Quantitative estimation of physical work load requires breakdown of jobs into smaller entities. The objective was to study the inter-rater reproducibility of the contents, frequency and duration of work tasks assessed by telephone interview. Two researchers interviewed 18 industrial workers with an interval of from 2 to 3 weeks in a balanced and blinded design. Altogether 114 tasks were identified, 68 of which were recorded by both interviewers. The tasks were classified into regularly occurring (n = 34) and occasional (n = 80). The outcome was the total duration of the tasks per day computed from the data on frequency and duration. Validity of the interview was studied against prestructured diaries filled in by nine workers. The interviewers' assessments of the overall contents of the tasks were rated as 'similar' or 'very similar' for 17 of the 18 workers. Both interviewers detected all 34 regularly occurring tasks. The intraclass correlation coefficient (ICC) of the total duration between the interviewers was 0.81 for regularly occurring tasks. ICCs of the total duration between the diary and the two interviewers were 0.90 and 0.91. However, in many cases the workers could not give a numerical value for duration or frequency. A telephone interview can be used as a first step in exposure assessment in epidemiological studies on risk factors of musculoskeletal disorders. These results show that a single telephone interview can give reproducible and valid information of the frequency and duration of tasks occurring daily. For occasional tasks interview methods should be developed further.
To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife.
Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18-24 years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test).
After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association (p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men.
Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back.
The incidence of upper-limb, neck-shoulder, and low-back disorders and their induction times were investigated among new workers in tasks with various physical workloads.
New trailer assemblers (N=364) were followed prospectively for 45 months--the workers' health status via medical records and exposure to physical workload factors via job titles, walk-throughs, task descriptions, and some direct measurements. The incidence rate of first sick leave due to such disorders was calculated for different workload groups. The proportion of workers surviving without musculoskeletal disorders was estimated by the Kaplan-Maier product-limit estimator, and the effect of the exposure on the risk of incident disorders was estimated with the Cox proportional hazards model.
The highest annual incidences were observed for strenuous tasks, the incidence rate for men being 16.8 per 100 person-years [95% confidence interval (95% CI) 8.0-30.9] for upper-limb disorders in strenuous tasks and 6.1 (95% CI 2.0-14.1) in nonstrenuous tasks and that for women being 32.0 (95% CI 11.7-69.7) and 9.9 (95% CI 0.2-54.9), respectively. The men's risk of contracting an upper-limb or neck-shoulder disorder in strenuous tasks was about threefold [hazard ratio (HR) 3.2 (95% CI 1.1-9.4) for upper-limb disorders and 2.7 (95% CI 0.9-8.1) for neck-shoulder disorders] that of nonstrenuous tasks, whereas workload seemed not to affect low-back disorders. The workers first sought medical advice for their disorders typically some months after employment began.
Newly employed workers in hand-intensive tasks have a high risk of upper-limb and neck-shoulder disorders. An etiologic role for activities involving high force demands in upper-limb and neck-shoulder disorders is possible.
To explore the combination of data on functioning and work load for early identification of patients at risk for diminished work productivity in rheumatoid arthritis (RA).
In the FIN-RACo trial, 162 patients with recent onset RA and available for the workforce were treated with either a combination of disease-modifying antirheumatic drugs (DMARDs) or a single DMARD for 2 years. Otherwise, they received routine care and were followed up for 5 years. Data on their individual income and lost work days came from official registers. Loss of productivity was computed by the human capital approach. Self-reported data on physical work demand (Finnish Institute for Occupational Health Questionnaire) at baseline and on functioning (HAQ) at 6 months were linked according to the International Classification of Functioning, Disability and Health.
Data on 112 patients were analyzable at 6 months; 35 (31%) of them had diminished capacity in functions required at paid work. Any mismatch between perceived abilities and requirements predicted future (7 through 60 months) loss of productivity - on average Euro 14,040 (95% confidence interval (CI): 9,143-20,511) per year in patients with the mismatch compared to Euro 3,043 (1,623-5,534) in those without any mismatch - and was associated with RA-related permanent work disability (hazard ratio: 11.6; 95%CI: 4.0-33.4).
Linking together self-reported data about functioning and work load helps in early identification of the RA patients at risk for loss of working days.
OBJECTIVES: To evaluate the effects of work related and individual factors as well as physical activity and sports on the incidence and persistence of shoulder pain among forestry workers. METHODS: Workers in a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic questionnaire) on musculoskeletal pain and its possible risk factors for 4 consecutive years 1992-5. This 1 year follow up study covers the time 1994-5. Year 1994 was chosen as baseline because in that year the questionnaire contained for the first time more detailed questions about different sports. The response rate in 1995 was 90%. The effects of the predictors on 1 year incidence and persistence of shoulder pain were studied with multivariate logistic regression modelling. RESULTS: At baseline, 2094 subjects had been free of shoulder pain during the preceding 12 months. After 1 year, 14% (n=285) reported having mild or severe shoulder pain. Higher age, obesity, and mental stress as well as physically strenuous work and working with trunk forward flexed or with a hand above shoulder level increased the risk of incident shoulder pain. Of the different sports activities, dancing increased the risk of incident pain whereas jogging decreased the risk significantly. Of those 419 workers who had severe shoulder pain at baseline, 55% (n=230) still had severe pain 1 year later. Higher age, overload at work, and working with a hand above shoulder level increased the risk of persistent severe shoulder pain whereas cross country skiing and general sports activity decreased the risk. CONCLUSION: Our results support the current view that shoulder pain is the result of many factors, including occupational and individual factors. In this longitudinal study, physical work with a heavy load, awkward work postures, mental stress, and obesity were the risk factors at which preventive measures could be aimed. As a new finding, physical exercise had more protective than impairing effects on the shoulders.
This study assessed the validity of self-reported physical work load by questionnaire and logbook against task analysis and observation. It also investigated factors (job type and low-back or neck pain) affecting the self-assessment of physical work load and compared the assessments between the questionnaire and the logbook.
A self-administered questionnaire including 10 questions (ordinal scales) on physical work load and musculoskeletal symptoms was filled out by 2756 men in the forest industry. From this population, 36 men were selected for task analysis and observation. Logbooks including 10 continuous variables were analyzed for 386 men.
The Spearman rank correlation coefficients between the self-assessments and observations for the frequency of manual handling, duration of trunk flexion, neck rotation, hand above shoulder level, and squatting or kneeling ranged between 0.42 and 0.55. The correlation coefficients for the questionnaire items were higher in general, and the accuracy better, for those with no low-back pain than for those with pain. The duration of trunk flexion, neck flexion and hand above shoulder level was overestimated in the questionnaires and less so in the logbooks.
Self-administered questionnaires may help to classify groups with heterogeneous occupational tasks according to some work-load factors. The accuracy of the assessments is not good for studying quantitative exposure-effect relationships, however. The logbook method might give more valid information. The perception of musculoskeletal pain may bias the self-assessment of work load.