We describe the 40-year weight history and adult morbidity and mortality in a cohort of 504 overweight children, aged 2 months to 16 years, who were admitted for investigation of their overweight to four children's hospitals in Stockholm between 1921 and 1947. Follow-up information was gathered by questionnaire at 10-year intervals, most recently in 1980-1983 (n = 458), on weight history (based on the body mass index (BMI = kg/m2)), as well as prevalence of cardiovascular disease (n = 143), diabetes (n = 39), and cancer (all types (n = 20)), reported during the 40 years of follow-up, and mortality from all causes (n = 55), determined from death certificate. The sample of overweight children remained overweight as adults; after age 55 years, the BMI began to decline for both genders. Female subjects were heavier than their male counterparts from postpuberty onward. Subjects who died by the 40-year follow-up and those reporting cardiovascular disease were significantly (P
The main purpose of the study was to investigate the prevalence of perceived symptoms of musculoskeletal disorders (MSD) among workers on large-scale dairy and pig farms in Sweden (herd size more than 300 cows and 450 sows) and to identify potential risk factors in the development of MSD. A study based on questionnaires was carried out among 42 workers on 10 large dairy farms and among 37 workers on 10 large pig farms in Southern Sweden during the autumn of 2002. Most importantly, the study showed that 86% of the dairy workers and 78% of the pig workers reported some kind of MSD during a period of 12 months prior to the study. The most frequently reported MSD among both the dairy and the pig workers were in the "upper extremities" (52% and 62%, respectively) especially in the shoulders and in "the back" (60% and 57%, respectively) especially in the lower back. Furthermore, being of short stature, doing repetitive work, working in awkward positions and being exposed to dust were significant risk factors in having MSD among the workers in this study. Thus, working with many cows and sows on large-scale farms in Sweden can be considered as a high risk job with regard to MSD.
Musculoskeletal disorders (MSDs) are the main reason for morbidity during military training. MSDs commonly result in functional impairment leading to premature discharge from military service and disabilities requiring long-term rehabilitation. The purpose of the study was to examine associations between various risk factors and MSDs with special attention to the physical fitness of the conscripts.
Two successive cohorts of 18 to 28-year-old male conscripts (N = 944, median age 19) were followed for six months. MSDs, including overuse and acute injuries, treated at the garrison clinic were identified and analysed. Associations between MSDs and risk factors were examined by multivariate Cox's proportional hazard models.
During the six-month follow-up of two successive cohorts there were 1629 MSDs and 2879 health clinic visits due to MSDs in 944 persons. The event-based incidence rate for MSD was 10.5 (95% confidence interval (CI): 10.0-11.1) per 1000 person-days. Most MSDs were in the lower extremities (65%) followed by the back (18%). The strongest baseline factors associated with MSDs were poor result in the combined outcome of a 12-minute running test and back lift test (hazard ratio (HR) 2.9; 95% CI: 1.9-4.6), high waist circumference (HR 1.7; 95% CI: 1.3-2.2), high body mass index (HR 1.8; 95% CI: 1.3-2.4), poor result in a 12-minute running test (HR 1.6; 95% CI: 1.2-2.2), earlier musculoskeletal symptoms (HR 1.7; 95% CI: 1.3-2.1) and poor school success (educational level and grades combined; HR 2.0; 95% CI: 1.3-3.0). In addition, risk factors of long-term MSDs (>or=10 service days lost due to one or several MSDs) were analysed: poor result in a 12-minute running test, earlier musculoskeletal symptoms, high waist circumference, high body mass index, not belonging to a sports club and poor result in the combined outcome of the 12-minute running test and standing long jump test were strongly associated with long-term MSDs.
The majority of the observed risk factors are modifiable and favourable for future interventions. An appropriate intervention based on the present study would improve both aerobic and muscular fitness prior to conscript training. Attention to appropriate waist circumference and body mass index would strengthen the intervention. Effective results from well-planned randomised controlled studies are needed before initiating large-scale prevention programmes in a military environment.
Cites: Med Sci Sports Exerc. 2007 Jul;39(7):1061-617596772
Cites: Clin J Sport Med. 2000 Oct;10(4):259-6311086751
Cites: Mil Med. 2000 Dec;165(12):905-1011149059
Cites: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-25311234459
Cites: Med Sci Sports Exerc. 2001 Jun;33(6):946-5411404660
STUDY DESIGN: This study analyzed the role of exposure to driving and other covariates in reports of back, neck, and shoulder pain and resultant disability. Cohorts in Sweden and the United States were compared. OBJECTIVES: To establish the effect of mechanical and psychosocial factors in reporting back, neck, and shoulder pain and work loss. SUMMARY OF BACKGROUND DATA: There are numerous reports of a positive relationship between back pain and driving. However, exposure data are minimal. The influence of job satisfaction has not been assessed. METHODS: The physical factors affecting reports of back, neck, and shoulder pain were investigated in a two-country cohort study of bus and truck drivers and sedentary workers. Vibration exposure was obtained by directly measuring the vibration imposed on the driver during a typical work day. Lifting exposure was attained by questionnaire. Cumulative exposure was computed based on work history. Musculoskeletal health information was based on a modified nordic questionnaire, and other questionnaires recorded the physical and psychosocial aspects of the work environment. RESULTS: Of the sample, 50% reported low back pain, with no difference between countries. The highest risk factors (odds ratios) for back and neck pain were long-term vibration exposure, heavy lifting, and frequent lifting. A combination of long-term vibration exposure and frequent lifting carried the highest risk of low back pain. Work loss from low back pain was influenced by perceived job stress. CONCLUSIONS: Vibration (resulting from driving) and lifting cause back, neck, and shoulder pain, whereas inability to work seems affected by stress at work.
OBJECTIVES: The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities. METHODS: All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated. RESULTS: There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in low-back pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain. CONCLUSIONS: In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.
Comment In: Scand J Work Environ Health. 2008 Aug;34(4):235-818820820
To chart the incidence and course of three types of arm morbidity (lymphedema, pain, and range of motion [ROM] restrictions) in women with breast cancer 6-12 months after surgery and the relationship between arm morbidity and disability.
Longitudinal mixed methods approach.
Four sites across Canada.
347 patients with breast cancer 6-12 months after surgery at first point of data collection.
Incidence rates were calculated for three types of arm morbidity, correlations between arm morbidity and disability were computed, and open-ended survey responses were compiled and reviewed.
Lymphedema, pain, ROM, and arm, shoulder, and hand disabilities.
Almost 12% of participants experienced lymphedema, 39% reported pain, and about 50% had ROM restrictions. Little overlap in the three types of arm morbidity was observed. Pain and ROM restrictions correlated significantly with disability, but most women did not discuss arm morbidity with healthcare professionals.
Pain and ROM restrictions are prevalent 6-12 months after surgery, but lymphedema is not. Pain and ROM restrictions are associated with disability.
Screening for pain and ROM restrictions should be part of breast cancer follow-up care. Left untreated, arm morbidity could have a long-term effect on quality of life. Additional research into the longevity of various arm morbidity symptoms and possible interrelationships also is required.
The primary objectives of the study were to 1) describe the physical exposures in a sawmill job with a high incidence of upper extremity musculoskeletal injuries in terms of multiple measures of posture, exertion and frequency (with varying definitions) and 2) to examine the comparability of those definitions. Surface electromyography and electrogoniometry were used to quantify the muscle demands and joint motions. Fourteen board edger operators from two sawmill facilities participated. All exposure assessments, with the exception of surface EMG measurements, were performed on the production lines. EMG measurements were performed within the facility in a location removed from the production line. The measurements showed that, on average, ranges of motions of 59, 102 and 84 degrees respectively in the planes of wrist radial/ulnar deviation, flexion/extension and pronation/supination were required to perform the job. Significant differences (p
BACKGROUND: Segregation of men and women into different jobs is often cited as one of the most plausible explanations for gender differences in exposure and musculoskeletal disorders. METHODS: Direct measurements of sitting, arm, and trunk postures were taken with two different technical instruments on 156 subjects (78 matched pairs of one female and one male worker) over one full workday in diverse labor markets. RESULTS: Exposure differences between workers were strongly associated with vertical occupational segregation (measured as level of status/authority). The results showed that this association was strongest for female-dominated jobs. Workers in female-dominated jobs with a low status/authority experienced longer duration in standing posture (P = 0.001), and higher frequency of arm elevation (P = 0.028 and 0.040 for the dominant and the non-dominant arm, respectively). They also had longer duration of work with bent trunk compared to corresponding workers with high status/authority (P = 0.035). The association was less pronounced for male-dominated jobs, and no such association was found for gender-integrated jobs. CONCLUSION: The findings have implications for prevention as well as for future research.
A case-control study was performed to elucidate the strength of the relation between musculoskeletal disorders in the neck and shoulders and physical, organisational, and psychosocial aspects of the work environment. Cases were identified as those persons who consulted a physician in a community in southern Sweden for new musculoskeletal disorders in the neck and shoulders during a study period from August 1988 to the end of October 1989. One hundred and nine cases were collected and clinically examined. The cases also answered the Nordic questionnaire on symptoms as well as a questionnaire on work conditions and background factors. Controls were drawn as a random sample of the working population in the community where the cases appeared. A total of 637 controls answered the same questionnaires as the cases. Odds ratios (ORs) were calculated by logistic regression. The odds ratios were 11.4 for women, 4.9 for immigrant background, and 3.7 for current smoking. To exercise rarely, compared with often, appeared as a preventive factor with an OR of 0.3. The ORs for various determinants of physical work load were 7.5 for repetitive movements demanding precision, 13.6 for light lifting, 3.6 for uncomfortable sitting positions, 4.8 for work with lifted arms, and 3.5 for a rushed work pace. Regarding work organisational determinants, the ORs were 16.5 for ambiguity of work role (uncertainty whether the person could manage the work) 2.6 for low quality work, and 3.8 for high demands on attention. Several of the determinants showed a significant dose-response relation with disease. It seems that work organisation and psychosocial work conditions are as important determinants for disease in the neck and shoulders as are the physical work conditions.
Researcher Stefan Pinzke, PhD, Swedish University of Agricultural Sciences, Department of Agricultural Biosystems and Technology, Division of Work Science, PO Box 88, SE-230 53 Alnarp, Sweden. firstname.lastname@example.org
The objective of this study was to describe and analyse the changes in working conditions and health among dairy farmers in Scania in southern Sweden during the period 1988-2002 by a repeat of a mail-in survey. Altogether, 83 % of the male and 90 % of the female dairy farmers reported some kind of symptoms in the musculoskeletal system during the 12 months prior to the 2002 questionnaire. This is an increase compared to the farmers in 1988. The highest significant changes were an increase of symptoms in the shoulder, neck and in the wrists/hands. The milkers reported most often incidental as well as persistent symptoms in the shoulders. The frequency of hip symptoms was significantly higher among those male milkers who had quit milking during the interim than for the active milkers in 1988. The milkers studied in 2002 had, on average, increased their working time per week, increased the number of cows milked as well as the use of more milking units. In 1988, almost all the milkers studied were working in tethering systems while in 2002 more than one quarter were working in loose-housing systems. The opinion among most of the farmers, both in 1988 and in 2002, regardless of age or sex, was that silage handling and the milking procedure were the most strenuous work operations. On the other hand, the milkers obtained their greatest pleasure from the actual milking job as well as from their work to promote the welfare of the animals. Unprofitability and great investment demands had a bearing on the retirement of milkers but, on the other hand, a high potential of the milkers could have continued 10-15 more years as dairy farmers if the work conditions had been better, e.g. associated with fewer health problems. Apart from the need for developing technical devices to facilitate the milking operation, further research is needed concerning the dairy farmers' well-being and quality of life, perceived stress, and leisure time activities and how these and similar factors influence the prevalence of musculoskeletal symptoms. Strategies for preventive and intervention measures must consider physical workplace factors as well as personal and lifestyle characteristics.