| 1. |
- Bergsten, Eva L
(author)
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Working conditions and musculoskeletal disorders in flight baggage handling
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Introduction: Baggage handling is considered to be a heavy manual handling job including biomechanical exposures suspected of increasing the risk for musculoskeletal disorders. Aims: To document low back pain (LBP), shoulder pain (SP), and physical and psychosocial factors in baggage handlers, and to evaluate the implementation of an ergonomic intervention aiming to increase the use of loading assist devices. Methods: A questionnaire was utilized to characterize pain and psychosocial work conditions in 525 baggage handlers. The postures of 55 baggage handlers during 114 shifts were measured using inclinometry, half shift video-recordings were made for subsequent task analysis, and the number of aircraft handled was registered. Associations for psychosocial and biomechanical exposures with pain were assessed using regression analyses. An ergonomic intervention was implemented and evaluated using questionnaires and repeated interviews. Feasibility, intermediate outcomes, barriers and facilitators were assessed. Results: The prevalence rates of reported LBP and SP were 70% and 60%, respectively. Pain interfering with work (LBP - 30% and SP - 18%) and high pain intensity (LBP - 34% and SP - 28%) were associated with poor psychosocial working conditions. Extreme postures with arms elevated >60° occurred for 6.4% of the total time, and in trunk flexion >60° for 2.1% total time. In contrast, 71% of the total time was spent in a neutral trunk posture. The 90th percentile trunk forward flexion was 34.1°. Daily shoulder pain increased in approximately one-third of all shifts and was positively associated with extreme work posture and the number of aircraft handled; this association was modified by influence and support. The intervention was delivered as planned, and dose received and satisfaction were rated as high. Motivated trainees facilitated implementation while lack of manager support, opportunities to observe and practice behaviors, follow-up activities, staff reduction, and job insecurity were barriers. Conclusion: The high prevalence rates of LBP and SP in baggage handlers were associated with psychosocial exposures, and daily shoulder pain was associated with higher biomechanical exposure. Barriers to implementation can be minimized by recruiting motivated trainees, securing strong organizational support, and carrying out follow-up activities.
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| 2. |
- Palm, Peter, 1975-
(author)
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Methods to assess physical load at work : With a focus on the neck and upper extremities
- 2017
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Doctoral thesis (other academic/artistic)abstract
- To prevent work-related musculoskeletal disorders (MSDs), useful, reliable and valid methods for assessing physical workload and risks for MSDs are needed. Ergonomists often assess work by short visual observations without a specific tool. A branch-specific tool was developed for assessing working technique during cash register work (BAsiK observation protocol).Inclinometers are an alternative for assessing upper arm postures - over several days. Ergonomists need guidelines explaining how to analyze and interpret such data.The aim was to examine and investigate methods for assessing physical load at work, with focus on the neck and upper extremities.In Paper:I, the reliability and criterion validity of the BAsIK observation protocol were assessed.II, the reliability of risk assessments of repetitive work, based on visual observations performed by 21 ergonomists without a specific tool, was assessed.III, whole-day inclinometer measurements of upper arm elevation were compared between work and leisure, across 13 different occupations – before and after arm elevations during sitting time was excluded.IV, the association between inclinometer-based upper arm elevation and neck/shoulder pain was assessed among 654 blue-collar workers. The intra-observer reliability of the BAsIK protocol was deemed acceptable, but only 3 of 10 questions in the protocol showed acceptable inter-observer reliability, and 3 showed acceptable criterion validity.Neither the inter- or intra-observer reliability of risk assessment without any specific method was acceptable for any upper body regions.None of the occupation groups, in paper III, had higher proportion of time with arm elevation during work than leisure. However, when arm elevation during sitting was excluded, 8 occupation groups had higher proportion of time with elevated arms during work than leisure.Whole-workday inclinometer-based upper arm elevation was not associated with neck/shoulder pain within the assessed population. The results indicate that, in most cases, a single visual observation of a work sequence is not a reliable means of assessing repetitive work. A large proportion of arm elevation may derive from sitting time. At low exposure levels, arm elevation per se may not be a risk factor for neck/shoulder pain.This must be taken into account when evaluating the risk for MSDs.
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| 3. |
- Seddigh, Aram, 1982-
(author)
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Office type, performance and well-being : A study of how personality and work tasks interact with contemporary office environments and ways of working
- 2015
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Doctoral thesis (other academic/artistic)abstract
- Today, many organisations are adopting offices that have an open design with or without flexible seating. While advocates of open-plan offices propose that these office types lead to cost savings and aid inter and intra-team communication, opponents argue that these office types are associated with decreased performance and worsened health among employees. This thesis investigates how the type of office (cell offices, shared room offices, small open-plan offices, medium-sized open plan offices, large open-plan offices and flex offices) influences employee health and performance, and whether this is different for different personalities and jobs with different concentration demands. Data were gathered by means of surveys and cognitive tests from five organisations with different office types. In Study I (N=1241), the aim was to investigate the main effect of office type on indicators of health and performance and the interaction effect of office type with the need to concentrate in order to carry out work tasks. Office type alone was associated with distraction and cognitive stress in such a way that cell offices were associated with fewest problems, followed by flex offices, while open-plan offices were associated with the most problems. While employees in open-plan offices and employees in flex offices reported more problems as the need for concentration increased, employees in cell offices reported the same level of problems regardless of the need of concentration. Study II (N=527) investigated how performance on a memory test was affected during normal working conditions as compared to a quiet baseline. There was a negative dose-response relationship between the size of the open-plan office environment and the drop in word recall during the normal working condition. However, Study II also showed that individuals working in cell offices had as high a drop in performance during normal working conditions as did those working in large open-plan office environments. Study III (N=1133–1171) focused on the interaction effect between office type and individual differences in personality. The personality trait agreeableness interacted with office type on the outcome variables distraction and job satisfaction. Specifically, Study III may indicate that as offices get more open and flexible, agreeable people will report more problems. In conclusion, the studies in the present thesis have implications for practice and suggest that office type impacts on employee health and performance, while concentration demands of the job and agreeableness moderate the effects. Although employees report higher level of distraction in open-plan office environments, when performance on a demanding task is measured, cell offices are not as favourable during normal working conditions as self-reported data usually indicate. Organisations should also be aware that, among open-plan offices, small open-plan offices are associated with fewer problems.
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| 4. |
- Gunnarsson, Kristina, 1947-
(author)
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Entrepreneurs and Small-Scale Enterprises : Self Reported Health, Work Conditions, Work Environment Management and Occupational Health Services
- 2010
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Doctoral thesis (other academic/artistic)abstract
- This thesis focused on factors contributing to improved work environment in small-scale enterprises and sustainable health for the entrepreneurs. In Study I, implementation of the provision of Systematic Work Environment Management (SWEM) with and without support was investigated. Two implementation methods were used, supervised and network method. The effect of the project reached the employees faster in the enterprises with the supervised method. In general, the work environment improved in all enterprises. However, extensive support to small-scale enterprises in terms of advice and networking aimed at fulfilling SWEM regulations had limited effect – especially considering the cost of applying these methods. Studies II, III, and IV focused on entrepreneurs’ health, work conditions, strategies for maintaining good health, and utilisation of Occupational Health Service (OHS). A closed cohort of entrepreneurs in ten different trades responded to two self-administered questionnaires on health and work conditions, with five years between the surveys: at baseline, 496 entrepreneurs responded, and 251 entrepreneurs responded at follow-up. Differences were tested by Chi2-test, and associations estimated with logistic regression analyses. Qualitative interviews on entrepreneurs’ strategies for maintaining good health were included. In Study II, the most frequently reported complaints, musculoskeletal pain and mental health problems, were associated with poor job satisfaction and poor physical work environment. In Study III, consistent self-reported good health, i.e. good health both at baseline and at follow up, was associated with self-valued good social life when adjusted for physical work conditions and job satisfaction. Entrepreneurs’ strategies for maintaining good health included good planning and control over work, flexibility at work, good social contact with family, friends and other entrepreneurs, and regular physical exercise. Study IV concerned entrepreneur’s utilisation of OHS. Entrepreneurs affiliated to OHS had either better or more adverse work conditions than non-affiliated entrepreneurs. Medical care and health check-ups were the services most utilised. Affiliation to OHS correlated with use of specific information sources and active work environment management. The entrepreneurs were not consistently affiliated to OHS over the five-year-period.
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| 6. |
- Helgesson, Magnus
(author)
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Unemployment and sick leave at a young age and associations with future health and work
- 2015
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Doctoral thesis (other academic/artistic)abstract
- The aim of this register-based longitudinal study was to explore the relationship between exposure to unemployment and sick leave at a young age and later health and work related outcomes. A comparison was also made between immigrants and native Swedes. The study population consisted of all immigrants, born between 1968 and 1972, and a random sample of native Swedes in the same age range. The follow-up period was 15 years, divided into three 5-year periods. Unemployment in 1992 was associated with later ≥60 days of sickness absence, disability pension and, for all subjects except native Swedish women, also mortality during follow-up. The risk of future sickness absence was about the same in all three follow-up periods. There was an increased risk of ≥100 days of unemployment in all three follow-up periods, but the risk declined, however, until the last follow-up period. Higher level of education at baseline as well as education attained between 1993 and 1997 decreased the risk of future unemployment. Participating in active labour market programmes was associated with higher risk of future unemployment. The risk of both future unemployment and future sickness absence increased with the length of unemployment in 1992. Immigrants had a higher risk of unemployment both at baseline and at follow-up compared with native Swedes, but matched the pattern of native Swedes during follow-up. Exposure to ≥60 days of sickness absence in 1993 was associated with increased risk for ≥60 days of sickness absence, ≥100 days of unemployment, disability pension and mortality during follow-up compared with no sick leave at baseline. The income from work, during the follow-up period, among individuals with spells of sick leave ≥60 days in 1993 was around two-thirds of that of individuals not on >60 days of sick leave. There was a rapid increase in future work absence for the first 1–7 days of sick leave claimed. Thereafter there was a lower, but steady increase in days of future work absence for every increase in sick leave. This of course affects the individual in the first place and to a society it means substantial costs in the form of increased welfare payments, and loss of productivity and tax income.
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| 7. |
- Helgesson, Magnus
(author)
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Unemployment at a young age and sickness absence, disability pension, death and future unemployment - A register-based study of native Swedish and immigrant young adults
- 2014
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Licentiate thesis (other academic/artistic)abstract
- Youth unemployment is an increasing burden on societies around the world. This prospective, register-based cohort study examined the relationship between unemployment and sickness absence, disability pension, death and future unemployment among youth in Sweden. A comparison was also made between immigrants and native Swedes. Another aim was to see if Active Labour Market Programs (ALMPs) and attained education moderated the outcomes. The baseline year was 1992, a year of severe economic downturn. The follow-up period was from 1993 to 2007, divided into three 5-year periods. The study group of 199,623 individuals comprised all immigrants born between 1968 and 1972 who immigrated before 1990 (25,607) and a random sample of native Swedes in the same age range (174,016). Individuals with unemployment benefit in 1990-1991, disability pension in 1990-1992 or severe disorders leading to hospitalization in 1990-1992 were excluded in order to minimize selection bias. Those who were unemployed in 1992 had elevated risk, measured as odds ratios, of ≥60 days of sickness absence, disability pension, ≥100 days of unemployment and all, except native Swedish women, had elevated risk of death during follow-up. The risk of future unemployment declined until the last follow-up period, while the elevated risk of future sickness absence was about the same in all three follow-up periods. Higher level of education at baseline decreased the risk of future unemployment. Individuals participating in ALMPs had an increased risk of future unemployment, and immigrant women had an increased risk of sickness absence, compared to non-participating individuals. Attained education between 1993 and 1997 decreased the risk of future unemployment and decreased the risk of sickness absence among immigrants. The risk of both future unemployment and future sickness absence increased with the length of unemployment in 1992. Immigrants had higher risk of unemployment both at baseline and follow-up compared with native Swedes, but followed the pattern of native Swedes when unemployed. The conclusion are that exposure to unemployment are associated with elevated risk of future unemployment, sickness absence, disability pension and death fifteen years after exposure. To a society this will mean substantial costs in the form of increased welfare payments and loss of productivity and tax income. Selection to unemployment by individuals already sick, may explain part of the association between unemployment and the studied outcomes.
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| 8. |
- Hansson, Ann-Sophie, 1949-
(author)
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Determinants of Individual and Organizational Health in Human Service Professions
- 2008
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Doctoral thesis (other academic/artistic)abstract
- The psychosocial work environment in human service organizations is in many respects rewarding from the aspect of human interaction. However, it has also been described in several research reports as demanding and stressful both physically and mentally, resulting in a negative impact on employee health and a high degree of sickness absence. From a public health perspective it is important to focus on determinants of health in occupational groups that are characterized by caring and human relations. This thesis aims at identifying determinants of individual and organizational health in human service professions from a multifactorial perspective. Based on both cross-sectional and longitudinal data, four studies of various aspects of psychosocial work exposures are carried out. Study I, an explorative and qualitative study, examines determinants of the psychosocial work environment in the Church of Sweden. Study II consists of a retrospective, randomized study assessing effects of goal clarity work on organizational well-being in the Church. Study III examines exposures resulting in stress-related sick leave among elderly care employees. Study IV is a longitudinal study that assesses effects of organizational change on health and sickness absence among elderly care employees. The results show some positive experiences, despite overall demanding work conditions within both of the studied professions. In the Church (Paper I), experiences of freedom and influence at work and the Christian values tend be factors with modifying effect on health. Four patterns are identified for negative health impact; these include unclear organization, a sense of being different, stressful work and destructive communication style. Effects of goal clarity work (Paper II) indicate an overall positive impact on organizational well-being. In elderly care (Paper III), the results suggest, in general, a positive work climate and high effectiveness. Work related exhaustion was significantly higher among employees with stress related sickness absence. Factors of risk for being absent due to stress are approximately three times higher among employees dissatisfied with both their work and their social situations. Finally, measuring effects of organizational change (Paper IV), the results reveal evidence of unchanged self-rated health (SRH), work satisfaction and work exhaustion after reorganization. However, sickness absence increased across time and there is an indication of impaired levels of the anabolic hormone DHEA-S among those individuals affected by the reorganization. The results point to a challenge for further research on the interplay between perceived stressors, resources available, biological stress markers and health in order to find adequate measures for improvements in psychosocial work environment in human service professions.
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| 9. |
- Jackson, Jennie
(author)
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Bias and Precision in Biomechanical Exposure Assessment : Making the Most of our Methods
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background: Insufficient exposure assessment is a suggested contributing factor to the current lack of clearly characterised relationships between occupational biomechanical risk factors and musculoskeletal disorders. Minimal attention has been paid to the potential bias of measurement tools from expected true values (i.e. accuracy) or between measurement tools, and empirical data on the magnitudes of variance contributed by methodological factors for measurement tool precision are lacking.Aim: The aim of this thesis was to quantify aspects of bias and precision in three commonly employed biomechanical risk factor assessment tools - inclinometry, observation, and electromyography (EMG) - and provide recommendations guiding their use. Methods: Upper arm elevation angles (UAEAs) were assessed using inclinometers (INC) and by computer-based posture-matching observation, and bias relative to true angles was calculated. Calibration models were developed for INC data, and their efficacy in correcting measurement bias was evaluated. The total variance of trapezius and erector spinae (ES) EMG recordings during cyclic occupational work was partitioned into biological and methodological sources, including the variance uniquely attributable to sub-maximal normalisation. Using algorithms to estimate the precision of a group mean, the efficacy of different trapezius EMG study designs was evaluated. Using precision criteria, the efficacy of different normalisation methods was assessed for ES EMG recordings.Results and Discussion: Inclinometer measured UAEAs were biased from true angles, with increasing bias at higher angles. In contrast, computer based posture-matching observations were not biased from true angles. Calibration models proved effective at minimizing INC data bias. The dispersion of estimates between- and within- observers at any given set angle underlined the importance of repeated observations when estimating UAEAs. For EMG, a unique but relatively small component of the total variance was attributable to the methodological process of normalisation. Performing three repeats of the trapezius EMG normalisation task proved optimal at minimizing variance for one-day EMG studies, while two repeats sufficed for multi-day EMG studies. A prone normalisation task proved superior for maximizing normalised lumbar ES EMG precision.Conclusion: Key aspects of measurement tool accuracy, bias between tools, and tool precision were quantified, and recommendations were made to guide future research study design.
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