S. van den Heuvel

Psychosocial work characteristics in relation to neck and upper limb symptoms

&NA; The aim of this study was to investigate the relationship between psychosocial work characteristics and neck and upper limb symptoms and to examine to what extent this relationship could be explained by other risk factors. Data were used from a prospective cohort study in a working population, with a follow‐up period of 3 years. The 3‐year cumulative incidence rates of neck or upper limb symptoms, neck/shoulder symptoms and elbow/wrist/hand symptoms were 32, 24 and 15%, respectively. After adjustment for potential confounders high job demands was identified as a risk factor for neck/shoulder symptoms (RR: 2.1; CI: 1.2–3.6) and elbow/wrist/hand symptoms (RR: 1.9; CI: 1.0–3.7), and low social support of co‐workers was identified as a risk factor for elbow/wrist/hand symptoms (RR: 2.2; CI: 1.0–4.9). Partly, but not exclusively, these relationships were intermediated by an increased exposure to physical risk factors and increased stress symptoms. Personal characteristics did not considerably influence the main effects of the identified risk factors.

Dose–response relation between physical activity and sick leave

Objective: To investigate the dose–response relation between moderate and vigorous physical activity and sick leave in a working population. Methods: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one prospective cohort study. A distinction was made between duration, frequency and intensity of physical activity. The outcome measure was the number of days of sick leave. Analyses of variance were used to compare sick leave (in days) for workers with different amounts of physical activity, in particular workers meeting the physical activity recommendations v those who did not. Linear and logistic regression analyses were used to obtain effect estimates in the prospective cohort study, with the generalised estimating equation (GEE) method. Results: No relation was found between moderate physical activity and sick leave. In two databases, workers meeting the recommendation of vigorous physical activity (active at a vigorous level for at least three times a week) had significantly less sick leave: more than one day over two months and more than four days over a year. The duration of vigorous physical activity was not associated with sick leave. Conclusion: Physical activity at a vigorous intensity level for at least three times a week, as in the CDC/ACSM recommendation, has a positive effect on sick leave.

The influence of chronic health problems on work ability and productivity at work: a longitudinal study among older employees

OBJECTIVES This study aimed to assess the influence of chronic health problems on work ability and productivity at work among older employees using different methodological approaches in the analysis of longitudinal studies. METHODS Data from employees, aged 45-64, of the longitudinal Study on Transitions in Employment, Ability and Motivation was used (N=8411). Using three annual online questionnaires, we assessed the presence of seven chronic health problems, work ability (scale 0-10), and productivity at work (scale 0-10). Three linear regression generalized estimating equations were used. The time-lag model analyzed the relation of health problems with work ability and productivity at work after one year; the autoregressive model adjusted for work ability and productivity in the preceding year; and the third model assessed the relation of incidence and recovery with changes in work ability and productivity at work within the same year. RESULTS Workers with health problems had lower work ability at one-year follow-up than workers without these health problems, varying from a 2.0% reduction with diabetes mellitus to a 9.5% reduction with psychological health problems relative to the overall mean (time-lag). Work ability of persons with health problems decreased slightly more during one-year follow-up than that of persons without these health problems, ranging from 1.4% with circulatory to 5.9% with psychological health problems (autoregressive). Incidence related to larger decreases in work ability, from 0.6% with diabetes mellitus to 19.0% with psychological health problems, than recovery related to changes in work ability, from a 1.8% decrease with circulatory to an 8.5% increase with psychological health problems (incidence-recovery). Only workers with musculoskeletal and psychological health problems had lower productivity at work at one-year follow-up than workers without those health problems (1.2% and 5.6%, respectively, time-lag). CONCLUSIONS All methodological approaches indicated that chronic health problems were associated with decreased work ability and, to a much lesser extent, lower productivity at work. The choice for a particular methodological approach considerably influenced the strength of the associations, with the incidence of health problems resulting in the largest decreases in work ability and productivity at work.

Study on Transitions in Employment, Ability and Motivation (STREAM): The Design of a Four-year Longitudinal Cohort Study among 15,118 Persons Aged 45 to 64 Years

The objective of the Study on Transitions in Employment, Ability and Motivation (STREAM) is to acquire knowledge on determinants of transitions in employment and work productivity among persons aged 45-64 years. Research Framework: A research framework was developed, in which transitions in employment (e.g. leaving the workforce, entering the workforce, job change) and work productivity are influenced by the following determinants: health, job characteristics, skills and knowledge, social factors, and financial factors. Central explanatory variables in the framework are the ability to work, the motivation to work, and the opportunity to work. Study Design: STREAM is a prospective cohort study among 12,055 employees, 1,029 self-employed persons, and 2,034 non-working persons, all aged 45 to 64 years at baseline. The study sample was stratified by age and employment status (employed, self-employed, non-working), and was drawn from an existing internet panel. The baseline measurement was carried out in 2010 (response: 70%), and with yearly follow-up measurements in 2011 (response: 82%), 2012 (response: 80%), and 2013. At each wave, participants fill out an online questionnaire covering all aspects of the research framework. Place and Duration of Study: The Netherlands, between October 2010 and December 2013. Methodology: Quantitative data on all aspects of the research framework were assessed with an online questionnaire, qualitative data were assessed with interview studies, and the questionnaire data can be linked to register data at Statistics Netherlands for 89% of the participants. Results: Transitions in employment between the first three waves of data among the participants are described. Conclusion: STREAM will provide insight in the determinants of healthy and productive labour participation among persons aged 45 years and older, which will support the development of interventions prolonging working life in good health, while maintaining good work productivity.

Differential Effects of Mental and Physical Health and Coping Style on Work Ability: A 1-Year Follow-Up Study among Aging Workers

Objective: This study examines whether mental and physical health relate differently to work ability and whether these associations vary with coping style. Methods: A 1-year longitudinal study was conducted among 8842 employees aged 45 to 64 years from the Study on Transitions in Employment, Ability and Motivation. On-line questionnaires measured self-perceived mental and physical health at baseline and coping and work ability at follow-up. The data were analyzed using hierarchical regression analysis. Results: Active coping and good mental and especially physical health predicted high work ability at follow-up. Avoidant coping was negatively related to work ability. Seeking support was unrelated to work ability. Interaction effects of coping and health on work ability were weak. Conclusions: Successful coping styles and good health predict high work ability, and thus, promoting such factors can help improve sustainable employability.

Towards exposure limits for working postures and musculoskeletal symptoms - a prospective cohort study

Abstract Occupational postures are considered to be an important group of risk factors for musculoskeletal pain. However, the exposure-outcome association is not clear yet. Therefore, we aimed to determine the exposure-outcome association of working postures and musculoskeletal symptoms. Also, we aimed to establish exposure limits for working postures. In a prospective cohort study among 789 workers, intensity, frequency and duration of postures were assessed at baseline using observations. Musculoskeletal pain was assessed cross-sectionally and longitudinally and associations of postures and pain were addressed using logistic regression analyses. Cut-off points were estimated based on ROC-curve analyses. Associations were found for kneeling/crouching and low-back pain, neck flexion and rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain. The results provide insight into exposure-outcome relations between working postures and musculoskeletal symptoms as well as evidence-based working posture exposure limits that can be used in future guidelines and risk assessment tools. Practitioner Summary: Our study gives insight into exposure-outcome associations of working postures and musculoskeletal symptoms (kneeling/crouching and low-back pain, neck flexion/rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain). Results furthermore deliver evidence-based postural exposure limits that can be used in guidelines and risk assessments.

Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

OBJECTIVES Epidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In this study, we aimed to relate periods of high peak exposure during computer use with the occurrence of neck-shoulder (NS) and arm-wrist-hand (AWH) symptoms. METHODS A prospective cohort study among 1951 office workers was carried out for two years, with periodical questionnaires and continuous measurements of computer input use. To define peak exposure, a distinction was made between peak days and weeks. Peak days were defined as days with a long duration of computer (ie, ≥4 hours) or mouse use (ie, ≥2.5 hours) or days with high frequency of mouse (ie, ≥20 clicks per minute) or keyboard use (ie, ≥160 keystrokes per minute). Weeks containing ≥3 peak days were considered peak weeks. Independent variables were numbers of peak days and peak weeks during a 3-month measurement period; dependent variables were self-reported NS and AWH symptoms during the following 3-month measurement period. RESULTS Valid data were available for 2116 measurements of 774 office workers. No relation was found between any of the peak exposure parameters and AWH symptoms or with peak exposure in duration and NS symptoms. Most parameters referring to high frequency-related peak exposure were associated with less NS symptoms, but the effect estimates were very small and the confidence intervals close to the null. CONCLUSION In this study, we found no indication that high peaks in computer use were related to the occurrence of NS or AWH symptoms.

Effects of Cued Micro-Breaks on Self-Reported Severity and Recovery of Upper Limb Disorders in Computer Operators

Software programs cueing computer workers to apply regular breaks and physical exercises may help in reducing work-related upper limb disorders. The effects of such a program was investigated among 268 computer workers with upper limb disorders, who were randomised into a control group, a group cued to take extra breaks and a group cued to perform exercises during the extra breaks. A comparison between pre- and post-intervention scores on the severity of the complaints showed no significant differences among the three groups. However, data on the self-reported recovery, obtained after the intervention, showed that, as compared to the controls, more subjects in the experimental groups reported recovery (55% vs. 34%) and less reported deterioration (4% vs. 20%). Hence, people who are cued to take extra breaks, perceive more recovery, although the effect on the severity level of the complaint was not detected. No effect was found of the physical exercises.Software programs cueing computer workers to apply regular breaks and physical exercises may help in reducing work-related upper limb disorders. The effects of such a program was investigated among 268 computer workers with upper limb disorders, who were randomised into a control group, a group cued to take extra breaks and a group cued to perform exercises during the extra breaks. A comparison between pre- and post-intervention scores on the severity of the complaints showed no significant differences among the three groups. However, data on the self-reported recovery, obtained after the intervention, showed that, as compared to the controls, more subjects in the experimental groups reported recovery (55% vs. 34%) and less reported deterioration (4% vs. 20%). Hence, people who are cued to take extra breaks, perceive more recovery, although the effect on the severity level of the complaint was not detected. No effect was found of the physical exercises.

Monitoring van RSI via vragenlijstonderzoek

SamenvattingIn onderzoeken onder werknemers worden regelmatig vragen opgenomen om RSI-klachten te monitoren. Daarbij is het van belang om ernstige klachten van milde klachten te kunnen onderscheiden. In de praktijk worden verschillende methodes gebruikt om de ernst in kaart te brengen. Vaak wordt hiervoor naar de frequentie van de klachten gevraagd. In de Monitor Arboconvenanten en de NEA wordt een schaal gebruikt die het aantal symptomen meet in combinatie met de frequentie waarin deze voorkomen. In deze analyse wordt onderzocht welke methode het beste in staat is om ernstige klachten van milde klachten te onderscheiden: de frequentie van symptomen, het aantal symptomen, of de combinatie van beide. De conclusie is dat alle onderzochte meetmethodes in redelijke mate in staat zijn om milde van ernstige klachten te onderscheiden op groepsniveau. De RSI-module die het aantal symptomen met de frequentie daarvan combineert heeft een sensitiviteit van 71% en een specificiteit van 69% bij een afkappunt van 7 op een schaal van 1 tot 36.