Work-relatedness of lateral epicondylitis: Systematic review including meta-analysis and GRADE work-relatedness of lateral epicondylitis.

BACKGROUND: Lateral epicondylitis (LE) is a highly prevalent musculoskeletal disorder in workers, often associated with physically demanding work. Knowledge of work-relatedness of LE is crucial to develop appropriate preventive measures. This study investigates the prospective association between work-related physical risk factors and LE. METHODS: A systematic literature review was conducted in MedLine using PubMed from January 1, 2010 until February 16, 2021. Published reports were included if: (1) LE was clinically assessed, (2) exposure to work-related physical risk factors was assessed, and (3) associations between LE and work-related physical risk factors were reported in prospective studies. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS: In total, 318 workers with LE from a population of 5036 workers in five studies were included. Meta-analyses revealed high-quality evidence for associations between LE and a Strain Index (SI) score >5.1 (odds ratio [OR]: 1.75, 95% confidence interval (CI): 1.11-2.78) and moderate-quality evidence for forearm rotation >4 h/day or forearm rotation ≥45° for ≥45% time (OR: 1.85, 95% CI: 1.10-3.10). Gripping, flexion and extension of the wrist, and repetitive movements showed no significant associations with LE. CONCLUSION: High-quality evidence was found indicating that a higher SI increased the risk of LE. Moderate-quality evidence was found for an association between forearm rotation and LE. No associations were found between other physical risk factors and LE. Primary preventive interventions should focus on a reduction of the SI and of high forearm rotation in work.

The view and policy of management of occupational health services on the performance of workers' health surveillance: a qualitative exploration.

BACKGROUND: Although workers' health surveillance is an important preventive activity, it is not regularly performed. In addition to the occupational physician, the management of occupational health services can also be involved in the performance of workers' health surveillance. The present study investigated the view and policy of the managements of occupational health services on the performance of workers' health surveillance by occupational physicians. METHOD: Semi-structured face-to-face interviews about the mission, view, and policy of the occupational health services with respect to workers' health surveillance were conducted with eighteen randomly selected board members of occupational health services in the Netherlands. The results were transcribed verbatim and were analysed using MAXQDA software to form themes and categories. RESULTS: The first theme found was the view of the management of occupational health services. Categories found were mission statements of occupational health services and the attitude of the management of occupational health services towards workers' health surveillance. Three types of mission statements were mentioned by the board members: keeping workers at work, improving the health of workers, or helping the employer with sick-leave management. Both positive and negative attitudes towards workers' health surveillance appeared from the interviews. Some board members mentioned that workers' health surveillance can improve workers' health, and creates awareness about workers' health. Other board members mentioned that performing workers' health surveillance is eliciting problems, and that employers do not have a positive attitude towards workers' health surveillance. The second theme was the policy on performing workers' health surveillance. Categories found were the policy on performing workers' health surveillance towards companies, and the policy on performing workers' health surveillance towards professionals. Some occupational health services recommend workers' health surveillance to all companies. However, in general workers' health surveillance was only performed at request of companies, and no instructions or training programmes for occupational physicians were provided. CONCLUSION: Although some of the mentioned views on workers' health surveillance are positive, the policy of occupational health services on workers' health surveillance does, so far, in general, not stimulate occupational physicians or employers to perform or organize workers' health surveillance.

Supporting Occupational Physicians in the Implementation of Workers' Health Surveillance: Development of an Intervention Using the Behavior Change Wheel Framework.

Workers' health surveillance (WHS) is an important preventive activity aimed at prevention of work-related diseases. However, WHS is not regularly implemented in some EU-countries. As occupational physicians (OPs) have to play an important role in implementation of WHS, this study aimed to develop an intervention to support OPs in implementation of WHS. The behavior change wheel framework (BCW) was used to develop the intervention. First, the problem was defined, and target behavior was selected by using results from a survey study among OPs. Subsequently, change objectives in target behavior were specified. Finally, appropriate intervention functions, behavior change techniques, and modes of delivery were identified to develop the intervention. Target behaviors were (1) OPs initiate WHS, and (2) OPs conduct preventive consultations with workers. OPs' capabilities, and experienced opportunities were identified as change objectives. Intervention functions (education, training, enablement) and behavior change techniques (information about consequences, demonstration, instructions, behavioral practice, feedback on behavior, goal setting, action planning, reviewing goals) were selected to develop the intervention, delivered by face-to-face group training and e-learning. The proposed intervention consists of training and e-learning to support OPs in implementing WHS. Feasibility and effect of the intervention will be evaluated in future studies.

The Implementation of Workers' Health Surveillance by Occupational Physicians: A Survey Study.

OBJECTIVE: Workers' health surveillance (WHS) is an important preventive activity to prevent work-related diseases. This study aimed to get insight in the implementation of WHS by occupational physicians (OPs). METHODS: A survey was conducted among 128 OPs, in which the actual implementation of WHS, OP's needs, knowledge, skills and motivation of, and opportunities for the implementation of WHS were assessed. RESULTS: In total, 96 OPs had implemented WHS in the past 5 years. Almost all OPs were motivated, and indicated the need for further development of knowledge and skills. The OPs experienced insufficient opportunities to implement WHS, and mentioned employers are not positive towards WHS. CONCLUSION: Even though OPs are motivated to implement WHS, development of knowledge and skills, and support to implement WHS at employers is needed to increase implementation of WHS.