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Larsen, Louise B.
(författare)
Factors related to musculoskeletal disorders in Swedish police
2018
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background: Police working in active duty are subject to occupation-specific exposures in the workplace which could place them at an increased risk of developing musculoskeletal disorders. These exposures include the requirement to wear a duty belt and body armour as well as sitting for long periods in fleet vehicles. It is well recognised that the development of musculoskeletal disorders is multifactorial and that both physical and psychosocial workplace factors must be considered when addressing this issue.Aim: The overall aim of this thesis was to increase knowledge related to musculoskeletal disorders in Swedish police by exploring the prevalence of pain and its relationship to physical and psychosocial factors in the work environment.Methods: Studies included in this thesis were conducted using different quantitative methods. Studies I and II were based on data from a self-administered online survey, distributed to all police officers working in active duty. Descriptive statistics and regression analyses were used to document the prevalence of musculoskeletal pain and the effects of exposure variables (physical and psychosocial) and covariates on multi-site pain. Study III was conducted using a three-dimensional gait analysis system incorporating two force plates to explore the effect of different load carriage systems on kinematic and kinetic variables. Study IV included the same three conditions as in Study III but investigated sitting postures and comfort. A pressure mat was utilised to determine contact pressure and contact area while sitting in and driving police vehicles while a survey was used to measure experienced discomfort related to the vehicle seat. Non-parametric statistical tests were used to investigate differences between load carriage conditions in Studies III and IV.Results: The results of this thesis revealed that the most frequently reported musculoskeletal disorder among Swedish police working in active duty was lower back pain (43.2%) and that multi-site musculoskeletal pain (41.3%) was twice as prevalent as single-site pain (19.7 The physical workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting discomfort experienced from wearing duty belts (OR 5.42 (95% CI 4.56 – 6.43)). The psychosocial workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting high-strain jobs (OR 1.84 (95% CI 1.51 – 2.24)). Wearing body armour, or body armour combined with a load-bearing vest, resulted in less rotation of the trunk when compared to not wearing any equipment. Wearing a thigh holster and load-bearing vest allowed for a greater range of rotation in the right hip compared to the standard load-bearing condition, which incorporated a belt-mounted hip holster. Kinetics of the ankle joints were greater for both load carriage conditions compared to the control condition. Discomfort ratings revealed a clear preference for the alternate load-carriage condition. The lower back was found to be the body region with most experienced discomfort (30.5; IQR 11 - 42 mm). Pressure data demonstrated that wearing a thigh holster and load-bearing vest resulted in less pressure in the lower back when compared to the standard load carriage condition. At the same time, contact pressure in the upper back increased followed by a decrease in contact area.Conclusion: Musculoskeletal pain is a considerable problem among Swedish police with lower back pain being the most frequently reported pain site. Multi-site musculoskeletal pain was found to be more common than single-site pain and both physical and psychosocial factors were associated to multi-site musculoskeletal pain. Of the exposures studied in this thesis, duty belts and high strain jobs were found to have the greatest association to musculoskeletal pain. The use of load-bearing vest and thigh holster were found to affect levels of discomfort, especially while driving. Also, range of motion in the trunk and right hip was affected by wearing mandatory equipment.
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Occupational Physiology
2012
Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt) abstract
In a clear and accessible presentation, Occupational Physiology focuses on important issues in the modern working life. Exploring major public health problems such as musculoskeletal disorders and stress, this book explains connections between work, well-being, and health based on up-to-date research in the field. It provides useful methods for risk assessments and guidelines on arranging a good working life from the perspective of the working individual, the company, and society as a whole.The book focuses on common, stressful situations in different professions in work life. Reviewing bodily demands and reactions in eight selected common but contrasting job types, the book explains relevant physiology in a novel way. Rather than being structured according to organs in the body, the book accepts the complex physiology of typical jobs and uses this as an entry. In addition to physiological facts, the book discusses risk factors for disorders and gives ideas on how to organize and design work and tasks so as to optimize health, work ability, and productivity.Although many books cover physiology, they are based on a traditional anatomical structure (e.g., addressing the physiology of the cardiovascular system, the gastrointestinal system, and so forth) and require readers to synthesize this knowledge into real-life complex applications. Occupational Physiology is, instead, structured around a number of typical jobs and explains their physiology, as complex as they may be. This approach, while still presenting the physiology needed to understand occupational life, demonstrates how to use this information in situations encountered in practice.
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Tengelin, Ellinor, 1982-
(författare)
Creating proactive boundary awareness - Observations and feedback on lowerlevel health care managers’ time commitments and stress
2012
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Aim. The aim of this thesis was to deepen the knowledge concerning health care managers’ everyday work experiences and their handling of stress and balance.Background. Health care managers’ work is characterized by daily hassles, conflicting perspectives, and unclear boundary setting. They could therefore use support in boundary and stress management.Methods. A qualitatively driven mixed methods approach was used. Qualitative interviews, focus groups and workplace observations were used for data collection in Study I. Physiological stress indicators, stress self-assessments, workplace observations and interviewing were used in Study II. Analyses were mainly carried out on the interview data, using grounded theory methodology (Study I) and conventional content analysis (Study II).Results. Paper I shows that a first step in managers’ boundary setting is to recognize areas at work with conflicting expectations and inexhaustible needs. Strategies can then be formed through proactive, continuous negotiating of their time commitments. These strategies, termed ‘boundary approaches’, are more or less strict regarding the boundary setting at work. Paper II shows that nonnormative, interactive feedback sessions could encourage understanding and meaningfulness of previous stress experiences through a two-step appraisal process. In the first appraisal in the study, feedback was spontaneously reacted on, while in phase two it was made sensible and given meaning. However, during the sessions, some obstacles appeared to managers’ learning about their stress, preventing a second appraisal of the feedback.Conclusions. Awareness and continuous negotiation regarding boundary dilemmas can be effective as a proactive stress management tool among managers. Further, non-normative feedback on stress indicators may initiate key 3 processes of sensemaking which can aid managers’ stress management by increasing awareness and supporting learning about their stress. Proactive boundary awareness is a concept leading to better understanding of lower-level managers’ management of their time commitments and stress, which can be supported by continuous reflection, feedback situations and a supportive context.
