Documents Hulshof, Carel T.J. 4 results

"Several recently published critical reviews conclude that there is strong epidemiological evidence for a relationship between occupational exposure to whole-body vibration (WBV), low back pain (LBP) and back disorders. Whether this exposure is only a modest or a substantial risk factor for the onset and recurrence of LBP is still a matter of debate. In spite of this controversy, four European Union countries have decided to recognize and compensate LBP and certain spinal disorders as an occupational disease. In this paper, we review the criteria currently in use for the recognition of this occupational disease. A search of the literature was performed; additional information was obtained in work visits to national occupational disease institutes in Germany, France and Belgium, in annual reports and national statistics on occupational diseases. Belgium was the first country to add WBV injury to the official list of occupational diseases (1978), followed by Germany (1993), the Netherlands (1997), and France (1999). The incidence of newly recognized cases in 1999 varied considerably: 763 in Belgium, 269 in France, 16 in Germany, and 10 reported cases in the Netherlands. The findings of this review indicate that significant differences exist in the established and applied diagnostic and exposure criteria in the four EU countries. This is illustrated by the case of Mrs Robinson, a 41-year-old forklift driver with LBP, who would probably get recognition and compensation in the Netherlands and Belgium but would be rejected in France and Germany. The development of uniform internationally accepted criteria is recommended, also from an epidemiological point of view, as many data are collected in the process of recognition of this occupational disease. "

"Musculoskeletal disorders (MSD) at the workplace cost a lot. These MSD, low back pain in particular, can be caused by exposure to whole body vibration (WBV). Preventive strategies to reduce vibration exposure may contribute to a decrease in MSD. Therefore the aim of this study was to explore which evidence-based preventive strategies reduce vibration exposure on drivers. A systematic literature search was performed using the following key words and synonyms: Whole body vibration, occupational, and prevention. Preliminary, inclusion and selection criteria were defined. 37 studies were included: 15 laboratory studies, 17 field studies, 4 laboratory/field studies and 1 intervention study. Only one, the intervention study, described an intervention strategy to reduce WBV exposure in the workplace. All other studies only presented factors that have effects on vibration exposure. These factors are categorized into two different categories: (1) design considerations and (2) skills and behavior. Most studies focus on factors within category (1) while factors within category (2) may be promising as well, as these factors are often less expensive and more easy to implement. Factors from both categories should be combined in preventive strategies as there is a lack of evidence of effective preventive strategies to reduce vibration exposure on drivers. This might lead to a decrease in the incidence of low back pain due to exposure to whole body vibration."

"Background: An effective intervention program aiming to reduce whole body vibration (WBV) exposure at work will reduce the number of low back complaints in the near future. Methods: An evaluation study with a controlled pretest-post-test design. Nine companies and 126 drivers were included in the study. Cluster randomization on company level divided the drivers and their employers in an intervention group and a care-as-usual group. At baseline (T0) and intervention program was implemented and evaluated after 7 months (T1). The main outcome measure was WBV exposure. Process measures included knowledge, attitude, and (intended) behavior towards reduction of WBV exposure for the drivers and knowledge and WBV policy for the employers. Results: At T1, no significant reduction was found in WBV exposure within both groups compared with T0.Conclusions: Probably due to poor to moderate compliance, the intervention program was not effective in reducing the WBV exposure on group level but small reductions in WBV exposure are possible when intervention compliance is high. "

"Objective
To explore the impact of occupational diseases (ODs) through estimations of population attributable fractions (PAFs) in a national context.
Methods
PAFs were calculated for eight prevalent ODs using existing data on the prevalence of exposure to risk factors at work and the strength of their association with diseases based on systematic reviews. Six systematic reviews with meta-analyses and two overview papers were selected. All addressed the relationship between occupational exposure to work-related risk factors for these eight prevalent ODs. Prevalence figures for exposure to work-related risk factors were retrieved from the Dutch National Working Conditions Survey (NWCS) based on self-reports by approximately 40 000 workers. The specific risk factors retrieved from the reviews were matched with the available and dichotomised self-reported exposure items from the NWCS by two authors.
Results
The eight frequently reported ODs among the Dutch working population revealed PAFs varying between 3% and 25%. Lateral epicondylitis and distress/burnout had the highest attributable fractions, with percentages of 25% and 18%, respectively. For knee osteoarthritis (13%), shoulder soft tissue disorders (10%) and non-specific low back pain (10%) approximately 1 in 10 cases were attributable to work. PAFs for irritant contact dermatitis, noise-induced hearing loss and chronic obstructive pulmonary disease were 15%, 6% and 3%, respectively.
Conclusion
Data from systematic reviews and self-reported data on exposure provide opportunities to estimate the impact of ODs. For the Netherlands, they revealed substantial and varying attributions of work for prevalent diseases."