Birgitta Pålsson

Disorders of the neck and upper limbs in women in the fish processing industry

OBJECTIVE--The aim was to study the association between personal factors and physical and psychosocial work environment factors and disorders of the neck or upper limbs among women in the fish processing industry. METHODS--A cross sectional study was performed on 206 women in the fish processing industry and 208 control women. Several physical and psychosocial work environment factors were evaluated. Subjective complaints about the neck or upper limbs were assessed by questionnaire and by a clinical examination. RESULTS--The study showed a high prevalence (35%) of diagnoses in the neck or shoulders of the exposed women. All prevalence odds ratios (PORs) were substantially higher in young women. There was a pronounced dose-response relation between disorders of the neck or shoulders and duration of employment for women < 45 years old. When studying 322 former workers, the proportion who claimed musculoskeletal complaints as the reason for leaving was highest among the older women. Muscular tension, stress or worry, work strain, and the largest fraction of the work time spent with highly repetitive work tasks were clearly associated with disorders of the neck or shoulders. The measurements of the wrist movements also showed that the work was performed almost without any pauses and that the median flexion and extension velocity was high (41 degree/s). The results of observation showed good agreement with the measurements of wrist motion. CONCLUSION--Work in the fish processing industry is a risk factor for disorders of the neck and upper limbs. Due to the homogenity of the physical work load in the exposed group, we could not show any associations between the objective measurements and disorders. In cross sectional studies the risk may be underestimated due to a healthy worker effect.

Fish processing work: the impact of two sex dependent exposure profiles on musculoskeletal health

OBJECTIVES: To evaluate the impact of work tasks, physical exposure, and psychosocial factors on the risk of musculoskeletal disorders in men and women, in a defined industrial setting. METHODS: 116 male and 206 female fish industry workers were compared with 129 men and 208 women with more varied work. Physical and psychosocial work load as well as musculoskeletal complaints were recorded by a questionnaire. A physical examination was performed and an observation method was used for work evaluation. 196 male and 322 female former fish processing workers received a postal questionnaire. RESULTS: The women workers in the fish industry had worse working conditions than the men for repetitiveness, constrained neck postures, and psychosocial work environment. They also had higher prevalences of complaints of the neck and shoulder (prevalence odds ratio (POR) 1.9; 95% confidence interval (95% CI) 1.1 to 3.2), neck and shoulder and elbow and hand complaints (POR 2.9; 95% CI 1.8 to 4.7 and POR 2.8; 95% CI 1.6 to 4.7, respectively). The women more often than the men left the industry because of neck and upper limb complaints. Also, women in other work had a higher prevalence of complaints of the neck and shoulder (POR 2.3; 95% CI 1.1 to 5.1) than the men. The men in the fish processing industry had a higher prevalence of complaints of the neck and shoulder than the men in other work (POR 3.6; 95% CI 1.6 to 8.0). This difference was not shown up by the questionnaire. CONCLUSIONS: Despite superficially similar work, there were clear sex differences in physical exposure and psychosocial work environment. Work in the fish processing industry was associated with a high risk of neck and upper limb disorders in women, which was probably mainly due to their extremely repetitive work tasks; the corresponding men had less repetitive work and less disorders. Also, a healthy worker effect on neck and upper limb disorders was found. The advantage of a physical examination compared with a questionnaire is clearly shown.

Impact of physical exposure on neck and upper limb disorders in female workers

Physical workload [muscular load of the trapezius and infraspinatus muscles using electromyography (EMG), wrist positions and movements by electrogoniometers] and neck and upper limb disorders (from, for example, a physical examination) were studied in women with repetitive industrial work (n = 95) and referents (n = 74). The repetitive work displayed higher ratings for wrist movements, but not for EMG. The prevalences of neck, shoulder and wrist/hand disorders were elevated for women with repetitive work [age-adjusted prevalence odds ratios (PORs) 2.0-7.5]. For the left hand, high frequency of wrist movements (mean power frequency 0.53 Hz) was associated with a high prevalence of disorders (56%), as compared to low (0.28 Hz and 26%; POR 3.5). We found no consistent and significant effect of muscular load, on either neck or shoulder disorders. However, selection and other bias may have diminished our possibility to observe such effects. Psychosocial work environment factors were not confounding the results. Measurements of wrist movements may be used for identification of high-risk work tasks.

Return to work after a workplace-oriented intervention for patients on sick-leave for burnout - a prospective controlled study

BackgroundIn the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.MethodsIn a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.ResultsThere was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.ConclusionsWe conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.Trial registrationCurrent Controlled Trials NCT01039168.

Long-term follow-up of psychological distress, social functioning, and coping style in treated and untreated patients with solvent-induced chronic toxic encephalopathy.

Patients with organic solvent-induced toxic encephalopathy (TE) (n = 13) were followed up seven years after the application of an intervention program. They were also compared with untreated TE patients diagnosed at the same time (n = 26) and with unexposed referents (n = 39). Psychological distress, social function, and coping ability and style were measured with the Symptom Checklist-90, Interview Schedule of Social Interaction, and Sense of Coherence and Strategies to Handle Stress questionnaires. Both TE groups had unchanged function in neuropsychological tests. Members of the treated group had improved their social functioning and reduced their mental stress but were not any better than the untreated patients. Compared with referents, the TE patients continued to live with increased psychological distress and used predominantly emotionally focused strategies to cope with their problems. This can be a cause for concern in family life and can also make gainful work impossible.

Psychological distress and coping in women married to men with a diagnosis of solvent-induced chronic toxic encephalopathy.

Background: Solvent-induced chronic toxic encephalopathy (TE) is a slowly developing brain disorder associated with both a direct effect on the nervous system and as indirect experienced psychological distress. It can presumably also imply negative influence on the subjects social surroundings. Methods: Seventeen women married to men diagnosed with TE (WTE) and 51 referent women of the same age married to healthy husbands were examined. Symptoms, social network and coping style were measured by questionnaires. Results: The WTE reported slightly more psychological distress and fewer social contacts than did the referents. The WTE did not report affected stress management. Retired women in the WTE group accounted for most of the deviances from the referents. Conclusions: The conclusion is that becoming a WTE does not necessarily imply more psychological distress, social isolation or poorer stress management capability if they continue with their work and social activities.