Documents Holtermann, Andreas 10 results

"Objectives This prospective cohort study investigates work-related risk factors for occupational back injury among healthcare workers. Methods The study comprised 5017 female healthcare workers in eldercare from 36 municipalities in Denmark who responded to a baseline and follow-up questionnaire in 2005 and 2006, respectively. Using logistic regression, the odds for occupational back injury (ie, sudden onset episodes) in 2006 from patient transfers in 2005 was modeled. Results In the total study population, 3.9% experienced back injury during follow-up, of which 0.5% were recurrent events. When adjusting for lifestyle (body mass index, leisure-time physical activity, smoking), work-related characteristics (seniority and perceived influence at work), and history of back pain and injury, daily patient transfers increased the risk for back injury (trend, P=0.03): odds ratio (OR) 1.75 [95% confidence interval (95% CI) 1.05–2.93] for 1–2 transfers per day, OR 1.81 (95% CI 1.14–2.85) for 3–10 transfers per day, and OR 1.56 (95% CI 0.96–2.54) for >10 transfers per day, referencing those with <1 patient transfer on average per day. The population attributable fraction of daily patient transfer for back injury was estimated to be 36%. Among those with daily patient transfer (N=3820), using an assistive device decreased the risk for back injury for “often” and “very often” use [OR 0.59 (95% CI 0.36–0.98) and OR 0.62 (95% CI 0.38–1.00), respectively] referencing those who “seldom” use assistive devices. Conclusion Daily patient transfer was associated with increased risk for back injury among healthcare workers. Persistent use of an assistive device was associated with reduced risk for back injury among healthcare workers with daily patient transfers."

"Objective The aim of this study was to investigate the risk of persistent low-back pain (LBP) based on the number of patient-handling activities among female healthcare workers with no LBP and those with sub-chronic LBP at baseline.Method Female healthcare workers in the eldercare services answered a questionnaire about the number of patient-handling activities (<1, 1–2, 3–10, >10 per day) and days with LBP in 2005. We prospectively investigated the odds ratio (OR) for developing persistent (>30 days in the past 12 months) LBP in 2006 from the frequency of patient-handling activities using multi-adjusted logistic regression analysis among female healthcare workers without LBP (0 days in the past 12 months) (N=1544) and with sub-chronic LBP (1–30 days in the past 12 months) (N=2294) in 2005. Results Among female healthcare workers with sub-chronic LBP at baseline, the multi-adjusted OR for developing persistent LBP was 1.04 [95% confidence interval (95% CI) 0.71–1.52] for those with 1–2 activities, 1.29 (95% CI 0.91–1.83) for those with 3–10 activities, and 1.61 (95% CI 1.07–2.42) for those with >10 patient-handling activities per day (P=0.01 for trend), referencing those not performing patient-handling activities. Among female healthcare workers without LBP at baseline, we did not find an increased risk for developing persistent LBP within one year resulting from performing several patient-handling activities. Conclusion Preventive initiatives for persistent LBP may aim to keep the number of patient-handling activities below ten per day among healthcare workers with sub-chronic LBP."

"Objective Increased risk of ischemic heart disease (IHD) mortality from high physical work demands has been observed among men with low physical fitness and leisure time physical activity. We tested whether hypertensive men are at a particularly high risk of IHD mortality when exposed to high physical work demands. Method We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 gainfully employed men aged 40–59 years. Of these, 274 men with a history of myocardial infarction or prevalent symptoms of angina pectoris or intermittent claudication were excluded from the follow-up. Men were classified as having hypertension when any of the following factors was present: (i) treatment for hypertension, (ii) a systolic blood pressure of >160 mm Hg, or (iii) a diastolic blood pressure of >90 mm Hg. Physical work demands were determined by two self-reported questions. Results Of the eligible study population, 587 men (11.9%) died due to IHD. Hypertensive men had more than a doubled risk of IHD mortality [hazard ratio (HR) 2.16, 95% confidence interval (95% CI) 1.80–2.59]. Cox analyses – adjusted for age, smoking, alcohol, body mass index, diabetes, physical fitness, leisure time physical activity, and social class – showed that high physical work demands were associated with an increased risk of IHD and all-cause mortality among normotensive men (N=4127, HR 1.36, 95% CI 0.96–1.92 and HR 1.24, 95% CI 1.06–1.44, respectively), but not among the hypertensive men (N=808, HR 1.07, 95% CI 0.63–1.81 and HR 1.07, 95% CI 0.80–1.42, respectively) using men with low physical work demands as the reference. Conclusion Compared to normotensive men, hypertensive men did not have a higher risk of IHD or all-cause mortality from high physical work demands."

"OBJECTIVES: Prolonged sitting at work has been found to increase risk for musculoskeletal pain. The office-based intervention "Take a Stand!" was effective in reducing sitting time at work. We aimed to study the effect of the intervention on a secondary outcome: musculoskeletal pain.
METHODS:Take a Stand! included 19 offices (317 workers) at four workplaces cluster randomized to intervention or control. The multicomponent intervention lasted three months and included management support, environmental changes, and local adaptation. Control participants behaved as usual. Musculoskeletal pain was measured by self-report questionnaire assessing pain in neck-shoulders, back and extremities in three categories at baseline, and one and three months follow-up.
RESULTS: At one month, there was no difference in odds ratio (OR) for pain in neck-shoulders between the two groups. However, after three months, the OR was 0.52 [95% confidence interval (95% CI) 0.30–0.92] for pain in neck-shoulders in the intervention compared to the control group. No differences were found between the intervention and control group for pain in back and extremities over the three months. For total pain score a slight reduction was found in the intervention compared to the control group at one and three months [-0.13 (95% CI -0.23– -0.03) and -0.17 (95% CI -0.32– -0.01)].
CONCLUSIONS: The secondary analyses showed that the office-based intervention Take a Stand! reduced neck-shoulder pain after three months and total pain score after one and three months among office workers, but not neck-shoulder pain after one month or pain in the back and extremities.

"BACKGROUND:
Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA.
METHODS:
A sample of 6572 Danish female health care workers responding to a questionnaire about health and working conditions were followed up in a national register of social transfer payments (DREAM) for 550 days. We estimated the risk for LTSA of four weeks or more, associated with depressive symptoms and number of musculoskeletal pain locations using a Cox proportional hazards model allowing multiple observations per individual. We conducted a test for multiplicative interaction between musculoskeletal pain locations and depressive symptoms, and presented stratified regression models to facilitate the interpretation of the results.
RESULTS:
The severity of depressive symptoms was correlated with the number of pain locations reported (Spearman's rho = .24, p < 0.001). We found a significant multiplicative interaction between depressive symptoms and musculoskeletal pain in predicting the risk of LTSA. Depressive symptoms and number of musculoskeletal pain locations were associated with increased risk of LTSA for individuals who did not have comorbid symptoms. However, we found no significant associations between the two predictors and LTSA among participants who reported comorbid symptoms.
CONCLUSIONS:
The risk of LTSA associated with depressive symptoms and musculoskeletal pain appears to be moderated by the presence of comorbid symptoms. The modified risk for LTSA among workers with comorbid symptoms requires further investigation."

"Objectives
Determining exposure to occupational factors by workers' job titles is extensively used in epidemiological research. However, the correspondence of findings regarding associations to health between job exposure matrices (JEMs) and individual-level exposure data is largely unknown. We set out to examine the prospective associations of physical work demands and psychosocial working conditions with musculoskeletal pain, comparing JEMs with individual-level self-reported exposures.
Methods
We analysed data of 8132 participants from the Work Environment and Health in Denmark cohort study. Using random intercept multilevel modelling, we constructed age-specific and sex-specific JEMs estimating predicted exposures in job groups. We analysed associations between working conditions (individual and JEM level) at baseline and musculoskeletal pain at follow-up using multilevel modelling stratified by sex, adjusting for age, education and baseline pain.
Results
Any consistent associations present in the individual-level analysis were also found in the JEM-level analysis. Higher pain levels at follow-up was seen for employees with higher baseline physical work demands, women exposed to violence and men with lower decision authority, whether measured at the individual or JEM level. Higher JEM-level quantitative demands were associated with less pain, but no association was seen at the individual level.
Conclusions
We found predominately comparable prospective associations between working conditions and pain, whether using JEMs or individual level exposures, with the exception of quantitative demands. The results suggest that, with few notable exceptions, findings obtained using JEMs may be comparable with those obtained when using self-reported exposures."

"Occupational health and safety (OHS) professionals have a key role in supporting the health and work ability of employees, including preventing and handling musculoskeletal disorders (MSDs) at workplaces. MSDs are the leading cause of work disability, productivity loss and sickness absence in Europe. This may be due to limited consensus on use of effective OHS practices as facilitation of evidence-based practices increases quality of provided services. This study explored consensus of OHS professionals' practices and examined OHS professionals' request for development of evidence-based guidelines for prevention and handling of MSDs at workplaces. This was done by 1) field observations and interviews with OHS professionals working with ergonomics or MSDs at workplaces, 2) development and pilot testing of a panel survey, 3) a three-round expert panel survey and 4) workshop with OHS stakeholders within the OHS organisations in Denmark. The findings indicate limited consensus of OHS practices and a request for development of practice- and evidence-based guidelines for prevention and handling of work-related MSDs in Denmark. The study also presents an end user involving process for increased uptake and implementation of guidelines."