Neck pain prevalence and associated occupational factors in Portuguese office workers

ObjectiveThis study aimed to assess the prevalence of neck pain and to identify associated occupational factors in Portuguese office workers.BackgroundThere is still necessary to quantify the association of the use of new technologies with neck pain in office workers.MethodsSix hundred-and-one office workers completed online questionnaires with questions related to anthropometric parameters, work-related variables, workstation setup, and musculoskeletal pain from the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire.ResultsThe prevalence of neck pain was 56.1%. An average of 35.6% of the office workers with neck pain reported pain in more than three body segments. The significantly risk factors were “age between 50 and 65” [OR: 1.92 (1.26–2.91) P = 0.002], “working without break for 2 h” [OR: 1.82 (1.00–3.31) P = 0.05], “more than 3 h” [OR: 2.41 (1.35–4.10) P = 0.003], screen localization not centered” [OR: 2.01 (1.01–4.00) P = 0.045], and “use of computer mouse more than 50% of the worktime” [OR: 2.05 (1.14–3.71) P = 0.017].ConclusionThere was a high prevalence of neck pain and a considerable number of painful body segments in office workers. Age, working without break, screen localization and the use of computer mouse where the significant risk factors associated with the development of neck pain.Relevance to industryA high prevalence of neck pain and number of areas with pain in office workers require a detailed pain mechanism assessment. There were associated occupational risk factors for the development of neck pain. Call for concerted actions to explore optimal and efficient management plans.     

Interactive effects from self-reported physical and psychosocial factors in the workplace on neck pain and disability in female office workers

This study explored the interaction between physical and psychosocial factors in the workplace on neck pain and disability in female computer users. A self-report survey was used to collect data on physical risk factors (monitor location, duration of time spent using the keyboard and mouse) and psychosocial domains (as assessed by the Job Content Questionnaire). The neck disability index was the outcome measure. Interactions among the physical and psychosocial factors were examined in analysis of covariance. High supervisor support, decision authority and skill discretion protect against the negative impact of (1) time spent on computer-based tasks, (2) non-optimal placement of the computer monitor and (3) long duration of mouse use. Office workers with greater neck pain experience a combination of high physical and low psychosocial stressors at work. Prevention and intervention strategies that target both sets of risk factors are likely to be more successful than single intervention programmes.

Statement of Relevance: The results of this study demonstrate that the interaction of physical and psychosocial factors in the workplace has a stronger association with neck pain and disability than the presence of either factor alone. This finding has important implications for strategies aimed at the prevention of musculoskeletal problems in office workers.     

Musculoskeletal disorder prevalence and psychosocial risk exposures by age and gender in a cohort of office based employees in two academic institutions

This study presents data on self-reported prevalence of Musculo-Skeletal Disorder (MSD) symptoms and psychosocial risk exposures by age and gender among a group of office based University workers who use their computers for at least 25% of their workday. Employees in two academic organisations received an invitation to participate in an on-line questionnaire. A total of n = 852 office workers participated in this study; yet respondents who were employed for greater than 12 months were only included in the study cohort. Furthermore, participants were only considered for further analysis if they spent 50% or more of their workday in their office, and of this time at least 50% was spent on computer work (n = 569). The study indicates that self-reported symptoms of MSDs for these workers were highest in the neck, shoulder and lower back. Neck, shoulder and back MSDs were higher for females than males, yet age differences within genders were not evident for these symptoms. For neck disorders, symptomatic individuals reported significantly higher levels of office work (p < 0.05) and PC usage (p < 0.005), and significantly lower levels of job content (p < 0.01), job demands (p < 0.05), and work environment (p < 0.05) compared to asymptomatic participants. For the shoulder, symptomatic individuals exposure levels were significantly higher for office work (p < 0.05) and PC usage (p < 0.05) and significantly lower for job content (p < 0.05) compared to asymptomatic individuals. There was evidence of important differences in the psychosocial exposures between age and genders, but associations between these differences and MSD symptoms were not present.Relevance to industryThis study presents prevalence data on age and gender differences in self-reported symptoms of MSDs and psychosocial risk exposures in a group of sedentary workers.     

Covariation between workplace physical and psychosocial stressors: evidence and implications for occupational health research and prevention.

There is increasing interest in distinguishing the effects of physical and psychosocial workplace stressors on the aetiology of work-related musculoskeletal disorders (MSD). Modest associations have been found between psychosocial stressors and MSD, such as intensive load, monotonous work and low job control. Interpretation of these results has been limited by likely covariation between physical and psychosocial stressors. This investigation examined exposure covariation among blue- and white-collar workers employed in a mass production manufacturing environment (N = 410). Physical stressors were assessed from questionnaire and accelerometry. Psychosocial stressors were assessed from questionnaire. Pearson and Spearman correlation coefficients were computed. An exploratory factor analysis procedure identified possible common factors linking specific physical and psychosocial stressors. Moderate to high correlations between some physical and psychosocial stressors showed evidence of covariation both across and within groups. Covariation was strongest among blue-collar production and low-status office workers. Factor analysis results showed considerable shared variance between some physical and psychosocial stressors, such as repetition and job control, suggesting that these disparate stressors manifest from common work organization factors that govern the structure of work. While recognizing the conceptual differences between physical and psychosocial stressors, these results call attention to the strong empirical relationships that can exist between some stressors in the workplace setting. To guard against ambiguous study findings that can occur when exposures are mixed, it is critical that future epidemiologic studies include information about the degree of association between task-level stressors. Future research on work organization determinants of task-level stressors, and their coincident occurrence in jobs with greater specialization, may provide promising new insights into the nature of risk for MSD and effective prevention strategies.     

Covariation between workplace physical and psychosocial stressors: evidence and implications for occupational health research and prevention

There is increasing interest in distinguishing the effects of physical and psychosocial workplace stressors on the aetiology of work-related musculoskeletal disorders (MSD). Modest associations have been found between psychosocial stressors and MSD, such as intensive load, monotonous work and low job control. Interpretation of these results has been limited by likely covariation between physical and psychosocial stressors. This investigation examined exposure covariation among blue- and white-collar workers employed in a mass production manufacturing environment (N = 410). Physical stressors were assessed from questionnaire and accelerometry. Psychosocial stressors were assessed from questionnaire. Pearson and Spearman correlation coefficients were computed. An exploratory factor analysis procedure identified possible common factors linking specific physical and psychosocial stressors. Moderate to high correlations between some physical and psychosocial stressors showed evidence of covariation both across and within groups. Covariation was strongest among blue-collar production and low-status office workers. Factor analysis results showed considerable shared variance between some physical and psychosocial stressors, such as repetition and job control, suggesting that these disparate stressors manifest from common work organization factors that govern the structure of work. While recognizing the conceptual differences between physical and psychosocial stressors, these results call attention to the strong empirical relationships that can exist between some stressors in the workplace setting. To guard against ambiguous study findings that can occur when exposures are mixed, it is critical that future epidemiologic studies include information about the degree of association between task-level stressors. Future research on work organization determinants of task-level stressors, and their coincident occurrence in jobs with greater specialization, may provide promising new insights into the nature of risk for MSD and effective prevention strategies.     

Digital vibration threshold testing and ergonomic stressors in automobile manufacturing workers: a cross-sectional assessment

Upper extremity musculoskeletal disorders (UEMSDs) comprise a large proportion of work-related illnesses in the USA. Physical risk factors including manual force and segmental vibration have been associated with UEMSDs. Reduced sensitivity to vibration in the fingertips (a function of nerve integrity) has been found in those exposed to segmental vibration, to hand force, and in office workers. The objective of this study was to determine whether an association exists between digital vibration thresholds (VTs) and exposure to ergonomic stressors in automobile manufacturing. Interviews and physical examinations were conducted in a cross-sectional survey of workers (n=1174). In multivariable robust regression modelling, associations with workers' estimates of ergonomic stressors stratified on tool use were determined. VTs were separately associated with hand force, vibration as felt through the floor (whole body vibration), and with an index of multiple exposures in both tool users and non-tool users. Additional associations with contact stress and awkward upper extremity postures were found in tool users. Segmental vibration was not associated with VTs. Further epidemiologic and laboratory studies are needed to confirm the associations found. The association with self-reported whole body vibration exposure suggests a possible sympathetic nervous system effect, which remains to be explored.     

Manufacturing assembly serial and cells layouts impact on rest breaks and workers’ health

Rest breaks are necessary for workers to avoid and/or recover from overall fatigue and to preserve their health. The type of assembly layout, either in lines or in cells, is a determining factor for organizing work at manufacturing companies, and it could also influence workers' work break and microbreak times. This study aimed at evaluating rest breaks in serial and cell assembly layout configurations as well as the layout's influence on workers' health. One hundred and twenty workers from a large automobile industry, divided into two groups (series and cells), were measured for their cycle-times and break times through biomechanical exposure analysis and questionnaires to evaluate the behaviors, physical, cognitive, and mental health. The Kolmogorov-Smirnov test was used to verify the distribution of the data with a significance level of p < 0.05. The cell assembly-line layouts had the greatest cycle-time and break time, and the workers had a higher level of physical activity (p < 0.05). The serial assembly-line layouts did not generate major occupational risk, need for rest, reduced capacity for work, or higher levels of stress for the workers. The production layouts differed in relation to the cycle-times for just-in-time manufacturing, but there was no difference in relation to the production demands and to the workers' health.Relevance to industryWhen taken at appropriate times, rest breaks in the workplace can improve workers’ overall health and productive performance, which reduces healthcare costs and improves industrial productivity.     

Reliability and validity of the Home Care STAT (Safety Task Assessment Tool)

Home care workers are a priority population for ergonomic assessment and intervention, but research on caregivers' exposures to hazards is limited. The current project evaluated the reliability and validity of an ergonomic self-assessment tool called Home Care STAT (Safety Task Assessment Tool). Participants (N = 23) completed a background survey followed by 10–14 days of self-monitoring with the STAT. Results showed that the most frequent task was house cleaning, and that participants regularly performed dangerous manual client moving and transferring tasks. Researcher in-home observations of 14 workers (duration ≤2 h) demonstrated that workers' self-assessments were moderately reliable. Correlational and multi-level analyses of daily self-assessment data revealed that several task exposures were significantly related to daily fatigue and/or pain. Other associations have implications for Total Worker Health™; for example, daily stress was positively associated with both pain and consumption of high calorie snacks. Findings support the STAT as a reliable and potentially valid tool for measuring home care workers' exposures to physically demanding tasks.     

Workers' intrinsic work motivation when job demands are high: The role of need for autonomy and perceived opportunity for blended working

Work overload or work pressure may undermine workers' intrinsic motivation. In the present research, we tested the conditions under which this may (not) occur, including the perceived opportunity to blend on-site and off-site working through the effective use of computers and modern information and communication technology. Our sample consisted of 657 workers (51% female) representing a variety of industries. As hypothesized, it is not high job demands per se, but high demands in combination with a high need for autonomy and a lack of perceived opportunities for blended working that undermines intrinsic work motivation. When workers high in need for autonomy perceived opportunities for blended working, their intrinsic work motivation was not negatively affected by increasing job demands. This main finding suggests that, particularly for workers high in need for autonomy, the perceived opportunity for blended working is an effective, contemporary resource to cope with the increasing job demands typically observed in today's workplace. Theoretically, these findings contribute to the refinement and extension of influential demands-resource models and Person-Job Fit theory. Practically, our findings may show managers how to effectively keep workers intrinsically motivated and productive in their jobs when job demands are high.     

Multifactor association of job,individual and psychosocial factors in prevalence of distal upper extremity disorders and quantification of job physical exposure

The objective of this study was to develop a multifactor model of job, individual and psychosocial factors in prevalence of distal upper extremity musculoskeletal disorders (DUE MSDs); and quantify job physical exposure to establish safe exposure limits. The study sample comprised of 525 workers who were part of a large prospective cohort study and represented a broad array of industrial practices and a wide range of job physical exposure. Only baseline data was considered for the analysis in the study. Workers underwent laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current DUE MSDs. All workers' jobs were individually measured for job physical exposure factors and videotaped. Binomial logistic regression was used to develop and test the multifactor association and quantification of job physical exposure for safe exposure limits. Results indicated that work-related DUE MSDs are multifactor in nature and are significantly affected by specific factors of (1) job physical exposure - percentage duration of exertion (PDOE), workers' subjective ratings of perceived effort or intensity of exertion (IOE) (using Borg CR-10), hand activity level measured by the American conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL), and presence of 2-point pinch grasps; (2) individual factors - female gender, diabetes, higher body mass index (BMI), and past and current smokers; (3) psychosocial factors - neither likely/unlikely or very unlikely to take up the current job again, divorced/separated, and presence of family problems. Quantification of job physical exposure indicated that prevalence of work-related DUE MSDs significantly increases with efforts per minute (Eff/min) >8 (OR = 1.69, p = 0.006) and woker's perceived effort based on Borg rating for IOE at the end of the shift >3 (OR = 2.46, p < 0.001). Further studies should be conducted to validate these safe exposure limit criteria.     

Implementation of Office Automation and Its Effects on Job Characteristics and Strain in a District Court

Using a longitudinal case study design, the implementation of office automation was examined at a district court office during a 4-year period. The aims of the study were to examine the effects of the implementation of office automation on perceived job characteristics and on the personnel's short-term mental strain, long-term mental strain, and job satisfaction. All occupational groups at the district court, that is, the office workers, the judges, and the court clerks, participated in the study. After the implementation, the office workers perceived their job as slightly more interesting than before the implementation. After the implementation, their short-term mental strain was slightly lower than before it. However, this effect seemed to diminish in the long run. On the other hand, a slight increase in the office workers' long-term strain was found. Moreover, the judges' job characteristics changed slightly. Using a longitudinal research design, the development of job stress among the personnel at the district court could be followed up, and the changes in job stress could be compared according to the phases of the implementation of office automation.     

HealthSit: Designing Posture-Based Interaction to Promote Exercise during Fitness Breaks

This research was motivated by a desire to help office workers change their sedentary behavior because a prolonged sedentary posture increases the risks of developing musculoskeletal injuries and chronic diseases, thus threatening their physical and psychological well-being. Regular breaks involving low-effort physical activities are effective in reducing the adverse impacts of inactive behaviors. In this article, we present the design of a posture-based interactive system called HealthSit, which was developed to promote a short lower-back stretching exercise during work breaks. Through a within-subject study involving 30 office workers, the effectiveness of HealthSit in facilitating the stretching exercise was examined by making comparisons between an interaction-aided, a guided, and a self-directed exercise mode. We also used HealthSit as a research probe to investigate the interactivity of the system in enhancing user experience and the psychological benefits of the fitness breaks. Compared with the other two modes, the interaction-aided exercise mode significantly improved the quality of the stretching exercise and enhanced motivation and emotional state. These results confirm the effectiveness of HealthSit in supporting fitness breaks as a new workplace technology. Based on our study, a set of design implications have been derived for technology-assisted fitness work breaks.     

Ergonomic assessment of office worker postures using 3D automated joint angle assessment

Sedentary activity and static postures are associated with work-related musculoskeletal disorders (WMSDs) and worker discomfort. Ergonomic evaluation for office workers is commonly performed by experts using tools such as the Rapid Upper Limb Assessment (RULA), but there is limited evidence suggesting sustained compliance with expert’s recommendations. Assessing postural shifts across a day and identifying poor postures would benefit from automation by means of real-time, continuous feedback. Automated postural assessment methods exist; however, they are usually based on ideal conditions that may restrict users’ postures, clothing, and hair styles, or may require unobstructed views of the participants. Using a Microsoft Kinect camera and open-source computer vision algorithms, we propose an automated ergonomic assessment algorithm to monitor office worker postures, the 3D Automated Joint Angle Assessment, 3D-AJA. The validity of the 3D-AJA was tested by comparing algorithm-calculated joint angles to the angles obtained from manual goniometry and the Kinect Software Development Kit (SDK) for 20 participants in an office space. The results of the assessment show that the 3D-AJA has mean absolute errors ranging from 5.6° ± 5.1° to 8.5° ± 8.1° for shoulder flexion, shoulder abduction, and elbow flexion relative to joint angle measurements from goniometry. Additionally, the 3D-AJA showed relatively good performance on the classification of RULA score A using a Random Forest model (micro averages F1-score = 0.759, G-mean = 0.811), even at high levels of occlusion on the subjects’ lower limbs. The results of the study provide a basis for the development of a full-body ergonomic assessment for office workers, which can support personalized behavior change and help office workers to adjust their postures, thus reducing their risks of WMSDs.     

Effects of forearm and palm supports on the upper extremity during computer mouse use

The use of forearm and palm supports has been associated with lower neck and shoulder muscle activity as well as reduced musculoskeletal discomfort during keyboard use, however, few studies have investigated their effect during computer mouse use. Eight men and eight women completed several computer mousing tasks in six arm support conditions: Forearm Support, Flat Palm Support, Raised Palm Support, Forearm + Flat Palm Support, Forearm + Raised Palm Support, and No Support. Concurrently, an infrared three-dimensional motion analysis system measured postures, six-degree-of-freedom force-torque sensors measured applied forces & torques, and surface electromyography measured muscle activity. The use of forearm support compared to the no support condition was significantly associated with less shoulder muscle activity & torque, and the raised palm support was associated with less wrist extension. Forearm supports reduced shoulder flexion torque by 90% compared to no support. The use of either support also resulted in lower applied forces to the mouse pad. Participants reported less musculoskeletal discomfort when using a support. These results provide recommendations for office workstation setup and inform ergonomists of effective ways to reduce musculoskeletal exposures.     

The musculoskeletal system complaints of office workers at a vehicle production factory

This study aimed to determine the prevalence of and factors contributing to musculoskeletal system complaints (MSC) in office workers of a vehicle production factory and absenteeism due to these complaints. A total of 86.2% (n = 333) of the workers completed the survey. Of the workers, 73 (21.9%) were women, and 260 (78.1%) were men, and the mean age was 36.9 ± 8.75 years. The majority of the personnel had more than one symptom with a prevalence of 80.8%. The most frequently observed discomfort was tension and pain in the back muscles (58.6%) and in the neck muscles (58.3%), followed by low back pain (41%) and shoulder pain (30.3%). Pain in the shoulders, neck, and the back and pain and numbness in the fingers were statistically significantly more prevalent in employees who spent more than 5 hours per day performing desk work. Furthermore, all of the complaints, excluding pain in the elbows and knees, were statistically significantly more common in the women. When each complaint and the effects of contributing risk factors were analyzed by logistic regression analysis, pain in the shoulders, neck, and back; pain that spread to the arms; and pain in the fingers were correlated with longer work hours and the female gender (p < 0.05). The number of employees who had used sick leave within the past year due to MSCs was 11.7%. In conclusion, duration of work hours, frequency of breaks, and gender were determined as the most important risk factors in computer users regarding MSCs. © 2011 Wiley Periodicals, Inc.     

Effects of office innovation on office workers' health and performance

The implementation of an innovative office concept (e.g. open-plan, flexible workplaces and a paperless office concept) on health and productivity among office workers was evaluated with questionnaires of 138 workers at baseline and 6 and 15 months afterwards. Work-related fatigue, general health, change in health status, upper extremity complaints and perceived productivity were outcomes. No short-term significant differences were found in most outcomes except for quantity of performed work (decrease from 96% to 92%, p = 0.008). In the long-term, no significant differences were found in most outcomes except for an increase in general health (p = 0.011) and a decrease in prevalences of upper extremity complaints (33% to 22%, p = 0.021). Perceived productivity increased significantly 15 months after the implementation. It is concluded that innovative office concepts had no or limited effects on work-related fatigue, health changes and productivity but some positive effects on workers' general health and upper extremity complaints in the long term. Office innovation is being administered often but up to now seldom evaluated on workers' health and productivity.     

Occupational exposure to noise and hearing thresholds among civilian aircraft maintenance workers

High noise exposure is anticipated to be present in the aircraft maintenance operations in civil aviation sector. The objective of the present study is the assessment of noise exposure and hearing threshold of the aircraft maintenance workers in this sector. Noise levels were measured in the aircraft hangers and in the workshops at a main international airport in Saudi Arabia. Two hundred aircraft maintenance workers were subjected to pure tone audiometry. The average L_eq,8h at most of the aircraft maintenance operations was considerably high and most of the workers (89.5%) were exposed to noise levels ≥85 dBA. Frequency analysis of sound pressure levels revealed that the contribution of the octave bands 1, 2 and 4 kHz to the overall noise level was high. The audiograms of the examined workers showed significant hearing impairment as compared to non-noise-exposed Saudi employees. Although the observed excessive noise levels can cause hearing loss, the effect among the studied aircraft maintenance workers was mild. This might be attributed to the usage of hearing protection devices, the intermittent nature of the workers' exposure to noise and job rotation. Statistical analysis revealed significant association of both age and usage of hearing protectors with hearing loss. The effect of exposure duration on hearing loss was also detected.     

Associations of office workers’ objectively assessed occupational sitting,standing and stepping time with musculoskeletal symptoms

We examined the association of musculoskeletal symptoms (MSS) with workplace sitting, standing and stepping time, as well as sitting and standing time accumulation (i.e. usual bout duration of these activities), measured objectively with the activPAL3 monitor. Using baseline data from the Stand Up Victoria trial (216 office workers, 14 workplaces), cross-sectional associations of occupational activities with self-reported MSS (low-back, upper and lower extremity symptoms in the last three months) were examined using probit regression, correcting for clustering and adjusting for confounders. Sitting bout duration was significantly (p < 0.05) associated, non-linearly, with MSS, such that those in the middle tertile displayed the highest prevalence of upper extremity symptoms. Other associations were non-significant but sometimes involved large differences in symptom prevalence (e.g. 38%) by activity. Though causation is unclear, these non-linear associations suggest that sitting and its alternatives (i.e. standing and stepping) interact with MSS and this should be considered when designing safe work systems.

Practitioner summary: We studied associations of objectively assessed occupational activities with musculoskeletal symptoms in office workers. Workers who accumulated longer sitting bouts reported fewer upper extremity symptoms. Total activity duration was not significantly associated with musculoskeletal symptoms. We underline the importance of considering total volumes and patterns of activity time in musculoskeletal research.     

Good vacation and job rotation systems were beneficial for the hemoglobin level of workers at high altitude,a cross-sectional study along the Qinghai Tibet railway,China

Working and travelling in high-altitude regions have been associated with a variety of adverse health effects. The aim of this study was to explore a good vacation and job rotation system to prevent workers at high altitude from chronic altitude sickness. A total of 985 healthy male workers along the Qinghai-Tibet Railway, aged from 21 to 58 years (mean age 37.7 ± 8.6 years), were included into this study. The subjects took different short–term vacations, with different ratios of rest and work days. Furthermore, job rotation in low altitude was implemented in 127 (12.9%) subjects, who were transferred to relatively low altitude areas after working in plateau areas for more than three months. The association between vacation type and low altitude job rotation with prevalence of hyperhemoglobin (hemoglobin >175 g/L) was analyzed. Results showed that the risk of hyperhemoglobin decreased significantly with the increase of ratio of rest and work days, after adjusting for other confounding variables (age, ethnicity, education, body mass index, etc.) using multivariable logistic regression analysis. Meanwhile, the prevalence of hyperhemoglobin in job rotated workers was significantly lower than that in non-rotated workers [OR = 0.56, 95% CI: 0.37 to 0.84, p < 0.05]. Besides that, BMI, labor intensity, altitude at the workplace and frequency of oxygen supplementation were also closely related to the increase of hemoglobin level. We concluded that good vacation and job rotation system were effective means to prevent hyperhemoglobin and should be promoted in immigrants at high altitude for a long time.     

Task exposures in an office environment: a comparison of methods

Task-related factors such as frequency and duration are associated with musculoskeletal disorders in office settings. The primary objective was to compare various task recording methods as measures of exposure in an office workplace. A total of 41 workers from different jobs were recruited from a large urban newspaper (71% female, mean age 41 years SD 9.6). Questionnaire, task diaries, direct observation and video methods were used to record tasks. A common set of task codes was used across methods. Different estimates of task duration, number of tasks and task transitions arose from the different methods. Self-report methods did not consistently result in longer task duration estimates. Methodological issues could explain some of the differences in estimates seen between methods observed. It was concluded that different task recording methods result in different estimates of exposure likely due to different exposure constructs. This work addresses issues of exposure measurement in office environments. It is of relevance to ergonomists/researchers interested in how to best assess the risk of injury among office workers. The paper discusses the trade-offs between precision, accuracy and burden in the collection of computer task-based exposure measures and different underlying constructs captures in each method.