| 1. |
- Aasa, Ulrika
(författare)
-
Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a national questionnaire survey on work-related factors, and musculoskeletal and other health complaints. Physical demands was associated with activity limitation due to neck-shoulder and low-back complaints among the female personnel. Among the male personnel, physical demands was associated with low-back complaints and activity limitation due to low-back complaints. Psychological demands was significantly associated with neck-shoulder complaints, sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Worry about work conditions was associated with musculoskeletal disorders and sleeping problems, headache and stomach symptoms. A local sample of 26 ambulance personnel was followed during a 24-hour work shift and for the next two work-free days. Subjective stress- and energy levels, and cortisol levels were measured at regular intervals, and heart rate was registered continuously by electrocardiogram (ECG). Autonomic reactivity to standardized tests before (pre-work) and at the end of the work shift (post-work) was also investigated. For the whole group, baseline values of heart rate were higher pre-work than post-work, but autonomic reactivity did not differ. Increased reactivity to the mental test, modest deviation in heart rate variability (HRV) pattern during the late night hours at work and higher morning cortisol values during work than during leisure time were observed in personnel with many health complaints, but not among their co-workers without or with few complaints. Ambulance personnel with many health complaints also reported higher psychological demands and tended to be more worried about work conditions. Heart rate (HR), lactate level (LL) and perceived exertion (RPE) were investigated in 17 female and 48 male ambulance personnel during a simulated standardized work task “carry a loaded stretcher”. The ambulance personnel had to carry the loaded stretcher (920 N) up and down three flights of stairs twice. The high physiological strain (HR, LL, RPE) for the male, and near or at maximal strain for the female ambulance personnel, implied the importance to identify what kind of physical capacity is most important for ambulance personnel. Therefore, the explained variance of developed fatigue by tests of cardiorespiratory capacity, muscular strength and endurance, and coordination was investigated. The results showed that VO2max and isometric back endurance were important predictors for development of fatigue when carrying a loaded stretcher. The influence of body size on the relationships between maximal strength and functional performance was investigated in a methodological study. The results confirm that the assessment of physical performance could be confounded by the body weight. Therefore, the models for explaining development of fatigue when carrying the loaded stretcher were adjusted for height and weight. Including height in the models significantly increased the explained variance of accumulated lactate among female, but not among male personnel. Lactate levels were higher among short compared to tall female personnel. Weight had no effect on any of the models. In conclusion, the national survey showed that self-reported physical demands was a risk factor of having MSDs, and that self-reported psychological demands and worry about work were important risk factors of having MSDs and other health complaints. Stress monitoring of ambulance personnel during work and leisure time showed that physiological and subjective stress markers did not show any differences between the 24-hour ambulance work shift and leisure time afterwards. However, ambulance personnel with many health complaints had certain physiological changes during the work shift in comparison with the next two work-free days. The physiological and subjective responses during carrying a loaded stretcher, especially among the female ambulance personnel, showed that female and male ambulance personnel could be exposed to internal exposures at different levels when performing the same work task. A better understanding of the relationships between occupational demands and health-related outcomes require further studies on age- and gender matched groups in long-term perspective studies.
|
|
| 2. |
|
|
| 3. |
- Eklöf, Mats, 1953, et al.
(författare)
-
Feedback of workplace data to individual workers, workgroups or supervisors as a way to stimulate working environment activity: a cluster randomized controlled study.
- 2004
-
Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 77:7, s. 505-14
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To test whether feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers had an effect on activity to modify workplace design, working technique and psychosocial aspects of work. METHODS: A total of 36 workgroups from nine organizations representing different trades was randomized (stratified for organization) to three feedback conditions or control with no feedback. Data were collected 1 month before and 6 months after feedback sessions. The effects studied were: (1) change in the proportion of workgroup members who reported any modification regarding workplace design or working technique; (2) change in the proportion of workgroup members who reported any modification regarding psychosocial aspects; (3) average number of modification types regarding workplace design or working technique per individual in a workgroup; (4) average number of modification types regarding psychosocial aspects per individual in a workgroup. RESULTS: All feedback conditions differed positively from controls regarding change in the proportion of workgroup members who reported any modification in workplace design or working technique. No such effect was found for psychosocial aspects. For change in average number of psychosocial modification types per individual in a workgroup an effect was observed for feedback to supervisors. No intervention effect was observed for the average number of modifications in workplace design or working technique per individual in a workgroup. CONCLUSION: Feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers may have a positive effect on how many people in a workgroup modify (or have modifications done regarding) workplace design and working technique. Feedback to supervisors may have an effect on the average number of psychosocial modification types per individual in a workgroup. Feedback to group supervisors appeared to be the most cost-effective variant.
|
|
| 4. |
- Hagberg, Mats, 1951, et al.
(författare)
-
Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users.
- 2007
-
Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 50:11, s. 1820-34
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to assess the incidence and identify possible risk factors for self-reported reduced productivity owing to musculoskeletal symptoms among computer users. DESIGN: a cohort study with a baseline questionnaire and monthly follow ups during 10 months. METHODS: the study base consisted of 1,283 computer users, 636 men and 896 women. Ergonomists observed workstation characteristics before entering the cohort. Cases were defined as subjects reporting reduced productivity or reporting being on sick leave owing to musculoskeletal symptoms. RESULTS: women had approximately two times the incidence of self-reported reduced productivity owing to symptoms in the neck, shoulder and in the forearm/hand than men. There was no difference in gender for the incidence of self-reported reduced productivity owing to back symptoms. Working overtime and job demands were risk factors for self-reported reduced productivity owing to neck and back symptoms. Physical exercise fewer than 8 times the last month was a risk factor for self-reported reduced productivity owing to neck, shoulder and forearm/hand symptoms. Computer mouse use for more than 0.5 h/day was a risk factor for self-reported reduced productivity owing to shoulder and forearm/hand symptoms. CONCLUSIONS: risk factors for self-reported reduced productivity owing to musculoskeletal symptoms included life style factors, such as overweight and low physical exercise, occupational factors, such as overtime, job demands and computer mouse operating time.
|
|
| 5. |
- Hagberg, Mats, 1951, et al.
(författare)
-
Self-reported reduced productivity due to musculoskeletal symptoms: associations with workplace and individual factors among white-collar computer users.
- 2002
-
Ingår i: Journal of occupational rehabilitation. - 1053-0487. ; 12:3, s. 151-62
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to assess whether self-reported reduced productivity occurred in computer users due to musculoskeletal symptoms and the association to workplace, symptom, and individual factors. The study group consisted of 1283 computer users from different occupations, of whom 498 were men and 785 were women. Reduced productivity was self-assessed by two questions addressing if and how much productivity was reduced the previous month due to musculoskeletal symptoms. There were 63 women (8.0%) and 42 men (8.4%) of the total study group who reported reduced productivity due to musculoskeletal symptoms. The mean magnitude of the reduction was 15% for women and 13% for men. This outcome was weakly associated with computer mouse position and task and symptom persistence for both men and women. For women, work demands, computer problems, and being divorced/separated were also associated with reduced productivity. Although limited by problems of subjectivity of self-report and the possibility of significant underreporting, these results suggest that a variety of interventions may serve to decrease the impact of musculoskeletal disorders in the workplace.
|
|
| 6. |
- Hallman, David, 1979-
(författare)
-
Autonomic nervous system regulation in chronic neck-shoulder pain : Relations to physical activity and perceived stress
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Neck-shoulder pain (NSP) is a highly prevalent musculoskeletal disorder with unclear causes, and effective prevention and treatment require a further understanding of the underlying mechanisms. Aberrant autonomic nervous system (ANS) regulation is a hypothesized causal element in the development and maintenance of chronic muscle pain.The overall aim of this thesis was to investigate possible differences in ANS regulation between chronic NSP and healthy control (CON) groups using both laboratory assessment and ambulatory monitoring in daily life.Four papers are included in this thesis, based on data from three groups with chronic NSP. Autonomic responses to laboratory stressors were assessed using heart rate variability (HRV), blood pressure, trapezius muscle activity and blood flow measurements (Study І) in NSP and CON. Long-term ambulatory monitoring of HRV, physical activity and perceived symptoms were assessed in Studies ІІ and IV to investigate group differences in real-life conditions. Finally, the effects of a ten-week intervention (using individually adjusted HRV biofeedback) to reinstating ANS balance in subjects with chronic NSP were evaluated using self-reported symptoms and health ratings, as well as autonomic regulation testing (i.e., evaluating HRV at rest and in response to stress) (Study ІІІ).The main findings from the four studies demonstrated aberrant ANS regulation in the NSP group compared to CON, which was predominantly characterized by diminished parasympathetic cardiac activity during rest and sleep, and altered sympathetic reactivity to laboratory stressors (Studies І, ІІ and IV). Different patterns in physical activity were observed between the NSP and CON groups, with reduced physical activity during leisure time in the NSP group (Studies ІІ and IV). Physical activity was found to be positively associated with HRV. Positive effects of HRV-biofeedback were found on perceived health, including social function, vitality and bodily pain, and improved HRV (Study ІІІ).In conclusion, imbalanced ANS regulation was demonstrated among persons with chronic NSP at both the systemic and local levels. Diminished parasympathetic activity in NSP was modulated by lower levels of physical activity in leisure time. Interventions targeting ANS functions might benefit persons with chronic NSP.
|
|
| 7. |
- Karlqvist, Lena, et al.
(författare)
-
Self-reported working conditions of VDU operators and associations with musculoskeletal symptoms : a cross-sectional study focussing on gender differences
- 2002
-
Ingår i: International Journal of Industrial Ergonomics. - 0169-8141 .- 1872-8219. ; 30:4-5, s. 277-294
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe working conditions and the prevalence of musculoskeletal symptoms among male and female VDU operators, and to assess associations between work-related physical and psychosocial exposures and neck and upper limb symptoms by gender. The study population comprised a variety of occupations from both private and public sectors. Data on physical and psychosocial exposures were collected by questionnaires, as were data on musculoskeletal symptoms. Univariate associations between exposures and symptoms affecting the neck and upper limbs were estimated by calculating the prevalence ratios with 95% confidence intervals. We also assessed the potential excess odds ratio attributable to interaction between gender and, one by one, exposure variable. Women (n=785) used the computer on average 3.9 h/day and men (n=498) 3.6. Variation of different work tasks was lower among females than among males. Nineteen per cent of the women and 12% of the men did >3 h of continued computer work without breaks (>10 min) at least twice a week. Twice as many women as men experienced high job strain (high demands and low decision latitude). A higher proportion of women than men reported symptoms 3 days the preceding month from the upper body, irrespective of body region. For many of the studied exposures the prevalence of symptoms in one or several body regions was increased with increasing exposure, indicating exposure-response relationships. Duration of computer work was associated with symptoms among both men and women. Only among men, duration of work with a non-keyboard computer input device was associated with symptoms. Only among women, job strain was associated with symptoms. Time pressure was associated with higher prevalence of symptoms among women. Among men, time pressure was associated with lower prevalence of symptoms. Thus, the associations differed between the genders. Women experienced higher prevalence of symptoms than men in all body regions and they were more often exposed to physical and psychosocial conditions that in previous studies have been considered harmful, than men.
|
|
| 8. |
- Kjellberg, Anders, 1942-, et al.
(författare)
-
Stress, energy and psychosocial conditions in different types of call centres
- 2010
-
Ingår i: Work. - 1051-9815 .- 1875-9270. ; 36:1, s. 9-25
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. Participants: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. Method: A cross sectional questionnaire study. Results: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. Conclusions: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work.
|
|
| 9. |
- Lindegård, Agneta, et al.
(författare)
-
Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms.
- 2012
-
Ingår i: BMC Musculoskeletal Disorders. - London : BioMed Central. - 1471-2474. ; 13, s. 38-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. METHODS: At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. RESULTS: The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. CONCLUSION: There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.
|
|
| 10. |
- Lindegård Andersson, Agneta, 1955, et al.
(författare)
-
Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures.
- 2005
-
Ingår i: Applied ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 36:3, s. 319-25
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures.
|
|
