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- Palm, Peter, 1975-
(författare)
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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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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)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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| 2. |
- Eliasson, Kristina, 1979-
(författare)
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Ergonomists’ risk assessments : From guesstimates to strategic approaches
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Musculoskeletal disorders are among the most prevalent causes of work-related ill-health, consequently risk assessments of hazardous factors related to these disorders are important for prevention. Occupational Health Services (OHS) providers are independent experts, supporting employers regarding work environment issues and rehabilitation. Ergonomists represents one of the professions within OHS, and risk assessment regarding musculoskeletal disorders is within the scope of their work tasks. The overall objective was to explore Swedish ergonomists’ practices and approaches with risk assessments, in order to contribute new knowledge about how ergonomists’ work methods can be further developed to improve prevention of work-related musculoskeletal disorders. Paper I explored the process of risk assessment assignments and the ergonomists’ use of observation-based risk-assessment tools. The result showed a lack of systematic approaches regarding risk assessment assignments and limited use and knowledge of observation-based risk-assessment tools. In Paper II inter-observer and intra-observer reliability of risk assessments, without the use of an explicit observational method were assessed. The results showed a non-acceptable reliability. Paper III explored ergonomists experiences of an e-learning concept for knowledge translation in the OHS context. The e-learning concept was considered as feasible. The knowledge translation inspired increased use of risk-assessment tools, changes in the risk assessment procedures, e.g. selection of tools, and employing a participatory approach. Paper IV described the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (HIW-model), and the studies that will explore the model. Paper V explored company representatives’ experiences of the HIW-model, and factors which facilitated the execution of the model. The model contributed to increased risk awareness and understanding of how individual workers’ musculoskeletal ill-health relates to exposures in work. Facilitating factors were: a joint start-up meeting in which the process was planned, clear communication, and clarity regarding the ownership of the process. In conclusion, the findings showed that ergonomists’ expertise is needed in the entire risk management process and not only in the risk assessment phase. In this process, the ergonomists need to be active and take the expert role (which includes a stocked toolbox) and support the employer through the whole risk management process from initiation to evaluation of risk controlling measures.
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| 3. |
- Qvarfordt, Mikaela, Doktorand, 1979-
(författare)
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Environmental exposures, body composition and pulmonary function : How can we improve diagnostics?
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Pulmonary diseases are influenced by numerous factors such as lifestyle, environment, genetics, and adipose tissue. A common factor for these diseases is that early and accurate diagnosis is beneficial for effective treatment. The improvement and development of diagnostic tools, including nanotechnology, offers the potential for more reliable diagnosis.The main aim of this thesis was to improve our understanding of respiratory assessment through a comprehensive approach. This approach included studying the effectiveness of training and feedback in conducting spirometry tests to accepted diagnostic standard (paper I). Evaluating the association of body impedance analysis (BIA) and waist circumference in assessing the decline in lung function induced by excessive adipose tissue (paper II) and investigating the effects of weight change on lung function (paper III). In addition, the thesis investigated the potential of inhaled nano particles in individuals with impaired lung epithelium as a possible new diagnostic method (paper IV). Overall, these studies aimed to improve lung function diagnostics to make them more reliable, accessible and to advance the development of cutting-edge technological methods.Our results show that the use of structured on-line feedback improve the quality of spirometry and that there is a potential gender differences in the effects of excess adipose tissue on lung function. Data also demonstrated a difference in clearance of inhaled nanoparticles between healthy and patients with impaired alveolar integrity, opening the possibility for new diagnostic approaches.
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| 4. |
- Vihlborg, Per, 1978-
(författare)
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Health effects from occupational hand-arm vibration
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hand-arm vibration (HAV) is a common occupational exposure in Sweden and worldwide that causes both acute transient effects and persistent hand-arm symptoms. The health effects include vibration-induced Raynaud’s phenomenon, neuropathic symptoms, carpal tunnel syndrome (CTS), and musculoskeletal disorders. The overall aim of this thesis was to investigate vascular and neurological effects in the hands of workers exposed to hand-arm vibrations.Methods: In study 1, the aim was to investigate the risk of CTS from hand-arm vibration. This study was conducted as a register study using the National Outpatient Register and a job exposure matrix to estimate HAV exposure. Study 2 aimed to investigate the acute effects of HAV on the nerve functions of the hands and the impact of grip force. Nerve function was evaluated before and after vibration exposure. In study 3, the aim was to identify low molecular organic biomarkers in blood samples from vibration-exposed workers using a novel metabolomics approach. HAV-exposed workers underwent medical examination and blood samples were collected and analysed before and after a work shift. In study 4, the aim was to investigate if arterial abnormalities in the hands could be identified in patients with VWF which also had a positive Allen’s test. In this case series, Doppler ultrasound and magnetic resonance angiography (MRA) investigations were performed to investigate the arterial status in the hands. Results: Study 1 showed that the risk of CTS for HAV exposed individuals increased with an OR of 1.61 (95% CI 1.46-1.77) for the whole population. The risk was highest in HAV exposed younger males. Study 2 showed that HAV exposure with high grip force affect nerve function different than with low grip force. In study 3, workers with VWF had metabolic profiles different from participants without VWF, both before and after vibration exposure. In study 4, ultrasound and MRA identified vascular abnormalities in all participants; these abnormalities were a predominantly missing or not complete superficial arch. Conclusion: The overall finding is that HAV exposure, even at levels under legislated values, can give negative health effects. These results add new knowledge about CTS, HAV exposure and gender. Both metabolomics and studies of acute effects of HAV could be further studied to find a level of exposure where no health effects appear. With the findings on MRA, there is the possibility that a subgroup of VWF can be subject for treatment.
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| 5. |
- Fornander, Louise, 1983-
(författare)
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Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- People are, in their daily lives, exposed to a number of airborne foreign compounds that do not normally affect the body. However, depending on the nature of these compounds, dose and duration of exposure, various airway symptoms may arise. Early symptoms are often manifested as upper airway mucosal inflammation which generates changes in protein composition in the airway lining fluid.This thesis aims at identifying, understanding mechanisms and characterizing protein alterations in the upper airway mucosa that can be used as potential new biomarkers for inflammation in the mucosa. The protein composition in the mucosa was studied by sampling of nasal lavage fluid that was further analyzed with a proteomic approach using twodimensional gel electrophoresis and mass spectrometry. Additionally, by studying factors on site through environmental examination, health questionnaires and biological analyses, we have tried to understand the background to these protein alterations and their impact on health.Respiratory symptoms from the upper airways are common among people who are exposed to irritative and microbial agents. This thesis have focused on personnel in swimming pool facilities exposed to trichloramine, metal industry workers exposed to metalworking fluids, employees working in damp and moldy buildings and infants diagnosed with respiratory syncytial virus infection. The common denominator in these four studies is that the subjects experience upper airway mucosal inflammation, which is manifested as cough, rhinitis, phlegm etc. In the three occupational studies, the symptoms were work related. Notably, a high prevalence of perceived mucosal symptoms was shown despite the relatively low levels of airborne irritants revealed by the environmental examination. Protein profiling verified an ongoing inflammatory response by identification of several proteins that displayed altered levels. Interestingly, innate immune proteins dominated and four protein alterations occurred in most of the studies; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin. Similarly, these proteins were also found in nasal fluid from children with virus infection and in addition a truncated form of SPLUNC1 and two other S100 proteins (S100A7-like 2 and S100A16), not previously found in nasal secretion, were identified.Altogether, the results indicate the potential use of a proteomic approach for identifying new biomarkers for the upper respiratory tract at an early stage in the disease process after exposure to irritant and microbial agents. The results indicate an effect on the innate immunity system and the proteins; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin are especially promising new biomarkers. Moreover, further studies of these proteins may help us to understand the molecular mechanisms involved in irritant-induced airway inflammation.
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| 6. |
- Grooten, Wilhelmus Johannes Andreas, et al.
(författare)
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Health risk appraisals in Swedish occupational health services
- 2016
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 55:4, s. 849-859
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided.Objectives: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction.Methods: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n = 272) and employees that participated in a single session (HRA-S) (n = 104). Associations between feedback and individual status concerning life style were assessed with Cohen's kappa (k).Results: The employees received mainly information and advice for improvement on health and lifestyle issues (89-100%), while advice for improvement of working conditions was less common (15-59%). The feedback provided on life style was not based on individual status (k < 0.4), except for smoking and risky alcohol consumption (k > 0.55). A great majority of employees reported good overall satisfaction with their HRAs.Conclusions: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors.
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