Work - Volume 51, issue 2

Article Type: Editorial

DOI: 10.3233/WOR-152018

Citation: Work, vol. 51, no. 2, pp. 159-159, 2015

Authors: Kloetzer, Laure | Quillerou-Grivot, Edwige | Simonet, Pascal

Article Type: Research Article

Abstract: BACKGROUND: This paper reports on two case studies conducted by the Activity Clinic team to support the prevention of Work-Related Musculoskeletal Disorders (WRMSDs) in the workplace. Research so far qualifies WRMSDs as multifactorial and organizational pathologies. It has also demonstrated that in situ clinical analysis of the work activity improves the understanding of WRMSDs and their long-term prevention. OBJECTIVE: In the two cases reported here (one in the car industry and the other among gravediggers in a large French city), the interventionist framework combined ergonomic observations, biomechanical monitoring, and a developmental methodology called Cross Self-Confrontation (CSC). …The goal was to help workers and managers reflect on their work constraints, the impact of those constraints on health, and the possibility of transforming the work. METHOD: Volunteers among the workers were prompted to engage in collective re-thinking of their work based on video-recordings and monitoring of their physical activity. In the CSC dialogues, biomechanical or ergonomic quantitative representations of the work activity were transformed by the researchers and the workers into argumentation and analysis tools for understanding and prevention of WRMSDs. CSC interviews were recorded and analyzed to track the dynamics of collective elaboration - both conceptual and practical - on WRMSDs prevention. RESULTS: CSC discussions helped workers and managers transform their views on health, activity, and work constraints, and experiment with alternatives for health protection. The dialogical framework and quantitative representations were instrumental in the process of collective re-conceptualization of conflicts in the work activity and of resources for its transformation. CONCLUSION: This research demonstrates how the integration of biomechanical and ergonomic mediations in the CSC framework promotes WRMSDs prevention in the workplace. This integration supports discussions within work teams and across organizational levels on work dimensions, which may lead to alternatives supporting health. Show more

Keywords: Power to act, cross self-confrontations, intervention, dialogue, developmental methodology

DOI: 10.3233/WOR-141970

Citation: Work, vol. 51, no. 2, pp. 161-173, 2015

Authors: Soeker, Shaheed | Bonn, Gerri-Lee | de Vos, Zahraa | Gobhozi, Thobile | Pape, Candice | Ribaudo, Shelly

Article Type: Research Article

Abstract: BACKGROUND: The South African constitution protects the rights of gays; however in the workplace gays experience discrimination and marginalization. As a result of marginalization they struggle to reach their potential regarding career development and the fulfilment of their worker role. OBJECTIVE: The study explored the experiences and perceptions of gay males with regard to acquiring and maintaining their worker roles. METHODS: The study is phenomenological and qualitative in design. Eleven of these men participated in two focus groups. One male participated in two in-depth interviews and one interview was conducted with a key …informant. RESULTS: Three themes emerged: 1) Being boxed in, 2) The glass ceiling, 3) This is where I can wear my feather boa. CONCLUSIONS: The study findings clearly depicted the many barriers experienced by homosexual men and how this negatively impacts on their worker role. Minimal facilitatory factors exist, to assist gay males %in with regard to their worker role. It was found that homo-prejudice still exists in South Africa and its workplaces and has a negative impact not only on gay men's worker role but also their well-being. This significantly highlights the great need for occupational therapy intervention in the lives of these gay men, and their workplaces. Show more

Keywords: Occupational therapy, occupation, homosexuality, vocational rehabilitation, qualitative research, ex-offenders

DOI: 10.3233/WOR-141848

Citation: Work, vol. 51, no. 2, pp. 175-186, 2015

Authors: Marfeo, Elizabeth E. | Eisen, Sue | Ni, Pengsheng | Rasch, Elizabeth K. | Rogers, E. Sally | Jette, Alan

Article Type: Research Article

Abstract: BACKGROND: Questions exist related to the best way to use medical evidence relative to self-report as part of the SSA disability determination process. OBJECTIVE: To examine concordance between provider and claimant responses along the four dimensions of work related behavioral health functioning: Social Interactions, Mood and Emotions, Behavioral Control, and Self-Efficacy. METHODS: Using secondary data from a larger study, which collected data on individuals reporting difficulties with work (claimants) due to mental conditions, 39 items were completed by claimants and their healthcare provider. Inter-rater agreement was assessed using three techniques: Cohen's kappa, percent absolute …agreement, and folded mountain plots. RESULTS: A sample of 65 dyads was obtained. Inter-rater agreement was low for most items (k = 0.0-0.20) with a minority of items having fair agreement (k = 0.21-0.40) Percent agreement was fair: Mood and Emotions (46%), Self-Efficacy (44%), Behavioral Control (39%) and Social Interactions (38%). Overall, providers reported lower functioning compared to claimants for the Behavioral Control and Self-Efficacy scales; the reverse trend held for the Mood and Emotions scale. CONCLUSIONS: Results indicate discordance between provider and claimant report of behavioral health functioning. Understanding reasons for and approaches to reconciling the inconsistencies between claimant and provider perspectives is a complex task. These findings have implications for how best to assess mental and behavioral-health related work disability in the absence of an established gold standard measure. Show more

Keywords: Work disability, behavioral health, disability evaluation

DOI: 10.3233/WOR-141847

Citation: Work, vol. 51, no. 2, pp. 187-194, 2015

Authors: von Thiele Schwarz, Ulrica | Hasson, Henna | Lindfors, Petra

Article Type: Research Article

Abstract: BACKGROUND: Two objectives are central when implementing occupational health interventions: high intervention fidelity, i.e. alignment with existing theory/evidence, and the need for fit, i.e., matching organizational and employee needs. These objectives can be contradictory and there is little advice on how to successfully combine them. OBJECTIVE: This study examines if an implementation fidelity framework can be used to categorize and describe how to adapt an occupational health intervention. METHODS: Using an adapted version of the Conceptual Framework for Implementation Fidelity, we analyzed the implementation of a workplace-based physical exercise intervention and its contextualized adaptations. Adaptations …are described in terms of content, dose, coverage and timeliness, each on three levels: individual, unit and organizational. Data sources include systematic project documentation and reflexive discussions. RESULTS: The intervention was adapted across all aspects and levels of fidelity. Adaptations involved aligning the intervention with level characteristics: organizational level adaptations aligned health policies with cost/benefits, whereas unit level adaptations minimized interference with production and coordinated the intervention with employee preferences. On the individual level, the exercise type varied, which aligned individual needs with the intervention. CONCLUSIONS: The Conceptual Framework for Implementation Fidelity can help describe the balance between adaptation and adherence at different organizational levels. Show more

Keywords: Physical exercise, physical activity, workplace - based intervention, Tailored interventions, adherence, fidelity, program theory, occupational safety and health

DOI: 10.3233/WOR-141840

Citation: Work, vol. 51, no. 2, pp. 195-203, 2015

Authors: Muslim, Khoirul | Nussbaum, Maury A.

Article Type: Research Article

Abstract: BACKGROUND: Concerns have been raised regarding the high prevalence of musculoskeletal symptoms (MSS) among manual material handling (MMH) workers. However, limited investigations have been undertaken among one large group of workers using a particular MMH method called posterior load carriage (PLC). This is typically done without the use of a backpack in developing countries, and involves exposure to known risk factors for MSS such as heavy loads, non-neutral postures, and high levels of repetition. OBJECTIVES: To 1) determine the types and prevalence of MSS among PLC workers and the impacts of these MSS on workers, 2) …explore job demands potentially contributing to MSS, and (3) obtain input from workers regarding possible improvements to facilitate future interventions. METHODS: Structured interview applied to 108 workers to assess PLC worker characteristics and job demands in eight cities in Indonesia. RESULTS: MSS were reported in all anatomical regions evaluated, with symptoms most commonly reported at the lower back (72.2%), feet (69.4%), knees (64%), shoulders (47.2%), and neck (41.7%). Logistic regression indicated that MSS in the lower back were associated with longer work hours/day, MSS in the hands were associated with load mass, and MSS in the ankles/feet were associated with stature and load carriage frequency. MSS were reported to interfere with daily activity, but only few workers sought medical treatment. Possible improvements included the use of a belt, hook, or backpack/frame, and changes in the carriage method. CONCLUSIONS: The study suggests that PLC workers incur a relatively high MSS burden. Future studies are needed to develop and evaluate practical interventions and specific guidelines to improve working conditions and occupational health and safety for PLC workers. Show more

Keywords: Low back pain, prevalence, ergonomics, Nordic questionnaire, developing country

DOI: 10.3233/WOR-141853

Citation: Work, vol. 51, no. 2, pp. 205-213, 2015

Authors: Li, Jing | Tian, Yinsheng | Ding, Li | Zou, Huijuan | Ren, Zhaosheng | Shi, Liyong | Feathers, David | Wang, Ning

Article Type: Research Article

Abstract: BACKGROUND: High-temperatures in the cockpit environment can adversely influence pilot behavior and performance. OBJECTIVE: To investigate the impact of high thermal environments on Chinese pilot performance in a simulated cockpit environment. METHODS: Ten subjects volunteered to participate in the tests under 40°C and 45°C high-temperature simulations in an environmentally controlled chamber. Measures such as grip strength, perception, dexterity, somatic sense reaction, and analytical reasoning were taken. The results were compared to the Combined Index of Heat Stress (CIHS). RESULTS: CIHS exceeded the heat stress safety limit after 45 min under 40°C, …grip strength decreased by 12% and somatic perception became 2.89 times larger than the initial value. In the case of 45°C, CIHS exceeded the safety limit after only 20 min, while the grip strength decreased just by 3.2% and somatic perception increased to 4.36 times larger than the initial value. Reaction and finger dexterity were not statistically different from baseline measurements, but the error rate of analytical reasoning test rose remarkably. CONCLUSION: Somatic perception was the most sensitive index to high-temperature, followed by grip strength. Results of this paper may help to improve environmental control design of new fighter cockpit and for pilot physiology and cockpit environment ergonomics research for Chinese pilots. Show more

Keywords: Thermal environments, cockpit, Combined Index of Heat Stress (CIHS), perception

DOI: 10.3233/WOR-141842

Citation: Work, vol. 51, no. 2, pp. 215-222, 2015

Authors: Kim, Min-Hee | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND: Differences in LBP symptoms are particularly important with regard to the controversy over repositioning error because there can be considerable variation in the pattern of LBP symptoms in a heterogeneous LBP group. For this reason, several researchers have suggested that a study of subdivided LBP types is needed. Indeed, some recent studies have attempted to differentiate LBP subgroups. OBJECTIVE: This study used a comparative cross-sectional design to compare the lumbar flexion angle and repositioning error between people with and without LBP during a lumbar flexion-extension task. METHODS: The subjects were divided into three …groups: a control group of 13 asymptomatic subjects, 13 LBP subjects with L4-5 pain associated with lumbar flexion, and 13 LBP subjects with L4-5 pain associated with lumbar extension. The subjects performed a lumbar flexion-extension task. Joint kinematics on the lumbar flexion angle and lumbar spine repositioning error were measured using a 3-D motion capture system. RESULTS: The lumbar flexion angle of the LBP group with flexion pain was significantly greater than that of the asymptomatic group and the LBP group with extension pain. The difference in lumbar repositioning error was significantly greater in the LBP group with lumbar flexion pain than in the asymptomatic group. CONCLUSIONS: This study suggests that lumbar hyper-mobility occurred and proprioception of the lumbar segment was decreased in people with LBP associated with lumbar flexion compared with people with LBP associated with lumbar extension. We also suggest that a lumbar repositioning error measurement using the lumbar flexion-extension test may be a more effective evaluation method in people with LBP associated with lumbar flexion than in those with LBP associated with lumbar extension. Show more

Keywords: Hyper-mobility, low back pain, proprioception, repositioning error

DOI: 10.3233/WOR-141856

Citation: Work, vol. 51, no. 2, pp. 223-228, 2015

Authors: Schmidt, Lisa | Sjöström, John | Antonsson, Ann-Beth

Article Type: Research Article

Abstract: BACKGROUND: Occupational health services (OHS) are often described as an important resource to reduce work-related diseases and improve the workplace. OBJECTIVE: This paper identifies key factors for successful collaboration between Swedish OHS providers and their client companies. METHODS: Interviews were carried out with representatives of 15 companies and their OHS providers. The interviews were transcribed and their content analyzed. RESULTS: The results revealed that successful collaboration was highly correlated with six factors. First, the collaboration depends on both parties; ``it takes two to tango''. Second, the company and the OHS provider have …a joint commitment to a long-term collaboration. Third, the collaboration is built on frequent contact at different organizational levels. Fourth, the company has a well-structured work environment for occupational health and safety management. Fifth, the OHS provider uses a consultative approach in its prevention and promotion activities. Finally, OHS providers seek to treat the company, not the individual. CONCLUSIONS: Our research indicates that a successful collaboration requires both occupational health and safety management (OHSM) within the company and the assistance of a competent OHS provider. A change toward more promotion and prevention services benefits the company, since the occupational health services are better tailored to the company's needs. Show more

Keywords: Work environment, work-related illness prevention, dialogue, trust and confidence

DOI: 10.3233/WOR-141855

Citation: Work, vol. 51, no. 2, pp. 229-237, 2015

Authors: Sadeghian, Farideh | Coggon, David | Ntani, Georgia | Hosseinzadeh, Samaneh

Article Type: Research Article

Abstract: BACKGROUND: A previous survey had indicated high rates of low back pain (LBP) in Iranian nurses and office workers. OBJECTIVE: To explore possible risk factors, we carried out a longitudinal study of the same subjects. METHODS: Baseline information about risk factors and recent history of LBP was collected by self-administered questionnaire from 246 nurses and 182 office workers. Approximately 12 months later, 385 (90%) answered a second questionnaire about LBP in the past month. Predictors of LBP at follow-up were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs) with 95% confidence …intervals (CIs). RESULTS: In a regression model that included all risk factors, the strongest predictor of LBP at follow-up was report of recent LBP at baseline. In addition, LBP was associated with older age, adverse beliefs about the work-relatedness of LBP (PRR 1.3, 95%CI 1.0-1.5), and incentives from piecework or bonuses (PRR 1.4, 95%CI 1.1-1.6). When baseline report of LBP was omitted from the model, associations were also observed with tendency to somatise, poor mental health and time pressures at work. CONCLUSIONS: Our findings support the importance of psychosocial risk factors for LBP, including adverse health beliefs and working conditions that encourage higher output. Show more

Keywords: Psychosocial, health beliefs, piecework, somatising, mental health

DOI: 10.3233/WOR-141850

Citation: Work, vol. 51, no. 2, pp. 239-244, 2015