Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce.

BACKGROUND: The present study aimed to investigate the possible association between specific ergonomic and individual risk factors and musculoskeletal pain (MSP) in the back, shoulder, hip and knee region in workers aged 50-65y. METHODS: The study was a population based cross-sectional survey. The study population comprised citizens born between 1952-1966, living in Esbjerg municipality, Denmark, ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A multivariate logistic regression was used for each of the following dependent variables; musculoskeletal pain for the past 3 months in the back, shoulder, hip and knee, where independent variables included ergonomic exposure, age, sex, body mass index (BMI) and leisure time physical activity (LTPA). RESULTS: The overall response rate was 58% and the data of individuals at work (n = 9,263) demonstrated several ergonomic exposures with increased odds for pain in specific regions. Exposure to back twisted or bend, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the back, whereas exposure to back twisted or bend, arms above shoulder and repeated arm movement were associated with pain in the shoulder. Exposure to back twisted or bend, repeated arm movement, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the hip. Important individual risk factors were also identified. Increasing age was significantly associated with increased pain in the hip but associated with less risk for pain in the back and shoulder. Males had higher odds for pain in the back and knee compared to females but lower odds for pain in the hip. BMI was particularly important for knee pain. The level of LTPA did not have an important association with MSP in any region. CONCLUSION: There is a significant positive association between ergonomic exposures and musculoskeletal pain, which were specific for the back, shoulder, hip and knee. In addition, the data demonstrated a differential association with age, sex and BMI. This needs to be considered for the treatment and classification of musculoskeletal pain and for future preventive initiatives.

Returning to Work Within Two Years After First-Time, Single-Level, Simple Lumbar Discectomy: A Multifactorial, Predictive Model.

Purpose Continued inability to work has societal and individual consequences. Thus, the factors associated with sustained return to work after lumbar discectomy should be identified. Prior studies of the biopsychosocial factors associated with sustained RTW were primarily based on patient-reported outcome data and have shown conflicting results because of small study samples. In patients undergoing first-time, single-level, simple lumbar discectomy, we describe the time to sustained return to work within 2 years after surgery using outcome data from a national database and identify the pre- and peri-operative factors associated with sustained return to work within 2 years by developing and validating a predictive multivariable model. Methods The time to a sustained return to work within the study period was described using a Kaplan-Meier plot. A temporal validated Cox proportional hazards model examined associations between biopsychosocial factors and return to work. Results In the derivation cohort made up by 351 operated patients who were on sick-leave for more than 3 weeks around the time of surgery, 62% returned to work (median 15 weeks). The probability of sustained return to work was associated with a high education level, positive expectations towards future labor market attachment, pre-operative stable labor market attachment, pre-operative higher physical quality of life, and less disability. Conclusions Through the development and validation of a predictive model, this study identifies a number of patient-related factors associated with sustained return to work after lumbar discectomy, while revealing that most disease-related clinical findings were not associated with the outcome.

A cross-sectional study of the upper limb non-neurogenic physical findings in computer operators and their relation to pain and neurological findings.

OBJECTIVES: The character of upper limb disorders in computer operators is subject to debate. While nerve involvement is suggested by the presence of pain, paresthesia and subjective weakness, these symptoms are mainly interpreted as related to pathologies outside the nervous system. Findings in a previous study involving computer operators indicated peripheral nerve afflictions with specific locations in symptomatic subjects. Based on the same sample, this study addresses the relation of non-neurogenic findings to pain and neurological findings. MATERIAL AND METHODS: Overall, 96 computer operators scored their perceived pain in the neck, shoulder, elbow, and wrist/hand on a Visual Analogue Scale of 0-9. They underwent 2 sets of blinded physical examinations of selected non-neurogenic and neurological items, respectively. The authors analyzed correlations between the scores of each non-neuropathic finding, and a) mean pain scores for each and all regions, and b) scores for neurological patterns reflecting brachial plexopathy, median neuropathy (the elbow), and posterior interosseous neuropathy, respectively, and their combination. Kendall's rank correlation test was applied for all statistical analyses. RESULTS: A median pain level of 1 or 0.5 was reported by 80 and 57 participants on the mouse-operating or contralateral side, respectively. Non-neurogenic and neurological findings were frequent. The mean overall pain correlated with palpation soreness of the neck insertions, and of the trapezius and supraspinatus muscles. Neck and elbow pain correlated with palpation soreness at the neck insertions and the lateral epicondyles, respectively. Significant correlations on the mouse-operating side were identified between posterior interosseous neuropathy and lateral epicondyle soreness, and between median neuropathy and any neurological pattern, and trapezius and lateral epicondyle soreness. CONCLUSIONS: Pain correlated with palpation soreness, which again correlated with the neurological patterns. Palpation soreness may be less significant as a marker of a painful disorder as it correlated no better with regional than with overall pain. The physical examination of computer operators should include a sufficient neurological assessment. Int J Occup Med Environ Health. 2021;34(5):679-91.

Workability in the Ageing Workforce-A Population-Based Cross-Sectional Study.

BACKGROUND: The purpose of this study was to investigate the impact of age, musculoskeletal pain and ergonomic exposure on workability in the oldest group of workers. METHODS: The study was a population based cross-sectional survey. The study population comprised citizens born between 1952-1966, living in Esbjerg municipality ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A stereotype logistic regression was used with the primary dependent variable being workability and independent variables included age, musculoskeletal pain, and ergonomic exposure. RESULTS: The response rate was 58% and the data demonstrated a significant negative association between age and workability. With excellent workability as a reference, the odds for poor workability increased by 97% being 60+ y compared to 50-55 y. Both moderate intensity and severe musculoskeletal pain in the back, shoulder and knee/hip all showed significantly higher odds for poor workability. Ergonomic exposures, such as standing/walking, working with back bent or twisted and carrying or lifting had a significant negative impact on workability. CONCLUSION: Age, musculoskeletal pain and ergonomic exposures showed a significant negative impact on workability in the oldest group of workers and should be targeted with preventive initiatives.

Effect of bariatric surgery on employment status-a 7 years controlled nationwide registry study.

BACKGROUND: Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigated the effect of bariatric surgery on employment status in the Danish population. METHODS: In this nationwide study, we identified 5450 subjects who underwent bariatric surgery and 10 900 control subjects matched for age, sex and municipality. From accessible registries, we extracted data regarding employment, absenteeism, sick leave and pension. Using a multistate model, we compared time in occupational states and transitions between these states to determine the effect of bariatric surgery on employment status. FINDINGS: Before surgery, cases had an absolute risk increase (95% CI)(ARI (CI)) and a relative risk (RR (CI)) of being in full-time employment of -0.12 (-0.14 to -0.10) and 0.84 (0.82 to 0.86) and were more often unemployed or in a subsidised job than the background population. Taking into account the employment status before surgery, the bariatric surgery group increased their probability of being in full-time employment 1-3 years after bariatric surgery. However, this positive effect was not present with a longer duration of follow-up. Being male, above 50 years of age, or employed as a craftsman or office worker were associated with a sustained positive effect of being in full-time employment (ARI (CI) and RR (CI) 0.05 (0.04 to 0.05) and 1.05 (1.04 to 1.06), 0.06 (0.06 to 0.07) and 1.08 (1.07 to 1.09) and 0.05 (0.05 to 0.06) and 1.05 (1.05 to 1.06), respectively). INTERPRETATION: Compared with a matched control group, those undergoing bariatric surgery did not improve their employment status in the long term. Certain subgroups had a more sustained positive effect.

[Sickness absence may impair self-efficacy]. / Sygefravær kan svække troen på egen formåen.

Self-efficacy (SE) questionnaire data from the DWECS study in 2000 and 2005, age, sex, and transfer of sickness absence compensation data from the DREAM register. Men: sickness absence for more than 12 weeks and one and three absence spells are associated with decline in SE; women: decline in SE is associated with sickness absence for more than 52 weeks and two sickness absence spells. For both sexes SE declines at age 40-50 years. SE declines with length of sickness and sickness absence spells.