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Journal of Low Frequency Noise Vibration and Active Control 01/2010; 29(1):33-39. · 0.21 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the existence of neck pain and arm pain among professional forest machine drivers and to find out if pain were related to their whole-body vibration (WBV) exposure. A self-administered questionnaire was sent to 529 forest machine drivers in northern Sweden and the response was 63%. Two pain groups were formed; 1) neck pain; 2) neck pain combined with arm pain. From WBV exposure data (recent measurements made according to ISO 2631-1, available information from reports) and from the self-administered questionnaire, 14 various WBV exposure/dose measures were calculated for each driver. The prevalence of neck pain reported both for the previous 12 months and for the previous 7 d was 34% and more than half of them reported neck pain combined with pain in one or both arms. Analysis showed no significant association between neck pain and high WBV exposure; however, cases with neck pain more often experienced shocks and jolts in the vehicle as uncomfortable. There was no significant association between the 14 WBV measures and type of neck pain (neck pain vs. neck pain combined with arm pain). It seems as if characteristics of WBV exposure can explain neither existence nor the type of neck pain amongst professional drivers of forest machines. The logging industry is important for several industrialised countries. Drivers of forest machines frequently report neuromusculoskeletal pain from the neck. The type of neck pain is important for the decision of treatment modality and may be associated with exposure characteristics at work.
Ergonomics 10/2009; 52(10):1240-7. · 1.41 Impact Factor
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ABSTRACT: Quantitative sensory testing assesses non-invasively the function of the sensory pathways from receptors to cortex. Studies of workers exposed to vibration support evidence that neuro-sensory hand-arm vibration syndrome also encompasses neuropathy of the small-diameter nerve fibres.
To assess the risk of disturbed thermal perception developing among young adults exposed to vibration and hand-intensive manual work. The aim also encompasses the study of alternative covariates in small-diameter nerve fibre neuropathy assessment.
This cross-sectional multi-centre study comprised 202 males and females from vocational school programs in auto mechanics, construction and catering. The testing included a baseline questionnaire, a clinical examination focusing on upper extremity disorders and quantitative somatosensory testing. Thermal perception thresholds were assessed, on both hands, second and fifth digits, using a modified Marstock method for warmth and cold.
Reduced thermal perception sensitivity was found for digit II compared to digit V, for females compared to males, and between the two study centres. Subjects exposed to vibration at work showed reduced sensitivity to temperature compared to non-vibration exposed. In univariate analyses odds ratios of 1.06 (95% CI 1.006-1.118) and 1.02 (95% CI 0.971-1.078) for reduced perception to cold for the right and left hands, respectively, was found for vibration. This association was lost in multivariate analyses. The study centre was the strongest confounding influence.
Sensitivity to temperature appears to be reduced despite the subjects short exposure-time and low exposure to vibration. The effect is small in relation to other confounding factors. A low agreement between the modalities indicates the need for separate tests for cold and warmth. Hand-side, age, stature, and BMI were not important for thermal perception but study centre, gender and choice of digit were. Conventional electro-diagnostic investigations are inadequate for evaluating the status of the small-fibre afferent systems leaving QST of thermal perception as the preferred diagnostic tool.
Archiv für Gewerbepathologie und Gewerbehygiene 05/2008; 81(5):519-33. · 1.89 Impact Factor
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ABSTRACT: The aim of the present study was to assess the incidence and identify possible risk factors for self-reported reduced productivity owing to musculoskeletal symptoms among computer users.
a cohort study with a baseline questionnaire and monthly follow ups during 10 months.
the study base consisted of 1,283 computer users, 636 men and 896 women. Ergonomists observed workstation characteristics before entering the cohort. Cases were defined as subjects reporting reduced productivity or reporting being on sick leave owing to musculoskeletal symptoms.
women had approximately two times the incidence of self-reported reduced productivity owing to symptoms in the neck, shoulder and in the forearm/hand than men. There was no difference in gender for the incidence of self-reported reduced productivity owing to back symptoms. Working overtime and job demands were risk factors for self-reported reduced productivity owing to neck and back symptoms. Physical exercise fewer than 8 times the last month was a risk factor for self-reported reduced productivity owing to neck, shoulder and forearm/hand symptoms. Computer mouse use for more than 0.5 h/day was a risk factor for self-reported reduced productivity owing to shoulder and forearm/hand symptoms.
risk factors for self-reported reduced productivity owing to musculoskeletal symptoms included life style factors, such as overweight and low physical exercise, occupational factors, such as overtime, job demands and computer mouse operating time.
Ergonomics 12/2007; 50(11):1820-34. · 1.41 Impact Factor
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ABSTRACT: Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems.
This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992-95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095).
The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care.
The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.
Occupational and environmental medicine 04/2006; 63(3):198-201. · 3.64 Impact Factor
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ABSTRACT: The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures.
Applied Ergonomics 06/2005; 36(3):319-25. · 1.43 Impact Factor
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ABSTRACT: To determine whether perceived muscular tension, job strain, or physical exposure are associated with increased risk of developing neck pain among VDU users.
A baseline questionnaire was answered by 1283 respondents, of whom 671 were free from neck pain at baseline. Perceived muscular tension, job strain, and physical exposure were assessed at baseline. Information about newly developed neck pain was collected in 10 follow up questionnaires and the case definition was the first report of such pain in any of the follow up questionnaires. Median follow up time was 10.9 months.
Both men and women who perceived muscular tension at least a few times per week, compared to those who had not perceived muscular tension the preceding month, had an incidence rate ratio (IRR) of 1.9 (95% CI 1.25 to 2.93) for developing neck pain, when stratifying for sex. High perceived muscular tension was associated with an increased risk (IRR 1.6, 95% CI 1.02 to 1.91), even when controlling for job strain, physical exposure, and age in the model stratified by sex.
Perceived muscular tension was associated with an increased risk of developing neck pain among VDU users. The combination of high job strain and high perceived muscular tension was associated with higher risk of developing neck pain than the combination of high physical exposure and high perceived muscular tension. There was an indication of an excess risk due to interaction between high physical exposure and high job strain.
Occupational and environmental medicine 07/2004; 61(6):523-8. · 3.64 Impact Factor
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ABSTRACT: The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p=0.006, peak force p=0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.
Ergonomics 06/2003; 46(6):598-615. · 1.41 Impact Factor
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ABSTRACT: The aim was to determine the incidence of symptoms of decompression sickness (DCS) in dive masters and instructors in relation to number of dives and possible risk factors.
Retrospective cohort study of dive masters and instructors in Sweden. STUDY BASE: All dive masters and instructors listed with PADI, NAUI and CMAS in Sweden as of January 1st 1999 (2380 divers).
The dive masters and instructors received a validated questionnaire on diving activities and symptoms of DCS in 1999. 1516 men and 226 women answered, i.e. 73% of the initial study base.
DCS symptoms were reported by 190 divers. The incidence of DCS symptoms was 1.52 for males and 1.27 for females per 1000 dives. Dive masters, divers not performing decompression-stop dives, divers not practicing advanced diving and divers with a low number of total lifetime dives had a higher proportion (p < 0.05) of DCS symptoms per 1000 dives. There were no major differences in DCS symptom incidence related to sex, age, asthma, overweight or alcohol abuse in this study.
Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc 02/2003; 30(2):93-102. · 0.80 Impact Factor
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ABSTRACT: The overall aim of this study was to investigate whether time pressure and verbal provocation has any effect on physiological and psychological reactions during work with a computer mouse. It was hypothesised that physiological reactions other than muscle activity (i.e. wrist movements, forces applied to the computer mouse) would not be affected when working under stressful conditions. Fifteen subjects (8 men and 7 women) participated, performing a standardised text-editing task under stress and control conditions. Blood pressure, heart rate, heart rate variability, electromyography, a force-sensing computer mouse and electrogoniometry were used to assess the physiological reactions of the subjects. Mood ratings and ratings of perceived exertion were used to assess their psychological reactions. The time pressure and verbal provocation (stress situation) resulted in increased physiological and psychological reactions compared with the two control situations. Heart rate, blood pressure and muscle activity in the first dorsal interosseus, right extensor digitorum and right trapezius muscles were greater in the stress situation. The peak forces applied to the button of the computer mouse and wrist movements were also affected by condition. Whether the increases in the physiological reactions were due to stress or increased speed/productivity during the stress situation is discussed. In conclusion, work with a computer mouse under time pressure and verbal provocation (stress conditions) led to increased physiological and psychological reactions compared to control conditions.
Arbeitsphysiologie 08/2002; 87(3):257-63. · 2.15 Impact Factor
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ABSTRACT: The aim of this study was to assess the influence of work-related physical and psychosocial factors on seeking care for neck or shoulder disorders among men and women in a general working population. The study population comprised gainfully employed (>17 hours per week) men and women in the municipality of Norrtälje, altogether 392 cases and 1,511 controls. Cases were defined as persons seeking care because of neck or shoulder disorders by any caregiver in the region. The study began in 1994 and continued to 1997. We assessed physical and psychosocial exposures by questionnaires and interviews. The pattern of seeking care for neck or shoulder disorders differed between men and women. Among men, work with vibrating tools [relative risk (RR) = 1.6], not having a fixed salary (RR = 1.9), and low demands in relation to competence (RR = 1.5) were the strongest risk indicators obtained in analyses stratified for age and previous symptoms. Among women, repetitive hand or finger movements (RR = 1.6), constrained sitting (RR = 1.6), not having a fixed salary (RR = 2.0), and solitary work (RR = 1.8) were the strongest risk indicators. A large proportion of the general population was exposed to several of these moderately harmful conditions, and their concomitant effect may explain the high incidence of neck and shoulder disorders in the general working population.
Epidemiology 09/2001; 12(5):537-45. · 5.57 Impact Factor
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ABSTRACT: The objectives of the study were to explore the musculoskeletal health of computer users in the Swedish workforce with regard to gender and psychosocial factors, and to describe gender differences between the occupational groups. A subset was chosen from a large survey of 12,462 individuals representing the workforce of Sweden, performed by Statistics Sweden. Included in the subset were 2044 subjects who worked for at least half their working hours with personal computers, or an equivalent device, and also used a computer mouse. All occupational groups had prevalence ratios (women/men) > 1. When using regression models, the variables 'learn and develop' and 'involved in planning your work' were health factors, and 'too much to do' was a risk factor for upper body symptoms for both women and men. For women 'PC duration 100' was a risk factor and 'support from superiors' was a health factor. Age seemed to be a stronger risk factor for men than for women.
Occupational Medicine 12/2000; 50(8):608-13. · 1.14 Impact Factor
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ABSTRACT: The purpose of this study was to develop and validate a sampling strategy for characterizing the finger force exposures associated with computer mouse use.
Mouse forces were measured from 16 subjects (8 men, 8 women), on 3 separate days, at their actual workstations while they performed (i) their regular work, (ii) a battery of standardized tasks, and (iii) simulated mouse use.
The forces applied to the mouse did not vary between hours or days. During regular work, the mouse was used 78.0 (SD 40.7) times per hour, accounting for 23.7 (SD 9.5)% of the worktime. The mean forces applied to the sides and button of the mouse were low, averaging 0.6 % (0.35 N) and 0.8 % (0.43 N) of the maximal voluntary contraction, respectively. The forces applied to the mouse during the standardized tasks differed from the regular work forces; however, there were moderate-to-strong correlations between the 2 measures.
With respect to performing exposure assessment studies, the 3 major findings were (i) mouse force measurements should be made while subjects perform their actual work in order to characterize the absolute applied force accurately, (ii) the forces applied to the mouse during the performance of a short battery of standardized tasks can be used to characterize relative exposure and identify computer operators or work situations for which higher forces are applied to the mouse, and (iii) subjects cannot accurately simulate mouse forces.
Scandinavian journal of work, environment & health 11/2000; 26(5):398-405. · 3.12 Impact Factor
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ABSTRACT: The aim of this study was to investigate whether gender or different methods of operating a computer mouse have an effect on performance and musculoskeletal load in the use of a computer mouse.
Thirty experienced computer mouse users, 15 men and 15 women, participated in the study. Electromyography (right first dorsal interossei, right extensor digitorum and right and left trapezius), a force-sensing mouse, and subjective ratings were used to register muscular load. An electrogoniometer was used to register the wrist movements. The subjects worked with 3 different methods, their own, a wrist-based method and an arm-based method. Gender comparisons were made when the subjects used their own method.
The women worked with greater extension and range of motion and tended to work with a greater ulnar deviation of the wrist. They also applied higher forces to the mouse when expressed as a percentage of a maximum voluntary contraction and had higher muscular activity in the right extensor digitorum. When using the arm-based method, the subjects worked with greater wrist extension, had higher muscular activity in the right and left trapezius muscles, and had the highest ratings of perceived exertion in the neck and shoulder. The wrist-based method resulted in higher forces being applied to the sides of the mouse and the highest ratings of perceived exertion in the wrist and hand-fingers.
Gender differences were found for musculoskeletal load, and for most of the measured variables the women worked with higher loads than the men. The work method affected performance and musculoskeletal load. Finally, subjective measures appeared to have some utility in characterizing muscular load.
Scandinavian journal of work, environment & health 11/2000; 26(5):390-7. · 3.12 Impact Factor
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ABSTRACT: We conducted a case-referent study to identify and quantify work-related and non-work-related risk indicators for reported over-exertion back injuries among nursing personnel. The source population was all nursing personnel employed in the Stockholm County hospitals during a 32-month period. The 240 cases and 614 referents completed questionnaires about occupation, type of clinic, working hours, shift work, patient transfers, perceived exertion, back pain, prior back injury, job strain, body mass index (BMI), smoking, immigrant status, physical training, and self-rated fitness. The highest relative risks (RR) were observed for work-related factors: working at an orthopedic clinic (RR = 5.2; 95% CI = 2.7-10.2), > or =1 patient transfer/shift (RR = 2.7; 95% CI = 1.6-4.5), and working full-time (RR = 2.4; 95% CI = 1.6-3.6). Training in the use of transfer devices, and regular use of transfer devices, reduced the relative risk from patient transfer. Among the non-work-related factors, only body mass index > or =25 kg/m2 and immigrant status was associated with a slight increase in relative risk.
Epidemiology 09/2000; 11(5):519-22. · 5.57 Impact Factor
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ABSTRACT: To study whether isometric shoulder endurance was more advantageous than isometric shoulder strength training in reducing pain and perceived exertion and to increase shoulder function through improved muscle endurance and strength.
Randomized trial.
Three occupational health care centers.
Women industrial workers with nonspecific neck-shoulder pain. The International Classification of Diseases, 10th Revision (ICD-10) diagnosis was "cervicobrachial syndrome" (M53.1). Thirty-eight patients completed the isometric shoulder endurance training and 31 patients completed the isometric shoulder strength training.
Twelve weeks of training.
Self-reported pain and rating of perceived exertion (RPE), arm motion performance test, shoulder muscle strength, shoulder muscle endurance, and shoulder functional tests, as well as follow-up after supervised training had ended.
The isometric shoulder strength training resulted in an almost one-scale step decrease in RPE at work and a 5% to 15% improvement of arm motion performance compared with the endurance training. The isometric shoulder strength training more effectively improved left side shoulder abduction strength (p < .026), but no major differences were found for the other strength measurements. The isometric shoulder endurance training was not more successful than the strength training in the endurance test (p .51 to .81).
Physical training programs for neck-shoulder pain may include isometric shoulder muscular strength exercise in addition to isometric shoulder endurance training, rather than endurance training only.
Archives of Physical Medicine and Rehabilitation 08/2000; 81(8):1051-8. · 2.28 Impact Factor
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ABSTRACT: A population-based case referent study.
To determine whether current and past physical and psychosocial occupational factors are associated with care-seeking for low back pain in working men and women.
The importance of physical and psychosocial workloads as causal factors of low back pain has mostly been investigated in special occupational groups and with a cross-sectional design, which makes generalizability and interpretations more difficult.
The study comprised 2118 working men and women 20 to 59 years old (695 cases, and 1423 referents). Cases were defined as persons seeking care by any caregiver for low back pain. The exposure assessments were made through questionnaires and interviews about current and past physical and psychosocial loads during work and leisure time.
In a logistic regression analysis, physical load from forward bending in men (RR = 1.8) and high physical load, in general, in women (RR = 2.0) showed increased relative risks. Psychosocial factors alone seemed to be of less importance in women, but "poor job satisfaction" and "mostly routine work without possibilities of learning" increased the risk in men. Combined current and past exposures further increased the risks. A combination of high physical and psychosocial loads increased the risk substantially, but few were exposed to such loads. Adjustment for lifestyle and other loads outside work did not change the results.
Current and past physical and psychosocial occupational factors, both separately and combined, seem to be gender-specific, and to have a moderate impact on care-seeking for low back pain in a general working population.
Spine 03/2000; 25(4):493-500. · 2.08 Impact Factor
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American Journal of Industrial Medicine 10/1999; Suppl 1:26-8. · 1.63 Impact Factor
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ABSTRACT: The objectives of the study were to examine whether occupational use of vibrating hand-held tools was associated with an impaired vibrotactile perception, whether any exposure-response relationship exists, and whether the different populations of mechano-receptive afferent units are equally affected.
Vibrotactile perception thresholds have been measured at seven frequencies (8-500 Hz) and evaluated among 125 vibration-exposed and 45 non-exposed male employees in a heavy engineering production workshop. Vibration exposure measurements were assessed on tools in accordance with ISO 5349. Vibrotactile perception thresholds have been individually graded in stages and placed in relation to individual vibration exposure.
The outcome did not reveal a clear relationship between vibration exposure and reduced vibrotactile sensitivity on an individual basis. There was a clear tendency on a group basis towards elevated thresholds when the study population was divided into three exposure categories. A fourfold increase in relative risk of reduced vibrotactile sensitivity for test frequencies above 40 Hz was observed between the highest exposure category compared to the non-exposed.
It was concluded that reduced tactile sensitivity is related to the degree of vibration exposure but it is not at present possible to delineate an exposure-response relationship.
American Journal of Industrial Medicine 06/1999; 35(5):456-64. · 1.63 Impact Factor
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ABSTRACT: Nerve compression of the brachial plexus can be provoked by the Abduction External Rotation (AER) test where the arms are held in a "hands-up" position.
The AER test was conducted among 137 male industrial and office workers at baseline and after 5 years follow-up, together with a medical examination/history and exposure analysis. Nerve conduction measurements in the wrist regions were also made.
The cumulated incidence of neurological signs during the AER test, was estimated to be 2/100 person-years. Factors related to work-conditions, constitution, disease, and neck trauma were associated with AER signs. Subjects with AER signs exhibited a slowing of the nerve conduction velocities in the wrist region. The AER test predicted future neck and upper extremity symptoms and signs of nerve compression.
The results of this study gave support to the "double or multiple crush" theory of nerve compression. Prevention, evaluation, and management of neck and upper extremity nerve compression diseases should, therefore, attend to all probable locations of such compression, even when a specific location is in focus. The AER test can be a supplementary tool in such work, both in epidemiological and occupational health settings.
American Journal of Industrial Medicine 02/1999; 35(1):32-42. · 1.63 Impact Factor