Musculoskeletal symptoms associated with workplace physical exposures estimated by a job exposure matrix and by self‐report

ObjectivesIt has often been suggested that screen work (ie, work on desktop, laptop, notebook or tablet computers) is a risk factor for neck and upper extremity symptoms. However, an up-to-date overview and quantification of evidence are lacking. We aimed to systematically review the association of exposure to screen work with neck and upper extremity symptoms from prospective studies.MethodsAn electronic database search (PubMed, Embase, Cinahl and Scopus) for prospective studies on the association of exposure to screen work and musculoskeletal symptoms was conducted. Studies were synthesised regarding extracted data and risk of bias, and meta-analyses were conducted.ResultsAfter screening 3423 unique references, 19 articles from 12 studies (with 18 538 participants) were included for the current review, with the most recent exposure assessment reported in 2005. Studies described duration and input frequency of screen work (ie, computer, keyboard and mouse use, assessed using self-reports or software recordings) and musculoskeletal symptoms (ie, self-reported neck/shoulder and distal upper extremity symptoms and diagnosed carpal tunnel syndrome [CTS]). Although there was overall an increased occurrence of musculoskeletal symptoms with larger exposure to screen work (relative risk: 1.11 [1.03 1.19]), findings were rather inconsistent with weaker (and statistically non-significant) risks when screen work was assessed by software recording (1.05 [0.91 1.21]) compared to with self-report (1.14 [1.03 1.19]).ConclusionsWe found an increased risk of musculoskeletal symptoms with screen work. However, the evidence is heterogeneous, and it is striking that it lacks information from contemporary screen work using laptop, notebook or tablet computers.

Download Full-text

Job control and risk of disability pension in the nationwide Danish Work Life Course Cohort

European Journal of Public Health ◽

10.1093/eurpub/ckz185.166 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Svane-Petersen ◽

E Framke ◽

J K Sørensen ◽

R Rugulies ◽

I E H Madsen

Keyword(s):

Life Course ◽

Disability Pension ◽

Job Control ◽

Work Life ◽

Self Report ◽

Reporting Bias ◽

Job Exposure Matrix ◽

Transfer Payments ◽

Increased Risk ◽

Selection Of

Abstract Background A large number of studies have found job control to be consistently associated with an increased risk of disability pension. However, most previous studies have measured job control by self-report, introducing possible reporting bias inflating the risk estimates. Furthermore, previous studies have not accounted for the potential selection of individuals with pre-existing risk factors for disability pensioning into low control jobs. Methods We analyzed data from the nationwide register-based Danish Work Life Course Cohort (DAWCO; n = 960,562 with approx. 6 million person-years). We measured job control annually by a job exposure matrix, based on a scale of five self-reported items from The Danish Work Environment Cohort Study, and disability pension using registers on public transfer payments. To account for potential selection into occupations with lower levels of job control, we included numerous life course confounders, including parental socioeconomic position and psychiatric and somatic diagnoses. Results Employees in jobs with lower levels of job control had increased risk of disability pensioning. The association attenuated after adjustment for confounders but was not explained by selection into job groups with lower levels of job control (hazard ratio: 1.16 (95% CI: 1.03-1.31). Conclusions Our findings suggest that lower levels of job control are associated with an increased risk of disability pension, and that this association is explained by neither reporting bias nor a selection of individuals with an increased risk of disability pensioning into job groups with lower levels of job control. Key messages Lower levels of job control appear associated with an increased risk of disability pension independent of life course confounders. Further research is needed on preventive measures in occupations with low levels of job control.

Download Full-text

0165 A job exposure matrix from self-reported physical exposures: a method to control bias from symptoms

10.1136/oemed-2017-104636.133 ◽

2017 ◽

Author(s):

Ann Marie Dale ◽

Alexis Descatha ◽

Johann Hviid Andersen ◽

Skye Buckner-Petty ◽

Bradley Evanoff

Keyword(s):

Job Exposure Matrix ◽

Physical Exposures

Download Full-text

Adverse Events and Perception of Benefit from Duloxetine for Treating Aromatase Inhibitor–Associated Arthralgias

JNCI Cancer Spectrum ◽

10.1093/jncics/pkab018 ◽

2021 ◽

Author(s):

Patrick M Schnell ◽

Maryam B Lustberg ◽

N Lynn Henry

Keyword(s):

Adverse Events ◽

Aromatase Inhibitor ◽

Short Form ◽

Credible Interval ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Favorable Effect ◽

Low Grade ◽

Double Blind ◽

Perceived Benefit

Abstract Background Duloxetine effectively treats aromatase inhibitor–associated musculoskeletal symptoms (AIMSS) in women with breast cancer but causes low-grade toxicities. This secondary analysis examines the relationship between adverse events (AE) and patient-perceived benefit, based on patient self-report that the treatment received was beneficial despite side effects. We hypothesized that duloxetine had a favorable effect on patient-perceived benefit, even among duloxetine-treated patients who experienced AEs and who, had they been treated with placebo, would have experienced none. Methods Principal stratification was used to estimate the effect of duloxetine versus placebo on patient-perceived benefit and FACT-ES functional quality of life (FQOL) in the randomized, double-blind trial SWOG S1202 (n = 289). Subgroups of patients were defined by observed and counterfactual (what would have occurred had they been randomized to the opposite study arm) experiences of AEs and the original primary outcome, reduction of average pain after 12 weeks of ≥ 2 points on the Brief Pain Inventory–Short Form. Results Duloxetine caused an estimated 23.4% (95% credible interval [CI] = 13.4% to 33.7%) of patients to experience an AE even though they would have experienced none on placebo. Those patients remained more likely to report that their received treatment was beneficial than comparable patients assigned placebo (73.3% vs 41.8%, respectively, 95%CI for difference = 15.4 to 47.2 percentage points), though there was no statistically significant effect of duloxetine on FQOL (11.3 vs 9.0, 95%CI for difference = -2.2 to + 6.7). Conclusion Duloxetine resulted in higher patient-perceived benefit, even among those who would have an AE on duloxetine but none on placebo. Treatment of AIMSS with duloxetine should be considered for appropriate patients.

Download Full-text

O5A.2 Musculoskeletal symptoms and work-related accidents: a hospital-based case-control study

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.111 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A41.1-A41

Author(s):

Adriano Dias ◽

João Marcos Bernardes ◽

Juan Gomez-Salgado ◽

Carlos Ruiz-Frutos

Keyword(s):

Logistic Regression ◽

Case Control Study ◽

Case Control ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Upper Limbs ◽

Work Related ◽

Self Reports ◽

Nordic Musculoskeletal Questionnaire ◽

Control Study

This hospital-based case-control study aimed to determine whether self-reports of musculoskeletal symptoms (MSS) were associated with the occurrence of work-related accidents. Study participants were recruited from the emergency department at Botucatu Medical School University Hospital. Cases were workers who suffered work-related accidents that required hospitalization, while controls were selected patients who suffered a non-work-related accident. Participants were interviewed using a standardized structured questionnaire with close-ended questions and a modified version of the Brazilian Portuguese Nordic Musculoskeletal Questionnaire. Associations between self-reports of MSS and work-related accidents were analyzed with two logistic regression models (one for symptoms that occurred in the 12 months period and the other for those that occurred in the previous 7 days). These analyses were performed in two steps: univariate and multiple model. Variables with a P-value ≤0.25 in the univariate analysis were included in the multiple models, using the forward stepwise selection procedure. In the multiple models two-sided P-values less than 0.05 were considered statistically significant. Altogether, 80 cases and 125 controls were included. The participants had a mean age of 36.9 years (SD = 11.4) and 72.2% were men. In the 12 months multiple logistic regression model, self-report of MSS in the upper limbs (OR 2.689 95% CI 1.357-5.326) was associated with increased odds of work-related accidents occurrence, while in the 7 days multiple logistic regression model, self-report of MSS in the upper limbs (OR 2.374 95% CI 1.083-5.201) and in the vertebral column (OR 2.154 95% CI 1.017-4.561) were associated. Thus, this case–control study suggests that MSS in the upper limbs and in the vertebral column are associated with increased odds of work-related accidents; and that the Nordic Musculoskeletal Questionnaire may be used as a complementary screening tool for identifying workers at risk for work-related accidents.

Download Full-text

The Agreedness between Observation and Self-report Method in Work Posture Analysis

Jurnal Ilmiah Teknik Industri ◽

10.23917/jiti.v17i2.6800 ◽

2018 ◽

Vol 17 (2) ◽

pp. 186

Author(s):

Ari Widyanti

Keyword(s):

Descriptive Analysis ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Entire Body ◽

Posture Analysis ◽

Service Company ◽

Advantages And Disadvantages ◽

Work Posture ◽

Report Analysis ◽

Postural Analysis

Work posture analysis plays an important role in providing safe and productive workplace, through minimizing musculoskeletal symptoms or disorders. The postural analysis can be conducted through observation, direct, and self-report method. Each has their advantages and disadvantages. Purpose of this study is to compare obervation and self-report analysis in the context of degre of agreenes. One rater observes and gives rating to the fifteeen work postures in an automotive service company using Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA). In addition, six workers in the automotive service company also fill out the Nordic questionnaire as a self-report of musculoskeletal symptoms or disorders. Descriptive analysis is conducted to compare the musculoskeletal symptoms using both observer and self-report analysis. Results show that RULA is slighlty better than REBA in accordance to the Nordic questionnaire’ result. Implications of the result is discussed.

Download Full-text

Self-Reported Versus Recorded Sleep Position: An Observational Study

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2004.1034 ◽

2004 ◽

Author(s):

Susan Gordon ◽

Karen Grimmer ◽

Patricia Trott

Keyword(s):

Observational Study ◽

Red Light ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Sleep Position ◽

Allied Health Professionals ◽

Good Reliability ◽

Sleep Questionnaire ◽

Video Record ◽

Self Reports

Background: Patient reports of ‘usual’ and ‘recent’ sleep positions are used by allied health professionals to direct the management of waking and nocturnal musculoskeletal symptoms. However no published studies have determined if self reports of sleep position are valid, consistent or reliable. An observational study was conducted at the Centre for Sleep Research of the University of South Australia. Twelve subjects, four in each of the age groups 18 to 39 years, 40 to 59 years and 60 years and over, without any known sleep disorders or sleep-disturbing medical or emotional problems participated in the study. Subjects spent two non-consecutive nights in a sleep laboratory, where an infra-red light source allowed their sleep position during the night to be recorded on video. Prior to retiring, subjects recorded the position in which they believed they spent the most time during a ‘usual’ nights sleep. In the morning, they recorded the position in which they believed they spent the most time during the recorded nights sleep. Videos were viewed in order to count the number of position shifts per night and to calculate the total amount of time each subject spent lying prone, supine and on their side. Subjects’ pre- and post-sleep questionnaire responses were then compared to the video record to determine validity, the amount of time spent in each sleep position was compared across the two nights to determine consistency and pre-and post-sleep questionnaire responses were compared to determine reliability of self reported sleep position. High correlation was found when comparing subjects’ self report of their common sleep positions with the video record. The sensitivity of self reported ‘usual’ night side lying sleep position was 89% and ‘last’ night reports 95%. Sleep position was consistent across repeated nights’ sleep, and there was good reliability between subjects’ self report of ‘usual’ (92%) and ‘last night’ (83%) sleep positions. This study reports high validity, reliability and consistency in self reports of ‘usual’ and ‘recent’ sleep positions

Download Full-text

Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104744 ◽

2018 ◽

Vol 75 (7) ◽

pp. 501-506 ◽

Cited By ~ 8

Author(s):

Ann Marie Dale ◽

Christine C Ekenga ◽

Skye Buckner-Petty ◽

Linda Merlino ◽

Matthew S Thiese ◽

...

Keyword(s):

Proportional Hazards ◽

Cox Proportional Hazards ◽

Job Exposure Matrix ◽

Data Set ◽

Occupational Classification ◽

Gold Standard Method ◽

Individual Level ◽

Work Related ◽

Disease Associations ◽

Physical Exposures

BackgroundThere is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures.ObjectiveThis study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O*NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study.Methods2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O*NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O*NET.ResultsBoth exposure methods found associations between incident CTS and exposures of force and repetition, with evidence of dose–response. Observed associations were similar across the two methods, with somewhat wider CIs for HRs calculated using the JEM method.ConclusionExposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the ‘gold standard’ method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures.

Download Full-text

Joint associations of occupational standing and occupational exertion with musculoskeletal symptoms in a US national sample

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-106911 ◽

2020 ◽

pp. oemed-2020-106911

Author(s):

Ciaran P Friel ◽

Christian B Pascual ◽

Andrea T Duran ◽

Jeff Goldsmith ◽

Keith M Diaz

Keyword(s):

Physical Exertion ◽

National Sample ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Representative Survey ◽

Lower Back ◽

Interview Survey ◽

Nationally Representative ◽

The Individual ◽

Joint Associations

ObjectiveObservational studies have linked occupational standing or walking to musculoskeletal pain. These prior studies, however, are flawed as few accounted for physical exertion; a potential confounder that accompanies many standing-based occupations. The purpose of this study was to examine the individual and joint associations of occupational standing/walking and exertion with musculoskeletal symptoms.MethodsData for this analysis come from the 2015 National Health Interview Survey, a US nationally representative survey. Occupational standing/walking and exertion were assessed by self-report on a 5-point Likert scale. The presence of musculoskeletal symptoms (pain, aching and stiffness) for upper extremities (neck, shoulders, elbows, wrists and fingers), lower extremities (hips, knees, ankles and toes) and lower back was also assessed.ResultsOccupational standing/walking was associated with a greater likelihood of upper extremity, lower extremity and lower back musculoskeletal symptoms; however, associations were attenuated and no longer significant with adjustment for exertion. When stratified by levels of occupational exertion, occupational standing/walking was associated with musculoskeletal symptoms only among the group with high exertion (eg, OR=1.69 (95% CI: 1.48 to 1.94) for lower back symptoms comparing high/high for standing or walking/exertion vs low/low). Among groups with low exertion, occupational standing/walking was not associated with musculoskeletal symptoms (eg, OR=1.00 (95% CI: 0.85 to 1.16) for lower back symptoms comparing high/low for standing or walking/exertion vs low/low).ConclusionResults from this US representative survey suggest that the association between occupational standing/walking and musculoskeletal symptoms is largely driven by the co-occurrence of occupational exertion and does not provide evidence that standing or walking incurs adverse musculoskeletal symptoms.

Download Full-text

O5C.6 The health and wellbeing of new zealand veterans

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.127 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A47.1-A47

Author(s):

David McBride ◽

Dianne Gardner ◽

Amy Richardson ◽

Emma Wyeth ◽

Ari Samaranayaka ◽

...

Keyword(s):

New Zealand ◽

General Health Questionnaire ◽

Psychiatric Morbidity ◽

Adverse Outcomes ◽

Self Report ◽

Musculoskeletal Symptoms ◽

Post Traumatic Stress ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health And Wellbeing

The psychological and physical health and wellbeing of New Zealand contemporary veteransBackgroundFor New Zealand veterans, operational service and transition to civilian life are critical life events. Most veterans do well, but a significant minority fare poorly. Adverse outcomes are associated with post-traumatic stress disorder, PTSD, and also the development of minor but multiple health complaints, ‘multiple symptom illness’ (MSI).AimThis project investigates factors associated with both wellbeing and ill health in NZ veterans, with the aim of developing a parsimonious instrument to detect ‘at risk’ veterans prior to, or at, transition.MethodsAn on-line cross-sectional survey.Wellbeing is measured by the EQ-5D, a health-related quality of life instrument assessing mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The adverse outcome is PTSD, identified using the PCL-M, an instrument reflecting DSM-IV PTSD symptoms.Risk factors include MSI conforming to the Centers for Disease Control definition as ‘the presence, for at least six months, of one or more chronic symptoms from at least two of three categories, namely fatigue, mood-cognition and musculoskeletal symptoms’. The General Health Questionnaire-28 (GHQ-28) screens for emotional distress and possible psychiatric morbidity. The Brief Trauma Questionnaire (BTQ), a 10-item self-report questionnaire derived from the Brief Trauma Interview, assesses the role of stressors contributing to PTSD.Protective factors include the 24-item Social Provisions Scale (SPS) assessing social relationships and various dimensions of social support.AnalysisLogistic regression will identify the model of best fit for PTSD (PCL-M) and wellbeing (EQ-5D) respectively.For MSI, a factor analysis will describe the pattern of symptom reporting. If this matches international experience, 3 factors will explain the majority of the variance in the data.ResultsAs at the 14th Nov 2018 we have 1592 completed questionnaires. Analysis will commence in mid-November 2018.

Download Full-text