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  • 501.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Uppsala universitet, Arbets- och miljömedicin.
    Forsman, Mikael
    Institutet för miljömedicin, Karolinska Institutet, Stockholm, Sverige.
    Richter, Hans O.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Neck/shoulder discomfort due to visually demanding near work is influenced by previous neck pain, task duration, astigmatism, eye discomfort and accommodation2017Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 8, artikkel-id e0182439Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Here, to investigate direct effects of experimental near work on eye and neck/shoulder discomfort, 33 individuals with chronic neck pain and 33 healthy control subjects performed four visual tasks, rating eye and neck/shoulder discomfort at baseline and after each task. The cumulative performance time (reflected in the temporal order of the tasks), astigmatism, concurrent eye discomfort, and extent of accommodation all aggravated neck/shoulder discomfort. There was an interaction effect between the temporal order and eye discomfort: participants with a greater mean increase in eye discomfort also developed more neck/shoulder discomfort with time. Since moderate musculoskeletal symptoms are a risk factor for more severe symptoms, it is important to ensure a good visual environment in occupations involving visually demanding near work.

  • 502.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lindberg, Per
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Hemphälä, Hillevi
    Lund University.
    Intra-rater reliability of the Visual Ergonomics Risk Assessment Method (VERAM)2018Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Apart from visual demands and dryness a number of environmental factors including design of the work station, lighting, glare, and the quality of the computer screen might exert an impact on eye-related symptoms. To date, there is a lack of valid and reliable instruments assessing factors associated with eye- or visual symptoms. Therefore, a new method to assess visual ergonomics at workplaces was developed in Sweden between 2014 and 2016, the Visual Ergonomics Risk Assessment Method - VERAM. A first version of the method was drafted by the researchers mainly from existing checklists and instruments, and tested in the field by trained visual ergonomists. The method was then revised and used in the field to collect data for validity and reliability analyses. The final version of VERAM includes both a questionnaire for the employee, and an expert evaluation of the employee’s workplace. The questionnaire consists of subjective ratings in six domains: eye discomfort (frequency and intensity), musculoskeletal discomfort (frequency and intensity), ratings of visual symptoms (e.g. blurred and double vision) and ratings of the visual environment (e.g. illumination levels, glare and reflexes from a work object or a computer screen). The expert evaluation consists of both objective measurements and subjective assessments resulting in an overall expert risk assessment (no risk, low risk or high risk) of eight factors: daylight, lighting, illuminance, glare, flicker, work space, work object and work posture.

    Aim: At the IEA conference 2018 the new VERAM method will be presented together with results from intra-rater reliability analyses.

    Results: Intra-rater reliability was evaluated with a re-test interval of minimum two and maximum three weeks. 99 employees were included in the analyses and 32 visual ergonomists performed the corresponding expert evaluations. The Intraclass Correlations (ICC) were between 0.70 and 0.87 for the six subjective domains, and there were no significant systematic differences between the first and second rating for any of the subjective domains (rmANOVA, p > 0.05, α = 0.008). For the eight environmental factors the expert estimated the risk equally during the first and the second assessment in 69-92% of the cases, and, as seen for the subjective domains, there were no significant systematic differences for any of the eight factors (Wilcoxon sign rank test, p > 0.014, α = 0.006). To control for multiple comparisons the Bonferroni method was used.

    Conclusion: The Visual Ergonomics Risk Assessment Method – VERAM showed good intra-rater reliability, both for the subjective questionnaire for the employee, and for the expert evaluation of the employee’s workplace when performed by a trained visual ergonomist.

  • 503.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lindberg, Per
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Nylén, Per
    Swedish Work Environment Authority, Stockholm, Sweden.
    Hemphälä, Hillevi
    Division of Ergonomics and Aerosol Technology, Design Sciences, Lund University, Lund, Sweden.
    Reliability of a new risk assessment method for visual ergonomics2019Inngår i: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 72, s. 71-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction

    The Visual Ergonomics Risk Assessment Method (VERAM) is a newly developed and validated method to assess visual ergonomics at workplaces. VERAM consists of a questionnaire and an objective evaluation.

    Objective

    To evaluate reliability of VERAM by assessing test-retest reliability of the questionnaire, and intra- and inter-rater reliability of the objective evaluation.

    Methods

    Forty-eight trained evaluators used VERAM to evaluate visual ergonomics at 174 workstations. The time interval for test-retest and intra-rater evaluations was 2–3 weeks, and the time interval for inter-rater evaluations was 0–2 days. Test-retest reliability was assessed by intraclass correlation (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC). Intra- and inter-rater reliability were assessed with weighted kappa coefficients and absolute agreement. Systematic changes were analysed with repeated measures analyses of variance and Wilcoxon sign rank test.

    Results

    The ICC of the questionnaire indices ranged from 0.69 to 0.87, while SEM ranged from 7.21 to 10.19 on a scale from 1 to 100, and SDC from 14.42 to 20.37. Intra-rater reliability of objective evaluations ranged from 0.57 to 0.85 (kappa coefficients) and the agreement from 69 to 91%. Inter-rater reliability of objective evaluations ranged from 0.37 to 0.72 (kappa coefficients) and the agreement from 52 to 87%.

    Conclusion

    VERAM is a reliable instrument for assessing risks in visual work environments. However, the reliability might increase further by improving the quality of training for evaluators. Complementary evaluations of VERAM's sensitivity to changes in the visual environment are needed.

    Relevance to industry

    It is advantageous to set up a work environment for maximal visual comfort to avoid negative effects on work postures and movements and thus prevent visual- and musculoskeletal symptoms. This method, VERAM, satisfies the need of a valid and reliable tool for determining risks associated with the visual work environment.

  • 504.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Medical Sciences, Section of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden..
    Hemphälä, Hillevi
    Ergonomics, Design Sciences, Lund University, Lund, Sweden.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Lighting, visual ergonomics and health implications : A workshop2014Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Aim of the workshop:

    Deficient visual ergonomics is a problem across many occupations. Poor viewingand lighting conditions is associated with both visual and neck/shoulder discomfort,and can also impact productivity. According to the provision from the Swedish WorkEnvironment Authority on prevention of musculoskeletal disorders (AFS 2012:02), riskassessment of the visual conditions are mandatory. The aim of this workshop is toincrease knowledge about visual ergonomics among practitioners working with riskassessment, and to allow participants hands-on practice in assessing the visual environment.

    Format of the workshop:

    The first part of the workshop will involve a brief presentation of the subject visualergonomics and its implications on health and performance. The impact of progressiveglasses, too small or blurred font letters, or blurred vision on posture at e.g. computerwork will be demonstrated together with advice how to proceed to improve the conditions.The second part of the workshop will allow participants some hands-on practicein for example; how to measure light (luminance and illuminance); how different lightconditions impact pupil size and visual comfort; how to measure and quantify amountof flicker, light modulation and colour rendering in different light sources. Several usefulmobile phone applications concerning light and vision will be demonstrated.

  • 505.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Hemphälä, Hillevi
    Lund University.
    Nylén, Per
    The Swedish Work Environment Authority, and The Royal Institute of Technology.
    Workshop in visual ergonomics2013Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Increased use of computers is common across many work sectors. Prolonged near work at a computer screen is associated with both visual discomfort and neck/shoulder discomfort and pain. Inadequate visual ergonomics at a computer workstation can also influence both visual and neck/shoulder discomfort. The new provision from the Swedish Work Environment Authority on prevention of musculoskeletal disorders includes risk assessment of occupational visual conditions. These assessments require practitioners to have knowledge of the topic, as well as experience with practical assessment tools.

    The first part of the workshop proposed here will involve a presentation of the theories underlying visual ergonomic practices and a discussion of the most important factors to assess at a computer workstation. These factors include contrast, font size, resolution, glare, reflexion, non-visual flicker, and edge sharpness. The second part of the workshop, will allow participants hands-on practice in measuring and evaluating visual ergonomics at a computer workstation.

  • 506.
    Zetterberg, Camilla
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Medical Sciences, Section of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden..
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Forsman, Mikael
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Temporal co-variation between eye lens accommodation and trapezius muscle activity during a dynamic near-far visual task2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikkel-id e0126578Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanism is still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapezius muscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.

  • 507.
    Zetterlund, Christina
    et al.
    Centre for Rehabilitation Research, Örebro University Hospital.
    Lundqvist, Lars-Olof
    Centre for Rehabilitation Research, Örebro University Hospital.
    Richter, Hans
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap.
    The relationship between low vision and musculoskeletal complaints: A case control study between age-related macular degeneration patients and age-matched controls with normal vision2009Inngår i: Journal of Optometry, ISSN 1888-4296, Vol. 2, nr 3, s. 127-133Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Age-related Macular Degeneration (AMD) patients often describe complaints from neck and scapula area muscles and a decreased postural control. In clinical assessment, these complaints are considered to be due to old age. Purpose: This study focuses on low vision patients with AMD, compared to age matched controls, without eye disease, in order to evaluate if a linkage between self-rated visual and muskuloskeletal complaints are more prominent when low vision is present. Methods: In a cross-sectional study, 24 AMD patients, aged 65-85 years, were compared to 24 controls of similar ages without visual problems. Visual acuity, the need for magnification plus other optical and visual data, were obtained. Visual, muskuloskeletal and balance/propriopceptive complaints were collected with a self-rating questionnaire. The Visual Functioning Questionnaire -Near Activities Subscale (VFQ-NAS) was used to evaluate visual function and related complaints. Results: The correlation coefficient between visual and musculoskeletal complaints yielded significant values when computed separately within each group as well as when calculated on the entire material (AMD ρ = 0.60, P = 0.002; control group ρ = 0.59, P = 0.004; both groups together ρ = 0.50 P < 0.001). Stepwise multiple regression analysis supported the hypothesized effect of vision (Visual complaints + Minimal readable typefaces) on musculoskeletal complaints, (R2 = 0.42, P < 0.05). Conclusions: The results in this study support the hypothesis of a relationship between visual and muskuloskeletal problems.

  • 508.
    Zetterlund, Christina
    et al.
    School of Health and Medicine, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Centre for Rehabilitiation Research, Örebro County Council, Örebro, Sweden.
    Richter, Hans
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Visual, musculoskeletal and balance symptoms in individuals with visual impairment and with age-normal vision2019Inngår i: Clinical and experimental optometry, ISSN 0816-4622, E-ISSN 1444-0938, Vol. 102, nr 1, s. 63-69Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Visual impairment is globally among the most prevalent disabilities. Research concerning the health consequences of visual deficits is challenged by confounding effects of age, because visual impairment becomes more prevalent with age. This study investigates the influence of visual deficits on visual, musculoskeletal and balance symptoms in adults with and without visual impairment, while controlling for age effects.

    METHODS:

    Thirty-nine patients with visual impairment, aged 18-72 years, were compared to 37 age-matched controls with normal vision, allocated to two age groups: < 45 and ≥ 45 years. Self-reported symptoms were measured using the Visual, Musculoskeletal and Balance Symptoms Questionnaire and compared with demographic and optometric variables.

    RESULTS:

    In total, patients with visual impairment reported more symptoms than age-matched normally sighted controls. Younger adults in the control group were almost free from symptoms, whereas younger adults with visual impairment reported levels of symptoms equal to older adults with visual impairment. Multiple logistic regression modelling identified use of eyeglasses, magnifying aids and presence of anisometropia to be the most influential risk factors for reporting visual, musculoskeletal and balance symptoms, with accentuated influence on balance symptoms.

    CONCLUSIONS:

    People with visual impairments and people with age-related normal visual deficits are both predisposed to report visual, musculoskeletal and balance symptoms relative to people without visual defects or need for eye-wear correction. Age-related variations in symptoms were observed in the control groups but not in the visual impairment groups, with younger visual impairment patients reporting as many symptoms as older visual impairment patients. These findings indicate a need for a wider interdisciplinary perspective on eye care concerning people with visual impairment and people with need for habitual daily use of eye wear correction.

  • 509.
    Zetterlund, Christina
    et al.
    The Low Vision Centre, Region Örebro County, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Richter, Hans O.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Lundqvist, Lars-Olov
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Visual, Musculoskeletal, and Balance Complaints in AMD: A Follow-Up Study2016Inngår i: Journal of Ophthalmology, ISSN 2090-004X, E-ISSN 2090-0058, Vol. 2016, artikkel-id 2707102Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. To investigate whether patients with age-related macular degeneration (AMD) run a potentially higher risk of developing visual, musculoskeletal, and balance complaints than age-matched controls with normal vision. Methods. Visual assessments, self-rated visual function, self-rated visual, musculoskeletal, and balance complaints, and perceived general health were obtained in 37 AMD patients and 18 controls, at baseline and after an average of 3.8 years later. Results. At follow-up both groups reported decreased visual acuity (VA) and visual function, but only AMD patients reported significantly increased visual, musculoskeletal, and balance complaints. Decreased VA, need for larger font size when reading, need for larger magnification, and decreased self-rated visual function were identified as risk markers for increased complaints in AMD patients. These complaints were also identified as risk markers for decreased health. For controls, decreased VA and self-reported visual function were associated with increased visual and balance complaints. Conclusions. Visual deterioration was a risk marker for increased visual, musculoskeletal, balance, and health complaints in AMD patients. Specifically, magnifying visual aids, such as CCTV, were a risk marker for increased complaints in AMD patients. This calls for early and coordinated actions to treat and prevent visual, musculoskeletal, balance, and health complaints in AMD patients.

  • 510.
    Åsell, Malin
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Svenska Rygginstitutet AB, Sundsvall, Sweden; Department of Odontology, Clinical Oral Physiology, Umeå University, Umeå, Sweden.
    Sjölander, Per
    Högskolan i Gävle, Centrum för belastningsskadeforskning. Southern Lapland Research Department, Vilhelmina, Sweden.
    Kerschbaumer, Helmut
    Svenska Rygginstitutet AB, Sundsvall, Sweden.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects?2006Inngår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 87, nr 9, s. 1170-1176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN: A single-blinded, controlled, multigroup comparative study.

    SETTING: Vocational rehabilitation center.

    PARTICIPANTS: Ninety-two patients with CLBP, divided into subgroups based on severity of symptoms and diagnostic characteristics. An age- and sex-matched group (n=31) of healthy subjects were the control. I

    NTERVENTIONS: Not applicable.

    MAIN OUTCOME MEASURES: We measured repositioning errors (variable, constant) at 3 positions of the lumbar spine. Subjects were guided to a sitting target posture and asked to perform lumbar flexion before reproducing the target posture. Self-assessed pain, self-efficacy, and functional ability were addressed through questionnaires.

    RESULTS: There were no differences in repositioning errors between the patients with CLBP or the subgroups of patients and the control group. We found only weak correlations between the repositioning errors and the self-reported data on functional disability, self-efficacy, and pain.

    CONCLUSIONS: We suggest that sensorimotor dysfunctions in CLBP should be evaluated with methods other than repositioning tests in order to generate data relevant to the development of rational diagnostic methods and rehabilitation programs.

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