Article

Work and neck pain: A prospective study of psychological, social, and mechanical risk factors

October 2010
Pain 151(1):162-73

DOI:10.1016/j.pain.2010.07.001

Source
PubMed

Authors:

Jan Olav Christensen

National Institute of Occupational Health (STAMI)

Stein Knardahl

National Institute of Occupational Health (STAMI)

To determine the impact of occupational psychological/social and mechanical factors on neck pain, a prospective cohort study with a follow-up period of 2 years was conducted with a sample of Norwegian employees. The following designs were tested: (i) cross-sectional analyses at baseline (n=4569) and follow-up (n=4122), (ii) prospective analyses with baseline predictors, (iii) prospective analyses with average exposure over time [(T1+T2)/2] as predictor, and (iv) prospective analyses with measures of change in exposure from T1 to T2 as predictors. A total of 2419 employees responded to both the baseline and follow-up questionnaire. Data were analyzed using ordinal logistic regression. After adjustment for age, sex, neck pain at T1, and other exposure factors that had been estimated to be confounders, the most consistent risk factors were role conflict (highest OR 2.97, 99% CI: 1.29-6.74) and working with arms raised to or above shoulder level (highest OR 1.37, 99% CI: 1.05-1.78). The most consistent protective factors were empowering leadership (lowest OR 0.53, 99% CI: 0.35-0.81) and decision control (lowest OR 0.60, 99% CI: 0.36-1.00). Hence, psychological and social factors are important precursors of neck pain, along with mechanical factors. Although traditional factors such as quantitative demands and decision control play a part in the etiology of neck pain at work, in this study several new factors emerged as more important.

Individual work-motive values: determinants and consequences for the appraisal of specific health-related work characteristics

Article

Full-text available

Aug 2024

The objectives of the present study were to determine whether (I) work-motive values influence the appraisal of specific work characteristics of significance for health and function and (II) subject variables impact work-motive values. Two aspects of work-motive values were studied: values that assign importance to pursuing one’s personal goals and interests, internally based work-motive values (IntWMVs), and values that assign importance to external factors, externally based work-motive values (ExtWMVs). These aspects of motive values, age, gender, skill level, managerial role, and specific psychosocial work characteristics were analyzed in a cross-sectional sample of 12,994 employees in 101 private and public organizations. Two-year follow-up prospective data from 6,252 employees in 69 organizations elucidated whether associations were stable over time. The results showed that IntWMV influenced reports of levels of control of decisions, empowering leadership, innovative climate, quantitative demands, feedback from work, and self-leadership. ExtWMVs were most consistently associated with role clarity. Skill level and managerial role were associated with reporting higher levels of IntWMVs and lower ExtWMVs. In conclusion, the present data support the assumption that work-motive values influence the appraisal, reporting, and consequently measurements of work characteristics. Managers differ from subordinates in work-motive values and may face challenges in ascertaining and supporting subordinates’ needs.

Workplace Psychosocial Factors and Their Association With Musculoskeletal Disorders: A Systematic Review of Longitudinal Studies

Article

Full-text available

Sep 2023

This systematic review examines literature regarding the relationship between workplace psychosocial factors and musculoskeletal disorders (MSDs). Musculoskeletal disorders are the leading cause of work disability, resulting in billions of dollars of financial losses. Evidence suggests that workplace psychosocial factors can lead to the development and progression of MSDs. A data search was conducted in MEDLINE, EMBASE, PsychINFO, Scopus, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) from August 2009 to May 2020 inclusive. Other eligibility criteria included studies published in English, conducted on adults within a workplace setting, conducted in developed economies, and were stability-control longitudinal observational studies. Studies were independently screened for eligibility, using COVIDENCE (software for managing and streamlining systematic reviews) and assessed for quality by multiple authors, using the JBI Evidence synthesis tool. From 6,812 studies, 47 articles were included in the final analysis. The most common MSDs investigated were lower back pain, neck and shoulder pain, and upper extremity symptoms and disorders. Included articles identified that psychosocial workplace factors of support, collaboration, job control, and job demands were statistically significantly associated with risk and progression of MSDs. Review of the articles included in this article supports the theory that MSDs have a multifactorial, complex etiology that includes psychosocial factors. Interventions to enhance psychosocial work environment provide opportunities to reduce the risk of MSDs.

The Impact of a Workplace Terrorist Attack on the Psychosocial Work Environment: A Longitudinal Study From Pre- to Post-disaster

Article

Full-text available

Nov 2021

The psychosocial work environment is of great importance for regaining health and productivity after a workplace disaster. Still, there is a lack of knowledge about the impact of a disaster on the psychosocial work environment. The purpose of this study was to examine whether employees' perceptions of role clarity, role conflicts, and predictability in their work situation changed from before to after a workplace terrorist attack. We combined data from two prospective work environment surveys of employees in three governmental ministries that were the target of the 2011 Oslo terrorist attack. A first two-wave survey was conducted 4–5 years and 2–3 years before the attack, and a second three-wave survey took place 10 months, 2 years, and 3 years after the attack. Of 504 individuals who were employed at the time of the bombing, 220 were employed in both pre- and post-disaster periods, participated in both the first and the second survey, and consented to the linking of data from the two surveys. We found no significant changes in levels of role clarity, role conflict, and predictability from before to after the terrorist attack. Adjusting for sex, age and education had no effect on the results. The findings suggest that perceptions of the psychosocial working environment are likely to be maintained at previous levels in the aftermath of a workplace disaster. Considering the importance of the psychosocial work environment for regaining health and productivity, the findings are important for the preparation for, and management of, future crises.

A prospective study of work–private life conflict and number of pain sites: moderated mediation by sleep problems and support

Article

Full-text available

Apr 2019
J BEHAV MED

The objective of the current study was to elucidate how work-private life conflict prospectively affects musculoskeletal pain complaints by exploring possible mediation through sleep problems. In addition, the study determined whether support from coworkers and superior moderate this mediated relationship. The study incorporated a two-wave full panel design and participants included 4681 Norwegian working men and women. Path analyses were performed to study direct and indirect effects of work-private life conflict on sleep problems and multisite musculoskeletal pain, moderated by support. This study suggested time-lagged relationships of work-private life conflict with number of pain sites. Furthermore, sleep problems may mediate the effects of work-private life conflict on number of pain sites. While support has been found to affect the direct relationship between work-private life conflict and number of pain sites, it does not significantly moderate the indirect mediation effect, i.e. no moderated mediation effect of support was established. Findings from the present study suggest sleep may be one explaining factor in the complex work-pain mechanism, and this may aid the development of theories on work-private life conflict and pain. Since both work-private life conflict and support are modifiable work factors, primary workplace interventions by the employer aiming to reduce sleep problems and musculoskeletal pain in employees could target these specific work factors, and help prevent work-related pain complaints.

Pain, Conflicted Feelings About Work, and Sickness Absence: A Prospective Study of the Effects of Number of Pain Sites and Role Conflicts on Medically Certified Sickness Absence

Article

Full-text available

Oct 2023
J PAIN

The contribution of office design to the appraisal of job control: A longitudinal study

Article

Full-text available

Jun 2023
SCAND J PSYCHOL

The appraisal of control over work intensity and decisions at the workplace is a well-established determinant of health and well-being among employees. Building on job design theories, the overarching aim of this study was to determine office layout as a predictor of perceived job control. Specifically, we investigated between-group differences in control by contrasting employees in cellular offices with employees in shared/open offices, as well as effects on control among employees transitioning from one office design to another. This is a longitudinal study with three survey points across 48 months comprising 3,415 Norwegian office employees. Data were analyzed with latent growth curve analyses, adjusted for gender, age, leadership responsibility, and teleworking. Employees in cellular offices reported significantly higher control over work intensity and control over decisions when compared with employees in shared/open workspaces. Transitioning from a shared/open workspace to a cellular office led to a significant increase in perceived control regarding work intensity. As the experience of control may buffer the negative impact of job demands, organizations that rely on shared or open office solutions may benefit from identifying tools that can contribute to enhancing their employees' perceived control.

Working at home and expectations of being available: effects on perceived work environment, turnover intentions, and health

Article

Full-text available

Nov 2021

Objectives: The aim of this study was to determine if (i) working at home and (ii) expectations of being available to the employer in their spare time influences employees' perceptions of their work environment and well-being, health, organizational commitment, or intention to leave. Methods: We conducted cross-sectional analyses of survey data from 7861 office workers reporting hours worked at home and 3146 reporting frequency of expectations of being available to the employer in spare time (availability expectations). Prospective analyses (two-year follow up) comprised 5258 and 2082, respectively. Dependent variables were work factors previously associated with health complaints, mental distress, positive affect, work-private life conflict, commitment, and intention to leave. Random intercept linear and logistic regressions controlled for time worked (in addition to regular hours), age, gender, and skill level. Results: "Hours working at home" was cross-sectionally associated with higher levels of demands, role ambiguity, role conflicts, decision control, empowering leadership, human resource primacy, commitment, work-private life conflict, and lower support from co-workers. "Availability expectations" was associated with higher levels of demands, role conflicts, neck pain, mental distress, thinking that work was not finished when going to bed, sleep problems, work-private life conflict, intentions to leave and with lower levels of superior support, co-worker support, fair leadership, and commitment. There were no prospective associations. Conclusions: Working at home was associated with both positive and negative factors. Specific factors pertaining to role expectations and support from co-workers pose challenges. Availability expectations was associated with potentially negative work factors and health, organizational commitment, and intentions to leave. There were no long-term effects.

Workplace bullying, mental distress, and sickness absence: the protective role of social support

Article

Full-text available

Jan 2020
INT ARCH OCC ENV HEA

Purpose This study examined the protective effects of supervisor, colleague, and non-work-related social support on the associations between workplace bullying, mental distress, and medically certified sickness absence. We hypothesized that social support moderated the direct association between workplace bullying and mental distress as well as the indirect association between bullying and sickness absence through mental distress. We also hypothesized that the protective effects of social support were stronger among women than among men. Methods A sample of 10,627 employees was recruited from 96 Norwegian organizations. Workplace bullying, mental distress, and social support were assessed through a questionnaire survey and responses were linked to official registry data on medically certified sickness absence for the year following the survey assessment. Results The results showed that all three investigated sources of social support moderated the direct association between workplace bullying and mental distress. Supervisor support moderated the indirect association between workplace bullying and sickness absence through mental distress among both male and female respondents, whereas colleague support moderated this indirect association among women only. Non-work-related support had no protective effect on the indirect association. Conclusions The findings suggest that social support, and especially supervisor support, is beneficial with regard to reducing the negative impact of workplace bullying on health and work ability of those exposed. Organizations should, therefore, include social support in interventions targeting bullying.

Workplace Bullying and Medically Certified Sickness Absence: Direction of Associations and the Moderating Role of Leader Behavior

Article

Full-text available

Apr 2019

The aim of this study was to determine (1) associations between workplace bullying and subsequent risk and duration of medically certified sickness absence, (2) whether employees’ perceptions of supportive, fair, and empowering leader behavior moderate the association between bullying and absence, and (3) whether prior sickness absence increases the risk of being a new victim of bullying. Altogether, 10,691 employees were recruited from 96 Norwegian organizations in the period 2004–2014. The study design was prospective with workplace bullying and leader behavior measured at baseline and then linked to official registry data on medically certified sickness absence for the year following the survey assessment. For analyses of reverse associations, exposure to bullying was reassessed in a follow-up survey after 24 months. The findings showed that workplace bullying was significantly associated with risk (risk ratio = 1.23; 95% CI = 1.13–1.34), but not duration (incidence rate ratio = 1.05; 95% CI = 0.89–1.25) of medically certified sickness absence after adjusting for age, gender, and supportive, fair, and empowering leader behavior. None of the indicators of leader behavior moderated the association between bullying and sickness absence (both risk and duration). Adjusting for baseline bullying, age, and gender, prior long-term sickness absence (>21 days) was associated with increased risk of being a new victim of bullying at follow-up (odds ratio = 1.86; 95% CI = 1.28–2.72). Effective interventions toward workplace bullying may be beneficial with regard to reducing sickness absence rates. Organizations should be aware that long-term sickness absence might be a social stigma as sick-listed employees have an increased risk of being bullied when they return to work.

Pain in the Civilian and Military Workplace

Chapter

Sep 2018

Acute and chronic pain affects more Americans than heart disease, diabetes, and cancer combined. Conservative estimates suggest the total economic cost of pain in the United States is $600 billion, and more than half of this cost is due to lost productivity, such as absenteeism, presenteeism, and turnover. In addition, an escalating opioid epidemic in the United States and abroad spurred by a lack of safe and effective pain management has magnified challenges to address pain in the workforce, particularly the military. Thus, it is imperative to investigate the organizational antecedents and consequences of pain and prescription opioid misuse (POM). This chapter provides a brief introduction to pain processing and the biopsychosocial model of pain, emphasizing the relationship between stress, emotional well-being, and pain in the military workforce. We review personal and organizational risk and protective factors for pain, such as post-traumatic stress disorder, optimism, perceived organizational support, and job strain. Further, we discuss the potential adverse impact of pain on organizational outcomes, the rise of POM in military personnel, and risk factors for POM in civilian and military populations. Lastly, we propose potential organizational interventions to mitigate pain and provide the future directions for work, stress, and pain research.

Emotional Dissonance, Mental Health Complaints, and Sickness Absence Among Health- and Social Workers. The Moderating Role of Self-Efficacy

Article

Full-text available

Apr 2018

Health- and social workers are frequently exposed to emotionally demanding work situations that require emotion regulation. Studies have demonstrated a direct relationship between emotion regulation and health complaints and sickness absence. In order to prevent health complaints and to reduce sickness absence among health- and social workers, there is need for greater attention to mechanisms explaining when and how emotionally demanding work situations are related to employee health and sickness absence. The overarching aim of this study was therefore to examine the moderating role of generalized self-efficacy on the association between emotional dissonance, employee health (mental distress and exhaustion), and registry based sickness absence. The sample consisted of 937 health- and social workers. Data on emotional dissonance, generalized self-efficacy, exhaustion, and mental distress was collected through questionnaires, whereas official registry data were used to assess sickness absence. A two-step hierarchical regression analysis showed that emotional dissonance was significantly associated with exhaustion, mental distress, and sickness absence, after adjusting for sex, age, and occupation. Interaction analyses with simple slope tests found that self-efficacy moderated the association between emotional dissonance and both exhaustion and mental distress, but not the association with sickness absence. This study shows that health- and social workers who frequently experience emotional dissonance report higher levels of exhaustion and mental distress, and have a higher risk of medically certified sickness absence. Further, health- and social workers with lower self-efficacy beliefs are apparently more sensitive to the degree of emotional dissonance and experienced higher levels of exhaustion and mental distress.

Emotional Dissonance and Sickness Absence Among Employees Working With Customers and Clients: A Moderated Mediation Model via Exhaustion and Human Resource Primacy

Article

Full-text available

Apr 2018

Emotional dissonance, i.e., a discrepancy between required and felt emotions, has been established as a predictor of sickness absence in studies, but little is known about mechanisms that can explain this association. In order to prevent and reduce the impact of emotional dissonance on sickness absence, there is a need for greater attention to variables explaining when and how emotional dissonance is related to sickness absence. The overarching aim of this study was to examine whether emotional dissonance has an indirect association with sickness absence through exhaustion. In addition, we examined whether human resource primacy (HRP), which is the employer’s degree of concern for human resources, moderates this indirect effect. A sample of 7758 employees, all working with customers and clients, were recruited from 96 Norwegian organizations. Emotional dissonance, exhaustion, and HRP were measured through surveys and then linked to registry data on medically certified sickness absence for the year following the survey assessment. Results showed that exhaustion is a mediator for the relationship between emotional dissonance and sickness absence. Furthermore, higher levels of HRP were found to reduce the positive association between emotional dissonance and exhaustion, and the indirect effect of emotional dissonance on sickness absence through exhaustion is found to be weaker when HRP is high. By testing this moderated mediation model, the current study contributes to the literature on emotion work by clarifying mechanisms that are crucial for the development of targeted interventions that aim to reduce and prevent sickness absence in client-driven work environments.

Impact of Workplace Exposure and Stress on Neck Pain and Disabilities in Women-A Longitudinal Follow-up After a Rehabilitation Intervention

Article

Mar 2018

Introduction: The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups. Methods: Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated. Results: High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High 'control of decision' was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups. Conclusion: High perceived stress and low 'control of decision' were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

Neck and shoulder pain and inflammatory biomarkers in plasma among forklift truck operators – A case–control study

Article

Full-text available

Aug 2024

Objectives The aim of this study was to investigate a panel of inflammatory biomarkers in plasma from forklift truck operators (FLTOs) and healthy controls, and their relation to neck pain characteristics. Methods From employees in a warehouse, 26 FLTOs were recruited and 24 healthy age- and sex-matched controls (CONs) were recruited via advertisement. The inclusion criterion for FLTOs was that they should operate reach decker and/or counterbalanced tilting mast forklift trucks. All participants were asked to answer a questionnaire covering demographic data, pain intensity numeric rating scale (NRS), anatomical spread, psychological distress, and health aspects. Pain sensitivity was measured using a pressure algometer. Blood samples were collected and analyzed for inflammatory proteins in plasma using a panel of 71 cytokines and chemokines. Multivariate data analysis including orthogonal partial least square-discriminant analysis (OPLS-DA) was performed to identify significant biomarkers. Results Thirty percent of FLTOs reported NRS > 3 in the neck. Shoulder pain was common in 26% of the FLTOs. Pain and discomfort that most often prevented completion of activities were in the neck (20%), lower back (32%), and hips (27%). The FLTOs reported significantly (p = 0.04) higher levels of anxiety than the CON group and they had significantly lower pressure pain thresholds in the trapezius muscle on both right (p < 0.001) and left sides (p = 0.003). A significant OPLS-DA model could discriminate FLTOs from CON based on nine inflammatory proteins where the expression levels of four proteins were upregulated and five proteins were downregulated in FLTOs compared to CONs. Twenty-nine proteins correlated multivariately with pain intensity. Conclusions The profile of self-reported health, pain intensity, sensitivity, and plasma biomarkers can discriminate FLTOs with pain from healthy subjects. A combination of both self-reported and objective biomarker measurements can be useful for better understanding the pathophysiological mechanisms underlying work-related neck and shoulder pain.

Unsupervised machine learning for clustering forward head posture, protraction and retraction movement patterns based on craniocervical angle data in individuals with nonspecific neck pain

Article

Full-text available

May 2024
BMC MUSCULOSKEL DIS

Objectives The traditional understanding of craniocervical alignment emphasizes specific anatomical landmarks. However, recent research has challenged the reliance on forward head posture as the primary diagnostic criterion for neck pain. An advanced relationship exists between neck pain and craniocervical alignment, which requires a deeper exploration of diverse postures and movement patterns using advanced techniques, such as clustering analysis. We aimed to explore the complex relationship between craniocervical alignment, and neck pain and to categorize alignment patterns in individuals with nonspecific neck pain using the K-means algorithm. Methods This study included 229 office workers with nonspecific neck pain who applied unsupervised machine learning techniques. The craniocervical angles (CCA) during rest, protraction, and retraction were measured using two-dimensional video analysis, and neck pain severity was assessed using the Northwick Park Neck Pain Questionnaire (NPQ). CCA during sitting upright in a comfortable position was assessed to evaluate the resting CCA. The average of midpoints between repeated protraction and retraction measures was considered as the midpoint CCA. The K-means algorithm helped categorize participants into alignment clusters based on age, sex and CCA data. Results We found no significant correlation between NPQ scores and CCA data, challenging the traditional understanding of neck pain and alignment. We observed a significant difference in age (F = 140.14, p < 0.001), NPQ total score (F = 115.83, p < 0.001), resting CCA (F = 79.22, p < 0.001), CCA during protraction (F = 33.98, p < 0.001), CCA during retraction (F = 40.40, p < 0.001), and midpoint CCA (F = 66.92, p < 0.001) among the three clusters and healthy controls. Cluster 1 was characterized by the lowest resting and midpoint CCA, and CCA during pro- and -retraction, indicating a significant forward head posture and a pattern of retraction restriction. Cluster 2, the oldest group, showed CCA measurements similar to healthy controls, yet reported the highest NPQ scores. Cluster 3 exhibited the highest CCA during protraction and retraction, suggesting a limitation in protraction movement. Discussion Analyzing 229 office workers, three distinct alignment patterns were identified, each with unique postural characteristics; therefore, treatments addressing posture should be individualized and not generalized across the population.

Is new tech a pain in the neck? The impact of introducing new technologies in home-care on neck pain: a prospective study

Article

Full-text available

Mar 2024
BMC PUBLIC HEALTH

Background Home healthcare services are increasingly utilizing novel technologies to enhance quality and efficiency of caregiving, to reduce workloads and compensate for expected labor shortages in the future due to ageing populations. However, rapid, ongoing implementation of new technologies may demand considerable adaptation for employees. The objective of this study was to prospectively examine associations of newly introduced work technologies with neck pain complaints. Methods With a nationally representative prospective sample of home-care workers in Norway (N = 887), we estimated effects of 1) introducing new technologies and 2) the appraised quality of training during implementation on neck pain eight months after. Results A majority of employees reported new technologies having been introduced the previous 12 months (73.8%). This was not by itself associated with neck pain. However, perceived high quality of training was associated with less subsequent neck pain, also after adjustment for job demands and job control. The strongest effect was seen for “very good” versus “very poor” quality training (OR 0.35, 95% CI 0.17,0.71, in the fully adjusted model). Cross-lagged path analyses ruled out potential reverse causation stemming from the influence of pain on needs for or appraisals of training. Conclusion The present findings suggest the introduction of new work technologies has a significant impact on home-care workers’ health, depending on the quality of training during implementation. This highlights the need to include training programs in risk assessments when implementing new technologies.

Influence of psychosocial factors at work on the non-departmental security officers of the National Guard of the Russian Federation

Article

Full-text available

Dec 2022

An analysis of modern research has shown insufficient study of the labor factors that influence the development of various functional states of non-departmental security officers which allow to develop the recommendations to improve their psychological safety. The aim of the study. To identify and to describe psychosocial factors at work in relation to the general functional state of the body, stress and performance of non-departmental security officers. Methods. We used the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic), psychophysiological testing using “Psychophysiologist” device, M. Lüscher color preference test, multivariate statistical methods. The study involved 74 non-departmental security officers of the Arkhangelsk region. Results. The general functional state of the body, stress and performance, measured by objective and projective methods, are differentially interconnected with psychosocial factors at work. The general functional state of the body is related with the personal attitude to the work performed; stress and performance – with factors of social support, organizational culture and work requirements. The general functional state of non-departmental security officers is favorably influenced by such factors as understanding the goals of the work performed and the expected results, satisfaction with the quality of work and labor safety. Insufficient ability to maintain good relations with the team unfavorably influences the general functional state of the officers. The factors of work intensity include one-type tasks, tight schedule, increased alertness during work and greater precision in movements. Risk factors are associated with strict working hours and insufficient attention of the manage-ment to the opinion and interests of subordinates. At the same time, the environmental resource is the possibility of realizing professional motives and demonstrating mastery in work, as well as a favorable organizational culture.

The Psychosocial Risk Factors Evaluation and Management of Shift Personnel at Forest Harvesting

Article

Full-text available

Sep 2022

The study describes psychosocial risk factors at work in relation to the general functional state of a body, working capacity and stress among shift workers at a logging enterprise in the Far North. The study involved 153 loggers with a 14-day shift period. Research methods included the psychophysiological instrumental method (variocardiointervalometry) used to assess the general functional state of a body, M. Luscher’s color test to assess working capacity and stress and QNordic to assess psychosocial factors. Statistical analysis was performed using multiple stepwise regression analysis and frequency analysis. It was found that 71.1% of employees have a favorable general functional state of the body, 28.9%—unfavorable; the forest loggers who took part in the survey have a high level of working capacity and a low level of stress. It was substantiated that the general functional state of a body, stress and working capacity, measured by objective and subjective methods, are differentially interconnected with psychosocial factors at work. The general functional state of forest harvesting workers is influenced by factors of labor content, intensity and organization. The relationships with the immediate supervisor are important in order to increase the working capacity and efficiency of employees as well as their involvement in work.

Predictive Factors of Short-Term Related Musculoskeletal Pain in the Automotive Industry

Article

Full-text available

Dec 2021
Int J Environ Res Publ Health

To determine the short-term associations between biomechanical risk factors and musculoskeletal symptoms in the upper limbs and low back in an automotive company, a longitudinal study with a follow-up of 4 days was conducted in a sample of 228 workers of the assembly and paint areas. Data were analyzed using generalized estimating equations, calculating the crude and adjusted model for age, sex, seniority, and intensity of pain at baseline. The interactions found were the same for both models. Workers were divided in low-risk and high-risk group for posture, force, exposure, percentage of cycle time with the arm at/above shoulder level, and with the trunk flexed or/and strongly flexed. The predictive factors showed by time × group effect were found between pain intensity on the left shoulder for posture (β = 0.221, p < 0.001), percentage of time with the trunk flexed (β = 0.136, p = 0.030) and overall exposure (β = 0.140, p = 0.013). A time × group interactions were observed, namely between neck pain and posture (β = 0.218, p = 0.005) and right wrist and force (β = 0.107, p = 0.044). Workers in the high-risk group were more prone to report unfavorable effects on their self-reported musculoskeletal pain, across a workweek when exposed to specific risk factor, being posture important to neck, right wrist and left shoulder pain.

Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users

Article

Full-text available

Nov 2021
Compl Ther Clin Pract

Background Computer use is a well-known source of chronic pain, leading to absenteeism and reduced productivity and well-being. This study evaluated the feasibility of conducting a full-scale randomised controlled trial. Several methodological variables defined trial feasibility. Materials and methods Thirty adults, daily computer users reporting pain, were recruited. Data collection took place at LABIOMEP. Participants were randomised into 1 of 3 parallel groups and received either osteopathic, sham or no treatment. Only the volunteers were blind to group assignments. The primary objective was to study the feasibility and acceptability of the protocol. Results Of 77 participants interested, 30 were included and randomised into three groups of ten. All participants concluded the study, and all the data was analysed. The feasibility outcomes were deemed appropriate. No adverse events or severe side effects were reported or identified. Conclusion Studying the efficacy of osteopathic consultation on computer users by conducting an RCT is feasible and safe. With adjustments, a full-scale study can be designed. Trial registration ClinicalTrials.gov with the identifier: NCT04501575. Date registered August 06, 2020.

MODERATING ROLE OF RESILIENCE: WHEN ABUSIVE SUPERVISION IMPACTS DISTRIBUTIVE JUSTICE AND EMPLOYEES' VOICE

Article

Jan 2019

The purpose of this study is to investigate the role played by abusive supervision in decreasing the voice of employees. This study tested the mediating role of distributive justice in the relationship between abusive supervision and employee's voice and moderating role of resilience in the relationship between abusive supervision and employee voice, and abusive supervision and distributive justice as well. A sample of 461 employees was contacted from 3S and 2S dealerships of automobiles sector of Pakistan. Using convenience sampling technique, data was collected through four structured questionnaires. Respondents duly filled in consent form for being participants of the study. To avoid variable biasedness Time Lag Technique was used for collecting data. Data Analyses were carried out by using SPSS and AMOS. Abusive supervision was found having negative impact on employees' voice. Perception of abusive supervision has a negative impact on perception of distributive justice which in turn decreases employees' voice. Resilience as a psychological resource has been found moderating the relationship between abusive supervision and employees' perception of distributive justice, and the relationship between abusive supervision and employees' voice. This study provides an insight to managers to figure out the adverse impact of abusive supervision on voice behaviors of employees. Abusive supervision works as a hurdle in voicing the silence of the subordinates. Mangers, therefore, need to take measures for discouraging abusive supervision in the work place. An abuse free organizational environment will induce employees to give their much-needed feedback 444 and opinion in the organizational matters. Moreover, managers need to find ways to develop resilience in the employees as resilience like other components of PsyCap is a state which can be developed and strengthened. The present study investigates the supervisor's abusive behavior to be an obstacle in voicing the silence of subordinates. It provides evidence that distributive justice mediates the relationship between abusive supervision and employees' voice behaviors. This study broadens the understanding that how abusive supervision leads to employees' voice behaviors through mediation of distributive justice, moreover, the mitigating role of resilience, (a component of Psychological Capital), has been emphasized in this study.

Working at home and alcohol use

Article

Full-text available

Sep 2021

Working at home has become a frequent work arrangement following the COVID-19 pandemic. However, little is known about how working at home influence alcohol use among employees. This study examines associations between working at home at least 15 h per week and alcohol consumption using data from a pre-COVID-19 sample. Self-reported questionnaire data on working at home and alcohol use from a large cross-sectional sample of Norwegian employees (N = 14,728). Data were collected between 2004 and 2019 and were analyzed by ordinal logistic regressions. Working at home for >15 h per week was significantly associated with alcohol use (OR 1.67, 95% CI: 1.30 - 2.16). The association remained significant after adjusting for age, gender, leadership position, and educational level. Working at home may facilitate alcohol use that otherwise would not happen. Organizations must ensure that policies and procedures are in place to prevent alcohol use during working hours among employees working at home.

Effects of psychosocial work factors on number of pain sites: The role of sleep quality as mediator

Article

Full-text available

Dec 2019
BMC MUSCULOSKEL DIS

Background: Objective of the current study was to determine which of thirteen specific psychosocial work factors were related to number of musculoskeletal pain sites (NPS) prospectively over a two-year time span. Furthermore, the study aimed to explore possible mediation of these prospective relationships through sleep problems. Methods: The study was a two-wave full panel study. Participants included 6277 employees of Norwegian companies, representing a wide range of occupations. Structural equation modelling was employed to analyze direct and indirect effects of thirteen specific psychological- and social work factors on sleep problems and NPS. Results: Out of the thirteen work factors studied, positive challenges at work, role conflict, decision control, superior support, coworker support, empowering leadership, and social climate were statistically significantly related to subsequent NPS, both directly and indirectly through sleep quality. Sleep quality was related to NPS in all analyses. Most psychosocial work factors exhibited direct effects on either sleep or number of pain sites. Decision demands and control over work pacing were not statistically significantly related to sleep or pain. Conclusion: In conclusion, the results suggested sleep quality to be involved in the mechanisms by which work affects the number of pain complaints employees experience. Significance: Findings from this study suggest sleep may play a role in the complex mechanism from work stressors to musculoskeletal pain. Workplace interventions aiming to reduce musculoskeletal pain may wish to target work factors described in this study, as they affect sleep and may thereby increase number of musculoskeletal pain sites.

Objectively measured versus self-reported occupational physical activity and multisite musculoskeletal pain: a prospective follow-up study at 20 nursing homes in Denmark

Article

Full-text available

Apr 2020
INT ARCH OCC ENV HEA

Purpose To explore the prospective association of objectively measured and self-reported occupational physical activity (OPA) with multisite musculoskeletal pain (MSP) among Danish eldercare workers. Methods The study population consisted of eldercare workers in 20 Danish nursing homes (N = 553, response rate 59%, 525 female). Baseline data were collected in 2013–2014 and the 1-year follow-up was completed in 2016. At baseline, we measured objective OPA by a thigh-worn ActiGraph GT3X + accelerometer during work and self-reported OPA by a questionnaire survey. Information on musculoskeletal pain during the past four weeks in seven different body sites was reported by a structured questionnaire at baseline (n = 389) and by SMS and telephone interview during follow-up (n = 284). MSP was defined as having pain in two or more body sites. Using log-binomial models we calculated risk ratios (RRs) with their 95% confidence intervals (CIs) to estimate the association between objectively measured and self-reported OPA and MSP. Results We found statistically significant positive associations between self-reported OPA (RR for high OPA 1.24, 95% CI 1.05–1.46) and MSP while there was no significant association found between objective OPA and MSP. Conclusion Our study indicates that self-reported, but not objectively measured OPA is positively associated with MSP. This finding highlights the need for better understanding, use, and interpretation of self-reported and objectively measured OPA in the study of MSP.

Pain complaints are associated with quick returns and insomnia among Norwegian nurses, but do not differ between shift workers and day only workers

Article

Full-text available

Apr 2020
INT ARCH OCC ENV HEA

Purpose To determine whether common work schedule characteristics among Norwegian nurses were associated with subjective pain complaints. Methods A cross-sectional study in a sample of 1585 nurses, part of the longitudinal questionnaire-based cohort project ‘Survey of Shift work, Sleep and Health’ (SUSSH). Pain from six regions were assessed: ‘headache’, ‘neck/shoulder/upper back’, ‘upper extremities’, ‘lower back’, ‘lower extremities’, and ‘abdomen’. Logistic and negative binomial regression (adjusted for age, sex, percentage of full-time equivalent, marital status and children living at home) were conducted where work schedule, number of night shifts last year, number of quick returns (QR) last year (< 11 h between shifts) and insomnia were predictors of localized pain, widespread pain and number of pain sites. Results Localized pain, widespread pain and number of pain sites were associated with insomnia (OR 2.06, 95% CI 1.66–2.55, OR 2.14, 95% CI 1.47–3.09, IRR 1.70, 95% CI 1.51–1.91, respectively). Work schedule and number of night shifts worked last year were not associated with any of the three pain measures. Number of QRs worked last year tended to be associated with number of pain sites. Conclusion The study did not support the hypothesis that non-daytime work schedules are associated with pain complaints. Neither was there support for the hypothesis linking number of night shifts, or the number of QRs, to pain complaints. Future studies should aim to determine the association between QRs and pain in more detail. Pain complaints were associated with insomnia.

Effects of static stretching in comparison with Kaltenborn mobilization technique in nonspecific neck pain

Article

Aug 2018

Muhammad Mustafa Qamar

BACKGROUND: Neck pain is a common medical problem resulting from any diseases or biomechanical disturbances. In mechanical/nonspecific neck pain, muscles become tighten, leading to restricted neck mobility. The study purposed to determine the efficacy of Kaltenborn mobilization technique and static stretching in pain and regain of a normal cervical range of motion (ROM) in patients with nonspecific/mechanical neck pain. MATERIALS AND METHODS: Forty-four patients suffering from non-specific neck pain were randomly divided into two groups. Group A, in which participants received static stretching (n = 22) and Group B, in which participants received Kaltenborn mobilization technique (n = 22). Pain intensity was measured by numeric rating pain scale and active ROM (AROM) by neck disability index at baseline and post-study. RESULTS: At baseline, there was no difference in pain intensity and ROM in both groups. At post-study, a significant improvement was found in both groups in improving ROM and pain. However, no intervention was superior. CONCLUSION: Both the Kaltenborn mobilization technique and static stretching are effective in reducing nonspecific neck pain and increasing cervical AROM.

The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review

Article

Full-text available

Jun 2019

Objective: To identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI. Data sources: We searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017. Study selection: Eligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded. Data extraction: Studies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale, and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance. Data synthesis: Of the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies. Conclusions: Pain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.

Comparação do reposicionamento da cabeça em jovens assintomáticos e com dor cervical

Article

Apr 2016

Felipe J J Reis

A dor cervical é uma das principais condições musculoesqueléticas responsáveis por provocar limitações funcionais. O comprometimento de músculos profundos da coluna cervical pode alterar as informações do sistema proprioceptivo cervical e consequentemente suas interações com o sistema vestibular e visual. O estudo buscou comparar a capacidade de reposicionamento da cabeça em jovens assintomáticos e com dor cervical mecânica. Participaram 60 voluntários sendo 43 assintomáticos e 17 com história de dor cervical mecânica. Avaliou-se a capacidade de reposicionamento da cabeça com os participantes sentados, vendados, utilizando um capacete com um laser pointer fixado. Os participantes realizaram 6 repetições do movimento de rotação e as diferenças entre o posicionamento inicial e final eram mensuradas em centímetros (erro absoluto-EA) e convertidas em graus. A diferença entre os grupos foi realizada por meio do teste de Mann-Whitney com p ≤ 0,05. Para as rotações direita e esquerda as médias do EA foram: no grupo com dor cervical 6,1 e 4,7 graus e no assintomático 5,3 e 5,3 graus. Não houve diferença na capacidade de reposicionamento da cabeça entre os grupos. É possível que outros fatores associados a dor contribuam para o comprometimento da cinestesia cervical.Palavras-chave: cervicalgia, propriocepção, cinestesia, dor.

Physicians’ Mental Health and Nationality Affect how Work Characteristics Influence Presenteeism

Article

Full-text available

Sep 2018

This study aimed to investigate how variations in mental health and nationality affect the influence of job demands and job resources on presenteeism among physicians. By differentiating between hindrances and challenging job demands and between buffering and motivational job resources, the current study investigated the mechanisms of physicians’ presenteeism by conducting separate analyses for respondents with good and poor mental health within two countries. A total of 1596 physicians employed at Swedish and Norwegian university hospitals were split into four subsamples according to nationality and mental health status. A score of ≥4 on the General Health Questionnaire-12 defined poor mental health. A set of 't'-tests showed that overall, the Norwegian sample experienced higher presenteeism, lower demands, and higher resources than the Swedish sample. Within the national samples, the samples with poor mental health indicated that they experienced higher demands and lower resources and showed higher presenteeism than the samples with good mental health. A set of regression analyses in the four subsamples showed that hindrance demands were positively associated with presenteeism and buffering resources were negatively associated with presenteeism in all four subsamples. However, only the subsamples of physicians with good mental health were found to have positive associations between both challenging demands and motivating resources and presenteeism. The study concludes that the association of both demands and resources with presenteeism depend upon how they interact with both personal health and national context.

Exposure to Upper Arm Elevation During Work Compared to Leisure Among 12 Different Occupations Measured with Triaxial Accelerometers

Article

Full-text available

Jun 2018

Regarding prevention of neck and shoulder pain (NSP), unsupported arm elevation is one factor that should be taken into account when performing work risk assessment. Triaxial accelerometers can be used to measure arm elevation over several days but it is not possible to differentiate between supported and unsupported arm elevation from accelerometers only. Supported arm elevation is more likely to exist during sitting than standing. The aim of the study was to evaluate the use of whole workday measurements of arm elevation with accelerometers to assess potentially harmful work exposure of arm elevation, by comparing arm elevation at work with arm elevation during leisure, in a population with diverse work tasks, and to assess how the exposure parameters were modified when upper arm elevation during sitting time was excluded. The participants, 197 workers belonging to 12 occupational groups with diverse work tasks, wore triaxial accelerometers on the dominant arm, hip, and back for 1-4 days to measure arm elevation and periods of sitting. None of the groups were found to have higher exposure to arm elevation during work compared to leisure. Even though some occupations where known to have work tasks that forced them to work with elevated arms to a large extent. A high proportion of arm elevation derived from sitting time, especially so during leisure. When arm elevation during sitting time was excluded from the analysis, arm elevation was significantly higher at work than during leisure among construction workers, garbage collectors, manufacturing workers, and domestic cleaners. Together this illustrates that it is not suitable to use whole workday measurments of arm elevation with accelerometer as a sole information source when assessing the risk for NSP due to arm elevation. Information on body posture can provide relevant contextual information in exposure assessments when it is known that the potential harmful exposure is performed in standing or walking.

Are Leadership Fairness, Psychological Distress, and Role Stressors Interrelated? A Two-Wave Prospective Study of Forward and Reverse Relationships

Article

Full-text available

Feb 2018

While previous research has mainly considered leadership as an antecedent to psychological distress and role stressors (i.e., role ambiguity and role conflict) among subordinates, a reverse relationship where these variables influence reports of leadership is also possible. To determine the directionality of the associations this two-wave prospective study assesses bidirectional relationships between fair leadership and role stressors and examines whether psychological distress mediates the reciprocal associations between fair leadership and the role stressors. Analyses were conducted in a sample of 6,790 Norwegian employees with a 2-year time-lag between measurement points. Fair leadership was associated with lower stability adjusted role ambiguity, but not role conflict, over time. Role conflict, but not role ambiguity, was related to subsequent reports of the immediate leader as less fair. Psychological distress did neither mediate the relationship between fair leadership and subsequent reports of role stressors, nor the association between role stressors and subsequent reports of fair leadership. The findings suggest that the fair leadership – role stressor association is not a one-directional process, but that exposure to role stressors also influence subordinates’ perceptions of leadership. An implication of the findings is that theoretical models of organizational leadership should include this reverse impact of role stressors. To reduce the effects of role stressors, organizations could set consistent, clear and attractive goals and provide employees with necessary information for conducting their work tasks in order to help workers understand and master their roles at the workplace.

The association of sleepiness, insomnia, sleep disturbance and pain: a study amongst shiftworking nurses

Article

Nov 2017

Sleep problems are commonly associated with chronic pain. It is not known whether pain is more related to a particular type of sleep problem or to more composite measures of sleep disturbance. The aim of the study was to investigate cross-sectionally the association between three commonly used sleep problem scales and musculoskeletal pain, when controlling for age, lifestyle and work factors. A total of 1032 nurses answered the Epworth Sleepiness Scale, Bergen Insomnia Scale, Pittsburg Sleep Quality Index and questionnaires regarding work, personality and lifestyle factors. Data collection started in October 2014 and ended in November 2015. Data were analyzed with hierarchical multiple regressions. Musculoskeletal pain was associated with Epworth Sleepiness Scale and Bergen Insomnia Scale, with Bergen Insomnia Scale showing the strongest association. Post hoc analyses of the most frequently reported pain locations, back pain headache and neck pain, confirmed that Bergen Insomnia Scale showed the strongest association. Insomnia seems to be more strongly associated with musculoskeletal pain than subjective sleepiness, thus the measures used to explore this association should be carefully selected when studying the relation between disturbed sleep and pain.

Alcohol Use and Psychosocial Stressors in the Norwegian Workforce

Article

Full-text available

Mar 2018

Background: Although alcohol use can have detrimental effects for employees, little is known about the prevalence, distribution, and correlates in the Norwegian workforce. Aims: To determine the overall and the work-related prevalence of weekly alcohol use, and to establish associations between psychosocial work stressors and alcohol use among Norwegian employees. Methods: Data were from a 2015 national probability sample of 1,608 Norwegian employees (response rate 32%). Job demands, lack of job control, role expectations, workplace bullying, and leadership were examined as correlates of several dimensions of alcohol use. Results: Averageweekly alcohol consumptionwas 4.28 units (SD = 7.91). Male workers reported significantly higher consumption than female workers. Also, 2.6% of male and 2.0% of female workers reported problematic alcohol use. Only 0.1% of workers reported weekly alcohol use before theworkday, 0.4% reportedweekly use during theworkday, 20.1% reported weekly use after ending thework day, and 80% reported use duringweekends/days off. Alcohol intake increased with age, but was not related to marital status, educational level, work schedule, or leadership position. Problematic alcohol use was related to job demands and workplace bullying. Alcohol use afterwork was positively related to lack of job control and role ambiguity and negatively related to bullying. Conclusions/importance:Weekly alcohol use before and during the workday is not prevalent among Norwegianworkers. Interventions to reduce job demands andworkplace bullyingmay reduce problematic alcohol intake, whereas increasing job control and reducing role ambiguity may reduce after work use.

Effects of upper-limb exoskeleton on muscle activity in tasks requiring arm elevation: Part II - In-field experiments in construction industry settings

Article

Apr 2024

Background: The body of literature regarding the use of an upper limb exoskeleton during authentic working conditions is sparse. Objective: The aim of this study was to evaluate the effectiveness of an upper limb exoskeleton in reducing muscle strain during authentic industrial construction work. Methods: Fifteen male participants, comprising of roofers, scaffolders, builders, bricklayers, and graders performing overhead work participated in the study. During work without (REF) and with exoskeleton (EXO), muscle activity from 8 muscles, heart rate (HR), metabolic equivalent (MET), and upper arm elevation angles were recorded. Results: When using the exoskeleton, a significant reduction of 20.2% in average muscle activity of 8 muscles was found. The largest effect focused on m. deltoideus, where 46.2 and 32.2% reduction occurred in medial and anterior parts of the muscle, respectively. HR and MET were unaffected. Upper arm elevation angles were similar between REF and EXO, indicating equal biomechanical loading. Conclusions: This study indicates that exoskeletons show great promise in reducing the potential for musculoskeletal strain during authentic overhead construction work.

Managing Neck Pain: Treatment Preferences Amongst PhysicalTherapist of Khyber Pakhtunkhwa

Article

Jun 2023

“I'm too old for this!”: A prospective, multilevel study of job characteristics, age, and turnover intention

Article

Full-text available

Nov 2022

Introduction Deciding to leave a job is often foreshadowed by burgeoning job dissatisfaction, which is in turn often attributed to characteristics of the job and work environment. However, while we know that job characteristics influence job satisfaction, health, and motivation, their associations with turnover intention is less clear. Moreover, despite aging workforces, an understanding of how working conditions influence workers across the lifespan is lacking. Therefore, drawing on job design theories and bridging turnover- and aging research, we studied 15 specific job characteristics to determine whether they predicted turnover intentions, and whether the predictive value was modified by age. Methods Data were collected from various public and private enterprises in Norway. Moderated multilevel regressions were conducted cross-sectionally (N = 12,485) and prospectively over 2 years (N = 5,504). Results Most work factors were associated with turnover intention at both the individual and work unit levels. A social climate of support, trust, and encouragement was most strongly inversely associated with turnover intentions, while role conflict was most strongly positively associated with turnover intentions. Organizational climate, leadership styles, and job control were more important with age while job demands, predictability and role stressors were more important to younger workers. Ten individual level- and four work-unit level factors predicted turnover intentions prospectively, suggesting turnover intentions due to poor working conditions persisted in employees that did not quit. Discussion Our results highlight several specific, modifiable job characteristics that are likely to affect turnover intentions, and the impact of certain factors specifically for older workers.

Comparative effectiveness of proprioceptive neuromuscular facilitation and Passive Vertebral Mobilization for neck disability in patients with mechanical neck pain: A randomized controlled trial

Article

Mar 2022

Objective To compare the effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) and Passive Vertebral Mobilization (PVM), both when given in adjunct to routine physical therapy (RPT), on neck disability in patients with mechanical neck pain (MNP). Methods A single-blinded randomized controlled trial was conducted on 90 patients with MNP at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from September 2015 to March 2018. The participants aged between 18 and 65 years were recruited through a simple random sampling technique and randomly divided into three groups i.e. PNF + RPT, PVM + RPT, and RPT. Each participant was evaluated pre and post-intervention (after four weeks) through neck disability index (NDI). The data were analyzed by using SPSS version 21. Results The MANOVA was run on the pre-post mean differences of the variables to determine the changes within the groups which showed that the participants improved significantly in all the groups in terms of the NDI components and overall NDI score (p < 0.05). Univariate analysis with the post-hoc comparison and Tuckey HSD correction was used to determine the differences between the groups which showed that there was a significant difference between the interventional groups in the overall pain intensity, as well as pain experienced while performing personal care activities, reading, doing work, driving, sleeping, recreation and in the total NDI score (p < 0.05). Conclusion PVM (in adjunct to RPT) was more effective than PNF (in adjunct to RPT) for the patients with MNP to manage themselves in daily activities. Clinical trial registration NCT03813680 (at clinicaltrials.gov) (https://clinicaltrials.gov/ct2/show/NCT03813680)

Fafo-rapport 2021:20. Det erfarne blikket. Seniorer i pleie- og omsorgssektoren.

Book

Full-text available

Jun 2021

Denne rapporten omhandler sykepleiere, helsefagsarbeidere og assistenter som er seniorer og jobber på pleie- og omsorgsinstitusjoner og i hjemmetjenesten. Vi ser på omfanget av ansatte 50+ i de aktuelle yrkene og kartlegger pensjoneringsmønster og frafall. Vi undersøker også hvordan det er å være senior i disse yrkene, hvilke utfordringer de har, hvordan de opplever arbeidsmiljø og ledelse, om de føler seg sett og anerkjent, hvilke utviklingsmuligheter de har, og ikke minst om de opplever yrket og bransjen som et godt sted å være i seinkarrieren, og hva som eventuelt skal til for å kunne stå lenger i arbeid i disse yrkene.

Exploring dynamic relationships between employees’ personalities and psychosocial work factors

Article

Apr 2021

The current study addresses the potentially dynamic relationship between employees’ personality and their working conditions. A six-year full-panel longitudinal study of employed individuals was used to test whether (I) task-related, (II) social and (III) organizational work factors contribute to change Big-Five personality traits over time and whether personalities change working conditions. Bivariate latent change score analyses were conducted on repeated-measures data (four waves) from 2356 Norwegian employees. The results showed that specific work factors pertaining to task-related and social characteristics (i.e. leadership) were associated with personality trait changes. Contrary to our expectations, none of the work factors predicted change in neuroticism and extraversion, and we offer several possible explanations for these findings. The results also showed that all personality traits may play an active role in shaping specific attributes of the work environment over time and thereby shed light on how employees’ working conditions emerge.

The Health and Wellbeing of Healthcare Workers. Concepts, Theories and Key Work Factors

Chapter

Jan 2020

Stein Knardahl

Human capital consists of knowledge, skills, and abilities of employees. Motivation is essential for translating human capital into effective healthcare. The first part of this chapter reviews general theories of effects of challenges. Appraisal of a challenge, availability of a response at one’s discretion (control), feedback from responses, and expectancy to cope, impact outcomes. Studies of management and leadership have produced a plethora of theories of motivation. Theories reviewed here highlight job contents (task-level factors), equity, leadership behaviours, and fit between job- and person-characteristics. Prevailing theories of work and health emphasize balance between demands or effort on the one side, and control or rewards and status control or factors defined as resources on the other. Other theories posit that justice, psychological contracts, or social support influence health. Shortcomings are unspecific dimensions and circular reasoning. Maintaining human capital depends on knowledge of specific factors that contribute to motivation, well-being, and health.

Prevalence and occupational predictors of psychological distress in the offshore petroleum industry: a prospective study

Article

Nov 2013

Objectives This study investigates the prevalence of psychological distress and stressors in the work environment as prospective predictors of distress, among employees in the offshore petroleum industry.Methods Correlation and logistic regression analyses were employed to examine longitudinal relationships between stressors and distress in a randomly drawn sample of 741 employees from the Norwegian petroleum offshore industry. Time lag between baseline and follow-up was 6 months. Work environment stressors included safety factors, leadership, and job characteristics.ResultsThe prevalence of psychological distress was 9 % at baseline and 8 % at follow-up. All investigated work environment factors correlated with subsequent distress. In bivariate logistic regression analyses, caseness of distress was predicted by baseline distress, near miss accidents, risk perception, poor safety climate, tyrannical leadership, laissez-faire leadership, job demands, and workplace bullying. After adjustment for baseline distress, control variables, and other predictors, laissez-faire leadership (OR = 1.69; 95 % CI: 1.12–2.54) and exposure to bullying (OR = 1.49; 95 % CI: 1.07–2.10) emerged as the most robust predictors of subsequent distress.Conclusions The findings show that the prevalence of psychological distress is lower among offshore employees than in the general population. Although offshore workers operate in a physically challenging context, their mental health is mainly influenced by stressors in the psychosocial work environment. This highlights the importance of developing and implementing psychosocial safety interventions within the offshore industry.

The Interaction Between Pain Intensity and Pain Self-Efficacy in Work Functioning Impairment: A Cross-Sectional Study in Japanese Construction Workers

Article

Jan 2020

Objective: To examine the pain intensity and pain self-efficacy interaction in workers' work functioning impairment. Methods: A cross-sectional study using a self-reporting survey. Of 6,657 Japanese construction company employees, 5,129 (77.0%) valid responses were analyzed for work functioning impairment. Further analysis using current pain intensity and pain self-efficacy was performed on 1,622 employees who experienced physical pain in the past 12 months. Results: Pain intensity showed a dose-response relationship with work functioning impairment. Further analysis showed an interaction between pain intensity and pain self-efficacy for work functioning impairment. Stratification by pain self-efficacy showed that high pain self-efficacy was not associated with an increase in work functioning impairment, even in those with severe pain (odds ratio = 1.79; 95% confidence interval = 0.69-4.68). Conclusions: Pain self-efficacy may be a key determinant for work functioning impairment in workers with pain.

A preliminary biopsychosocial analysis of online information on causes of neck pain

Article

Feb 2019

Objective The aim of the present study was to analyse the freely available online information on the causes of neck pain based on the biopsychosocial model of pain. Methods A preliminary biopsychosocial analysis tool was developed, after an extensive literature review of the pathoanatomical and psychosocial contributors for neck pain. The websites that commonly appeared after the search term “causes of neck pain” in the first two pages of the search engines (Google, Yahoo and Bing) were selected for the biopsychosocial analysis. In addition, the websites were reviewed for Health on Net (HON) certification. Results Ten websites were analysed, of which eight were identified to contain a predominant biomedical orientation, as they reported only the pathoanatomical causes of neck pain. The remaining two websites were determined to represent limited psychosocial information and described only two psychological contributors to the neck pain. Conclusions The online information on the causes of neck pain appears to contain limited biopsychosocial orientation. Further detailed analysis is essential to obtain firm conclusions on the content validity of online information on neck pain.

Lifetime socioeconomic circumstances and chronic pain in later adulthood: Findings from a British birth cohort study

Article

Full-text available

Jan 2019

Objectives To investigate associations between a range of different indicators of socioeconomic position (SEP: occupational class, education, household overcrowding and tenure, and experience of financial hardship) across life and chronic widespread and regional pain (CWP and CRP) at age 68. Design Prospective birth cohort; the Medical Research Council National Survey of Health and Development. Setting England, Scotland and Wales. Participants Up to 2378 men and women who have been followed-up since birth in 1946 to age 68. Primary outcome measures On the basis of their self-report of pain at age 68, participants were classified as: CWP (American College of Rheumatology criteria), CRP (pain of at least 3 months’ duration but that does not meet the definition of CWP), other pain (<3 months in duration) or no pain. Results At age 68, the prevalence of CWP was 13.3% and 7.8% in women and men, respectively, and that of CRP was 32.3% and 28.7% in women and men, respectively. There was no clear evidence that indicators of SEP in childhood or later adulthood were associated with pain. Having experienced (vs not) financial hardship and being a tenant (vs owner-occupier) in earlier adulthood were both associated with an increased risk of CWP; for example, moderate hardship adjusted relative risk ratio (RRR adj ) 2.32 (95% CI: 1.19 to 4.52) and most hardship RRR adj 4.44 (95% CI: 2.02 to 9.77). Accumulation of financial hardship across earlier and later adulthood was also associated with an increased risk of CWP. Conclusions Consideration of socioeconomic factors in earlier adulthood may be important when identifying targets for intervention to prevent CWP in later life.

Brain systems at the intersection of chronic pain and self-regulation

Article

Nov 2018
NEUROSCI LETT

Chronic pain is a multidimensional experience with cognitive, affective, and somatosensory components that can be modified by expectations and learning. Individual differences in cognitive and affective processing, as well as contextual aspects of the pain experience, render chronic pain an inherently personal experience. Such individual differences are supported by the heterogeneity of brain representations within and across chronic pain pathologies. In this review, we discuss the complexity of brain representations of pain, and, with respect to this complexity, identify common elements of network-level disruptions in chronic pain. Specifically, we identify prefrontal-limbic circuitry and the default mode network as key elements of functional disruption. We then discuss how these disrupted circuits can be targeted through self-regulation and related cognitive strategies to alleviate chronic pain. We conclude with a proposal for how to develop personalized multivariate models of pain representation in the brain and target them with real-time neurofeedback, so that patients can explore and practice self-regulatory techniques with maximal efficiency.

Et muskel-og skjelettregnskap Forekomst og kostnader knyttet til skader, sykdommer og plager i muskel-og skjelettsystemet

Book

Full-text available

Oct 2013

Vel 75 % av alle voksne i Norge opplever smerter eller plager fra muskel- og skjelettsystemet i en eller annen form i løpet av en måned. Det meste av dette er lette plager, som ikke krever behandling. Det er imidlertid en betydelig del av befolkningen som har kroniske smerter. Det er vanligst å ha plager fra korsryggen, nakken og skuldrene. Det er også mange som har smerter i hofter, bekken og knær. Ofte er det ikke mulig å stille spesifikke diagnoser på slike plager, og mange har symptomdiagnoser. De fleste som har plager fra muskel- og skjelettsystemet har plager fra flere områder og ofte mange symptomer fra andre organer og kropsdeler. Korsryggsplager er den hyppigste årsaken til sykefravær (11 %) og uførhet (9 %) blant muskel- og skjelettplagene. Nakke- og skulderplager er også vanlige årsaker til sykefravær. Utbredte og uspesifikke muskel- og skjelettsmerter, ofte sammen med andre symptomer, er en viktig risikofaktor for uførhet.

Modifiable individual and work-related factors associated with neck pain in 740 office workers: a cross-sectional study

Article

Mar 2018
REV BRAS FISIOTER

Background Office workers have the highest incidence of neck pain of all occupations. However, the relationship between symptoms and the risk factors is unclear. Objective To examine the relationship between self-reported neck pain with a comprehensive range of individual and work-related risk factors. Methods This study utilised a cross-sectional study design. Office workers with and without neck pain (n = 763) were recruited. Participants completed a survey which included a Pain Numerical Rating Scale (dependent variable), and measures of independent variables including demographic, individual, work-related factors, neck/shoulder muscle strength, endurance, and range of motion (ROM). The relationships between the independent and dependent variables were analysed in a logistic regression model. Results Neck pain was significantly associated with more senior occupational categories, working more than six hours per day on the computer, female sex, greater fear avoidance beliefs for work, greater psychological distress, and reduced cervical flexion ROM. The low severity of neck pain of the participants in this study may limit a robust determination of their association with the risk factor variables, but the studied sample is a realistic representation of the office worker population. Conclusion Several potentially modifiable individual and work-related factors were identified to be associated with the presence of self-reported neck pain in office workers. Future studies will be needed to investigate whether strategies to alter these modifiable risk factors translate to changes in neck pain. Trial registration: ACTRN12612001154897 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363209)

Work disengagement among SME workers: Evidence from India

Article

Feb 2018
Benchmark Int J

Purpose The purpose of this paper is to examine two alternative theoretical explanations of disengagement at work. Following JD-R perspective, relationship between job complexity and disengagement is tested. In accordance with the process model of burnout, association between exhaustion and disengagement is examined. Another aim is to examine conservation of resources (COR) as an integrative framework as far as moderating role of resilience in both these relationships is concerned. Design/methodology/approach Survey based quantitative methodology was followed. A total of 138 employees of an agro-processing unit in North India were surveyed, and 119 usable responses were obtained. Besides the constructs of interest, the questionnaire also sought responses on relevant demographic variables. Findings Both job complexity and exhaustion predicted disengagement at work. However, contrary to a negatively hypothesized relationship between job complexity and disengagement, a positive association was found. Resilience was found to be negatively moderating exhaustion-disengagement relationship. No influence of resilience was found on the complexity-disengagement association. Research limitations/implications The findings could be specific to the sample and to India. Caution should be exercised while generalizing. Future researchers should validate the findings across contexts. Practical implications Results suggest that complexity may not necessarily be perceived as a resource. Hence organizations must invest in training and skill development programs for their workers. Further, managers should assess resilience as an important component while selecting workers. Originality/value Contrary findings vis-à-vis job complexity and disengagement could have implications for JD-R perspective. Further, this research integrates alternative explanations of disengagement employing COR framework.

Neck Pain

Chapter

Jan 2018

Physical demands at work: objectively measured exposure and musculoskeletal pain in construction- and healthcare workers

Thesis

Full-text available

Feb 2017

Lars-Kristian Lunde

Longitudinal Studies in Organizational Stress Research: A Review of the Literature With Reference to Methodological Issues

Article

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Apr 1996

Demonstrating causal relationships has been of particular importance in organizational stress research. Longitudinal studies are typically suggested to overcome problems of reversed causation and third variables (e.g., social desirability and negative affectivity). This article reviews the empirical longitudinal literature and discusses designs and statistical methods used in these studies. Forty-three longitudinal field reports on organizational stress were identified. Most of the investigations used a 2-wave panel design and a hierarchical multiple regression approach. Six studies with 3 and more waves were found. About 50% of the studies analyzed potential strain-stressor (reversed causation) relationships. In about 33% of the studies there was some evidence of reverse causation. The power of longitudinal studies to rule out third variable explanations was not realized in many studies. Procedures of how to analyze longitudinal data are suggested.

Static work load and occupational myalgia – A new explanation model

Article

Full-text available

Jan 1991

Göran M Hägg

Organizational Stress and Work Attitudes as Predictors of Health Outcomes: A Prospective Study

Article

Full-text available

Apr 2009

The aim of the present study was to examine the effects of the two indices of chronic organizational stress (work conflict and overload. and role ambiguity). job involvement and the two indices of organizational commitment (affective- -normative and instrumental commitment) on professional burnout and subjective health complaints. Data were collected from 118 hospital nurses from various hospital wards in Clinical Hospital Rijeka in a two-wave prospective study. There were two measurements. the first one taking place four years before the second one. The first measurement time (Time 1) included measures of organizational stress. job involvement and organizational commitment as well as professional burnout and subjective health complaints. while the second measurement time (Time 2) included only those measures that refer to health outcomes (professional burnout and subjective health complaints). The results show that various combinations of organizational stress. organizational commitment and job involvement variables predict each of the three indices of professional burnout and even after controlling for the same subjective health outcome measured four years before. The results are interpreted focusing on the potentially protective role of the variables that significantly predict subjective health outcomes.

Linear and Nonlinear Relations Between Psychosocial Job Characteristics, Subjective Outcomes, and Sickness Absence: Baseline Results From SMASH

Article

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Apr 2000

This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company administrated sickness absence). Hypotheses were tested in a heterogeneous sample of 1,739 employees from a 3–year prospective cohort study called SMASH (Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health). Baseline results showed that a linear additive model was superior for job satisfaction, psychosomatic health complaints, and sickness absence, whereas a curvilinear model was superior for emotional exhaustion and depression. It is concluded that, first, there was no evidence of interactive effects. Second, it seems sensible to pay more attention to curvilinear relationships in future research. Finally, the DCS model was not supported using a more objective outcome measure. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Integrating ‘psychosocial’ factors into a theoretical model for work-related musculoskeletal disorders

Article

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Nov 2005
Theor Issues Ergon Sci

Julia Faucett

The psychosocial aspects of jobs, in addition to their biomechanical aspects, have demonstrated significant relationships with work-related musculoskeletal symptoms and disorders (WRMSDs). Current models that seek to explain these associations build on the stress paradigm and propose that job strain impacts WRMSDs through increases in muscle tension; alterations in endocrine, immune, neurological and vascular systems that condition tissue injury and repair; and higher cognitive processes that alter symptom awareness and evaluation. These models vary in the emphasis placed on worker characteristics as opposed to work stressors. The paper provides a critical review of these models and draws on concepts advanced in the field of occupational safety to propose a modification of these approaches. The model advanced here integrates psychosocial and biomechanical risk factors as characteristics of work environment and emphasizes the role of management systems and the work environment as key sources of strain. Strain, as indicated by the physiological, behavioural and other responses of the worker, in turn influences WRMSDs and related outcomes as well as worker performance and productivity. The integrated model also takes into account the importance of viewing the work environment as a dynamic phenomenon with interaction among risk factors and between workers and managers.

The Very Best of the Millennium: Longitudinal Research and the Demand-Control-(Support) Model

Article

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Oct 2003

This study addressed the methodological quality of longitudinal research examining R. Karasek and T. Theorell's (1990) demand-control-(support) model and reviewed the results of the best of this research. Five criteria for evaluating methodological quality were used: type of design, length of time lags, quality of measures, method of analysis, and nonresponse analysis. These criteria were applied to 45 longitudinal studies, of which 19 (42%) obtained acceptable scores on all criteria. These high-quality studies provided only modest support for the hypothesis that especially the combination of high demands and low control results in high job strain. However, good evidence was found for lagged causal effects of work characteristics, especially for self-reported health or well-being outcomes.

Psychosocial risk factors for neck pain: A systematic review

Article

Full-text available

Feb 2001
AM J IND MED

Background Neck pain, which is assumed to be a multifactorial disease, is a major problem in modern society.Methods To identify the most important psychosocial risk factors for neck pain, a systematic review of the literature was carried out. The methodological quality of all studies in the review was assessed. Four levels of evidence were defined to assess the strength of evidence for potential risk factors for neck pain (strong, moderate, some or inconclusive evidence).ResultsSome evidence was found for a positive relationship between neck pain and high quantitative job demands, low social (coworker) support, low job control, high and low skill discretion and low job satisfaction. Inconclusive evidence was found for high job strain, low supervisor support, conflicts at work, low job security, and limited rest break opportunities.Conclusions The procedure of the assessment of the methodological quality and the rating system applied to distinguish between high- and low-score studies, had a considerable influence on the level of evidence, indicating that changes in this procedure may have a major impact on the overall conclusions of this review. Am. J. Ind. Med. 39:180–193, 2001. © 2001 Wiley-Liss, Inc.

Longitudinal studies in organizational stress research: A review of the literature with reference to methodological issues

Article

Full-text available

May 1996

Morbidity in responders and non-responders in a register-based population survey

Article

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Jul 1998

Non-response analysis is often restricted to the influence of age, sex and socio-economic status on response status. In this study the health status of responders and non-responders was also compared. Responders were comparable to non-responders with regard to the number of diagnosed disorders as well as to the prevalences of disorders within body systems. Non-responders only showed psychological disorders more often. It is useful to assess the relation between non-response and morbidity patterns in other studies as well, in order to detect selective non-response and bias.

Measuring Job Stressors and Studying the Health Impact of the Work Environment: An Epidemiologic Commentary

Article

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Oct 1998

Stanislav V. Kasl

This article provides a commentary on 5 articles in the special section that marshal a substantial amount of information about 4 instruments for measuring work stress. The perspective is that of psychosocial epidemiology and highlights the differences between the environmental and the psychological traditions of studying stress and health. Several issues are addressed: (a) placing the 4 measures in a broader taxonomy of dimensions of work environment and evaluating the measures in that context, (b) discussing alternative strategies for measuring job strains, (c) analyzing some of the issues in the triviality debate, and (d) reconsidering a number of issues in the ongoing debate about "subjective" versus "objective" measurement approaches to work dimensions.

The Job Content Questionnaire (JCQ): An Instrument for Internationally Comparative Assessments of Psychosocial Job Characteristics

Article

Full-text available

Oct 1998

Part I discusses the Job Content Questionnaire (JCQ), designed to measure scales assessing psychological demands, decision latitude, social support, physical demands, and job insecurity. Part II describes the reliability of the JCQ scales in a cross-national context using 10,288 men and 6,313 women from 6 studies conducted in 4 countries. Substantial similarity in means, standard deviations, and correlations among the scales, and in correlations between scales and demographic variables, is found for both men and women in all studies. Reliability is good for most scales. Results suggest that psychological job characteristics are more similar across national boundaries than across occupations.

Article

Full-text available

Jul 1999

To describe the prevalence of self reported musculoskeletal complaints in the back, arms or neck, and legs among workers in the spinning industry, and to investigate the relations between these complaints and work related variables. An interview based questionnaire survey was carried out in two spinning industry factories in Lithuania. The study group consisted of all workers in production (n = 363). Symptoms of the legs were the musculoskeletal symptom reported most often (61%). Many subjects had arms or neck (55%) or back problems (28%). 20% had experienced pain from all three sites. Almost 25% had had musculoskeletal pain every day and 16% had experienced constant pain during previous year. Packers had the highest risk of arms or neck problems whereas spinners had the highest risk of back or leg problems. Working in a strained posture (bending, work with arms raised up above shoulder level, and repetitive movements of the fingers) was associated with all three complaints. Only arms or neck complaints were associated with age. Musculoskeletal disorders are a common problem among workers producing gobelin or synthetic thread in Lithuania and working in a strained posture is a risk factor for developing musculoskeletal disorders in three body sites: legs, arms or neck, and back. To better understand the different aspects of physical load as risk factors, a more detailed study of the frequency of postural changes as well as an observation of individually adopted postures would be necessary. This applies to intervention studies in factories of the spinning industry to prevent complaints of the legs and shoulders.

The relationship between psychosocial work characteristics and low back pain: Underlying methodological issues

Article

Full-text available

Aug 2000
CLIN BIOMECH

To evaluate the current epidemiological evidence linking psychosocial work characteristics with low back pain. Psychosocial work characteristics have been widely evaluated as potential risk factors for low back injury. However, studies with different study populations and using various types of measures have had conflicting results. This review is the most extensive to date, reviewing 66 articles that have provided empirical evidence about the relationship between psychosocial work characteristics and initial reporting of lower back pain. The studies are reviewed with an emphasis on certain methodological issues: controlling for potential confounding; timing of the data collection; and measurement of the exposures and outcomes. The results of this review suggest that controlling for potential confounding from occupational biomechanical demands had a large influence on the associations found between psychosocial work characteristics and lower back pain. In addition, the use of accurate and reliable measures for the occupational exposures (biomechanical and psychosocial) and the lower back pain outcomes appears to influence the strength of the associations found between psychosocial work characteristics and lower back pain. Given the methodological concerns discussed in this review, it is difficult to draw strong causal inferences from this literature. However, it does appear that psychosocial characteristics are related to some lower back pain outcomes, and that employees' reactions to psychosocial work characteristics (e.g., job dissatisfaction and job stress) are more consistently related to lower back pain than are the psychosocial work characteristics themselves (e.g., work overload, lack of influence over work, quality of relationships with coworkers). This review attempts to identify and address methodological issues in the literature evaluating the relationship between psychosocial work characteristics and lower back pain. Implications for future research are presented.

Occupational risk factors for shoulder pain: a systematic review

Article

Full-text available

Jul 2000

To systematically evaluate the available evidence on occupational risk factors of shoulder pain. Relevant reports were identified by a systematic search of Medline, Embase, Psychlit, Cinahl, and Current Contents. The quality of the methods of all selected publications was assessed by two independent reviewers using a standardised checklist. Details were extracted on the study population, exposures (physical load and psychosocial work environment), and results for the association between exposure variables and shoulder pain. 29 Studies were included in the review; three case-control studies and 26 cross sectional designs. The median method score was 60% of the maximum attainable score. Potential risk factors related to physical load and included heavy work load, awkward postures, repetitive movements, vibration, and duration of employment. Consistent findings were found for repetitive movements, vibration, and duration of employment (odds ratio (OR) 1.4-46 in studies with method scores >/= 60%). Nearly all studies that assessed psychosocial risk factors reported at least one positive association with shoulder pain, but the results were not consistent across studies for either high psychological demands, poor control at work, poor social support, or job dissatisfaction. Studies with a method score >/=60% reported ORs between 1.3 and 4.0. Substantial heterogeneity across studies for methods used for exposure assessment and data analysis impeded statistical pooling of results. It seems likely that shoulder pain is the result of many factors, including physical load and the psychosocial work environment. The available evidence was not consistent across studies, however, and the associations were generally not strong. Future longitudinal research should evaluate the relative importance of each individual risk factor and the role of potential confounding variables-such as exposure during leisure time-to set priorities for the prevention of shoulder pain in occupational settings.

Systematic Review of Psychosocial Factors at Work and Private Life as Risk Factors for Back Pain

Article

Full-text available

Sep 2000

A systematic review of observational studies. To assess whether psychosocial factors at work and in private life are risk factors for the occurrence of back pain. Several reviews on risk factors for back pain have paid attention to psychosocial factors. However, in none of the published reviews was a strict systematic approach used to identify and summarize the available evidence. A computerized bibliographical search of several databases was performed, restricted to studies with a cohort or case-control design. A rating system was used to assess the strength of the evidence for various factors, based on the methodologic quality of the studies and the consistency of the findings. Eleven cohort and two case-control studies were included in this review. Strong evidence was found for low social support in the workplace and low job satisfaction as risk factors for back pain. Insufficient evidence was found for an effect of a high work pace, high qualitative demands, low job content, low job control, and psychosocial factors in private life. Evidence was found for an effect of low workplace social support and low job satisfaction. However, the result for workplace social support was sensitive to slight changes in the rating system, and the effect found for low job satisfaction may be a result of insufficient adjustment for psychosocial work characteristics and physical load at work. In addition, the combined evaluation of job content and job control, both aspects of decision latitude, led to strong evidence of a role for low job decision latitude. Thus, based on this review, there is evidence for an effect of work-related psychosocial factors, but the evidence for the role of specific factors has not been established yet.

Longitudinal study on work related and individual risk factors affecting radiating neck pain

Article

Full-text available

May 2001

To study the effects of work related and individual factors affecting radiating neck pain. A longitudinal study was carried out with repeated measurements. A total of 5180 Finnish forest industry workers replied to a questionnaire survey in 1992 (response rate 75%). Response rates to follow up questionnaires in 1993, 1994, and 1995 were 83%, 77%, and 90%, respectively. The outcome variable was the number of days with radiating neck pain during the preceding 12 months with three levels (<8, 8-30, >30 days). The generalised estimating equations method was used to fit a marginal model and a transition model was used in a predictive analysis. Items showing associations with radiating neck pain in both analyses were sex, age, body mass index, smoking, duration of work with a hand above shoulder level, mental stress, and other musculoskeletal pains. In the transition model, radiating neck pain in a previous questionnaire was included in the model. Although it was a strong predictor, the variables already mentioned retained their significance. Programmes targeted to reduce physical load at work, mental stress, being overweight, and smoking could potentially prevent radiating neck pain.

Review of factors associated with musculoskeletal problems in epidemiological studies

Article

Full-text available

Apr 2001

To review systematically all epidemiological studies of the past 15 years concerning the factors associated with musculoskeletal disorders (MSDs) or complaints of the neck and upper limbs. Fifty-seven cross-sectional and seven longitudinal studies were reviewed. A list was made of all personal, occupational, extra-occupational and psycho-organisational factors taken into consideration in each study, and of those that were found in association with MSDs. MSDs of the neck-shoulder region (NSs) and hand-wrist (HWs) were considered separately. About 70 different factors are listed. This inventory identifies the factors or categories of factors that were generally taken into consideration. It makes it possible also to evaluate the strength of the association with a given factor, in considering the number of studies finding an association, and those that did not consider this factor. Based on this review, some factors taken into consideration (such as weight or hobbies) could be excluded in further studies, and replaced by more specific psycho-organisational factors.

Common Method Biases in Behavioral Research: A Critical Review of the Literature and Recommended Remedies

Article

Full-text available

Oct 2003

Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.

Psychosocial factors at work in relation to low back pain and consequences of low back pain: A systematic, critical review of prospective cohort studies

Article

Full-text available

Feb 2004
OCCUP ENVIRON MED

Relevant studies of low back pain (LBP) published between 1990 and 2002 were systematically retrieved via electronic databases and checking of reference lists. Forty papers fulfilled the inclusion criteria; 10 were of high quality. A wide variety of instruments had been used for collection of data on work related psychosocial factors, many of which had not undergone any form of validation. Moderate evidence was found for no association between LBP and perception of work, organisational aspects of work, and social support at work. There was insufficient evidence for a positive association between stress at work and LBP. No conclusions could be drawn regarding perception of work and consequences of LBP. There was strong evidence for no association between organisational aspects of work and moderate evidence for no association between social support at work and stress at work and consequences of LBP.

Incidence of shoulder pain in repetitive work

Article

Full-text available

Feb 2004
OCCUP ENVIRON MED

To determine the predictiveness of personal and occupational factors for the onset of shoulder pain in occupations requiring repetitive work. A sample of 598 workers in five activity sectors completed a self administered questionnaire in 1993-94 and again three years later. Both questionnaires included questions about shoulder pain. The associations between various factors at baseline and subsequent shoulder pain were studied among subjects free from shoulder pain at baseline. The incidence of shoulder pain was associated with several independent risk factors: depressive symptoms, low level of job control, and biomechanical constraints. After adjustment for other risk factors, the presence of depressive symptoms predicted occurrence of shoulder pain. A low level of job control was also associated with the onset of shoulder pain in both sexes. For men, repetitive use of a tool was a strong predictor, while the two most important biomechanical risk factors for women were use of vibrating tools and working with arms above shoulder level. This study used a longitudinal approach to examine different sets of risk factors for shoulder pain simultaneously. The results confirm the role of several biomechanical constraints. Psychological symptoms and a low level of job control also play a role.

Risk Factors, Confounding, and the Illusion of Statistical Control

Article

Full-text available

Nov 2004
PSYCHOSOM MED

When experimental designs are premature, impractical, or impossible, researchers must rely on statistical methods to adjust for potentially confounding effects. Such procedures, however, are quite fallible. We examine several errors that often follow the use of statistical adjustment. The first is inferring a factor is causal because it predicts an outcome even after "statistical control" for other factors. This inference is fallacious when (as usual) such control involves removing the linear contribution of imperfectly measured variables, or when some confounders remain unmeasured. The converse fallacy is inferring a factor is not causally important because its association with the outcome is attenuated or eliminated by the inclusion of covariates in the adjustment process. This attenuation may only reflect that the covariates treated as confounders are actually mediators (intermediates) and critical to the causal chain from the study factor to the study outcome. Other problems arise due to mismeasurement of the study factor or outcome, or because these study variables are only proxies for underlying constructs. Statistical adjustment serves a useful function, but it cannot transform observational studies into natural experiments, and involves far more subjective judgment than many users realize.

Psychological and social factors at work: Contribution to musculoskeletal disorders and disabilities

Article

Full-text available

Jan 2005

Stein Knardahl

Psychological and social factors at work may contribute to musculoskeletal disorders by the following processes: (i) Direct pathogenic effects by affecting physiological mechanisms, such as muscle blood vessels and hormonal secretion; (ii) by altering work procedures and thereby altering the biomechanical loads through changes in posture, movements, and exerted forces; (iii) by altering sensations, mood, and cognitions, and thereby influencing symptoms, consequences of symptoms, and functional impairment; (iv) by interfering with buffer mechanisms, reducing the tolerance to other exposures. Almost all hypotheses of direct pathogenic effects (i) of psychological "stress" on muscle pain, maintain that the pain results from muscle-cell activation. The mechanisms proposed for the generation of pain are related to effects of energy deficit or intracellular calcium accumulation, leading to muscle-cell damage. However, it has not been possible to find reliable causal associations between muscle activation and pain. Furthermore, during active coping behaviours, muscle blood flow generally increases, rendering hypoxia less probable. Other hypotheses propose that increase in muscle-cell activity in musculoskeletal disorders is a consequence of the pain or that the pain originates from interactions between blood vessels and nociceptive nerves of the muscle. Explanations of the pathogenesis of pain generally do not yet account for the activation of sensory nerves (the nociceptors) that mediate information of potential tissue injury to the nerve system. Psychophysiological mechanisms determine whether pain become chronic and the consequences of pain. Mechanisms of the spinal medulla may amplify or inhibit transmission in the nociceptive circuits. Attention and perception are determined by the appraisal of the threat value of sensations. Pain sensations that are appraised to signal threat of injury or disability, are maintained and amplified. Pain beliefs contribute to the cognitive appraisal process. Health care personnel play a central role in forming pain beliefs by the way they inform of potential risk factors at the workplace and by the way they perform interventions and prevention measures. Therefore, the occupational health personnel must possess specific knowledge of which psychological and social factors contribute to musculoskeletal disorders and how their own recommendations may prevent or promote chronic disabilities.

The prevalence of neck pain in the world population: A systematic critical review of the literature

Article

Full-text available

Jul 2006

The objective of this study was to determine the prevalence of neck pain (NP) in the world population and to identify areas of methodological variation between studies. A systematic search was conducted in five databases (MEDLINE, EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of reference lists of relevant papers. Included papers were extracted for information and each paper was given a quality score. Mean prevalence estimates were calculated for six prevalence periods (point, week, month, 6 months, year, and lifetime), and considered separately for age, gender, quality score, response rate, sample size, anatomical definition, geography, and publication year. Fifty-six papers were included. The six most commonly reported types of prevalence were point, week, month, 6 months, year, and lifetime. Except for lifetime prevalence, women reported more NP than men. For 1-year prevalence, Scandinavian countries reported more NP than the rest of Europe and Asia. Prevalence estimates were not affected by age, quality score, sample size, response rate, and different anatomical definitions of NP. NP is a common symptom in the population. As expected, the prevalence increases with longer prevalence periods and generally women have more NP than men. At least for 1-year prevalence Scandinavian countries report higher mean estimates than the rest of Europe and Asia. The quality of studies varies greatly but is not correlated with the prevalence estimates. Design varies considerably and standardisation is needed in future studies.

Incidence of shoulder and neck pain in a working population: Effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malm?? shoulder and neck study cohort

Article

Full-text available

Oct 2005

To assess the impact of mechanical exposure and work related psychosocial factors on shoulder and neck pain. A prospective cohort study. 4919 randomly chosen, vocationally active men and women ages 45-65 residing in a Swedish city. Neck and shoulder pain were determined by the standardised Nordic questionnaire. Mechanical exposure was assessed by an index based on 11 items designed and evaluated for shoulder and neck disorders. Work related psychosocial factors were measured by the Karasek and Theorell demand-control instrument. High mechanical exposure was associated with heightened risk for shoulder and neck pain among men and women during follow up. Age adjusted odds ratios (OR) were 2.17 (95% confidence intervals (CI): 1.65, 2.85) and 1.59 (95% CI: 1.22, 2.06), respectively. In women, job strain (high psychological job demands and low job decision latitude) correlated with heightened risk (OR = 1.73, 95% CI: 1.29, 2.31). These risk estimates remained statistically significant when controlled for high mechanical exposure regarding job strain (and vice versa), and for sociodemographic factors. Testing for effect modification between high mechanical exposure and job strain showed them acting synergistically only in women. Job related mechanical exposure in both sexes, and psychosocial factors in women, seem independently of each other to play a part for development of shoulder and neck pain in vocationally active people. The effect of psychosocial factors was more prominent in women, which could be the result of biological factors as well as gender issues. These results suggest that interventions aiming at reducing the occurrence of shoulder and neck pain should include both mechanical and psychosocial factors.

Psychosocial Work Environment Exposures as Risk Factors for Long-Term Sickness Absence Among Danish Employees: Results From DWECS/DREAM

Article

Full-text available

Dec 2005

This study examines effects of psychosocial risk factors on long-term sickness absence, and investigates possible interactions between psychosocial and physical work environment risk factors. A total of 5,357 employees were interviewed in 2000 regarding work environment and followed up during the proceeding 1.5 years regarding onset of long-term sickness absence. Long-term sickness absence among female employees was associated with role conflict, low reward, and poor management quality. Demands for hiding emotions and high emotional demands predicted long-term sickness absence among men. No significant interactions between psychosocial and physical exposures were found for female or male employees. The study suggests a potential for reducing long-term sickness absence through interventions targeted toward reducing role conflict, and improving reward and management quality among female employees, and through reducing emotional demands and demands for hiding emotions among male employees.

Validation of the general nordic questionnaire (QPSNordic) for psychological and social factors at work

Article

Jan 2000

Multivariable Analysis: A Practical Guide for Clinicians and PublicHealth Researchers

Article

Jan 2011

M.H. Katz

Common Method Biases in Behavioral Research: A Critical Review of the Literature and Recommended Remedies

Article

Oct 2003

Morbidity in responders and non-responders in a register-based population survey

Article

Jun 1998

Marjan van den Akker

Multivariable Analysis

Article

Apr 1999
ANN INTERN MED

Mitchell H. Katz

Multivariable analysis is a challenging subject for clinicians, whether they are novice researchers or trained practitioners. Most basic biostatistics books do not cover multivariable analysis, while existing multivariable analysis books are dense with mathematical formulas. Multivariable Analysis: A Practical Guide for Clinicians steps aside from mathematics and offers conceptual explanations. Dr. Mitchell Katz follows a nonthreatening, question-and-answer approach to explain how to perform and interpret multivariable analyses. He begins by explaining why clinicians should do multivariable analyses and then guides the reader through topics such as how to choose which type of multivariable method to perform, how to deal with missing data, and how to validate multivariable models. The book is loaded with useful tips, tables, figures, and references. Examples from the medical literature demonstrate several real-world applications and uses of multivariable analysis. This book will prove to be an indispensable guide for medical students, residents, and practicing physicians.

The Significance of Statistical Significance: Two Authors Restate An Incontrovertible Caution. Why A Book?

Article

May 2008

Richard Lempert

"The Significance of Statistical Significance" reviews "THE CULT OF STATISTICAL SIGNIFICANCE: How the Standard Error Costs Us Jobs, Justice and Lives" by Stephen T. Ziliak and Dierdre N. McCloskey. The book's core message is that statistical significance should not be equated with substantive significance and that empirical researchers should convey more information about the magnitude of relationships and effects than many now do. This review summarizes, approves of and elaborates on Ziliak and McCloskeys message with special attention to concerns of the legal academy. It clarifies appropriate uses of significance tests within the research framework of controlling for plausible rival hypotheses.

Work and neck pain: A prospective study of psychological, social, and mechanical risk factors

Abstract

No full-text available