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  • 1.
    Gold, Judith
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Punnett, Laura
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    Gore, Rebecca
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    ProCare Research Team, .
    Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
    Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme2017In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 74, no 6, p. 389-395Article in journal (Refereed)
    Abstract [en]

    Objectives. Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors.

    Methods. Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5–6 years (F5) post-SRHP implementation among workers also in at least one prior survey.

    Results. LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and ‘intense’ aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work– family imbalance (RR=1.82 (1.12 to 2.98)).

    Conclusions. In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.

  • 2.
    Jackson, Jennie
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Umeå university.
    Olsson, David
    Umeå university.
    Burdorf, Alex
    Department of Public Health, Erasmus MC, Rotterdam.
    Punnett, Laura
    University of Massachusetts Lowell.
    Järvholm, Bengt
    Umeå university.
    Wahlström, Jens
    Umeå university.
    Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers2019In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, no 5, p. 326-331Article in journal (Refereed)
    Abstract [en]

    Objectives The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period. Methods A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships. Results The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00). Conclusions Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.

  • 3.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska Institutet.
    Nybergh, Lotta
    Karolinska Institutet.
    Lornudd, Caroline
    Karolinska Institutet.
    Hagberg, Jan
    Karolinska Institutet.
    Bodin, Lennart
    Karolinska Institutet.
    Kwak, Lydia
    Karolinska Institutet.
    Jensen, Irene
    Karolinska Institutet.
    Lohela-Karlsson, Malin
    Uppsala universitet.
    Torgén, Margareta
    Uppsala universitet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska Institutet.
    Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services2020In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926Article in journal (Refereed)
    Abstract [en]

    Objectives. Common mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.

    Methods. Randomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.

    Results. A statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.

    Conclusion. PSI was effective in reducing sickness absence which was the primary outcome in this study.

  • 4. Svendsen, S W
    et al.
    Mathiassen, S E
    University of Gävle, Belastningsskadecentrum.
    Bonde, J P
    Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters.2005In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 62, no 1, p. 18-27Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore the precision of task based estimates of upper arm elevation in three occupational groups, compared to direct measurements of job exposure. METHODS: Male machinists (n = 26), car mechanics (n = 23), and house painters (n = 23) were studied. Whole day recordings of upper arm elevation were obtained for four consecutive working days, and associated task information was collected in diaries. For each individual, task based estimates of job exposure were calculated by weighting task exposures from a collective database by task proportions according to the diaries. These estimates were validated against directly measured job exposures using linear regression. The performance of the task based approach was expressed through the gain in precision of occupational group mean exposures that could be obtained by adding subjects with task based estimates to a group of subjects with measured job exposures in a "validation" design. RESULTS: In all three occupations, tasks differed in mean exposure, and task proportions varied between individuals. Task based estimation proved inefficient, with squared correlation coefficients only occasionally exceeding 0.2 for the relation between task based and measured job exposures. Consequently, it was not possible to substantially improve the precision of an estimated group mean by including subjects whose job exposures were based on task information. CONCLUSIONS: Task based estimates of mechanical job exposure can be very imprecise, and only marginally better than estimates based on occupation. It is recommended that investigators in ergonomic epidemiology consider the prospects of task based exposure assessment carefully before placing resources at obtaining task information. Strategies disregarding tasks may be preferable in many cases

  • 5.
    Trask, Catherine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Teschke, Kay
    School of Environmental Health, University of British Columbia, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada.
    Morrison, Jim
    Simon Fraser University School of Kinesiology, Burnaby, Canada.
    Johnson, Peter
    Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States.
    Koehoorn, Mieke
    School of Environmental Health, University of British Columbia, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada.
    Optimising sampling strategies: components of low-back EMG variability in five heavy industries2010In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 67, no 12, p. 853-860Article in journal (Refereed)
    Abstract [en]

    Background Direct/ measurement of work activities iscostly, so researchers need to distribute resourcesefficiently to elucidate the relationships betweenexposures and back injury.

    Methods This study used data from full-shiftelectromyography (EMG; N¼133) to develop threeexposure metrics: mean, 90th percentile and cumulativeEMG. For each metric, the components of variance werecalculated between- and within-subject, and betweengroupfor four different grouping schemes: grouping byindustry (construction, forestry, transportation,warehousing and wood products), by company, by job andby quintiles based on exposures ranked by jobs withinindustries. Attenuation and precision of simulatedexposureeresponse relationships were calculated for eachgrouping scheme to determine efficient sampling strategies.

    Results As expected, grouping based on exposurequintiles had the highest between-group variances andlowest attenuation, demonstrating the lowest possibleattenuation with this data.

    Conclusion There is potential for grouping schemes toreduce attenuation, but precision losses should beconsidered and whenever possible empirical data shouldbe employed to select potential exposure groupingschemes.

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