Poul Frost

Danish Ramazzini Centre, Ålborg, North Denmark, Denmark

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Publications (43)107.12 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures.
    Occupational and environmental medicine. 08/2014;
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    ABSTRACT: Surgery for subacromial impingement syndrome is often performed in working age and postoperative physiotherapy exercises are widely used to help restore function. A recent Danish study showed that 10% of a nationwide cohort of patients retired prematurely within two years after surgery. Few studies have compared effects of different postoperative exercise programmes on shoulder function, and no studies have evaluated workplace-oriented interventions to reduce postoperative work disability. This study aims to evaluate the effectiveness of physiotherapy exercises and occupational medical assistance compared with usual care in improving shoulder function and reducing postoperative work disability after arthroscopic subacromial decompression.
    BMC Musculoskeletal Disorders 06/2014; 15(1):215. · 1.88 Impact Factor
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    ABSTRACT: When conducting large scale epidemiologic studies, it is a challenge to obtain quantitative exposure estimates, which do not rely on self-report where estimates may be influenced by symptoms and knowledge of disease status. In this study we developed a job exposure matrix (JEM) for use in population studies of the work-relatedness of hip and knee osteoarthritis.
    BMC Musculoskeletal Disorders 06/2014; 15(1):204. · 1.88 Impact Factor
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    ABSTRACT: Little is known about the influence of occupational mechanical shoulder exposures on the development of acromioclavicular joint degeneration. We aimed to evaluate if arm elevation >90(o), force requirements, and repetitive work are associated with acromioclavicular joint degeneration as assessed by magnetic resonance imaging (MRI).
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A28.
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    ABSTRACT: To evaluate relations between occupational mechanical exposures and (1) carpal tunnel syndrome verified by ENG (ENG+CTS) and (2) CTS-like symptoms with normal ENG (ENG-CTS).
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A85.
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    ABSTRACT: Controversies have long existed on causes for low back pain, and the role of occupational mechanical exposures, e.g. lifting has been debated for several decades. The aim of this study was to investigate if lifting is a risk factor for low back surgery.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A33.
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    ABSTRACT: Little is known about the time window for accumulation of occupational exposures and shoulder disorders. We aimed to evaluate cumulative occupational shoulder exposures as risk factors for surgery for subacromial impingement syndrome (SIS), and to examine how long the relevant exposure time period is.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A94.
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    ABSTRACT: We constructed a lower body job exposure matrix (JEM) based on five experts' assessments of occupational mechanical exposures. The aim of this study was to evaluate the face validity of the rankings of the job groups and the inter-rater agreement between the experts' rankings.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A23.
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    ABSTRACT: To investigate the risk of total hip replacement (THR) due to primary osteoarthritis (OA) in relation to cumulative occupational mechanical exposures and lifestyle factors.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A17.
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    ABSTRACT: Objective: To investigate the risk of total hip replacement (THR) due to primary osteoarthritis in relation to cumulative occupational mechanical exposures and lifestyle factors.Methods: Using register information, we identified first-time THR cases within the Danish working population, 2005-2006. Two age- and sex-matched controls were drawn. Persons within 2500 randomly selected case-control sets received a questionnaire on job history, weight at age 25, present weight and height, smoking, and sports activities at age 25. Job history was combined with a job exposure matrix. Cumulative exposure estimates were expressed according to the pack-year concept of smoking (e.g. cumulative lifting expressed as ton-years). We used conditional logistic regression.Results: 1776 (71%) case-control sets contributed. The adjusted odds ratio for exposure to ≥20 ton-years was 1.37 (95% CI 1.06-1.75) for men and 1.02 (95% CI 0.73-1.42) for women. Standing/walking and whole body vibration showed no associations. The adjusted odds ratio for body mass index (BMI) ≥30 kg/m2 at age 25 was 2.45 (95% CI 1.40-4.32) for men and 5.23 (95% CI 2.35-11.64) for women. The corresponding adjusted odds ratios for an increase in BMI of ≥10 kg/m2 since age 25 were 2.19 (95% CI 1.28-3.73) and 2.44 (95% CI 1.46-4.09). Sports participation showed weak positive associations, while pack-years of smoking showed no associations.Conclusion: Results indicated a modest increase in risk of THR in relation to cumulative lifting among men and an increased risk in relation to a high BMI at age 25 and to a gain in BMI in both sexes. © 2014 American College of Rheumatology.
    Arthritis Care & Research. 03/2014;
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    ABSTRACT: We examined the association between occupational lifting during pregnancy and risk of fetal death and preterm birth using a job exposure matrix (JEM). For 68,086 occupationally active women in the Danish National Birth Cohort, interview information on occupational lifting was collected around gestational week 16. We established a JEM based on information from women, who were still pregnant when interviewed. The JEM provided mean total loads lifted per day within homogeneous exposure groups as informed by job and industry codes. All women were assigned an exposure estimate from the JEM. We used Cox regression models with gestational age as underlying time variable and adjustment for covariates. We observed 2,717 fetal deaths and 3,128 preterm births within the study cohort. No exposure-response relation was observed for fetal death, but for women with a prior fetal death, we found a hazard ratio (HR) of 2.87 (95% CI 1.37, 6.01) for stillbirth (fetal death ≥22 completed gestational weeks) among those who lifted >200 kg/day. For preterm birth, we found an exposure-response relation for primigravid women, reaching a HR of 1.43 (95% CI 1.13, 1.80) for total loads >200 kg per day. These findings correspond to an excess fraction of 11% for stillbirth and 10% for preterm birth. We found an increased risk of stillbirth among women with a prior fetal death, who lifted >200 kg/day, and an exposure-response relationship between occupational lifting and preterm birth among primigravid women. The study adds to a large body of prospective studies on occupational lifting and adverse pregnancy outcomes by refined exposure assessment.
    PLoS ONE 01/2014; 9(3):e90550. · 3.53 Impact Factor
  • Muscle & Nerve 11/2013; · 2.31 Impact Factor
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    ABSTRACT: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. The study was based on the Musculoskeletal Research Database at the Danish Ramazzini Centre. We linked baseline questionnaire information from 1993-2004 on neck-shoulder complaints, job titles, psychosocial work factors, body mass index, and smoking with register information on first-time surgery for SIS from 1996-2008. Biomechanical exposure measures were obtained from a job exposure matrix based on expert judgment. We applied multivariable Cox regression. During 280 125 person-years of follow-up among 37 402 persons, 557 first-time operations for SIS occurred. Crude surgery rates increased from 1.1 to 2.5 per 1000 person-years with increasing shoulder load. Using no neck-shoulder complaints and low shoulder load at baseline as a reference, no neck-shoulder complaints and high shoulder load showed an adjusted hazard ratio (HR adj) of 2.55 [95% confidence interval (95% CI) 1.59-4.09], while neck-shoulder complaints in combination with high shoulder load showed an HR adjof 4.52 (95% CI 2.87-7.13). Subanalyses based on 18 856 persons showed an HR adjof 5.40 (95% CI 2.88-10.11) for complaints located specifically in the shoulder in combination with high shoulder load. Based on these findings, persons with neck-shoulder and especially shoulder complaints in combination with high shoulder load seem an obvious target group for interventions aimed at reducing exposures to prevent surgery for SIS.
    Scandinavian Journal of Work, Environment & Health 07/2013; · 3.10 Impact Factor
  • Scandinavian Journal of Work, Environment & Health 07/2013; 39(4):420. · 3.10 Impact Factor
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    ABSTRACT: OBJECTIVES: This study aims to (i) evaluate relative risks, excess fraction of cases, and rate advancement periods for total hip replacement (THR) due to primary osteoarthritis in relation to lifelong cumulative physical workload and (2) describe temporal trends in the proportion employed in the most highly exposed industries from 1986-2006. METHODS: In a cohort study of the Danish working population, we assessed cumulative physical workload by combining year-by-year register information on employment industry with an industry exposure matrix that provided point scores (0-2) of physical workload. Cumulative physical workload was expressed as point-years corresponding to the pack-year concept of smoking. We retrieved register information on first-time THR during 1996-2006 and used a logistic regression technique to fit discrete time hazards models adjusting for age and other factors. We calculated excess fraction of cases and rate advancement periods. RESULTS: Total numbers of point-years ranged from 0-86. For men, an exposure-response relation was observed reaching an odds ratio of 1.33 [95% confidence interval (95% CI) 1.17-1.53] for the highest exposure category (35-86 point-years) compared to 0 point-years. The excess fraction of cases was 18%, and THR took place up to 3.4 years earlier with increasing exposure. For women, no exposure-response relation was found. CONCLUSIONS: At the population level, cumulative physical workload increased the risk of THR among men, with surgery being performed slightly earlier in life. The proportion employed in the most highly exposed industries remained constant.
    Scandinavian Journal of Work, Environment & Health 04/2013; · 3.10 Impact Factor
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    ABSTRACT: OBJECTIVE: The aim of this paper was to identify prognostic factors for severity of symptoms and disability among patients with ulnar neuropathy confirmed by nerve conduction studies (NCS) or ulnar neuropathy-like symptoms with normal ulnar nerve NCS. METHODS: We conducted a cohort study based on a matched case-referent study. In 2008, we mailed a questionnaire to 1179 patients who were examined by NCS for suspected ulnar neuropathy at the age of ≥18�<65 years, 2001-2007. Potential prognostic factors included occupational biomechanical exposures, lifestyle factors, and NCS result. Outcomes were severity of symptoms and disability according to questionnaire scores. Referents delivered reference values. We used ordinal logistic regression. RESULTS: The percentage of those responding was 61%, comprising 324 patients with ulnar neuropathy and 396 with ulnar neuropathy-like symptoms. At follow-up, both patient groups had more severe symptoms and disability than age and sex matched referents. Abnormal NCS indicated a poorer prognosis regarding symptom severity [odds ratio (OR) 1.44, 95% confidence interval (95% CI) 1.01-2.01], but not disability (OR 0.78, 95% CI 0.57-1.08). High occupational force requirements indicated a poorer prognosis regarding both symptom severity (OR 1.78, 95% CI 1.10-2.88) and disability (OR 1.66, 95% CI 1.06-2.59). Other negative prognostic factors for both outcomes were current smoking, obesity, distal upper-extremity fractures, female sex, and a recent NCS date (suggesting improvement over time). CONCLUSIONS: NCS confirmation of ulnar neuropathy identified patients with a poorer prognosis regarding symptoms. A negative impact of high occupational force requirements, current smoking, and obesity on both outcomes suggested that reduction of these factors might improve prognosis of ulnar neuropathy and ulnar neuropathy-like symptoms.
    Scandinavian Journal of Work, Environment & Health 02/2013; · 3.10 Impact Factor
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    ABSTRACT: Introduction: We examined whether lifestyle factors differ between patients with ulnar neuropathy confirmed by electroneurography (ENG) and those with ulnar neuropathy-like symptoms with normal ulnar nerve ENG. Methods: Among patients examined by ENG for suspected ulnar neuropathy, we identified 546 patients with ulnar neuropathy and 633 patients with ulnar neuropathy-like symptoms. These groups were compared to 2 separate groups of matched community referents and to each other. Questionnaire information on lifestyle was obtained. The electrophysiological severity of neuropathy was also graded. We used conditional and unconditional logistic regression. Results: The responses were obtained from 59%. Ulnar neuropathy was related to smoking, adjusted OR 4.31 (95% CI 2.43-7.64) for >24 pack-years. Ulnar neuropathy-like symptoms were related to body mass index ≥30 kg/m(2) , OR 1.99 (95% CI 1.25-3.19). Smoking was associated with increased severity of ulnar neuropathy. Discussion: Findings suggest that smoking specifically affects the ulnar nerve. © 2013 Wiley Periodicals, Inc.
    Muscle & Nerve 02/2013; · 2.31 Impact Factor
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    ABSTRACT: OBJECTIVES: Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. METHODS: This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. RESULTS: High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. CONCLUSION: Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.
    International Archives of Occupational and Environmental Health 09/2012; · 2.10 Impact Factor
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    ABSTRACT: We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair. Among all men born in Denmark between 1938 and 1988, we established a cohort comprising those aged 18-65 years of age, who had at least 1 year of full-time employment between 1993 and 2007. Using information from a Job Exposure Matrix based on expert judgement and year-by-year information on Danish International Standard Classification of Occupations codes for each individual since 1993, we established time-varying cumulative estimates of exposure to daily lifting activities and standing/walking. Cumulative exposures for lagged 5-year time windows were expressed in a way that corresponds to the pack-year concept of smoking (ton-years, frequent-heavy-lifting years, and standing-years). First-time inguinal hernia repairs in the period 1998-2008 were identified in the Danish Hernia Database. We used a logistic regression technique equivalent to survival analysis, adjusting for age, socioeconomic status, region of residence and calendar year. Within the cohort of 1 545 987 men, we identified 22 926 lateral, 15 877 medial and 1592 pantaloon or unspecified first-time inguinal hernia repairs. The risk of lateral hernia repair increased with ton-years, frequent-heavy-lifting-years, and standing-years, with ORs of up to around 1.4. The exposures correlated, but standing-years remained as the most robust risk factor after adjustment for lifting exposures. In general, the risk of medial hernia repair was unrelated to the exposures. Our findings suggest an increased risk of lateral inguinal hernia repair in relation to occupational mechanical exposures and a preventive potential of around 15% of all cases.
    Occupational and environmental medicine 08/2012; 69(11):802-9. · 3.64 Impact Factor
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    ABSTRACT: We aimed to evaluate relations between occupational biomechanical exposures and (1) ulnar neuropathy confirmed by electroneurography (ENG) and (2) ulnar neuropathy-like symptoms with normal ENG. In this triple case-referent study, we identified all patients aged 18-65 years, examined with ENG at a neurophysiological department on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms and two separate groups of community referents, matched on sex, age and primary care centre (risk set sampling). The two patient groups were also compared to each other directly. We constructed a Job Exposure Matrix to provide estimates of exposure to non-neutral postures, repetitive movements, hand-arm vibrations and forceful work. Conditional and unconditional logistic regressions were used. The proportion who responded was 59%. Ulnar neuropathy was related to forceful work with an exposure-response pattern reaching an OR of 3.85 (95% CI 2.04 to 7.24); non-neutral postures strengthened effects of forceful work. No relation was observed with repetitive movements. Ulnar neuropathy-like symptoms were related to repetitive movements with an OR of 1.89 (95% CI 1.01 to 3.52) in the highest-exposure category (≥2.5 h/day); forceful work was unrelated to the outcome. Ulnar neuropathy and ulnar neuropathy-like symptoms differed with respect to associations with occupational biomechanical exposures. Findings suggested specific effects of forceful work on the ulnar nerve. Thus, results corroborated the importance of an electrophysiological diagnosis when evaluating risk factors for ulnar neuropathy. Preventive effects may be achieved by reducing biomechanical exposures at work.
    Occupational and environmental medicine 07/2012; 69(11):773-80. · 3.64 Impact Factor

Publication Stats

664 Citations
107.12 Total Impact Points

Institutions

  • 2012–2014
    • Danish Ramazzini Centre
      • Department of Occupational Medicine
      Ålborg, North Denmark, Denmark
  • 2007–2014
    • Herning Hospital
      Herning, Central Jutland, Denmark
  • 1998–2014
    • Aarhus University Hospital
      • Department of Occupational Medicine
      Aarhus, Central Jutland, Denmark
  • 2013
    • Bispebjerg Hospital, Copenhagen University
      • Department of Occupational and Environmental Medicine
      Copenhagen, Capital Region, Denmark
  • 2011
    • Aarhus University
      Aarhus, Central Jutland, Denmark