 0.001). CONCLUSION Except for a transient increase in sick leave during treatment, RT did not seem to affect the working lives of patients with PCa significantly.
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Affiliation(s)
- Joen Sveistrup
- a Department of Oncology , Rigshospitalet , Copenhagen , Denmark
| | - Ole S Mortensen
- b Department of Occupational Medicine , Køge Hospital , Køge , Denmark
| | | | | | - Peter M Petersen
- a Department of Oncology , Rigshospitalet , Copenhagen , Denmark
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Andersen CH, Andersen LL, Pedersen MT, Mortensen P, Karstad K, Mortensen OS, Zebis MK, Sjøgaard G. Dose-response of strengthening exercise for treatment of severe neck pain in women. J Strength Cond Res 2014; 27:3322-8. [PMID: 23478473 DOI: 10.1519/jsc.0b013e31828f12c6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Specific strength training is shown to relieve neck pain in office workers. The purpose of this study is to evaluate the effectiveness of specific strength training in women with severe neck pain and to analyze the dose-response relationship between training adherence and pain reduction. One hundred eighteen untrained women with severe neck pain (>30 mm VAS pain) were included from a larger study, in which the subjects were randomized to 20-week specific strength training for the neck/shoulders or to a control group. In the intention-to-treat analysis, the training group experienced greater pain relief than the control group (p < 0.01). Participants who adhered "per protocol" decreased pain by 35 mm VAS (95% confidence interval: -26 to -44) from baseline to follow-up corresponding to a 70% reduction. In the dose-response analyses, participants with medium and high training adherence showed better pain relief than the control group and those with low adherence (p < 0.0001). The decrease from baseline in the medium and high adherence groups was 37 mm VAS (28-46 mm) and 33 mm VAS (24-43 mm), respectively. Specific strength training reduces pain intensity in women with severe neck pain, and 1-2 training sessions per week for 20 weeks (∼30 training sessions) seems sufficient for optimal pain relief.
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Affiliation(s)
- Christoffer H Andersen
- 1National Research Centre for the Working Environment, Copenhagen, Denmark; 2Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; 3Institute of Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark; and 4Department of Occupational Health, Køge Hospital, Lykkebækvej 1, DK-4600, Køge, Denmark
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Poulsen OM, Aust B, Bjorner JB, Rugulies R, Hansen JV, Tverborgvik T, Winzor G, Mortensen OS, Helverskov T, Ørbæk P, Nielsen MBD. Effect of the Danish return-to-work program on long-term sickness absence: results from a randomized controlled trial in three municipalities. Scand J Work Environ Health 2013; 40:47-56. [PMID: 24045856 DOI: 10.5271/sjweh.3383] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. METHODS The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI). RESULTS The intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31-1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HR M11.12, 95% CI 0.97-1.29, and HR M30.80, 95% CI 0.63-1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR. CONCLUSION The effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success or failure of this complex intervention.
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Affiliation(s)
- Otto M Poulsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100 Copenhagen, Denmark.
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Andersen LL, Burdorf A, Fallentin N, Persson R, Jakobsen MD, Mortensen OS, Clausen T, Holtermann A. Patient transfers and assistive devices: prospective cohort study on the risk for occupational back injury among healthcare workers. Scand J Work Environ Health 2013; 40:74-81. [DOI: 10.5271/sjweh.3382] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Møller A, Reventlow S, Hansen ÅM, Andersen LL, Siersma V, Lund R, Avlund K, Andersen JH, Mortensen OS. Does a history of physical exposures at work affect hand-grip strength in midlife? A retrospective cohort study in Denmark. Scand J Work Environ Health 2013; 39:599-608. [DOI: 10.5271/sjweh.3368] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Sundstrup E, Jakobsen MD, Andersen CH, Zebis MK, Mortensen OS, Andersen LL. Muscle activation strategies during strength training with heavy loading vs. repetitions to failure. J Strength Cond Res 2012; 26:1897-903. [PMID: 21986694 DOI: 10.1519/jsc.0b013e318239c38e] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Going to failure, or not, has probably been one of the most debated issues during the history of strength training. However, few studies have directly compared the physiological effect of failure vs. nonfailure strength training. The purpose of this study was to evaluate muscle activation strategies with electromyography (EMG) during heavy repetitions vs. repetitions to failure with lighter resistance. Fifteen healthy untrained women performed a set with heavy loading (3 repetition maximum [RM]) and a set of repetitions to failure with lower resistance (∼15 RM) during lateral raise with elastic tubing. Electromyographic amplitude and median power frequency of specific shoulder and neck muscles were analyzed, and the BORG CR10 scale was used to rate perceived loading immediately after each set of exercise. During the failure set, normalized EMG was significantly lower during the first repetition and significantly higher during the latter repetitions compared with the heavy 3-RM set (p < 0.05). Normalized EMG for the examined muscles increased throughout the set to failure in a curvilinear fashion--e.g., for the trapezius from 86 to 124% maximal voluntary contraction (p < 0.001)--and reached a plateau during the final 3-5 repetitions before failure. Median power frequency for all examined muscles decreased throughout the set to failure in a linear fashion, indicating progressively increasing fatigue. In conclusion, going to complete failure during lateral raise is not necessary to recruit the entire motor unit pool in untrained women--i.e., muscle activity reached a plateau 3-5 repetitions from failure with an elastic resistance of approximately 15 RM. Furthermore, strengthening exercises performed with elastic tubing seem to be an efficient resistance exercise and a feasible and practical alternative to traditional resistance equipment.
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Affiliation(s)
- Emil Sundstrup
- National Research Center for the Working Environment, Copenhagen, Denmark.
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Andersen LL, Andersen CH, Sundstrup E, Jakobsen MD, Mortensen OS, Zebis MK. Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial. Pain Physician 2012; 15:385-394. [PMID: 22996850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Understanding the mechanisms of long-standing musculoskeletal pain and adaptations in response to physical rehabilitation is important for developing optimal treatment strategies. The influence of central adaptations of pain perception in response to rehabilitation of musculoskeletal pain remains unclear. OBJECTIVE To investigate the effect of neck/shoulder resistance training on pressure pain threshold (PPT) of the painful neck/shoulder muscles (upper trapezius) and a non-painful reference muscle of the leg (tibialis anterior) in adults with neck/shoulder pain. STUDY DESIGN Examiner-blinded, parallel-group randomized controlled trial with allocation concealment. TRIAL REGISTRATION ISRCTN60264809 SETTING: Office workplaces in the capital of Denmark. METHODS The study contained 198 adults with frequent neck/shoulder pain (174 women and 24 men, mean: age 43 years, duration of pain 186 days during the previous year, computer use 93% of work time) were randomly allocated to 10 weeks of specific resistance training for the neck/shoulder muscles for 2 or 12 minutes per day 5 times a week, or weekly information on general health (control group). Primary outcomes were changes in PPT of the painful neck/shoulder muscles (upper trapezius) and a distant non-painful reference muscle (tibialis anterior) at 10 weeks. RESULTS PPT of both the trained painful trapezius and the non-trained reference muscle of the leg increased more in the training groups compared with the control group (P < 0.05), providing evidence of central adaptations. The change in PPT of the reference muscle was of similar magnitude to that of the painful muscle. Compared with the control group, the change in PPT of the trapezius and tibialis anterior was 31 (95% CI 3 to 60) kPa and 36 (8 to 65) kPa in the 2 min group, respectively, and 29 (1 to 58) kPa and 36 (7 to 64) kPa in the 12 min group. LIMITATIONS Blinding of participants is not possible in behavioural interventions. CONCLUSION Central adaptations of pain perception occur in response to rehabilitation of musculoskeletal pain. Thus, treating pain in one region of the body reduces sensitivity to pressure in other regions of the body. Clinicians and researchers may use this knowledge to better understand adaptations of pain perception in patients with musculoskeletal pain.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Holtermann A, Clausen T, Aust B, Mortensen OS, Andersen LL. Does occupational lifting and carrying among female health care workers contribute to an escalation of pain-day frequency? Eur J Pain 2012; 17:290-6. [PMID: 22641396 DOI: 10.1002/j.1532-2149.2012.00175.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND The aim of the study was to investigate if different frequencies, loads and trunk postures of occupational lifting and carrying increases the risk of sub-chronic (1-30 days last 12 months) low back pain (LBP) to become persistent (>30 days last 12 months) among female health care workers. METHODS Female health care workers answered a questionnaire about occupational lifting or carrying frequency (rarely, occasionally and frequently), load (low: 1-7 kg, moderate: 8-30 kg and heavy: >30 kg) and trunk posture (upright or forward bent back), and days with LBP in 2005 and 2006. RESULTS The odds ratio (OR) for developing persistent LBP in 2006 from these characteristics of occupational lifting and carrying was investigated with multi-adjusted logistic regressions among female health care workers with sub-chronic LBP (n = 2381) in 2005. Among health care workers with sub-chronic LBP, increased risk of persistent LBP was found from frequently lifting or carrying with forward bent back of moderate loads (OR: 1.63; 95% CI: 1.15-2.33) and heavy loads (OR: 1.56; 95% CI: 1.04-2.34). No increased risk for LBP to develop into a persistent condition was found for frequent lifting with upright back, frequent lifting or carrying of light loads, or occasionally lifting or carrying of any loads. CONCLUSIONS Preventive initiatives for sub-chronic LBP to develop into a persistent condition ought to focus on reducing frequent lifting and carrying of moderate and heavy loads with forward bent back.
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Affiliation(s)
- A Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Holtermann A, Marott JL, Gyntelberg F, Søgaard K, Suadicani P, Mortensen OS, Prescott E, Schnohr P. Occupational and leisure time physical activity: risk of all-cause mortality and myocardial infarction in the Copenhagen City Heart Study. A prospective cohort study. BMJ Open 2012; 2:e000556. [PMID: 22331387 PMCID: PMC3282285 DOI: 10.1136/bmjopen-2011-000556] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 01/18/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Men with low physical fitness and high occupational physical activity are recently shown to have an increased risk of cardiovascular disease and all-cause mortality. The association between occupational physical activity with cardiovascular disease and all-cause mortality may also depend on leisure time physical activity. DESIGN A prospective cohort study. SETTING The Copenhagen City Heart Study. PARTICIPANTS 7819 men and women aged 25-66 years without a history of cardiovascular disease who attended an initial examination in the Copenhagen City Heart Study in 1976-1978. OUTCOME MEASURES Myocardial infarction and all-cause mortality. Occupational physical activity was defined by combining information from baseline (1976-1978) with reassessment in 1981-1983. Conventional risk factors were controlled for in Cox analyses. RESULTS During the follow-up from 1976 to 1978 until 2010, 2888 subjects died of all-cause mortality and 787 had a first event of myocardial infarction. Overall, occupational physical activity predicted all-cause mortality and myocardial infarction in men but not in women (test for interaction p=0.02). High occupational physical activity was associated with an increased risk of all-cause mortality among men with low (HR 1.56; 95% CI 1.11 to 2.18) and moderate (HR 1.31; 95% CI 1.05 to 1.63) leisure time physical activity but not among men with high leisure time physical activity (HR 1.00; 95% CI 0.78 to 1.26) (test for interaction p=0.04). Similar but weaker tendencies were found for myocardial infarction. Among women, occupational physical activity was not associated with subsequent all-cause mortality or myocardial infarction. CONCLUSIONS The findings suggest that high occupational physical activity imposes harmful effects particularly among men with low levels of leisure time physical activity.
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Affiliation(s)
- Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Finn Gyntelberg
- The Copenhagen Male Study, Epidemiological Research Unit, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Karen Søgaard
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Poul Suadicani
- The Copenhagen Male Study, Epidemiological Research Unit, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ole S Mortensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- The Copenhagen Male Study, Epidemiological Research Unit, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Eva Prescott
- The Copenhagen City Heart Study, Bispebjerg University Hospital, Copenhagen, Denmark
- Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Bispebjerg University Hospital, Copenhagen, Denmark
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Aust B, Helverskov T, Nielsen MBD, Bjorner JB, Rugulies R, Nielsen K, Sørensen OH, Grundtvig G, Andersen MF, Hansen JV, Buchardt HL, Nielsen L, Lund TL, Andersen I, Andersen MH, Clausen AS, Heinesen E, Mortensen OS, Ektor-Andersen J, Ørbæk P, Winzor G, Bültmann U, Poulsen OM. The Danish national return-to-work program--aims, content, and design of the process and effect evaluation. Scand J Work Environ Health 2012; 38:120-33. [PMID: 22245919 DOI: 10.5271/sjweh.3272] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100 Copenhagen, Denmark.
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Andersen LL, Jakobsen MD, Pedersen MT, Mortensen OS, Sjøgaard G, Zebis MK. Effect of specific resistance training on forearm pain and work disability in industrial technicians: cluster randomised controlled trial. BMJ Open 2012; 2:e000412. [PMID: 22331386 PMCID: PMC3282287 DOI: 10.1136/bmjopen-2011-000412] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians. DESIGN AND SETTING Two-armed cluster randomised controlled trial of 20 weeks performed at two industrial production units in Copenhagen, Denmark. PARTICIPANTS Working-age industrial technicians both with and without pain and disability. INTERVENTIONS The training group (n=282) performed specific resistance training for the shoulder, neck and arm muscles three times a week. The control group (n=255) was advised to continue normal physical activity. OUTCOME All participants rated forearm pain intensity (Visual Analogue Scale, 0-100 mm) once a week (primary outcome) and replied to a questionnaire on work disability (Disability of the Arm Shoulder and Hand, 0-100) at baseline and follow-up (secondary outcome). RESULTS Questionnaires were sent to 854 workers of which 30 (n=282) and 27 (n=255) clusters were randomised to training and control, respectively. Of these, 211 and 237 participants, respectively, responded to the follow-up questionnaire. Intention-to-treat analyses including both individuals with and without pain showed that from baseline to follow-up, pain intensity and work disability decreased more in the training group than in the control group (4-5 on a scale of 0-100, p<0.01-0.001). Among those with pain >30 mm Visual Analogue Scale at baseline (n=54), the OR for complete recovery at follow-up in the training group compared with the control group was 4.6 (95% CI 1.2 to 17.9). Among those with work disability >30 at baseline (n=113), the OR for complete recovery at follow-up in the training group compared with the control group was 6.0 (95% CI 1.8 to 19.8). CONCLUSION Specific resistance training of the shoulder, neck and arm reduces forearm pain and work disability among industrial technicians. TRIAL REGISTRATION NUMBER NCT01071980.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Markus D Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mogens T Pedersen
- Department of Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole S Mortensen
- Department of Occupational Health, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mette K Zebis
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Andersen LL, Clausen T, Mortensen OS, Burr H, Holtermann A. A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare. Int Arch Occup Environ Health 2011; 85:615-22. [PMID: 21986907 DOI: 10.1007/s00420-011-0709-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 09/27/2011] [Indexed: 11/29/2022]
Abstract
PURPOSE The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers. METHODS Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004-2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1-30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up. RESULTS At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17-1.85]), neck/shoulder (HR 1.60 [95% CI 1.27-2.02]) and knees (HR 1.92 [95% CI 1.52-2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09-1.82]) and knee pain (HR 1.69 [95% CI 1.32-2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions. CONCLUSION Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen, Denmark.
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Zebis MK, Andersen LL, Pedersen MT, Mortensen P, Andersen CH, Pedersen MM, Boysen M, Roessler KK, Hannerz H, Mortensen OS, Sjøgaard G. Implementation of neck/shoulder exercises for pain relief among industrial workers: a randomized controlled trial. BMC Musculoskelet Disord 2011; 12:205. [PMID: 21936939 PMCID: PMC3188479 DOI: 10.1186/1471-2474-12-205] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 09/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers. METHODS Cluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9). RESULTS 85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group--for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders. CONCLUSION High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain. TRIAL REGISTRATION NCT01071980.
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Affiliation(s)
- Mette K Zebis
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5320 Odense M, Denmark.
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Andersen LL, Hansen K, Mortensen OS, Zebis MK. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. BMC Musculoskelet Disord 2011; 12:169. [PMID: 21777478 PMCID: PMC3161919 DOI: 10.1186/1471-2474-12-169] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 07/22/2011] [Indexed: 11/26/2022] Open
Abstract
Background Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. Methods Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'. Results In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations. Conclusions A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius. Trial Registration ISRCTN60264809
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark.
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Holtermann A, Burr H, Hansen JV, Krause N, Søgaard K, Mortensen OS. Occupational physical activity and mortality among Danish workers. Int Arch Occup Environ Health 2011; 85:305-10. [DOI: 10.1007/s00420-011-0668-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 06/08/2011] [Indexed: 11/28/2022]
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Andersen LL, Mortensen OS, Zebis MK, Jensen RH, Poulsen OM. Effect of brief daily exercise on headache among adults – secondary analysis of a randomized controlled trial. Scand J Work Environ Health 2011; 37:547-50. [DOI: 10.5271/sjweh.3170] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Can Two Minutes of Exercise a Day Take the Pain Away? Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000402100.50843.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kristiansen J, Korshøj M, Skotte JH, Jespersen T, Søgaard K, Mortensen OS, Holtermann A. Comparison of two systems for long-term heart rate variability monitoring in free-living conditions--a pilot study. Biomed Eng Online 2011; 10:27. [PMID: 21481282 PMCID: PMC3080340 DOI: 10.1186/1475-925x-10-27] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 04/12/2011] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE A number of small portable systems that can measure HRV are available to address questions related to autonomic regulation in free-living subjects. However, ambulatory HRV measurements obtained through use of these systems have not previously been validated against standard clinical measurements such as Holter recordings. The objective of this study was to validate HRV obtained using a commonly used system, Actiheart, during occupational and leisure-time activities. METHOD Full-day ambulatory electrocardiography (ECG) signals were recorded from 8 females simultaneously using Actiheart and Holter recorders, and signals were processed to RR-interval time series. Segments of 5-minute duration were sampled every 30 minutes, and spectral components of the heart rate variability were calculated. Actiheart and Holter values were compared using Deming regression analysis and Bland-Altman plots. RESULTS In total, 489 segments were available with an HRV value from both Actiheart and Holter recordings after filtering out segments with >10% interpolated beats. No systematic differences between Actiheart and Holter HRV were found. The random deviations between Actiheart and Holter were comparable to the repeatability standard deviation between consecutive Holter measurements. DISCUSSION The results show that Actiheart is suited as a stand-alone ambulatory method for heart rate variability monitoring during occupational and leisure-time activities.
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Affiliation(s)
- Jesper Kristiansen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Mette Korshøj
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Jørgen H Skotte
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Tobias Jespersen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
| | - Ole S Mortensen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
- Department of Occupational and Environmental Health, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
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Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: Randomised controlled trial. Pain 2011; 152:440-446. [DOI: 10.1016/j.pain.2010.11.016] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 11/11/2010] [Accepted: 11/16/2010] [Indexed: 11/28/2022]
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Andersen CH, Andersen LL, Mortensen OS, Zebis MK, Sjøgaard G. Protocol for shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial. BMC Musculoskelet Disord 2011; 12:14. [PMID: 21235752 PMCID: PMC3033867 DOI: 10.1186/1471-2474-12-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 01/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. METHODS/DESIGN A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius.An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease. Before and after the intervention period the participants replied to a questionnaire about musculoskeletal disorders and work disability, and underwent a standardized clinical examination of the neck and shoulder girdle. Further, on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week.The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results from the clinical examination. Secondary outcomes are strength and work disability. TRIAL REGISTRATION ClinicalTrials (NCT): NCT01205542.
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Jay K, Frisch D, Hansen K, Zebis MK, Andersen CH, Mortensen OS, Andersen LL. Kettlebell training for musculoskeletal and cardiovascular health: a randomized controlled trial. Scand J Work Environ Health 2010; 37:196-203. [DOI: 10.5271/sjweh.3136] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Svensson AL, Marott JL, Suadicani P, Mortensen OS, Ebbehøj NE. Sickness absence in student nursing assistants following a preventive intervention programme. Occup Med (Lond) 2010; 61:57-61. [PMID: 20841317 DOI: 10.1093/occmed/kqq142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We have previously shown that a multidimensional programme combining physical training, patient transfer techniques and stress management significantly reduced sickness absence rates in student nurse assistants (NAs) after 14 months of follow-up. At follow-up, the control group had reduced SF-36 scores for general health perception [general health (GH)], psychological well-being [mental health (MH)] and energy/fatigue [vitality (VT)] compared with the intervention group, which remained at the baseline level for all three measures. AIMS To ascertain whether this effect remained after a further 36 months of follow-up and to analyse the association of GH, MH and VT scores with sickness absence. METHODS This was a cluster randomized prospective study. The original study involved assessment at baseline and follow-up at 14 months (the duration of the student NA course). Of 568 subjects from the original intervention study, 306 (54%) completed a postal questionnaire at 36 months. RESULTS Sickness absence increased in both groups between the first and second follow-up. At the second follow-up, the intervention group had a mean of 18 days of sickness absence compared with 25 in the control group but this was not significant. GH at 14 months follow-up was found to predict sickness absence levels after 3 years. MH and VT scores showed an inverse association with sickness absence but the results were not significant. CONCLUSIONS The results suggest that the initial intervention did not have a sustained effect on sickness absence 36 months after initial follow-up of the study group.
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Affiliation(s)
- A L Svensson
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen 2400 KBH NV, Denmark.
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Andersen LL, Zebis MK, Pedersen MT, Roessler KK, Andersen CH, Pedersen MM, Feveile H, Mortensen OS, Sjøgaard G. Protocol for work place adjusted intelligent physical exercise reducing musculoskeletal pain in shoulder and neck (VIMS): a cluster randomized controlled trial. BMC Musculoskelet Disord 2010; 11:173. [PMID: 20687940 PMCID: PMC2921353 DOI: 10.1186/1471-2474-11-173] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 08/05/2010] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Specific strength training is a promising type of physical exercise for relieving neck and shoulder pain in office workers. However, the optimal combination of frequency and exercise duration, as well as the importance of exercise supervision, is unknown. The VIMS study investigates in a cluster randomized controlled design the effectiveness of different time wise combinations of specific strength training with identical accumulated volume, and the relevance of training supervision for safe and effective training. METHODS/DESIGN A cluster randomized controlled trial of 20 weeks duration where employed office workers are randomized to 1 x 60 min, 3 x 20 min, 9 x 7 min per week of specific strength training with training supervision, to 3 x 20 min per week of specific strength training with a minimal amount of training supervision, or to a reference group without training. A questionnaire will be sent to 2000 employees in jobs characterized by intensive computer work. Employees with cardiovascular disease, trauma, hypertension, or serious chronic disease will be excluded. The main outcome measure is pain in the neck and shoulders at week 20. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov, number NCT01027390.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mette K Zebis
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mogens T Pedersen
- Institute of Exercise and Sport Sciences, University of Copenhagen, Denmark
| | - Kirsten K Roessler
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Christoffer H Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mette M Pedersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Helene Feveile
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Ole S Mortensen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Bispebjerg Bakke DK 2400 Copenhagen, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Holtermann A, Mortensen OS, Burr H, Søgaard K, Gyntelberg F, Suadicani P. Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study. Scand J Work Environ Health 2010; 36:357-65. [DOI: 10.5271/sjweh.2913] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Holtermann A, Jørgensen MB, Gram B, Christensen JR, Faber A, Overgaard K, Ektor-Andersen J, Mortensen OS, Sjøgaard G, Søgaard K. Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE. BMC Public Health 2010; 10:120. [PMID: 20214807 PMCID: PMC2841104 DOI: 10.1186/1471-2458-10-120] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 03/09/2010] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence. METHODS/DESIGN A novel approach of the FINALE programme is that the interventions, i.e. 3 randomized controlled trials (RCT) and 1 exploratory case-control study are tailored to the physical work demands, physical capacities and health profile of workers in each job-group. The RCT among cleaners, characterized by repetitive work tasks and musculoskeletal disorders, aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training (CBTr). Because health-care workers are reported to have high prevalence of overweight and heavy lifts, the aim of the RCT is long-term weight-loss by combined physical exercise training, CBTr and diet. Construction work, characterized by heavy lifting, pushing and pulling, the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health. At the industrial work-place characterized by repetitive work tasks, the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training, CBTr and participatory ergonomics. The overall aim of the FINALE programme is to improve the safety margin between individual resources (i.e. physical capacities, and cognitive and behavioral skills) and physical work demands, and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group. DISCUSSION The FINALE programme has the potential to provide evidence-based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration. TRIAL REGISTRATIONS ISRCTN96241850, NCT01015716 and NCT01007669.
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Affiliation(s)
- Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marie B Jørgensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Bibi Gram
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Anne Faber
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | | | - Ole S Mortensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Dept. of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Holtermann A, Mortensen OS, Burr H, Søgaard K, Gyntelberg F, Suadicani P. The interplay between physical activity at work and during leisure time – risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men. Scand J Work Environ Health 2009; 35:466-74. [DOI: 10.5271/sjweh.1357] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mortensen OS, Bjorner JB, Oldenburg B, Newman B, Groenvold M, Madsen JK, Andersen HR. Health-related quality of life one month after thrombolysis or primary PCI in patients with ST-elevation infarction. A DANAMI-2 sub-study. SCAND CARDIOVASC J 2009; 39:206-12. [PMID: 16118067 DOI: 10.1080/14017430510035989] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the health-related quality of life (HRQoL) following Primary percutaneous coronary intervention (PCI) or thrombolytic treatment for ST-elevation myocardial infarction (STEMI). DESIGN A questionnaire based study on patients randomised in the DANAMI-2 study to Primary PCI or thrombolysis for STEMI. A total of 1 351 patients (93.2% response rate) randomised in the DANAMI-2 study completed the HRQoL questionnaire one month after the infarction. RESULTS With respect to the primary end-points (SF-36 physical component score, angina pectoris, and dyspnoea), patients randomised to primary PCI scored better on the SF-36 physical component score (PCS) (p=0.007), and reported significantly less angina pectoris (p=0.010) and dyspnoea (p=0.010). Higher scores among PCI patients were also found on the SF-36 scales physical functioning (p=0.015), role-physical (p=0.017), and general health (p=0.009). CONCLUSION The results in this study support the hypothesis that primary PCI is superior to thrombolysis in treating STEMI, not only in clinical outcome, but also in quality of life outcome.
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Affiliation(s)
- O S Mortensen
- Department of Social Medicine, University of Copenhagen, Denmark.
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Christensen U, Kriegbaum M, Hougaard CO, Mortensen OS, Diderichsen F. Contextual factors and social consequences of incident disease. Eur J Public Health 2008; 18:454-9. [PMID: 18550567 DOI: 10.1093/eurpub/ckn049] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Large geographical variations in the incidence of disability benefits have been reported, but it is unclear to what extent that is confounded by variations in disability rates and disease pattern in the population and whether local variations in rehabilitation and health insurance practice modify the employment effect of disease. We have studied risk of labour market exclusion following incident hospitalization for ischaemic heart disease (IHD), and whether this risk may be modified by contextual factors on the municipal level. METHODS A cohort design on a 10% random sample of the whole Danish population including individuals aged 43-60 years, (n = 516.454 person-years including 840 cases of IHD). The independent variable was incident hospitalization for IHD and outcome variable was defined as job loss 2 years after the event. Regional-level data included all the 275 Danish municipalities in 1996. RESULTS There was a strong association between incident IHD and labour market exclusion 2 years later, odds ratio (OR) = 2.8 (95% confidence intervals (CI) 2.4-3.4). Men had less risk of being excluded than women and immigrant status, low-educational attainment and co-morbidity were significantly associated with job loss. Also, regional characteristics did independently effect labour market exclusion. However, the individual relative risk of exclusion following incident IHD was not modified substantially when neither the fixed effects of the regional-level variables nor the random effect of municipality was included in the analyses. CONCLUSION Geographical variation in incidence of labour market exclusion following incident disease is not primarily an effect of differential social consequences across municipal variations in labour market and socio-economic conditions.
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Affiliation(s)
- Ulla Christensen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, DK-1014 Copenhagen K, Denmark.
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Abstract
OBJECTIVE To investigate clinically relevant intra-individual and mean changes in health-related quality of life (HRQoL) with the Short Form-36 Health Survey (SF-36) need to acknowledge that SF-36 is trademarked ie: SF-36(R) following cardiac intervention for Australian and Danish patients. DESIGN Prospective observational study in tertiary cardiac centres in Townsville, Queensland, Australia and Copenhagen, Denmark. Two hundred coronary artery bypass graft surgery (CABG) patients of two Townsville hospitals, and 47 CABG or percutaneous coronary intervention (PCI) patients of a Copenhagen hospital. The main outcome measures are eight SF-36 health subscales at baseline and six months post-intervention. RESULTS Australian and Danish patients experienced similar HRQoL pre-intervention. By six months post-intervention, patients experienced a significant mean improvement in all subscales of the SF-36 survey (p < or = 0.05), although up to 27% of patients had a clinically significant decline in HRQoL from baseline. CONCLUSIONS These results demonstrate that it is necessary to investigate intra-individual changes in HRQoL as well as group mean changes as they produce different conclusions. In addition, establishing clinically significant intra-individual change standards may assist researchers and clinicians in determining whether an individual may benefit from therapy or intervention.
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Affiliation(s)
- Anna L Hawkes
- School of Public Health and Tropical Medicine, James Cook University, Queensland, Australia.
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Gammelgaard A, Mortensen OS, Rossel P. Patients' perceptions of informed consent in acute myocardial infarction research: a questionnaire based survey of the consent process in the DANAMI-2 trial. Heart 2004; 90:1124-8. [PMID: 15367504 PMCID: PMC1768493 DOI: 10.1136/hrt.2003.021931] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2003] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To analyse how patients in the acute phase of a myocardial infarct experience the informed consent procedure of a clinical trial. DESIGN A questionnaire based follow up survey including patients who gave informed consent as well as patients who did not consent to the trial. PATIENTS 103 patients who gave informed consent and 78 who did not consent to the second Danish acute myocardial infarction trial (DANAMI-2). RESULTS 76% of the trial participants and 63% of the non-participants agreed or mostly agreed that they felt able to make a decision about whether or not to participate in the trial; 50% of the trial participants and 34% of the non-participants found it acceptable that patients in their situation have to make such a decision. Only 28% of the trial participants and 7% of the non-participants read the information sheet before they made the decision. CONCLUSIONS Informed consent should be sought in acute myocardial infarction trials despite the emergency situation and the medical condition of the patients. Patients' self assessed ability to make a decision should be explicitly addressed during the informed consent process and patients should not be pressurised into decision making. Physicians and research ethics committees should focus specifically on improving the oral information.
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Affiliation(s)
- A Gammelgaard
- Department of Medical Philosophy and Clinical Theory, Institute of Public Health, Building 22.3, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N., Denmark.
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Mortensen OS, Madsen JK, Haghfelt T, Grande P, Saunamäki K, Haunsø S, Hjelms E, Arendrup H. Health related quality of life after conservative or invasive treatment of inducible postinfarction ischaemia. DANAMI study group. Heart 2000; 84:535-40. [PMID: 11040017 PMCID: PMC1729482 DOI: 10.1136/heart.84.5.535] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess health related quality of life in patients with inducible postinfarction ischaemia. DESIGN A questionnaire based follow up study on patients randomised to conservative or invasive treatment because of postinfarction ischaemia. SETTING Seven county hospitals in eastern Denmark and the Heart Centre, National University Hospital, Copenhagen, Denmark. PATIENTS 113 patients with inducible postinfarction ischaemia: 51 were randomised to conservative treatment and 62 to invasive treatment. Average follow up time was three years (19-57 months). MAIN OUTCOME MEASURES SF-36, Rose angina and dyspnoea questionnaire, drug use, lifestyle, and cognitive function. RESULTS Invasively treated patients scored better on the SF-36 scales of physical functioning (p = 0.03) and on role-physical (p = 0.04) and physical component scales (p = 0.05) and took significantly less anti-ischaemic drug treatment. Angina occurred in 18% of the invasively treated patients and 31% of the conservatively treated patients (p = 0.09). However, more invasively treated patients suffered from concentration difficulties (18% v 4%; p = 0.04). CONCLUSIONS Patients who were treated invasively had better health related quality of life scores in the physical variables compared with conservatively treated patients. However, a larger proportion of invasively treated patients had concentration difficulties.
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Affiliation(s)
- O S Mortensen
- Department of Internal Medicine, County Central Hospital, Naestved, Panum Institute, University of Copenhagen, DK 2200 Copenhagen N, Denmark.
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Mortensen OS, Sørensen FW, Gregersen M, Jensen K. [Poisonings with the herbicides glyphosate and glyphosate-trimesium]. Ugeskr Laeger 2000; 162:4656-9. [PMID: 10986892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Generally the herbicide glyphosate is considered harmless to humans. Glyphosate-trimesium is labelled harmful (Xn), whereas glyphosate-isopropylamine carries no warning sign. As cases of serious poisoning have emerged contacts to the Poison Information Centre have been reviewed. The persons exposed were mainly smaller children and adults 20 to 59 years of age. Oral exposure was recorded in 47 persons, inhalation exposure in 24 and topical contact in 42. About one fourth of the exposed persons were asymptomatic. Most of the symptomatic poisonings demonstrated complaints from the mouth, the gastrointestinal tract and the airways. Eleven patients were admitted to hospital. Two died, one of them having ingested the isopropylamine salt, the other the trimesium salt. Death ensued quickly in the latter patient. A similar fate was observed in a child--not included in the present material--who had also ingested the trimesium compound.
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Affiliation(s)
- O S Mortensen
- H:S Bispebjerg Hospital, arbejds- og miljømedicinsk klinik
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Mortensen OS. [Not everything green is healthy!]. Ugeskr Laeger 1999; 161:2384. [PMID: 10235050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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