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  • 1.
    Aasa, Ulrika
    et al.
    Umeå universitet.
    Wiitavaara, Birgitta
    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.
    Personalens hälsa och arbetsmiljö2016In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Lars Lundberg, Stockholm: Liber, 2016, 2, p. 72-79Chapter in book (Other academic)
  • 2.
    Abbott, Rebecca
    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.
    Straker, Leon
    Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Mathiassen, Svend Erik
    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.
    Patterning of children's sedentary time at and away from school2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, p. E131-E133Article in journal (Refereed)
    Abstract [en]

    Objective:

    Sedentary behavior in children is positively associated with an increased risk of both obesity and insulin resistance. Children spend a considerable portion of their awake time in sedentary behavior; however, the pattern of accumulation is not known. Thus the objective of this study was to describe the patterning of sedentary behavior of children at and away from school.

    Design and Methods:

    The patterns of sedentary time in a sample of 53 children (28 girls) aged 10-12 years during school-term time were examined. Children wore an accelerometer for 1 week. Total sedentary time, prolonged sequences (bouts) of sedentary time, and frequency of active interruptions to sedentary were examined on school days and weekends and within school time and non-school time on school days.

    Results:

    The data did not support our hypothesis that children accumulated more sedentary time on school days when compared with weekend days (mean [SD]: 64.4% [5.3] vs. 64.9% [9.0], P = 0.686). However, when comparing school time with non-school time on school days, children accumulated more sedentary time at school (66.8% [7.3] vs. 62.4% [5.2], P < 0.001) and spent more time at school in sustained sedentary sequences, that is, uninterrupted sedentary time for 30 min or more (75.6 min [45.8] vs. 45.0 min [26.8], P < 0.002). The children also recorded less breaks per sedentary hour within school time when compared with non-school time (8.9 h−1 vs. 10.2 h−1, P < 0.001).

    Conclusion:

    Reducing total sedentary time spent both in and out of school remains an important challenge. Interrupting sedentary time more often in the “working” (school) day could also reap important musculoskeletal and metabolic health rewards for children.

  • 3.
    Ahmadi, Elena
    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.
    Vilhelmson, Pär
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Larsson, Johan
    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.
    FRAMFÖR (Framgångsrika företag i Gästrikland): ett longitudinellt projekt om ledarskap, arbetsmiljö och effektivitet – fördel för både forskning, utbildning och ett hållbart arbetsliv?2016In: Inkluderande och hållbart arbetsliv: Book of abstracts - FALF 2016, Östersund: Mittuniversitetet , 2016, p. 48-48Conference paper (Refereed)
    Abstract [sv]

    Projektbeskrivning: FRAMFÖR har under 15 år bedrivits i Gästrikland i samarbete mellan utbildning och forskning vid Högskolan i Gävle, företagsutvecklare vid kommuner, företag och näringslivsorganisationer. Varje år delas utmärkelsen FRAMFÖR ut till 50 företag. Ambitionen är att uppmuntra framgångsrika företagare och visa upp intressanta exempel på hur framgång kan skapas. Processen startar med att 120 företag (>4 anställda) nomineras utifrån finansiella kriterier (ex. omsättningstillväxt, vinstmarginal). Sedan genomför studenter vid Ekonomprogrammet intervjuer med cheferna för dessa företag. Intervjuerna sker utifrån ett standardiserat frågeformulär kring arbetsmiljö, ledarskap, organisering och effektivitet. Avslutningsvis väljer en jury ut de 50 mest framgångsrika företagen utifrån såväl finansiella kriterier som studenternas intervjuresultat. Projektets trippel helixuppbyggnad (Utbildning, Forskning och, Företag) skapar nyttor för olika intressenter.

    Utbildningsnyttor: Studenterna får möjlighet till interaktion med företagare i sin direkta närhet. Aktiviteterna underlättar att uppfylla utbildningsmål där flera mål kan uppfyllas med samma aktiviteter. Förståelse för näringslivets förutsättningar samt kunskaper om ett vetenskapligt angreppssätt ökar.

    Forskningsnyttor: Stärker pågående forskning om hälsofrämjande och effektivt ledarskap inom arbetshälsovetenskap samt företagsutveckling inom företagsekonomi. Det stora urvalet av företag ger en bra bild av företagen i regionen och en möjlighet att följa dem över tid. Ambitionen är att få mer kunskap om hållbara och effektiva företag. Fördjupade studier av utmärkelseföretag möjliggörs och ett doktorandprojekt med inriktning på ledarskapsbeteenden, organisationsfaktorer, tidsanvändning samt chefers/medarbetares arbetsmiljö/hälsa i utmärkelseföretag är uppstartat.

    Företagsnyttor: Företagare får möta studenter och förstå hur de tänker. Ställda frågor, t.ex. rörande arbetsmiljö och ledarskap, kan starta reflektionsprocesser som bidrar till fortsatt utveckling. FRAMFÖR-utmärkelsen delas ut vid en högtidlig tillställning där företagarna kan bygga nätverk. Flera företagare lyfter fram det positiva symbolvärdet av att få utmärkelsen.

    Projektets framtid: Målet är att fortsätta ytterligare 15 år och fortsätta utveckla nyttorna för samtliga intressenter. Ett prioriterat område är återkoppling till företag i någon form samt ökad samverkan mellan studenter och företagare.

  • 4.
    Aleksandrov, A. A.
    et al.
    St Petersburg State University, Russia.
    Deinekina, T. S.
    St Petersburg State University, Russia.
    Mathiassen, Svend Erik
    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.
    Lyskov, Eugene B.
    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.
    ВЛИЯНИЕ НАБЛЮДЕНИЯ ЗА ДВИЖЕНИЕМ НА ВОССТАНОВЛЕНИЕ РАБОТОСПОСОБНОСТИ ПОСЛЕ ФИЗИЧЕСКОГО УТОМЛЕНИЯ [The influence of movement's observation on recuperation after physical fatigue]2014In: Zurnal vyssej nervnoj deâtel'nosti im. I.P. Pavlova, ISSN 0044-4677, Vol. 64, no 5, p. 481-487Article in journal (Refereed)
    Abstract [en]

    The study aim was to investigate effects of mental activity, accompanied by mu-rhythm depression, on recuperation after physical fatigue. In a study participants performed 11 one minute bouts of static hand grip intermitted by 2 minutes rest pauses. During pauses participants watched video with either dynamic hand grips (biological movements) or deformation of geometric figure (control). Obtained data showed there was a significant depression of mu-rhythm during biological movement's observation. There was significant fatigue of subjects in an exercise with physical activity, but there was no reliable influence of performed mental activity on recovery after fatigue.

  • 5.
    Andersson, Linus
    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. Department of Psychology, Umeå University, Umeå, Sweden.
    Claeson, Anna-Sara
    Department of Psychology, Umeå University, Umeå, Sweden.
    Not getting used to the smell – Chemical intolerance as lack of habituation2017In: Biological Psychology, ISSN 0301-0511, E-ISSN 1873-6246, Vol. 129, no Suppl. C, p. 377-Article in journal (Refereed)
    Abstract [en]

    Background:

    Chemical intolerance is a prevalent, medically unexplained symptom characterized by diverse symptoms following weak chemical exposure. The symptom-eliciting exposures are often odorous, and include perfume, fabric softeners and fragrant flowers. Several explanatory mechanisms have been proposed, but empirical data is scarce. By reanalyzing data from previous studies, we aimed to find a criterion for chemical intolerance based on reactions to actual chemical exposure.

    Method:

    We grouped participants from six previous studies based on their pattern of habituation to weak olfactory (amylacetate and n-butanol) and trigeminal (CO2 and acrolein) compounds. In two studies utilizing event-related potentials, and one functional magnetic resonance imaging study, stimuli were presented intranasally using a dynamic olfactometer. An exposure chamber that allowed full body exposure was used in the remaining three studies.

    Results:

    Individuals who did not habituate to weak chemical exposure, compared with those who did, reported (1) increasing symptoms during the course of the exposure, (2) greater problems with odors in everyday life, and (3) greater levels of everyday distress. They (4) performed worse on cognitively demanding tasks during exposure, and differed in measures of (5) the autonomic nervoussystem(respiratoryrateandpulseratevariability),(6)low-level inflammation and oxidative stress, and (7) the so called pain matrix of the brain.

    Discussion:

    Lack of habituation to weak chemical exposure may be a fruitful method of defining a sub-group of chemical intolerance.

  • 6.
    Andersson, Linus
    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.
    Claeson, Anna-Sara
    Department of Psychology, Umeå University, Umeå, Sweden.
    Dantoft, Thomas Meinertz
    Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte, Gentofte, Denmark; Department of Systems Biology, Center for Biological Sequence Analysis, Technical University of Denmark, Lyngby, Denmark.
    Skovbjerg, Sine
    Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte, Gentofte, Denmark.
    Lind, Nina
    Department of Psychology, Umeå University, Umeå, Sweden.
    Nordin, Steven
    Department of Psychology, Umeå University, Umeå, Sweden.
    Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 1, p. 79-88Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol.

    METHODS: We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorant n-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which the n-butanol concentration increased and reached a plateau at 11.5 mg/m(3).

    RESULTS: MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses.

    CONCLUSIONS: We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.

  • 7.
    Andersson, Linus
    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. Department of Psychology, Umeå University, Umeå, Sweden.
    Claeson, Anna-Sara
    Department of Psychology, Umeå University, Umeå, Sweden.
    Nyberg, Lars
    Department of Integrative Medical Biology and Physiology, Umeå University, Umeå, Sweden; Department of Radiation Sciences, Umeå University, Umeå, Sweden.
    Nordin, Steven
    Department of Psychology, Umeå University, Umeå, Sweden.
    Short-term olfactory sensitization involves brain networks relevant for pain, and indicates chemical intolerance2017In: International journal of hygiene and environmental health (Print), ISSN 1438-4639, E-ISSN 1618-131X, Vol. 220, no 2, p. 503-509Article in journal (Refereed)
    Abstract [en]

    Chemical intolerance is a medically unexplained affliction that implies deleterious reactions to non-toxic everyday chemical exposure. Sensitization (i.e. increased reactivity to repeated, invariant stimulation) to odorous stimulation is an important component in theoretical explanations of chemical intolerance, but empirical evidence is scarce. We hypothesized that (1) individuals who sensitize to repeated olfactory stimulation, compared with those who habituate, would express a lower blood oxygenated level dependent (BOLD) response in key inhibitory areas such as the rACC, and higher signal in pain/saliency detection regions, as well as primary and/or secondary olfactory projection areas; and (2) olfactory sensitization, compared with habituation, would be associated with greater self-reported chemical intolerance. Moreover, we assessed whether olfactory sensitization was paralleled by comparable trigeminal processing – in terms of perceptual ratings and BOLD responses. We grouped women from a previous functional magnetic imaging study based on intensity ratings of repeated amyl acetate exposure over time. Fourteen women sensitized to the exposure, 15 habituated, and 20 were considered “intermediate” (i.e. neither sensitizers nor habituaters). Olfactory sensitizers, compared with habituaters, displayed a BOLD-pattern in line with the hypothesis, and reported greater problems with odours in everyday life. They also expressed greater reactions to CO2 in terms of both perceived intensity and BOLD signal. The similarities with pain are discussed.

  • 8.
    Andersson, Linus
    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.
    Claeson, Anna-Sara
    Department of Psychology, Umeå University, Sweden.
    Sandberg, Petra
    Department of Psychology, Umeå University, Sweden.
    Highlighting the large variation in perceived properties of odors over time2017In: Chemical Senses, ISSN 0379-864X, E-ISSN 1464-3553, Vol. 42, no 2, p. E26-Article in journal (Refereed)
    Abstract [en]

    Individuals differ considerably when rating the perceived properties of odors, especially over time. A second glance at previously published data-sets from our laboratory revealed that the same invariant exposure often produced both floor and roof effects. An odor that at the end of the exposure ses-sion was regarded as non-existent by one participant, could border the “absoulte maximum” rating category in another. We provide re-analyses from four exposure studies where we illustrate the perceptual variability over time, and outcomes associated with such ratings. We note that high, compared with low ratings of odor intensity over time is associated with ratings of unpleasantness and symptoms, but also with everyday distress, cognitive performance, autonomous nerv-ous system activity and deviating responses in the so-called pain or saliency matrix of the brain. We bring an open ques-tion to ECRO regarding how this considerable variability should be interpreted, and what the consequenced are for research and for setting exposure limits.

  • 9.
    Andersson, Linus
    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. Department of Psychology, Umeå University, Umeå, Sweden.
    Sandberg, Petra
    Department of Psychology, Umeå University, Umeå, Sweden.
    Olofsson, Jonas K.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Nordin, Steven
    Department of Psychology, Umeå University, Umeå, Sweden.
    Effects of Task Demands on Olfactory, Auditory, and Visual Event-Related Potentials Suggest Similar Top-Down Modulation Across Senses2018In: Chemical Senses, ISSN 0379-864X, E-ISSN 1464-3553, Vol. 43, no 2, p. 129-134, article id bjx082Article in journal (Refereed)
    Abstract [en]

    A widely held view is that top-down modulation of sensory information relies on an amodal control network that acts through the thalamus to regulate incoming signals. Olfaction lacks a direct thalamic projection, which suggests that it may differ from other modalities in this regard. We investigated the late positive complex (LPC) amplitudes of event-related potentials (ERP) from 28 participants, elicited by intensity-matched olfactory, auditory and visual stimuli, during a condition of focused attention, a neutral condition, and a condition in which stimuli were to be actively ignored. Amplitudes were largest during the attend condition, lowest during the ignore condition, with the neutral condition in between. A Bayesian analysis resulted in strong evidence for similar effects of task across sensory modalities. We conclude that olfaction, despite its unique neural projections, does not differ from audition and vision in terms of task-dependent neural modulation of the LPC.

  • 10.
    Anderzén, Ingrid
    et al.
    Department of Public Health and Caring Sciences, Uppsala University.
    Karlsson, Thomas
    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.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Gustafsson, Susanne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Lindberg, Per
    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.
    Predictors of Well-being at work2016In: Scientific Programme: Wellbeing at Work 2016, 2016Conference paper (Refereed)
    Abstract [en]

    The concept of healthy workplace has been defined as an organization that maximizes the integration of worker goals for wellbeing and company objectives for profitability and productivity. Conditions in today’s working life make new approaches necessary in order to limit negative health effects of work and to enhance wellbeing and health at work. About 24 % of the working population in Sweden report to have had work-related disorders during the last twelve months. In order to achieve a sustainable working life it is likely that strategies and actions from different and new angles are needed.ObjectivesThe present study is a part of a larger study (the GodA –study; a Swedish acronym for good work environments and healthy workplaces) and aims to investigate how work environment factors, work ability, work motivation, work and life balance predict well-being at work.

    Methods

    The GodA study is a 2-year follow up study in Sweden with a survey feedback design in three companies with both blue- and white collar workers. One of the companies serves as “intervention-company”, the other two as controls. A baseline questionnaire was sent out 2013 and the results from the survey were reported back to the companies, which have been processing their results. In spring 2015 a follow up survey has been administered. Data have been analysed with univariate and multivariate linear regression analyses.

    Results

    A baseline multivariate linear regression model, which included background factors, perceived psychosocial work climate and work environmental factors (motivation, leadership, employee responsibilities, efficacy, work ability and management committed to employee health) and work life balance, showed that psychosocial work climate (B= .48, 95% CI=.27 – .69) leadership, (B= .27, 95% CI=.05– .49), work ability (B= -.12, 95% CI= .03 – .21), motivation (B= -33, 95% CI= .14 – .51) and work life balance (B= -.34, 95% CI=-.57– -.12), were signifi-cantly associated with well-being at work and explained 40% of the variance (Adjusted R2=.40, p<.001).

    Conclusions

    Results showed that not only work environment factors are important predictors. To maintain a healthy work place a promotion of balance between work and private life is needed.

  • 11.
    Anderzén, Ingrid
    et al.
    Department of Public Health and Caring Sciences, Uppsala University.
    Lindberg, Per
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Karlsson, Thomas
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work. University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Gustafsson, Susanne
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Predictors of well-being at work2015Conference paper (Other academic)
    Abstract [en]

    Background

    The concept of healthy workplace has been defined as an organization that maximizes the integration of worker goals for wellbeing and company objectives for profitability and productivity. Conditions in today’s working life make new approaches necessary in order to limit negative health effects of work and to enhance wellbeing and health at work. About 24 % of the working population in Sweden report to have had work-related disorders during the last twelve months. In order to achieve a sustainable working life it is likely that strategies and actions from different and new angles are needed.

    The present study is a part of a larger study (the GodA –study; a Swedish acronym for good work environments and healthy workplaces) and aims to investigate how work environment factors, work ability, work motivation, work and life balance predict well-being at work.

    Methods

    The GodA study is a 2-year follow up study in Sweden with a survey feedback design in three companies with both blue- and white collar workers. One of the companies serves as “intervention-company”, the other two as controls. A baseline questionnaire was sent out 2013 and the results from the survey were reported back to the companies, which have been processing their results. In spring 2015 a follow up survey has been administered. Data from the baseline measurements have been analysed with univariate and multivariate linear regression analyses.

    Results

    A baseline multivariate linear regression model, which included background factors, perceived psychosocial work climate and work environmental factors (motivation, leadership, employee responsibilities, efficacy, work ability and management committed to employee health) and work life balance, showed that psychosocial work climate (B= .48, 95% CI=.27 – .69) leadership, (B= .27, 95% CI=.05– .49), work ability  (B= -.12, 95% CI= .03 – .21), motivation (B= -33, 95% CI= .14 – .51) and work life balance (B= -.34, 95% CI=-.57– -.12), were significantly associated with well-being at work and explained 40% of the variance  (Adjusted R2=.40, p<.001). Results from the two-year follow up will be presented at the conference.

    Conclusions

    Results showed that not only work environment factors are important predictors. To maintain ahealthy work place apromotion ofbalancebetween workand private life is needed.

  • 12.
    Arvidsson, Inger
    et al.
    Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden.
    Hansson, Gert-Åke
    Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden.
    Mathiassen, Svend Erik
    University of Gävle, Centre for Musculoskeletal Research. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Skerfving, Staffan
    Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden.
    Changes in physical workload with implementation of mouse-based information technology in air traffic control2006In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 36, no 7, p. 613-622Article in journal (Refereed)
    Abstract [en]

    Effects on physical workload were quantified when introducing new information technology in air traffic control. Seven female and seven male air traffic controllers were studied in an old control system, and during simulated - but similar - work in a new, mouse-based system. Postures, movements and muscular load were recorded (inclinometry for head, neck, back and upper arms; goniometry for wrists; electromyography for the trapezius and forearm extensor muscles). The new system was associated with lower movement velocities than the old one (examples; [50th percentiles] head flexion: 2 vs. 5 o/s, P<0.01; right arm elevation: 3 vs. 6 o/s; P<0.01; [90th percentile] wrist flexion: 19 vs. 50 o/s, P<0.01), less varying postures (head: 95th-5th percentile range 17° vs. 34o; P<0.01), and less muscular rest in the right forearm extensors (3.5 vs. 9% of time; P<0.05). The old/new system differences were amplified at high work intensities. The new air traffic control system caused a major change of physical exposures, probably associated with an increased risk of musculoskeletal disorders in arms and hands.

    Relevance to industry

    While this study concerned the specific changes in the introduction of a new air traffic control system, we believe that the findings are applicable to similar technological developments in other settings.

  • 13.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos, São Paulo, BRAZIL.
    dos Santos, Wilian
    Department of Mechatronics Engineering, University of São Paulo, BRAZIL.
    Inoue, Roberto Santos
    Department of Electrical Engineering, Federal University of São Carlos, São Paulo, BRAZIL.
    Gonçalves Siqueira, Adriano Almeida
    Department of Mechatronics Engineering, University of São Paulo, BRAZIL.
    Mathiassen, Svend Erik
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Srinivasan, Divya
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos, São Paulo, BRAZIL.
    Adjustable sit-stand tables in office settings: development of a system for controlled posture changes2015In: Proceedings of the 19th Triennial Congress of the International Ergonomics Association, Melbourne 9-14 August 2015, 2015Conference paper (Refereed)
  • 14.
    Barbieri, Dechristian Franca
    et al.
    Department of Physical Therapy, Federal University of São Carlos, Brazil.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University.
    Mathiassen, Svend Erik
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos, Brazil.
    Comparison of sedentary behaviors in office workers using sit-stand tables with and without semi-automated position changes2017In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 59, no 5, p. 782-795Article in journal (Refereed)
    Abstract [en]

    Objective: This study compared usage patterns of two different electronically controlled sit-stand tables during a 2-month intervention period among office workers.

    Background: Office workers spend most of their working time sitting, which is likely detrimental to health. Although the introduction of sit-stand tables has been suggested as an effective intervention to decrease sitting time, limited evidence is available on usage patterns of sit-stand tables, and whether patterns   are influenced by table configuration.

    Methods: Twelve workers were provided with standard sit-stand tables (non-automated table group) and 12 with semi-automated sit-stand tables programmed to change table position according to a pre-set pattern, if the user agreed to the system-generated prompt (semi-automated table group). Table position was monitored continuously for two months after introducing the tables, as a proxy for sit-stand behavior.

    Results: On average, the table was in a “sit” position for 85% of the work-day in both groups; this did not change significantly during the 2-month period. Switches in table position from sit to stand were, however, more frequent in the semi-automated table group than in the non-automated table group (0.65 vs. 0.29 hr-1; p=0.001).

    Conclusion: Introducing a semi-automated sit-stand table appeared to be an attractive alternative to a standard sit-stand table, since it led to more posture variation.

    Application: A semi-automated sit-stand table may effectively contribute to making postures more variable among office workers, and thus aid in alleviating negative health effects of extensive sitting.

  • 15.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos.
    Mathiassen, Svend Erik
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Srinivasan, Divya
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    de Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos.
    The effect of non-computer tasks on job exposure variability in computer-intensive office work2013In: Eighth International Conference on Prevention of Work-related Musculoskeletal Disorders; Abstracts, 2013, p. 334-Conference paper (Refereed)
  • 16.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
    Mathiassen, Svend Erik
    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.
    Srinivasan, Divya
    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.
    dos Santos, Wilian Miranda
    Department of Mechanical Engineering, University of São Paulo, São Carlos, Brazil.
    Inoue, Roberto Santos
    Department of Electrical Engineering, Federal University of São Carlos, São Carlos, Brazil.
    Siqueira, Adriano
    Department of Mechanical Engineering, University of São Paulo, São Carlos, Brazil.
    Nogueira, Helen
    Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
    Sit-stand tables with semi-automated position changes: a new interactive approach for reducing sitting in office work2017In: IISE Transactions on Occupational Ergonomics and Human Factors, ISSN 2472-5838, Vol. 5, no 1, p. 39-46Article in journal (Refereed)
    Abstract [en]

    Background: Introduction of sit-stand tables has been proposed as an initiative to decrease sedentary behavior among office workers and thus reduce risks of negative cardiometabolic health effects. However, ensuring proper and sustainable use of such tables has remained a challenge for successful implementation. Objective: We developed a new system to promote and sustain the use of sit-stand tables. Methods: The system was programmed to change the position of the table between “sit” and “stand” positions according to a regular pre-set pattern, if the user agreed to the system-generated prompts prior to each change. The user could respond to the system-generated prompts by agreeing, refusing or delaying the changes by 2 minutes. We obtained user compliance data when this system was programmed to a schedule of 10 minutes of standing after every 50 minutes of sitting. Compliance was investigated in nine office workers who were offered the semi-automated sit-stand table for two months. Results: On average, the system issued 12-14 alerts per day throughout the period. Average acceptance rate ranged from 75.0-82.4%, and refusal rate ranged from 11.8-10.1% between the first and eighth weeks of intervention (difference not statistically significant). During the first week after introduction, the table was in a standing position for 75.2 min on average, increasing slightly to 77.5 min in the eighth week. Conclusion: Since the workers were essentially sitting down before the table was introduced, these results suggest that the system was accepted well, and led to an effective reduction of sitting during working hours. Users also reported that the system contributed positively to their health and wellbeing, without interrupt their regular work, and that they would like to continue using the sit-stand table even beyond the two-month period, as part of their regular work. Compliance beyond two months of use, however, needs to be verified.

  • 17.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos.
    Mathiassen, Svend Erik
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Srinivasan, Divya
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    dos Santos, Willian Miranda
    Department of Mechanical Engineering, University of São Paulo.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos.
    Use of sit-stand stations during the first 2 months after their introduction2016Conference paper (Refereed)
    Abstract [en]

    Background. There is increasing evidence that sedentary behaviour during the workday is associated with negative health effects. In this context, interventions to reduce total sedentary time and breaking up periods of continuous sitting during computerized office work are urgently needed. Several reviews conclude that introducing sit-stand stations may lead to positive effects, but they also state that long-term interventions in real occu-pational settings are still rare. Therefore, the aim of this study was to investigate usage of sit-stand tables among Brazilian office workers during an intervention lasting two months.

    Methods.Nine office workers (6 females, 3 males; age 42 [SD 12] years) participated. The workers received traditional sit-stand tables and ergonomics information. They then used the workstation for two months. The tables were furnished with a system that recorded and kept track of table use during the intervention period. Table use early and late in the intervention period was compared using the Wilcoxon signed-rank test for repeated measurements.

    Results. In the beginning of the eight-week intervention period, workers, in median, changed table position 2.4 (1.9 – 4.7) times per day, decreasing to 2.3 (1.0 – 3.3) times at the end (P=0.09). Moreover, we also found a non-significant decrease in total time stand-ing per day, from 88.6 (67.4 – 94.3) minutes to 58.8 (33.1 – 95.7) minutes (P=0.31).

    Discussion. Two months after introducing sit-stand tables, some decrease in usage could be seen, if not statistically significant. Based on this, we emphasize that introduction of sit-stand tables should be accompanied by continued encouragement of the workers, preferably informed by a personalized follow up of actual use.

  • 18.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil.
    Mathiassen, Svend Erik
    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.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, USA.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil.
    For sit-stand desks, semiautomated prompting may lead the way2017In: Industrial and Systems Engineering at Work, ISSN 2168-9210, Vol. 49, no 5, p. 51-52Article in journal (Other academic)
  • 19.
    Barbieri, Dechristian
    et al.
    Universidade Federal de São Carlos.
    Srinivasan, Divya
    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.
    Mathiassen, Svend Erik
    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.
    Nogueira, Helen
    Universidade Federal de São Carlos.
    Oliveira, Ana Beatriz
    Universidade Federal de São Carlos.
    The ability of non-computer tasks to increase biomechanical exposure variability in computer-intensive office work2015In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 58, no 1, p. 50-64Article in journal (Refereed)
    Abstract [en]

    Postures and muscle activity in the upper body were recorded from 50 academics office workers during 2 hours of normal work, categorised by observation into computer work (CW) and three non-computer (NC) tasks (NC seated work, NC standing/walking work and breaks). NC tasks differed significantly in exposures from CW, with standing/walking NC tasks representing the largest contrasts for most of the exposure variables. For the majority of workers, exposure variability was larger in their present job than in CW alone, as measured by the job variability ratio (JVR), i.e. the ratio between min–min variabilities in the job and in CW. Calculations of JVRs for simulated jobs containing different proportions of CW showed that variability could, indeed, be increased by redistributing available tasks, but that substantial increases could only be achieved by introducing more vigorous tasks in the job, in casu illustrated by cleaning.

  • 20.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brasil.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.
    Mathiassen, Svend Erik
    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.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brasil.
    The effect of sit-stand workstations to decrease sedentariness in office work: tests of 2 systems with and without automatic reminders2016Conference paper (Refereed)
    Abstract [en]

    Sedentary behaviors in office workers has become a major public health concern and several initiatives have been proposed to break up sedentary behavior patterns during the performance of computer-intensive office work. Among such initiatives, the use of sit-stand workstations has been suggested to be one of the most promising by recent reviews. However, there still is only limited scientific evidence showing how effective sit-stand workstations are, in reducing sedentary behaviors and also documentation of their sustainability of use in studies of regular office work (i.e. as the “newness” of the system wears off, with time since introduction). This study aimed to document user behaviors and compare the use of two sit-stand workstation based interventions among two groups of administrative office workers: an “autonomous” group in which these workstations were introduced following some general ergonomic guidelines, and another “feedback-system” group in which the sit-stand tables were furnished with a semi-automatic reminder system, programmed to raise the table to a high (i.e. standing) position for 10 minutes after every accumulated 50 minutes of the table being in a low (i.e. sitting) position, i.e. to result in about 83% sitting per day. In addition, the sustainability of the use of these two kinds of sit-stand workstation interventions over two continuous months since their introduction was also studied. The results averaged over two months of usage of the two interventions showed that the percentage (%) sitting time was 87.4 (84.9-89.2) on average in the autonomous group and 84.0 (83.5-85.4) on average in the feedback-system group (P=0.001), and the frequency of switches between sitting and standing was 0.3 (0.2-0.3) per hour in the autonomous group and 0.7 (0.6-0.7) per hour in the feedback-system group (P=0.001). Thus, the sit-stand table system integrated with the automatic reminder system led to more reduction in sitting time and more switches in posture between sitting and standing as compared to the traditional sit-stand table, and behaviors of both groups were seen to be sustained over the 2-month intervention period (no difference across time for any of the variables tested for any group).

  • 21.
    Barbieri, Dechristian
    et al.
    Department of Physical Therapy, Federal University of São Carlos.
    Srinivasan, Divya
    Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University.
    Mathiassen, Svend Erik
    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.
    Oliveira, Ana Beatriz
    Department of Physical Therapy, Federal University of São Carlos.
    Variation in upper extremity, neck and trunk postures when performing computer work at a sit-stand station2017In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the extent of upper arm, neck and trunk posture variation that can be obtained by combining seated and standing computer work, compared to performing only seated computer work. Posture data were recorded for two hours during each of three days of ordinary work from 24 office workers that had been using a sit-stand station for two months. Periods with sitting and standing computer work were identified using on-site observations, and posture means and minute-to-minute variance were determined for both. Expected minute-to-minute posture variability in different temporal combinations of sitting and standing computer work were determined by simulation, and expressed in terms of a Job Variance Ratio, i.e. the relative increase in variability compared to sitting-only work. For all three postures, mean values differed between sitting and standing computer work, and both showed a notable minute-to-minute variability. For most workers, posture variability was larger when combining sitting and standing than when sitting only, and simulations suggested to introduce more standing than what the worker currently practiced. The results indicate that introducing a sit-stand table could, for most office workers, have a positive effect on upper arm, neck and trunk posture variability.

  • 22.
    Bergsten, Eva L
    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.
    Flygplanslastning –  ett samarbetsprojekt som leder till arbetsmiljöförbättringar2014Conference paper (Other academic)
  • 23.
    Bergsten, Eva L
    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. Department of Medical Sciences, Occupational and Environmental Medicine, Akademiska sjukhuset, Uppsala Universitet.
    Working conditions and musculoskeletal disorders in flight baggage handling2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    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.

  • 24.
    Bergsten, Eva L.
    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.
    Mathiassen, Svend Erik
    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.
    Kwak, Lydia
    Unit of Intervention and Implementation Research for worker health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Vingård, Eva
    Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day2017In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 61, no 9, p. 1145-1153Article in journal (Refereed)
    Abstract [en]

    Objectives: This study of flight baggage handlers aimed at examining the extent to which shoulder pain developed during single work shifts, and whether a possible development was associated with biomechanical exposures and psychosocial factors during the same shift.

    Methods: Data were collected during, in total, 82 work shifts in 44 workers. Right and left shoulder pain intensity was rated just before and just after the shift (VAS scale 0-100 mm). Objective data on time in extreme and time in neutral upper arm postures were obtained for the full shift using accelerometers, and the baggage handlers registered the number of aircrafts handled in a diary. During half of the shift, workers were recorded on video for subsequent task analysis of baggage handling. Influence at work and support from colleagues were measured by use of Copenhagen Psychosocial Questionnaire (COPSOQ). Associations between exposures and the increase in pain intensity during the shift (daily pain) were analysed for the right and left shoulder separately using Generalized Estimating Equations (GEE).

    Results: Daily pain was observed in approximately one third of all shifts.  It was significantly associated with the number of aircrafts handled for both the right and left shoulder. In multivariate models including both biomechanical exposures and the psychosocial factors influence at work and support from colleagues, aircrafts handled was still significantly associated with daily pain in both shoulders, and so was influence and support, however in opposite directions.

    Conclusions: Daily pain was, in general, associated with biomechanical exposures during the same shift and with general influence and support in the job. In an effort to reduce pain among flight baggage handlers, it may therefore be justified to consider a reduction of biomechanical exposures during handling of aircrafts, combined with due attention to psychosocial factors at work.

  • 25.
    Bergsten, Eva L
    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.
    Palm, Peter
    Anundi, Helena
    Rehfisch, Pia
    Vibrationsexponering i saneringsföretag - Var är FHV?2014Conference paper (Other academic)
  • 26.
    Bergsten, Eva
    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.
    Mathiassen, Svend Erik
    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.
    Larsson, Johan
    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.
    Kwak, Lydia
    Unit of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Evaluation of an ergonomic intervention in Swedish flight baggage handlers2016Conference paper (Refereed)
    Abstract [en]

    Background: Flight baggage handling is a worldwide occupation where baggage and cargo is sorted, loaded and unloaded on and off aircrafts. With the ultimate purpose of reducing and preventing musculoskeletal disorders among flight baggage handlers in Sweden, the Vocational Training and Working Environment Council (TYA) - a council formed by employers and unions in the Swedish transportation sector – initiated and implemented a project (2010-2012). This project revealed that ergonomics equipment was not used adequately, and this was considered a major factor of concern. Therefore, a training program was initiated 2014 in one handling company, aiming to improve ergonomics, behavior and attitudes. We evaluated the implementation process with regard to process items, intermediate outcomes, barriers and facilitators; for the purpose of gaining knowledge that could facilitate successful implementation in other handling companies. Methods: A mixed methods design was applied, based on qualitative and quantitative data. We evaluated six process items, recruitment, context, reach, dose delivered, dose received and satisfaction; intermediate outcomes of the intervention; skills, confidence and behaviour in the workforce; barriers and facilitators for successful implementation. Data was retrieved using company data, course evaluations, web questionnaires, and telephone interviews with company ‘observers’ and key persons. Preliminary results: The implementation process was judged to be feasible with regard to some of the process items. According to the informants, work place behaviour related to use of equipment had, however, not changed after the training period. Reported barriers were, 1) insufficient time and leader support for practicing new procedures during and after the training, 2) simultaneous reorganization of teams and work tasks, 3) lack of follow-up of the training, which would have supported good performance according to the informants. Conclusion: The implementation process was hampered by barriers, some of which could be addressed in future ergonomics training programs in other baggage handling companies.

  • 27.
    Bergsten, Eva
    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. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Mathiassen, Svend Erik
    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.
    Larsson, Johan
    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.
    Kwak, Lydia
    Unit of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet.
    Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 3, article id e0191760Article in journal (Refereed)
    Abstract [en]

    Objective: To conduct a process evaluation of the implementation of an ergonomics training program aimed at increasing the use of loading assist devices in flight baggage handling.

    Methods: Feasibility (recruitment, reach, context, dose delivered, dose received, satisfaction); intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods.

    Results: Implementation proved feasible regarding dose delivered, dose received and satisfaction. Confidence among participants in the training program in using and talking about devices, observed use of devices among colleagues, and internal feedback on work behavior increased significantly (p<0.01). Main facilitators were self-efficacy, motivation, and perceived utility of training among the trainees. Barriers included lack of peer support, opportunities to observe and practice behaviors, and follow-up activities; as well as staff reduction and job insecurity.

    Conclusions: In identifying important barriers and facilitators for a successful outcome, our study can help supporting the effectiveness of future interventions. Our results show that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation.   

      

  • 28.
    Bergsten, Eva
    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. Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Mathiassen, Svend Erik
    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.
    Vingård, Eva
    Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Psychosocial work factors and musculoskeletal pain: a cross-sectional study among Swedish flight baggage handlers2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, article id 798042Article in journal (Refereed)
    Abstract [en]

    Objective. Flight baggage handlers sort and load luggage to airplanes. This study aimed at investigating associations between psychosocial exposures and low back and shoulder musculoskeletal disorders (MSDs) among Swedish flight baggage handlers.

    Methods. A questionnaire addressing MSDs (Standardized Nordic Questionnaire) and psychosocial factors (Copenhagen Psychosocial Questionnaire, COPSOQ) was answered by 525 baggage handlers in six Swedish airports.

    Results. Low back (LBP) and shoulder pain (SP) was reported by 70% and 60%, respectively. Pain was reported to interfere with work (PIW) by 30% (low back) and 18% (shoulders), and intense pain (PINT) occurred in 34% and 28% of the population. Quality of leadership was the most dissatisfying psychosocial factor, while the most positive was social community at work. Low ratings in the combined domain Work organization and job content were significantly associated with PIW in both low back and shoulders (Adjusted Hazard Ratios 3.65 (95% CI 1.67-7.99) and 2.68 (1.09-6.61)) while lower ratings in the domain Interpersonal relations and leadership were associated with PIW LBP (HR 2.18 (1.06-4.49)) and PINT LBP and SP (HRs 1.95 (1.05-3.65) and 2.11 (1.08-4.12)).

    Conclusion. Severity of pain among flight baggage handlers was associated with psychosocial factors at work, suggesting that they may be a relevant target for intervention in this occupation.

  • 29.
    Bergsten, Eva
    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. b Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Mathiassen, Svend Erik
    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.
    Vingård, Eva
    Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Psychosocial work factors and musculoskeletal pain among Swedish flight baggage handlers2015In: Proceedings of the 19th Triennial Congress of the International Ergonomics Association, Melbourne, 9-14 August 2015 / [ed] Gitte Lindgaard & Dave Moore, 2015Conference paper (Refereed)
    Abstract [en]

    Flight baggage handlers are employed by handling companies engaged in sorting, loading and unloading luggage, cargo and mail, so called ramp service work. After check-in, luggage are transported through a sorting area and further out to the ramp. This transportation involves manual handling by baggage handlers at several stages, using conveyor belts, carts and trucks for transport. In addition to these tasks, baggage handlers are also engaged in communicating with air traffic controllers directing air traffic on the ground, towing aircrafts to gates and serving them with auxiliary power units, brakes and light. Baggage handling services are similar in all larger airports, and so baggage handlers perform similar tasks all over the world. In Sweden the handlers’ union claimed a high prevalence of low back and shoulder pain and a dissatisfying psychosocial work environment, but systematically collected empirical data were not available, and the literature was surprisingly sparse, considering that the occupation is global. Thus, a comprehensive project initiated by the Vocational Training and Working Environment Council, TYA, in Sweden - a council formed by employers’ and employees’ organizations in the transportation sector -was conducted at 14 handling companies in six Swedish airports between 2010 and 2012. The project aimed to document the physical and psychosocial work environment and to contribute to the development of ergonomic interventions within this occupation, which could, eventually, lead to better health among the employees. The present study was part of this project, in aiming at documenting psychosocial exposures and musculoskeletal disorders (MSDs) in the flight baggage handler population, and at determining possible associations between exposures and disorders.

  • 30.
    Bergsten, Eva
    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.
    Zetterberg, Camilla
    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.
    Bjärntoft, Sofie
    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.
    Edvinsson, Johanna
    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.
    Hallman, David
    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.
    Mathiassen, Svend Erik
    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.
    Kjellberg, Anders
    University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    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.
    Jahncke, Helena
    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.
    Schemalagt arbete - Hälsofrämjande återhämtningsmönster i schemalagda arbeten: Delområde Färjerederiet2017Report (Other academic)
  • 31.
    Bergsten, Eva
    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.
    Zetterberg, Camilla
    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.
    Bjärntoft, Sofie
    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.
    Edvinsson, Johanna
    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.
    Hallman, David
    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.
    Mathiassen, Svend Erik
    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.
    Kjellberg, Anders
    University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    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.
    Jahncke, Helena
    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.
    Schemalagt arbete - Hälsofrämjande återhämtningsmönster i schemalagda arbeten: Delområde Förarprov2017Report (Other academic)
  • 32.
    Bergsten, Eva
    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.
    Zetterberg, Camilla
    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.
    Bjärntoft, Sofie
    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.
    Edvinsson, Johanna
    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.
    Hallman, David
    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.
    Mathiassen, Svend Erik
    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.
    Kjellberg, Anders
    University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    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.
    Jahncke, Helena
    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.
    Schemalagt arbete - Hälsofrämjande återhämtningsmönster i schemalagda arbeten: Delområde Trafikledning2017Report (Other academic)
  • 33.
    Bergsten, Eva
    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.
    Zetterberg, Camilla
    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.
    Bjärntoft, Sofie
    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.
    Edvinsson, Johanna
    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.
    Hallman, David
    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.
    Mathiassen, Svend Erik
    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.
    Kjellberg, Anders
    University of Gävle, Centre for Musculoskeletal Research.
    Larsson, Johan
    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.
    Jahncke, Helena
    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.
    Schemalagt arbete: Hälsofrämjande återhämtningsmönster i schemalagda arbeten: Kartläggning hösten 20162017Report (Other academic)
  • 34.
    Björklund, Martin
    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. Institutionen för samhällsmedicin och rehabilitering, fysioterapi, Umeå universitet.
    What works for whom:challenges in personalising physical therapy: Discussion panel2015Conference paper (Other academic)
  • 35.
    Björklund, Martin
    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. Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Djupsjöbacka, Mats
    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.
    Svedmark, Åsa
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Häger, Charlotte
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain: a randomized controlled trial2014Conference paper (Refereed)
    Abstract [en]

    Aim of the investigation: The evidence for physiotherapy treatments of nonspecific neck pain is modest despite a large increase of intervention studies the last decade. One reason could be different underlying causes for pain in individuals with nonspecific neck pain, and that identification of sub-groups or individual needs is seldom accounted for in studies. In the absence of causal treatment options, a tailored treatment approach based on an explicit clinical decision model guided by assessment of function, clinical signs and symptoms, should be considered. Our aim was to evaluate tailored treatment based on such a decision model, targeting women with nonspecific neck pain. Our main hypothesis was that the tailored treatment (T) would have better short, intermediate and long-term effects on pain intensity and pressure pain threshold for the trapezius muscles than either non-tailored treatment (NT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that T or NT has better effect than TAU. For details, cf. Current Controlled Trials registration ISRCTN49348025 and published study protocol.

    Methods: 120 working women with minimum six weeks duration of neck pain were randomized to the T, NT or TAU groups. All participants had more than “no disability” but less than “complete disability” according to the Neck Disability Index, and reported impaired capacity on the quality or quantity to work the preceding month. Main exclusion criteria were trauma-related neck pain, specific diagnoses and generalized pain or concomitant low back pain. The decision model for tailored treatment was based on tests and symptoms with defined cut-off levels comprising the following main categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, trapezius myalgia, cervicogenic headache and impaired eye-head-neck control (cf. published study protocol). Assessment was performed one week before and after the 11-weeks intervention, with follow-ups 6-months (intermediate-term) and 12-months (long-term) after the intervention. Outcome variables were pain intensity (Numeric Rating Scale, NRS, 0 – 10) and pressure pain threshold (PPT) of the upper trapezius muscles (kPa). PPT was not measured at long-term follow-up.  Preliminary statistical analyses for the predefined hypotheses were performed with analysis of covariance (ANCOVA) with baseline outcome values as covariates. This was supplemented with pairwise Bonferroni-compensated comparisons in case of significance of factor group.

    Results: 86% of the participants completed the intervention, and the attrition was similar across groups. Preliminary results for the short term evaluation showed a reduction in NRS from an average of 4.4 and 4.5 to 2.5 in the T and NT groups, respectively, which was significantly greater compared to the TAU group (p=0.024 and p=0.014 for T and NT). For the PPT, there was no difference between T and NT groups at the short term evaluation, but close to a significantly increased threshold for the T compared to the TAU group (p=0,058). No differences were found between treatment groups on the intermediate and long-term evaluations for neither of the two outcome variables.

    Conclusions: The results indicate that tailored treatment for women with nonspecific neck pain may not be more effective, with respect to pain reduction, compared to non-tailored treatment. The hypothesis of superiority of tailored or non-tailored treatment over treatment-as-usual was partly supported for the short-term evaluation. However, the short-term results should be interpreted with caution since the impact of higher attention given to the participants in T and NT groups is not known. Reference:1. Björklund M, Djupsjöbacka M, Svedmark Å, Häger C. (2012) Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial. BMC Musculoskeletal Disorders. May 20;13(1):75

  • 36.
    Björklund, Martin
    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. Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden,.
    Tronarp, Rebecca
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Granås, Marie
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Dahlgren, Gunilla
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    McDonough, Suzanne
    University of Ulster, UK.
    Nyberg, André
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Häger, Charlotte
    Umea University, Dept of Community Medicine and Rehabilitation; Physiotherapy, Umeå, Sweden.
    Office-cycling while working: An innovative concept to prevent and reduce musculoskeletal pain in office workers - a controlled feasibility study2015Conference paper (Refereed)
    Abstract [en]

    Background: According to the World Health Organization, WHO, a sedentary lifestyle is the single largest health risk for a number of diseases including musculoskeletal disorders and metabolic diseases. The negative health effects of excessive sitting are not compensated for by shorter bouts of increased physical activity. However, evidence shows that increased physical activity reduces musculoskeletal pain, which is very prevalent in those who are inactive. About 50-70 % of those who work at a computer report musculoskeletal pain and spend on average about 5 hours/day with very low energy metabolism. Work places are therefore an important arena for prevention and intervention by means of reducing sedentary time and increasing physical activity both for general health benefits and effects on the musculoskeletal pain.

    Purpose: To test the feasibility of office-cycling in an office work place and explore its potential effects on musculoskeletal pain in office workers.

    Methods: Twenty office workers (ages 27-61, 5 males) with musculoskeletal pain participated in this three-week controlled pilot field study. The intervention group (n=10), had access to an innovative customized cycle ergometer (OfficeBiking®) at their regular office workstation whilst performing their usual work tasks. Offie-cycling was an alternative to sitting/standing by their height adjustable office desk; they were instructed to bike as often as comfortable. The control group (n=10) was instructed to continue to work as usual. The experiences of office-cycling and how it influenced work performance was studied with a questionnaire. Musculoskeletal pain was evaluated using pain drawings and pain ratings and participants' total pain was calculated by adding each individuals' self-reported pain from their three most painful areas (NRS 0-10).

    Results: Importantly, office-cycling did not reduce self-reported work performance; the majority (9/10) would like daily access; and made suggestions to improve the user-friendliness of the bike. Office-cycling was used regularly (median, 11/15 workdays; median active time 59 min/day IQR 39;91). There was no observed difference regarding either number of self-reported areas of pain (NSAP) or general musculoskeletal pain (GMP) between the intervention group and the control group at baseline. Self-reported GMP decreased in 8 persons in the intervention group which was one more than in the control group (n=7). NSAP decreased in the intervention group (n=7; md -1,0 IQR -2,3;0,0); and the control group (n=5; md -0,5 IQR -1,3;0,3). The difference in total pain (intervention end-baseline) revealed a clinically important change in the intervention group (NRS -2,5, IQR -8,8;4,0) but not in the control group (NRS 0,0 IQR -6,2;2,5).

    Conclusions: The results suggest that office-cycling is a feasible method for use in work place interventions with some promising results. Future research suggestions are: underlying mechanisms regarding effects of physical activity on pain in parallel with controlled studies in laboratory environments to investigate dose-effects for metabolic expenditure and optimal pain reduction whilst office-cycling.

    Implications: The results in this feasibility study indicate a promising potential of the innovative office-cycling concept to prevent and reduce musculoskeletal pain in sedentary office workers.

  • 37.
    Björklund, Martin
    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. Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umeå Sweden.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 1, p. 161-170Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    Methods

    Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    Results

    The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).

    Conclusions

    Validity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.

  • 38.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Josephson, Malin
    Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rissén, Dag
    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. Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Prominent attractive qualities of nurses’ work in operating room departments: a questionnaire study2015In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 52, no 4, p. 877-889Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The shortage of nurses in operating room departments (ORs) in Sweden and other countries can lead to reduced capacity and quality in healthcare, as well as more intense work for those on the job. Little is known about what nurses in ORs perceive as crucial for their workplace to be attractive.

    OBJECTIVE: To capture attractive qualities of nurses work in ORs and to adapt the Attractive Work Questionnaire (AWQ).

    METHODS: The AWQ, rating attractive qualities of work, were completed by 147 (68%) nurses in four Swedish ORs. Principal Component Analyses were performed to determine the underlying structure of the data.

    RESULTS: The factors in the area Work conditions were: relations, leadership, equipment, salary, organisation, physical work environment, location, and working hours; in the area Work content: mental work, autonomy and work rate; and in the area Job satisfaction: status and acknowledgement. The Principal Component Analysis showed consistency with the original AWQ. Cronbach’s alpha varied between 0.57-0.90.

    CONCLUSIONS: The AWQ captured attractive qualities for nurses in ORs, some less discussed regarding nurse retention, i.e. equipment, physical work environment and location. The results suggest that the questionnaire is reliable and valid and can be a useful tool in identifying attractive work.

  • 39.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden .
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Rissén, Dag
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Significant factors for work attractiveness and how these differ from the current work situation among operating department nurses2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 1-2, p. 109-116Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim was to examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses. A second objective was to examine the associations between age, gender, length of employment, work engagement, work ability, self-rated health indicators and attractiveness of the current work situation.

    BACKGROUND: The attractiveness of work is rarely taken into account in research on nurse retention. To expand this knowledge, it is relevant to examine factors that make work attractive and their associations with related concepts.

    DESIGN: Correlational, cross-sectional survey using a convenience sample.

    METHODS: Questionnaires were answered by 147 nurses in four operating departments in Sweden. Correlation and regression analyses were conducted.

    RESULTS: The nurses rated the significance of all factors of work attractiveness higher than they rated those factors in their current work situation; salary, organisation and physical work environment had the largest differences. The most significant attractive factors were relationships, leadership and status. A statistically significant positive correlation between work engagement and attractive work was found. In the multiple regression model, the independent variables work engagement and older age significantly predicted work attractiveness.

    CONCLUSIONS: Several factors should be considered in the effort to increase work attractiveness in operating departments and thereby to encourage nurse retention. Positive aspects of work seem to unite work engagement and attractive work, while work ability and self-rated health indicators are other important dimensions in nurse retention.

    RELEVANCE TO CLINICAL PRACTICE: The great discrepancies between the significance of attractive factors and the current work situation in salary, organisation and physical work environment suggest ways in which work attractiveness may be increased. To discover exactly what needs to be improved may require a deeper look into the construct of the examined factors.

  • 40.
    Björn, Catrine
    et al.
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University.
    Rissén, Dag
    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.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University.
    Josephson, Malin
    Department of Occupational and Environmental Medicine, Uppsala University.
    Goal-setting documents did not facilitate nurses’ work at an operating department – a descriptive qualitative study2014In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800Article in journal (Refereed)
    Abstract [en]

    Both effectiveness and good care is demanded of nurses in a complex environment. The aim of the study was to describe how nurse managers and nurses interpret and are guided by stated goals in their health-care organisation, their own influence over work and obstacles to carry out work in an operating department. A qualitative study, consisting of interviews with nurse managers and nurses, and a description of goal documents and the workplace, were conducted in an operating department in Sweden. The interviews were analysed with manifest content analysis. Work was guided by daily goals for the nurses: to meet the operating schedule and to ensure good-quality patient care. The organisational goals were little known and used. The nurse managers and nurses had limited influence over their work, changes in assignments and in the operating schedule, and unsuitable environmental premises created obstacles in their work. If organisational goals are to guide work there is a need for nurse managers to transform them into understandable, applicable goals and incorporate them into nurses’ daily work. Letting the nurses influence the operating schedule could be one way to overcome obstacles in work. The study also highlights the importance of a functional physical work environment.

  • 41.
    Björn, Catrine
    et al.
    Uppsala University, Uppsala, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden; Karlstad University, Sweden.
    Rissén, Dag
    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. Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Wadensten, Barbro
    Josephson, Malin
    The opportunities and obstacles nurses have in carrying out their work: a case study in an operating department in Sweden2017In: Perioperative Care and Operating Room Management, ISSN 2405-6030, Vol. 6, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Background To improve working conditions and counteract nursing shortages, more knowledge is needed about the opportunities nurses have to carry out their work and what guide nurses’ work. The aim of this study was to use the ARIA guide to identify the opportunities and obstacles in nurse managers, registered specialist nurses and non-registered assistant nurses work in an operating department. Methods A descriptive case study design was performed in an operating department, comprising structured individual and group interviews according to work content analyses with nurse managers, registered specialist nurses and assistant nurses. Interviews were analysed in terms of predetermined aspects regarding working conditions and criteria for performance obstacles. Extracts from documents stating goals and registered data supplemented the interviews. Results The findings show that the daily surgery schedule, not the goal documents, guided daily work. An over-optimistic surgery schedule with unplanned changes and cancellations, over which the nurses had very little influence, as well as the time required to locate necessary equipment that was spread throughout the ward, resulted in nurses rushing through medical records and other preparations rather than preparing calmly for surgery. Although the registered specialist nurses and assistant nurses considered quality of care to be highly important, no standardised evaluations on quality of care were performed. Conclusion The study reveals the importance of a functioning physical work environment including storage, technical equipment supplies, and the positioning of technical equipment in operating rooms, in order for registered specialist and assistant nurses to perform their tasks well. Due to goal incongruence and performance obstacles, the nurses were often unable to reach their daily goals. Involving registered specialist nurses in the process of planning of the surgery schedule could facilitate their work to better match the prerequisites in the physical work environment and among available staff. In order for the Operating Department Goal Document to guide work, goals must be transformed into understandable, realistic, applicable and evaluable aims, and incorporated into daily work. 

  • 42.
    Borg, Tina
    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.
    Björklund, Martin
    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. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi..
    Djupsjöbacka, Mats
    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.
    Wänman, Anders
    Hellström, Fredrik
    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.
    Perceived muscular tension in healthy subjects: a cross-sectional study2016In: PREMUS2016: Book of abstracts, 2016, p. 411-411Conference paper (Refereed)
    Abstract [en]

    Background. Perceived muscular tension (PMT) has been suggested to predict development of neck/shoulder pain. It has been hypothesized to be an early sign of musculoskeletal disorder and a possible mediator of stress on symptoms. However, the content of the concept of PMT is not clear. This study examined the association between PMT and physical and psychosocial factors and physical activity in a group of healthy students.

    Methods. This cross-sectional study was conducted on the baseline measurements of an ongoing longitudinal case-control study. A total of 63 healthy university students without complaints of neck/shoulder pain were included (21 males, 42 females, mean age 24 years). PMT was measured by asking the question “Have you, during the past month, experienced muscular tension (for example, wrinkled your forehead, ground your teeth, raised your shoulders)?” with the following response options: never, a few times, a few times per week, or one or several times per day. Self-reports on symptoms in the neck, anxiety, depression, stress, mental health, physical health, sleep and physical activity were collected with questionnaires, as well as by tenderness on palpation of neck muscles and trapezius pressure pain threshold. This produced a total of 15 variables. The relationship between these variables and PMT were analyzed using Spearman’s rank correlation coefficient.

    Results. Positive correlations were found between PMT and temporomandibular complaints (rho= .34, p < .001), neck crepitus (rho= .33, p < .001), anxiety (rho= .33, p < .001), depression (rho= .31, p < .05), tenderness on palpation (rho= .25, p < .05). There was a negative correlation between PMT and mental health (rho= -.26, p < .05). Frequent experience of PMT had weak to moderate correlations with frequency of symptoms and higher psychosocial strain, but not with stress. This suggests some covariance between PMT and both physical and psychosocial factors.

  • 43.
    Carlsson, Ruth
    et al.
    Swedish Work Environment Authority.
    Mathiassen, Svend Erik
    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.
    Physical variation at work – a scientific review2016In: NES2016 - Ergonomics in theory and practice: Proceedings of 48th Annual Conference of Nordic Ergonomics and Human Factors Society / [ed] Järvelin-Pasanen, S, 2016, p. 156-159Conference paper (Refereed)
    Abstract [en]

    Physical variation is generally considered to be an important factor influencing the risk for musculoskeletal disorders in repetitive work, but a comprehensive scientific basis for this assumption has not been available. Thus, the Swedish Work Environment Authority requested the Centre for Musculoskeletal Research at the University of Gävle to review scientific standings regarding physical variation and its effects.  In total, 56 articles were included in the review. The results showed that occupationally relevant studies of the effects of physical variation are few, and that the effectiveness of initiatives promoting variation has also been studied to a limited extent. Thus, current research cannot provide a clear answer to what an effective combination would be of work tasks in a job in the context of physical variation, let alone the optimal time distribution of tasks in a short (hours, days) and long (weeks, months, years) perspective. Also, gender aspects of physical variation were considered to a very limited extent. There is a need for more studies of relevant initiatives aiming at creating increased physical variation by changing the contents of work or its temporal structure; including studies placing this issue in a gender perspective.

  • 44.
    Ciccarelli, Marina
    et al.
    School of Occupational Therapy & Social Work, Curtin University, Perth, Australia.
    Straker, Leon
    School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
    Mathiassen, Svend Erik
    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.
    Pollock, Clare
    Faculty of Health Sciences, Curtin University, Perth, Australia.
    Posture variation among office workers when using different information and communication technologies at work and away from work2014In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 57, no 11, p. 1678-1686Article in journal (Refereed)
    Abstract [en]

    Office workers perform tasks using different information and communication technologies (ICT) involving various postures. Adequate variation in postures and muscle activity is generally believed to protect against musculoskeletal complaints, but insufficient information exists regarding the effect on postural variation of using different ICT. Thus, this study among office workers aimed to determine and compare postures and postural variation associated with using distinct types of ICT. Upper arm, head and trunk postures of 24 office workers were measured with the Physiometer® over a whole day in their natural work and away-from-work environments. Postural variation was quantified using two indices; APDF(90-10) and EVA(sd).Various ICT had different postural means and variation. Paper-based tasks had more non-neutral, yet also more variable postures. Electronics-based tasks had more neutral postures, with less postural variability. Tasks simultaneously using paper- and electronics-based ICT had least neutral and least variable postures. Tasks without ICT usually had the most posture variability. Interspersing tasks involving different ICT could increase overall exposure variation among office workers and may thus contribute to musculoskeletal risk reduction.

  • 45.
    Ciccarelli, Marina
    et al.
    Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Straker, Leon
    Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Mathiassen, Svend Erik
    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.
    Pollock, Clare
    Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Variation in Muscle Activity Among Office Workers When Using Different Information Technologies at Work and Away From Work2013In: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 55, no 5, p. 911-923Article in journal (Refereed)
    Abstract [en]

    Objective: To determine differences in muscle activity amplitudes and variation of amplitudes, when using different Information and Communication Technologies (ICT).

    Background: Office workers use different ICT to perform tasks. Upper body musculoskeletal complaints are frequently reported by this occupational group. Increased muscle activity and insufficient muscle activity variation are potential risk factors for musculoskeletal complaints.

    Method: Muscle activity of right and left upper trapezius and right wrist extensor muscle bundle (extensor carpi radialis longus and brevis) of 24 office workers (performing their usual tasks requiring different ICT at work and away-from-work) were measured continuously over 10-12 hours. Muscle activity variation was quantified using two indices, APDF(90-10) and EVAsd.

    Results: There was a trend for electronics-based New ICT tasks to involve less electromyography (EMG) variation than paper-based Old ICT tasks. Performing Combined ICT tasks (i.e. using paper- and electronics-based ICT simultaneously) resulted in the highest muscle activity levels and least variation; however, these Combined ICT tasks were rarely performed. Tasks involving no ICT (Non-ICT) had the greatest muscle activity variation.

    Conclusion: Office workers in this study used various ICT during tasks at work and away-from-work. The high EMG amplitudes and low variation observed when using Combined ICT may present the greatest risk for musculoskeletal complaints, and use of Combined ICT by workers should be kept low in office work. Breaking up Combined, New and Old ICT tasks; for example, by interspersing highly variable Non-ICT tasks into office workers’ daily tasks, could increase overall muscle activity variation and reduce risk for musculoskeletal complaints.

  • 46.
    Clays, Els
    et al.
    Department of Public Health, Ghent University, Belgium.
    Hallman, David
    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.
    Oakman, J.
    Department of Public Health, La Trobe University, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Objectively measured occupational physical activities in blue collar jobs: do psychosocial resources matter?2017In: European Journal of Preventive Cardiology, 2017, Vol. 24(2S)Conference paper (Refereed)
  • 47.
    Coenen, Pieter
    et al.
    School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
    Korshøj, Mette
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Hallman, David M.
    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.
    Huysmans, Maaike A.
    Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
    van der Beek, Allard J.
    Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
    Straker, Leon M
    School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
    Differences in heart rate reserve of similar physical activities during work and in leisure time - A study among Danish blue-collar workers2018In: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 185, p. 45-51Article in journal (Refereed)
    Abstract [en]

    Recent studies suggest that while leisure-time physical activity (LTPA) promotes general health, engaging in occupational physical activity (OPA) may have negative health consequences. It has been hypothesized that the different health effects from OPA and LTPA can be explained by differences in physical activity (PA) intensity in these two domains. To assess the intensity of OPA and LTPA, we aimed to study the percentage heart rate reserve (%HRR) during similar types of OPA and LTPA during workdays. Data from the NOMAD study on Danish blue-collar workers (n=124) with objective measurements of PA (using accelerometers) and heart rate (using heart rate monitors) for 4 workdays were analysed. Activities of sitting, standing, moving, walking, and stair climbing were identified and %HRR in each of these activities was determined for work and leisure. %HRR was significantly higher during OPA than LTPA. These differences were more pronounced in men than in women. Although not statistically significant in the fully adjusted model, we found indications that these differences were more pronounced in those with low compared to high fitness. To our knowledge, this is the first study with objective measurements showing that %HRR is higher during the same gross-body postural activities when performed at work compared to leisure-time during workdays. This elevated intensity may help explaining the negative health consequences of engagement in high levels of OPA. Future guidelines should distinguish OPA from LTPA, possibly by advising workers to remain active during their leisure time, in particular when they are highly active at work.

  • 48.
    Coenen, Pieter
    et al.
    Department of Public and Occupational Health, VU University Medical Center, The Netherlands.
    Korshøj, Mette
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Hallman, David
    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.
    van der Beek, Allard
    Department of Public and Occupational Health, VU University Medical Center, The Netherlands.
    Straker, Leon
    School of Physiotherapy and Exercise Science, Curtin.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Differences in heart rate reserve during occupational and leisure time physical activity in Danish blue-collar workers2017In: European Journal of Preventive Cardiology / [ed] European Journal of Preventive Cardiology, Sage Publications, 2017, Vol. 24(2S), p. 7-53Conference paper (Refereed)
  • 49.
    Coenen, Pieter
    et al.
    Curtin University, Perth, Australia; VU University Amsterdam, the Netherlands; Body@Work, Research Center on Physical Activity, Work and Health, the Netherlands.
    Mathiassen, Svend Erik
    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.
    Kingma, Idsart
    VU University Amsterdam, the Netherlands; Body@Work, Research Center on Physical Activity, Work and Health, the Netherlands.
    Boot, Cécile
    Body@Work, Research Center on Physical Activity, Work and Health, the Netherlands; EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands.
    Bongers, Paulien
    Body@Work, Research Center on Physical Activity, Work and Health, the Netherlands; TNO Healthy Living, Hoofddorp, the Netherlands.
    van Dieën, Jaap
    VU University Amsterdam, the Netherlands; King Abdulaziz University,Jeddah, Saudi Arabia.
    Bias and power in group-based epidemiologic studies of low-back pain exposure and outcome: effects of study size and exposure measurement efforts2015In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 59, no 4, p. 439-454Article in journal (Refereed)
    Abstract [en]

    Objectives: Exposure-outcome studies, for instance on work-related low-back pain (LBP), often classify workers into groups for which exposures are estimated from measurements on a sample of workers within or outside the specific study. The present study investigated the influence on bias and power in exposure-outcome associations of the sizes of the total study population and the sample used to estimate exposures.

    Methods: At baseline, lifting, trunk flexion, and trunk rotation were observed for 371 of 1131 workers allocated to 19 a-priori defined occupational groups. LBP (dichotomous) was reported by all workers during three years of follow-up. All three exposures were associated with LBP in this parent study (p<0.01).

    All 21 combinations of n=10,20,30 workers per group with an outcome, and k=1,2,3,5,10,15,20 workers actually being observed were investigated using bootstrapping, repeating each combination 10,000 times. Odds ratios (OR) with p-values were determined for each of these virtual studies. Average OR and statistical power (p<0.05 and p<0.01) was determined from the bootstrap distributions at each (n,k) combination.

    Results: For lifting and flexed trunk, studies including n≥20 workers, with k≥5 observed, led to an almost unbiased OR and a power >0.80 (p-level 0.05). A similar performance required n≥30 workers for rotated trunk. Small numbers of observed workers (k) resulted in biased OR, while power was, in general, more sensitive to the total number of workers (n).

    Conclusions: In epidemiologic studies using a group-based exposure assessment strategy, statistical performance may be sufficient if outcome is obtained from a reasonably large number of workers, even if exposure is estimated from only few workers per group.

  • 50.
    Coenen, Pieter
    et al.
    Faculty of Human Movement Sciences, VU University Amsterdam.
    Mathiassen, Svend Erik
    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. University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science.
    Kingma, Idsart
    Faculty of Human Movement Sciences, VU University Amsterdam.
    Boot, Cécile
    Body@Work, Research Center on Physical Activity, Work and Health, The Netherlands.
    Bongers, Paulien
    Body@Work, Research Center on Physical Activity, Work and Health, The Netherlands.
    van Dieën, Jaap
    Faculty of Human Movement Sciences, VU University Amsterdam.
    Group-based exposuremeasurement strategies and their effects on trunk rotation and low-back pain exposure-outcome associations2013In: Occupational & Environmental Medicine: 23rd Conference on Epidemiology in Occupational Health EPICOH 2013: Improving the Impact June 18–21, 2013, Utrecht, The Netherlands, BMJ Journals , 2013, p. A101-A102Conference paper (Refereed)
    Abstract [en]

    Objectives In epidemiological studies of occupational exposures (e.g. lifting) and low-back pain (LBP), group-based exposure measurement strategies are common. Workers are classified into exposure groups; exposure is measured only in a selection of workers in each group, and their mean exposure is assigned to all workers in the group. Exposure-outcome relationships are then determined by regression, relating exposure estimates with individual LBP data from all subjects. The objective of this study was to assess the effect of different group-based measurement strategies on exposure-outcome associations.

    Methods 1122 workers, classified into 19 groups on the basis of job-related exposure, participated in this study. In each group, videos were collected from ~25% of the workers (in total, 370 workers), and percentage of the work day spent in trunk rotation was estimated by observation of the videos. This estimate of trunk rotation was significantly associated with self-reported LBP during three years of follow-up (OR:1.43 (1.06–1.93)).

    Using a bootstrap simulation, workers per group (n = 10, 20, 30, 40) and percentage of observed workers (k = 10, 20, 30, 40, 50%) were varied. For each combination, (nk) workers were selected with replacement in each job group among those observed, and n (100-k) workers among those not observed. The mean exposure of the observed workers was assigned to all group members which was related to individual LBP data. ORs and accompanying p-level was estimated using logistic-regression.

    Results A group-based measurement protocol led to significant (p < 0.05) ORs when the total number of workers was larger than n = 30 in each job group, and ≥20% was actually observed.

    Conclusions The proportion of observed workers did have an effect on p-values, but it appeared weaker than that of changing the total group size. These results suggest that it may be sufficient to observe only a minor proportion of workers if the overall size of the population is reasonably large.

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