Background

Repetitive work is associated with increased risk for occupational musculoskeletal health problems. Job rotation (JR) is an organizational approach for increasing variation within workers and promoting health, although evidence for the effectiveness of JR is limited.PurposeTo evaluate the extent of JR implementation and assess JR effectiveness on increasing within-worker muscle activity variability and improving health.

Methods

Together with laundromat management and staff, we created a team-based JR with a five-day rotation cycle and performed a pre-post intervention case study with a 12-month follow-up period. We assessed the extent to which the company had implemented the JR (delivery and adherence). We measured trapezius and forearm muscle activity for all tasks at baseline and created a task exposure matrix that we used to estimate within-worker variance over five days at baseline, for the planned JR, and for the actual JR observed at follow-up. Planned and actual JR variance estimates were compared to baseline to determine the theoretical and actual effects of the JR intervention. Changes in health-related outcomes were assessed at follow-up using questionnaires.

Results

At follow-up, the company had successfully delivered the JR to 65% of day-shift workers. For these workers, the planned JR had the potential to increase the mean within-worker job-level variance by 35% compared with baseline, and the actual JR achieved approximately 80% of that increase at follow-up. Over 45% of JR workers reported decreased work demands, fatigue, and need for recovery at follow-up compared to baseline. However, there was also a slight increase in the number of JR workers reporting musculoskeletal symptoms at follow-up.

Conclusion

This case study demonstrated that JR can increase within-worker variance in muscle activity, and that this change may decrease perceived occupational demands, fatigue, and need for recovery; however further consideration of the longer-term effects on musculoskeletal symptoms is warranted.

Introduction: Repetitive work is associated with increased risk for musculoskeletal disorders (MSDs). We collaborated with a commercial laundromat to design and implement a job rotation (JR) inspired by the Goldilocks Work paradigm. The JR was designed to increase within-worker variability and positively impact worker health. The aim of the study was to evaluate the effectiveness of the JR by assessing pre-post changes in within-worker variability (assessed as within-worker variance) and health related outcomes. 

Methods: This pre-post case study had a 12-month follow-up after company implementation of the co-created JR intervention. All day-shift operations employees (N=57) were included in the JR. We measured trapezius (Trap) and forearm (FA) muscle activity at baseline for all 21 JR tasks and created a task exposure matrix (TEM). Estimates of within-worker variance were made for all individual workers at baseline, for the planned JR, and for the actual JR observed at follow-up using the TEM combined with the tasks performed (self-reported at baseline and follow-up) and the planned JR schedule. Variance estimates for the planned and actual JR were compared to baseline estimates to determine the theoretical and actual effects of the JR. Self-reported health-related outcomes on fatigue, recovery and MSD symptoms were collected by survey at follow-up. JR delivery and adherence to were assessed

Results: At follow-up, the JR intervention had been delivered to 65% of all day-shift operations workers, all of whom demonstrated adherence to the JR.  The planned JR showed the potential to increase the average within-worker variance in Trap and FA muscle activity by 45% compared with baseline. At follow-up, the actual JR was shown to have achieved approximately 80% of the planned increase.  Positive health-related changes were also evident at follow-up: approximately 40% of participants reported both lower physical and mental occupational demands, and over 50% of workers reported less fatigue after work and feeling more rested and recovered when starting a workday at follow-up compared to baseline. The number of workers experiencing upper extremity MSD problems ‘fairly often’ or ‘very often’ showed a slight increase at follow-up compared to baseline. 

Discussion: This is the first JR study to demonstrate a positive effect on both within-worker variability and health related variables.  Consideration of variability is key to JR studies since the proposed effects of a JR on improved musculoskeletal health are expected occur through JR-related increases in variability. Further, the positive findings on decreased self-reported physical and mental demands and fatigue and increased recovery lend support for the theory that a re-distribution of existing tasks can increase the average within-worker variability for the workers in the JR and that this increase may lead to health benefits. However, no positive changes in MSD were associated with the JR. 

Conclusion: This case study demonstrated both the potential (planned) and actual effectiveness of the JR to increase within-worker variability in Trap and FA muscle activity. Further, the findings suggest the JR had positive impacts on health-related outcomes. 

Introduction: The combination at work of physical activity behaviours (e.g. sitting, standing, and physical activity) and psychosocial factors (e.g. influence and leadership quality) may be more important for preventing work-related pain than each of the exposures isolated (i.e., sitting or influence at work). However, this needs to be tested using accurate measurements of physical behaviours. We aimed to investigate the independent and combined associations of physical behaviours and psychosocial factors with pain in a sample of eldercare workers with high occurrence of pain.

Methods: We analysed cross-sectional data on 191 eldercare workers in a Swedish municipality. Participants responded to a web-survey and took part in technical measurements of physical behaviours using thigh-worn accelerometers over 7 days. We determined the proportion of time spent in sitting, standing and active behaviours during working hours for each participant. We then used the Aitchison distance to calculate the closeness (on a scale from 0 “worst possible” to 100 “ideal”) to the composition recommended by the EU (60%,30%,10% for sitting, standing and active, respectively). Leadership quality and influence at work were assessed using COPSOQIII. Pain intensity (0-10 scale) and worsening of pain due to work (0-5 scale) were used as outcomes in MANCOVA models with closeness and psychosocial factors as predictors.

Results: We found that being closer to the recommended composition of sitting, standing and being active at work was associated with lower pain intensity (F=6.3, p=0.01) and less worsening of pain due to work (F=9.2, p=0.003), independent of leadership quality and influence at work. We found no statistically significant interactions between closeness and psychosocial factors regarding these outcomes, but both higher leadership quality and influence at work showed associations with lower pain. 

Discussion: Physical behaviours and psychosocial factors at work were independently associated with pain in eldercare workers, while combining the exposures did not contribute to any additional explained variance in pain. These results should be interpreted with caution due to the cross-sectional design and risk of confounding by non-measured factors.

Conclusion: Musculoskeletal pain in eldercare workers was associated with the composition of sitting, standing and active, expressed in terms of closeness to EU guidelines, and physical and psychosocial exposures did not interact. Further research is required to understand the effects on musculoskeletal health of combining physical and psychosocial exposures, including their temporal patterns, in various occupational settings.

Objective: We aimed to assess the impact of telework conditions on stress levels among 294 Swedish white-collar workers.

Methods: Telework during the COVID-19 pandemic was evaluated in terms of the allowance to telework (ie, the degree to which the employee could decide whether to telework), and the utilization of that allowance, using self-reported questions with answers dichotomized into 'high' and 'low'. Perceived stress was measured using the Single Item Stress Question and physiological stress was measured using parameters of heart rate variability (HRV) continuously for three days [root mean square of successive differences (RMSSD) and standard deviation of the interbeat intervals of normal heart beats (SDNN)]. Multilevel linear mixed models examined the effects of telework allowance and utilization on perceived stress and HRV during work, leisure and sleep.

Results: High allowance was associated with higher HRV (lower stress), while a high utilization of telework was associated with higher perceived stress and lower HRV (more stress). After adjusting for age, sex, body mass index, and objectively measured physical activity, these associations became smaller and/or non-significant, with exception of high allowance still being positively associated with higher RMSSD.

Conclusions: Our findings indicate that allowing employees more autonomy in telework decisions (ie, a high allowance in this study) is associated with reduced physiological stress. These results can be used by organizations to improve telework conditions (how, where and how much), while being observant that white-collar workers do not utilize increased autonomy to work extensively and for long hours outside work. Further verification, preferably using prospective designs, is needed to confirm our results.

Background: High levels of occupational physical activity (OPA) may be related to pain and sickness absence in the eldercare sector, which is dependent on foreign-born workforce. However, no study has investigated the closeness of OPA in eldercare to the recommendations proposed by EU-OSHA and compared workers born in different countries, which is important to address inequalities in occupational health.

Aim: To determine how close the physical activity compositions of Swedish-born and foreign-born eldercare workers are to EU-OSHA's recommended composition (60% sitting, 30% standing, and 10% moving) during work hours. 

Methods: We analyzed data from 222 eldercare workers in three Swedish municipalities. Physical activity was assessed with a thigh-worn accelerometer for seven days.  Time spent sitting, standing, and moving at work (diary based) was analyzed using the Actipass software. The Aitchison distance between each observed OPA composition and the composition recommended by EU-OSHA was calculated and expressed as a closeness index ranging from 0 (‘worst possible’ composition [1:1:98]) to 100 (EU-OSHA composition [60:30:10]). The closeness indices for Swedish-born and foreign-born workers were compared using linear mixed models.

Results: The Swedish-born group (n=160, 72.1%) had an average composition of 49:39:12, which led to a closeness index of 88.3 [SD 7.1], while the foreign-born had a composition of 44:40:15 and closeness index of 84.9 [SD 7.6]. The two groups were significantly different (β=3.34; CI=[1.19:5.48]; p<0.01), even after adjustments for age, gender and sector (nursing home or homecare) (β=3.98; CI=[1.74:6.22]; p<0.01).

Conclusions: Compositions of OPA among foreign-born workers were further from the EU-OSHA recommendation compared to their Swedish peers. Task-related differences in patient care may explain our findings. Future studies should consider alternations between sitting, standing and moving, and develop interventions to promote a more balanced OPA between Swedish-born and foreign-born workers, and thus address potential inequalities in the eldercare sector.

Introduction: Occupational physical activity (OPA) plays a complex role in recovery and health, where both too much and too little activity can be detrimental. To promote sustainable work, the European Agency for Safety and Health at Work (EU-OSHA) recommends a balanced OPA composition for jobs involving prolonged standing – such as in eldercare – of approximately 60% sitting, 30% standing, and 10% moving. This study examines whether eldercare workers whose OPA compositions align more closely with EU-OSHA recommendations report less need for recovery than those with less aligned compositions.

Methods: We analyzed data from 212 eldercare workers (188 [88.7%] women, 46.5 [SD 12.3] years of age) in three Swedish municipalities. Of these, 79 (37.3%) worked in nursing homes, and 133 (62.7%) in homecare services. Physical behaviors were assessed using a thigh-worn accelerometer worn for seven days, and working hours were identified using a self-report diary. Time spent sitting, standing, and moving at work was determined using the ActiPass software. The Aitchison distance between each worker‘s OPA composition and the EU-OSHA recommendation was calculated and expressed in terms of a closeness index ranging from 0 (composition furthest from the recommendation, [1:1:98] to 100 (ideal alignment with the recommendation, [60:30:10]). Need for recovery was assessed using the short version of the Dutch Need for Recovery Scale. The association between the closeness index and need for recovery was examined in linear mixed models, adjusting for age, sex, and sector (nursing home vs. homecare), while accounting for the hierarchical structure of the data.

Results: Eldercare workers spent on average, 47.4% of their working time sitting, 39.4% standing and 13.2% moving. The mean closeness index was 87.3 (SD 7.3). We found a negative association between the closeness index and need for recovery, for both unadjusted (β=-0.89; CI=[-1.4:-0.37]; p<0.01) and adjusted models (β=-0.95; CI=[-1.77:-0.14]; p<0.02).

Discussion: Our findings suggest that eldercare workers with OPA compositions closer to the EU-OSHA recommendation experience less need for recovery than those having more diverging compositions. This supports previous evidence indicating that an imbalance in OPA—in the present case excessive standing or moving—can contribute to fatigue and increased recovery needs. Workers were relatively close to the EU-OSHA recommended composition of behaviors, yet even small deviations were, on average, associated with higher recovery needs. However, understanding what constitutes a ‘high’ or ‘low’ closeness index in relation to health and well-being remains limited.

Conclusion: Our results show that structuring work tasks to promote a balanced mix of sitting, standing, and moving is important to prevent high recovery needs in eldercare settings. Further research is needed to understand the validity of the EU-OSHA guidelines for predicting physical behaviors that promote health. Also, in addition to the overall composition, the pattern of alternations between these behaviors should be considered to understand the extent to which different time patterns of OPA are associated with health outcomes.

We evaluated differences in work environment conditions and health by gender and place of birth in a commercial laundromat prior to (baseline) and at the end of the first wave of the COVID-19 pandemic (follow-up). Using survey data, including dimensions from the Copenhagen Psychosocial Questionnaire, from forty-one workers, we assessed work environment conditions and health at baseline, follow-up and in change scores between baseline and follow-up. At baseline, men and women reported similar scores, while foreign-born (FB) workers reported better work environment conditions than Swedish-born (SB) workers. During the pandemic, conditions generally declined for all workers, but FB reported smaller declines than SB. A consistent inequality hierarchy across the 4 groups was not clear at baseline, follow-up or in change scores between time points. The study suggests potential cultural differences may exist in how work environment conditions are experienced. This should be considered in future studies and when managing future crises

ObjectiveWe investigated and compared temporal sitting patterns among male and female hybrid office workers when working at the office (WAO), working from home (WFH), and for non-working days (NWD).

MethodsWe analyzed data collected in 2020 among 165 hybrid office workers, carrying thigh-worn accelerometers for 938 days in total. Day type (WAO, WFH, or NWD) and time in bed were identified using diaries. Time awake was exhaustively classified as non-sitting time and time sitting in short, moderate, and long bouts. Effects of day type and gender on the 24-h compositions of physical behaviors were analyzed using multilevel linear mixed models.

ResultsDuring workdays (both WAO and WFH), workers spent less time in bed and more time sitting, particularly in moderate and long bouts, than during NWD. Time in bed was longer when working from home than when working at the office, and more of the awake time was spent sitting. Differences between WAO and WFH in ratios between short, moderate, and long bouts of sitting were small and inconsistent. Men spent more time sitting than women, and more time in moderate and long sitting bouts relative to short bouts.

ConclusionsWhen working from home, hybrid office workers sat more during their hours awake compared to when working at the office. Sitting time was larger during working days than during non-working days and was higher in men than in women. These results may contribute to support organizational policies for hybrid work.

Objective: We investigated the extent to which ward-level leadership quality was associated with prospective low-back pain among eldercare workers, and how this association was mediated by observed resident handlings.

Methods: 530 Danish eldercare workers, employed in 121 wards, distributed across 20 nursing homes were evaluated. At baseline, leadership quality was measured using the Copenhagen Psychosocial Questionnaire, and resident handlings [handlings per shift, handlings not using assistive devices, handlings done alone, interruptions to handlings, impediments to handlings] were assessed using observations. Frequency and intensity of low-back pain was assessed monthly during the following year. All variables were averaged for each ward. We used ordinary least squares regressions to examine direct effects of leadership on low-back pain and indirect effects through handlings, using PROCESS-macro for SPSS. 

Results: After adjustments for low-back pain at baseline, type of ward, staff ratio (i.e., number of workers divided by number of residents) and proportion of devices not in place, leadership quality showed no effect on prospective low-back pain frequency (β=0.01 [-0.05:0.07]) and a small beneficial effect on pain intensity (β=-0.02 [-0.04:0.00]). Resident handlings did not mediate the association between leadership quality and frequency or intensity of low-back pain. 

Conclusions: Good leadership quality was associated with a small decrease in prospective low-back pain intensity, but resident handlings did not seem to play a mediating role, although better ward-level leadership quality contributed to fewer workplace-observed resident handlings without assistance. Potentially, organizational factors such as type of ward and staff ratio, may have a greater influence on handlings and low-back pain than leadership quality per se among eldercare workers.