Work - Volume 55, issue 4

Authors: Gyemi, Danielle L. | van Wyk, Paula M. | Statham, Melissa | Casey, Jeff | Andrews, David M.

Article Type: Research Article

Abstract: BACKGROUND: In agricultural field work many tasks have been cited as high priority risk factors for the development of work-related musculoskeletal disorders (WRMDs). Although video-based biomechanical approaches have been effective in documenting the physical demands and risks associated with various occupational and non-occupational tasks, to date, this method has yet to be used to document jobs such as crop harvesting in a greenhouse environment. OBJECTIVE: To document and assess the postural characteristics and 3D peak and cumulative low back and shoulder loads associated with greenhouse pepper harvesting using a video-based posture sampling approach. METHODS: Nine …male (28.2 (4.1) years) pepper harvesters from a greenhouse in Southwestern Ontario, Canada were videotaped during a normal shift. 3DMatch was used to document working trunk and shoulder postures, from which 3D peak and cumulative forces and moments were quantified. RESULTS: On average, workers spent the majority of their time in neutral trunk postures (lateral bend: 99.1%; axial twist: 59.9%; flexion: 89.8%). Consistent results were found for the left and right shoulder, with the arms held in a neutral flexion posture 50% of the time or more. Four participants experienced peak L4/L5 compression forces (between 4116.3 N and 5937.0 N) which exceeded the NIOSH Action Limit (3400 N) during the cart pushing/pulling task, but remained below the threshold during picking. Mean cumulative L4/L5 extension and shoulder flexion moments ranged in magnitude from 18.5 Nm to 28.2 Nm, and between 19.4 Nm and 23.2 Nm, respectively, across all tasks. CONCLUSIONS: The postural characteristics and biomechanical loads associated with greenhouse pepper harvesting were quantified with a video-based biomechanical approach. Further investigations of the physical risk factors for low back and shoulder musculoskeletal disorders is warranted in pepper harvesting, given the postures and loads documented in this study. Show more

Keywords: Video-based posture assessment, biomechanical loads, vegetable harvesting, agriculture, work-related musculoskeletal disorders

DOI: 10.3233/WOR-162442

Citation: Work, vol. 55, no. 4, pp. 817-829, 2016

Authors: Lindahl, Marianne | Teljigović, Sanel | Heegaard Jensen, Lars | Hvalsoe, Berit | Juneja, Hemant

Article Type: Research Article

Abstract: BACKGROUND: Quality in rehabilitation is important for recovery and return to work for people at working age, who sustain fractures, but there is limited information about what constitutes quality in rehabilitation. OBJECTIVE: To identify factors that therapists and patients define as quality in the rehabilitation process for working population after simple or multiple fractures. METHODS: The study is a qualitative study based on grounded theory approach with semi-structured interviews conducted individually or in focus groups. Seven patients with fractures, 15 physiotherapists and eight occupational therapists from hospitals, municipalities and private practice were included in the …study. Grounded theory was used to analyze data and develop a theory about quality in the rehabilitation process. RESULTS: Partnership was identified as the core category with continuity of rehabilitation and patient-centred approach as its dimensions. Themes in the patient-centred approach were Biopsychosocial understanding and Professionalism . The patient’s perceived control enhanced when the therapist addressed the whole situation, especially return to work. Therapist’s individual considerations and patient’s involvement in decisions about the therapeutic methods had the same effect. CONCLUSION: Quality in rehabilitation was enhanced in all its dimensions namely structure, process and outcome when therapists used the patient-centred approach and addressed the patient’s overall situation. Show more

Keywords: Physical therapy, occupational therapy, qualitative research, return to work, occupation

DOI: 10.3233/WOR-162446

Citation: Work, vol. 55, no. 4, pp. 831-839, 2016

Authors: Alleblas, Chantal C.J. | Formanoy, Margriet A.G. | Könemann, Reinier | Radder, Celine M. | Huirne, Judith A. | Nieboer, Theodoor E.

Article Type: Research Article

Abstract: BACKGROUND: Gynecologists are exposed to multiple risk factors for developing physical complaints. To enhance the workplace ergonomics in gynecological practice, a more detailed insight about job content and associated demands is necessary to subsequently decrease the exposure to risk factors. OBJECTIVE: The aim of this study was to investigate the prevalence of physical complaints and the presence of ergonomic constraints in Dutch gynecological practice. METHODS: A questionnaire was distributed among the 1200 members of the Dutch Society of Obstetrics and Gynecology. It consisted of 52 Dutch questions derived from the validated Dutch Musculoskeletal Questionnaire. …RESULTS: A total of 227 respondents completed the questionnaire (response rate 18.9%). Overall, 99.5% of the respondents rated their health status as reasonable or good. However, the twelve-month prevalence of physical complaints in one or more body part was 89.4%. Sustained adverse body postures were particularly reported for performing abdominal, and endoscopic surgery, and for assisting in vaginal surgery. Limited workspace, instruments, and patient size were reported by more than 60% of the respondents as constraints for adopting a neutral body posture during vaginal, endoscopic and abdominal surgery respectively. CONCLUSION: The results emphasize the necessity of enhancing ergonomics in gynecological practice. Better ergonomic circumstances will most likely benefit both the health of the gynecologists as well as the quality of surgical care. Show more

Keywords: Musculoskeletal disorders, physical work, health care, workplace ergonomics, work organization

DOI: 10.3233/WOR-162451

Citation: Work, vol. 55, no. 4, pp. 841-848, 2016

Authors: Grooten, Wilhelmus Johannes Andreas | Müller, Mira | Forsman, Mikael | Kjellberg, Katarina | Toomingas, Allan | Björn Olov, Ång | Svartengren, Magnus

Article Type: Research Article

Abstract: BACKGROUND: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided. OBJECTIVES: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction. METHODS: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n  = 272) and employees that participated …in a single session (HRA-S) (n  = 104). Associations between feedback and individual status concerning life style were assessed with Cohen’s kappa (k). RESULTS: The employees received mainly information and advice for improvement on health and lifestyle issues (89–100%), while advice for improvement of working conditions was less common (15–59%). The feedback provided on life style was not based on individual status (k  < 0.4), except for smoking and risky alcohol consumption (k  > 0.55). A great majority of employees reported good overall satisfaction with their HRAs. CONCLUSIONS: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors. Show more

Keywords: Health examinations, occupational health, occupational medicine, public health

DOI: 10.3233/WOR-162443

Citation: Work, vol. 55, no. 4, pp. 849-859, 2016

Authors: Ojala, Birgitta | Nygård, Clas-Håkan | Nikkari, Seppo T.

Article Type: Research Article

Abstract: BACKGROUND: The aging of the workforce poses new challenges for maintaining work ability. Because of limited information on the effectiveness of vocational rehabilitation performed in traditional inpatient programs, extended interest in outpatient rehabilitation has risen in the past few years. OBJECTIVE: We examined the effects of a new outpatient rehabilitation program where every participant defined their own goals to improve work ability by the aid of a goal-oriented multi-professional team. This report will focus on the employees’ physical capacity during a nine-month program. METHODS: A total of 605 municipal employees from different production areas of …the City of Tampere took part in the outpatient rehabilitation program, implemented by the occupational health unit. Groups of 12 employees participated in eight one-day sessions at intervals of two to three weeks; the final follow-up was 9 months from the beginning. Submaximal aerobic capacity was tested by a calibrated cycle ergometer with a commercial program (Aino Fitware pro, Helsinki, Finland). Musculoskeletal tests assessed muscle strength, balance and mobility. RESULTS: During the 9-month follow-up of the rehabilitation program, the employees’ physical capacity was improved. The follow-up test scores from a total of 329 employees were significantly higher in the submaximal aerobic capacity test (p  < 0.001). Other tests were also improved, such as standing on one foot (p  = 0.001), back side bending flexibility test (p  < 0.001), dynamic sit up (p  = 0.001), upper extremity right (p  < 0.001), and knee bending (p  = 0.029). About 40% of the participants did not have an adequate health situation to take part in physical capacity tests; however they took part in the intervention. CONCLUSIONS: The new outpatient rehabilitation program organized by the occupational health unit had a positive influence on employees’ physical capacity during a nine-month follow up. Show more

Keywords: Health promotion, work ability, cognitive behavioral theory based training (CBTr)

DOI: 10.3233/WOR-162458

Citation: Work, vol. 55, no. 4, pp. 861-871, 2016

Authors: Townsend, Robert | Bell, Shane | Harry, John

Article Type: Research Article

Abstract: BACKGROUND: Distraction based material handling tests are used to measure effort during functional capacity evaluations. OBJECTIVE: To identify validity of effort using the under loading method with the XRTS Lever Arm. Classification of effort between the two sessions (100% effort and estimated 50% effort) was compared with current validity criteria. METHODS: Fifty healthy and asymptomatic subjects were tested under two conditions (100% effort and an estimated 50% effort). Comparisons were made between percent changes from crate lifts to lever arm lifts from three starting heights (0.25 m, 0.38 m and 0.051 m). RESULTS: During the 100% …effort sessions, no subject had a mean percent change >20%, a majority of lift comparison >25% or a single lift comparison >30%. The specificity of the current validity criteria is 100%. The under loading method of using the XRTS lever arm was 20% sensitive in identifying an equivocal or invalid test result when subjects gave an estimated 50% effort. CONCLUSIONS: The results indicate the under loading method of distraction based testing is very specific but lacks sensitivity in identifying feigned weakness with asymptomatic, non-injured individuals. The high specificity of the test should eliminate concern of having a false positive for insincere effort during functional testing. Show more

Keywords: Functional capacity evaluation, cross-reference testing, percent change

DOI: 10.3233/WOR-162450

Citation: Work, vol. 55, no. 4, pp. 873-882, 2016

Authors: Haraldsson, P. | Jonker, D. | Strengbom, E. | Areskoug-Josefsson, K.

Article Type: Research Article

Abstract: BACKGROUND: Important success factors for the Occupational Health Service (OHS) include services being based on active participation and risk identification from a multidisciplinary/multifactorial perspective. Despite an extensive search, no questionnaire with this approach was found so a new questionnaire was developed at the OHS. The aim of this study was to develop and validate the new questionnaire named Structured Multidisciplinary work Evaluation Tool (SMET) through action research. METHOD: Communicative and pragmatic validity were tested through the development of the questionnaire using action theory and presented in a descriptive portrayal. The Content Validity Index (CVI) was used to …test content validity for each item as well as for the questionnaire as a whole. RESULT: Communicative and pragmatic validity were developed and tested over time in four different periods between 2008 and 2014, in 24 clinics (with a total of approximately 1000 employees) in Region Jönköping County. The content validity of the SMET questionnaire as a whole was close to excellent and the validity of the questions regarding physically and psychosocially demanding work factors were found to be excellent. The questions regarding environmentally demanding work factors were found to have a lower, but still good, validity. CONCLUSION: The SMET questionnaire has very good content validity. The pervasive work with the SMET questionnaire also shows good pragmatic and communicative validity. Show more

Keywords: Occupational health care, work questionnaire, validity, participatory ergonomics

DOI: 10.3233/WOR-162454

Citation: Work, vol. 55, no. 4, pp. 883-891, 2016

Authors: Sarkar, Sonali | Taylor, Wendell C. | Lai, Dejian | Shegog, Ross | Paxton, Raheem J.

Article Type: Research Article

Abstract: BACKGROUND: Few studies have examined the associations among family, friend, and coworker social support for physical activity. It is important to know the sources of social support that facilitate and promote physical activity among fulltime working adults. OBJECTIVE: We analyzed the associations among family, friend, and coworker social support for physical activity and moderate-to-vigorous physical activity among participants in a worksite study. METHODS: This study was a cross-sectional analysis of baseline data from 144 participants from four worksites in a large, southwestern city in the United States. The intervention for the worksite study was Booster …Breaks (a physical activity routine of 15 minutes) practiced daily to break-up prolonged sitting time. Descriptive statistics and multiple linear regressions were conducted using SPSS version 20. RESULTS: Age was inversely associated (p  = 0.001), and social support from friends (p  = 0.04) and coworkers (p  = 0.003) were positively associated with physical activity in the unadjusted model. After controlling for all the covariates (age, sex, marital status, BMI, education, and income) in the model, only coworker social support was positively (p  = 0.027) associated with physical activity among participants in the workplace study. CONCLUSIONS: Coworker social support is an important correlate of physical activity and should be incorporated in workplace health promotion programs. Show more

Keywords: Workplace health promotion, social support, physical activity

DOI: 10.3233/WOR-162459

Citation: Work, vol. 55, no. 4, pp. 893-899, 2016

Authors: Hellman, Therese | Bergström, Aileen | Eriksson, Gunilla | Hansen Falkdal, Annie | Johansson, Ulla

Article Type: Research Article

Abstract: BACKGROUND: Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. OBJECTIVE: To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders’ aspects exploring different perspectives that may influence optimal RTW. METHODS: Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. RESULTS: Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work …ability in the RTW process. Despite the stakeholders’ agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. CONCLUSIONS: A stroke coordinator may remediate the stakeholders’ divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal. Show more

Keywords: Work, vocational rehabilitation, occupation

DOI: 10.3233/WOR-162455

Citation: Work, vol. 55, no. 4, pp. 901-911, 2016

Authors: Mani, Karthik | Provident, Ingrid | Eckel, Emily

Article Type: Research Article

Abstract: BACKGROUND: Work-related musculoskeletal disorders (WMSDs) related to computer work have become a serious public health concern. Literature revealed a positive association between computer use and WMSDs. OBJECTIVE: The purpose of this evidence-based pilot project was to provide a series of evidence-based educational sessions on ergonomics to office computer workers to enhance the awareness of risk factors of WMSDs. METHODS: Seventeen office computer workers who work for the National Board of Certification in Occupational Therapy volunteered for this project. Each participant completed a baseline and post-intervention ergonomics questionnaire and attended six educational sessions. The Rapid Office …Strain Assessment and an ergonomics questionnaire were used for data collection. RESULTS: The post-intervention data revealed that 89% of participants were able to identify a greater number of risk factors and answer more questions correctly in knowledge tests of the ergonomics questionnaire. Pre- and post-intervention comparisons showed changes in work posture and behaviors (taking rest breaks, participating in exercise, adjusting workstation) of participants. CONCLUSIONS: The findings have implications for injury prevention in office settings and suggest that ergonomics education may yield positive knowledge and behavioral changes among computer workers. Show more

Keywords: Musculoskeletal disorders, occupational therapy, prevention

DOI: 10.3233/WOR-162457

Citation: Work, vol. 55, no. 4, pp. 913-922, 2016