Search

Introduction Obesity and unhealthy behaviour are more prevalent among workers with a low compared with a high socioeconomic position (SEP), and thus contribute to socioeconomic health inequalities. The occupational setting is considered an important setting to address unhealthy behaviours due to the possibility to efficiently reach a large group of adults through worksite health promotion. This paper describes the rationale and design for an individual participant data (IPD) meta-analysis and a socioeconomic equity-specific reanalysis aiming to: (1) investigate socioeconomic differences in the effectiveness of interventions aimed at promoting healthy behaviour and preventing obesity, (2) examine socioeconomic differences in reach and compliance and (3) to investigate underlying factors affecting possible socioeconomic differences. Methods and analysis A systematic search was conducted in electronic databases including Embase, Medline Ovid, Web of Science, Cochrane Central and Google Scholar as well as in grey literature and trial registries. Two researchers have independently selected a total of 34 relevant studies (from 88 articles). Responsible researchers of these eligible studies were asked to provide their study data and an assessment of the methodological criteria was done. The data of the intervention studies will be pooled for the IPD meta-analysis, whereas the socioeconomic equity-specific reanalysis will focus on each study separately, stratified for SEP. Both methods will be conducted to investigate socioeconomic differences in effectiveness, reach and compliance (research aims 1 and 2). For research aim 3, different factors, such as population characteristics, organisational work environment and intervention characteristics, will be investigated as possible moderators in the associations between SEP and effectiveness, reach and compliance. Ethics and dissemination The Medical Ethical Committee of Erasmus MC declared that the Medical Research Involving Hu

We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-e_ective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

The aim of this study was to develop and evaluate calibration models to predict objectively measured time spent sitting, standing and walking during office work from self-reported time-use compositions using a compositional data analysis (CoDA) approach. Ninety-nine office workers (49 women) at the Swedish Transport Administration participated in an intervention study on relocation to activity-based offices. At baseline and at a 3-months follow-up, physical behaviours (sitting, standing and walking) at work were assessed for five days using a thigh-mounted accelerometer (Actigraph) and by self-report (IPAQ). The time-use composition of the three behaviours was expressed in terms of isometric log-ratios (ILR). Calibration models predicting accelerometry-based time-use from self-reported compositions were constructed using linear regression on baseline data, and then validated using follow-up data. The accelerometer data showed that, on average, workers spent 69.9% of their day sitting, 23.7% standing, and 6.4% walking. The corresponding percentages for self-reports were 71.7%, 21.6%, and 7.4%, respectively. Non-calibrated self-reports were biased: the RMS errors obtained from the ILRs expressing sitting, standing and walking were 0.73, 1.09 and 1.05, respectively. Calibration models reduced these errors by 45% (sitting), 56% (standing), and 76% (walking). Validation of the calibration models using follow-up data from the same workers showed calibration remained equally effective; RMS errors were reduced by 55% (sitting), 58% (standing), and 75% (walking). In conclusion, calibration models for compositional time-use data were effective in reducing bias in self-reported physical behaviours at work, and the models remained effective when used on new data from the same workers. Calibrated self-reports may represent a cost-effective method for obtaining physical behaviour data with a satisfying accuracy in large-scale cohort and intervention studies.

Objectives: Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms. The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self-reported factors, software-recorded computer usage patterns, and worksite measurements of anthropometrics and workstation set-up (full models); and (ii) a practical set of predicting variables, only including the self-reported factors and software-recorded computer usage patterns, that are relatively easy to assess (practical models).Methods: Prediction models were build using data from a field study among 117 office workers who were symptom-free at the time of measurement. Arm-wrist-hand physical exposures were measured for approximately two hours while workers performed their own computer work. Each worker's anthropometry and workstation set-up were measured by an experimenter, computer usage patterns were recorded using software and self-reported factors (including individual factors, job characteristics, computer work behaviours, psychosocial factors, workstation set-up characteristics, and leisure-time activities) were collected by an online questionnaire. We determined the predictive quality of the models in terms of R2 and root mean squared (RMS) values and exposure classification agreement to low-, medium-, and high-exposure categories (in the practical model only).Results: The full models had R2 values that ranged from 0.16 to 0.80, whereas for the practical models values ranged from 0.05 to 0.43. Interquartile ranges were not that different for th

© 2017 Elsevier Ltd Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities.

© The Author(s) 2017. Objectives: Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms.The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self-reported factors, software-recorded computer usage patterns, and worksite measurements of anthropometrics and workstation set-up (full models); and (ii) a practical set of predictingvariables, only including the self-reported factors and software-recorded computer usage patterns, that are relatively easy to assess (practical models). Methods: Prediction models were build using data from a field study among 117 office workers who were symptom-free at the time of measurement. Arm-wrist-hand physical exposures were measured for approximately two hours while workers performed their own computer work. Each worker’s anthropometry and workstation set-up were measured by an experimenter, computer usage patterns were recorded using software and self-reported factors (including individual factors, job characteristics, computer work behaviours, psychosocial factors, workstation set-up characteristics, and leisure-time activities) were collected by an online questionnaire. We determined the predictive quality of the models in terms of R2and root mean squared (RMS) values and exposure classification agreement to low-, medium-, and high-exposure categories (in the practical model only). Results: The full models had R2values that ranged from 0.16 to 0.80, whereas for the practical models values ranged from 0.05 to 0.43. Interquartile ranges were not that different for

© 2018 Informa UK Limited, trading as Taylor & Francis Group Due to concerns about excessive sedentary exposure for office workers, alternate work positions such as standing are being trialled. However, prolonged standing may have health and productivity impacts, which this study assessed. Twenty adult participants undertook two hours of laboratory-based standing computer work to investigate changes in discomfort and cognitive function, along with muscle fatigue, movement, lower limb swelling and mental state. Over time, discomfort increased in all body areas (total body IRR [95% confidence interval]: 1.47[1.36–1.59] ). Sustained attention reaction time (ß = 18.25[8.00–28.51]) deteriorated, while creative problem solving improved (ß = 0.89[0.29–1.49] ). There was no change in erector spinae, rectus femoris, biceps femoris or tibialis anterior muscle fatigue; low back angle changed towards less lordosis, pelvis movement increased, lower limb swelling increased and mental state decreased. Body discomfort was positively correlated with mental state. The observed changes suggest replacing office work sitting with standing should be done with caution. Practitioner Summary: Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study involving 2 h prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.

Objectives Spinal (ie, back and neck) pain often develops as early as during adolescence and can set a trajectory for later life. However, whether early-life spinal-pain-related behavioral responses of missing school/work are predictive of future work absenteeism is yet unknown. We assessed the association of adolescent spinal-pain-related work or school absenteeism with early adulthood work absenteeism in a prospective population-based cohort. Methods Six year follow-up data from the Western Australian Pregnancy Cohort (Raine) study were used (N=476; with a 54% response rate). At age 17, participants reported spinal pain (using the Nordic questionnaire) and adolescent spinal-pain-related work/school absenteeism (with a single item question). Annual total and health-related work absenteeism was assessed with the Health and Work Performance questionnaire distributed in four quarterly text messages during the 23rd year of age. We modelled the association of adolescent spinal-pain-related absenteeism with work absenteeism during early adulthood, using negative binomial regression adjusting for sex, occupation and comorbidities. Results Participants with adolescent low-back or neck pain with work/school absenteeism reported higher total work absenteeism in early adulthood [148.7, standard deviation (SD) 243.4 hours/year], than those without pain [43.7 (SD 95.2) hours/year); incidence rate ratio 3.4 (95% CI 1.2-9.2)]. Comparable findings were found when considering low-back and neck separately, and when considering health-related absenteeism. Conclusions We found a more than three-fold higher risk of work absenteeism in early adulthood among those with adolescent spinal-pain-related absenteeism, compared to those without. These findings suggest that, to keep a sustainable workforce, pain prevention and management should focus on pain-related behaviors as early as in adolescence.

Aim: Physical activity (PA) is considered to be an important factor in the prevention of various cardiovascular diseases. However, recent studies suggest that while leisure time PA promotes cardiovascular health, occupational PA might impair cardiovascular health. An explanation for this PA health paradox may be a difference in the intensity and associated physical demands between occupational and leisure time PA. Occupational PA often consists of low-intensity, long-lasting physically demanding tasks, such as repetitive work and prolonged static working postures, which are presumed to cause sustained elevated heart rate that may stress the cardiovascular system. Despite this notion, the differences in physiological responses between occupational and leisure time PA are not well understood. Therefore, we aimed: (a) to study the difference in intensity of occupational and leisure time PA (expressed in percentage heart rate reserve; % HRR); and b) to assess whether this potential difference varies by gender and cardiorespiratory fitness level. Methods: We used data from the NOMAD study, in which Danish blue-collar workers from seven different workplaces took part in a four-day protocol of objective measurements of PA (using hip and thigh-worn accelerometers) and heart rate (using an ambulatory heart rate monitor). During occupational and leisure time, activities of sitting, standing, moving, walking and stair climbing were identified, and %HRR in each of these activities was determined. Differences in %HRR between occupational and leisure time PA were tested using generalised estimating equations (expressed in regression coefficient – beta with 95% confidence interval (CI)) adjusted for personal, health,work and lifestyle confounders. Result: In 124 workers with data on PA and heart rate, %HRR was higher for occupational PA compared to leisure time PA (beta1.9, 95% CI2.4,1.4,P<0.001). Differences in %HRR between occupational and leisure time PA were more pronounced, DOI: 10.1177/2047487317698870

Objectives: Work-related musculoskeletal disorders (MSD) are highly prevalent and put a large burden on the (working) society. Primary prevention of work-related MSD focuses often on physical risk factors (such as on manual lifting and awkward postures), but has not been too successful in reducing the MSD burden. This may partly be caused by insufficient knowledge of etiological mechanisms and/or a lack of adequately feasible interventions (theory failure and program failure, respectively), possibly due to limited integration of research disciplines. A research framework could link research disciplines thereby strengthening the development and implementation of preventive interventions. Our objective was to define and describe such a framework for multi-disciplinary research on work-related MSD prevention. Methods: We described a framework for MSD prevention research, partly based on frameworks from other research fields (i.e., sports injury prevention and public health). Results: The framework is composed of a repeated sequence of six steps comprising the assessment of 1) incidence and severity of MSD, 2) risk factors for MSD, and 3) underlying mechanisms; and the 4) development, 5) evaluation, and 6) implementation of preventive intervention(s). Conclusions: In the present framework for optimal work-related MSD prevention, research disciplines are linked. This framework can thereby help to improve theories and strengthen the development and implementation of prevention strategies for work-related MSD.

Objective: Low back pain (LBP) places a large burden on society through health professional services and medication use, and interferences with work, normal and physical activities. Widely used and accepted questionnaires for measuring the impact of musculoskeletal pain (including LBP) exist, but do not cover all these aspects and may be too lengthy for some epidemiologic research and clinical practice settings. We evaluated the use of five single items of LBP impact on professional service, medication, and interferences with work, normal and physical activities; and compared these five items against established validated questionnaires of LBP disability and multi-dimensional screening of pain disability. Methods: We performed cross-sectional analyses of two population-based cohorts (with young adults and middle-aged adults). In both cohorts, LBP (Nordic questionnaire) and LBP impact (using the proposed five single items) were assessed. Validated questionnaires for multi-dimensional screening of long-term musculoskeletal pain disability (Orebro Musculoskeletal Pain Questionnaire) for young adults and LBP disability (Oswestry Disability Index) for middle-aged adults were used. Results: In both cohorts, participants who reported LBP with impact on the proposed items displayed higher scores on validated questionnaires compared to those reporting LBP without impact. Number of LBP impacts increased with increasing scores on validated questionnaires and showed high predictive value. The five proposed items of LBP impact are able to distinguish people with different clinically important scores (from established questionnaires), showing their construct validity. Conclusion: The described items provide a relevant and feasible tool to establish LBP impact in epidemiological research and clinical practice.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To investigate the effectiveness of workplace interventions to increase standing or walking for decreasing musculoskeletal symptoms in sedentary workers.

Objective Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms. Design A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous. Data sources Electronic databases were systematically searched. Eligibility criteria Peer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified. Results Of the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, 'substantial' (>4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms. Conclusions The evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing.