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- Aasa, Ulrika
(författare)
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Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes
- 2005
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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.
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| 2. |
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| 3. |
- Hagberg, Mats, 1951, et al.
(författare)
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Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users.
- 2007
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 50:11, s. 1820-34
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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.
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| 4. |
- Lindegård Andersson, Agneta, 1955, et al.
(författare)
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Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures.
- 2005
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Ingår i: Applied ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 36:3, s. 319-25
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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.
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| 5. |
- Norman, Kerstin, 1959-
(författare)
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Call centre work : characteristics, physical, and psychosocial exposure, and health related outcomes
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Call centres (CCs) are one of the most rapidly growing forms of workplaces in Sweden. The overall aim of this thesis was to describe work characteristics, physical and psychosocial exposures, and health related outcomes, for CC operators in selected CC in Sweden. The purpose was also to study the test-retest reliability and internal consistency of questions, and the inter-rater reliability of observations and measurements in studies of CCs.This thesis is based on two projects, where study I was a cohort study and studies II-V were a cross-sectional survey. Fifty-seven CC operators were compared with a reference group of 1459 professional computer users from other occupations, study I, and 1183 operators (848 women and 335 men) (response rate 77%) from 28 CCs were studied in studies II-V . Questionnaires covering organisation and work characteristics, physical and psychosocial exposures, individual characteristics and symptoms during the previous month was used, studies I-V. Structured observations in accordance with an ergonomic checklist were used to assess workstation design during the subject’s ordinary work, study I and II.Operators at external CCs spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring was more common at external CCs.There were deficiencies in workspace, keyboard- and input device placement. External CCs showed somewhat more problems in the work environment compared with the internal CCs. The CC group spent longer continuous time in front of the computer than other professional computer users.Emotional and cognitive demands and time pressure were reported considered high. Emotional demands and limited decision latitude were dominating features in CC work.A higher proportion of the CC group reported musculoskeletal symptoms compared to other professional computer users. Three out of four operators reported symptoms in the Neck/shoulder or Arm/hand region, with no major differences between internal and external CCs. Comfort of the work environment showed the strongest association with symptoms in the Neck/shoulder or Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and lack of support from a supervisor. The thesis confirms previously suggested associations between unfavourable work characteristics and management, as well as poor physical and psychosocial environment, and musculoskeletal symptoms in computer-interactive tasks. Among operators at internal CCs, symptoms were particularly related to the nature of calls during work, whereas at external CCs critical exposures were the time spent seated with continuous computer work.About half of the questions were classified as having fair to good or higher testretest reliability and can be recommended in further analyses. Other questions should be used with care. A majority of the variables on the ergonomic checklist are classified as having fair to good or higher inter-rater reliability.
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| 6. |
- Norman, Kerstin, et al.
(författare)
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Musculoskeletal symptoms in relation to work exposures at call centre companies in Sweden
- 2008
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 30:2, s. 201-214
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. Methods: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1183 operators from 28 CCs. Results: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. Conclusions: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs.
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| 7. |
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| 8. |
- Norman, Kerstin, et al.
(författare)
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Reliability of a questionnaire and an ergonomic checklist for assessing working conditions and health at call centres
- 2006
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Ingår i: International Journal of Occupational Safety and Ergonomics. - : Informa UK Limited. - 1080-3548 .- 2376-9130. ; 12:1, s. 53-68
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Tidskriftsartikel (refereegranskat)abstract
- Background. The purpose was to study the test-retest reliability and internal consistency of questions in a questionnaire concerning working conditions and health and the inter-rater reliability of observations and measurements according to an ergonomic checklist.Method. Fifty-seven operators participated in a retest questionnaire and 58 operators participated in an inter-observer test.Results. The questions had fair to good or higher reliability in 142 of the total of 312. Twenty-seven of the total of 44 variables in the ergonomic checklist were classified as having fair to good or higher reliability.Conclusions. About half of the questions had fair to good or higher reliability and can be recommended for further analyses. The majority of variables in the ergonomic checklist were classified as having fair to good or higher reliability. Low reliability does not necessarily indicate that the reliability of the test, per se, is low but may signify that the conditions measured vary over time or that the answers are aggregated in one part of the scale.
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| 9. |
- Norman, Kerstin, et al.
(författare)
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Working conditions in a selected sample of call centre companies in Sweden
- 2008
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Ingår i: International Journal of Occupational Safety and Ergonomics. - : Informa UK Limited. - 1080-3548 .- 2376-9130. ; 14:2, s. 177-194
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Tidskriftsartikel (refereegranskat)abstract
- Background. Call centres (CCs) are among the most rapidly growing forms of workplaces in Sweden. The purpose of the study was to describe and compare working conditions between operators at internal and external CC companies and work tasks of different complexity. Method. A questionnaire was answered by 1183 operators, 848 women and 335 men, from 28 different CCs. The questionnaire covered background factors, employment, working hours and remuneration, call logging and monitoring, duties, computer work and workplace design during the previous month. Results. Operators at external companies and operators with low-complexity work tasks were younger, more often employed by the hour and worked on a varying roster. They spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring were more common at external companies and among operators with low-complexity work tasks. Conclusion. The working conditions varied between internal and external CCs. There was also a variation in working conditions between work tasks of different complexity. There were aspects of supervision style and organization of work at CCs, especially at external ones and those with low-complexity tasks that could introduce stress and lack of well being among the staff.
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| 10. |
- Palm, Peter, 1975-, et al.
(författare)
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Computer use, neck and upper-extremity symptoms, eyestrain and headache among female and male upper secondary school students
- 2007
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; , s. 33-41
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Computer use, neck and upper-extremity symptoms, headache, and eyestrain were studied in upper secondary school students. Methods A questionnaire was completed by 1575 female and 1251 male students. Associations between computer use and health problems were analyzed by calculating the prevalence ratios for the health variables, considering computer use for >14-56 or >56 hours/week as compared with <= 14 hours/week (reference). Health problems were defined as aches or pain or other trouble at least three days in the preceding month. Results Computer use (median) was reported to be 31 hours/week by the male students and 19 hours/week by the females. Most computer use (about 90%) took place outside school (eg, for entertainment). Headache was reported by 51% and 24%, and neck or shoulder symptoms by 31% and 15%, of the females and mates, respectively. More than 50% of the females with health complaints indicated that their problems had disturbed their sleep, and they used painkillers to handle them. Between 10% and 43% experienced their health complaints as being related to computer use. For those using computers >56 hours/week, the prevalence ratios were significantly increased for neck or shoulder symptoms among both the females and the males, and for eyestrain and forearm symptoms among the females. Exposure-response relationships were indicated for the aforementioned associations. Approximately two-thirds of the students reported that they had not received any information in school about appropriate workplace layout and techniques for computer work. Conclusions Despite their young age, the students were not protected from computer-related health complaints. Therefore, providing adolescents with information about proper computer ergonomics may help prevent such health problems.
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