| 1. |
- Arvidsson, Inger, et al.
(författare)
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Betydelsen av fysiska och psykosociala riskfaktorer för sjukdom/besvär i muskler och leder - En uppföljningsstudie av kvinnor inom vård och skola
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vi har upprättat en kohort med 1591 kvinnor från fem vanliga yrken: Operationssköterskor (Op), anestesisköterskor (Ane), undersköterskor på operation (Usk), biomedicinska analytiker som gör ultraljudsundersökningar (BMA) samt lärarinnor (Lär). Enkät har skickats ut vid baseline och i genomsnitt ca 28 månader därefter. Data från uppföljningen är inte analyserade ännu, varför rapporten enbart omfattar resultat från baseline. Fallen definierades baserat på kombinationen av frekvens och intensitet av rapporterade besvär. Samband mellan smärttillstånd och arbetsbelastning, individ- och livsstilsfaktorer analyserades med multivariat analys, backward proceedure. Samband påvisades för nacken med högt mekaniskt index, lågt fysiskt index, missnöje med datorarbetsplatsens utformning, höga krav, låg kontroll, höga känslomässiga krav, låga sensoriska krav samt låg ålder. axlarna med högt mekaniskt index, missnöjd med datorarbetsplatsens utformning, krav och lite egen tid för återhämtning. handleder/händer med högt mekaniskt index, höga krav, låg kontroll, hög ålder, högt BMI och inga/få hemmavarande barn. ländryggen med högt mekaniskt index, höga krav, låg kontroll, låga sensoriska krav, hög ålder, högt BMI och lite egen tid för återhämtning. fötterna med högt BMI, högt fysiskt index, hög ålder, höga krav, inga eller få hemmavarande barn samt låg kontroll. De ergonomiska problem som framkommit vid intervjuerna av operationspersonal har presenterats för studenter på Lunds tekniska högskola. Ett särskilt problem avsåg de statiska, obekväma och ansträngande arbetsställningarna som uppkom då operationssjuksköterskorna assisterade under operationer. Med hjälp av en operationhake höll de isär såret under operationen. Haken har ett grepp som tvingar Op till ett böjt och icke funktionellt handgrepp. Studenterna tog fram prototyp för en hållare till haken, som ger möjlighet till en mer ergonomisk handledsställning, samt att byta hand vid behov under operationen. Hållaren till haken utvärderas f n på två operationsavdelningar.
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| 2. |
- Arvidsson, Inger, et al.
(författare)
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Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers.
- 2016
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- It is usually assumed that musculoskeletal pain is associated with both the physical workload and the psychosocial work environment, as well as with personal and lifestyle factors. This study aims to ascertain the prevalence of musculoskeletal pain in women with varying or different occupational exposures, and to explore the associations between musculoskeletal pain and the occupational and personal factors.
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| 3. |
- Dahlqvist, Camilla, et al.
(författare)
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Arbetsbelastning vid städning av hotellrum
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Enligt Arbetsmiljöverkets rapport ”Arbetsmiljön 2013” har 40 procent av alla hotell- och kontorsstädare ont i nacke, rygg, axlar eller armar varje vecka. 60 procent av dem känner sig uttröttade i kroppen. Arbets- och miljömedicin (AMM) Syd har tagit fram åtgärdsnivåer för ett antal belastningsmått, ”AMM Syds åtgärdsnivåer för ergonomisk belastning”, och om man överstiger dessa, anser vi att risken för belastningsskada är stor. Vi har studerat hotellrumsstädares belastning och jämfört med våra åtgärdsnivåer.Vi mätte den fysiska arbetsbelastningen hos fjorton kvinnliga hotellrumsstädare under en vanlig arbetsdag, på en deltagare åt gången. De arbetade på sju olika hotell i södra Sverige. Några var anställda av städföretag och några direkt av hotellen.Vi fann att hotellrumsstädare har en väldigt hög arbetsbelastning i övre delen av kroppen, både vad gäller rörelsehastighet, arbetsställningar och muskelansträngning (se Tabell på sid 3). Samtliga deltagare hade för hög rörelsehastighet i överarm och handled och för lite vila i underarmens muskler i jämförelse med våra åtgärdsnivåer. Även vad gäller framåtböjningen av huvudet, överarmens arbetsställning och underarmens muskelbelastning fann vi för höga nivåer. Hotellrumsstädning överskrider nio av våra elva åtgärdsnivåer för ergonomisk belastning. Detta betyder att hotellrumsstädare har en väldigt hög risk att drabbas av belastningsskador.RekommendationerFör att minska risken för belastningsskador bland hotellrumsstädare måste arbetstempot sänkas, genom att minska antalet rum som ingår i en hotellrumsstädares arbetsdag.Personalen bör erbjudas regelbundna medicinska kontroller avseende ergonomiskt belastande arbete så att man tidigt sätter in åtgärder för den arbetstagare eller grupp av arbetstagare som är på väg att utveckla skada i muskler och/eller leder. Arbetsplatsen rekommenderas att ha företagshälsovård knuten till sig, som kan genomföra de medicinska kontrollerna och som kontinuerligt gör riskbedömningar av arbetet. De bör också ha som uppgift att utbilda städpersonalen i ergonomi.
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| 4. |
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| 5. |
- Dahlqvist, Camilla, et al.
(författare)
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Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity : refining risk assessments for work-related wrist disorders
- 2018
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Ingår i: Work. - : IOS Press. - 1051-9815. ; 59:2, s. 231-242
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Tidskriftsartikel (refereegranskat)abstract
- Background: Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable.Objective: To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning.Methods: Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions.Results: The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip.Conclusions: The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.
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| 6. |
- Dahlqvist, Camilla
(författare)
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Improving technical methods for assessment of workplace ergonomic exposure
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Repetitive work, work performed in awkward and constrained postures and work with excessive or sustained muscular load is common in many occupational settings. Such work is known to be risk factors for developing musculoskeletal disorders in the neck/shoulder region and in arms and hands. One method that can be used to assess the exposure to these risk factors is technical recordings that rely on sensors attached directly to a subject. However, there is a commonly held belief that the methods are time consuming, require expensive equipment and also demand technical knowledge to perform and are therefore not suitable for all. Aims: To simplify the inclinometry method in order to make it easier to use for different actors in the work environment field, and to refine the surface electromyography (sEMG) method of the forearm extensor muscles for more accurate estimates of recorded muscular load. Methods: For the inclinometry method in the laboratory, one model of the new generation of triaxial accelerometers with integrated data loggers (GC inclinometer) were validated against traditional ones (LT inclinometer). Also the deviation angles of two simplified reference postures for upper arms from a standard reference posture were evaluated. For the field study, self-recordings of upper arm elevations were evaluated by analysing each recording twice; once with a simplified reference posture and once with a standard reference posture. For the sEMG method in the laboratory, the electrical activity of right forearm extensor muscles was recorded from four electrode pair positions during two maximal voluntary contractions (MVC; hand grip and resisted wrist extension). In the field study, the electrical activity was recorded using two electrode pair positions and the two MVCs during one working day of hotel room cleaning. Each recording was analysed twice; once with hand grip as reference contraction and once with resisted wrist extension as reference. Results: For the inclinometry method in the laboratory, all group mean absolute differences of simulated work tasks and body parts between the two inclinometers were less than 2.5°. In the field study, the upper arm elevations during work (50th percentile) were almost identical (group mean difference of 0.2°) for the two analyses using different reference postures. For sEMG in the laboratory, resisted wrist extension showed 1.2 – 1.7 times higher EMG amplitudes and lower coefficient of variation than hand grip. In the field study, the workload during cleaning was lower when using resisted wrist extension as the reference than when using hand grip. The workload (99th percentile) was overestimated in two subjects when hand grip was used as reference contraction. Conclusions: For the inclinometry method, the obtained data from the GC inclinometers were fully comparable to the data from the LT inclinometers. The simplified reference posture deviated somewhat from the standard reference, but the effect of this deviation on group recordings of work was negligible. The hotel room cleaners managed to perform self-recordings of upper arm elevations and velocities. For the sEMG, the use of resisted wrist extension may be a more accurate maximal effort of forearm extensor contraction than using hand grip. Problems associated with poorly activated forearm extensors can be overcome by using resisted wrist extension as reference.
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| 7. |
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| 8. |
- Dahlqvist, Camilla, et al.
(författare)
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Self-recordings of upper arm elevation during cleaning - comparison between analyses using a simplified reference posture and a standard reference posture
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : BMC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background To reduce ergonomic risk factors in terms of awkward and constrained postures and high velocities, it is important to perform adequate risk assessments. Technical methods provide objective measures of physical workload. These methods have so far mainly been used by researchers. However, if written instructions how to apply the sensors and how to adopt the reference posture are provided, together with triaxial accelerometers, it may be possible for employees to record their own physical workload. The exposure in terms of e.g. upper arm elevations could then easily be assessed for all workers in a workplace. The main aims of this study were: 1) to compare analyses for self-recording of upper arm elevation during work using a simplified reference posture versus using a standard reference posture, and 2) to compare the two reference postures.MethodsTwenty-eight cleaners attached an accelerometer to their dominant upper arm and adopted a simplified reference according to a written instruction. They were thereafter instructed by a researcher to adopt a standard reference. Upper arm elevations were recorded for 2 or 3 days. Each recording was analysed twice; relative to the simplified reference posture and relative to the standard reference posture. The group means of the differences in recorded upper arm elevations between simplified and standard reference analyses were assessed using Wilcoxon signed ranks test. Furthermore, we calculated the group mean of the differences between the simplified reference posture and the standard reference posture.ResultsFor arm elevation during work (50(th) percentile), the group mean of the differences between the two analyses was 0.2 degrees (range-7 - 10 degrees). The group mean of the differences between the two references was 9 degrees (range 1-21 degrees). The subjects were able to follow the instructions in the protocol and performed self-recording of upper arm elevation and velocity.ConclusionsThe small difference between the two analyses indicates that recordings performed by employees themselves are comparable, on a group level, with those performed by researchers. Self-recordings in combination with action levels would provide employers with a method for risk assessment as a solid basis for prevention of work-related musculoskeletal disorders.
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| 9. |
- Dahlqvist, Camilla, et al.
(författare)
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Validity of a small low-cost triaxial accelerometer with integrated logger for uncomplicated measurements of postures and movements of head, upper back and upper arms
- 2016
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 55, s. 108-116
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Tidskriftsartikel (refereegranskat)abstract
- Repetitive work and work in constrained postures are risk factors for developing musculoskeletal disorders. Low-cost, user-friendly technical methods to quantify these risks are needed. The aims were to validate inclination angles and velocities of one model of the new generation of accelerometers with integrated data loggers against a previously validated one, and to compare meaurements when using a plain reference posture with that of a standardized one. All mean (n = 12 subjects) angular RMS-differences in 4 work tasks and 4 body parts were <2.5° and all mean median angular velocity differences <5.0 °/s. The mean correlation between the inclination signal-pairs was 0.996. This model of the new generation of triaxial accelerometers proved to be comparable to the validated accelerometer using a data logger. This makes it well-suited, for both researchers and practitioners, to measure postures and movements during work. Further work is needed for validation of the plain reference posture for upper arms.
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| 10. |
- Dahlqvist, Per, et al.
(författare)
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Pseudoacromegaly : A Differential Diagnostic Problem for Acromegaly With a Genetic Solution
- 2017
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Ingår i: Journal of the Endocrine Society. - : The Endocrine Society. - 2472-1972. ; 1:8, s. 1104-1109
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Tidskriftsartikel (refereegranskat)abstract
- Acromegaly is usually not a difficult condition to diagnose once the possibility of this disease has been raised. However, a few conditions present with some aspects of acromegaly or gigantism but without growth hormone (GH) excess. Such cases are described as "pseudoacromegaly" or "acromegaloidism". Here we describe a female patient investigated for GH excess at 10 years of age for tall stature since infancy (height and weight > +3 standard deviations) and typical acromegalic features, including large hands/feet, large jaw, tongue, hoarse deep voice, and headache. Results of radiography of the sella turcica and GH response at an oral glucose tolerance test and insulin-arginine- thyrotrophin-luteinizing hormone-releasing hormone test were normal. Ethinylestradiol and medroxyprogesterone were given for 2 years; this successfully stopped further height increase. Although the patient's growth rate plateaued, coarsening of the facial features and acral enlargement also led to investigations for suspicion of acromegaly at 23 and 36 years of age, both with negative results. On referral at the age of 49 years, she had weight gain, sweating, sleep apnea, headaches, joint pain, and enlarged tongue. Endocrine assessment again showing normal GH axis was followed by genetic testing with a macrocephaly/overgrowth syndrome panel. A denovo mutation in the NSD1 gene (c.6605G>C; p.Cys2202Ser) was demonstrated. Mutations affecting the same cysteine residue have been identified in patients with Sotos syndrome. In summary, Sotos syndrome and other overgrowth syndromes can mimic the clinical manifestations of acromegaly or gigantism. Genetic assessment could be helpful in these cases.
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