How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was 'patients having a medical emergency' with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

Psychophysiological stress reactions, trapezius muscle activity, and neck and shoulder pain among female cashiers before and after introduction of job rotation

The aim of this study was to evaluate the effects of the introduction of a job rotation model on supermarket cashiers, with respect to psychophysiological stress reactions, muscle activity of the trapezius muscle (which covers the upper back, the neck and the shoulder), and musculoskeletal symptoms in the neck and shoulders. Thirty-one female cashiers were investigated before and after job rotation was introduced. Before the reorganization the participants were only performing cash register work at the checkout counters. After the reorganization they shifted between cash register work and work in different departments in the supermarket. At follow-up the participants, all right-handed, had a significantly lower diastolic blood pressure, and surface electromyography (EMG) showed a significantly decreased muscle activity in the trapezius muscle on the left side. Musculoskeletal symptoms of the neck and shoulders were only partly changed, and there was no change in prevalence of musculoskeletal pain, which was around 70%. From questionnaires, but not from self-ratings during work, it was found that the introduction of job rotation had been experienced as positive in several regards, although the perceptions of stress and hurry were the same at follow-up.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

Abstract

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was ‘patients having a medical emergency’ with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

Psychophysiological stress reactions,trapezius muscle activity,and neck and shoulder pain among female cashiers before and after introduction of job rotation

The aim of this study was to evaluate the effects of the introduction of a job rotation model on supermarket cashiers, with respect to psychophysiological stress reactions, muscle activity of the trapezius muscle (which covers the upper back, the neck and the shoulder), and musculoskeletal symptoms in the neck and shoulders. Thirty-one female cashiers were investigated before and after job rotation was introduced. Before the reorganization the participants were only performing cash register work at the checkout counters. After the reorganization they shifted between cash register work and work in different departments in the supermarket. At follow-up the participants, all right-handed, had a significantly lower diastolic blood pressure, and surface electromyography (EMG) showed a significantly decreased muscle activity in the trapezius muscle on the left side. Musculoskeletal symptoms of the neck and shoulders were only partly changed, and there was no change in prevalence of musculoskeletal pain, which was around 70%. From questionnaires, but not from self-ratings during work, it was found that the introduction of job rotation had been experienced as positive in several regards, although the perceptions of stress and hurry were the same at follow-up.     

Work-related psychosocial,physical and individual factors associated with musculoskeletal symptoms in computer users

The aim of this study was to study associations between psychosocial, physical and individual factors, and musculoskeletal symptoms in the neck, shoulder and hand/wrist regions of computer users. Questionnaires were distributed to 5033 employees in 11 Danish companies; these employees all used computers for at least some of their work time. The response rate was 69% ( n = 3475). The analyses were based on employees working 32-41 h/week ( n = 2579). Symptomatic respondents reported symptoms for at least 8 days within the previous year. Multiple logistic regression analyses were used. Gender (female), age and duration of employment in the same job were associated with an increased prevalence of symptoms. High quantitative job demands and low possibilities for development at work were predictors of neck and hand/wrist symptoms. A high degree of repetitiveness and disturbing reflections on the computer screen were associated with symptoms in all three body regions. Repetitive movements were defined as the same finger, hand or arm movements performed many times per minute for at least 75% of their work time. Repetitiveness was the only factor that could partly explain associations between symptoms and duration of computer use, i.e. respondents who used the computer almost all the time at work reported more repetitive movements than those who used it less. Thus, long hours of computer use may be associated with musculoskeletal symptoms, due to physical factors such as repetitive movements, whereas psychosocial factors appeared to be associated with the symptoms independently of the duration of computer use.     

Work-related psychosocial, physical and individual factors associated with musculoskeletal symptoms in computer users

The aim of this study was to study associations between psychosocial, physical and individual factors, and musculoskeletal symptoms in the neck, shoulder and hand/wrist regions of computer users. Questionnaires were distributed to 5033 employees in 11 Danish companies; these employees all used computers for at least some of their work time. The response rate was 69% ( n = 3475). The analyses were based on employees working 32-41 h/week ( n = 2579). Symptomatic respondents reported symptoms for at least 8 days within the previous year. Multiple logistic regression analyses were used. Gender (female), age and duration of employment in the same job were associated with an increased prevalence of symptoms. High quantitative job demands and low possibilities for development at work were predictors of neck and hand/wrist symptoms. A high degree of repetitiveness and disturbing reflections on the computer screen were associated with symptoms in all three body regions. Repetitive movements were defined as the same finger, hand or arm movements performed many times per minute for at least 75% of their work time. Repetitiveness was the only factor that could partly explain associations between symptoms and duration of computer use, i.e. respondents who used the computer almost all the time at work reported more repetitive movements than those who used it less. Thus, long hours of computer use may be associated with musculoskeletal symptoms, due to physical factors such as repetitive movements, whereas psychosocial factors appeared to be associated with the symptoms independently of the duration of computer use.     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

Importance of active listening in treating workers with musculoskeletal disorders

Female assembly workers reporting constant neck and shoulder pain, despite ergonomically acceptable working conditions, were interviewed. As a starting point in the interviews, the patients were asked to describe their general situation at work. Their reports were fed back and discussed with company management in a wider group meeting and resulted in an improvement in their attitudes to those workers. A climate of confidence and well-being was created, which the women experienced as genuine. The workers' report of pains improved dramatically and absence due to musculoskeletal disorders was reduced by more than 90% during the following year.     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

Abstract

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

Importance of active listening in treating workers with musculoskeletal disorders

Abstract

Female assembly workers reporting constant neck and shoulder pain, despite ergonomically acceptable working conditions, were interviewed. As a starting point in the interviews, the patients were asked to describe their general situation at work. Their reports were fed back and discussed with company management in a wider group meeting and resulted in an improvement in their attitudes to those workers. A climate of confidence and well-being was created, which the women experienced as genuine. The workers' report of pains improved dramatically and absence due to musculoskeletal disorders was reduced by more than 90% during the following year.     

Control at work: a generalized resource factor for the prevention of musculoskeletal symptoms?

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.     

The validity of the occupational stress indicator

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.     

Women, men, VDU work and health: A questionnaire survey of British VDU operators

This paper presents the results of a questionnaire survey of male and female VDU operators distributed through Health & Safety at Work magazine. 3819 questionnaires were analysed using the SPSS computer program. 57% of the sample were female, 68% were under 35 years old and 73% were members of a trade union or staff association. The large number of male respondents meant that it was possible to compare work patterns, types of work and health effects for men and women. It appears that women are engaged in more repetitive and less varied tasks at the VDU and that they work longer hours and for longer periods without a break than men. The most frequently reported health problems were eyestrain, painful or stiff neck and shoulders, fatigue and irritated eyes. The incidence of symptoms was related to hours of work at the VDU. Women were more likely to report health effects than men. This difference remains when hours of work, type of work and hours worked without a break are taken into account. Ergonomically designed equipment such as adjustable chairs, lighting or keyboard did not have an obvious effect on the reporting of symptoms. It appeared that there is a complex interaction between the physical, ergonomic and psychosocial factors associated with new technology. All these factors need to be taken into account in further research into the health problems of VDU operators.     

Women,men, VDU work and health: A questionnaire survey of British VDU operators

Abstract

This paper presents the results of a questionnaire survey of male and female VDU operators distributed through Health & Safety at Work magazine. 3819 questionnaires were analysed using the SPSS computer program. 57% of the sample were female, 68% were under 35 years old and 73% were members of a trade union or staff association. The large number of male respondents meant that it was possible to compare work patterns, types of work and health effects for men and women. It appears that women are engaged in more repetitive and less varied tasks at the VDU and that they work longer hours and for longer periods without a break than men. The most frequently reported health problems were eyestrain, painful or stiff neck and shoulders, fatigue and irritated eyes. The incidence of symptoms was related to hours of work at the VDU. Women were more likely to report health effects than men. This difference remains when hours of work, type of work and hours worked without a break are taken into account. Ergonomically designed equipment such as adjustable chairs, lighting or keyboard did not have an obvious effect on the reporting of symptoms. It appeared that there is a complex interaction between the physical, ergonomic and psychosocial factors associated with new technology. All these factors need to be taken into account in further research into the health problems of VDU operators.     

Healthy lower backs in the construction industry in Sweden

This corss-sectional study exmaines the relationship between healthy lower and psychosocial and physical factors in a random sample of 1773 male construction workers. Infoamtion on lower back status, lifestyle habits, stress, psychosomatic and psychological symptoms, psychosocizal demands and resoruces and physical workload were collected by means of a postal questionnaire. Measures of psycholocial and physical factors were based on factor analysis of the data. The criterion variable 'healthy lower back' (HLB)—no lifetime history of low back pain—proved to be valid compared with an interview and a physical examination. A total of 216 workers (12%) reported HLB. The prevalance rate decreased significantly with increasing age. The prevalence rate of HLB was 6% among workers reporting high stress levels. It was postively influenced when there was a balance between demands and resoruces. A low level of physical workload also increased the prevalence rate of HLB. When age, lifestyle and physical factors were kept constant in a multivariate analysis high scores on the discretions index and low scores on eh psychosomatic, psychological and stress indices cosntributed significantly to an increase prevalence rate of HLB.     

The manager's role in employees' successful return to work following back injury

This study reports on the short-term effects of an educational programme for immediate supervisors on employees' back pain problems. The course was designed to help supervisors more efficiently deal with employees returning to work after being treated for back pain. Forty-seven supervisors who had personnel either undergoing treatment for back pain problems or were candidates for this treatment were invited to attend a one-day course. This educational package consisted of information about back pain and stressed specific behaviours which supervisors could use to help their employees successfully return to work. The results showed that 78% of the supervisors found the course to be satisfactory enough to recommend it to a colleague without hesitation. Furthermore, independent ratings made by the supervisors and their employees suggested that supervisors complied with the recommended programme. Returning employees, moreover, gave their supervisors significantly higher ratings of support than a control group whose supervisors had not attended the educational programme. It was concluded that an educational programme which alters specific supervisory behaviours may be an effective method of assisting employee return to work after treatment for back pain. Further research is needed to determine the long-term effects of such a programme on absenteeism due to illness.     

The manager's role in employees' successful return to work following back injury

Abstract

This study reports on the short-term effects of an educational programme for immediate supervisors on employees' back pain problems. The course was designed to help supervisors more efficiently deal with employees returning to work after being treated for back pain. Forty-seven supervisors who had personnel either undergoing treatment for back pain problems or were candidates for this treatment were invited to attend a one-day course. This educational package consisted of information about back pain and stressed specific behaviours which supervisors could use to help their employees successfully return to work. The results showed that 78% of the supervisors found the course to be satisfactory enough to recommend it to a colleague without hesitation. Furthermore, independent ratings made by the supervisors and their employees suggested that supervisors complied with the recommended programme. Returning employees, moreover, gave their supervisors significantly higher ratings of support than a control group whose supervisors had not attended the educational programme. It was concluded that an educational programme which alters specific supervisory behaviours may be an effective method of assisting employee return to work after treatment for back pain. Further research is needed to determine the long-term effects of such a programme on absenteeism due to illness.     

Are psychosocial factors associated with low-back pain among nursing personnel?

The aim of this study was to investigate whether psychosocial factors at work are related to low-back pain among nursing personnel. It was conducted as a short-term follow-up study of 200 Danish female nursing personnel, providing care for the elderly. Self-reported measures of psychosocial factors such as time pressure, emotional demands of clients, control and social support were obtained by questionnaire at baseline, while stress, physical exertion and low-back pain were reported by diary records made in two, three-day periods in the subsequent 6 months. The study examines the possible influence of psychosocial factors preceding low-back pain as well as stress and physical exertion reported simultaneously with low-back pain. Only stress was associated with low-back pain (Odds Ratio (OR)=2.3; Confidence Interval (CI)=1.3-3.9) while neither physical exertion or any of the psychosocial factors were related to low-back pain. A possible pathway connecting emotional demands of clients to low-back pain through the mediation of stress was suggested.