André Klussmann

Bergische Universität Wuppertal, Wuppertal, North Rhine-Westphalia, Germany

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Publications (12)14.93 Total impact

  • Work 07/2012; 43(2):251-2. · 0.52 Impact Factor
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    ABSTRACT: In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee. In a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years) with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15) on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed. Inter-observer agreement between readers 1 and 2 was good (kappa = 0.65) within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively), the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52). Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed. According to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis.
    BMC Musculoskeletal Disorders 01/2010; 11:75. · 1.88 Impact Factor
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    ABSTRACT: A number of occupational risk factors are discussed in relation to the development and progress of knee joint diseases (for example, working in a kneeling or squatting posture, lifting and carrying heavy weights). Besides the occupational factors, a number of individual risk factors are important. The distinction between work-related and other factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In a case-control study, patients with and without symptomatic knee osteoarthritis (OA) were questioned by means of a standardised questionnaire complemented by a semi-standardised interview. Controls were matched and assigned to the cases by gender and age. Conditional logistic regression was used in analysing data. In total, 739 cases and 571 controls were included in the study. In women and men, several individual and occupational predictors for knee OA could be described: obesity (odds ratio (OR) up to 17.65 in women and up to 12.56 in men); kneeling/squatting (women, OR 2.52 (>8,934 hours/life); men, 2.16 (574 to 12,244 hours/life), 2.47 (>12,244 hours/life)); genetic predisposition (women, OR 2.17; men, OR 2.37); and sports with a risk of unapparent trauma (women, OR 2.47 (>or=1,440 hours/life); men, 2.58 (>or=3,232 hours/life)). In women, malalignment of the knee (OR 11.54), pain in the knee already in childhood (OR 2.08), and the daily lifting and carrying of loads (>or=1,088 tons/life, OR 2.13) were related to an increased OR; sitting and smoking led to a reduced OR. The results support a dose-response relationship between kneeling/squatting and symptomatic knee OA in men and, for the first time, in women. The results concerning general and occupational predictors for knee OA reflect the findings from the literature quite well. Yet occupational risks such as jumping or climbing stairs/ladders, as discussed in the literature, did not correlate with symptomatic knee OA in the present study. With regards to occupational health, prevention measures should focus on the reduction of kneeling activities and the lifting and carrying of loads as well as general risk factors, most notably the reduction of obesity. More intervention studies of the effectiveness of tools and working methods for reducing knee straining activities are needed.
    Arthritis research & therapy 01/2010; 12(3):R88. · 4.27 Impact Factor
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    ABSTRACT: Upper extremity musculoskeletal symptoms and disorders are common in the working population. The economic and social impact of such disorders is considerable. Long-time, dynamic repetitive exposure of the hand-arm system during manual handling operations (MHO) alone or in combination with static and postural effort are recognised as causes of musculoskeletal symptoms and disorders. The assessment of these manual work tasks is crucial to estimate health risks of exposed employees. For these work tasks, a new method for the assessment of the working conditions was developed by the Federal Institute for Occupational Safety and Health (BAuA) and released as a draft in the year 2007. The draft of the so-called Key Indicator Method for Manual Handling Operations (KIM-MHO) was developed in analogy with the existing KIM for Lifting/Holding/Carrying (KIM-LHC) and Pulling/Pushing (KIM-PP) of loads. The KIM-MHO is designed to fill the gap existing in risk assessment of manual work processes, since the existing KIMs deal only with manual handling of loads.This research project focused on the following: - Examination of the validity of workplace assessment with the KIM-MHO comparing expert ratings with the results of the observations. - Examination of the objectivity of workplace assessment with the KIM-MHO applied by different examiners. - Examination of the criterion validity of the risk assessment provided by KIM-MHO with respect to the association between exposure and the occurrence and prevalence of health related outcomes. To determine the objectivity and validity of workplace assessment, the KIM-MHO is applied by occupational health and safety officers at different workplaces involving manual handling operations.To determine the criterion validity of risk assessment, a survey of employees at different workplaces takes place with standardised questionnaires and interviews about symptoms in the neck and upper extremities. In addition, physical examinations of these employees following a standardised medical diagnostic procedure are also carried out. This research project will provide scientific evaluation of the new KIM-MHO and, if necessary, indicate areas for modification to improve this new method for assessment of the health risk of manual handling operations at diverse workplaces.
    BMC Musculoskeletal Disorders 01/2010; 11:272. · 1.88 Impact Factor
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    ABSTRACT: The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol. Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands. Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand. Ambulance service personnel seem to be used to critical situations. There was few awareness of the "physiological" stress response indicating that stress is probably not perceived in work situations characterised by routines.
    International Archives of Occupational and Environmental Health 07/2009; 82(9):1057-64. · 2.10 Impact Factor
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    ABSTRACT: Knee osteoarthritis (OA) is one of the frequent and functionally impairing disorders of the musculoskeletal system. In the literature, a number of occupational risk factors are discussed as being related to the development and progress of knee joint diseases, e.g. working in kneeling or squatting posture, lifting and carrying of heavy weights. The importance of the single risk factors and the possibility of prevention are currently under discussion. Besides the occupational factors, a number of individual risk factors are important, too. The distinction between work-related factors and individual factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In existing studies, the occupational stress is determined mainly by surveys in employees and/or by making assumptions about individual occupations. Direct evaluation of occupational exposure has been performed only exceptionally. The aim of the research project ArGon is the assessment of different occupational factors in relation to individual factors (e.g. constitutional factors, leisure time activities, sports), which might influence the development and/or progression of knee (OA). The project is designed as a case control study. To raise valid data about the physical stress associated with occupational and leisure time activities, patients with and without knee OA are questioned by means of a standardised questionnaire and an interview. The required sample size was estimated to 800 cases and an equal number of controls. The degree and localisation of the knee cartilage or joint damages in the cases are documented on the basis of radiological, arthroscopic and/or operative findings in a patient record. Furthermore, occupational exposure is analysed at selected workplaces. To evaluate the answers provided in the questionnaire, work analysis is performed. In this research project, specific information on the correlation of occupational and individual factors on the one hand and the current state of knee OA on the other will be analysed in order to describe preventive measures. In addition, information regarding a better evaluation of various forms of physical stress in different occupations will be available. This might lead to more effective prevention strategies.
    BMC Musculoskeletal Disorders 02/2008; 9:26. · 1.88 Impact Factor
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    ABSTRACT: The aim of this study was to determine the prevalence and the predictors of musculoskeletal symptoms in the upper extremities and neck at visual display terminal (VDT) workstations. In a cross-sectional study 1,065 employees working at VDT > 1 h/d completed a standardised questionnaire. Workstation conditions were documented in a standardised checklist, and a subgroup of 82 employees underwent a physical examination. Using the Nordic Questionnaire, the 12-month prevalence of symptoms of the neck, shoulder region, hand/wrist, or elbow/lower arm was 55%, 38%, 21%, and 15% respectively. The duration of VDT work had a significant impact on the frequency of neck symptoms in employees performing such work > 6 h/d. With regard to musculoskeletal symptoms of the upper extremities, preventive measures at VDT workstations should be focused on neck and shoulder symptoms (e.g. ergonomic measures, breaks to avoid sitting over long periods).
    BMC Musculoskeletal Disorders 01/2008; 9:96. · 1.88 Impact Factor
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    ABSTRACT: Das Deutsche Rote Kreuz untersuchte in einer groß angelegten Studie die Arbeitsbedingungen seiner Rettungsdienstmitarbeiter. Dabei wurden mittels Fragebogen Beschwerden des Muskel-Skelett-Systems, psychosoziale Faktoren und das Belastungsempfinden geprüft. An einem kleineren Kollektiv wurden zusätzlich während des Arbeitsablaufs kontinuierliche Herzfrequenzmessungen und Bestimmungen des Speichelcortisols durchgeführt. Am Häufigsten werden körperliche Belastungen in Folge von Heben, Tragen, Halten etc. als belastende Faktoren angegeben. Beschwerden im Nacken- und Schulterbereich, im unteren Rücken und den Knien werden trotz des relativ niedrigen Durchschnittsalters der Befragten gehäuft angegeben. Ergebnisse dieser Untersuchung werden zurzeit in neue DRK-Ausbildungsrichtlinien eingearbeitet, so werden ein Arbeitstechniktraining oder ein Trainingsprogramm zum Muskelaufbau erprobt. Die insgesamt relativ hohe Arbeitszufriedenheit der Rettungsdienstmitarbeiter kann durch gute Führungsqualität der Vorgesetzten und Einbeziehung in Entscheidungsprozesse noch gefördert werden.
    Notfall 01/2005; 8(8):564-568. · 0.54 Impact Factor
  • Notfall & Rettungsmedizin - NOTFALL RETTUNGSMED. 01/2005; 8(8):564-568.
  • Hj Gebhardt, A Klußmann, K.-H Lang

Publication Stats

65 Citations
14.93 Total Impact Points


  • 2008–2010
    • Bergische Universität Wuppertal
      Wuppertal, North Rhine-Westphalia, Germany
    • Institut für Arbeitsschutz
      Sankt Augustin, North Rhine-Westphalia, Germany