Office workers are exposed to high levels of sedentary time. In addition to cardio-vascular and metabolic health risks, this sedentary time may have musculoskeletal and/or cognitive impacts on office ...workers. Participants (n = 20) undertook two hours of laboratory-based sitting computer work to investigate changes in discomfort and cognitive function (sustained attention and problem solving), along with muscle fatigue, movement and mental state. Over time, discomfort increased in all body areas (total body IRR 95% confidence interval: 1.43 1.33⁻1.53) reaching clinically meaningful levels in the low back and hip/thigh/buttock areas. Creative problem solving errors increased (β = 0.25 0.03⁻1.47) while sustained attention did not change. There was no change in erector spinae, trapezius, rectus femoris, biceps femoris and external oblique median frequency or amplitude; low back angle changed towards less lordosis, pelvis movement increased, and mental state deteriorated. There were no substantial correlations between discomfort and cognitive function. The observed changes suggest prolonged sitting may have consequences for musculoskeletal discomfort and cognitive function and breaks to interrupt prolonged sitting are recommended.
Although it is generally accepted that physical activity reduces the risk for chronic non-communicable disease and mortality, accumulating evidence suggests that occupational physical activity (OPA) ...may not confer the same health benefits as leisure time physical activity (LTPA). It is also unclear if workers in high OPA jobs benefit from LTPA the same way as those in sedentary jobs. Our objective was to determine whether LTPA and leisure time sedentary behaviour (LTSB) confer the same health effects across occupations with different levels of OPA. Searches were run in Medline, Embase, PsycINFO, ProQuest Public Health and Scopus from inception to June 9, 2020. Prospective or experimental studies which examined the effects of LTPA or LTSB on all-cause and cardiovascular mortality and cardiovascular disease, musculoskeletal pain, diabetes, metabolic syndrome, arrhythmias and depression among adult workers grouped by OPA (low OPA/sitters, standers, moderate OPA/intermittent movers, high OPA/heavy labourers) were eligible. Results were synthesized using narrative syntheses and harvest plots, and certainty of evidence assessed with GRADE. The review includes 38 papers. Across all outcomes, except cardiovascular mortality, metabolic syndrome and atrial fibrillation, greater LTPA was consistently protective among low OPA, but conferred less protection among moderate and high OPA. For cardiovascular mortality and metabolic syndrome, higher levels of LTPA were generally associated with similar risk reductions among all OPA groups. Few studies examined effects in standers and none examined effects of LTSB across OPA groups. Evidence suggests that LTPA is beneficial for all workers, but with larger risk reductions among those with low compared to high OPA jobs. This suggests that, in our attempts to improve the health of workers through LTPA, tailored interventions for different occupational groups may be required. More high-quality studies are needed to establish recommended levels of LTPA/LTSB for different OPA groups.
The use of mobile touch screen devices (MTSDs) has increased rapidly over the last decade, and there are concerns that their use may have negative musculoskeletal consequences; yet evidence on the ...association of MTSD use with musculoskeletal symptoms and exposures is currently dispersed. The aim of this study was to systematically review available literature on musculoskeletal symptoms and exposures associated with MTSD use. The synthesised information may facilitate wise use of MTSDs and may identify areas in need of further research.
EMBASE, Medline, Scopus, PsycINFO and Proquest electronic databases were searched for articles published up to June 2016, using keywords describing MTSD, musculoskeletal symptoms (e.g. pain, discomfort) and musculoskeletal exposures (e.g. posture, muscle activity). Two reviewers independently screened the articles, extracted relevant data and assessed methodological quality of included studies. Due to heterogeneity in the studies, a meta-analysis was not possible and a structured narrative synthesis of the findings was undertaken.
A total of 9,908 articles were screened for eligibility with 45 articles finally included for review. Included articles were of cross-sectional, case-control or experimental laboratory study designs. No longitudinal studies were identified. Findings were presented and discussed in terms of the amount, features, tasks and positions of MTSD use and its association with musculoskeletal symptoms and musculoskeletal exposures.
There is limited evidence that MTSD use, and various aspects of its use (i.e. amount of usage, features, tasks and positions) are associated with musculoskeletal symptoms and exposures. This is due to mainly low quality experimental and case-control laboratory studies, with few cross-sectional and no longitudinal studies. Further research is warranted in order to develop guidelines for wise use of MTSDs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence ...regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality.
A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality.
We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.87-1.15 and females (HR 0.95, 95% CI 0.82-1.09). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 15% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.15, 95% CI 0.88-1.49).
While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
Due to concerns about excessive sedentary exposure for office workers, alternate work positions such as standing are being trialled. However, prolonged standing may have health and productivity ...impacts, which this study assessed. Twenty adult participants undertook two hours of laboratory-based standing computer work to investigate changes in discomfort and cognitive function, along with muscle fatigue, movement, lower limb swelling and mental state. Over time, discomfort increased in all body areas (total body IRR 95% confidence interval: 1.471.36-1.59). Sustained attention reaction time (β = 18.258.00-28.51) deteriorated, while creative problem solving improved (β = 0.890.29-1.49). There was no change in erector spinae, rectus femoris, biceps femoris or tibialis anterior muscle fatigue; low back angle changed towards less lordosis, pelvis movement increased, lower limb swelling increased and mental state decreased. Body discomfort was positively correlated with mental state. The observed changes suggest replacing office work sitting with standing should be done with caution. Practitioner Summary: Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study involving 2 h prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.
Lifting at work is considered an important risk factor for low back pain (LBP). However, contradictory findings have been reported, partly because frequency, duration and intensity (ie, the weight of ...the load) of lifting have not been systematically considered. This has hampered developments of threshold values for lifting. The aims of this study were: to assess the effect of lifting during work (quantified in duration, frequency or intensity) on the incidence of LBP and to quantify the impact of these relationships on the occurrence of LBP in occupational populations exposed to lifting. We searched in PubMed and EMBASE.com for longitudinal studies assessing the effect of occupational lifting on LBP incidence. For each study, the exposure–response slope of the association was estimated by loglinear regression analysis. When possible, a meta-analysis on these slopes was conducted. In a health impact assessment, the effects of the pooled exposure–response relationships on LBP incidence was assessed. Eight longitudinal studies were included. Pooled estimates resulted in ORs of 1.11 (1.05 to 1.18) per 10 kg lifted and 1.09 (1.03 to 1.15) per 10 lifts/day. Duration of lifting could not be pooled. Using these ORs, we estimated that lifting loads over 25 kg and lifting at a frequency of over 25 lifts/day will increase the annual incidence of LBP by 4.32% and 3.50%, respectively, compared to the incidence of not being exposed to lifting. Intensity and frequency of lifting significantly predict the occurrence of LBP. Exposure–response relationships show that lifting heavy loads may have a substantial impact on musculoskeletal health of the working population. This information may direct the development of occupational lifting guidelines and workplace design for LBP prevention.
Decades of workplace health promotion research Robroek, Suzan; Coenen, Pieter; Hengel, Karen Oude
Scandinavian journal of work, environment & health,
11/2021, Letnik:
47, Številka:
8
Journal Article
Recenzirano
Odprti dostop
The workplace is a promising setting for health promotion as workers spend a lot of time at work, and existing social networks for social support could be used to change behavior and enhance health. ...Workplace health promotion programs could be a way to improve workers' health and can for example include elements of support, policies, or environmental changes to encourage healthy behavior. Traditionally, programs have focused on providing workers with advice on how to change their behavior. Such programs have been criticized because they do not take a broader perspective such as the environment. However, still many of these traditional programs are offered to employees and evaluated. The effects of such programs remain disappointing thus far. Here, Robroek et al reflect on the body of research regarding workplace health promotion. They also describe gaps in the literature, most notably regarding the need for more targeted workplace health promotion, a systems approach for workplace health promotion, and the delivery of workplace health promotion. Furthermore, they propose some research agenda concerning workplace health promotion.
Objective:
To investigate whether use of a movement intervention when undertaking prolonged standing affected discomfort and cognitive function.
Background:
Alternate work positions to break up ...prolonged sitting for office workers are being trialed, such as standing. Prolonged standing has potential negative health implications, including low back and lower limb discomfort, and may influence cognitive function. Introducing movement during standing may provide a healthy and productive alternative work posture.
Method:
Twenty adult participants undertook a laboratory study of 2 hr of standing and standing with movement (using a footrest) while performing computer work. Changes in discomfort and cognitive function, with muscle fatigue, low back angle, pelvis movement, lower limb swelling, and mental state, were investigated.
Results:
Discomfort increased significantly over time across all body regions. Ankle/foot differed between conditions (incident rate ratio 95% confidence interval: 1.89 1.10–3.23), with higher discomfort during standing with movement. Creative problem-solving errors increased during standing with movement and decreased during standing (Time × Condition: β = 0.64 0.10–1.18), with no other cognitive function measure differences. Mental state deteriorated over time for both conditions, greater during standing with movement (Time × Condition: β = 2.44 0.23–4.66). No significant interaction effects were found for the other outcome variables.
Conclusion:
Standing with movement provided no advantage in discomfort or cognitive function. There were some negative effects for ankle/foot discomfort and creative problem solving. An alternate footrest design and protocol for use may yield more favorable results.
Application:
Based on the results from this study, footrest use to raise alternative foot for forced 5-min intervals would not be recommended to assist with managing discomfort while prolonged standing in workplaces.
Background
The prevalence of musculoskeletal symptoms among sedentary workers is high. Interventions that promote occupational standing or walking have been found to reduce occupational sedentary ...time, but it is unclear whether these interventions ameliorate musculoskeletal symptoms in sedentary workers.
Objectives
To investigate the effectiveness of workplace interventions to increase standing or walking for decreasing musculoskeletal symptoms in sedentary workers.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, OSH UPDATE, PEDro, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to January 2019. We also screened reference lists of primary studies and contacted experts to identify additional studies.
Selection criteria
We included randomised controlled trials (RCTs), cluster‐randomised controlled trials (cluster‐RCTs), quasi RCTs, and controlled before‐and‐after (CBA) studies of interventions to reduce or break up workplace sitting by encouraging standing or walking in the workplace among workers with musculoskeletal symptoms. The primary outcome was self‐reported intensity or presence of musculoskeletal symptoms by body region and the impact of musculoskeletal symptoms such as pain‐related disability. We considered work performance and productivity, sickness absenteeism, and adverse events such as venous disorders or perinatal complications as secondary outcomes.
Data collection and analysis
Two review authors independently screened titles, s, and full‐text articles for study eligibility. These review authors independently extracted data and assessed risk of bias. We contacted study authors to request additional data when required. We used GRADE considerations to assess the quality of evidence provided by studies that contributed to the meta‐analyses.
Main results
We found ten studies including three RCTs, five cluster RCTs, and two CBA studies with a total of 955 participants, all from high‐income countries. Interventions targeted changes to the physical work environment such as provision of sit‐stand or treadmill workstations (four studies), an activity tracker (two studies) for use in individual approaches, and multi‐component interventions (five studies). We did not find any studies that specifically targeted only the organisational level components. Two studies assessed pain‐related disability.
Physical work environment
There was no significant difference in the intensity of low back symptoms (standardised mean difference (SMD) ‐0.35, 95% confidence interval (CI) ‐0.80 to 0.10; 2 RCTs; low‐quality evidence) nor in the intensity of upper back symptoms (SMD ‐0.48, 95% CI ‐.96 to 0.00; 2 RCTs; low‐quality evidence) in the short term (less than six months) for interventions using sit‐stand workstations compared to no intervention. No studies examined discomfort outcomes at medium (six to less than 12 months) or long term (12 months and more). No significant reduction in pain‐related disability was noted when a sit‐stand workstation was used compared to when no intervention was provided in the medium term (mean difference (MD) ‐0.4, 95% CI ‐2.70 to 1.90; 1 RCT; low‐quality evidence).
Individual approach
There was no significant difference in the intensity or presence of low back symptoms (SMD ‐0.05, 95% CI ‐0.87 to 0.77; 2 RCTs; low‐quality evidence), upper back symptoms (SMD ‐0.04, 95% CI ‐0.92 to 0.84; 2 RCTs; low‐quality evidence), neck symptoms (SMD ‐0.05, 95% CI ‐0.68 to 0.78; 2 RCTs; low‐quality evidence), shoulder symptoms (SMD ‐0.14, 95% CI ‐0.63 to 0.90; 2 RCTs; low‐quality evidence), or elbow/wrist and hand symptoms (SMD ‐0.30, 95% CI ‐0.63 to 0.90; 2 RCTs; low‐quality evidence) for interventions involving an activity tracker compared to an alternative intervention or no intervention in the short term. No studies provided outcomes at medium term, and only one study examined outcomes at long term.
Organisational level
No studies evaluated the effects of interventions solely targeted at the organisational level.
Multi‐component approach
There was no significant difference in the proportion of participants reporting low back symptoms (risk ratio (RR) 0.93, 95% CI 0.69 to 1.27; 3 RCTs; low‐quality evidence), neck symptoms (RR 1.00, 95% CI 0.76 to 1.32; 3 RCTs; low‐quality evidence), shoulder symptoms (RR 0.83, 95% CI 0.12 to 5.80; 2 RCTs; very low‐quality evidence), and upper back symptoms (RR 0.88, 95% CI 0.76 to 1.32; 3 RCTs; low‐quality evidence) for interventions using a multi‐component approach compared to no intervention in the short term. Only one RCT examined outcomes at medium term and found no significant difference in low back symptoms (MD ‐0.40, 95% CI ‐1.95 to 1.15; 1 RCT; low‐quality evidence), upper back symptoms (MD ‐0.70, 95% CI ‐2.12 to 0.72; low‐quality evidence), and leg symptoms (MD ‐0.80, 95% CI ‐2.49 to 0.89; low‐quality evidence). There was no significant difference in the proportion of participants reporting low back symptoms (RR 0.89, 95% CI 0.57 to 1.40; 2 RCTs; low‐quality evidence), neck symptoms (RR 0.67, 95% CI 0.41 to 1.08; two RCTs; low‐quality evidence), and upper back symptoms (RR 0.52, 95% CI 0.08 to 3.29; 2 RCTs; low‐quality evidence) for interventions using a multi‐component approach compared to no intervention in the long term. There was a statistically significant reduction in pain‐related disability following a multi‐component intervention compared to no intervention in the medium term (MD ‐8.80, 95% CI ‐17.46 to ‐0.14; 1 RCT; low‐quality evidence).
Authors' conclusions
Currently available limited evidence does not show that interventions to increase standing or walking in the workplace reduced musculoskeletal symptoms among sedentary workers at short‐, medium‐, or long‐term follow up. The quality of evidence is low or very low, largely due to study design and small sample sizes. Although the results of this review are not statistically significant, some interventions targeting the physical work environment are suggestive of an intervention effect. Therefore, in the future, larger cluster‐RCTs recruiting participants with baseline musculoskeletal symptoms and long‐term outcomes are needed to determine whether interventions to increase standing or walking can reduce musculoskeletal symptoms among sedentary workers and can be sustained over time.
This study aimed to quantify the absenteeism costs of knee and hip osteoarthritis in the Netherlands for the Dutch workforce and specific groups of workers.
We used a longitudinal, dynamic database ...from a large occupational health service in which occupational physicians register information about personal information and sick leave of workers with the diagnosis of knee- and/or hip osteoarthritis. We included all employees aged 15 to 75 years performing paid work and diagnosed with knee and/or hip osteoarthritis. Costs were calculated annually and per episode for different subgroups from an employer's perspective using the Human Capital Approach. In the Netherlands, the employer has to pay 70% of the employee's wage out of pocket for the first two years of sick leave and also for the occupational health care. In this way, employers receive information about the costs of workers on sick leave due to knee or hip osteoarthritis. This might stimulate investments in targeted prevention and work-directed care.
For the period 2015-2017, 1399 workers fulfilled the inclusion criteria. An average sick leave episode of knee osteoarthritis had a duration of 186 calendar days and was associated with €15,550 in costs. For hip osteoarthritis these data were 159 calendar days and €12,482 in costs. These costs are particularly high among male workers and workers with a higher number of weekly working hours. The average annual costs for the Dutch workforce due to sick leave for knee and hip osteoarthritis were €26.9 million and €13.8 million, respectively. Sick leave costs decreased for hip and not for knee osteoarthritis during 2015-2017.
Annual sick leave costs due to knee and hip osteoarthritis are about €40 million for the Dutch workforce and approximately twice as high for knee compared to hip osteoarthritis. Average costs per sick leave episode are particularly high among male workers and workers with a higher number of weekly working hours.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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