Risk factors for computer visual syndrome (CVS) among operators of two call centers in São Paulo, Brazil

The aims of this study were to investigate work conditions, to estimate the prevalence and to describe risk factors associated with Computer Vision Syndrome among two call centers' operators in S?o Paulo (n = 476). The methods include a quantitative cross-sectional observational study and an ergonomic work analysis, using work observation, interviews and questionnaires. The case definition was the presence of one or more specific ocular symptoms answered as always, often or sometimes. The multiple logistic regression model, were created using the stepwise forward likelihood method and remained the variables with levels below 5% (p < 0.05). The operators were mainly female and young (from 15 to 24 years old). The call center was opened 24 hours and the operators weekly hours were 36 hours with break time from 21 to 35 minutes per day. The symptoms reported were eye fatigue (73.9%), "weight" in the eyes (68.2%), "burning" eyes (54.6%), tearing (43.9%) and weakening of vision (43.5%). The prevalence of Computer Vision Syndrome was 54.6%. Associations verified were: being female (OR 2.6, 95% CI 1.6 to 4.1), lack of recognition at work (OR 1.4, 95% CI 1.1 to 1.8), organization of work in call center (OR 1.4, 95% CI 1.1 to 1.7) and high demand at work (OR 1.1, 95% CI 1.0 to 1.3). The organization and psychosocial factors at work should be included in prevention programs of visual syndrome among call centers' operators.     

Musculoskeletal symptoms and work ability among agricultural machinery operators

Those subjects whose employment has physical demands present more frequently musculoskeletal symptoms than others. The agricultural sector activities include tasks with important physical demands that may have a negative impact in the workers health. The aim of this study was to evaluate the presence of musculoskeletal symptoms and its association with work ability in agricultural machinery operators. It is a cross-sectional study. The participants (n = 204) answered a self-administered questionnaire on demographics, work and lifestyle characteristics, Work Ability Index and the Nordic Musculoskeletal Symptoms Questionnaire. The response rate was 89.78%. The mean age of the workers was 32.3 years, and 47.1% of them reported musculoskeletal symptoms at least one body part over the past 12 months. Those subjects who presented work ability index <37 points, 87.5% reported some kind of musculoskeletal symptom. This study showed that the work ability was significantly (p ≤ 0.05) correlated to musculoskeletal symptoms presence. It is recommended that measures to promote and improve the work ability are designed and deployed based on musculoskeletal disorders prevention.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

Psychosocial indicators among aircraft maintenance workers with and without neck and shoulder musculoskeletal symptoms

In the aircraft maintenance industry, most of workers performs manual handling tasks of different materials, varying from small objects up to large pieces of the aircraft. It can increase the occurrence of work-related musculoskeletal disorders (WMSDs), which are strongly associated with high physical demands required by the task. Moreover, psychosocial demands are considered as risk factors for musculoskeletal disorders in both the upper limbs and lumbar spine. Thus, the objective of this study was to assess psychosocial indicators among aircraft maintenance workers according to the presence of neck and shoulder musculoskeletal symptoms. Eighty workers of an aircraft maintenance company were evaluated (32.69 ± 8.25 years, 79.8 ± 13.4 kg, 175 ± 7 cm). According to physical examination, 50 workers were classified as asymptomatic (AS - 4.1 ± 3.17 positive signs) whilst 30 workers were classified as symptomatic (SS - 26.72 ± 11.44 positive signs). AS and SS have shown similar profile of demand (p = 0.62), control (p = 0.66) and social support (p = 0.74) according to the Job Content Questionnaire. However, the groups are different when considering work engagement variables. In general, SS have higher scores than AS (p < 0.05).     

VDU workstations and vision in post office and bank operators

A cross-sectional study was carried out on a sample of 26 VDU operators in a post office and a bank, working regularly on video display units. The study aimed at (1) determining the physical working conditions, particularly lighting conditions, (2) assessing employees' complaints, (3) measuring visual defects among operators in VDU workstations. The following results are revealed: (a) ergonomic shortcomings in workplace and work station design were clearly noticed (b) noise level was between 60 db and 78 db, (c) illumination parameters did not much the task and caused ocular symptoms and visual fatigue, (d) visual tests revealed vision defects in 84.6% of the cases, (e) visual fatigue was noticed at the end of the working day. The abnormal frequency of operators' complaints can be explained by the association of visual defects and inadequate working conditions.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Physical and psychosocial indicators among office workers from public sector with and without musculoskeletal symptoms

Work-related musculoskeletal disorders (WRMD) are the result of the combination of different risk factors. They are very common among computer workers, mainly when neck and upper limbs are considered. Forty-two office workers from a public university participated in this study. They were divided into two groups: Symptomatic Subjects (SS, n=20) and Asymptomatic Subjects (AS, n=22), according to the Nordic Musculoskeletal Questionnaire (NMQ). Psychosocial indicators were assessed using the Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES). Workplaces were evaluated according to the Ergonomic Workplace Analysis (EWA), proposed by the Finnish Institute of Occupational Health. The NMQ showed higher weekly prevalence of complaints on neck, shoulders and wrist/hands (p=0.00) among SS. The annual prevalence of symptoms on wrist/hands was also higher among SS (p=0.02). The JCQ did not show any difference between groups (p>0.05). Higher proportion of servers with 'high level' of engagement, dedication and absorption, according to UWES, was identified among SS (p<0.01). EWA showed worse scores for 'Work Site', 'Job Content' and 'Repetitiveness of the Work' among SS (p<0.05). Servers are exposed to physical and psychosocial risk factors that can contribute to the development of WRMD. Work conditions need to be change in order to improve musculoskeletal health.     

Musculoskeletal reported symptoms among aircraft assembly workers: a multifactorial approach

The aim of this study was to evaluate factors associated with reported work-related musculoskeletal symptoms among aircraft assembly workers. Population consisted of 552 (491 men/61 women) workers who performed tasks related to the work of aircraft assembly. Participants completed a comprehensive questionnaire, including socio-demographic information, habits/lifestyles, working conditions, and work organization. Workers also answered the Nordic Musculoskeletal Questionnaire to obtain data on musculoskeletal symptoms. Multivariate logistic regression was performed to analyze factors associated with musculoskeletal reported symptoms. Results showed that body regions with the highest prevalence of reported musculoskeletal symptoms were similar when referred the past twelve months and the past seven days. Significant factors associated with musculoskeletal symptoms included variables related to conflicts at work, sleep problems, mental fatigue, and lack of time for personal care and recovery. Working time in the industry was associated only with reports for the last seven days and regular physical activity off-work seems to be a positive factor in preventing musculoskeletal symptoms for the past twelve months. The results highlight the multi-factorial nature of the problem. Actions to prevent musculoskeletal diseases at the aircraft assembly work should consider multiple interventions that would promote better recovery between work shifts.     

Need for recovery from work and sleep-related complaints among nursing professionals

The concept of need for recovery from work (NFR) was deduced from the effort recuperation model. In this model work produces costs in terms of effort during the working day. When there is enough time and possibilities to recuperate, a worker will arrive at the next working day with no residual symptoms of previous effort. NFR evaluates work characteristics such as psychosocial demands, professional work hours or schedules. However, sleep may be an important part of the recovery process. The aim of the study was to test the association between sleep-related complaints and NFR. A cross-sectional study was carried out at three hospitals. All females nursing professionals engaged in assistance to patients were invited to participate (N = 1,307). Participants answered a questionnaire that included four sleep-related complaints (insomnia, unsatisfactory sleep, sleepiness during work hours and insufficient sleep), work characteristics and NRF scale. Binomial logistic regression analysis showed that all sleep-related complaints are associated with a high need for recovery from work. Those who reported insufficient sleep showed a greater chance of high need for recovery; OR=2.730 (CI 95% 2.074 - 3.593). These results corroborate the hypothesis that sleep is an important aspect of the recovery process and, therefore, should be thoroughly investigated.     

The Development of a Reliable Change Index and Cutoff for the Revised Dyadic Adjustment Scale

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non‐distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.     

The ergonomics approach for thin film transistor-liquid crystal display manufacturing process

The thin film transistor-liquid crystal display (TFT-LCD) has been used all over the world. Although the manufacture process of TFT-LCD was highly automated, employees are hired to do manual job in module assembly process. The operators may have high risk of musculoskeletal disorders because of the long work hours and the repetitive activities in an unfitted work station. The tools of this study were questionnaire, checklist and to evaluate the work place design. The result shows that the participants reported high musculoskeletal disorder symptoms in shoulder (59.8%), neck (49.5%), wrist (39.5%), and upper back (30.6%). And, to reduce the ergonomic risk factors, revising the height of the work benches, chairs and redesigning the truck to decrease the chance of unsuitable positions were recommended and to reduce other ergonomics hazards and seta good human machine interface and appropriate job design.     

Using social media-based drama therapy and family counselling to treat symptoms of postpartum depression among women

This study examines the impact of social media-based drama therapy and family counselling in reducing symptoms of postpartum depression (PPD) in women aged 18–34. The researchers used a quasi-experimental design and randomly assigned the participants (n = 303) to the control, drama therapy, and family counselling groups. The key findings of the study are as follows. First, at baseline, women not only showed more symptoms of PPD than their male counterparts, but men also reached the PPD threshold of 12/13. Second, the difference between women and men regarding their PPD scores achieved statistical significance (p = 0.004). However, during the post-intervention assessment, men who received drama therapy intervention reported a significant drop in their PPD below the threshold of 12/13. Only women whose spouses received family counselling on spousal support reported a significant drop in their PPD. However, those whose partners did not receive family counselling on spousal support still reported PPD scores within the threshold. In both instances, women in the control group still had high PPD scores. Finally, during the 6-month follow-up assessment, even men in the control group did not have significant symptoms of PPD as their scores dropped below the threshold. On the contrary, women in the control group still had high PPD, indicating that PPD lasted more in women than in men. Also, women whose husbands received family counselling on spousal support reported PPD scores below the threshold. However, women whose husbands did not receive spousal counselling still had PPD scores at the threshold, even though their scores marginally dropped.     

Relationship between productivity, quality and musculoskeletal disorder risk among deboning workers in a Chilean salmon industry

The purpose of this ergonomic investigation is to establish a relationship between quality, productivity and risk of musculoskeletal disorder (MSD) in manual bone-removal process in the salmon fish industry. The method consists in a follow up study of 14 workers in a lane that processes salmon steak. Time between each steak (work cycle), quality of the steak's meat through inspection of deepness and length of the gapping generated by the manual bone-removal process and risk for musculoskeletal disorders through OCRA method were considered for this study. IMC and musculoskeletal Nordic Questionnaire of Kourinka were applied to the workers evaluated. Fourteen women worker's completed the evaluation, age 37.67 ± 8.1, with 65.27 ± 34.41 months of experience, with an IMC of 27.18 ± 3.87 (1.52 ± 0.057 meters of height) at the time of the evaluation. Time for deboning per steak averaged 38 ± 14 seconds with 68.33 ± 14.79 steaks per hour per worker. In quality terms, 74% of the steaks were qualified as "premium steaks" and 26% as "grade or industrial" (lower category and cheapest price). OCRA index for the right hand average 13.79 ± 4.59 and 3.59 ± 0.41 for the left hand. From Nordic questionnaire 80% of the workers manifested musculoskeletal symptoms in the right hand/wrist, followed up by shoulder with 60% of the workers and arm/elbow with over 50%. There was no statistically significant relationship between productivity and quality of the steak after manual bone removal process and between quality and MSD risk. However, there was a statistically significant relationship between productivity and MSD risk (p<0.05). Discussion around the results allows to see complementary results that did have strong correlation between MSD risk and the presence of lower grade salmon steaks and between areas that present musculoskeletal symptoms (MSS) and the intensity of the MSS (p<0.05). The results showed that further research is needed to validate these relationships, due to the increasing demands of health-care services from this productive sector, considering its importance for this region.     

Reliability of the Demand-Control Questionnaire for sewing machine operators

The Demand-Control Questionnaire (DCQ), a 20-item scale that measures psychological work demands, job control and workplace social support, has frequently been used to assess occupational stress. The purpose of this study was to determine the test-retest reliability and internal consistency of the DCQ with sewing machine operators. Forty-six sewing machine operators completed the DCQ on two occasions with an 11-week time interval. A repeated measures analysis of variance model and subsequent application of generalizability theory were used to calculate the test-retest reliability of the subjects' ratings on the DCQ. Cronbach's alpha was used to determine the internal consistency of the scale. The test-retest reliability was 0.33 (95% confidence interval = 0.05-0.61), indicating fair reliability. Good internal consistency (Cronbach's alpha = 0.70) was found. The DCQ appears to be a reliable measure for assessing occupational stress in sewing machine operators. Workplaces need to place greater emphasis on the role of occupational stress in the prevention and treatment of musculoskeletal injuries among sewing machine operators.     

Gender differences in the roles and functions of inpatient psychiatric nurses

This study explored the difference between male and female psychiatric nurses' job performance and job satisfaction levels on an acute care inpatient unit. The amount of time male (n = 28) and female (n = 45) nurses spent on 10 specific functions and roles during a shift were observed and recorded. The nurses also self-rated the amount of time they spent on these specific functions and roles. The observed and self-rated functions were then correlated with job satisfaction. Female nurses were observed and self-rated as spending significantly more time on patient care activities, and these activities were significantly correlated with higher job satisfaction levels. Male nurses who self-rated spending more time on patient care activities had significantly lower job satisfaction scores. Findings confirm the concepts from social role theory that gender identity and expectations influence job performance in psychiatric nursing. The results offer insight for increasing job satisfaction and recruitment/retention efforts.     

Construction of a survey to assess workload and fatigue among AMT operators in Mexico

Operators of machinery classified as Advanced Manufacturing Technology (AMT) are exposed to high levels of workload and fatigue. However, only few studies have been conducted on this topic in Hispanic-American countries workers. Several instruments be used to assess workload and fatigue; however, only few of them have been adapted to Spanish language. This paper reports on the development and validity testing of a survey instrument in Spanish, aiming to subjectively assess workload and fatigue among AMT operators in Mexico. Method: After an exhaustive literature review in search of already available measurement instruments, they were adapted for content and later translated into Spanish; a pilot test was conducted to evaluate validity and reliability; afterwards appropriate modifications were made to the testing instruments. Final version of the instrument was applied to a group of 121 operators of CNC lathes. Reliability was analyzed using KMO and Cronbach alpha indices. Results: For the assessment of workload, both NASA-TLX and ISTAS 21 methods were incorporated to the survey instrument. As for fatigue assessment tools, these were SOFI-S, FAS and OFER questionnaires. Results show KMO value and Cronbach alpha above 0.6.Conclusions. The survey instrument as designed, allows the collection of reliable and valid data regarding workload and fatigue among AMT operators in Mexico.     

The imbalance of sex-hormones related to depressive symptoms in obese men

Obese men may present hypogonadothrofic hypogonadism, mainly related to higher insulinemia and aromatase activity. Our objectives were to evaluate the relationship of sex-hormones profiles and frequency of depressive symptoms in 43 obese men, in a cross-sectional study. They had 19–60 years, and body mass index 30–50?kg/m². LH, total and free testosterone (TT and FT), estradiol (E₂), sex hormone binding globulin, estradiol/total testosterone ratio (E₂/T) were analyzed. Depressive symptoms were evaluated by “beck depression inventory” (BDI), and significant depression was considered if BDI?≥?16.Thirty-four (80%) presented low TT levels, but only 4 (14%) had low free testosterone and hypogonadism symptoms; 12 of 43 (28%) presented increased E₂. Forty five (56%) presented depressive symptoms, but 16 (28% of the 45) had significant depression. BDI correlated positively with E₂ (r?=?0.407; p?=?0.001) and E₂/T (r?=?0.473; p?=?0.001), but not TT or FT. Patients with significant depressive showed higher levels of estradiol (136?±?48 versus 103?±?48?pg/ml, p?=?0.02) and E₂/T (16.0?±?9.9 versus 9.8?±?4.6; p?=?0.002) (mean?±?SD).In conclusion, obese men may present relatively excess of estradiol and deficiency in testosterone, leading to an imbalance between these two hormones. The greater this imbalance, the more depressive symptoms had our patients.     

Novel symptom questionnaire for the differential diagnosis of detrusor underactivity and bladder outlet obstruction in men

Objective: To develop a questionnaire for the differential diagnosis of detrusor underactivity (DUA) and bladder outlet obstruction (BOO) without performing invasive pressure flow studies.

Study design and methods: Symptoms of men with DUA were analyzed and compared with those of men with BOO using eight questions from the developing questionnaire. Patients with DUA have a bladder contractility index (PdetQmax+5xQmax) less than 100, whereas those with BOO have a BOO index (PdetQmax?2xQmax) greater than 40 in urodynamic studies (UDS). Men with detrusor overactivity in UDS and neurogenic issues were excluded from the analysis. One urologist reviewed patients’ medical records, and responded to eight questions without using information from UDS. Scores in the developing questionnaire were then compared to make a differential diagnosis between DUA and BOO.

Results: Overall, 318 men who underwent UDS were included. Symptoms were compared in patients diagnosed with DUA without BOO (n?=?165) and BOO without DUA (n?=?153). Questions 1, 2, 4, 5, 6, and 7 were significantly different between groups. The sensitivity and specificity of the questionnaire were 95.8% and 95.4%, respectively, for predicting DUA in patients with scores greater than 45 points (cutoff value).

Conclusions: Men with DUA and BOO may be distinguished using a developing questionnaire without invasive evaluation. Men with scores greater than 45 points would be expected to have DUA but not BOO.     

Diagnosis,pathogenesis and treatment of erectile dysfunction

Introduction: After middle age, some men show androgen-deficiency symptoms leading to so-called PADAM (partial androgen deficiency in aging males). We tested the oral form of testosterone, testosterone undecanoate (Andriol^®, NV Organon, The Netherlands), in men with PADAM and evaluated its efficacy and safety in Korean male patients. Methods: We included those patients with the clinical symptoms of PADAM who had decreased levels of serum total testosterone (< 2.8 ng/ml) or free testosterone (< 13 pg/ml). We excluded patients with biopsy-confirmed prostrate cancer, abnormal findings in digital rectal examination or prostate specific antigen testing (until prostrate cancer was ruled out), breast cancer, severe voiding symptoms and secondary hypogonadism. At the first visit, the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF) and Korean Andropause Questionnaires were administered; complete blood count, the lipid profile, and levels of total and free testosterone, prolactin, luteinizing hormone, follicle stimulating hormone and prostate specific antigen were measured and a digital rectal examination was given. Patients were administered oral testosterone undecanoate 160 mg daily for 3 weeks. The dosage was then decreased to 80 mg daily and changes in symptoms were assessed at every visit. After 3 months, serum tests, including testosterone, were repeated. Results: We evaluated 28 patients who had received testosterone undecanoate for more than 3 months. The patients' mean age was 56.1 (48-68) years. The score of the Korean Andropause Questionnaire changed from 56.2 ± 21.7 at baseline to 52.9 ± 21.3 (p = 0.03) after 3 weeks, to 49.3 ± 19.3 (p = 0.03) after 8 weeks, and to 46.5 ± 25.6 (p = 0.028) after 12 weeks. With respect to sexual function, mean IIEF scores were 37.2 ± 19.6 at baseline and 38.7 ± 19.2 and 40.2 ± 22.0 (p = 0.033) after 3 and 12 weeks, respectively. Serum total testosterone increased from 2.13 ± 1.20 ng/ml at baseline to 6.04 ± 3.08 ng/ml (p = 0.005) after 12 weeks, and free testosterone was marginally significantly changed from 8.60 ± 2.25 pg/ml to 11.40 ± 3.81 pg/ml (p = 0.13). However, there were no significant changes in liver function tests, red blood cell count or lipid profiles. There were no significant adverse reactions that led to the cessation of the administration of oral testosterone. Conclusion: Oral administration of testosterone undecanoate can improve symptoms of PADAM in Koreans. It may, therefore, be an appropriate treatment option with few adverse effects for PADAM patients.     

Effects of at-work exercises on computer operators

At-work exercises are commonly recommended for computer operators. This randomized control trial assessed adherence, pain and satisfaction after 4 weeks of at-work exercise. Subjects (n=72) were randomized into 3 groups: resistance exercise, stretching, and control. Outcomes included a satisfaction survey, a visual analogue pain scale (VAS), a pain drawing, and the Neck Disability Index (NDI). The VAS, the drawing, and NDI were analyzed together as a composite variate referred to as Pain Impact. Exercise frequency was similar across the 3 groups (median=1.5 times per day). No differences were found between groups on Pain Impact p=0.714) or individual pain variables. Most satisfaction survey item scores did not differ between groups. However, a significant difference between groups on the survey item related to discomfort. The resistance and stretching group differed from the control group with regard to their perception that the exercises were helpful in reducing discomfort in the back and neck (p<0.001). We conclude that most subjects found the resistance and the stretching exercises easy to do, performed them 1 to 2 times daily, and said they reduced discomfort. To determine optimal type and frequency of at-work exercises, further study is needed.