Allan Toomingas

Self-reported working conditions of VDU operators and associations with musculoskeletal symptoms : a cross-sectional study focussing on gender differences

The aim of the present study was to describe working conditions and the prevalence of musculoskeletal symptoms among male and female VDU operators, and to assess associations between work-related physical and psychosocial exposures and neckand upper limb symptoms by gender. The study population comprised a variety of occupations from both private and public sectors. Data on physical and psychosocial exposures were collected by questionnaires, as were data on musculoskeletal symptoms. Univariate associations between exposures and symptoms affecting the neck and upper limbs were estimated by calculating the prevalence ratios with 95% confidence intervals. We also assessed the potential excess odds ratio attributable to interaction between gender and, one by one, exposure variable. Women (n ¼ 785) used the computer on average 3.9 h/day and men (n ¼ 498) 3.6. Variation of different worktask s was lower among females than among males. Nineteen per cent of the women and 12% of the men did >3 h of continued computer work without breaks (>10 min) at least twice a week. Twice as many women as men experienced high job strain (high demands and low decision latitude). A higher proportion of women than men reported symptoms X3 days the preceding month from the upper body, irrespective of body region. For many of the studied exposures the prevalence of symptoms in one or several body regions was increased with increasing exposure, indicating exposureresponse relationships. Duration of computer work was associated with symptoms among both men and women. Only among men, duration of work with a non-keyboard computer input device was associated with symptoms. Only among women, job strain was associated with symptoms. Time pressure was associated with higher prevalence of symptoms among women. Among men, time pressure was associated with lower prevalence of symptoms. Thus, the associations differed between the genders. Women experienced higher prevalence of symptoms than men in all body regions and they were more often exposed to physical and psychosocial conditions that in previous studies have been considered harmful, than men. Relevance to industry Work-related exposures and the associations between these factors and musculoskeletal symptoms among VDU operators differed in some respect between men and women. This should be considered in intervention programs. The results from this study gives further support to the advice that duration of computer work, time pressure and job strain

Risk factors for neck and upper limb disorders: results from 24 years of follow up.

OBJECTIVES: To investigate associations between different potential risk factors, related and not related to work, and disorders of the neck and upper extremities occurring up to 24 years later. METHODS: The study comprised 252 women and 232 men, Swedish citizens, 42-59 years of age and in a broad range of occupations. Information about potential risk factors was available from a former study conducted in 1969. Data on disorders of the neck, shoulder, and hand-wrist disorders were obtained retrospectively for the period 1970-93. RESULTS: Risk factors were found to differ between the sexes. Among women over-time work, high mental workload, and unsatisfactory leisure time were associated with disorders in the neck-shoulder region. Interaction was found between high mental workload and unsatisfactory leisure time. Neck symptoms earlier in life were associated with recurrent disorders. Hand and wrist disorders were associated mainly with physical demands at work. Among men blue collar work and a simultaneous presence of high mental workload and additional domestic workload predicted disorders in the neck-shoulder region. CONCLUSIONS: Factors related and not related to work were associated with disorders of the neck, shoulders, and hands and wrist up to 24 years later in life. These included factors related to working hours which previously have not been noted in this context. Interactions between risk factors both related and not related to work were commonly found.

Perceived muscular tension, job strain, physical exposure, and associations with neck pain among VDU users; a prospective cohort study

Aims: To determine whether perceived muscular tension, job strain, or physical exposure are associated with increased risk of developing neck pain among VDU users. Methods: A baseline questionnaire was answered by 1283 respondents, of whom 671 were free from neck pain at baseline. Perceived muscular tension, job strain, and physical exposure were assessed at baseline. Information about newly developed neck pain was collected in 10 follow up questionnaires and the case definition was the first report of such pain in any of the follow up questionnaires. Median follow up time was 10.9 months. Results: Both men and women who perceived muscular tension at least a few times per week, compared to those who had not perceived muscular tension the preceding month, had an incidence rate ratio (IRR) of 1.9 (95% CI 1.25 to 2.93) for developing neck pain, when stratifying for sex. High perceived muscular tension was associated with an increased risk (IRR 1.6, 95% CI 1.02 to 1.91), even when controlling for job strain, physical exposure, and age in the model stratified by sex. Conclusions: Perceived muscular tension was associated with an increased risk of developing neck pain among VDU users. The combination of high job strain and high perceived muscular tension was associated with higher risk of developing neck pain than the combination of high physical exposure and high perceived muscular tension. There was an indication of an excess risk due to interaction between high physical exposure and high job strain.

Self-Reported Reduced Productivity Due to Musculoskeletal Symptoms: Associations with Workplace and Individual Factors Among White-Collar Computer Users

The aim was to assess whether self-reported reduced productivity occurred in computer users due to musculoskeletal symptoms and the association to workplace, symptom, and individual factors. The study group consisted of 1283 computer users from different occupations, of whom 498 were men and 785 were women. Reduced productivity was self-assessed by two questions addressing if and how much productivity was reduced the previous month due to musculoskeletal symptoms. There were 63 women (8.0%) and 42 men (8.4%) of the total study group who reported reduced productivity due to musculoskeletal symptoms. The mean magnitude of the reduction was 15% for women and 13% for men. This outcome was weakly associated with computer mouse position and task and symptom persistence for both men and women. For women, work demands, computer problems, and being divorced/separated were also associated with reduced productivity. Although limited by problems of subjectivity of self-report and the possibility of significant underreporting, these results suggest that a variety of interventions may serve to decrease the impact of musculoskeletal disorders in the workplace.

Risk factors for neck and shoulder disorders: A nested case–control study covering a 24-year period

BACKGROUND In 1969 a population-based study was conducted in the Stockholm region. From the 2,579 randomly selected participants (18-65 years of age in 1969), the youngest subset were asked to participate in a reexamination in 1993. Information regarding working conditions, conditions outside work, and neck and shoulder disorders was collected retrospectively for the period 1970-1993. METHODS Of 783 eligible subjects (42-59 years of age in 1993), 484 responded. Cases of neck/shoulder disorders were defined by past sick leave or medical attention or recent symptoms, depending on available information. For each case (n = 271) two controls were randomly selected, matched by age and gender. Variables regarding both physical and psychosocial conditions were included in the matched analyses. RESULTS Among women mainly psychosocial factors and among men mainly physical factors were associated with neck/shoulder disorders. The only gender common risk indicator found was repetitive hand work (OR approximately 1.5). Interactive effects were also observed. CONCLUSIONS The impact on neck/shoulder disorders from separate factors was moderate but combinations of physical and psychosocial factors, as well as of work-related and non-work-related factors, produced relative risks above 2.

Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users.

The aim of the present study was to assess the incidence and identify possible risk factors for self-reported reduced productivity owing to musculoskeletal symptoms among computer users. Design: a cohort study with a baseline questionnaire and monthly follow ups during 10 months. Methods: the study base consisted of 1283 computer users, 636 men and 896 women. Ergonomists observed workstation characteristics before entering the cohort. Cases were defined as subjects reporting reduced productivity or reporting being on sick leave owing to musculoskeletal symptoms. Results: women had approximately two times the incidence of self-reported reduced productivity owing to symptoms in the neck, shoulder and in the forearm/hand than men. There was no difference in gender for the incidence of self-reported reduced productivity owing to back symptoms. Working overtime and job demands were risk factors for self-reported reduced productivity owing to neck and back symptoms. Physical exercise fewer than 8 times the last month was a risk factor for self-reported reduced productivity owing to neck, shoulder and forearm/hand symptoms. Computer mouse use for more than 0.5 h/day was a risk factor for self-reported reduced productivity owing to shoulder and forearm/hand symptoms. Conclusions: risk factors for self-reported reduced productivity owing to musculoskeletal symptoms included life style factors, such as overweight and low physical exercise, occupational factors, such as overtime, job demands and computer mouse operating time.

Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel.

Objectives: Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems. Methods: This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992–95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095). Results: The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care. Conclusions: The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.

Variation between seated and standing/walking postures among male and female call centre operators

BackgroundThe dose and time-pattern of sitting has been suggested in public health research to be an important determinant of risk for developing a number of diseases, including cardiovascular disorders and diabetes. The aim of the present study was to assess the time-pattern of seated and standing/walking postures amongst male and female call centre operators, on the basis of whole-shift posture recordings, analysed and described by a number of novel variables describing posture variation.MethodsSeated vs. standing/walking was recorded using dichotomous inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analysed using an extensive set of variables describing occurrence of and switches between seated and standing/walking, posture similarity across the day, and compliance with standard recommendations for computer work.ResultsThe majority of the operators, both male and female, spent more than 80% of the shift in a seated posture with an average of 10.4 switches/hour between seated and standing/walking or vice versa. Females spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; males 4.6% (p = 0.013). Only 38% and 11% of the operators complied with standard recommendations of getting an uninterrupted break from seated posture of at least 5 or 10 minutes, respectively, within each hour of work. Two thirds of all investigated variables showed coefficients of variation between subjects above 0.5. Since work tasks and contractual break schedules were observed to be essentially similar across operators and across days, this indicates that sedentary behaviours differed substantially between individuals.ConclusionsThe extensive occurrence of uninterrupted seated work indicates that efforts should be made at call centres - and probably in other settings in the office sector - to introduce more physical variation in terms of standing/walking periods during the work day. We suggest the metrics used in this study for quantifying variation in sedentary behaviour to be of interest even for other dichotomous exposures relevant to occupational and public health, for instance physical activity/inactivity.

Self-administered examination versus conventional medical examination of the musculoskeletal system in the neck, shoulders, and upper limbs

A self-administered examination protocol of the musculoskeletal system in the neck, shoulders, and upper limbs was mailed to 350 subjects and the results were compared to those of a subsequent medical examination. The prevalences of reported positive findings were higher than in the medical examination. Validity ranged between poor and good. Acceptable validity was noted for items measuring tenderness. No systematic substantial exposure-related misclassification was noted. Self-administered examination of the musculoskeletal system is not suitable to replace a traditional medical examination in epidemiological studies. Self-administered examination of tenderness could, however, be used as a screening method in analytical studies of relations between exposure and disorders in the musculoskeletal system. Subjects reporting such findings at a self-administered examination could be further examined by professional examiners for definite diagnostic appraisal. Substantial savings in medical examination resources could thereby be obtained.

Symptoms and clinical findings from the musculoskeletal system among operators at a call centre in Sweden--a 10-month follow-up study.

The musculoskeletal health among 57 operators at 1 call centre in Sweden was studied with 10 monthly follow-ups, parallel to a reference group of 1,226 professional computer users in other occupations. Operators at this call centre were more symptom-loaded than the other professional computer users in spite of their younger age and shorter exposure to computer work. Symptoms were long-lasting or recurrent. Muscle tenderness and nerve affections in the neck- shoulder region were the most common specific findings and diagnoses at medical examination of incident symptom cases. More extensive studies should be done on the working conditions and health status among call centre workers.