2015-06-01 12:00 - Messages

La prévention des troubles musculo-squelettiques dans le secteur de l'agriculture

Dans cette brochure, les propriétaires d’exploitations agricoles et les travailleurs trouveront une description générale des troubles musculo-squelettiques (TMS) et de leurs stades de développement. On y propose également des moyens de prévention à appliquer pour prévenir les TMS et une méthode d’évaluation des risques. Finalement, on y trace un portrait des TMS dans le secteur de l’agriculture et on y décrit des situations de travail propres au secteur de même que les risques de TMS que ces dernières comportent.

Source: http://www.csst.qc.ca/publications/300/Pages/DC_300_1002.aspx

Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality

Results from the Danish work environment cohort study
BACKGROUND: Prolonged sitting has been negatively associated with a range of non-communicably diseases. However, the role of occupational sitting is less clear, and little is known on the changes of occupational sitting in a working population over time. The present study aimed to determine 1) temporal changes in occupational sitting time between 1990 and 2010 in the Danish workforce; 2) the association and possible dose-response relationship between occupational sitting time and all-cause mortality. METHODS: This study analysed data from the Danish Work Environment Cohort Study (DWECS), which is a cohort study of the Danish working population conducted in five yearly intervals between 1990 and 2010. Occupational sitting time is self-reported in the DWECS. To determine the association with all-cause mortality, the DWECS was linked to the Danish Register of Causes of Death via the Central Person Register. RESULTS: Between 1990 and 2010 the proportion of the Danish workforce who sat for at least three quarters of their work time gradually increased from 33.1 to 39.1 %. All-cause mortality analyses were performed with 149,773 person-years of observation and an average follow-up of 12.61 years, during which 533 deaths were registered. None of the presented analyses found a statistically significant association between occupational sitting time and all-cause mortality. The hazard ratio for all-cause mortality was 0.97 (95 % CI: 0.79; 1.18) when >/=24 hr/wk occupational sitting time was compared to <24 hr/wk for the 1990-2005 waves. CONCLUSIONS: Occupational sitting time increased by 18 % in the Danish workforce, which seemed to be limited to people with high socio-economic status. If this increase is accompanied by increases in total sitting time, this development has serious public health implications, given the detrimental associations between total sitting time and mortality. The current study was inconclusive on the specific role that occupational sitting might play in the increased all-cause mortality risk associated with the total volume of sitting.

Source: van der Ploeg HP, Møller SV, Hannerz H, et al. International Journal of Behavioral Nutrition and Physical Activity, 2015; 12 (1): 71.

Occupational exposures and sick leave during pregnancy

Results from a Danish cohort study
Objective: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10–29 completed pregnancy weeks in a large cohort of Danish pregnant women.
Methods: Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996–2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome.
Results: We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HRrange 1.55–2.79), cumulative lifting HRtrend 1.29, 95% CI 1.26–1.31, shift work (HRevening 1.90, 95% CI 1.73–2.09, HRnight 1.52, 95% CI 1.15–2.01), monthly night shifts HRtrend 1.12, 95% CI 1.11–1.14, increasing weekly work hours HRtrend 0.93, 95% CI 0.91–0.95 and high job strain HR 1.52, 95% CI 1.42–1.63. Some exposures influenced HR in either a positive or negative time-dependent way.
Conclusion: Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

Source: Hansen ML, Thulstrup AM, Juhl M, Kristensen JK, Ramlau-Hansen CH. Scand J Work Environ Health, 2015. 

Portrait des pratiques de prévention primaire et secondaire en bureautique au Québec chez les intervenants et dans les milieux de travail

Dans la perspective de stimuler la prévention des troubles musculo-squelettiques (TMS) dans le domaine de la bureautique au Québec, et de préparer un guide de bonnes pratiques, une première étape nous est apparue incontournable : documenter les pratiques de praticiens et celles mises en œuvre dans les milieux de travail au Québec. Il s'agissait de décrire ce qui se fait au Québec, de déterminer les approches les plus prometteuses, de décrire les difficultés rencontrées et, inversement, les conditions de succès.

Source: http://www.irsst.qc.ca/-publication-irsst-pratiques-prevention-bureautique-intervenants-r-874.html

Is musculoskeletal pain a consequence or a cause of occupational stress?

A longitudinal study
Objectives: Longitudinal studies have linked stress at work with a higher incidence of musculoskeletal pain. We aimed to explore the extent to which musculoskeletal pain is a cause as opposed to a consequence of perceived occupational stress.
Methods: As part of the international cultural and psychosocial influences on disability study, we collected information from 305 Italian nurses, at baseline and again after 12 months, about pain during the past month in the low-back and neck/shoulder, and about effort–reward imbalance (ERI) (assessed by Siegrist's ERI questionnaire). Poisson regression was used to assess the RR of ERI >1 at follow-up according to the report of pain and of ERI >1 at baseline.
Results: Among nurses with ERI ≤1 at baseline, ERI >1 at follow-up was associated with baseline report of pain in the low-back (RR 2.7, 95 % CI 1.4–5.0) and neck/shoulder (RR 2.6, 95 % CI 1.3–5.1). However, there was no corresponding association with persistence of ERI in nurses who already had ERI >1 at baseline. Associations of ERI at baseline with pain at follow-up were weak.
Conclusion: Our results suggest that the well-documented association between job stress and musculoskeletal pain is not explained entirely by an effect of stress on reporting of pain. It appears also that workers who report musculoskeletal pain are more likely to develop subsequent perceptions of stress. This may be because pain renders people less tolerant of the psychological demands of work. Another possibility is that reports of pain and stress are both manifestations of a general tendency to be aware of and complain about symptoms and difficulties.

Source: Bonzini, Matteo, Bertu, Lorenza, Veronesi, Giovanni, Conti, Marco, Coggon, David, & Ferrario, Marco M. (2015). International Archives of Occupational and Environmental Health, 88(5), 607-612.

Height-adjustable workstations to reduce sedentary behaviour in office-based workers

Systematic review
Background: Time spent sitting in the workplace is an important contributor to overall sedentary risk. Installation of height-adjustable workstations has been proposed as a feasible approach for reducing occupational sitting time in office workers.
Aims: To provide an accurate overview of the controlled trials that have evaluated the effects of height-adjustable workstation interventions on workplace sitting time in office-based workers.
Methods: A comprehensive search was conducted up until March 2014 in the following databases: Medline, PsychINFO, CENTRAL, EMBASE and PEDro. To identify unpublished studies and grey literature, the reference lists of relevant official or scientific web pages were also checked. Studies assessing the effectiveness of height-adjustable workstations using a randomized or non-randomized controlled design were included.
Results: The initial search yielded a total of 8497 citations. After a thorough selection process, five studies were included with 172 participants. A formal quality assessment indicated that risk of bias was high in all studies and heterogeneity in interventions and outcomes prevented meta-analysis. Nevertheless, all studies reported that height-adjustable workstation interventions reduced occupational sitting time in office workers. There was insufficient evidence to determine effects on other relevant health outcomes (e.g. body composition, musculoskeletal symptoms, mental health).
Conclusions: There is insufficient evidence to make firm conclusions regarding the effects of installing height-adjustable workstations on sedentary behaviour and associated health outcomes in office workers. Larger and longer term controlled studies are needed, which include more representative populations.

Source: Tew, G.A., Posso, M.C., Arundel, C.E., & McDaid, C.M. (2015). Occupational Medicine.

A multi-faceted workplace intervention for low back pain in nurses' aides

A pragmatic stepped wedge cluster randomised controlled trial
The present study established the effectiveness of a workplace multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training for low back pain. Between November 2012 and May 2014, we conducted a pragmatic stepped-wedge cluster-randomized controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomized to four successive time periods, three months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training (12 sessions), cognitive behavioural training (2 sessions) and participatory ergonomics (5 sessions)). Low back pain was the outcome and was measured as days, intensity (worst pain on a 0-10 numeric rank scale) and bothersomeness (days) by monthly text messages. Linear mixed models were used to estimate the intervention effect. Analyses were performed according to intention to treat, including all eligible randomized participants and were adjusted for baseline values of the outcome. The linear mixed models yielded significant effects on low back pain days of -0.8 (95% confidence interval -1.19 to -0.38), low back pain intensity of -0.4 (95% confidence interval -0.60 to -0.26) and bothersomeness days of -0.5 (95% confidence interval -0.85 to -0.13) after the intervention compared to the control group. This study shows that a multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training can reduce low back pain among workers in eldercare. Thus, multi-faceted interventions may be relevant for improving low back pain in a working population.This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivatives 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially  

Source: Rasmussen CDN, Holtermann A, Bay H, et al. Pain, 2015.

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