Musculoskeletal disorders among dentists in the Greater Athens area, Greece: risk factors and correlations

Aim

To quantify the magnitude of musculoskeletal disorders (MSDs) in dentists working in the Greater Athens area in relation with personal characteristics, work and psychological risk factors.

Methods

Using cross-sectional methodology and by means of a self-administered questionnaire, 80 dentists provided information on personal characteristics, employment history, use of specific dental instruments, working and personal habits, perception of the job’s physical and psycho-social demands, general health status, need for recovery at the end of a regular working day, the affected body region and the MSDs frequency.

Results

A total of 83 % dentists reported at least one MSD (past year), 54 and 70 % reported monotonous/repetitive movements and strenuous back postures, respectively, while 38 % sought medical help for MSDs of the cervical/shoulder and back region. Direct vision in the oral cavity was significantly related with a higher frequency of chronic pain in the cervical region (odds ratio, OR?=?6.8). Absence of a dental assistant and use of manually handled endodontic instruments were significantly related with a higher prevalence of hand senso-neural disorders (OR?=?3 and 3.4 respectively). Passive free-time activities were significantly related with a higher prevalence of MSDs in the shoulder region (OR?=?4.16). Smokers had significantly higher need for recovery at the end of a working day compared to non-smokers (OR?=?2.6).

Conclusions

Dentists could prevent or alleviate MSDs, by adopting appropriate work practices and by modifying personal habits. Education in dental ergonomics and correct working postures is of paramount importance and should preferably be introduced during undergraduate dental practice.     

Effectiveness of participatory training for prevention of musculoskeletal disorders: a randomized controlled trial

Purpose

Health and safety training program has been applied to prevent work-related musculoskeletal disorders (MSDs) in workplace. We evaluated the effectiveness of participatory training and didactic training programs on MSD prevention among frontline workers in Shenzhen, China.

Methods

The authors randomly assigned 918 workers from intervention factories to receive participatory training (intervention group), and 907 workers from intervention factories and 1,654 workers from control factories to receive didactic training (control_1 group, control_2 group, respectively) from June 1, 2008 to November 30, 2009. Participants were asked to report experience of ache, pain or discomfort in 10 body parts at baseline and 1 year after training. Data were analyzed to compare the MSD prevalence 1 year before and 1 year after training in different groups from 2009 to 2010.

Results

The follow-up rate was 61 % (2,120/3,479) at 1 year after training. In the year after training, there were no statistically significant changes in the proportion of workers who reported MSD in any body part. MSD prevalence rates in the intervention group reduced from 16.8 to 9.9 % for lower extremities (χ² = 13.102, p < 0.001) and from 12.9 to 8.3 % (χ² = 9.433, p = 0.002) for wrist and finger at 1 year after training. However, the rates did not change significantly for upper back, lower back, neck, shoulder and elbow in the intervention group and for all 10 body parts in two control groups.

Conclusions

Overall, the training programs did not seem to prevent the occurrence of MSD among frontline workers. However, participatory training might be effective to reduce MSD in the lower extremities and wrist and finger.     

Are musculoskeletal complaints,related work impairment and desirable adjustments in work age-specific?

Purpose

Musculoskeletal complaints from employees commonly occur and may lead to work impairments. Desirable adjustments in work may differ according to age and the type of complaint. We determined whether the prevalence of musculoskeletal complaints, resulting work impairment and desirable and feasible adjustments in work differs between employees of various age groups at a railway company.

Methods

Employees (n = 2,021) were asked to fill out a questionnaire about musculoskeletal complaints by body regions, the resulting work impairment and the desirable and feasible adjustments in their own work situation. Differences between employees of four age groups (22–35, 36–45, 46–55 and 56–66 years) were tested for significance using the chi-square test.

Results

Musculoskeletal complaints in the neck, arm and at least one other body region were most prevalent in the 46–55-year age group compared with the other age groups. Impairments in work due to the musculoskeletal complaints only differed significantly between age groups for lower back complaints, which occurred most often in the oldest age group. Regarding adjustments in work, proportionally more of the youngest employees with musculoskeletal complaints found it desirable and feasible to switch to another job in the company, whereas proportionally more employees within the oldest age group found it desirable and feasible to work fewer days per week.

Conclusions

Employee age groups differed significantly regarding musculoskeletal complaints, resulting work impairment and desirable adjustments in work. Age-specific preventive measures for musculoskeletal complaints could be useful to keep employees healthy to perform their job until retirement and may reduce the costs associated with absenteeism and health care.     

Longitudinal evidence for the association between work-related physical exposures and neck and/or shoulder complaints: a systematic review

Background

Most existing reviews focus on evidence for the association between neck and/or shoulder complaints and physical exposures at the workplace gathered from cross-sectional studies. In comparison, this review summarizes existing evidence from longitudinal studies only.

Methods

A systematic literature research was conducted in Medline and EMBASE (1975–2009), and all studies were scanned by at least two researchers according to strict inclusion criteria. Levels of evidence were assigned according to the number of studies reporting similar findings, and according to the methodological quality of the included studies.

Results

Altogether 21 longitudinal studies (19 high-quality studies) met the inclusion criteria and were included in this review. In comparison with former reviews, we found strong evidence for an association between shoulder complaints and manual material handling (MMH) (range between Odds Ratio (OR) 1.4 and 4.9), vibration (range between OR 1.6 and OR 2.5), trunk flexion or rotation (range between OR 1.8 and OR 5.1), and working with hands above shoulder level (range between OR 1.1 and OR 1.8). Apart from that, the included studies confirmed existing knowledge on the association between physical exposures at the workplace and neck and/or shoulder complaints.

Conclusions

This analysis of longitudinal studies allowed for new evidence with regard to four cause-effect chains between physical exposures at work and the development of shoulder, neck and neck/shoulder complaints. As outcome variables varied greatly among the included studies, harmonization in studies on musculoskeletal research is desirable.     

Different working and living conditions and their associations with persistent neck/shoulder and/or low back disorders

Objectives

To investigate whether different combinations of working and living conditions are associated with the risk for persistent neck/shoulder and/or low back disorders. The underlying purpose of this contextual approach was to identify target groups for primary/secondary prevention.

Methods

In a baseline study, 11 groups with different working and living conditions were identified by cluster analysis. In this study, these 11 groups were followed up by a postal questionnaire 5 years after baseline (response rate 82%, n = 1095).

Results

Five of the groups—the onerous human services job, the free agent, the family burden, the mentally stretched and the physically strained groups—had an increased risk for persistent disorders (OR 2.38–2.70). Four of these groups had rather sex‐specific working and living conditions.

Conclusions

The results support the hypothesis that different combinations of working and living conditions may increase the risk for persistent neck/shoulder and/or low back disorders to different degrees. Sex‐specific working and living conditions increased the risk for women as well as for men, irrespective of whether the conditions were specific to women or men.Substantial evidence shows that the neck/shoulder region and the lower back are the most affected body parts with regard to musculoskeletal disorders (MSDs). These disorders are the most frequent sources of complaints of pain, health care utilisation, lost work time and early retirement.^1,2 The sizeable number of people having neck/shoulder or low back disorders underscores the societal importance of the problem, emphasising an urgent need for effective strategies to deal with it.The basis in prevention of MSDs is a sound foundation of knowledge, which must include the identification of risk factors contributing to MSDs as well as the identification of individuals or groups—for example occupational groups—exposed to these risk factors.^{3,4,5,6,7,8,9,10,11} However, this approach has often led to prevention strategies that focus on one single domain—that is, work or non‐work factors—even though the multifactorial causes and complexity of MSDs are often emphasised.¹¹To counterbalance the somewhat limited perspective of single risk‐factor modification, primary/secondary prevention strategies tailored to the needs of the individual and considering the individual''s whole working and living conditions have been recommended.¹² For this a more contextual approach, working as well as living conditions, and strain‐inducing factors as well as supportive factors, should be appraised.^13,14 Consequently, there is a need to identify groups with similar working and living conditions and to explore whether, in the long term, different combinations of working and living conditions are associated with MSDs to different degrees. The identification of such risk groups for MSDs may facilitate a selective prevention approach, allowing us to match and market the most suitable broad‐based preventive actions to the most appropriate target group.In a previous study, we applied a person‐oriented approach on a dataset of 1332 gainfully employed men and women who had not sought care for neck/shoulder or low back disorders during the 6 months before enrolment in the study.¹⁵ Eleven groups with different combinations of working and living conditions were identified by cluster analysis of 15 variables on ergonomic physical and psychosocial work factors, and factors in the private sphere. Personal factors such as sex were not included in the formation of the clusters. Two of the clusters were dominated by women and two by men (⩾70% of one sex), whereas seven clusters had a more even distribution of men and women. The clusters dominated by men and women indicated rather sex‐specific working and living conditions (see table in appendix).The aim of this study was to follow‐up these 11 groups after a 5‐year period, in order to compare the groups and investigate which working and living conditions might be associated with persistent disorders in the neck/shoulder and/or low back. The underlying purpose was to identify target groups for prevention of such disorders, which, in turn, would facilitate a selective primary/secondary prevention approach.     

Analyse von Wirbels?ulenbelastungen in ?rztlichen Berufsfeldern

Background

Back pain is a common health problem in medical occupations. Work-related awkward postures have often been cited as potential risk factors. Despite the high prevalence of back pain valid measurements of posture and kinematics of the spine in field studies are still missing. Therefore the aim of the present study was to analyse work-related postures of sitting and standing medical occupations with a new mobile measurement system.

Methods

Data were collected by the recently developed three-dimensional measurement system (3D-SMG). Nonsurgical periodontal treatment modalities and ENT surgeries were recorded by an individual case study.

Results

Both occupations were performed in a mainly asymmetrical position of the spine. Moreover, the analysis of the spine kinematics revealed static postures in 70?C80% of the work duration. Movements were rare and of small amplitude. Asymmetric postures, forward trunk inclination and posture variability were increased during ENT surgery.

Conclusions

To compensate for physiological load factors the implementation of ergonomic measures is insufficient. The present data indicate that loosening movements should be integrated into the daily work routine in order to reduce the strain-dependent pain genesis.     

A one-item workability measure mediates work demands, individual resources and health in the prediction of sickness absence

Objectives

The study tested the hypothesis that a one-item workability measure represented an assessment of the fit between resources (the individuals’ physical and mental health and functioning) and workplace demands and that this resource/demand fit was a mediator in the prediction of sickness absence. We also estimated the relative importance of health and work environment for workability and sickness absence.

Methods

Baseline data were collected within a Danish work and health survey (3,214 men and 3,529 women) and followed up in a register of sickness absence. Probit regression analysis with workability as mediator was performed for a binary outcome of sickness absence. The predictors in the analysis were as follows: age, social class, physical health, mental health, number of diagnoses, ergonomic exposures, occupational noise, exposure to risks, social support from supervisor, job control and quantitative demands.

Results

High age, poor health and ergonomic exposures were associated with low workability and mediated by workability to sickness absence for both genders. Low social class and low quantitative demands were associated with low workability and mediated to sickness absence among men. The mediated part was from 11 to 63 % of the total effect for the significant predictors.

Conclusion

Workability mediated health, age, social class and ergonomic exposures in the prediction of sickness absence. The health predictors had the highest association with both workability and sickness absence; physical work environment was higher associated with the outcomes than psychosocial work environment. However, the explanatory value of the predictors for the variance in the model was low.     

The relative contribution of work exposure, leisure time exposure, and individual characteristics in the onset of arm–wrist–hand and neck–shoulder symptoms among office workers

Purpose

To identify the risk factors for the onset of arm–wrist–hand and neck–shoulder symptoms among office workers and to estimate the relative contribution of these risk factors by calculating Population Attributable Fractions (PAFs).

Methods

A prospective cohort study was conducted among 1951 office workers with a follow-up duration of 2?years. Data on self-reported risk factors were collected at baseline and after 1?year of follow-up. Every 3?months, the occurrence of upper extremity symptoms was assessed using questionnaires. PAFs for individual risk factors were estimated based on Rate ratios (RRs) obtained from Poisson regression using Generalized Estimation Equations.

Results

Previous disabling symptoms were identified as the most important risk factor for the onset of arm–wrist–hand and neck–shoulder symptoms. Modifiable risk factors for arm–wrist–hand symptoms with relatively large PAFs were: at least 4?h per day of self-reported computer use at work, high level of overcommitment, and low task variation and for neck-shoulder symptoms: supporting the arms during keyboard use and at least 4?h per day of self-reported mouse use at work. Compared to having 0 or 1 risk factor, the RR for arm–wrist–hand symptoms increased to 6.2 (95% CI 3.7–10.5) for having 5–7 potentially modifiable risk factors and for neck–shoulder symptoms to 3.0 (95% CI 2.1–4.4) for having 4 or 5 potentially modifiable risk factors.

Conclusion

Preventive interventions at the population level should be aimed at changing modifiable risk factors with large PAFs. At the individual level, preventive interventions should be aimed at changing multiple modifiable risk factors simultaneously.     

Verhaltensprävention im betrieblichen Setting

Background

The office routine of many employees restrains physical activity and is full of one-sided work-load and stressful cognitive events. Tension in neck and shoulder, back pain, headaches, fatigue, difficulties in concentrating, skin and gastrointestinal problems may result. In order to contribute to employee’s physical and mental well-being, a 15-minute work-place activity program (“Break in Motion”) was implemented in the Schwäbisch Gmünd plant of ZF Lenksysteme.

Method

To assess whether “Break in Motion” reduces physical complaints, adds to subjective well-being and improves the working atmosphere, a longitudinal study was carried out. Written questionnaires were utilize before and after the intervention to screen possible effects (n?=?68 and 79).

Results

Comparison of means revealed reduction in health problems in the neck, the back and the shoulder and the dorsal spine area. Improved subjective well-being was statistically significant only for female participants. Almost all participants stated that the activity program strengthens social cohesion on the work floor.

Conclusion

The results suggest that, if regularly conducted, even a relatively short and as such amendable to the work-place demands and moreover demonstrably scalable exercise and activity program shows positive effects.     

Across-shift changes of exhaled nitric oxide and spirometric indices among cotton textile workers

Objectives

For the purpose of evaluation of exhaled NO as an index of airway inflammation, we assessed changes in fractional exhaled NO (FeNO) across a work shift and its relationship with respiratory complaints.

Material and Methods

Chronic and work-aggravated respiratory complaints were assessed using a questionnaire in 89 male textile workers. FeNO and spirometry were performed before and after a work shift and all the changes were registered.

Results

A significant increase in FeNO after a work shift was observed. Post-shift FeNO was significantly higher among the subjects with chronic respiratory complaints. There was an obvious decrease in FVC, and FEV₁ after a work shift; however, we couldn’t find a significant relationship between changes in respiratory parameters and concentration of inhalable dusts.

Conclusions

FeNO increase after a work shift along with pulmonary function decrement and higher post-shift FeNO among subjects with respiratory complaints makes across-shift FeNO a non-invasive test for assessment of airway hyper-responsiveness in textile workers.     

Symptoms and health complaints and their association with perceived stress: students from seven universities in England, Wales and Northern Ireland

Aim

This research assessed the relationships between perceived stress and a range of self-reported symptoms and health complaints in a representative sample of students across UK universities.

Subjects and methods

The data comprised 3,706 students and was collected between 2007 and 2008 simultaneously at seven universities in three countries of the UK: England, Wales, and Republic of Northern Ireland. A self-administered questionnaire measured health complaints (22 symptoms) and Cohen’s Perceived Stress Scale. Sociodemographic and lifestyle data were also collected. Factor analysis developed four groups of health complaints: psychological, circulatory/breathing, gastro intestinal, and pains/aches.

Results

The symptoms most often reported as having occurred sometimes/very often in the last 12 months were fatigue (61.0 %), headache (59.5 %) and difficulties to concentrate (54.4 %), while back (43.3 %) and neck/shoulder pain (39.4 %) were also frequent. Multinominal logistic regression revealed a clear association and a linear trend between increasing level of stress and a higher frequency of psychological symptoms which remained significant after adjustment for many other factors. For circulatory/breathing symptoms and for pains/aches, associations with perceived stress were only significant at higher perceived stress levels. There was no association between perceived stress and gastrointestinal symptoms. For most symptoms, poor health was consistently associated with higher frequency of symptoms across all four symptom groups. Similarly, better quality of life was associated with lower frequency of psychological and circulatory/breathing symptoms, but not for the other two symptom groups.

Conclusions

The different profiles of reported complaints and their association with perceived stress, poor health and low quality of life should give rise to tailored interventions in this young population.     

Psychische Gesundheit im Lehrerberuf

Background

In respect of results reporting an above-average rate of psychosomatic and mental health impairment in teaching profession due to work related stress, the aim of this study was to record personal and work related factors and to analyse their influence on mental health of teachers.

Methods

A sample of 986 teachers in primary-, secondary- and grammar schools in Saxony, Germany was investigated applying a questionnaire covering different aspects of their mental health status, occupational school-related and socio-demographic lifestyle factors.

Results

By comparison psychologically normal teachers (n=794) and those with impaired mental health (n=192) physical complaints, work ability and effort-reward-imbalance were extracted as important predictors of mental health. Impaired teachers reported significantly more physical complaints, a lower work ability and a higher imbalance of work related effort and reward.

Conclusions

Working conditions make hardly any contribution for clearing up the variance of mental health; it is not adequate to explain and to influence the health status preventatively. Individual attributes are proved to be relevant factors to analyse risks and resources of teachers health.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.     

Relationships of organizational social capital with the presence of “gossip and slander,” “quarrels and conflicts,” sick leave,and poor work ability in nursing homes

Purpose

This study aimed to explore the associations of organizational social capital (OSC) with the presence of “gossip and slander,” the presence of “conflicts and quarrels,” sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes.

Methods

A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of “gossip and slander,” “conflicts and quarrels,” sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall’s tau correlation coefficients).

Results

Significant associations were found between OSC and “gossip and slander,” sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = ?0.722; p = 0.002).

Conclusions

This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.     

Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review

Objective

Assessments of whether patients with musculoskeletal disorders (MSDs) can participate in work mainly consist of case history, physical examinations, and self-reports. Performance-based measures might add value in these assessments. This study answers the question: how well do performance-based measures predict work participation in patients with MSDs?

Methods

A systematic literature search was performed to obtain longitudinal studies that used reliable performance-based measures to predict work participation in patients with MSDs. The following five sources of information were used to retrieve relevant studies: PubMed, Embase, AMA Guide to the Evaluation of Functional Ability, references of the included papers, and the expertise and personal file of the authors. A quality assessment specific for prognostic studies and an evidence synthesis were performed.

Results

Of the 1,230 retrieved studies, eighteen fulfilled the inclusion criteria. The studies included 4,113 patients, and the median follow-up period was 12 months. Twelve studies took possible confounders into account. Five studies were of good quality and thirteen of moderate quality. Two good-quality and all thirteen moderate-quality studies (83%) reported that performance-based measures were predictive of work participation. Two good-quality studies (11%) reported both an association and no association between performance-based measures and work participation. One good-quality study (6%) found no effect. A performance-based lifting test was used in fourteen studies and appeared to be predictive of work participation in thirteen studies.

Conclusions

Strong evidence exists that a number of performance-based measures are predictive of work participation in patients with MSDs, especially lifting tests. Overall, the explained variance was modest.

     

Determinants and stability over time of perception of health risks related to mobile phone base stations

Objective

Perception of possible health risks related to mobile phone base stations (MPBS) is an important factor in citizens’ opposition against MPBS and is associated with health complaints. The aim of the present study is to assess whether risk perception of MPBS is associated with concerns about other environmental and health risks, is associated with psychological strain, and is stable on the individual level over time.

Methods

Self-administered questionnaires filled in by 3,253 persons aged 15–69?years in 2004 and 2006 in Germany.

Results

Risk perception of MPBS was strongly associated with concerns about various other risks like side effects of medications, air pollution or electric power lines. Persons showing more anxiety, depression, or stress were more often concerned about MPBS and also more often attributed health complaints to MPBS. 46.7% of those concerned about MPBS in 2004 expressed these concerns again 2?years later, the corresponding figure for attribution of health complaints to MPBS was 31.3%.

Conclusion

Risk perception of MPBS is strongly associated with general concern, anxiety, depression, and stress, and rather instable over time.     

Modest associations between self-reported physical workload and neck trouble: a population-based twin control study

Objectives

To investigate the relationship between self-reported physical workload and neck trouble (NT) in twins. Additionally, to explore whether the relationship between physical workload and NT is influenced by genetic factors.

Methods

A twin control study was performed within a population-based, cross-sectional questionnaire study using 3,208 monozygotic (MZ) and same-sexed dizygotic (DZ) twins aged 19–70. Twin pairs discordant for self-reported NT during the past year (“Any NT”) were included. Self-reported physical workload in four categories was used as exposure (“sitting,” “sitting and walking,” “light physical,” and “heavy physical” work). Paired analyses including conditional logistic regression were made for all participants and for each sex, and MZ and DZ pairs separately.

Results

No marked associations between physical workload and NT were seen. A moderate risk elevation in “heavy physical” work was seen in DZ men (odds ratio 2.3, 95 % confidence intervals 1.3–4.0), but not in MZ men or the MZ or DZ women.

Conclusions

The findings in some degree supported that “heavy physical” work is a determinant of NT, perhaps only in men, but hardly of any greater importance. The different results between DZ and MZ men suggest that genetic factors influence the relationship between physical workload and NT.     

Predictors of work ability in occupations with psychological stress

Aim

This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW).

Method

Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable).

Results

Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken.

Conclusion

The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.     

Psychosocial work conditions, perceived stress, perceived muscular tension, and neck/shoulder symptoms among medical secretaries

Purpose

Unfavorable psychosocial working conditions are hypothesized to lead to perceived stress, which, in turn, can be related to an increased risk of development of neck/shoulder symptoms through increased and sustained muscle activation. The aim of the present study was to test this hypothesized process model among medical secretaries, a female-dominated profession characterized by a high amount of visual display unit use and a high prevalence of neck/shoulder symptoms.

Methods

In this cross-sectional study, a questionnaire survey was conducted among medical secretaries (n = 200). The proposed process model was tested using a path model framework.

Results

The results indicate that high work demands were related to high perceived stress, which in turn was related to a high perceived muscle tension and neck/shoulder symptoms. Low influence at work was not related to perceived stress, but was directly related to a high perceived muscle tension.

Conclusions

In general, these cross-sectional results lend tentative support for the hypothesis that adverse psychosocial work conditions (high work demands) may contribute to the development of neck/shoulder symptoms through the mechanism of stress-induced sustained muscular activation. This process model needs to be further tested in longitudinal studies.     

Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial

Purpose

The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers.

Methods

Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months.

Results

In the intervention group, body posture (p < 0.001) and workstation layout (p = 0.002) improved over 6 months; furthermore, intensity (p < 0.001), duration (p < 0.001), and frequency (p = 0.009) of WUEMSS decreased significantly in the intervention group compared with the control group. Additionally, the functional status (p = 0.001), and physical (p < 0.001), and mental (p = 0.035) health-related quality of life improved significantly compared with the controls. There was no improvement of work day loss due to WUEMSS (p > 0.05).

Conclusions

Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.