Value Stream Maps - Improving Procurement of Ergonomic Office Equipment

This article presents research that shows how value stream maps (VSMs) were used to document the procurement process for office equipment to establish better methods of helping users obtain equipment to reduce the risk of overuse injuries in their office jobs.
• The research consisted of two parts: 1) a survey to employees regarding office equipment; and 2) three focus groups with employees who were active in the procurement process. VSMs of the current process were created from the survey data and improved with focus group input.
• The benefits of using a VSM include obtaining user input, creating better documentation and offering recommendations to streamline the process.
• VSMs are recommended as a structured way for OSH professionals to obtain information about user needs and ways to improve processes to reduce workplace injuries.

Source: Hayden, M. A. et Schwerha, D. J. (2019). Professional Safety, 64(5), 53-58.

Sex Differences in Glenohumeral Muscle Activation and Coactivation During a Box Lifting Task

Manual material handling is associated with shoulder musculoskeletal disorders, especially for women. Sex differences in glenohumeral muscle activity may contribute to women's higher injury risk by affecting shoulder load and stability. We assessed the effects of sex (25 women vs 26 men) and lifting load (6 kg vs 12 kg) on muscle activation during box lifting from hip to eye level. Surface and intramuscular electromyography were recorded from 10 glenohumeral muscles. Most muscles were more activated for the heavier box and for women. These effects were larger for “prime movers” than for stabilisers and antagonists. Despite their apparently heterogeneous effects on muscle activity, sex and mass did not affect Muscle Focus, a metric of coactivation. This may be partly related to the limited sensitivity of the Muscle Focus. Nevertheless, sex differences in strength, more than in coactivation patterns, may contribute to the sex imbalance in the prevalence of musculoskeletal disorders.

Source: Bouffard, J., Martinez, R., Plamondon, A., Côté, J. N. et Begon, M. (2019). Ergonomics.

Comparative analysis of manual handling practices in kerbside collection of recyclable waste

Government targets for reducing waste going to landfill h ave led to an increase in the processing of domestic waste to reclaim recyclable materials. Manual sorting tasks can occur at the kerbside during waste collection and, if poorly designed, can introduce manual handling risks.
This report describes research to better understand the kerbside collection and sorting methods currently employed by the waste industry and to determine how manual handling risks can best be reduced or controlled. Six detailed case studies are presented showing a range of vehicles and processes in operation.
Manual handling risks were influenced by both vehicle and waste collection container design and some encouraged poor handling approaches. The Researchers make recommendations that the waste management industry capture the key features of best equipment design in a ‘design principles' document that would form an industry benchmark for designers and customers and that the industry continue to seek to design out manual handling risks before new waste collection vehicles enter widespread use.


Risk factors of hospitalization for carpal tunnel syndrome among the general working population

Objectives: Carpal tunnel syndrome (CTS) causes a considerable amount of sick leave and healthcare costs. The etiology of CTS is multifactorial, involving both personal and occupational risk factors. To date, few prospective cohort studies on occupational risk factors of CTS have examined the general working population.
Methods: The study population consisted of participants from the Northern Finland Birth Cohort of 1966 who attended the 31-year follow-up in 1997 and were working ≥3 days a week in a paid job (N=6326). Information
on socio-economic status, weight and height, smoking, exposure to occupational physical factors, and long-term illnesses was collected at baseline in 1997. Data on hospitalizations due to CTS came from the Care Register for Health Care, 1997–2016.
Results: Between 1997 and 2016, 3.4% of the participants had been hospitalized (attended secondary care) for CTS. After adjusting for confounders, women [hazard ratio (HR) 3.77, 95% confidence interval (CI) 2.70–5.25], overweight/obese participants (HR 1.69, 95% CI 1.29–2.22), smokers (HR 1.48, 95% CI 1.12–1.96), farmers and manual workers (HR 3.02, 95% CI 1.85–4.92 compared with upper clerical workers), lower clerical workers (HR 1.74, 95% CI=1.08–2.80), workers exposed to hand vibration (HR 2.29, 95% CI 1.48–3.54) and participants with physically demanding jobs (HR 1.71, CI 1.06–2.76) were at increased risk of hospitalization for CTS. Physically demanding work increased the risk of hospitalization for CTS for overweight/obese participants at baseline, but not for participants of normal weight.
Conclusions: Excess body mass and occupational physical factors increase the risk of hospitalization for CTS. Excess body mass potentiates the adverse effects of strenuous work on CTS.

Source: Hulkkonen, S., Shiri, R., Auvinen, J., Miettunen, J., Karppinen, J. et Ryhänen, J. (2019). Scandinavian journal of work, environment & health.

Comparative analysis of manual handling practices in kerbside collection of recyclable waste

Government targets for reducing waste going to landfill h ave led to an increase in the processing of domestic waste to reclaim recyclable materials. Manual sorting tasks can occur at the kerbside during waste collection and, if poorly designed, can introduce manual handling risks.
This report describes research to better understand the kerbside collection and sorting methods currently employed by the waste industry and to determine how manual handling risks can best be reduced or controlled. Six detailed case studies are presented showing a range of vehicles and processes in operation.
Manual handing risks were influenced by both vehicle and waste collection container design and some encouraged poor handling approaches. The Researchers make recommendations that the waste management industry capture the key features of best equipment design in a ‘design principles' document that would form an industry benchmark for designers and customers and that the industry continue to seek to design out manual handling risks before new waste collection vehicles enter widespread use.


Troubles musculosquelettiques et risques psychosociaux dans une population de conducteurs ambulanciers hospitaliers

Objectif: L'objectif de notre étude a été de déterminer la prévalence des TMS et des RPS au sein d'une population de conducteurs ambulanciers (CA) d'un centre hospitalier public et d'évaluer les liens entre eux.
Méthodologie: Nous avons étudié une population de 65 agents de la Fonction publique, à l'aide d'un hétéro-questionnaire tiré du guide des bonnes pratiques de l'INRS. Les caractéristiques générales des sujets, les plaintes liées aux TMS, le vécu au travail et les facteurs potentiels de RPS ont été étudiés.
Résultats: Au total 61 des 65 agents ont participé à l'étude. Plus des trois-quarts des agents présentent des symptômes de TMS, plus des deux tiers rapportent l'existence d'au moins un épisode douloureux par semaine et plus de 90 % au moins une fois par mois. Plus de la moitié des CA présente au moins une localisation douloureuse d'intensité « forte ». Les troubles les plus fréquemment rencontrés sont les lombalgies basses alléguées par près de trois-quarts des agents ; viennent ensuite les cervicalgies qui concernent un tiers des agents, puis les douleurs des épaules (20 %). Près de 80 % des CA disent devoir travailler vite « parfois ou souvent », et près des trois-quarts signalent être « souvent » soumis à des contraintes de délai. Environ 90 % estiment ne pouvoir moduler que « rarement » leur quantité de travail, et les deux tiers « jamais ». Moins de la moitié des agents peuvent compter ou même discuter facilement avec leur hiérarchie, alors qu'ils sont plus des trois-quarts à pouvoir le faire avec leurs collègues.
Conclusion: L'association entre sollicitations physiques et psychologiques suggère que l'apparition de troubles musculosquelettiques chez les chauffeurs-ambulanciers hospitaliers est fortement impactée par la présence de risques psychosociaux.

Source: Solitaire, C. et Martin, F. (2019). Archives des Maladies Professionnelles et de l'Environnement, 80(3), 191-198.

Quebec Serve and Protect Low Back Pain Study: What About Mental Quality of Life?

As of now, the impact of low back pain (LBP) and its chronic state, chronic low back pain (CLBP), on mental health-related quality of life (HRQOL) has never been investigated among police officers. The present investigation aims at studying this relationship using a biopsychosocial model.
Between May and October 2014, a Web-based cross-sectional study was conducted among Quebec police officers (Quebec, Canada). Mental HRQOL was measured using the role emotional (RE) and the mental health (MH) domains of the SF-12v2 Health Survey. The impact of CLBP on mental HRQOL (as opposed to acute/subacute LBP or no LBP) was studied with a multivariate linear regression model.
Of the 3,589 police officers who participated in the study, 1,013 (28.4%) reported CLBP. The mean age of respondents was 38.5 ± 8.7 years, and 32.0% were females. The RE (44.1/100) and MH (49.0/100) mean scores of the CLBP group were comparable with the scores found in populations suffering from cancer or heart diseases. Compared to officers without LBP, the presence of CLBP was significantly associated with lower RE (β: −0.068; p = 0.003) and MH (β: −0.062; p = 0.002) scores. These relationships were not found in the acute/subacute LBP group.
Our results underscore how frequent CLBP is among police officers and how burdensome it is. Considering the importance of good physical and mental health for this occupational population, police organizations should be aware of this issue and contribute to the efforts toward CLBP prevention and management in the workplace.

Source : Douma, N.B., Côté, C. et Lacasse, A. (2019). Safety and Health at Work, 10, (1), 39-46.

Caractéristiques socioprofessionnelles, reconnaissance en maladie professionnelle et devenir fonctionnel et professionnel de patients opérés d’un syndrome du canal carpien en Île-de-France (2009-2012)

Points clés

  •  Cette étude menée par Santé publique France en partenariat avec le Réseau Prévention Main Île-de-France (IdF), chez des patients opérés d'un syndrome du canal carpien (SCC), décrit les caractéristiques socio-professionnelles (CSP, déclaration en maladie professionnelle…) des patients et leurs liens avec la durée d'arrêt de travail.
  •  Parmi les patients en activité au cours des 10 ans précédant l'intervention, 59 % considéraient leur travail comme cause probable principale du SCC. Mais seuls 25 % des patients salariés avaient effectué une demande de reconnaissance en maladie professionnelle (MP).
  •  La durée médiane d'arrêt de travail chez les salariés en emploi était de 30 jours, variant de 21 jours pour les non-manuels à 40 jours pour les manuels lourds.
  •  La durée d'arrêt de travail était plus longue chez les patients ayant réalisé une déclaration en MP que chez les autres patients salariés (durée médiane de 44 jours contre 30 jours).
  •  Elle était plus longue également chez les patients soumis à un job strain, manipulant ou portant souvent au travail des charges de plus de 4 kg ou utilisant des outils vibrants en dehors du travail.
  •  Pour favoriser le retour au travail des patients opérés d'un SCC en IdF, la prévention devrait viser à réduire les expositions professionnelles telles que le port de charges ou les situations de job strain.
  •  L'augmentation de la durée d'arrêt de travail liée à la déclaration en MP justifie une attention particulière pour le retour au travail, avec une plus grande synergie entre les services de santé au travail, les soignants, l'assurance maladie et les employeurs.

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Acceptation des exosquelettes par les opérateurs : étude exploratoire

L'introduction des exosquelettes, comme toute nouvelle technologie, constitue un changement au niveau de l'organisation et de l'activité des opérateurs. C'est dans ce cadre qu'est abordée la question spécifique de l'acceptabilité et de l'acceptation de ces dispositifs par les opérateurs. Pour cela, un questionnaire a été élaboré et administré à des utilisateurs, anciens utilisateurs et nonutilisateurs d'exosquelettes.
En termes de santé et sécurité, les résultats préliminaires présentés permettent de recueillir des informations sur la qualité de l'interaction opérateur-exosquelette, d'identifier des points bloquants et/ou facilitateurs de l'usage de ces dispositifs et d'envisager certains facteurs de risques psychosociaux, physiques et accidentels chez les utilisateurs.


Acquisition et intégration d'un exosquelette en entreprise

Ce guide, destiné aux préventeurs, permet à l'entreprise d'appréhender les nombreuses questions posées par l'intégration d'un exosquelette. Il propose une démarche allant de la définition du besoin d'assistance physique jusqu'à son intégration en situation réelle de travail.
Structurée en trois phases, cette méthode vise à accompagner l'entreprise dans sa réflexion d'acquisition d'un exosquelette, à créer les conditions permettant son intégration dans la situation de travail et à évaluer les usages de l'exosquelette au cours du temps.

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Troubles musculo-squelettiques et facteurs psychosociaux au travail

Ce rapport présente l'état des connaissances scientifiques sur la façon dont les facteurs psychosociaux influencent les troubles musculo-squelettiques (TMS). Il analyse l'impact des TMS sur l'aptitude au travail et la qualité du travail. Près de 40 millions de travailleurs en Europe souffrent de TMS des membres et du dos, ce qui en fait la maladie professionnelle la plus répandue dans l'UE. L'objectif de ce rapport est d'influencer les efforts d'intervention et de fournir des recommandations scientifiquement fondées pour améliorer la santé des travailleurs européens

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Work-related Musculoskeletal Disorders, a tri-sector exploration

High rates of WRMSD-related sick leave put pressure on employers and businesses, hitting their bottom lines and potentially leading to understaffing, reduced productivity and lower staff morale. Directly affected workers not only suffer pain but also consequences that can be felt across their working, home and social lives.
The construction, healthcare and transportation and storage industries were selected as the focus of this research because they have significantly higher rates of WRMSDs compared with the average rate for all industry. Qualitative research was commissioned to:
- Explore what employers and workers knew about WRMSDs and regulation.
- Explore employers' attitudes and perceptions of WRMSDs, their approaches to prevention and management and what was limiting engagement with health and safety issues.
- Explore the journeys of workers and how they have managed health challenges in relation to WRMSDs.
- Uncover the needs of ‘both sides' to highlight barriers and opportunities regarding future intervention, communication and campaign strategies.
- Understand current workplace practice and inspire improvements in WRMSD prevention and management.


Mechanical and psychosocial work exposures: the construction and evaluation of a gender-specific job exposure matrix (JEM)

Objectives: The aim of this study was to (i) construct and evaluate a gender-specific job exposure matrix (JEM) for mechanical and psychosocial work exposures and (ii) test its predictive validity for low-back pain.
Methods: We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006 and 2009. We classified occupations on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). The mechanical and psychosocial exposure information was collected by personal telephone interviews and included exposures that were known risk factors for low-back pain. We evaluated the agreement between the individual- and JEM-based exposure estimates, with kappa, sensitivity and specificity measures. We assessed the JEM's predictive validity by testing the associations between low-back pain and the individual- and JEM-based exposure.
Results: The results showed an overall fair-to-moderate agreement between the constructed JEM and individual work exposures. The JEM performed considerably better for mechanical work exposures compared with psychosocial work exposures. The predictive validity of the mechanical and psychosocial JEM showed a consistently lower but predominantly reproducible association with low-back pain for both genders.
Conclusions: The mechanical estimates and psychosocial stressors, such as psychological demands, monotonous work and decision latitude in the constructed JEM, may be useful in large epidemiological register studies. The predictive validity of the matrix was evaluated as being overall acceptable and can be an effective and versatile approach to estimate the relationship work exposures and low-back pain.

Source: Hanvold, T. N., Sterud, T., Kristensen, P. et Mehlum, I. S. (2018). Scandinavian Journal of Work, Environment & Health.

Exosquelettes au travail : impact sur la santé et la sécurité des opérateurs état des connaissances

Ce guide, destiné aux préventeurs, fait un point sur les connaissances actuelles des exosquelettes afin de mettre en évidence les intérêts et les limites de leur usage en matière de prévention des troubles musculosquelettiques (TMS).
L'objectif est d'aider à mieux appréhender l'impact des exosquelettes pour accompagner efficacement l'entreprise dans sa démarche d'acquisition et d'intégration d'un exosquelette.


Musculoskeletal disorders of agricultural workers in the greenhouses of Almería (Southeast Spain)

In southeast Spain (Almería), we find the highest concentration of greenhouse crops in Europe, an agricultural sector that directly employs 55,000 people. The objective of this research was to evaluate the musculoskeletal working conditions of greenhouse workers through the standardized Nordic questionnaire. This questionnaire presents 28 multiple choice questions referring to different parts of the body. A total of 1002 questionnaires were completed, and information was collected on nine socio-demographic variables for each worker: sex, age, height, weight, surface area, cultivation, staking, greenhouse and nationality. Although the results show a high overall rate of symptoms of musculoskeletal disorders (MSDs), these findings do not mean that the workers are unable to perform agricultural tasks.

Source: López-Aragón, L., López-Liria, R., Callejón-Ferre, Á. J. et Pérez-Alonso, J. (2018). Safety Science, 109, 219-235.

Acute Effects of Interrupting Sitting on Discomfort and Alertness of Office Workers

Objective: The aim of this study was to compare the effect of 4 hours of sitting interrupted with hourly bouts of standing and/or pedaling versus uninterrupted sitting on alertness and discomfort among sedentary office workers.
Methods: Fifteen middle-aged sedentary workers were randomized to three 4-hour conditions: (1) uninterrupted sitting; (2) sitting interrupted with 10 minutes of standing/hour; and (3) sitting interrupted with 10 minutes of pedaling/hour. Self-reported measures of alertness and discomfort were collected.
Results: Uninterrupted sitting significantly increased discomfort (P < 0.001). Discomfort was lower in both the standing (P < 0.001) and pedaling (P < 0.001) conditions than the uninterrupted sitting condition. Short-lived improvements in alertness were observed immediately following several standing (50%) and pedaling (100%) interruptions.
Conclusion: Prolonged sitting increases discomfort while brief standing and pedaling interruptions attenuate impairments in discomfort among sedentary workers.

Source: Benzo, R. M., Kruse, N. T., Hughes, W. E., Casey, D. P. et Carr, L. J. (2018). Journal of occupational and environmental medicine, 60(9), 804-809.

Participatory organizational intervention for improved use of assistive devices in patient transfer

A single-blinded cluster randomized controlled trial
Objectives: This randomized controlled trial (RCT) evaluated the effect of a participatory organizational intervention for improved use of assistive devices (AD) in patient transfer.
Methods: We randomly allocated 27 departments from five hospitals in Denmark to a participatory intervention (14 clusters, 316 healthcare workers) or a control group (13 clusters, 309 healthcare workers). The intervention consisted of 2×2 hour workshops with managers, the hospital's health and safety staff, and 2–5 healthcare workers from each department. Based on an assessment of barriers and solutions conducted prior to randomization, participants developed an action plan for implementing department-specific solutions for improving the use of AD. Use of necessary AD (using digital counters as primary outcome), and general use of AD (using accelerometers as secondary outcome), pain intensity in the low-back, work-related back injuries during patient transfer, and communication and guidance in the use of AD were measured at baseline, 6 and 12 months.
Results: Use of necessary AD (primary outcome), low-back pain, and back injuries did not change in the intervention compared with control group at 12-month follow-up. However, general use of AD measured with accelerometers as well as communication and guidance improved significantly in the intervention versus control group.
Conclusion: The intervention did not result in more frequent use of the necessary AD but led to more general use of AD, as well as increased communication and guidance.

Source: Jakobsen, M. D., Aust, B., Kines, P., Madeleine, P. et Andersen, L. L. (2018). Scandinavian Journal of Work, Environment & Health.

Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers

Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders worldwide. Studies have shown that the percentage of office workers that suffer from MSDs ranges from 20 to 60 per cent. The direct and indirect costs of work-related upper limb MSDs have been reported to be high in Europe, Australia, and the United States. Although ergonomic interventions are likely to reduce the risk of office workers developing work-related upper limb and neck MSDs, the evidence is unclear. This is an update of a Cochrane Review which was last published in 2012.


Évaluation des processus : comprendre comment le contexte des entreprises influence le déroulement des premières étapes d’interventions ergonomiques

Bien qu'il soit généralement convenu que les ergonomes adaptent leur intervention au contexte de chaque entreprise, la façon précise dont ils y parviennent et sur quels critères cette adaptation se base sont peu renseignés au plan scientifique. Une évaluation des processus a été réalisée en adoptant un devis d'étude de cas multiple, en vue d'identifier les indicateurs de contexte ayant influencé quatre interventions du courant de l'ergonomie de l'activité, réalisées par des ergonomes en formation. L'évaluation a porté sur les étapes de l'intervention précédant l'implantation des changements, soit de l'analyse de la demande jusqu'au moment où le plan d'action est convenu avec les acteurs-clés. La collecte des données a été effectuée grâce à un journal de bord, des documents produits dans le cadre de l'intervention, ainsi que des entretiens avec les intervenants et les acteurs-clés impliqués dans l'intervention. Nos résultats présentés sous forme de modèles logiques font ressortir 12 indicateurs de contexte ayant représenté des leviers ou des obstacles au déroulement de l'intervention ou au plan d'action. Des combinaisons d'indicateurs ont eu un effet synergique positif ou négatif sur les cas. Le modèle d'évaluation proposé dans cette étude interdisciplinaire pourrait être repris lors d'études subséquentes pour bonifier la compréhension de l'influence du contexte dans d'autres situations d'interventions ergonomiques.

Source: Albert, V., Vézina, N., Bilodeau, H. et Coutarel, F. (2018). Activités, (15-2).

Intégration de la préparation physique dans l’approche ergonomique

Quel dispositif pour quel(s) objectif(s)?
L'article présente un cas d'intervention ergonomique proposant la préparation physiologique des ouvriers comme levier de prévention des Troubles Musculo-Squelettiques dans le secteur agroalimentaire. Dans une entreprise dont les activités présentent de fortes contraintes organisationnelles et physiologiques, la place des marges de manœuvre dans un tel dispositif est questionnée. La mise en œuvre d'échauffements au sein d'une entreprise nécessite d'une part de disposer de compétences tant ergonomiques que sur la préparation physiologique. D'autre part, l'intégration des échauffements, forme de préparation physiologique ici mise en œuvre, imposerait une construction sociale spécifique de l'intervention. Enfin, les conditions de réussite du projet tant du point de vue des intervenants que de l'entreprise devraient être posées au préalable afin de garantir le succès du dispositif global de prévention.

Source: Uguen, C., Sablon, S. et Carballeda, G. (2018). Activités, (15-2).

Intervention, conception et transformations : comment construire une prévention durable des TMS

Cet article a pour but de participer aux réflexions sur le rôle de l'ergonome dans l'intervention en entreprise. Il présente une intervention-formation relative à la prévention de la pénibilité et des TMS au travail. Cette intervention, menée comme une conduite de projet, s'est basée sur l'adoption de principes fondamentaux pour l'ergonomie dite centrée sur l'activité (Daniellou & Rabardel, 2005). Ces principes portent sur (1) la conception et la pérennisation des démarches de prévention durable, (2) la conduite et l'efficacité des interventions en ergonomie. Sur la base de ce corps de connaissances et de nos pratiques d'intervention antérieures, nous postulons que la mobilisation des acteurs et la transformation des représentations/perceptions sur le travail et la santé participent à l'augmentation du pouvoir d'agir des acteurs en matière de prévention. Ces principes sont illustrés et discutés à partir des résultats d'une intervention menée dans un abattoir de canards.

Source: Ciccone, E., Cuvelier, L., Decortis, F. et Bationo-Tillon, A. (2018). Activités, (15-2).

Recurrent back pain during working life and exit from paid employment

A 28-year follow-up of the Whitehall II Study
Objectives To examine the impact of recurrent, as compared with single, reports of back pain on exit from paid employment over decades of follow-up.
Methods The study sample was from the British Whitehall II Study cohort (n=8665, 69% men, aged 35–55 at baseline), who had provided information about their reports of back pain between 1985 and 1994. Data about exit from paid employment (health-related and non-health related exit, unemployment and other exit) were collected between 1995 and 2013. Repeated measures logistic regression models were fitted to examine the associations, and adjust for covariates.
Results Recurrent pain was reported by 18% of participants, while 26% reported pain on an occasion and 56% did not report pain. Report of back pain on an occasion was not associated with health-related job exit, whereas recurrent pain was associated with such an exit (OR 1.51; 95% CI 1.15 to 1.99), when compared with those who did not report pain. These associations were somewhat stronger among middle-grade and lower-grade employees, while these associations were not seen among higher-grade employees. Differences in associations by age and psychosocial working conditions were small.
Conclusions These results highlight the need for early detection of recurrent back pain to prevent exit out of paid employment for health reasons. As the risk varies by occupational grade, this emphasises the importance of identification of high-risk groups and finding ways to address their modifiable risk factors.

Source: Lallukka, T., Mänty, M., Cooper, C., Fleischmann, M., Kouvonen, A., Walker-Bone, K. E., ... et Halonen, J. I. (2018). Occupational & Environmental Medicine, 75(11), 786-791.

Démarche multidisciplinaire appliquée à l’analyse d’une activité dans un environnement dynamique

La conduite de véhicules légers à La Poste pour la distribution du courrier et des colis
Activité complexe différente de la conduite personnelle, la conduite professionnelle de véhicules légers prend une importance croissante dans le secteur de la livraison/messagerie confronté aux nouveaux modes de consommation. Peu étudiés, les risques pour la santé autres que les accidents de la route ont été approchés dans une étude exploratoire multidisciplinaire menée en collaboration avec le groupe La Poste. Son objectif a été d'explorer, en situation de travail, les différentes composantes de l'activité de distribution de courrier/colis, et particulièrement l'activité de conduite comme partie structurante de l'activité de distribution. La démarche méthodologique alliant des analyses ergonomiques et une approche médicale a mis en évidence des contraintes ainsi que des plaintes en relation principalement avec les caractéristiques des tournées de distribution. Ces résultats ont permis d'orienter la construction d'une étude épidémiologique visant à analyser les facteurs de risque spécifiques à la conduite de véhicules légers dans les activités de distribution.

Source: Hella, F., Radauceanu, A., Atain-Kouadio, J. J., Payet, R. et Colin, R. (2018). Perspectives interdisciplinaires sur le travail et la santé, (20-2).

Bi-directional relation between effort-reward imbalance and risk of neck-shoulder pain

Assessment of mediation through depressive symptoms using occupational longitudinal data
Objectives: Bi-directional associations between perceived effort?reward imbalance (ERI) at work and neckshoulder pain have been reported. There is also evidence of associations between ERI and depressive symptoms, and between depressive symptoms and pain while the links between ERI, depressive symptoms and pain have not been tested. We aimed to assess whether depressive symptoms mediate the association between ERI and neck-shoulder pain, as well as the association between neck-shoulder pain and ERI.
Methods: We used prospective data from three consecutive surveys of the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. ERI was assessed with a short version of the ERI questionnaire, and pain was defined as having had neck-shoulder pain that affected daily life during the past three months. Depressive symptoms were assessed with a continuous scale based on six-items of the (Hopkins) Symptom Checklist. Counterfactual mediation analyses were applied using exposure measures from 2010/2012 (T1), depressive symptoms from 2012/2014 (T2), and outcomes from 2014/2016 (T3), and including only those free of outcome at T1 and T2 (N=2876?3239).
Results: ERI was associated with a higher risk of neck-shoulder pain [risk ratio (RR) for total effect 1.24, 95% confidence interval (CI) 1.02–1.50] and 40% of this total effect was mediated through depressive symptoms.
Corresponding RR for association between neck-shoulder pain and ERI was 1.36 (95% CI 1.13–1.65), but the mediating role of depressive symptoms was less consistent.
Conclusions: Depressive symptoms appear to be an intermediate factor in the relationship between ERI and neck-shoulder pain.

Source: Halonen, J. I., Lallukka, T., Virtanen, M., Rod, N. H. et Hanson, L. L. M. (2018). Scandinavian Journal of Work, Environment & Health.

Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence

Background: Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA.
Methods: A sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results.
Results: The severity of depressive symptoms was correlated with the number of pain locations reported (Spearman's rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms.
Conclusions: The risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation.

Source: Melkevik, O., Clausen, T., Pedersen, J., Garde, A. H., Holtermann, A. et Rugulies, R. (2018). BMC public health, 18(1).

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