2016-08-01 12:00 - Messages

Predicting chronic low-back pain based on pain trajectories in patients in an occupational setting

An exploratory analysis
We applied latent class growth analysis was applied in low-back pain patients in an occupational setting to determine different pain trajectories, something that has never been done before. The pain trajectories were used as outcome to evaluate a previously developed prognostic model for the development of chronic low back pain. The prediction model shows (after internal validation) a good predictive performance (AUC: 0.75).

Source: Panken G, Hoekstra T, Verhagen A, van Tulder M, Twisk J, Heymans MW. Scand J Work Environ Health, 2016.

The Impact of a Rigorous Multiple Work Shift Schedule and Day Versus Night Shift Work on Reaction Time and Balance Performance in Female Nurses

A Repeated Measures Study
Objective: The aim of this study was to determine the impact of a demanding work schedule involving long, cumulative work shifts on response time and balance-related performance outcomes and to evaluate the prevalence of musculoskeletal disorders between day and night shift working nurses.
Methods: A questionnaire was used to identify the prevalence of past (12-month) and current (7-day) musculoskeletal disorders. Nurses worked three 12-hour work shifts in a 4-day period. Reaction time and balance tests were conducted before and after the work period.
Results: The work period induced impairments for reaction time, errors on reaction time tasks, and balance performance, independent of shift type. Musculoskeletal symptom prevalence was high in workers of both work shifts.
Conclusions: Compressed work shifts caused performance-based fatigue in nurses. Reaction time and balance tests may be sensitive fatigue identification markers in nurses.

Source: Thompson, Brennan J.; Stock, Matt S.; Banuelas, Victoria K.; Akalonu, Chibuzo C. Journal of Occupational & Environmental Medicine: July 2016, Volume 58, Issue 7, p. 737-743.

Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders

Longitudinal data from the Norwegian HUNT Study
Objectives: To prospectively investigate if the risk of chronic neck/shoulder pain is associated with work stress and job control, and to assess if physical exercise modifies these associations. Material and Methods: The study population comprised 29 496 vocationally active women and men in the Norwegian Nord-Trøndelag Health Study (HUNT Study) without chronic pain at baseline in 1984–1986. Chronic neck/shoulder pain was assessed during a follow-up in 1995–1997. A generalized linear model (Poisson regression) was used to calculate adjusted relative risks (RRs). Results: Work stress was dosedependently associated with the risk of neck/shoulder pain (ptrend < 0.001 in both sexes). The women and men who perceived their work as stressful “almost all the time” had multi-adjusted RRs = 1.27 (95% confidence interval (CI): 1.1–1.47) and 1.71 (95% CI: 1.46–2), respectively, referencing those with no stressful work. Work stress interacted with sex (p < 0.001). Poor job control was not associated with the risk of neck/shoulder pain among the women (RR = 1.04, 95% CI: 0.92–1.19) nor the men (RR = 1.09, 95% CI: 0.95–1.26). Combined analyses showed an inverse dose-dependent association between hours of physical exercise/week and the risk of neck/shoulder pain in the men with no stressful work (ptrend = 0.05) and among the men who perceived their work as “rarely stressful” (ptrend < 0.02). This effect was not statistically significant among the women or among men with more frequent exposure to work stress. Conclusions: Work stress is an independent predictor of chronic neck/shoulder pain and the effect is stronger in men than in women. Physical exercise does not substantially reduce the risk among the persons with frequent exposure to work stress.

Source: Fanavoll R, Nilsen TI, Holtermann A, et al. International Journal of Occupational Medicine and Environmental Health. 2016; 29 (4): 585-95.

Impact of Work Organizational Factors on Carpal Tunnel Syndrome and Epicondylitis

Objective: The aim of this study was to identify relationships between work organizational variables (job rotation, overtime work, having a second job, and work pacing) (These work organizational variables and their relationships with biomechanical and psychosocial exposures were studied previously and published in a separate paper.) and health outcome measures [carpal tunnel syndrome (CTS), lateral and medial epicondylitis (LEPI/MEPI)].
Methods: Using a pooled baseline cohort of 1834 subjects, the relationships were studied using logistic regression models.
Results: Varied degrees of associations between the work organizational and outcomes variables were found. Job rotation was significantly associated with being a CTS case [odds ratio (OR)=1.23, 95% confidence interval (95% CI): 1.00 to 1.50]. Overtime work was significantly associated with lower LEPI prevalence (OR=0.48, 95% CI: 0.28 to 0.84). No statistically significant associations were found between having a second job and different work pacing and any of the three health outcome measures.
Conclusions: Work organizational variables were only partially associated with the studied health outcomes.

Source: Bao, Stephen S.; Kapellusch, Jay M.; Merryweather, Andrew S.; Thiese, Matthew S.; Garg, Arun; Hegmann, Kurt T. Silverstein, Barbara A.; Marcum, Jennifer L; Tang, Ruoliang. Journal of Occupational & Environmental Medicine: August 2016, Volume 58, Issue 8, p. 760-764.

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