Are resident handlings in eldercare wards associated with musculoskeletal pain and sickness absence among the workers? A prospective study based on onsite observations

Objectives:We aimed to identify eldercare wards with different types of resident handling characteristics (‘phenotypes’) and determine the prospective association between these characteristics and musculoskeletal pain and sickness absence among workers during a one-year follow-up.Methods:Our study was based on the DOSES cohort, including 467 workers at 103 eldercare wards. At baseline, resident handlings were assessed using onsite observations. Workers’ self-reported musculoskeletal pain and sickness absence were assessed during the following year using text messages. Observations of the frequency of handlings per shift, use of assistive devices, assistance from others, and barriers (interruptions and impediments) were estimated for each worker, aggregated at ward level, and entered into a latent profile analysis, identifying ward phenotypes. We then used generalized estimating equations to determine associations between ward phenotypes, musculoskeletal pain and sickness absence.Results:We identified four ward phenotypes: ‘turbulent’ (many handlings with devices and assistance, many barriers), ‘strained’ (many handlings without devices or assistance, some barriers), ‘unpressured’ (few handlings, yet without devices or assistance, few barriers) and ‘balanced’ (some handlings with devices and assistance, some barriers). Compared to workers in balanced wards, workers in turbulent wards had more days with neck-shoulder and low-back pain (LBP); and those working in strained wards had more days with LBP and higher pain intensities.Conclusion:We found that ward phenotypes based on resident handling characteristics were predictive of musculoskeletal pain and sickness absence over one year. This shows that organizational factors related to resident handling are important determinants of musculoskeletal health among eldercare workers.     

Are occupational factors important determinants of socioeconomic inequalities in musculoskeletal pain?

OBJECTIVES: The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities. METHODS: All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated. RESULTS: There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in low-back pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain. CONCLUSIONS: In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.     

Musculoskeletal Discorders in Industrial Workers of Delhi

Abstract

To study the musculoskeletal disorders in industrial workers in Delhi, 631 workers from 60 factories representing small and medium-sized enterprises located in Delhi were interviewed. Many (59.4%) of the workers had musculoskeletal disorders. Tailors, those working near furnaces, cooks, workers in buffing, checking and assembly work, and those working with chemicals had the most joint complaints. Cervical pain was more frequent in tailoring and packing work, whereas lumbar pain was more common in buffing, operators working on presses, those using hand and power tools, and those lifting heavy manual loads. Contract workers had less musculoskeletal morbidity than regular and temporary workers. Skilled workers also had less morbidity. Workers experiencing more job satisfaction reported fewer musculoskeletal disorders. The high prevalence of musculoskeletal disorders in workers needs urgent attention from the health and labor sectors. An ergonomic approach to prevention should be considered. The current manual load handling limits prescribed in the Indian Factory Rules potentially expose workers to back stress.It is also inappropriate to have separate load-lifting limits for men and women. Research is urgently required to determine the safe load handling limits for the Indian working population based on ergonomic principles. Until internationally acceptable safe limits are established, back pain should be a notifiable diseasein India.     

Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis

OBJECTIVES—To assess the occurrence and persistence of two restrictively defined neck-shoulder disorders among sewing machine operators. To assess factors associated with the development of neck-shoulder disorder and prognostic factors for remaining a case, when disorders were already present.
METHODS—In an initial group of 243 sewing machine operators, 178 were followed up for 2 years. At baseline and at 1 and 2 years follow up the participants underwent a clinical examination of the neck and arms and filled in a questionnaire about current musculoskeletal complaints. Clinical criteria for two main neck-shoulder disorders were defined: rotator cuff tendinitis and myofascial pain syndrome. A baseline control group consisted of 357 women with varied non-repetitive work.
RESULTS—At baseline the overall prevalence of myofascial pain syndrome and rotator cuff tendinitis was 15.2% and 5.8% among sewing machine operators compared with 9.0% and 2.2%, respectively, among controls. The presence of the disorders was strongly associated with a self perception of poor general health. Although myofascial pain syndrome showed a U shaped association with years as a sewing machine operator, rotator cuff tendinitis was absent among the newest recruits and present among 15% of the women with more than 20 years as a sewing machine operator. Besides years as a sewing machine operator, the risk of having a neck-shoulder disorder at baseline was significantly associated with high stress (prevalence ratio (PR)=2.54; 95% confidence interval (95% CI) 1.28 to 5.05) when adjusted for age, body mass index, smoking, living alone with children, job strain, and social support from colleagues and supervisors. Only one of 13 participants with rotator cuff tendinitis at baseline recovered during follow up. Myofascial pain syndrome showed a much more fluctuating tendency. Low social support (RR 3.72; 95% CI 1.22 to 11.30) and smoking (RR 3.93; 95% CI 1.33 to 11.58) were associated with the development of neck-shoulder disorders, which was also associated with neck-shoulder pain score and living alone with children.
CONCLUSION—Rotator cuff tendinitis showed a higher degree of persistence than myofascial pain syndrome. Both disorders highly influenced the perception of general health. Women who lived alone with children, were smokers, or experienced low support from colleagues and supervisors had a higher risk of contracting a neck-shoulder disorder.


Keywords: rotator cuff syndrome; myofascial pain syndrome; follow up study; prognostic risk factors     

Effects of Ambulant Myofeedback Training and Ergonomic Counselling in Female Computer Workers with Work-Related Neck-Shoulder Complaints: A Randomized Controlled Trial

Objective: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling alone (EC), on work-related neck-shoulder pain and disability. Methods: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline, immediately after intervention, and at three and six months follow-up. Results: Pain intensity and disability had significantly decreased immediately after four weeks Mfb or EC, and the effects remained at follow up. No differences were observed between the Mfb and EC group for outcome and subjects in both intervention groups showed comparable chances for improvement in pain intensity and disability. Conclusions: Pain intensity and disability significantly reduced after both interventions and this effect remained at follow-up. No differences were observed between the two intervention groups.     

Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?

OBJECTIVES: This study investigates whether an imbalance between physical capacity and exposure to work-related physical factors is associated with low-back, neck, or shoulder pain. METHODS: Data of the longitudinal study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), with a follow-up of 3 years (N=1789), were used. At baseline, physical capacity (isokinetic lifting strength, static muscle endurance, and mobility of the spine) and exposure to work-related physical factors were assessed. During the follow-up, low-back, neck, and shoulder pain were self-reported annually. "Imbalance" was defined as lower than median capacity combined with higher than median exposure, "high balance" was high capacity and high exposure, and "low balance" was low capacity and low exposure. RESULTS: For both the low-back and neck, imbalance between static endurance and working with flexed postures was a risk factor for pain [relative risk (RR) 1.35, 95% confidence interval (95% CI) 1.08-1.68, and RR 1.36, 95% CI 0.96-1.91, respectively]. Low balance was also associated with low-back pain (RR 1.29, 95% CI 1.04-1.68). Furthermore, low balance between isokinetic lifting strength and lifting exposure was a risk factor for low-back and neck pain [RR between 1.22 (95% CI 0.99-1.49) and 1.35 (95% CI 1.03-1.79)]. No associations were found with shoulder pain. CONCLUSIONS: Some relationship between low-back and neck pain and combined measures of physical capacity with exposure to work-related physical factors seems to exist, but an imbalance between physical capacity and exposure was not found to yield higher risks than high balance or low balance.     

某汽车公司铸造厂工人腰背痛的危险因素分析

目的 通过横断面流行病学记查,寻找汽车铸造厂作业工人腰背痛的主要危险因素,为此类疾患的预防提供科学依据.方法 在某汽车公司铸造厂对1340名工人进行腰背痛和劳动负荷问卷调查,利用logistic回归进行危险因素分析.结果 铸造厂工人的腰背痛年患病率为58.9%,其中铸造、物流和造型工种工人腰背痛年患病率较高,分别为64.6%、64.6%和62.5%.以不适体位搬举、大幅度弯腰、弯腰与转身并存及搬运重物这些负荷因素导致患腰背痛危险性最高,其OR值分别为2.085、1.961、1.967和1.956.各个危险因素在不同工种中的分布不同.多元logistic同归分析表明,搬运重物、不适体位搬举、大幅度弯腰、弯腰与转身并存及工龄和性别均被选人模型.结论 手工搬运重物、不良劳动姿势或二者同时存在是导致腰背痛的首要危险因素,应从这方面入手,加强工效学干预研究,减少此类疾患.

Abstract：

Objective To study the main risk factors of low back pain of workers in a foundry factory of the automobile company using cross sectional epidemiological investigation, and to provide scientific base for preventing the disorder. Methods The low back pain and work loads of 1340 workers in a foundry factory of the automobile company were investigated using questionnaire, and logistic regression analysis was used to analyze the risk factors. Results The one-year morbidity of low back pain in workers was 58.9%the morbidities of low back pain in workers engaged in foundry, transportation and modeling were 64.6 %, 64.6 % and 62.5 %, respectively. The lifting with squat postures, bending trunk heavily, bending trunk with twisting and moving the heave objects were found to be the most dominant risk factors for low-back pain, the OR values were 2.085, 1.961, 1.967 and 1.956, respectively. The distributions of risk factors were different among the different jobs. The logistic regression analysis showed that moving the heave objects, lifting with squat postures, bending trunk heavily, bending trunk with twisting existed simultaneously, also the work years and gender were the risk factors. Conclusion The manual moving heave objects, awkward working posture or both were the most important risk factors for low-back pain. The intervene ergonomic study should be performed in future to reduce the morbidity of low-back pain.     

Coexistence of Chronic Musculoskeletal Pain and Depressive Symptoms and Their Combined and Individual Effects on Onset of Disability in Older Adults: A Cohort Study

ObjectivesCoexistence of chronic musculoskeletal pain and depressive symptoms is common, and their combined effect on adverse events warrants investigation. The purpose of this study was to investigate the individual and combined effect of chronic musculoskeletal pain and depressive symptoms on the onset of disability, which is a crucial outcome in older adults.DesignA 1-year cohort study.Setting and participants1251 community-dwelling older adults.MeasurementsThe number of chronic musculoskeletal pain sites was measured using a self-reported questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale–15. Disability was self-reported as any difficulty in basic activities of daily living. Incidence of disability was defined as any difficulty in performing 1 or more tasks at the follow-up assessment, that was absent at baseline.ResultsOlder adults with more chronic musculoskeletal pain sites tend to have depressive symptoms at baseline (P for trend < .001). Compared to older adults without both chronic musculoskeletal pain and depressive symptoms, older adults with both chronic multisite musculoskeletal pain and depressive symptoms have the higher risk for development of disability (adjusted odds ratio: 6.84, 95% confidence interval: 3.72 to 12.58), followed by older adults with chronic multisite musculoskeletal pain and without depressive symptoms (adjusted odds ratio: 2.13, 95% confidence interval: 1.35 to 3.37).Conclusions/ImplicationsSimultaneous assessment of both chronic musculoskeletal pain and depressive symptoms may be useful for accurate prognosis and preventing disability in older adults.     

Musculoskeletal pain in ragpickers in a southern city in Brazil

BACKGROUND: Ragpickers are informal workers who collect recyclable materials to earn a small wage. Their life and working conditions are extremely precarious. The ergonomic hazards and musculoskeletal pain in a sample of ragpickers in Pelotas, a city in southern Brazil are examined. METHODS: Two comparison groups were available: a matched sample of non-ragpickers from the same poor neighborhoods, and a random sample of the general population of the city. The cross-sectional study gathered data by interview on 990 individuals in 2004. Musculoskeletal pain was assessed using the Standardized Nordic Questionnaire. RESULTS: Ragpickers reported higher prevalences for most awkward postures and ergonomic exposures compared to neighbors with other demanding manual jobs. The prevalence within the last 12 months of low back pain (LBP), lower extremity pain (LEP), and upper extremity pain (UEP) among ragpickers were 49.2%, 45.1%, and 34.9%, respectively; levels similar to those reported by neighborhood controls. Both ragpickers and non-ragpickers reported considerably higher ergonomic exposures, and more prevalent LBP, than the general population. CONCLUSIONS: Ragpickers experience many occupational hazards and ergonomic stressors. Their overall prevalence of musculoskeletal pain was similar to a comparison group with other physically demanding manual jobs. For LBP, this prevalence was substantially higher (49% vs. 35%) than in the general population.     

Work-related musculoskeletal problems among women workers in the semiconductor industry in Peninsular Malaysia

A cross-sectional study to identify the prevalence of musculoskeletal problems and work-related risk factors was conducted among 906 women semiconductor workers. Highest prevalences were pain in the lower limbs, neck/shoulders, and upper back, and highest exposures were prolonged (> or = four hours per workshift) hand/wrist movement, standing, and lifting with hands. After logistic regression, lower-limb pain was significantly associated with standing, neck/shoulder pain with sitting and lifting, upper-back pain with climbing steps, low back pain with hand/wrist movement, and hand/wrist pain with lifting. Neck/shoulder pain was significantly higher for workers with shorter working durations, while lower-limb pain was significantly higher for workers with longer working durations. End-of-line assembly workers had significantly higher odds ratios for pain at all sites, while middle-of-line workers had higher odds ratios for pain in neck/shoulders and upper back, and wafer-fabrication workers had higher odds ratios for pain in low back and lower limbs.     

Effect of an ergonomic intervention involving workstation adjustments on musculoskeletal pain in office workers—a randomized controlled clinical trial

Office workers remain in a awkward position for long periods, which can lead to musculoskeletal symptoms. Ergonomic guidelines are recommended to avoid such problems. Evidence of the long-term effectiveness of ergonomic interventions is scarce. The aim of this randomised controlled trial was to compare pain intensity among office workers who received an ergonomic intervention and a control group before as well as 12, 24, and 36 wk after the intervention. Workers were randomly allocated to a control group (CG) and experimental group (EG). The EG received an ergonomic workstation intervention. Furniture measurements were related to individual anthropometric measurements to identify mismatches. The outcome was pain intensity, which was determined using a numerical pain scale and the Nordic Musculoskeletal Questionnaire. A linear mixed model was created with pain intensity as the dependent variable. Group and time were the independent variables. No significant interactions were found between group and time. Significant differences between groups were found for the pain intensity in the neck, shoulder, upper back, and wrist/hand (p<0.05), with lower intensity in the EG. The intervention reduced pain intensity in the neck, shoulder, upper back, and wrist/hand. However, no reduction in pain intensity was found for the lower back or elbow.     

中国医疗行业工作相关肌肉骨骼疾患发生模式及其影响因素分析

  目的  调查中国医疗行业工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)发生情况,探究不同岗位不良工效学职业危害因素及WMSDs发生模式。  方法  通过《北欧肌肉骨骼疾患问卷(修改版)》电子问卷系统对中国6 854名医疗行业从业人员进行横断面调查。根据美国国家职业安全卫生研究所(National Institute for Occupational Safety and Health, NIOSH)判定WMSDs方法进行发生结果统计分析。应用潜类别分析(latent class analysis, LCA)对主要工种WMSDs多部位发生模式进行分析,利用logistic回归分析法确定不良工效学因素。  结果  调查样本中,不计部位的总体WMSDs发生率为56.1%。其中,医生为54.15%、护士为58.66%、护工为51.04%、技师为54.05%、药师为48.48%。根据LCA分类结果,医生与护士WMSDs发生模式主要有颈肩型和躯干型;技师主要为颈肩型;药师为颈肩型;护工主要为颈肩型和轻微疼痛型。多因素logistic回归分析结果显示,颈肩型医生发生危险主要来自手腕长期弯曲(OR=1.383, P=0.036),频繁坐位工作(OR=2.110, P=0.020),工作姿势经常不舒服(OR=2.023, P=0.001);躯干型医生发生危险主要有腿部姿势受限(OR=1.413, P=0.044),频繁不舒适工作姿势(OR=4.402, P＜0.001);颈肩型护士发生危险主要来自颈部大幅度前倾(OR=2.218, P=0.024),长时间频繁坐位工作(OR=1.533, P=0.006);躯干型护士发生危险有长时间频繁坐位工作(OR=1.883, P < 0.001),频繁不舒适工作姿势(OR=2.137, P < 0.001)。  结论  中国医疗行业WMSDs发生率同世界主流国家地区相比处于中等水平。但行业总体不良工效学危害水平较高,不良作业姿势普遍存在。其中颈部、肩部、上背部、下背部的工效学负荷水平较高,主要与颈部工作中长时间保持不变、长时间低头、颈部大幅度前倾、手腕长期弯曲、长时间保持转身、腿部空间受限、长时间坐姿、作业姿势不舒服等职业因素有关。应通过加强宣教培训、增加辅助助力设施、改善工作组织模式等方式,降低肌肉骨骼损伤危险。     

Biopsychosocial Risk Factors for Musculoskeletal Symptoms of the Spine in Salespeople

Abstract

This study aimed to identify biopsychosocial factors associated with the self-reported prevalence of musculoskeletal symptoms in the spine in saleswomen in department stores. A cross-sectional survey was conducted in which 1310 saleswomen in 18 department stores received a self-administered questionnaire. Returns were 1200 (92%) questionnaires, and after screening for exclusion criteria, 1189 saleswomen were eligible for the study. Standing/walking for >10 hours/day, as well as frequent working in static postures and twisting the body during work were each significantly associated with a high prevalence of experiencing head/neck symptoms. A significant association was found between standing/walking for > 10 hours/day and a high prevalence of experiencing upper back symptoms. Working for > 10 hours/day, standing/walking for > 5 hours/day without rest breaks, as well as frequent working in static postures and sitting during work were each significantly related to a high prevalence of experiencing lower back symptoms. Surprisingly, poor self-rated perceptions of physical work environments significantly correlated with a low prevalence of musculoskeletal symptoms in all spinal regions.     

Personal and occupational factors associated with low-back pain in a general working population in France

BackgroundLow-back pain is a major public health concern because of its socioeconomic burden, especially for chronic forms. The purpose of this study was to analyse the associations between low-back pain and occupational and personal factors, with a special focus on interactions between age and occupational exposures.MethodsThe study population comprised a sample of 3958 and 4526 working women and men aged 30 to 59 derived from a national health survey (2002–2003 EDS). Low-back pain was assessed using the French version of the Nordic questionnaire. Weight, height and smoking status were obtained through interview at home. Occupational exposures were self-assessed. The associations between low-back pain for more than 30 days in the previous year and occupational and personal factors were assessed using logistic models. An interaction between age and each occupational exposure was studied.ResultsIn the multivariate models, age was the only personal factor significantly associated with low-back pain for both genders. The other personal factors studied were significantly associated with low-back pain for women only. Handling heavy loads and awkward postures at work were strongly associated with low-back pain for both genders (respectively OR = 1.80 [1.46–2.23] and OR = 1.65 [1.34–2.03] for men, and OR = 1.65 [1.32–2.06] and OR = 1.28 [1.04–1.59] for women). A high level of psychological demands at work and a low level of decision latitude were also associated with low-back pain for both genders (respectively OR = 1.22 [1.03–1.46] and OR = 1.32 [1.11–1.57] for men, and OR = 1.31 [1.10–1.56] and OR = 1.27 [1.06–1.51] for women). Only the interaction between age and awkward postures for men was borderline significant.ConclusionThis study showed strong associations between occupational exposures and persistent/recurrent low-back pain in a general working population in France. Targeting these exposures in prevention programs could be useful.     

Smoking, heavy physical work and low back pain: a four-year prospective study.

Data from a community-based four-year prospective study were used to test the hypothesis that heavy physical work is a stronger predictor of low back pain in smokers than in non-smokers. Of 708 working responders without low back pain during the entire year prior to 1990, 562 (79%) completed a questionnaire four years later in 1994. A job involving heavy lifting and much standing in 1990 was a strong predictor of low back pain in smokers four years later [odds ratio (OR) = 5.53, 95% confidence interval (CI) = 1.93-15.84, p < 0.01) after having adjusted for other job characteristics, demographic factors, emotional symptoms, physical exercise and musculoskeletal pain elsewhere. In non-smokers, having a job with heavy lifting and much standing was not associated with low back pain. One explanation may be that smoking leads to reduced perfusion and malnutrition of tissues in or around the spine and causes these tissues to respond inefficiently to mechanical stress.     

Changes in Cognitive-Behavioral Factors and Muscle Activation Patterns after Interventions for Work-Related Neck-Shoulder Complaints: Relations with Discomfort and Disability

Objectives Knowledge regarding the working mechanism of an intervention is essential for obtaining a better understanding of the intervention and contributes to optimize its outcome. This study aimed at investigating whether changes in cognitive-behavioral factors and muscle activation patterns after myofeedback training and ergonomic counseling were associated with outcome, in subjects with work-related musculoskeletal neck-shoulder complaints. Methods Seventy-nine symptomatic subjects received either myofeedback with ergonomic counseling (Mfb/EC) or ergonomic counseling alone (EC). Outcome measures discomfort and disability, and process factors catastrophizing, pain control, fear-avoidance beliefs, and muscle activation patterns were assessed at baseline, after the interventions (T0), and at 3 months follow-up (T3). Mixed modeling techniques were used for analysis. Results Outcome in terms of discomfort and disability was generally comparable between both interventions. Catastrophizing was significantly reduced and fear-avoidance beliefs about work slightly increased after the interventions, but no consistent changes in muscle activation patterns were observed. Changes in discomfort were especially associated with changes in catastrophizing at T0 and T3, but R² was low (<0.14). Reduced catastrophizing at T0 and T3, and also reduced fear-avoidance beliefs about work at T3, were related to reduced disability (R² between 0.30 and 0.40). No differences between the two intervention groups were observed. Conclusions Intervention effects were generally non-specific and findings suggested that cognitive-behavioral factors underlie the outcome of these interventions rather than changes in muscle activation patterns. Emphasizing these factors during therapy may increase the beneficial outcome of occupational interventions.     

Ergonomic stressors and upper extremity musculoskeletal disorders in automobile manufacturing: a one year follow up study

Aims: To estimate the one year cumulative incidence and persistence of upper extremity (UE) soft tissue disorders, in a fixed cohort of automotive manufacturing workers, and to quantify their associations with ergonomic exposures.

Methods: At baseline and at follow up, cases of UE musculoskeletal disorders were determined by interviewer administered questionnaire and standardised physical examination of the upper extremities. The interview obtained new data on psychosocial strain and updated the medical and work histories. An index of exposure to ergonomic stressors, obtained at baseline interview, was the primary independent variable. Cumulative incidence and persistence of UE disorders (defined both by symptoms and by physical examination plus symptoms) were analysed in relation to baseline ergonomic exposures, adjusting for other covariates. The incidence of new disorders was modelled using multivariate proportional hazards regression among workers who were not cases in the first year and the prevalence on both occasions was modelled by repeated measures analysis.

Results: A total of 820 workers (69% of eligible cohort members) was examined. Follow up varied slightly by department group but not by baseline exposure level or other characteristics. Among the non-cases at baseline, the cumulative incidence of UE disorders was 14% by symptoms and 12% by symptoms plus examination findings. These rates increased with index of physical exposures primarily among subjects who had the same jobs at follow up as at baseline. Increased exposure during follow up increased risk of incidence. The persistence of UE disorders from baseline to follow up examination was nearly 60% and somewhat associated with baseline exposure score.

Conclusions: These longitudinal results confirm the previous cross sectional associations of UE musculoskeletal disorders with exposure to combined ergonomic stressors. The exposure-response relation was similar for incident cases defined by symptoms alone and those confirmed by physical examination.

     

The effect of training for a participatory ergonomic intervention on physical exertion and musculoskeletal pain among childcare workers (the TOY project) – a wait-list cluster-randomized controlled trial

ObjectiveMany employees have high physical exertion at work and suffer from musculoskeletal pain (MSP) leading to sickness absence with large costs. Participatory ergonomics is a potentially effective intervention for reducing physical exertion, MSP and sickness absence. The main aim of this study was to investigate the effectiveness of a 20-week workplace participatory ergonomic intervention among childcare workers on physical exertion and MSP.MethodsIn a two-arm cluster-randomized trial, 190 workers were recruited from 16 childcare institutions and randomly assigned to either a 20-week participatory ergonomics intervention consisting of three training workshops or a control group receiving usual care. Primary outcomes were physical exertion during work, maximal pain intensity, number of pain regions, and pain-related work interference. Secondary outcomes were MSP-related sickness absence, need for recovery (NFR), employee involvement, and self-efficacy. We followed the intention-to-treat principle and adhered to the registered study protocol (ISRCTN10928313).ResultsAfter 20 weeks, half the workers noticed some positive changes in their work. However, there were no statistically discernible effects in physical exertion, maximum pain intensity, pain-related work interference, or number of pain regions. We found a significant reduction of MSP-related sickness absence in the intervention compared to the control group [-0.48 days per month (95% confidence interval (CI), -0.8– -0.1]. We found no significant effects in NRF or involvement of employees, but self-efficacy was reduced in the intervention compared to the control group [-0.2 (95% CI, -0.3– -0.0)].ConclusionThis 20-week training for a participatory ergonomic intervention in childcare workers did not show effects on physical exertion and MSP, but was both feasible and effective in reducing MSP-related sickness absence.