Perceived physical exertion during healthcare work and risk of chronic pain in different body regions: prospective cohort study

Purpose

To estimate the risk of developing chronic musculoskeletal pain in different body regions from varying degrees of perceived physical exertion during healthcare work.

Methods

Prospective cohort study among 4,977 Danish female healthcare workers responding to a baseline and follow-up questionnaire in 2005 and 2006, respectively. Using multi-adjusted logistic regression analysis, the risk of developing chronic pain (>30 days last year) at follow-up in the low back, neck/shoulder, and knees—among those without pain (0 days last year) in these respective body regions at baseline—from moderate and strenuous (reference: light) perceived physical exertion during healthcare work was modeled.

Results

Adjusted for age, BMI, tenure, smoking status, and leisure physical activity, strenuous perceived physical exertion during healthcare work increased the risk of chronic low back pain (OR 3.16, 95 % CI 1.79–5.57) and chronic knee pain (OR 1.87, 95 % CI 1.19–2.94) at follow-up among those without pain in these respective body regions at baseline. With additional adjustment for psychosocial work conditions, only the risk of developing chronic low back pain from strenuous physical exertion remained significant (OR 1.99, 95 % CI 1.02–3.88). Strenuous physical exertion was not a risk factor for chronic neck pain, and moderate physical exertion was not a risk factor for chronic pain in any of the body regions.

Conclusion

Strenuous perceived physical exertion during healthcare work is a risk factor especially for developing chronic pain in the low back. The possible preventive effect of reducing strenuous physical exertion should be tested in randomized controlled trials.     

Work-related psychosocial and mechanical risk factors for neck/shoulder pain: a 3-year follow-up study of the general working population in Norway

Purpose

This study examines the impact of work-related psychosocial and mechanical exposure on the development of neck/shoulder pain in the general working population.

Methods

A randomly drawn cohort from the general population in Norway aged 18–66 was followed up for 3 years (n = 12,550, response rate = 67 %). Eligible respondents were in paid work during the reference week in 2006 and 2009, or temporarily absent from such work (n = 6,745). Four work-related psychosocial factors and six mechanical exposures were measured. Outcomes of interest were moderate or severe neck/shoulder pain at follow-up adjusted for baseline neck/shoulder pain.

Results

In total, 16.9 % (1,138 individuals) reported neck/shoulder pain during the last month at follow-up. Work related psychosocial predictors of neck/shoulder pain were high job demands (highest OR 1.41, 95 % CI 1.11–1.78) and low levels of supportive leadership (highest OR 1.66, 95 % CI 1.08–2.54). Mechanical factors were neck flexion (highest OR 1.77, 95 % CI 1.31–2.39) and lifting in awkward postures (highest OR 1.81, 95 % CI 1.21–2.71). The estimated population risk attributable to these factors was about 23 %. The relative risk for neck/shoulder pain associated with psychosocial exposure was slightly influenced by adjustment for physical risk factors, and vice versa. There was no substantial confounding related to age, gender, education, occupation or psychological distress.

Conclusions

Highly demanding jobs, neck flexion and awkward lifting appear as the most important predictors of neck/shoulder pain.     

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers

Purpose

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization.

Methods

From 3,710 workers, representative of a French region’s working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling.

Results

Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23–3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41–4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08–3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17–3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01–3.11) for men.

Conclusion

This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.     

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.     

Do physical or psychosocial factors at work predict multi-site musculoskeletal pain? A 4-year follow-up study in an industrial population

Purpose

Musculoskeletal pain at multiple sites is common among working-age people and greatly increases work disability risk. Little is known of the work-related physical and psychosocial factors contributing to multi-site pain.

Methods

Survey responses from 734 employees (518 blue- and 216 white-collar; 65 % female) of a food processing company were collected twice, in 2005 and 2009. Information on musculoskeletal pain during the preceding week, and on environmental, biomechanical and psychosocial work exposures were obtained through a structured questionnaire. The association of multi-site pain with work exposures was estimated with logistic regression by gender and age group.

Results

At baseline, 54 % of informants reported pain in more than one area, and 50 % at 4-year follow-up. Forty percent of all employees had multi-site pain both at baseline and at follow-up. Among those with multi-site pain at baseline, 69 % had multi-site pain at follow-up. Both repetitive work and awkward work postures at baseline were associated with multi-site pain at follow-up. Psychosocial factors (low job satisfaction, low team spirit, and little opportunity to exert influence at work) also strongly predicted multi-site pain at follow-up, especially among younger workers and men.

Conclusion

This prospective study provides new evidence of the high occurrence and persistence of musculoskeletal pain at multiple body sites in an industrial population with a strong association between biomechanical and psychosocial exposures at work and multi-site pain. Prevention of multi-site pain with many-sided modification of work exposures is likely to reduce work disability.     

Sick leave due to back pain in a cohort of young workers

Purpose

Evidence on risk factors for sick leave from prospective studies in work settings is limited. Furthermore, most available studies focused on workers with substantial low back disorders. These studies consistently report that physical work factors constitute a hindrance to work. However, it remains unclear whether the same risk factors are relevant in workers with less severe conditions or in early phases of the development of back pain. Therefore, this article aims to study risk factors for the occurrence of sick leave due to low back pain (LBP) among young workers with no or a modest history of back pain.

Methods

Participants were 716 young healthcare or distribution workers with no or minimal antecedents of LBP in the year before inclusion. We investigated the role of potential physical, psychosocial and individual risk factors at baseline on the occurrence of sick leave due to LBP 1 year later. To this purpose, we used Cox regression with a constant risk period.

Results

Six per cent (95 % CI 4.1–7.6) of the workers reported sick leave 1 year later; they accounted for 12 % of the sick-leave days independent of cause. A non-stimulating psychosocial work environment turned out to be the strongest risk factor for sick leave due to LBP (RR 6.08; 95 % CI 1.42–26.07). Physical factors were not predictive.

Conclusions

In the early phases of back pain and in less severe conditions, the main benefit of interventions lies in targeting the organisation and design of jobs to create a challenging professional environment.     

Risk factors for work-related musculoskeletal disorders in an aluminum smelter

A cross-sectional study of selected jobs in an aluminum smelter was conducted to assess the prevalence of work-related musculoskeletal disorders (WMDs), and to estimate their association with physical and psychosocial characteristics of the jobs. A structured interview and physical exam were used to assess the musculoskeletal health status of the participants, and a self-administered questionnaire was used to assess the psychosocial factors. Observational job analysis was conducted to evaluate 37 potential physical risk factors. Complete data were available for 104 subjects. The prevalence of WMDs on interview and physical exam were 0.8%, 14.9%, 11.6%, 14.9%, and 17.4% for the neck, shoulder, elbow/forearm, hand/wrist, and low back regions, respectively. Unconditional multiple logistic regression was used to model the relationship between physical and psychosocial factors and health status. Years of forearm twisting were found to be a significant predictor for hand/wrist disorders on interview (OR = 17, 95% CI = 2.9–106); for elbow/foream disorders on physical exam and interview (OR = 37, 95% CI = 3.0–470); and for shoulder disorders on interview (OR = 92, 95% CI = 7.3–∞) and on interview and physical exam (OR = 46, 95% CI = 3.8–550). Low decision latitude was also found to be significant for the shoulder on interview (OR = 4.5, 95% CI = 1.3–16). High job satisfaction (OR = 5.9, 95% CI = 1.4–25) and low social support (OR = 5.3, 95% CI = 1.3–22) were associated with low back pain report on interview; only high job satisfaction (OR = 5.3, 95% CI = 1.1–26) was associated with low back pain on both interview and physical exam. Am. J. Ind. Med. 32:66-75, 1997. © 1997 Wiley-Liss, Inc.     

A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare

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.     

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

Purpose

The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.

Methods

The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).

Results

The overall prevalence of WRSP was 5.1  % (95  % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).

Conclusion

The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.     

Back and neck pain due to working in a cold environment: a cross-sectional study of male construction workers

Objective

To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.

Methods

This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine.

Results

The prevalence’s of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52–1.66) and 1.39 (95 % CI 1.30–1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature.

Conclusions

Outdoor work in a cold environment may increase the risk of low back and neck pain.     

Contractor-, steward-, and coworker-safety practice: associations with musculoskeletal pain and injury-related absence among construction apprentices

Objectives

This paper sought to assess organizational safety practices at three different levels of hierarchical workplace structure and to examine their association with injury outcomes among construction apprentices.

Methods

Using a cross-sectional sample of 1,775 construction apprentices, three measures of organizational safety practice were assessed: contractor-, steward-, and coworker-safety practice. Each safety practice measure was assessed using three similar questions (i.e., on-the-job safety commitment, following required or recommended safe work practices, and correcting unsafe work practices); the summed average of the responses ranged from 1 to 4, with a higher score indicating poorer safety practice. Outcome variables included the prevalence of four types of musculoskeletal pain (i.e., neck, shoulder, hand, and back pain) and injury-related absence.

Results

In adjusted analyses, contractor-safety practice was associated with both hand pain (OR: 1.27, 95 % CI: 1.04, 1.54) and back pain (OR: 1.40, 95 % CI: 1.17, 1.68); coworker-safety practice was related to back pain (OR: 1.42, 95 % CI: 1.18, 1.71) and injury-related absence (OR: 1.36, 95 % CI: 1.11, 1.67). In an analysis that included all three safety practice measures simultaneously, the association between coworker-safety practice and injury-related absence remained significant (OR: 1.68, 95 % CI: 1.20, 2.37), whereas all other associations became non-significant.

Conclusions

This study suggests that organizational safety practice, particularly coworker-safety practice, is associated with injury outcomes among construction apprentices.     

Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence

OBJECTIVES: The aim of this study was to investigate whether individual, work-related physical and psychosocial risk factors involved in the occurrence of musculoskeletal complaints also determine musculoskeletal sickness absence. METHODS: This cross-sectional study used a self-administered questionnaire to collect data on individual and work-related risk factors and the occurrence of musculoskeletal complaints and musculoskeletal sickness absence among 373 employees of laundry-works and dry-cleaning establishments (response rate 87%). Logistic regression models were used to determine associations between risk factors and the occurrence of musculoskeletal complaints and sickness absence due to these complaints. RESULTS: Both work-related physical and psychosocial factors showed strong associations with low-back pain and upper-extremity complaints. Work-related physical factors did not influence sickness absence, whereas psychosocial factors showed some associations with sickness absence. Sickness absence was associated with The Netherlands as the country of birth [odds ratio (OR) 0.3, 95% confidence interval (95% CI) 0.2-0.6], and female workers had an episode of sickness absence due to low-back pain less often (OR 0.5, 95% CI 0.3-0.9), but more often due to upper-extremity complaints (OR 2.2, 95% CI 1.14.5). CONCLUSIONS: Work-related physical and psychosocial factors largely determine the occurrence of low-back pain and upper-extremity complaints, whereas individual factors predominantly determine whether persons with these musculoskeletal complaints take sick leave.     

Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

Objectives

Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP’s knowledge of what work-related factors might have influenced the patient’s decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period.

Methods

This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender.

Results

High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14–3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30–3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain.

Conclusion

Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.     

Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals

OBJECTIVES: To investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of the lower back, neck and shoulders. METHODS: In this cross-sectional study a questionnaire survey was carried out among 351 nursing personnel (response 84%) in six general hospitals in Athens, Greece. A questionnaire was used on physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence. In logistic regression analysis odds ratios (ORs) were estimated for all relevant risk factors. RESULTS: Self-reported factors of physical load were associated with the occurrence of back pain (OR=1.85), neck pain (OR=1.88), and shoulder pain (OR=1.87) but these factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.47 and 4.13 for two and three musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, or sickness absence was observed. A perceived moderate general health was also a risk factor, and strongest associations were observed for sickness absence due to back pain (OR=2.03), neck pain (OR=8.31), and shoulder pain (OR=6.84). CONCLUSIONS: The handling of physical loads among nurses seems to put them at risk for the occurrence of musculoskeletal disorders. The development of these complaints into chronic complaints and associated sickness absence is strongly determined by perceived general health and almost not associated with work-related physical and psychosocial risk factors. When the influence of work-related risk factors on musculoskeletal health is being investigated, the general health status of individual workers should be taken into account.     

Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time

Objectives

Neck–shoulder pain (NSP) is a common work-related musculoskeletal disorder with unclear mechanisms. Changes in physical activity and autonomic nervous system regulation may be involved in the pathogenesis of chronic NSP. The aim of the current study was to investigate autonomic regulation in relation to physical activity and perceived symptoms during work and leisure time among workers with chronic NSP (n = 29) as compared to a healthy control group (CON, n = 27).

Methods

Physical activity was objectively monitored for 7 days using accelerometry. Beat-to-beat heart rate was collected continuously for 72 h, with simultaneous momentary ratings of pain, stress, and fatigue. Duration of sitting/lying, standing and walking, number of steps, and energy expenditure were used as measures of physical activity. Heart rate variability (HRV) indices were extracted in time and frequency domains as reflecting autonomic regulation. Data were divided into work hours, leisure time, and sleep.

Results

The NSP group rated higher levels of stress and fatigue at work and leisure, and reduced sleep quality as compared to CON. Elevated heart rate and reduced HRV were found in NSP compared with CON, especially during sleep. The NSP group demonstrated a different pattern of physical activity than CON, with a lower activity level in leisure time. Higher physical activity was associated with increased HRV in both groups.

Conclusion

Changes in HRV reflected an autonomic imbalance in workers with chronic musculoskeletal pain. This can be explained by reduced physical activity in leisure time. Intervention studies aimed at increasing physical activity may shed further light on the association between autonomic regulation and physical activity in work-related NSP.     

The influence of perceived stress and musculoskeletal pain on work performance and work ability in Swedish health care workers

Objectives

To evaluate the influence of perceived stress and musculoskeletal ache/pain, separately and in combination, at baseline, on self-rated work ability and work performance at two-year follow-up.

Methods

Survey data were collected with a 2-year interval. Health care workers participating at both waves were included. Inclusion criteria were good self-reported work ability and unchanged self-rated work performance at baseline, resulting in 770 participants; 617 women and 153 men. Musculoskeletal pain was assessed using the question “How often do you experience pain in joints and muscles, including the neck and low back?”, perceived stress with a modified version of a single item from the QPS-Nordic questionnaire, work performance by the question “Have your work performance changed during the preceding 12 months?” and work ability by a single item from the work ability index. Associations between baseline data and the two outcomes at follow-up were analysed by means of the log binomial model and expressed as risk ratios (RR) with 95 % confidence intervals (CI).

Results

A combination of frequent musculoskeletal pain and perceived stress constituted the highest risk for reporting decreased work performance (RR 1.7; CI 1.28–2.32) and reduced work ability (RR 1.7; CI 1.27–2.30) at follow-up. Separately, frequent pain, but not stress, was clearly associated with both outcomes.

Conclusion

The results imply that proactive workplace interventions in order to maintain high work performance and good work ability should include measures to promote musculoskeletal well-being for the employees and measures, both individual and organizational, to minimize the risk of persistent stress reactions.     

Health-related quality of life among adults with work-related asthma in the United States

Purpose

The objective of this study was to examine health-related quality of life among adults with work-related asthma.

Methods

We analyzed 2006–2009 Behavioral Risk Factor Surveillance System Asthma Call-back Survey data for ever-employed adults with current asthma from 38 states and District of Columbia. Individuals with work-related asthma had been told by a doctor or other health professional that their asthma was related to any job they ever had. Health-related quality of life indicators included poor self-rated health, impaired physical health, impaired mental health, and activity limitation. We calculated prevalence ratios (PRs) adjusted for age, sex, race/ethnicity, education, income, employment, and health insurance.

Results

Of ever-employed adults with current asthma, an estimated 9.0 % had work-related asthma, 26.9 % had poor self-rated health, 20.6 % had impaired physical health, 18.2 % had impaired mental health, and 10.2 % had activity limitation. Individuals with work-related asthma were significantly more likely than those with non-work-related asthma to have poor self-rated health [PR, 1.45; 95 % confidence interval (CI), 1.31–1.60], impaired physical health (PR, 1.60; 95 % CI, 1.42–1.80), impaired mental health (PR, 1.55; 95 % CI, 1.34–1.80), and activity limitation (PR, 2.16; 95 % CI, 1.81–2.56).

Conclusions

Future research should examine opportunities to improve health-related quality of life among individuals with work-related asthma.     

Identifying Work Organization Targets for a Work-Related Musculoskeletal Symptom Prevention Program

While research linking work organization factors to work-related musculoskeletal disorders has been increasing, there is still a need to delineate specific dimensions to be targeted by intervention programs. The present cross-sectional investigation identified work organization risk factors for low back (LB) and upper extremity (UE) symptoms and determined the magnitudes of such associations. Questionnaires containing items on ergonomic, individual psychosocial, and occupational psychosocial factors were administered to a sample of workers (n = 248 U.S. Marines) in previously identified high-risk job categories for musculoskeletal disorders. Study participants were categorized into groups of either having LB symptoms only, UE symptoms only, concurrent LB and UE symptoms, or being asymptomatic on the basis of self-report. Additionally, measures of pain intensity, physical function, and mental health were obtained. Linear regression analyses adjusting for demographics, ergonomic factors, and individual psychosocial factors indicated that decision authority and experienced responsibility for work were significant correlates for pain intensity during the week. Logistic regression analyses indicated that ergonomic stressors were a risk factor for all symptomatic groups (OR = 1.02 per point increase; 95% CI: 1.0-1.1). Time pressure (OR = 1.2 per point increase; 95% CI: 1.0-1.4) was also a significant risk factor for all symptomatic groups, while cognitive processing placed workers at higher risks for concurrent LB and UE symptoms (OR = 1.2; 95% CI: 1.0-1.4). Interpersonal demands placed individuals at a lower risk for LB symptoms (OR = 0.8; 95% CI: 0.5-1.0). Findings highlight the importance of intervention approaches that address time pressure, cognitive processing factors, and interpersonal demands at work. In light of past biobehavioral studies, these results also suggest that job redesign and interventions that address a worker's workstyle when faced with increased work demands may help reduce the likelihood of musculoskeletal symptoms and/or their intensity.     

Pregnancy outcomes in female hairdressers

Purpose

The hairdressing occupation may entail exposure to a wide range of chemical products, psychosocial and physical stress. All these factors may affect the health of a pregnant hairdresser and her offspring. Our aim was to analyse whether employment in this profession is associated with adverse reproductive effects.

Method

Female hairdressers working in the 248 hairdressing salons in Alicante (Spain), who became pregnant for the first time after 1990 were included (n = 94). The incidence of spontaneous abortions, number of children born and their birth weight and preterm delivery among hairdressers was compared with a control group of shop assistants and office workers (n = 138). Information was collected through personal interviews at their work place. A structured questionnaire was used gathering information concerning exposure variables including the use of chemical products, ventilation at the salons, work-related stress and hours of standing work. In addition, socio-demographic factors and smoking information were obtained. Crude and adjusted relative risks (RR) and 95% confidence intervals (95%CI) were calculated using logbinomial regression.

Results

Hairdressers showed a non-significant increased risk of spontaneous abortions (RR = 1.6, 95%CI 0.9–2.7). There were no differences in preterm delivery and birth weight of the children born of mothers in the two groups. Among hairdressers, the RR of spontaneous abortion among those with high perceived work-related stress was 2.4 (95%CI: 0.2–28.3) relative to those with low or normal perceived stress.

Conclusions

A slightly increased risk of spontaneous abortion among hairdressers was found, mainly associated with perceived work-related stress. Observed results deserve further research.     

Risk for low back pain from different frequencies, load mass and trunk postures of lifting and carrying among female healthcare workers

Purpose

To investigate the risk of developing non-chronic and chronic low back pain (LBP) from frequency, load mass and trunk postures of occupational lifting and carrying among female healthcare workers.

Methods

A total of 9,847 workers in eldercare answered a questionnaire about occupational lifting and carrying frequency (rarely, occasionally and frequently), load mass (low: 1–7 kg, moderate: 8–30 kg and heavy: >30 kg), trunk posture (upright or forward bent back), and days with LBP in 2005. The odds ratio (OR) for developing non-chronic (1–30 days the last 12 months) and chronic (>30 days the last 12 months) LBP reported in 2006 from these characteristics of occupational lifting and carrying was investigated with multi-adjusted logistic regressions among female healthcare workers without LBP in 2005 (n = 1,612).

Results

Frequently lifting and carrying low load mass with forward bent back doubled the risk for developing chronic LBP (OR: 2.14; 95 % CI: 1.02–4.50). Occasionally and frequently lifting or carrying of any load mass with upright back did not increase the risk for chronic LBP. Lifting and carrying did not increase the risk for non-chronic LBP.

Conclusions

Preventive initiatives for LBP among healthcare workers ought to pay attention to frequent lifting and carrying of low load mass with forward bent back.