Purpose
This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work.
Methods
A ...systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process.
Results
Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with “negative effects”.
Conclusions
The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.
Systematic review registration
PROSPERO CRD42018116752 (
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752
).
Due to demographic changes across Europe there are strong political interests in maintaining the labour force by prolonging working life, i.e. increasing retirement age. This may pose both challenges ...and opportunities for societies, workplaces, and individuals. The SeniorWorkingLife (Danish: SeniorArbejdsLiv) project investigates push and stay mechanisms for labour market participation - now and in the future - among older workers (≥50 years).
In July 2018, 30,000 Danes age 50 or older (18,000 employed, 7000 unemployed, 3000 voluntary early retirements, 2000 disability pensions) were invited to participate, of which 15,721 (52.4%) replied to the entire questionnaire and 17,885 (59.6%) replied at least in part. Baseline data collection was terminated in October 2018. The questionnaire covers 14 domains in relation to push and stay mechanisms for labour market participation: 1) basic information (demographics, employment status etc.), 2) multiple-choice question covering a wide range of push and stay mechanisms, 3) role of the workplace, 4) age-discrimination, 5) personal economy, 6) possibility for voluntary early retirement among employed and unemployed, 7) gradual retirement, 8) competencies and continued education, 9) return-to-work, 10) new technologies at the workplace, 11) job satisfaction and well-being, 12) working environment, 13) lifestyle, 14) health and functional capacity. The project aspires to repeat the survey as a prospective cohort every 2-3 years and to perform longitudinal follow-up in Danish high-quality registers about work and health.
The SeniorWorkingLife project will provide important knowledge about push and stay mechanisms for labour market participation among older workers. Push refers to mechanisms that increase the risk of premature exit from the labour marker, e.g. due to poor health, poor working environment, age discrimination, and stay to mechanisms prolonging working life e.g. due to attractive working conditions and a good working environment. The project will also to some degree investigate stuck, pull and jump mechanisms. Collaboration and use of the data for scientific purposes by other researchers are encouraged. Interested researchers should contact the corresponding author.
Registered as cohort study in ClinicalTrials.gov Identifier NCT03634410 (August 16, 2018).
This study assesses the potential of workplace-based micro-exercise (brief and simple exercise bouts) to prevent long-term sickness absence (LTSA) at the population level. In the Work Environment and ...Health in Denmark Study (2012-2018), we followed 70,130 workers from the general working population, without prior LTSA, for two years in the Danish Register for Evaluation of Marginalisation. We used Cox regression with model-assisted weights and controlled for various confounders. From 2012 to 2018, the percentage of workers in Denmark using workplace-based micro-exercise during and outside of working hours increased from 7.1 to 10.9% and from 0.8 to 1.4%, respectively. The incidence of long-term sickness absence (at least 30 days) was 8.4% during follow-up. The fully adjusted model showed reduced risk of long-term sickness absence from using micro-exercise during working hours, (HR 0.86, 95% CI 0.77-0.96), but not when used outside of working hours. If used by all workers, micro-exercise during working hours could potentially prevent 12.8% of incident long-term sickness absence cases (population attributable fraction). In conclusion, micro-exercise performed during working hours holds certain potential to prevent incident long-term sickness absence in the general working population. Large-scale implementation of workplace-based micro-exercise may represent an unexploited opportunity for public health promotion.
Work-related musculoskeletal pain is a major cause of work disability and sickness absence. While pain is a multifactorial phenomenon being influenced by work as well as lifestyle, less is known ...about the association between specific lifestyle factors and the type of musculoskeletal pain. The aim of the study was to investigate if a dose-response association existed between lifestyle factors and musculoskeletal pain intensity in the low back and neck-shoulder.
Currently employed wage earners (N = 10,427) replied in 2010 to questions about work environment, lifestyle and health. Logistic regression analyses adjusted for various confounders tested the association of alcohol intake, physical activity, fruit and vegetable intake, and smoking (explanatory variables) with low back pain and neck-shoulder pain intensity (outcomes variables, scale 0-9, where ≥4 is high pain).
The minimally adjusted model found that physical activity and fruit and vegetable intake were associated with lower risk of musculoskeletal pain, while smoking was associated with higher risk of musculoskeletal pain. In the fully adjusted model, physical activity ≥5 h per week was associated with lower risk of low back pain and neck-shoulder pain with risk ratios (RR) of 0.95 (95% CI 0.90-1.00) and 0.90 (95% CI 0.82-0.99), respectively. No association was found between alcohol intake and pain.
Being physically active associated with lower risk of having musculoskeletal pain, while smoking habits and healthy eating were associated with higher pain when adjusting for age and gender. Considering the continuously increasing retirement age in many societies, initiatives to promote healthy habits should still be a political priority to help the workers to stay healthy and cope to their work.
Musculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between ...physical work demands and work ability in workers with musculoskeletal pain.
Workers with physically demanding jobs (n = 5377) participated in the Danish Work Environment Cohort Study in 2010. Associations between physical work ability and various physical work demands were modeled using cumulative logistic regression analyses while controlling for possible confounders.
In the fully adjusted model, bending and twisting/turning of the back more than a quarter of the workday (reference: less than a quarter of the workday) was associated with higher odds of lower work ability in workers with low-back pain (OR: 1.38, 95% CI: 1.09-1.74) and neck-shoulder pain (OR: 1.29, 95% CI: 1.01-1.64). When adding up the different types of demands, being exposed to two or more physical work demands for more than a quarter of the workday was consistently associated with lower work ability.
Work that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain. Regardless of the specific type of physical work demand, being exposed to multiple physical work demands for more than a quarter of the workday was also associated with lower work ability.
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common ...interventions, that is, prolonged exercise and strength training.
Thirty-six untrained men were divided into groups that completed 12 wk of intense interval running (INT; total training time 40 min wk(-1)), prolonged running (approximately 150 min wk(-1)), and strength training (approximately 150 min wk(-1)) or continued their habitual lifestyle without participation in physical training.
The improvement in cardiorespiratory fitness was superior in the INT (14% +/- 2% increase in V˙O2max) compared with the other two exercise interventions (7% +/- 2% and 3% +/- 2% increases). The blood glucose concentration 2 h after oral ingestion of 75 g of glucose was lowered to a similar extent after training in the INT (from 6.1 +/- 0.6 to 5.1 +/- 0.4 mM, P < 0.05) and the prolonged running group (from 5.6 +/- 1.5 to 4.9 +/- 1.1 mM, P < 0.05). In contrast, INT was less efficient than prolonged running for lowering the subjects' resting HR, fat percentage, and reducing the ratio between total and HDL plasma cholesterol. Furthermore, total bone mass and lean body mass remained unchanged in the INT group, whereas both these parameters were increased by the strength-training intervention.
INT for 12 wk is an effective training stimulus for improvement of cardiorespiratory fitness and glucose tolerance, but in relation to the treatment of hyperlipidemia and obesity, it is less effective than prolonged training. Furthermore and in contrast to strength training, 12 wk of INT had no impact on muscle mass or indices of skeletal health.
Purpose
Many older workers are working despite having neck-shoulder pain (NSP), which may give rise to work limitations due to pain, especially among those with high physical work demands. This study ...investigated the joint association of neck-shoulder pain intensity and physical work demands with work limitations among older workers.
Methods
In SeniorWorkingLife, workers ≥ 50 years (
n
= 11,800) replied to questions about NSP intensity, work limitations due to pain, and physical activity demands at work. The odds ratio for having a higher level of work limitations due to pain in relation to neck-shoulder pain intensity and physical work demands were modeled using logistic regression controlled for various confounders.
Results
The results showed that the neck-shoulder pain intensity was associated with work limitations in a dose–response fashion (
p
< 0.0001). Importantly, a significant interaction existed between neck-shoulder pain intensity and physical activity at work (
p
< 0.0001), e.g., 77% of workers with high pain and high work demands experienced work limitations due to the pain.
Conclusion
Higher neck-shoulder pain intensity and higher physical work demands—and particularly in combination—were associated with higher odds of work limitation due to pain among older workers. Thus, it seems especially important to accommodate work demands through a better work environment for these groups of workers.
This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA).
We followed 69 371 employees in the general working population ...(Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Danish Register for Evaluation of Marginalization. Using k-means cluster analyses and weighted Cox-regression controlling for age, gender, survey year, education, health-behaviors, and physical work demands, we determined the prospective association of 11 identified clusters - based on the combination of nine psychosocial work factors (recognition, quantitative demands, work pace, emotional demands, influence, justice, role clarity, role conflicts, and support from colleagues) - with the risk of LTSA.
During 124 045 person-years of follow-up, 6197 employees developed LTSA (weighted 8.5%). Using the cluster with the most favorable psychosocial scores as reference, clusters scoring poorly on several combined psychosocial factors had increased risk of LTSA. The cluster scoring poor on all nine psychosocial factors exhibited the highest risk hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45-1.94. Scoring poorly on one or two psychosocial factors did not increase the risk of LTSA when combined with favorable scores on the other psychosocial factors. Interaction analyses showed that gender, but not age and education, modified the association between cluster and LTSA.
Scoring poorly on several combined psychosocial work factors plays an important role in the risk of LTSA. Scoring favorably on several psychosocial factors outweighed the potentially adverse effects of scoring poorly on one or two factors.
Surveying expected reasons for retirement may be a useful strategy to maintain labor market affiliation. The aim was to investigate the prospective association between self-reported expected reasons ...for leaving the labour market and subsequent loss of paid employment before the state pension age among older workers.
The prospective risk of loss of paid employment before the official state pension age was estimated from expected reasons for leaving the labour market among 10,320 currently employed older workers (50-63 years) from the SeniorWorkingLife study. In 2018, participants replied to 15 randomly ordered questions about expected reasons for leaving the labour market and were in 2020 followed in a national register containing information on labour market participation.
Loss of paid employment before state pension age was predicted by expected reasons related to 'Health, work demands and occupational well-being': 'Poor physical health' (RR 1.47, 95% CI 1.45-1.49), 'Poor mental health' (RR 1.36, 95% CI 1.32-1.40), 'Not being capable of doing the job' (RR 1.20, 95% CI 1.18-1.22), and 'Not thriving at the workplace' (RR 1.14, 95% CI 1.11-1.17). Expected reasons related to the possibility of receiving voluntary early retirement benefits also increased this risk. Expected reasons related to 'Leisure' ('Wish for more self-determination'; 'Wish for more time for hobbies'), 'Economy' ('Economic considerations'; 'Possibility of receiving pension'), and 'Norms' ('Retirement norms'; 'To make space for younger employees') decreased the risk of loss of paid employment before state pension age. Age-stratified analyses revealed that expected reasons related to the domain of 'Health, work demands and occupational well-being' predicted risk of loss of paid employment to a greater extent among workers aged 50-55 compared to those aged 56-63.
Expected reasons for leaving the labour market predicted actual labour market participation among older workers in Denmark. Expected reasons related to poor physical and mental health, and not being capable of doing the job seem to be stronger PUSH-factors among workers aged 50-55 compared to those aged 56-63. Preventing early labour market detachment should take the worker's expected reasons for leaving into account.
Low-back pain (LBP) is highly prevalent among senior workers and may affect work ability, especially among those with hard physical work. This study determined the joint association of LBP intensity ...and physical work demands with work limitiations due to pain in senior workers.
In the SeniorWorkingLife study (2018), 11,738 senior workers (≥50 years) replied to questions about physical work demands, LBP intensity, and work limitations due to pain. Using logistic regression analyses and controlling for potential confounders, associations between the physical work demands and LBP intensity (interaction) with work limitiations due to pain (outcome) was modeled.
Higher LBP intensity, as well as higher physical work demands, significantly increased the odds of experiencing work limitiations due to pain, and these two factors interacted with each other (p < 0.0001). In analyses stratified for LBP intensity, higher physical work demands gradually increased the odds of experiencing work limitiations due to pain.
Senior workers with a combination of physically demanding work and LBP are more affected by their pain during everyday work tasks compared to workers with similar LBP-intensity in sedentary occupations. Accommodation of work demands seems especially relevant for this group of workers.
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