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Cold sensitivity, a common and disabling sequela of hand injury, can be assessed using the Cold Intolerance Symptom Severity (CISS) questionnaire, rating symptoms on a scale from 4 to 100. The primary objective of this study was to define a clinical cut-off for abnormal cold sensitivity based on the CISS score in a healthy working-age population. The secondary objective was to investigate how age, gender and previous injuries and diseases influence CISS scoring. In this study, 1239 out of 1582 selected healthy subjects of working age living in northern Sweden completed the questionnaire, yielding a response rate of 78%. The 95th percentile for the CISS score was 49.5 for men and 53.0 for women. The effects of age, gender and previous injuries and diseases were minor and not considered clinically relevant. The results support that a CISS score above 50 should be considered as abnormal cold sensitivity. Level of evidence: III

Purpose Work ability can be measured by the work ability index (WAI), and work-related questions measuring productivity loss in terms of quality and quantity of work. Dentists have high occupational risk of musculoskeletal pain and the exposure of ergonomic strain is already high during dental education. The aim was to evaluate work ability and productivity among dentists, and to identify gender differences and associations with sleep, stress, and reported frequent pain. Methods The study population comprised 187 dentists (123 women and 64 men) who had been working as dentists between 5 and 12 years. Participants completed a questionnaire regarding sleep, stress, presence of pain at different sites, work ability assessed by WAI, and productivity in terms of quality and quantity of work. Results Poor sleep quality and high level of stress were reported by 31% and 48.1% of participants, respectively, with no gender differences and no association with age. The prevalence of frequent pain ranged 6.4–46.5% with shoulders being the most prevalent site. Thirty-three percent reported reduced work ability. Poor sleep, high amount of stress, and multi-site pain were associated with decreased work ability. Conclusions A high prevalence of pain was shown among dentists. Decreased work ability in terms of productivity loss was associated with poor sleep quality, high amount of stress, and multi-site pain. Preventive actions at the workplace should promote good musculoskeletal health, and measures taken, both individual and organizational, to minimize the risk of high, persistent stress and work-related pain.

In 2017 a new railway tunnel containing two stations opened in Stockholm, Sweden. A series of field measurements were carried out on the platforms in this tunnel before and after it was opened for ...

ObjectivesThe aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period.MethodsA cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971–1993) was examined prospectively (2001–2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure–response relationships.ResultsThe total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00).ConclusionsOccupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.

With electrification of vehicles comes an increasing demand on low noise, which for gears translates to transmission error. In this paper, static transmission error, S T E , is found for a large number of manufacturing error combinations belonging to different tolerance classes, with focus on those typically used in the automotive industry. There is a lack of studies found in the scientific literature which investigate the link between S T E , contact pressure, and manufacturing error tolerances. Therefore, the aim of the present study is to investigate this link. This is done by utilizing a novel simulation tool, developed by the authors, to compute S T E for gear sets with pitch and profile slope errors combinations. The model uses a parametric description of the reference profile, includes tooth modifications, uses a hybrid method for compliance, and finds contact from equilibrium. The model handles contact outside the nominal line of action, including tip contact. A simplified method, with predictions based on simulated values, is shown to be accurate and suitable for estimations. Finally, S T E is linked to contact pressure for better understanding of how S T E and contact pressure interact as a consequence of manufacturing errors. It is shown how this can be used to optimize the gear set with respect to both S T E and contact pressure simultaneously.

Objectives: To characterise cold sensitivity using a semi-structured interview, physical examination, thermal quantitative sensory testing (QST), and laser speckle contrast analysis (LASCA). Methods: Eight women and four men, ages 22–74, with cold sensitivity were interviewed and examined by an occupational physician. Thermal perception thresholds were established using QST, on the pulp of the index and little finger of the most affected hand. Skin perfusion in the dorsum of the hand was measured using LASCA, at baseline, after two-minute 12°C water immersion, and during rewarming. Results: The physical examination yielded few findings indicative of vascular or neurosensory pathology. One subject (8%) had impaired thermal perception thresholds. LASCA at baseline showed absent proximal-distal perfusion gradients in six subjects (50%), and a dyshomogeneous perfusion pattern in five (42%). Perfusion on a group level was virtually unchanged by cold stress testing (median 52.5 PU; IQR 9.0 before versus 51.3 PU; IQR 27.2 afterwards). Conclusions: Physical examination and thermal QST offered little aid in diagnosing cold sensitivity, which challenges the neurosensory pathophysiological hypothesis. LASCA indicated disturbances in microvascular regulation and could prove a useful tool in future studies on cold sensitivity.

The aim of this study was to determine the association between individual and external exposure factors, and the reporting of Raynaud's phenomenon, with or without concomitant cold sensitivity. In a population-based nested case-control study, cases with Raynaud's phenomenon (N = 578), and matched controls (N = 1156), were asked to respond to a questionnaire focusing on different risk factors. Univariate and multiple conditional logistic regression were performed. Analyses were stratified according to whether the cases reported cold sensitivity or not. In total, 1400 out of 1734 study subjects answered the questionnaire (response rate 80.7%). In the final multiple model, the factor with the strongest association to Raynaud's phenomenon, with and without cold sensitivity, was previous frostbite affecting the hands (OR 12.44; 95% CI 5.84-26.52 and OR 4.01; 95% CI 1.78-9.01, respectively). Upper extremity nerve injury was associated to reporting Raynaud's phenomenon and cold sensitivity (OR 2.23; 95% CI 1.29-3.85), but not Raynaud's phenomenon alone. Reporting any exposure to hand-arm vibration or cumulative cold exposure was significant in univariate analyses for cases with both Raynaud's phenomenon and cold sensitivity, but not in the multiple model. Raynaud's phenomenon is strongly associated to previous cold injury, with a larger effect size among those who also report cold sensitivity. The fact that only upper extremity nerve injury differed significantly between case groups in our multiple model offers additional support to the neural basis for cold sensitivity.

Tobacco smoking is an injurious habit associated with a number of chronic disorders. Its influence on disc metabolism and degeneration including lumbar spinal stenosis (LSS) has been investigated in the literature.We aimed to investigate whether tobacco smoking is an independent risk factor for undergoing surgical intervention for LSS.This is a prospective cohort study.The patient sample of 331,941 workers was derived from a Swedish nationwide occupational surveillance program for construction workers.The outcome measure included the incidence of undergoing surgical intervention for LSS in tobacco smokers versus no smokers.At inclusion, age, sex, body mass index (BMI), workers' job title, and self-reported smoking habits were registered. The workers were divided into four categories: never smoked, former smoker, moderate current (1-14 cigarettes/day), and heavy current (≥15 cigarettes/day). Patients who underwent a surgically treated LSS were defined using the relevant International Classification of Diseases (ICD) disease code derived from the Swedish National Patient Register.A total of 331,941 participants were included in the analysis. Forty-four percent of the participants were non-smokers, 16% were former smokers, 26% were moderate smokers, and 14% were heavy smokers. The vast majority of construction workers were males (95%). During the average follow-up of 30.7 years, 1,623 participants were surgically treated for LSS. The incidence rate ratio (IRRs) of LSS varied across smoking categories, with the highest values found in heavy smokers. Compared with non-smokers, all smoking categories show an increased incidence of surgically treated LSS. The findings were consistent even when the comparison was performed for participants with BMIs between 18.5 and 25 and for participants aged between 40 and 74 years.Tobacco smoking is associated with an increased incidence of surgically treated LSS. The effect seems to be dose related, whereby heavy smokers have a higher risk than moderate or former smokers.

Background: Raynaud's phenomenon and neurosensory symptoms are common after hand-arm vibration exposure. Knowledge of early signs of vibration injuries is needed. Aims: To investigate the risk of developing Raynaud's phenomenon and paraesthesia in relation to sensation of cold hands in a cohort of male employees at an engineering plant. Methods: We followed a cohort of male manual and office workers at an engineering plant in Sweden for 21 years. At baseline (1987 and 1992) and each follow-up (1992, 1997, 2002, 2008), we assessed sensation of cold, Raynaud's phenomenon and paraesthesia in the hands using questionnaires and measured vibration exposure. We calculated risk estimates with univariate and multiple logistic regression analyses and adjusted for vibration exposure and tobacco usage. Results: There were 241 study participants. During the study period, 21 individuals developed Raynaud's phenomenon and 43 developed paraesthesia. When adjusting the risk of developing Raynaud's phenomenon for vibration exposure and tobacco use, the odds ratios were between 6.0 and 6.3 (95% CI 2.2-17.0). We observed no increased risk for paraesthesia in relation to a sensation of cold hands. Conclusions: A sensation of cold hands was a risk factor for Raynaud's phenomenon. At the individual level, reporting a sensation of cold hands did not appear to be useful information to predict future development of Raynaud's phenomenon given a weak to moderate predictive value. For paraesthesia, the sensation of cold was not a risk factor and there was no predictive value at the individual level. Originally published in thesis in manuscript form.

Aim To identify possible risk factors for cold sensitivity, by comparing cases to controls with regard to demographic and anthropometric characteristics, previous illnesses and injuries as well as ambient exposures. Methods Through a questionnaire responded to by the general population (n=12,627) cold sensitivity cases (n=502) and matched controls (n=1,004) were identified and asked to respond to a second questionnaire with focus on different aspects of cold sensitivity, hereditary factors, previous diseases, medication, tobacco use as well as exposure to ambient cold climate and hand-arm vibration (HAV). Results In total, 997 out of 1506 study subjects answered the second questionnaire, 374 cases and 623 match controls. Identified risk factors among the cases were frostbite of the hands Odds Ratio (OR) 10.3 (95% confidence interval (CI) 5.5-19.3), rheumatic disease OR 3.1 (95% CI 1.7-5.7), upper extremity nerve injury OR 2.0 (95% CI 1.3-3.0), and vascular disease OR 1.9 (95% CI 1.2-2.9). Sex differences in risk factors were HAV exposure for men and cold exposure for women increased the risk of cold sensitivity. Rheumatic diseases and migraine increased the risk of cold sensitivity among women but not among men. Conclusions The present study shows that cold sensitivity is associated with both inherent factors, acquired conditions and external exposures. Among acquired conditions, frostbite, vascular disease, nerve injury, joint disorders and migraine are significantly related to the reporting of cold sensitivity. Among external exposures, both cold climate and HAV exposure are significantly associated to cold sensitivity, and thus suitable targets for primary preventive measures. There was a difference in risk factors related to sex. HAV exposure for men and cold exposure for women increased the risk of cold sensitivity. Originally included in thesis in manuscript form with title [Cold sensitivity and associated factors: a case-control study performed in northern Sweden] CHINS

OBJECTIVES: The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE). METHODS: A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971–1993) were examined prospectively over a 13-year case ascertainment period (2001–2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register. RESULTS: There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18–1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers. CONCLUSION: Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.

Brake-related particulate matter contributes considerably to the non-exhaust emissions of the transport sector in urban areas of the world. The airborne particle emissions from automotive brakes currently lack any proper regulations. Future regulations require test stands, test cycles and particle instruments to be suitable for measuring the brake emissions. This present work focuses on the design of a novel test stand for reliable measurements of the brake emissions with a high sampling efficiency. A test stand in the form of an inertial disc brake dynamometer was redesigned to allow control of the cleanness of the incoming air and to assure isokinetic sampling. The cleanness of the incoming air, together with an over-pressurized chamber around the brake assembly, ensures that all the particles measured originate from the brake materials. In order to evaluate the novel design, the number and size distributions of the brake emissions are measured online with and without control of the cleanness of the intake air. The results reveal that this test stand can be proposed as a standard test stand to assess objectively the emissions of airborne brake particles in future regulations.

The present study assessed full-shift trunk and upper arm postural exposure amplitudes, frequencies, and durations among Swedish airport baggage handlers and aimed to determine whether exposures differ between workers at the ramp (loading and unloading aircraft) and baggage sorting areas.Trunk and upper arm postures were measured using inclinometers during three full work shifts on each of 27 male baggage handlers working at a large Swedish airport. Sixteen of the baggage handlers worked on the ramp and 11 in the sorting area. Variables summarizing postures and movements were calculated, and mean values and variance components between subjects and within subject (between days) were estimated using restricted maximum likelihood algorithms in a one-way random effect model.In total, data from 79 full shifts (651h) were collected with a mean recording time of 495min per shift (range 319-632). On average, baggage handlers worked with the right and left arm elevated60° for 6.4% and 6.3% of the total workday, respectively. The 90th percentile trunk forward projection (FP) was 34.1°, and the 50th percentile trunk movement velocity was 8° s(-1). For most trunk (FP) and upper arm exposure variables, between-subject variability was considerable, suggesting that the flight baggage handlers were not a homogeneously exposed group. A notable between-days variability pointed to the contents of the job differing on different days. Peak exposures (90°) were higher for ramp workers than for sorting area workers (trunk 0.6% ramp versus 0.3% sorting; right arm 1.3% ramp versus 0.7% sorting).Trunk and upper arm postures and movements among flight baggage handlers measured by inclinometry were similar to those found in other jobs comprising manual material handling, known to be associated with increased risks for musculoskeletal disorders. The results showed that full-shift trunk (FP) and, to some extent, peak arm exposures were higher for ramp workers compared with sorting workers.

Introduction The current risk prediction modelling (ISO-5349) for ‘Raynaud’s phenomenon’ is based on a few studies published 70 to 40 years ago. There are no corresponding risk prediction models for neurosensory injury or carpal tunnel syndrome, nor any systematic reviews comprising a statistical synthesis (meta-analysis) of the evidence. Methods This systematic review covers the scientific literature up to January 2016. The databases used for the literature search were PubMed and Science Direct. We found a total of 4335 abstracts, which were read and whose validity was assessed according to pre-established criteria. 294 articles were examined in their entirety to determine whether each article met the inclusion criteria. The possible risk of bias was assessed for each article. 52 articles finally met the pre-established criteria for inclusion in the systematic review. For the outcome neurosensory injury, 33 articles were included and for Carpal tunnel syndrome 7. Result The results show that workers who are exposed to HAV have an increased risk of neurological diseases compared to non-vibration exposed groups. The crude estimate of the risk increase is approximately 4–5 fold. The estimated effect size (odds ratio) of neurosensory injury is 7.4, when including only the studies judged to have a low risk of bias and the equivalent of carpal tunnel syndrome is 2.9. Discussion At equal exposures, neurosensory injury occurs with a 3-time factor shorter latency than Raynaud’s phenomenon. Which is why preventive measures should address this vibration health hazard with greater attention. Reference . Nilsson T, Wahlstrom J, Burstrom L. Hand-arm vibration and the risk of vascular and neurological diseases: A systematic review and meta-analysis. PloS One. 2017;12(7):e0180795.

With regard to airborne particles with an aerodynamic diameter of less than 10 mu m (PM10), in countries in the European Union, the mass of brake emissions equals approximately 8-27% of the total traffic-related emissions. Using a research methodology combining tests at different scale levels with contact mechanics simulations and PM10 chemical characterization, the REBRAKE EU-financed project had the following aims: i) to demonstrate the possibility of reducing the PM10 fraction of the airborne particulate from brake wear by 50 wt%; ii) to enhance the general understanding on the physical and chemical phenomena underlying the brake wear process. The results achieved so far indicate that it is possible to design a disc brake system for a European standard car affording at least a 32 wt% PM10 emission reduction using a standard European pad and a heat-treated rotor. A further reduction to 65 wt% PM10 emission could be achieved with NAO pad material and the same heat-treated disc. QC 20200505

Objective The aim was to examine if exposure to whole-body vibration (WBV) increases the risk for hospitalization due to lumbar disc herniation. Methods The study basis is a cohort of 288,926 Swedish construction workers who participated in a national occupational health surveillance programme from 1971 until 1992. Job title, smoking habits, body weight, height and age were registered at the examinations. Assessment of WBV were made for each of the constituent occupations by constructing a job-exposure matrix (JEM). Exposure to WBV was graded on a scale from 0 to 5. In addition, the occurrence of hospitalization due to lumbar disc herniation from January 1st 1987 until December 31st 2010 was collected from a linkage with the Swedish Hospital Discharge Register. Poisson regressions were used to estimate relative risk with 95 percent confidence intervals (95% CI), adjusting for age, height, weight and smoking, using white-collar workers and foremen as a reference group. Results There was an increased risk for hospitalization due to lumbar disc herniation for workers in the construction industry exposed to medium to high WBV compared to white-collar workers and foremen 1.35 (1.12–1.63). When restricting the analyses to include workers 30–49 years of age at the time of the hospital admission the risk was 1.69 (95% CI 1.29–2.21). Conclusion This study further supports that occupational exposure to whole-body vibration increases the risk for hospitalization due to lumbar disc herniation. Electronic supplementary material The online version of this article (10.1007/s00420-018-1316-5) contains supplementary material, which is available to authorized users.

Previous research suggests inclinometers (INC) underestimate upper arm elevation. This study was designed to quantify possible bias in occupationally relevant postures, and test whether INC perform ...

Objectives: The objectives of this study are to investigate the relation between obesity and labour force exit via diagnosis-specific disability benefits, and whether physical workload modifies this association. Methods: A longitudinal analysis was performed among 3 28 743 Swedish construction workers in the age of 15-65 years. Body weight and height were measured at a health examination and enriched with register information on disability benefits up to 37 years later. Diagnoses of disability benefits were categorised into cardiovascular diseases (CVDs), musculoskeletal diseases (MSDs), mental disorders and others. A job exposure matrix, based on self-reported lifting of heavy loads and working in bent forward or twisted position, was applied as a measure of physical workload. Cox proportional hazards regression analyses were performed, and the relative excess risk due to interaction (RERI) between obesity and physical workload was calculated. Results: Obese construction workers were at increased risk of receiving disability benefits (HR 1.70, 95% CI 1.65 to 2.76), mainly through CVD (HR 2.30) and MSD (HR 1.71). Construction workers with a high physical workload were also more likely to receive a disability benefit (HR 2.28, 95% CI 2.21 to 2.34), particularly via MSD (HR 3.02). Obesity in combination with a higher physical workload increased the risk of disability benefits (RERI 0.28) more than the sum of the risks of obesity and higher physical workload, particularly for MSD (RERI 0.44). Conclusions: Obesity and a high physical workload are risk factors for disability benefit. Furthermore, these factors are synergistic risk factors for labour force exit via disability benefit through MSD. Comprehensive programmes that target health promotion to prevent obesity and ergonomic interventions to reduce physical workload are important to facilitate sustained employment.

Workers in the Arctic open-pit mines are exposed to harsh weather conditions. Employers are required to provide protective clothing for workers. This can be the outer layer, but sometimes also inner or middle layers are provided. This study aimed to determine how the Arctic open-pit miners protect themselves against cold and the sufficiency, and the selection criteria of the garments. Workers' cold experiences and the clothing in four Arctic open-pit mines in Finland, Sweden, Norway and Russia were evaluated by a questionnaire (n=1323). Basic thermal insulation (Icl) of the reported clothing was estimated (ISO 9920). The Icl of clothing from the mines were also measured by thermal manikin (standing/walking) in 0.3 and 4.0 m/s wind. The questionnaire showed that the Icl of the selected clothing was on average 1.2 and 1.5 clo in mild (-5 to +5°C) and dry cold (-20 to -10°C) conditions, respectively. The Icl of the clothing measured by thermal manikin was 1.9w2.3 clo. The results show that the Arctic open-pit miners' selected their clothing based on occupational (time outdoors), environmental (temperature, wind, moisture) and individual factors (cold sensitivity, general health). However, the selected clothing was not sufficient to prevent cooling completely at ambient temperatures below -10°C. Special issue: New development of research on personal protective equipment (PPE) for occupational safety and health

Purpose To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms. Methods A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18–70 years and living in northern Sweden. Results A total of 12,627 out of 35,144 subjects returned the questionnaire (response rate 35.9%). Subjects living in the rural alpine areas reported more extensive cold exposure both during work and leisure time compared to the urbanized coastal regions. Frostbite in the hands was present in 11.4% of men and 7.1% of women, cold sensitivity was present in 9.7 and 14.4%, and Raynaud’s phenomenon was present in 11.0% of men and 14.0% of women. There was a positive association between cumulative cold exposure and neurovascular hand symptoms. Conclusion The present study demonstrates that the cold environment in northern Sweden might be an underestimated health risk. Our hypothesis that cold exposure is positively related to reporting of neurovascular hand symptoms was supported by our findings. In addition, such symptoms were common not only in conjunction with an overt cold injury. Our results warrant further study on pathophysiological mechanisms and suggest the need for confirmatory prevalence studies to support national public health planning. Electronic supplementary material The online version of this article (doi:10.1007/s00420-017-1221-3) contains supplementary material, which is available to authorized users.

Background Increased occurrence of Raynaud's phenomenon, neurosensory injury and carpal tunnel syndrome has been reported for more than 100 years in association with work with vibrating machines. The current risk prediction modelling (ISO-5349) for "Raynaud's phenomenon" is based on a few studies published 70 to 40 years ago. There are no corresponding risk prediction models for neurosensory injury or carpal tunnel syndrome, nor any systematic reviews comprising a statistical synthesis (meta-analysis) of the evidence. Objectives Our aim was to provide a systematic review of the literature on the association between Raynaud's phenomenon, neurosensory injuries and carpal tunnel syndrome and hand-arm vibration (HAV) exposure. Moreover the aim was to estimate the magnitude of such an association using meta-analysis. Methods This systematic review covers the scientific literature up to January 2016. The databases used for the literature search were PubMed and Science Direct. We found a total of 4,335 abstracts, which were read and whose validity was assessed according to pre-established criteria. 294 articles were examined in their entirety to determine whether each article met the inclusion criteria. The possible risk of bias was assessed for each article. 52 articles finally met the pre-established criteria for inclusion in the systematic review. Results The results show that workers who are exposed to HAV have an increased risk of vascular and neurological diseases compared to non-vibration exposed groups. The crude estimate of the risk increase is approximately 4-5 fold. The estimated effect size (odds ratio) is 6.9 for the studies of Raynaud's phenomenon when including only the studies judged to have a low risk of bias. The corresponding risk of neurosensory injury is 7.4 and the equivalent of carpal tunnel syndrome is 2.9. Conclusion At equal exposures, neurosensory injury occurs with a 3-time factor shorter latency than Raynaud's phenomenon. Which is why preventive measures should address this vibration health hazard with greater attention.

Airborne particulate matter emitted from motor vehicle brakes is a contributor to urban air quality. Therefore, a method to rank brake pairs (pads and rotors) with respect to their particle emission factors in a reliable way is needed to develop a low-emission disc brake. A novel inertial disc brake dynamometer designed for brake particle emission studies, a modified SAE J 2707 cycle, an electrical low-pressure cascade impactor and a filter are used to test five different pad materials against cast-iron rotors. By changing only the pad materials, it is shown that the differences between the mass emission factor and the number emission factor of the the worst brake pair and those of the best brake pair decreases by more than four times and 19 times respectively. Furthermore, the results show that the material combination ranked the best in terms of the mass emission factor is ranked the worst in terms of the number emission factor. The results reveal that this combination of a test stand, a test cycle and particle instruments can discriminate between different brake pair materials in a reliable way in the case of the mass emission factors while more research has to be carried out in the case of the number emission factors. QC 20170712

Airborne particle emissions from automotive disc brakes, one of the main sources of urban particulate matter, adversely affect health. Field measurement of brake particles is complicated, as various particle sources (such as tailpipe emissions, resuspended road dust and tyre wear) can interfere. Brake particles are usually measured on dyno benches or in model-scale tests in controlled environments. Such test results need confirmation in the field, where air flow around disc brakes differs completely. Few field studies focusing on disc brake particles have been reported in the literature. The objective of this work is to investigate further the possibility of measuring brake particles in the field using particle instruments mounted on a car. A car was instrumented with two GRIMM 1.109 aerosol spectrometers and two TSI DustTrak 8520 aerosol monitors. One GRIMM spectrometer and one TSI DustTrak monitor recorded data near the brake, and the other GRIMM spectrometer and the other TSI DustTrak monitor recorded data at the front of the car during five field tests in outer Stockholm. The results suggest that braking directly correlates with increased particle concentrations measured near the brake. The reported test stand results correlate with the field-measured number distributions. QC 20150420

Background Historically, working in iron-ore mines has been associated with an increased risk of lung cancer and silicosis. However, studies on other causes of mortality are inconsistent and in the ...

Purpose. To study the association of self-reported pain in adolescence with low back pain (LBP) in adulthood among mine workers and, also, study associations between the presence of LBP over 12-month or one-month LBP intensity during a health examination and daily ratings of LBP three and nine months later. Methods. Mixed design with data collected retrospectively, cross-sectionally, and prospectively. Data was collected using a questionnaire during a health examination and by using self-reported daily ratings of LBP three and nine months after the examination. Results. Pain prevalence during teenage years was 55% and it was 59% at age 20. Pain during teenage years had a relative risk of 1.33 (95% confidence interval 1.03–1.73) of LBP 12 months prior to the health examination, but with no associations with LBP intensity or LBP assessed by text messaging. Pain at age 20 years was not associated with any measure of LBP in adulthood. Daily ratings of LBP were associated with LBP during the health examination three and nine months earlier. Conclusions. There were no clear associations between self-reported pain in adolescence and LBP in adulthood. Self-reported daily ratings of LBP were associated with LBP from the health examination. Possible limitations for this study were the retrospective design and few participants.

Prospective cohort study.To study biomechanical factors in relation to symptomatic lumbar disc disease.The importance of biomechanical factors in lumbar disc disease has been questioned in the past decade and knowledge from large prospective studies is lacking.The study basis is a cohort of 263,529 Swedish construction workers who participated in a national occupational health surveillance program from 1971 until 1992. The workers' job title, smoking habits, body weight, height, and age were registered at the examinations. The occurrence of hospitalization due to lumbar disc disease from January 1, 1987, until December 31, 2003, was collected from a linkage with the Swedish Hospital Discharge Register.There was an increased risk for hospitalization due to lumbar disc disease for several occupational groups compared with white-collar workers and foremen. Occupational groups with high biomechanical loads had the highest risks, for example, the relative risk for concrete workers was 1.55 (95% confidence interval [CI], 1.29-1.87). A taller stature was consistently associated with an increased risk. The relative risk for a man of 190- to 199-cm height was 1.55 (95% CI, 1.30-1.86) compared with a man being 170- to 179-cm height. Body weight and smoking were also risk factors, but weaker than height. Workers in the age span of 30 to 39 years had the highest relative risk (RR = 1.87; 95% CI, 1.58-2.23) compared with those aged 20 to 29 years, whereas men aged 60 to 65 years had a lower risk (RR = 0.86; 95% CI, 0.68-1.09).This study indicates that factors increasing the load on the lumbar spine are associated with hospitalization for lumbar disc disease. Occupational biomechanical factors seem to be important, and a taller stature was consistently associated with an increased risk.

Documentation of posture measurement cost is rare and cost models that do exist are generally naive. This paper provides a comprehensive cost model for ergonomic research, documents the monetary co ...

Since brake wear is an important contributor to the concentration of airborne particles in urban atmospheres, it is important to increase our understanding of the origin of these particles. The con ...

Manual work involving vibrating power tools is associated with symptoms that include vascular, neurological and musculoskeletal disorders. This study examines the vibration exposure of welders to determine the change between 1987 and 2008. Vibration measurements on handheld tools were used to evaluate the acceleration and the daily exposure time was determined by subjective rating. From these data, the 8-hour equivalent vibration exposure A(8), has been calculated. During the period, the A(8) decreased from 3.9 m/s2 to 1.9 m/s2. It was concluded that this decrease is the result of fewer vibrating tools and a decrease in daily exposure time. Although the daily vibration exposure has decreased over the study time, for some welders the daily vibration exposure A(8) is still above the action value set by the EU directive on vibration. This means more effort should be spent to decrease vibration exposure.

Most modern passenger cars have disc brakes on the front wheels. Unlike drum brakes, disc brakes are not sealed off from the ambient air. During braking, both the rotor and the pads wear, and this wear process generates particles that may become airborne. In field tests it is difficult to distinguish these particles from others in the environment. It is thus preferable to conduct tests using laboratory test stands where the cleanness of the surrounding air can be controlled. However, the validity of results from these test stands should be verified by comparison with field tests. This article presents a comparison of the number and volume distributions of airborne wear particles as measured online in field tests, in a disc brake assembly test stand, and in a pin-on-disc machine. In all cases, grey cast iron rotors and low metallic pads were tested. A promising correlation between the three different test methods is shown. The number- and volume-weighted mean particle diameter for all test methods is about 0.4 and 2-3 μm, respectively.

Digging deeper into the assessment of upper arm elevation angles using standard inclinometry

Background. Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients.Objective. To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception thresholds and by symptom descriptions.Design. Fifteen patients with a local freezing cold injury in the hands or feet, acquired during military training, were studied with QST by assessment of vibrotactile (VPT), warmth (WPT) and cold (CPT) perception thresholds 4 months post-injury. In addition, a follow-up questionnaire, focusing on neurovascular symptoms, was completed 4 months and 4 years post-injury.Results. QST demonstrated abnormal findings in one or both affected hands for VPT in 6 patients, for WPT in 4 patients and for CPT in 1 patient. In the feet, QST was abnormal for VPT in one or both affected feet in 8 patients, for WPT in 6 patients and for CPT in 4 patients. Freezing cold injury related symptoms, e.g. pain/discomfort when exposed to cold, cold sensation and white fingers were common at 4 months and persisted 4 years after the initial injury.Conclusions. Neurosensory sequelae after local freezing cold injury, in terms of abnormal thermal and/or vibration perception thresholds, may last at least 4 months after the initial injury. Symptoms such as pain/discomfort at cold exposure, cold sensations and white fingers may persist at least 4 years after the initial injury.Keywords: case series; neurovascular; quantitative sensory testing; military; frostbite; Sweden(Published: 17 February 2014)Citation: Int J Circumpolar Health 2014, 73: 23540 - http://dx.doi.org/10.3402/ijch.v73.23540

OBJECTIVES: This study compared the cost efficiency of observation and inclinometer assessment of trunk and upper-arm inclination in a population of flight baggage handlers, as an illustration of a general procedure for addressing the trade-off between resource consumption and statistical performance in occupational epidemiology. METHODS: Trunk and upper-arm inclination with respect to the line of gravity were assessed for three days on each of 27 airport baggage handlers using simultaneous inclinometer and video recordings. Labor and equipment costs associated with data collection and processing were tracked throughout. Statistical performance was computed from the variance components within and between workers and bias (with inclinometer assumed to produce “correct” inclination angles). The behavior of the trade-off between cost and efficiency with changed sample size, as well as with changed logistics for data collection and processing, was investigated using simulations. RESULTS: At similar total costs, time spent at trunk and arm inclination angles >60 ° as well as 90^th percentile arm inclination were estimated at higher precision using inclinometers, while median inclination and 90th percentile trunk inclination was determined more precisely using observation. This hierarchy remained when the study was reproduced in another population, while inclinometry was more cost-efficient than observation for all three posture variables in a scenario where data were already collected and only needed to be processed. CONCLUSIONS: When statistical performance was measured only in terms of precision, inclinometers were more cost-efficient than observation for two out of three posture metrics investigated. Since observations were biased, inclinometers consistently outperformed observation when both bias and precision were included in statistical performance. This general model for assessing cost efficiency may be used for designing exposure assessment strategies with considerations not only of statistical but also cost criteria. The empirical data provide a specific basis for planning assessments of working postures in occupational groups.

Objectives The aim of this study was to investigate whether gender or different methods of operating a computer mouse have an effect on performance and musculoskeletal load in the use of a computer mouse. Methods Thirty experienced computer mouse users, 15 men and 15 women, participated in the study. Electromyography (right first dorsal interossei, right extensor digitorum and right and left trapezius), a force-sensing mouse, and subjective ratings were used to register muscular load. An electrogoniometer was used to register the wrist movements. The subjects worked with 3 different methods, their own, a wrist-based method and an arm-based method. Gender comparisons were made when the subjects used their own method. Results The women worked with greater extension and range of motion and tended to work with a greater ulnar deviation of the wrist. They also applied higher forces to the mouse when expressed as a percentage of a maximum voluntary contraction and had higher muscular activity in the right extensor digitorum. When using the arm-based method, the subjects worked with greater wrist extension, had higher muscle activity in the right and left trapezius muscles and had the highest ratings of perceived exertion in the neck and shoulder. The wrist-based method resulted in higher forces being applied to the sides of the mouse and the highest ratings of perceived exertion in the wrist and hand-fingers. Conclusions Gender differences were found for musculoskeletal load, and for most of the measured variables the women worked with higher loads than the men. The work method affected performance and musculoskeletal load. Finally, subjective measures appeared to have some utility in characterizing muscular load.

The aim of this study was to investigate whether different work methods with computer mouse had an effect on musculoskeletal load and to study whether there were any gender differences in performance and/or musculoskeletal load. Thirty experienced computer mouse users (15 men and 15 women) performed a text-editing task using two different work methods to operate the mouse. Women worked with higher muscular activity in the forearm, applied higher relative forces to the sides and button of the mouse and worked with more extreme postures in the wrist than men. Differences were also found between the two different work methods used to operate the mouse.

The aim of this systematic literature review was to evaluate the association between whole-body vibration (WBV) and low back pain (LBP) and sciatica with special attention given to exposure estimates. Moreover, the aim was to estimate the magnitude of such an association using meta-analysis and to compare our findings with previous reviews.The authors systematically searched the PubMed (National Library of Medicine, Bethesda), Nioshtic2 (National Institute for Occupational Safety and Health (NIOSH, Morgantown), and ScienceDirect (Elsevier, Amsterdam) databases for records up to December 31, 2013. Two of the authors independently assessed studies to determine their eligibility, validity, and possible risk of bias.The literature search gave a total of 306 references out of which 28 studies were reviewed and 20 were included in the meta-analysis. Exposure to WBV was associated with increased prevalence of LBP and sciatica [pooled odds ratio (OR) = 2.17, 95% confidence interval (CI) 1.61-2.91 and OR 1.92, 95% CI 1.38-2.67, respectively]. Workers exposed to high vibration levels had a pooled risk estimate of 1.5 for both outcomes when compared with workers exposed to low levels of vibration. The results also indicate that some publication bias could have occurred especially for sciatica.This review shows that there is scientific evidence that exposure to WBV increases the risk of LBP and sciatica.

There are numerous factors including physical, biomechanical, and individual that influence exposure to hand-transmitted vibration (HTV) and cause variability in the exposure measurements. Knowledge of exposure variability and determinants of exposure could be used to improve working conditions. We performed a quasi-experimental study, where operators performed routine work tasks in order to obtain estimates of the variance components and to evaluate the effect of determinants, such as machine-wheel combinations and individual operator characteristics.Two pre-defined simulated work tasks were performed by 11 operators: removal of a weld puddle of mild steel and cutting of a square steel pipe. In both tasks, four angle grinders were used, two running on compressed air and two electrically driven. Two brands of both grinding and cutting wheels were used. Each operator performed both tasks twice in a random order with each grinder and wheel and the time to complete each task was recorded. Vibration emission values were collected and the wheel wear was measured as loss of weight. Operators' characteristics collected were as follows: age, body height and weight, length and volume of their hands, maximum hand grip force, and length of work experience with grinding machines (years). The tasks were also performed by one operator who used four machines of the same brand. Mixed and random effects models were used in the statistical evaluation.The statistical evaluation was performed for grinding and cutting separately and we used a measure referring to the sum of the 1-s r.m.s. average frequency-weighted acceleration over time for completing the work task (a(sa)). Within each work task, there was a significant effect as a result of the determinants 'the machine used', 'wheel wear', and 'time taken to complete the task'. For cutting, 'the brand of wheel' used also had a significant effect. More than 90% of the inherent variability in the data was explained by the determinants. The two electrically powered machines had a mean a(sa) that was 2.6 times higher than the two air-driven machines. For cutting, the effect of the brand of wheel on a(sa) was ~0.1 times. The a(sa) increased both with increasing wheel wear and with time taken to complete the work task. However, there were also a number of interaction effects which, to a minor extent, modified the a(sa). Only a minor part (1%) of the total variability was attributed to the operator: for cutting, the volume of the hands, maximum grip force, and body weight were significant, while for grinding, it was the maximum grip force. There was no clear difference in a(sa) between the four copies of the same brand of each machine.By including determinants that were attributed to the brand of both machine and wheel used as well as the time taken to complete the work task, we were able to explain90% of the variability. The dominating determinant was the brand of the machine. Little variability was found between operators, indicating that the overall effect as due to the operator was small.

To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine.The prevalence's of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52-1.66) and 1.39 (95 % CI 1.30-1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature.Outdoor work in a cold environment may increase the risk of low back and neck pain.

In order to test the feasibility and sensitivity of the ergonomic exposure assessment tool Quick Exposure Check (QEC), a pilot-study was conducted. The aim was to test QEC in different occupational groups to compare the exposure in the most common work task with the exposure in the work task perceived as the most strenuous for the neck/shoulder region, and to test intra-observer reliability. One experienced ergonomist observed 23 workers. The mean observation time was 45 minutes, waiting time and time for complementary questions included. The exposure scores varied between the different occupational groups as well as between workers within the occupational groups. Eighteen workers rated their most common work task as also being the most strenuous for the neck/shoulder region. For the remaining five workers, the mean exposure score were higher both for the neck and shoulder/arm in the most common work task. Intra-observer reliability shows agreement in 86% of the exposure interactions in the neck and in 71% in the shoulder/arm. QEC seems to fulfill the expectations of being a quick, sensible and practical exposure assessment tool that covers physical risk factors in the neck, upper extremities and low back.

Background The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. Methods At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. Results The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively. Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. Conclusion There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.

This study examines the effect of changing the floor from a 2-mm homogenous vinyl floor to a 4-mm heterogeneous vinyl floor (1.5-mm wear layer and 2.5-mm foam layer) on musculoskeletal symptoms in the lower extremities and low back among nursing assistants in a geriatric care centre. A pre-post design with a reference group consisting of nursing assistants from a similar geriatric care centre was used. Follow-up measurements were carried out 12 and 24 months after the intervention by means of questionnaires. At the 1-year follow-up, the pain intensity score in the feet of the intervention group had decreased compared with the baseline value and remained statistically significant at the 2-year follow-up. The decrease in pain intensity score of the feet in the intervention group was statistically significantly different from the reference group, both after 1 and 2 years.The results show the importance of flooring in the workplace with regard to reducing musculoskeletal symptoms. Appropriate flooring is especially important in the female-dominated health care sector, where workers must stand or walk for long periods.

Background: Measurements of exposure to vibrations from hand-held tools are often conducted on a single occasion. However, repeated measurements may be crucial for estimating the actual dose with good precision. In addition, knowledge of determinants of exposure could be used to improve working conditions. The aim of this study was to assess hand–arm vibration (HAV) exposure during different grinding operations, in order to obtain estimates of the variance components and to evaluate the effect of work postures. Methods: Ten experienced operators used two compressed air-driven angle grinders of the same make in a simulated work task at a workplace. One part of the study consisted of using a grinder while assuming two different working postures: at a standard work bench (low) and on a wall with arms elevated and the work area adjusted to each operator’s height (high). The workers repeated the task three times. In another part of the study, investigating the wheel wear, for each grinder, the operators used two new grinding wheels and with each wheel the operator performed two consecutive 1-min grinding tasks. Both grinding tasks were conducted on weld puddles of mild steel on a piece of mild steel. Measurements were taken according to ISO-standard 5349 [the equivalent hand–arm-weighted acceleration (m s−2) averaged over 1 min]. Mixed- and random-effects models were used to investigate the influence of the fixed variables and to estimate variance components. Results: The equivalent hand–arm-weighted acceleration assessed when the task was performed on the bench and at the wall was 3.2 and 3.3 m s−2, respectively. In the mixed-effects model, work posture was not a significant variable. The variables ‘operator’ and ‘grinder’ together explained only 12% of the exposure variability and ‘grinding wheel’ explained 47%; the residual variability of 41% remained unexplained. When the effect of grinding wheel wear was investigated in the random-effects model, 37% of the variability was associated with the wheel while minimal variability was associated with the operator or the grinder and 37% was unexplained. The interaction effect of grinder and operator explained 18% of the variability. In the wheel wear test, the equivalent hand–arm-weighted accelerations for Grinder 1 during the first and second grinding minutes were 3.4 and 2.9 m s−2, respectively, and for Grinder 2, they were 3.1 and 2.9 m s−2, respectively. For Grinder 1, the equivalent hand–arm-weighted acceleration during the first grinding minute was significantly higher (P = 0.04) than during the second minute. Conclusions: Work posture during grinding operations does not appear to affect the level of HAV. Grinding wheels explained much of the variability in this study, but almost 40% of the variance remained unexplained. The considerable variability in the equivalent hand–arm-weighted acceleration has an impact on the risk assessment at both the group and the individual level.

OBJECTIVES: The aim of this study was to examine the association between white fingers, cold environment, and exposure to hand–arm vibration (HAV). The hypothesis was that working in cold climate increases the risk of white fingers. METHODS: The occurrence of white fingers was investigated as a cross-sectional study in a cohort of Swedish male construction workers (N=134 757). Exposure to HAV was based on a job-exposure matrix. Living in the north or south of Sweden was, in a subgroup of the cohort, used as an indicator of the exposure to cold environment (ie, living in the north meant a higher exposure to cold climate). The analyses were adjusted for age and use of nicotine products (smoking and snuff). RESULTS: HAV-exposed workers living in a colder climate had a higher risk for white fingers than those living in a warmer climate [odds ratio (OR) 1.71, 95% confidence interval (95% CI) 1.42–2.06]. As expected, we found that HAV-exposed workers had an increased risk compared to controls (OR 2.02, 95% CI 1.75–2.34). The risk for white fingers increased with increased level of exposure to HAV and also age. CONCLUSIONS: Cold environment increases the risk for white fingers in workers occupationally exposed to HAV. The results underscore the need to keep exposure to HAV at workplaces as low as possible especially in cold climate.

To describe upper arm postures and movements among female hairdressers, including the variability between hairdressers, between days within hairdresser, and between tasks, as a basis for understanding the characteristics of exposures in the job, considering possible sources of variation and recovery, and discussing appropriate exposure assessment strategies.Data on upper arm postures were collected using inclinometers during four working days the same week from 28 female hairdressers working in 13 salons. Twenty of the hairdressers noted customer on and off times in a diary, to allow separate analyses of customer tasks (CT) and auxiliary non-customer tasks (AT), including breaks. For a number of posture and movement variables, mean values and variance components between subjects (BS) and within subjects between days (BD) were estimated using restricted maximum likelihood algorithms in one-way random effect models.For the 20 hairdressers with diaries, CT accounted for 279 min (58%) (SD(BS) = 39 min and SD(BD) = 85 min) of the working day and AT and breaks for 207 min (42%) (SD(BS) = 46 min and SD(BD) = 88 min). The hairdressers worked with the right arm elevated60 degrees for 6.8% of the whole job (SD(BS) = 2.8% and SD(BD) = 2.0%). On average, the hairdressers worked with the right arm elevated60 degrees for 9.0% of the time during CT, compared to 3.7% during AT, resulting in a contrast between tasks of 0.35.Hairdressers may be at risk for developing musculoskeletal disorders in the neck and shoulders due to a considerable occurrence of highly elevated arms, especially during CT. On the other hand, we do not find reasons to classify hairdressing as a job with too little variation. Posture variability between days within hairdressers was in the same order of magnitude as that between hairdressers, suggesting that 'typical' workdays do not exist. The exposure contrast between CT and AT for variables describing elevated arm postures indicates that for these variables a simple task-based approach for estimating job exposure could be successful.

Analysis of repeated cross-sectional surveys.To investigate the prevalence of neck-shoulder-arm pain and concurrent low back pain and psychological distress in a geographical area over a 16-year period.A large number of studies have shown that nonspecific neck, shoulder, and arm pain is a very common symptom in the general population. However, few studies have followed the prevalence of neck-shoulder-arm pain within a geographical area, in order to investigate time-trends.This study provides an analysis of questionnaire data collected every 4 years between 1990 and 2006 on the prevalence of neck-shoulder-arm pain and concurrent low back pain or psychological distress in the County of Stockholm, Sweden (response rate: 61%-69%). All individuals aged 21 to 64 years (n = 1976-26,611) were included in the study.Over the 16-year period, the prevalence of self-reported neck-shoulder-arm pain rose slightly, from 22.8% to 25.0% among females (prevalence rate ratio [PRR]: 1.10) and from 12.8% to 15.4% among males (PRR: 1.21). The prevalence of neck-shoulder-arm pain with concurrent low back pain also rose slightly, from 8.4% to 10.8% among females (PRR: 1.28) and from 5.3% to 6.6% among males (PRR: 1.24). In contrast, the prevalence of neck-shoulder-arm pain with concurrent psychological distress rose more substantially, from 4.4% to 8.5% among females (PRR: 1.91) and from 2.0% to 4.3% among males (PRR: 2.18). All prevalence rates rose between 1990 and 2002, and decreased in 2006 compared to 2002. The gender gap in prevalence did not change over time.Although the prevalence of neck-shoulder-arm pain and concurrent symptoms decreased in 2006 compared to 2002, it is still too early to conclude that we have reached and passed the peak of the "epidemic" of neck-shoulder-arm pain.

Aims: To determine whether perceived muscular tension, job strain, or physical exposure are associated with increased risk of developing neck pain among VDU users. Methods: A baseline questionnaire was answered by 1283 respondents, of whom 671 were free from neck pain at baseline. Perceived muscular tension, job strain, and physical exposure were assessed at baseline. Information about newly developed neck pain was collected in 10 follow up questionnaires and the case definition was the first report of such pain in any of the follow up questionnaires. Median follow up time was 10.9 months. Results: Both men and women who perceived muscular tension at least a few times per week, compared to those who had not perceived muscular tension the preceding month, had an incidence rate ratio (IRR) of 1.9 (95% CI 1.25 to 2.93) for developing neck pain, when stratifying for sex. High perceived muscular tension was associated with an increased risk (IRR 1.6, 95% CI 1.02 to 1.91), even when controlling for job strain, physical exposure, and age in the model stratified by sex. Conclusions: Perceived muscular tension was associated with an increased risk of developing neck pain among VDU users. The combination of high job strain and high perceived muscular tension was associated with higher risk of developing neck pain than the combination of high physical exposure and high perceived muscular tension. There was an indication of an excess risk due to interaction between high physical exposure and high job strain.

Background Documentation of posture measurement costs is rare and cost models that do exist are generally naïve. This paper provides a comprehensive cost model for biomechanical exposure assessment in occupational studies, documents the monetary costs of three exposure assessment methods for different stakeholders in data collection, and uses simulations to evaluate the relative importance of cost components. Methods Trunk and shoulder posture variables were assessed for 27 aircraft baggage handlers for 3 full shifts each using three methods typical to ergonomic studies: self-report via questionnaire, observation via video film, and full-shift inclinometer registration. The cost model accounted for expenses related to meetings to plan the study, administration, recruitment, equipment, training of data collectors, travel, and onsite data collection. Sensitivity analyses were conducted using simulated study parameters and cost components to investigate the impact on total study cost. Results Inclinometry was the most expensive method (with a total study cost of € 66,657), followed by observation (€ 55,369) and then self report (€ 36,865). The majority of costs (90%) were borne by researchers. Study design parameters such as sample size, measurement scheduling and spacing, concurrent measurements, location and travel, and equipment acquisition were shown to have wide-ranging impacts on costs. Conclusions This study provided a general cost modeling approach that can facilitate decision making and planning of data collection in future studies, as well as investigation into cost efficiency and cost efficient study design. Empirical cost data from a large field study demonstrated the usefulness of the proposed models.

Urinary mutagenicity, thioethers in urine, and sister chromatid exchanges and micronuclei in peripheral lymphocytes were determined for 60 nurses handling cytostatic drugs and 60 referents matched for sex, age, and smoking habits. Safety hoods were used by most of the nurses. The exposed nurses had more sister chromatid exchanges and higher urinary mutagenicity, as measured by Salmonella typhimurium TA 98, than the referents. There were no differences in the other tests. No dose-response relationship was established for any parameter. It was concluded that urinary mutagenicity with the Salmonella strain is the most sensitive test for monitoring nurses handling cytostatic drugs. Determining sister chromatid exchanges may also be a viable test, but it has the drawback of uncertainty as to whether the changes are attributable to present or past exposure. Only comparisons of rather large groups are useful, and a study design requiring matched referents would seem to be optimal.

The overall aim of this study was to investigate whether time pressure and verbal provocation has any effect on physiological and psychological reactions during work with a computer mouse. It was hypothesised that physiological reactions other than muscle activity (i.e. wrist movements, forces applied to the computer mouse) would not be affected when working under stressful conditions. Fifteen subjects (8 men and 7 women) participated, performing a standardised text-editing task under stress and control conditions. Blood pressure, heart rate, heart rate variability, electromyography, a force-sensing computer mouse and electrogoniometry were used to assess the physiological reactions of the subjects. Mood ratings and ratings of perceived exertion were used to assess their psychological reactions. The time pressure and verbal provocation (stress situation) resulted in increased physiological and psychological reactions compared with the two control situations. Heart rate, blood pressure and muscle activity in the first dorsal interosseus, right extensor digitorum and right trapezius muscles were greater in the stress situation. The peak forces applied to the button of the computer mouse and wrist movements were also affected by condition. Whether the increases in the physiological reactions were due to stress or increased speed/productivity during the stress situation is discussed. In conclusion, work with a computer mouse under time pressure and verbal provocation (stress conditions) led to increased physiological and psychological reactions compared to control conditions.