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.     

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.     

Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

Objective

To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.

Methods

A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the “staffing adequacy subscale” of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.

Results

We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.

Conclusions

Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.     

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.     

The influence of psychosocial work characteristics on the need for recovery from work: a prospective study among computer workers

Purpose

To investigate the influence of high job demands, low job control, and high social support on need for recovery (NFR) among computer workers.

Methods

Data was obtained from a longitudinal cohort study, including 5 consecutive measurements, with an in-between period of 6 months. General estimating equations analyses were performed to assess the risk for high NFR 6 months later. Odds ratios (ORs) for high NFR were calculated for high job demands, low job control and low social support, separately. Likewise, ORs were calculated for combinations of job demands and job control, as well as for combinations of job demands, job control and social support.

Results

High job demands resulted in an increased risk for high NFR 6 months later, particularly in older workers. Low social support showed also an increased risk for future high NFR, but this was not the case for low job control. Furthermore, a combination of high job demands and low job control, as well as a combination of high job demands, low job control and low social support demonstrated an increased risk for future high NFR where older workers showed higher risks.

Conclusion

This study demonstrated that adverse psychosocial work characteristics predicted future NFR among computer workers.     

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.     

Exposure to disturbing noise and risk of long-term sickness absence among office workers: a prospective analysis of register-based outcomes

Purpose

To investigate the association between self-reported exposure to disturbing noise and risk of long-term sickness absence (LTSA) for more than two consecutive weeks among office workers.

Methods

LTSA was measured using register data that were linked to survey data from 2,883 office workers aged 18–59 who were surveyed in 2005 on exposure to disturbing noise. The risk of LTSA was investigated using Cox proportional hazards model.

Results

Of the study population, 4.4 % had LTSA in the 1-year follow-up period. Compared to office workers who were ‘rarely or never’ exposed to disturbing noise at work, office workers who reported being ‘frequently’ exposed to disturbing noise had a significantly increased estimated risk of LTSA when adjusting for age, gender, smoking status, and managerial position (HR = 1.90; 95 % CI, 1.12–3.22). After additional adjustment for psychosocial work conditions, the estimated risk of LTSA for office workers who were frequently exposed to disturbing noise became marginally insignificant (HR = 1.73; 95 % CI, 0.99–3.01). A subgroup analysis showed that women who reported being frequently exposed to disturbing noise had a significantly increased estimated risk of LTSA (HR = 1.94; 95 % CI, 1.04–3.64), whereas the corresponding risk for men was insignificant (HR = 1.28; 95 % CI, 0.37–4.41).

Conclusions

This study indicates that frequent self-reported exposure to disturbing noise at work is associated with increased risk of LTSA among office workers and that this association may be stronger for women than for men.     

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.     

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.     

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.     

Differences in predictors for return to work following musculoskeletal injury between workers with and without somatic comorbidities

Purpose

In workers with musculoskeletal injuries, comorbidity is associated with worse return to work (RTW) outcomes. In the context of RTW, it is unclear whether associations between predictors and RTW are similar or different for workers with and without comorbidity. This study aims to investigate differences and similarities between workers with and without comorbidity in 12-month predictors for RTW in workers who are absent from work due to a musculoskeletal injury.

Methods

All workers with lost-time claims who were off work at baseline were selected from the Early Claimant Cohort (Canada) (n = 1,566). Follow-up data on RTW were available of 810 workers after 12 months. Predictors included demographic, health-related, and work-related factors. Differences between coefficients of the groups with and without comorbidity were tested.

Results

Low household income was a predictor for RTW in workers without comorbidity only. Better mental health was a predictor for RTW in workers with comorbidity only. Higher education, less pain intensity, better general health, less bodily pain, better physical health, and a positive supervisor response were predictors for RTW in the total group.

Conclusions

Injured workers with and without comorbidity should be considered as two distinct groups when focusing on mental health or household income.     

Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis

Introduction

Identifying risk factors associated with the development of work-related neck pain in office workers is necessary to facilitate the development of prevention strategies that aim to minimise this prevalent and costly health problem. The aim of this systematic review is to identify individual worker (e.g., lifestyle activity, muscular strength, and posture) and workplace (e.g., ergonomics and work environment) physical factors associated with the development of non-specific neck pain in office workers.

Methods

Studies from 1980 to 2016 were identified by an electronic search of Pubmed, CINAHL, EMBASE, Psychlnfo and Proquest databases. Two authors independently screened search results, extracted data, and assessed risk of bias using the epidemiological appraisal instrument (EAI). A random effect model was used to estimate the risk of physical factors for neck pain.

Results

Twenty papers described the findings of ten prospective cohort studies and two randomized controlled trials. Low satisfaction with the workplace environment (pooled RR 1.28; CI 1.07–1.55), keyboard position close to the body [pooled RR 1.46; (CI 1.07–1.99)], low work task variation [RR 1.27; CI (1.08–1.50)] and self-perceived medium/high muscular tension (pooled RR 2.75/1.82; CI 1.60 /1.14–4.72/2.90) were found to be risk factors for the development of neck pain.

Conclusions

This review found evidence for a few number of physical risk factors for the development of neck pain, however, there was also either limited or conflicting factors. Recommendations for future studies evaluating risk factors are reported and how these may contribute to the prevention of neck pain in office workers.

     

The social tariff of EQ-5D is not adequate to assess quality of life in patients with low back pain

Background

We compared the quality of life perceived by patients with non-specific low back pain with that predicted by the social tariff of the Spanish version of EQ-5D questionnaire.

Methods

For each health state of the EQ-5D, an adjusted tariff for patients with back pain was obtained using a linear regression model in which the linear effect of the three levels of response for each of the five domains of the EQ-5D was assumed. These coefficients were compared with those obtained for the general Spanish population. In another model, equal in structure to the standard “Dolan N” model, the linear effect of the five domains was not assumed.

Results

In 633 patients, 93 health states were recorded. Significant differences in the coefficients of self-care (p = 0.003) and the maximum level of severity in any dimension (p < 0.0001) were observed. The social tariff of the healthy population is different from the tariff of low back pain patients, with general population values being lower than those of patients, particularly in the 211 health states in which any dimension is at level 3. Weights of the different EQ-5D dimensions showed a non-linear effect on the patients’ quality of life.

Conclusion

Methods used to develop the social tariff for the Spanish version of EQ-5D were inadequate. In addition, this study shows that values given by the general population are different from those of low back pain patients, further confirming that the social tariff of EQ-5D should not be used with actual patients.     

The impact of common mental disorders on work ability in mentally and physically demanding construction work

Purpose

To gain insight into (1) the prevalence and incidence of common mental disorders (CMD) and low work ability among bricklayers and construction supervisors; (2) the impact of CMD on current work ability and work ability 1 year later and (3) the added value of job-specific questions about work ability for detecting signs of low work ability.

Methods

We randomly selected 750 bricklayers and 750 supervisors. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire 1 year later. Work ability was measured with the first three questions of the Work Ability Index and job-specific questions. Self-reported CMD were measured with instruments designed to detect a high need for recovery after work, distress and depression. We used univariate logistic regression to analyse the presence or absence of CMD as independent variable.

Results

The prevalence and incidence of CMD among 199 bricklayers and 224 supervisors was 22 %/10 % and 32 %/15 %, respectively. The prevalence of low general work ability was comparable for both occupations (5 %). CMD were associated with low current work ability and low work ability at follow-up (ORs 4.3–22.4), but not with a reduction in work ability 1 year later. Questions on job-specific work ability resulted in more indications of low work ability among both occupations than did questions on general work ability.

Conclusions

Regardless of occupation, workers who report CMD at baseline have a high likelihood of current low work ability and low work ability 1 year later.     

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.     

Sleep disturbances predict long-term changes in low back pain among Finnish firefighters: 13-year follow-up study

Purpose

To investigate the prevalence of low back pain among Finnish firefighters and to examine whether sleep disturbances predict membership of low back pain trajectories.

Methods

In this prospective study, 360 actively working firefighters responded to a questionnaire in 1996, 1999 and 2009. The outcome variables were radiating and local low back pain during the preceding year. Using logistic regression modeling, the likelihood of membership of pain trajectories was predicted by sleep disturbances at baseline.

Results

During the 13-year follow-up, the prevalence of radiating low back pain increased from 16 to 29 % (p < 0.0001) and that of local low back pain from 28 to 40 % (p < 0.001). The following trajectories were identified: “pain free,” “recovering,” “new pain,” “fluctuating” and “chronic.” More than one-fifth of the participants belonged to the new pain trajectory as regards both pain types, 6 % of the participants belonged to the chronic radiating and 12 % to the chronic local low back pain trajectory. Those with sleep disturbances at baseline had a 2.4-fold risk (adjusted OR 2.4; 95 % CI 1.2–4.7) of belonging to the new pain or chronic radiating pain cluster compared to pain-free participants.

Conclusions

This is the first prospective study to show that low back symptoms are common and persistent among firefighters and that sleep disturbances strongly predict membership of a radiating pain trajectory. Occupational health and safety personnel, as well as the firefighters themselves, should recognize sleep problems early enough in order to prevent back pain and its development into chronic pain.

     

Occupational hazards and self-reported health problems of butchers in Ibadan, southwest Nigeria

Aim

Butchers are engaged in small-scale enterprises and their work involves contact with live animals, their carcasses, blood and body fluids. The purpose of this study was to assess the occupational hazards and health problems of butchers in Nigeria.

Subjects and methods

A cross-sectional design was used. Questionnaires were administered to butchers in selected markets and abattoirs in Ibadan, southwest Nigeria to collect information on socio demographic and occupational characteristics, perceived occupational hazards and health problems. Their hands were examined for evidence of dermatitis. Chi-squared test was used to test associations between health problems and butchers’ characteristics.

Results

Four hundred and eighty-five butchers participated in the survey, 434 males (90 %) and 52 females (10 %). Perceived occupational hazards reported were knives, 400 (82 %), live cows 111 (23 %) and bones 28 (6 %) all of which cause injury. Other hazards reported were dirty environment, 17 (3 %), wet/slippery floors 7 (1 %) and hot water 6 (1 %). Current health problems were low back pain, muscular and joint pain, eye irritation and knife injuries. Apprentices reported more knife injuries than butchers, 22 and 12 % respectively x ²?=?9.42, p?=?0.04. Hand dermatitis was seen in 11 % of butchers and was more prevalent among females than males, 24 % and 9 % respectively x ²?=?7.63, p?=?0.02.

Conclusion

The main health problems reported by butchers were musculoskeletal disorders and injuries. Occupational health intervention for these workers should address injury prevention, wound care, the use of appropriate protective clothing and correct postures at work.     

Impact of economic crisis on mental health of migrant workers: what happened with migrants who came to Spain to work?

Objectives

To assess changes in mental health in a sample of migrant workers after the eruption of the economic crisis in Spain.

Methods

318 migrant workers were interviewed. Mental health, sociodemographic, and economic crisis related variables were obtained through face-to-face (2008) and phone (2011) interviews. Prevalence of poor mental health (PMH) was compared (2011–2008) and multivariate logistic regression models were fitted.

Results

Change in prevalence of PMH was higher in men (aOR 4.63; 95 % CI 2.11–10.16). Subgroups of men showing the largest detrimental mental health effects were: unemployed, with low salaries (≤1,200 euros) and those reporting family burden. An increase of PMH was found in women, without significant associations.

Conclusions

Mental health of migrant workers in Spain has worsened during the economic crisis.     

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.     

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.