Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study.

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.

Relación entre el dolor lumbar y los movimientos realizados en postura sedente prolongada: Revisión de la literatura / The relationship between low back pain and movements in prolonged sitting posture: Literature review

La evidencia científica muestra que existe asociación entre dolor lumbar y postura sedente prolongada y que una de las poblaciones más propensa a esta enfermedad es la de conductores, con una alta prevalencia. De igual manera, los movimientos posturales en la silla son la respuesta natural del cuerpo debida a la incomodidad percibida por el dolor lumbar, pero esta difiere en función de la historia previa. Con base en esto se realizó una revisión de los estudios relacionados con el dolor lumbar y el movimiento en postura sedente prolongada, incluyendo la población de conductores, con el fin de comprender esta relación. Se recuperaron 6226 artículos, de los cuales 16 fueron publicados entre 1970 y 2010; estos proporcionaron la información necesaria para contestar la pregunta de revisión. Se pudo constatar que ninguno de los estudios fueron realizados en actividades de conducir y la mayoría involucró sujetos voluntarios sin considerar si la población era trabajadora. El movimiento con dolor lumbar en postura sedente prolongada solo se pudo explicar desde el rango de movimiento lumbar, debido a que solo se encontró un artículo con estas características. También se encontró que los sintomáticos se mueven más, pero que el dolor lumbar no disminuye en función del tiempo, es decir que conocemos muy poco acerca de la paradoja movimiento y dolor en postura sedente prolongada.

Scientific evidence shows an association between low back pain and prolonged sitting posture, also one of the most sensitive populations to this disorder are the drivers with a high prevalence. Postural movements in the chair are body's natural response to perceived discomfort caused by back pain but this is different depending on each individual's background of back pain. Based on this, we perform a review of studies related to low back pain and movement in prolonged sitting posture, including the driver population, in order to understand this relationship. We retrieved 6226 articles, of which 16 matched the established criteria and provided the information necessary to answer the review question. We found that none of the studies considered were conducted in driving activities and most of them were done with volunteer subjects regardless if they were workers or not. The movement with low back pain in prolonged sitting posture could only be explained from the range of lumbar motion because only one article matched these characteristics, finding that symptomatic people move more but low back pain does not decrease as a function of time, proving that we know very little about the paradoxical between movement and pain in prolonged sitting posture.

Ergonomía en floricultura en Colombia: resultados y lecciones / Ergonomics in Colombian Floriculture: Results and Lessons / Ergonomía em Floricultura na Colômbia: Resultados e lições

Introducción: el sector floricultor ha sido afectado por años por la alta ocurrencia de enfermedades músculo-esqueléticas entre sus trabajadores. Diversos esfuerzos han sido puestos en marcha para comprender la magnitud del problema, sus causas y sus posibles soluciones. Este manuscrito expone desde la perspectiva académica las lecciones y logros del modelo de actuación industria-academia para mejorar las condiciones ergonómicas de la población trabajadora de este importante sector industrial. Materiales y métodos: se hizo una recopilación de actas, comunicaciones, reportes y publicaciones científicas de los trabajos llevados a cabo desde el año 2007 con la participación del Centro de Estudios de Ergonomía del Departamento de Ingeniería Industrial de la Pontificia Universidad Javeriana. Un análisis retrospectivo de esta información buscó responder a preguntas sobre el origen de los trabajos, objetivos perseguidos, resultados alcanzados, beneficios obtenidos y lecciones aprendidas. Resultados: el modelo de trabajo fue participativo. El motor iniciador de los trabajos son las empresas productoras de flores que hacen explícitas sus necesidades a las aseguradoras del trabajo. El diseño global del estudio no fue encargado a la academia, sino construido con la academia; y, posteriormente, refinado con la agremiación de productores. Aunque el objetivo global del trabajo es la prevención de enfermedades, este se lleva a cabo a partir de proyectos que en la medida en que fue pasando el tiempo fueron asegurando fondos para la consecución de objetivos específicos relacionados con: la evaluación de las condiciones ergonómicas del trabajo, la caracterización de la población trabajadora y el desarrollo, implementación y prueba de soluciones. Conclusiones: el modelo de colaboración industria-academia presentada evidencia importantes resultados tanto de mejoras a las condiciones laborales como académicos. Aunque es necesario validar la visión de la industria sobre este tipo de modelos de trabajo colaborativo, se considera que este caso fue exitoso y, por lo tanto, debería ser replicado en otras industrias.

Introduction: The flower industry has been affected for years by the high occurrence of musculoskeletal disorders among workers. Various efforts have been done to understand the magnitude of the problem, its causes and possible solutions. This manuscript presents from the academic perspective the lessons and achievements of an industry-academics model of action to improve the ergonomic conditions of the working population of this important industry. Materials and methods: a review of minutes, communications, reports and scientific publications related to the ergonomics work done since year 2007 with the participation of the Center for Ergonomics Studies (CEE) of the Department of Industrial Engineering at Pontificia Universidad Javeriana was conducted. A retrospective analysis of the information sought to answer questions about the origin of the work, objectives, results, lessons learned and benefits gained. Results: The working model was participatory. Flower producers were the starters of the work. They made explicit their needs to workers' insurance companies. The overall study design was not just given but built with academics, and subsequently reined with the association of producers. Although the overall objective of the work was the prevention of musculoskeletal disease among workers, the work was carried out in time as funds were secured through studies with specific objectives related to: Workplace ergonomics evaluations, characterization of the working population, and the development, implementation and testing of solutions. Conclusions: The presented industry-academics collaboration model resulted in important improvements to working conditions and academic results. Although it is necessary to validate the view of the industry regarding this type of collaborative models, it is considered that this case was successful and therefore should be replicated in other industries.

Introdução: o setor floricultor tem sido afetado por anos por a alta ocorrência de doenças musculoesqueléticas entre seus trabalhadores. Diversos esforços têm sido postos em funcionamento para compreender a magnitude do problema, suas causas e suas possíveis soluções. Este manuscrito expõe desde a perspectiva acadêmica as lições e resultados do modelo de atuação indústria-academia para melhorar as condições ergonômicas da população trabalhadora deste importante setor industrial. Materiais e métodos: Se fez uma recopilação de atas, comunicações, reportes e publicações cientíicas dos trabalhos levados a cabo desde o ano 2007 com a participação do Centro de Estudos de Ergonomia do Departamento de Engenharia Industrial da Pontiicia Universidad Javeriana. Uma análise retrospectiva desta informação buscou responder a perguntas sobre a origem dos trabalhos, objetivos perseguidos, resultados alcançados, benefícios obtidos e lições aprendidas. Resultados: o modelo de trabalho foi participativo. O motor iniciador dos trabalhos são as empresas produtoras de flores que fazem explícitas suas necessidades às seguradoras do trabalho. A criação global do estudo não foi encarregada à academia, senão construído com a academia; e posteriormente refinado com a agremiação de produtores. Ainda que o objetivo global do trabalho é a prevenção de doenças, o trabalho se leva a cabo a partir de projetos, que na medida que foi passando o tempo, foram segurando fundos para a consecução de objetivos especíicos relacionados com: a avaliação das condições ergonômicas do trabalho, a caracterização da população trabalhadora e o desenvolvimento, implementação e prova de soluções. Conclusãos: o modelo de colaboração indústria-academia apresentada evidencia importantes resultados tanto de melhoras às condições laborais quanto acadêmicas. Ainda que é necessário validar a visão da indústria sobre este tipo de modelos de trabalho colaborativo, considera-se que este caso foi de sucesso e portanto deveria ser replicado em outras indústrias.

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs). METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world. FUNDING: Bill & Melinda Gates Foundation.