Julitta S. Boschman

Musculoskeletal disorders among construction workers: a one-year follow-up study

BackgroundWork-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors.MethodsWe randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD.ResultsBaseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time of follow-up.ConclusionsA substantial number of the bricklayers and the supervisors report musculoskeletal disorders, mainly back, knee and shoulder/upper arm complaints. The majority of the bricklayers and half of the supervisors believe that their complaints are work-related. Irrespective of occupation, participants with MSDs report substantial problems during work. Workplace intervention measures aimed at occupational physical tasks and activities seem justified for both occupations.

Effects of job rotation on musculoskeletal complaints and related work exposures: a systematic literature review

The aim of this systematic review was to summarise evidence on the effects of job rotation on musculoskeletal complaints, exposures related to musculoskeletal complaints and sustainable working life parameters. A total of 16 studies were included. No studies on sustainable working life parameters were found. The quality of the studies was assessed using a checklist; eight field studies and three laboratory studies of sufficient quality were used to summarise the following evidence: one field study showed positive results and one field study showed negative results for musculoskeletal complaints, two field studies showed positive results and two field studies showed inconsistent results for exposures, and two field studies showed inconsistent results for musculoskeletal complaints and exposures. Two laboratory studies showed inconsistent results and one laboratory study showed no changes for exposures. In conclusion, there is currently inconsistent evidence for positive or negative effects of job rotation on musculoskeletal complaints and exposures related to musculoskeletal complaints. Practitioners Summary: Currently, there is inconsistent evidence for recommending job rotation as a strategy for preventing musculoskeletal complaints. Exposures from all involved work activities and body regions should be identified and assessed first, to determine if job rotation provides increased exposure variation and/or beneficial changes in mean exposures related to musculoskeletal complaints.

Psychosocial work environment and mental health among construction workers.

We assessed psychosocial work environment, the prevalence of mental health complaints and the association between these two among bricklayers and construction supervisors. For this cross-sectional study a total of 1500 bricklayers and supervisors were selected. Psychosocial work characteristics were measured using the Dutch Questionnaire on the Experience and Evaluation of Work and compared to the general Dutch working population. Mental health effects were measured with scales to assess fatigue during work, need for recovery after work, symptoms of distress, depression and post-traumatic stress disorder. The prevalence of self-reported mental health complaints was determined using the cut-off values. Associations between psychosocial work characteristics and self-reported mental health complaints were analysed using logistic regression. Total response rate was 43%. Compared to the general working population, bricklayers experienced statistically significant worse job control, learning opportunities and future perspectives; supervisors experienced statistically significant higher psychological demands and need for recovery. Prevalence of self-reported mental health effects among bricklayers and supervisors, respectively, were as follows: high need for recovery after work (14%; 25%), distress (5%, 7%), depression (18%, 20%) and post-traumatic stress disorder (11%, 7%). Among both occupations, high work speed and quantity were associated with symptoms of depression. Further, among construction supervisors, low participation in decision making and low social support of the direct supervisor was associated with symptoms of depression. The findings in the present study indicate psychosocial risk factors for bricklayers and supervisors. In each occupation a considerable proportion of workers was positively screened for symptoms of common mental disorders.

Improving occupational health care for construction workers: a process evaluation

BackgroundTo evaluate the process of a job-specific workers’ health surveillance (WHS) in improving occupational health care for construction workers.MethodsFrom January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received.ResultsReach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation.ConclusionsProgramme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect to the intervention were the most prominent aspects that influenced the intervention process. The increase in the workers’ knowledge about their health status and work ability was substantial, and the workers’ satisfaction with the intervention was good. The perceived effect of the advised preventive actions on health status was sufficient.Trial registrationNetherlands Trial Register: NTR3012

Improving the assessment of occupational diseases by occupational physicians

BACKGROUND The prevention of occupational diseases is limited by a lack of insight into occupational exposure to risk. We developed a six-step approach to improve the diagnosis and reporting of occupational diseases and the selection of subsequent preventive actions by occupational physicians (OPs). AIMS To evaluate the effect of the six-step approach on the transparency and quality of assessing occupational diseases and the usability of the six-step approach according to OPs and their satisfaction with it. METHODS A randomized controlled trial. OPs in the control group used the standard information available. OPs in the intervention group used the six-step approach and accompanying educational materials. The actions and decisions of OPs in both groups were analysed using 17 performance indicators. To address the second issue, OPs used the six-step approach over 6 weeks and rated its usability and their satisfaction in relation to several aspects. RESULTS The average score of the OPs in the intervention group (n = 110) was statistically significantly higher (11/17 performance indicators, 62% of the maximum score) than that of the OPs in the control group (n = 120, 5/17 performance indicators, 30% of the maximum score, P < 0.001). The usability aspects of the six-step approach had mean scores of 7 and 8. Mean satisfaction with the six-step approach was 8. CONCLUSIONS The six-step approach resulted in better evidence-based and transparent decision-making about occupational diseases by OPs. Usability and satisfaction were rated as satisfactory by the OPs.

Within-person fluctuations in wellbeing and task-specific work ability

PurposeTo research within-person fluctuations in occupational health, work ability and wellbeing, we need new measurement strategies. We studied absolute agreement for weekly measurements of task-specific work ability and relationships between wellbeing, work demands and personal factors and task-specific work ability over time.MethodsForty-eight Dutch academic researchers answered questions during 12 consecutive weeks. Physical and mental work demands, indicators of wellbeing and task-specific work ability in each week were measured. Intra-class correlation coefficients (ICC) for absolute agreement between task-specific work ability measures were calculated. For application in individual workers, an ICC > 0.90 was regarded as suitable. Multilevel models were used to relate both time-invariant and time-varying predictors to task-specific work ability.ResultsMultiple measurements increased the reliability. Absolute agreement, however, did not reach the optimal level, except for the task ‘ability to conduct data analyses’ which had an ICC value of 0.95 (95% CI 0.91–0.98). Individuals’ leisure time physical activity (p = 0.03) and relational (p = 0.02) and social (p = 0.02) wellbeing were related to their average task-specific work ability. Weekly physical demands (p = 0.01) and personal (p = 0.04) and general wellbeing (p = 0.03) were related to weekly fluctuations in work ability.ConclusionsWe demonstrated intra-individual variability in repeated assessments of task-specific work ability, pointing to the need for multiple measurements when characterizing work ability. The finding that some time-invariant and time-varying predictors can be related to the estimate of aspects of task-specific work ability and its fluctuations is helpful in understanding the dynamics of this concept.

Het PreventieConsult Cardiometabool Risico. iets voor de bedrijfsarts

SamenvattingDe prevalentie van cardiometabole aandoeningen, zoals hart- en vaatziekten, diabetes mellitus en chronische nierinsufficiëntie in de algemene populatie neemt toe.

Stap 6: preventie van beroepsziekten

SamenvattingBeroepsziekten zijn vermijdbare aandoeningen door mogelijkheden voor preventieve maatregelen gericht op de werkplek én op de persoon. Een beroepsziekte is een klinisch waarneembare aandoening die in hoofdzaak door het werk wordt veroorzaakt. De oorzaak kan het werk zelf zijn (inhoudelijk), de werkomstandigheden of door de wijze waarop het werk wordt uitgevoerd.