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BACKGROUND: The Individual Work Performance Questionnaire (IWPQ), measuring task performance, contextual performance, and counterproductive work behavior, was developed in The Netherlands. OBJECTIVES: To cross-culturally adapt the IWPQ from the Dutch to the American-English language, and assess the questionnaire's internal consistency and content validity in the American-English context. METHODS: A five stage translation and adaptation process was used: forward translation, synthesis, back-translation, expert committee review, and pilot-testing. During the pilot-testing, cognitive interviews with 40 American workers were performed, to examine the comprehensibility, applicability, and completeness of the American-English IWPQ. RESULTS: Questionnaire instructions were slightly modified to aid interpretation in the American-English language. Inconsistencies with verb tense were identified, and it was decided to consistently use simple past tense. The wording of five items was modified to better suit the American-English language. In general, participants were positive on the comprehensibility, applicability and completeness of the questionnaire during the pilot-testing phase. Furthermore, the study showed positive results concerning the internal consistency (Cronbach's alphas for the scales between 0.79-0.89) and content validity of the American-English IWPQ. CONCLUSION: The results indicate that the cross-cultural adaptation of the American-English IWPQ was successful and that the measurement properties of the translated version are promising. © 2016 IOS Press and the authors.

BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. OBJECTIVE: This study was designed to (1) identify indicators for each dimension, (2) select the most relevant indicators, and (3) determine the relative weight of each dimension in ratings of work performance.METHODS: IWP indicators were identified from multiple research disciplines, via literature, existing questionnaires, and expert interviews. Subsequently, experts selected the most relevant indicators per dimension and scored the relative weight of each dimension in ratings of IWP.RESULTS: In total, 128 unique indicators were identified. Twenty-three of these indicators were selected by experts as most relevant for measuring IWP. Task performance determined 36% of the work performance rating, while the other three dimensions respectively determined 22%, 20% and 21% of the rating.CONCLUSIONS: Notable consensus was found on relevant indicators of IWP, reducing the number from 128 to 23 relevant indicators. This provides an important step towards the development of a standardized, generic and short measurement instrument for assessing IWP.

Purpose: To develop and evaluate two artificial neural network (ANN) models based on single-sensor accelerometer data and an ANN model based on the data of two accelerometers for the identification of types of physical activity in adults. Methods: Forty-nine subjects (21 men and 28 women; age range = 22-62 yr) performed a controlled sequence of activities: sitting, standing, using the stairs, and walking and cycling at two self-paced speeds. All subjects wore an ActiGraph accelerometer on the hip and the ankle. In the ANN models, the following accelerometer signal characteristics were used: 10th, 25th, 75th, and 90th percentiles, absolute deviation, coefficient of variability, and lag-one autocorrelation. Results: The model based on the hip accelerometer data and the model based on the ankle accelerometer data correctly classified the five activities 80.4% and 77.7% of the time, respectively, whereas the model based on the data from both sensors achieved a percentage of 83.0%. The hip model produced a better classification of the activities cycling, using the stairs, and sitting, whereas the ankle model was better able to correctly classify the activities walking and standing still. All three models often misclassified using the stairs and standing still. The accuracy of the models significantly decreased when a distinction was made between regular versus brisk walking or cycling and between going up and going down the stairs. Conclusions: Relatively simple ANN models perform well in identifying the type but not the speed of the activity of adults from accelerometer data. © 2010 by the American College of Sports Medicine.

Objective: The goal of this review was to summarize the evidence for an effect of lifestyle-targeted interventions at the workplace on the main biological risk factors for cardiovascular disease (CVD). Methods: We performed an extensive systematic literature search for randomized controlled trials (RCT) that met the following inclusion criteria: (i) targeted at workers; (ii) aimed at increasing physical activity and/or improving diet; and (iii) measured body weight, body fat, blood pressure, blood lipids and/or blood glucose. We used a nine-item methodological quality list to determine the quality of each study. A best-evidence system was applied, taking into account study quality and consistency of effects. Results: Our review included 31 RCT, describing a diversity of interventions (eg counseling, group education, or exercise). Of these studies, 18 were of high quality. Strong evidence was found for a positive effect on body fat, one of the strongest predictors of CVD risk. Among populations "at risk", there was strong evidence for a positive effect on body weight. Due to inconsistencies in results between studies, there was no evidence for the effectiveness of interventions on the remaining outcomes. Conclusions: We found strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight. Populations with an elevated risk of CVD seemed to benefit most from lifestyle interventions; supervised exercise interventions appeared the least effective intervention strategy. To gain better insight into the mechanisms that led to the intervention effects, the participants' compliance with the intervention and the lifestyle changes achieved should be reported in future studies. This work is licensed under a Creative Commons Attribution 4.0 International License.

In het verlengde hiervan is ook de vraag toegenomen naar valide en betrouwbare methoden voor het meten van sport en bewegen op verschillende niveaus, voor verschillende doelen en doelgroepen. Voor het formuleren en evalueren van beleidsdoelen is het van belang dat informatie over de ontwikkelingen met betrekkng tot sport en bewegen zo eenduidig mogelijk is. In de huidige situatie komen echter verschillende, schijnbaar tegenstrijdige cijfers met betrekking tot sport en bewegen naar voren. In dit artikel wordt aan de hand van een aantal voorbeelden nader ingegaan op verklaringen voor verschillen in cijfers over bewegen, toegespitst op de NNGB. Tevens wordt een voorstel gedaan voor het adresseren van lacunes en knelpunten op dit gebied.

Background: Sedentary behavior is an independent risk factor for excess body weight and other health problems. There are no published data on sitting time at work, or how this is related to occupation and sector (branch of business). No published study has shown whether extended sitting at work is compensated for by sitting less during leisure time. Methods: This study used data from a continuous cross-sectional survey, from 2000 to 2005 (N=7720). Workers were asked how many minutes they spent sitting during the preceding day, both at work and in their leisure time. To test differences in sitting times among occupational groups and sectors, descriptive analyses and analyses of variance were carried out in 2006. Results: On average, the Dutch working population reported sitting for 7 hours each day, one third of which was at work. Occupational groups and sectors differed significantly in sedentary behavior, mainly involving sitting periods at work. Workers spending long periods sitting at work did not compensate by sitting less during their leisure time. Conclusions: Workers spend a substantial part of their waking and working time seated. Those who sat for long periods at work did not compensate for this lack of activity by adopting less-sedentary behaviors during leisure time. To prevent health problems, the best approach may be to reduce sedentary behavior at work, when traveling to and from work, and during leisure time. © 2007 American Journal of Preventive Medicine.

This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms. Computer workers with frequent or long-term neck and upper limb symptoms were randomised into the work style group (WS, n = 152), work style and physical activity group (WSPA, n = 156), or usual care group (n = 158). The WS and WSPA group attended six group meetings. All meetings focused on behavioural change with regard to body posture, workplace adjustment, breaks and coping with high work demands (WS and WSPA group) and physical activity (WSPA group). Pain, disability at work, days with symptoms and months without symptoms were measured at baseline and after 6 (T1) and 12 months (T2). Self-reported recovery was assessed at T1/T2. Both interventions were ineffective in improving recovery. The work style intervention but not the combined intervention was effective in reducing all pain measures. These effects were present in the neck/shoulder, not in the arm/wrist/hand. For the neck/shoulder, the work style intervention group also showed an increased recovery-rate. Total physical activity increased in all study groups but no differences between groups were observed. To conclude, a group-based work style intervention focused on behavioural change was effective in improving recovery from neck/shoulder symptoms and reducing pain on the long-term. The combined intervention was ineffective in increasing total physical activity. Therefore we cannot draw conclusions on the effect of increasing physical activity on the recovery from neck and upper limb symptoms. © 2007 International Association for the Study of Pain.

Uit gegevens blijkt dat bijna de helft van de volwassen Nederlandse populatie overgewicht heeft en ruim 10 % obees is. Het doel van de onderhavige studie is na te gaan of Nederlandse werknemers met overgewicht of obesitas een hogere verzuimfrequentie en een langere verzuimduur hebben dan werknemers met een normaal gewicht, en de invloed van sportdeelname hierop. Uit de resultaten blijkt dat werknemers met overgewicht alleen een significant hogere middellange verzuimfrequentie hebben dan werknemers met een normaal gewicht. Obese werknemers verzuimden 14 dagen per jaar meer dan werknemers met een normaal gewicht. Ook de middellange en lange verzuimfrequentie lagen significant hoger. De verschillen tussen werknemers met obesitas en een normaal gewicht waren groter bij hen die niet regelmatig sportten. De interactie tussen BMI (Body Mass Index) en regelmatige sportdeelname was alleen significant voor het lange verzuim. De algemene conclusie luidt dat obese werknemers vaker en langer verzuimen, vooral wanneer zij niet regelmatig sporten.

Bewegen is goed voor de gezondheid en de levensverwachting neemt hierdoor toe (U.S. Department of Health and Human Services, 1996). Dat dit onderwerp vanuit het oogpunt van volksgezondheid steeds meer aandacht krijgt, is dan ook niet verwonderlijk (VWS, 2001). In het bedrijfsleven krijgt bewegingsstimulering tot nu toe nog relatief weinig aandacht. Vooral grotere bedrijven hebben soms fitnessprogramma’s. Het motief hiervoor ligt echter meer in de sfeer van goede secundaire arbeidsvoorwaarden dan in de overtuiging dat bewegingsstimulering een goedkoop middel kan zijn om de inzetbaarheid van werknemers te vergroten. In de literatuur worden vele redenen aangevoerd waarom een actief ‘beweegbeleid’ binnen een organisatie lucratief kan zijn: daling ziekteverzuim, minder (uitval door) rugklachten en RSI, meer ontspannen en minder gestresst personeel, gezonder, fitter en productiever personeel, minder verloop, grotere binding en grotere aantrekkingskracht op de arbeidsmarkt, een positief imago van het bedrijf en bevordering van de communicatie tussen medewerkers van de eigen en andere afdelingen.

Background: An individual's current status of physical activity and nutrition and readiness to change can be determined using PACE assessment forms. Practitioners have suggested that feedback on the fitness and health components can produce a change in a subject's awareness of their behaviour and thereby lead to a beneficial change in stage of behaviour change. Objective: To evaluate the short term effect of personalised feedback on fitness and health status on self reported appraisal of the stage of change. Methods: A total of 299 civil servants were randomised to an intervention or a reference group. After having been tested for fitness and health, the intervention group received immediate feedback on their test results, whereas the reference group did not. PACE assessment forms were completed twice: before testing and after testing (reference group), or after testing and feedback (intervention group). The time interval between was one hour. The influence of feedback was determined using a x2 test and analysis of variance. Results: On the basis of the x2 test, no significant effect of feedback was found on the stage of change of physical activity, nor on the stage of change with regard to nutrition. Analysis of variance results showed no significant effect on the raw PACE score as to physical activity, intake of fruit and vegetables and dietary fat. However, a significant effect was observed on the PACE score of "calorie intake and weight management". Subjects in the intervention group significantly more often regressed on their PACE score on this topic than the reference subjects. Conclusions: Feedback at baseline on measurements of an intervention study can influence PACE scores and can be considered as a small but relevant start of the intervention itself.

Background: Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program. Methods: A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol. Results: There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure. Conclusions: Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted. © 2003 American Journal of Preventive Medicine.

Software programs cueing computer workers to apply regular breaks and physical exercises may help in reducing work-related upper limb disorders. The effects of such a program was investigated among 268 computer workers with upper limb disorders, who were randomised into a control group, a group cued to take extra breaks and a group cued to perform exercises during the extra breaks. A comparison between pre- and post-intervention scores on the severity of the complaints showed no significant differences among the three groups. However, data on the self-reported recovery, obtained after the intervention, showed that, as compared to the controls, more subjects in the experimental groups reported recovery (55% vs. 34%) and less reported deterioration (4% vs. 20%). Hence, people who are cued to take extra breaks, perceive more recovery, although the effect on the severity level of the complaint was not detected. No effect was found of the physical exercises.

An epidemiological study was carried out to explore the relationship between climatic factors and non-specific low-back and neck-shoulder symptoms in working populations. In a review of published literature, 27 studies were found which related climatic factors to musculoskeletal symptoms, but none of these studies specifically addressed the subject. It can be concluded that a relationship between climatic factors and musculoskeletal symptoms is considered at least plausible by both researchers, workers and patients, but that the epidemiological evidence appearing from literature is very weak. Questionnaire data which were collected on musculoskeletal symptoms, workload and perceptions of climatic conditions of 2030 workers in 24 different occupations were analysed multi-variately. About one-quarter of the workers related symptoms of the low back and neck-shoulders to climatic factors. They perceived climatic factors in most cases as aggravating factors for their symptoms. No seasonal influence on prevalence rates was reported. For low-back and neck-shoulder symptoms and for sick leave due to neck-shoulder symptoms, an association was found with climatic factors, and in particular with respect to draughts in relation to neck-shoulder symptoms. In addition, neck-shoulder symptoms were negatively related to frequent outdoor work. The findings suggest a relationship between climatic factors and musculoskeletal symptoms and call for further detailed investigations.

Recently, the Individual Work Performance Questionnaire (IWPQ) version 0.2 was developed using Rasch analysis. The goal of the current study was to improve targeting of the IWPQ scales by including additional items. The IWPQ 0.2 (original) and 0.3 (including additional items) were examined using Rasch analysis. Additional items that showed misfit or did not improve targeting were removed from the IWPQ 0.3, resulting in a final IWPQ 1.0. Subsequently, the scales showed good model fit and reliability, and were examined for key measurement requirements (e.g., category ordening, unidimensionality, and differential item functioning). Finally, calculation and interpretability of scores were addressed. Compared to its previous version, the final IWPQ 1.0 showed improved targeting for two out of three scales. As a result, it can more reliably measure workers at all levels of ability, discriminate between workers at a wider range on each scale, and detect changes in individual work performance.

OBJECTIVE:: To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). METHODS:: A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs (convergent validity). Second, differences between known groups were tested (discriminative validity). RESULTS:: First, IWPQ scores correlated weakly to moderately with absolute and relative presenteeism, and work engagement. Second, significant differences in IWPQ scores were observed for workers differing in job satisfaction, and workers differing in health. CONCLUSION:: Overall, the results indicate acceptable construct validity of the IWPQ. Researchers are provided with a reliable and valid instrument to measure individual work performance comprehensively and generically, among workers from different occupational sectors, with and without health problems. © 2014 Lippincott Williams and Wilkins.

Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. Methods. Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to investigate the effectiveness of an intervention to stimulate physical activity and relaxation of office workers, on need for recovery. Individual work performance was a secondary outcome measure of the trial. In total, 39 hypotheses were formulated concerning correlations between changes on the IWPQ scales and changes on similar constructs (e.g., presenteeism) and distinct constructs (e.g., need for recovery) used in the trial. Results: 260 Participants completed the IWPQ at both baseline and 12 months of follow-up. For the IWPQ scales, 23%, 15%, and 38%, respectively, of the hypotheses could be confirmed. In general, the correlations between change scores were weaker than expected. Nevertheless, at least 85% of the correlations were in the expected direction. Conclusions: Based on results of the current study, no firm conclusions can be drawn about the responsiveness of the IWPQ. Several reasons may account for the weaker than expected correlations. Future research on the IWPQ's responsiveness should be conducted, preferably in other populations and intervention studies, where greater changes over time can be expected. © 2014 Koopmans et al.; licensee BioMed Central Ltd.

Het meten van individuele werkprestatie, gedefinieerd als “gedragingen of acties van werknemers die relevant zijn voor de doelstelling van de organisatie”, blijkt lastig. Tot op heden ontbrak een geschikte vragenlijst om individuele werkprestatie te meten in een generieke, overwegend gezonde, werknemerspopulatie. In het huidige artikel wordt de Individuele Werkprestatie Vragenlijst (IWPV) geintroduceerd. De IWPV is gebaseerd op een conceptueel model bestaande uit de drie dimensies taakprestatie, contextuele prestatie, en contraproductief werkgedrag. De factor structuur en interne consistentie van de IWPV schalen blijken goed te zijn. Ook de construct validiteit kan als redelijk goed worden geclassificeerd. Ten slotte worden normscores per type werk gepresenteerd. De IWPV is al met al een valide instrument om de relevante dimensies van individuele werkprestatie op een korte, volledige, en generieke manier (in alle typen werk en voor werknemers met en zonder gezondheidsklachten) te meten.

A questionnaire ('Dutch Musculoskeletal Questionnaire', DMQ) for the analysis of musculoskeletal workload and associated potential hazardous working conditions as well as musculoskeletal symptoms in worker populations is described and its qualities are explored using a database of 1575 workers in various occupations who completed the questionnaire. The 63 questions on musculoskeletal workload and associated potentially hazardous working conditions can be categorized into seven indices (force, dynamic and static load, repetitive load, climatic factors, vibration and ergonomic environmental factors). Together with four separate questions on standing, sitting, walking and uncomfortable postures, the indices constitute a brief overview of the main findings on musculoskeletal workload and associated potentially hazardous working conditions. Homogeneity of the indices is satisfactory. The divergent validity of the indices is fair when compared with an index of psychosocial working conditions and discomfort during exposure to physical loads. Worker groups with contrasting musculoskeletal loads can be differentiated on the basis of the indices and other factors. With respect to the concurrent validity, it appears that most indices and factors show significant associations with low back and/or neck-shoulder symptoms. This questionnaire can be used as a simple and quick inventory for occupational health services to identify worker groups in which a more thorough ergonomic analysis is indicated.

Objectives: To assess the association between leisure time physical activity and musculoskeletal morbidity, as well as possible interactions with physical activity at work. Methods: A literature search was performed to collect all studies on musculoskeletal disorders in which physical activity was involved as a variable. Next, an analysis was made of questionnaire data on a group of 2,030 workers in various occupations, on self-reported physical activity in leisure time and at work, musculoskeletal symptoms (from low back, neck-shoulder and lower extremity) and sick leave due to these symptoms. A logistic regression analysis was carried out to estimate the association between musculoskeletal morbidity and four physical-activity indices (participation in sports and sedentary activities, active life style, sedentary life style), adjusted for age, gender, education and work load. Interaction of leisure activities with age and work load was tested too. Results: Available literature data (39 studies) showed inconsistent results. Most studies did not show any effects. Some studies indicated favourable effects of physical activity, both on low back and neck pain. Participation in some vigorous sports seemed associated with unfavourable effects. The empirical data showed no association between participation in sports and/or other physical activities in leisure time and musculoskeletal symptoms. Sedentary activity in leisure time was associated with higher prevalence rates of low back symptoms and sick leave due to low back symptoms. Conclusions: Stimulation of leisure time physical activity may constitute one of the means of reducing musculoskeletal morbidity in the working population, in particular in sedentary workers.

OBJECTIVES: Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. METHODS: Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. RESULTS AND CONCLUSIONS: The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace. ispartof: Occupational and Environmental Medicine vol:55 issue:2 pages:73-83 ispartof: location:England status: published

A postal questionnaire survey was carried out in Dutch agriculture to identify high risk branches with respect to musculoskeletal symptoms and workload. The study population comprised a sample 2580 male employees and employers, with a response rate of 49%. A total of 75% of the employees and 71% of the employers reported musculoskeletal symptoms during the past 12 months. Low-back pain was most prevalent (one-year prevalence rate of 51% among employees, 47% among employers), followed by symptoms of the neck-shoulder (one-year prevalence rate of 35% among employees, 30% among employers) and knees (one-year prevalence rate of 22% among employees, 17% among employers). There were marked differences between specific branches in the size and nature of musculoskeletal morbidity as well as in self-reported musculoskeletal workload. In particular protective vegetables growing and arboriculture showed both relatively high rates of symptoms and relatively high exposure levels. The results of this study were used to decide which agricultural branches and workload factors should have priority in the ergonomic interventions that followed.

Background Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions. This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions. Methods and design This study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital) will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews) and quantitative methods (i.e. process evaluation questionnaires) applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and after 6, 12 and 18 months. Discussion This is one of the few studies to extensively and continuously monitor the natural course of the implementation process of a WHPP by a formative evaluation using a mix of quantitative and qualitative methods on different organizational levels (i.e. management, project group, employees) with an embedded scientist on site. Trial Registration NTR2861

OBJECTIVE: Individual work performance is differently conceptualized and operationalized in different disciplines. The aim of the current review was twofold: (1) identifying conceptual frameworks of individual work performance and (2) integrating these to reach a heuristic conceptual framework. METHODS: A systematic review was conducted in medical, psychological, and management databases. Studies were selected independently by two researchers and included when they presented a conceptual framework of individual work performance. RESULTS: A total of 17 generic frameworks (applying across occupations) and 18 job-specific frameworks (applying to specific occupations) were identified. Dimensions frequently used to describe individual work performance were task performance, contextual performance, counterproductive work behavior, and adaptive performance. CONCLUSION: On the basis of the literature, a heuristic conceptual framework of individual work performance was proposed. This framework can serve as a theoretical basis for future research and practice. ispartof: Journal of Occupational and Environmental Medicine vol:53 issue:8 pages:846-866 ispartof: location:United States status: published

Background The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA), diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD). Methods In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed. Results The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02) and fruit intake (β 1.7, 95%CI 0.6; 2.9) at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2). The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7), but not at 12 months (OR 0.8, 95%CI 0.4; 1.6). Conclusions Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD. Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior. Considering the rising prevalence of unhealthy lifestyle and CVD, especially in the aging population, implementation of this intervention in the occupational health care setting is recommended. Trial registration Current Controlled Trials ISRCTN60545588

In dit artikel gaan we na, met gebruikmaking van longitudinale data afkomstig uit de Cohortstudie Arbeid, Verzuim en Gezondheid (AVG), welke effecten een actief leefstijlbeleid van de werkgever heeft op de leefstijl, de arbeidstevredenheid en de zelf ingeschatte lichamelijke conditie van werknemers. Onder een actief leefstijlbeleid verstaan we het aantal door de werknemer gepercipieerde maatregelen van de werkgever op het gebied van leefstijl. Ook onderzoeken we de rol die de behoefte van werknemers aan een actief leefstijlbeleid heeft. Het AVG-bestand bevat data over 1.597 werknemers en is uitgevoerd in de periode 2004-2006. Uit deze studie blijkt dat actief leefstijlbeleid er niet voor zorgt dat de leefstijl van de werknemer verbetert. Ook zien we geen effect op de arbeidstevredenheid of de zelf ingeschatte lichamelijke conditie. Wel blijkt een grotere behoefte van werknemers aan actief leefstijlbeleid te leiden tot meer actief leefstijlbeleid. Dit onderzoek laat verder zien dat naarmate werknemers de eigen lichamelijke conditie positiever inschatten, zij een gezondere leefstijl hebben, een grotere arbeidstevredenheid en een minder grote behoefte aan actief leefstijlbeleid. Andersom leidt een gezonde leefstijl ook tot een betere lichamelijke conditie. Daarnaast draagt een gezonde leefstijl positief bij aan de arbeidstevredenheid van werknemers.

Objective: To study the association between commuter cycling and all-cause sickness absence, and the possible dose-response relationship between absenteeism and the distance, frequency and speed of commuter cycling. Method: Cross-sectional data about cycling in 1236 Dutch employees were collected using a self-report questionnaire. Company absenteeism records were checked over a one-year period (May 2007-April 2008). Propensity scores were used to make groups comparable and to adjust for confounders. Zero-inflated Poisson models were used to assess differences in absenteeism between cyclists and non-cyclists. Results: The mean total duration of absenteeism over the study year was more than 1. day shorter in cyclists than in non-cyclists. This can be explained by the higher proportion of people with no absenteeism in the cycling group. A dose-response relationship was observed between the speed and distance of cycling and absenteeism. Compared to people who cycle a short distance (≤ 5. km) three times a week, people who cycle more often and longer distances are absent for fewer days on average. Conclusion: Cycling to work is associated with less sickness absence. The more often people cycle to work and the longer the distance travelled, the less they report sick. © 2010 Elsevier Inc.

Background Non-response and drop-out are problems that are commonly encountered in health promotion trials. Understanding the health-related characteristics of non-participants and drop-outs and the reasons for non-participation and drop-out may be beneficial for future intervention trials. Methods Male construction workers with an elevated risk of cardiovascular disease (CVD) were invited to participate in a lifestyle intervention study. In order to investigate the associations between participation and CVD risk factors, and drop-out and CVD risk factors, crude and multiple logistic regression analyses were performed. The reasons for non-participation and drop-out were assessed qualitatively. Results 20% of the workers who were invited decided to participate; 8.6% of the participants dropped out before the first follow-up measurement. The main reasons for non-participation were 'no interest', 'current (para-)medical treatment', and 'feeling healthy', and for drop-out they were 'lack of motivation', 'current (para-)medical treatment', and 'disappointment'. Participants were 4.2 years older, had a higher blood pressure, higher total cholesterol, and lower HDL cholesterol than non-participants, and were more likely to report 'tiredness and/or stress' and 'chest pain and/or shortness of breath'. After adjusting for age, most risk factors were not significantly associated with participation. Drop-outs were 4.6 years younger than those who completed the study. The prevalence of smoking was higher among non-participants and drop-outs. Conclusion Participants had a worse CVD risk profile than non-participants, mainly because of the difference in age. Non-participants and drop-outs were younger and more likely to be smokers. The main reasons for non-participation and drop-out were health-related. Investigators in the field of health promotion should be encouraged to share comparable information. Trial registration Current Controlled Trials ISRCTN60545588

Voor de volwassen bevolking blijkt bewegen een belangrijke determinant van (on)gezondheid en vroegtijdig overlijden. Voldoende bewegen kan het beloop van tal van chronische ziekten gunstig beinvloeden. Daarnaast is bewegen een belangrijk middel om overgewicht te voorkomen of te beheersen. Voor werknemers geldt bovendien dat voldoende bewegen de inzet baarheid en productiviteit bevordert. Onvoldoende bewegen brengt dan ook een forse kostenpost met zich mee voor de gezondheidszorg en ook voor het bedrijfsleven in termen van ziekteverzuim.

Purpose: To describe the prevalence of overweight and obesity among different occupational groups and sectors in a representative sample of the Dutch working population, and to test whether these differences still exist after adjustment for socio-demographic variables. Methods: Cross-sectional data among 7,588 working adults were used. Univariate analyses of variance was performed to test differences in body mass index (BMI) values between occupational groups (n = 7) and sectors (n = 28). Adjusted analyses were carried out to examine the role of socio-demographic factors in the differences in overweight and obesity between occupational groups and sectors. Results: On average, the mean BMI was 24.3 kg/m2 with 31% being overweight and 6% being obese. Those working in trade, industrial, or transportation occupations as well as the legislators and senior managers had the highest BMI and a relatively high prevalence of overweight (36.7 and 35.5%, respectively) and obesity (6.9 and 7.5%, respectively). In contrast, those working in scientific and artistic professions had the most favorable BMI profile with 25.7% being overweight and 4.2% being obese. After adjusting for sex, age, and education, the proportion of variance changed from about 0.01 to 0.10 with age being the main contributor of the differences in overweight and obesity. Conclusions: BMI profile and prevalence of overweight and obesity differs between occupations and sectors. Despite the differences are explained partly by socio-demographic factors, based on a given distribution of age, sex, and education within each occupational group and sector, occupational group- and sector-specific strategies to prevent and reduce overweight are recommended. © 2009 Springer-Verlag.

Background: In recent years, many tailored lifestyle counseling programs have become available through the Internet. Previous research into such programs has shown selective enrollment of relatively healthy people. However, because of the known dose-response relationship between the intensity and frequency of counseling and the behavior change outcomes, selective retention may also be a concern. Objective: The aim of this study was to identify rates and determinants of repeat participation in a Web-based health behavior change program. Methods: A Web-based health behavior change program aimed to increase people's awareness of their own lifestyle, to promote physical activity, and to prevent overweight and obesity was available on the Internet from July 2004 onward at no cost. Univariate and multivariate logistic regression analyses were conducted to identify characteristics of people who participated in the program more than once. Age, compliance with physical activity guidelines, body mass index, smoking status, and the consumption of fruit, vegetables, and alcohol were included in the analyses. Results: A total of 9774 people participated in the baseline test, of which 940 used the site more than once (9.6%). After exclusion of individuals with incomplete data, 6272 persons were included in the analyses. Of these 6272 people, 5560 completed only the baseline test and 712 also participated in follow-up. Logistic regression predicting repeated use determined that older individuals were more likely to participate in follow-up than people aged 15-20 years. The odds ratios for the age categories 41-50, 51-60, and > 60 years were 1.40 (95% CI = 1.02-1.91), 1.43 (95% CI = 1.02-2.01), and 1.68 (95% CI = 1.03-2.72), respectively. Individuals who never smoked were more likely to participate repeatedly than current smokers and ex-smokers (OR = 1.44, 95% CI = 1.14-1.82 and OR = 1.49, 95% CI = 1.17-1.89, respectively). People meeting the guidelines for physical activity of moderate intensity (OR = 1.23 95% CI = 1.04-1.46) and for vegetable consumption (OR = 1.26 95% CI = 1.01-1.57) were also more likely to participate repeatedly than people who did not, as were obese people compared to individuals with normal weight (OR = 1.41 95% CI = 1.09-1.82). Conclusions: For some variables, this study confirms our concern that behavioral intervention programs may reach those who need them the least. However, contrary to most expectations, we found that obese people were more likely to participate in follow-up than people of normal body weight. The non-stigmatizing way of addressing body weight through the Internet may be part of the explanation for this. Our findings suggest that Web-based health behavior change programs may be more successful in the area of weight management than in many other health-related areas. They also stress the importance of adequate coverage of weight management in Web-based health promotion programs, as a driver to continue participation for overweight and obese people.

OBJECTIVE: To determine the relation between body mass index (BMI) and absenteeism. METHODS: Data were collected in a prospective cohort study (n = 1284). Multilevel analyses (linear mixed model with random intercept) with two levels (employee and company) were used to test whether BMI was related to duration and frequency of absenteeism and whether this relation was influenced by sports participation. RESULTS: Obese employees were absent 14 days a year more than normal-weight employees. Also the frequency of absenteeism of more than 7 days was significantly higher. The differences in absenteeism between obese and normal-weight employees were larger for employees who did not practice sport regularly. CONCLUSIONS: Obese employees are more often absent and are absent longer, especially when they do not practice sport regularly. An active company policy to prevent obesity is needed, both from a health and a business efficiency perspective. ©2007The American College of Occupational and Environmental Medicine.

Objective: The purpose of this study was to investigate associations among three modifiable risk factors (ie, physical activity, cardiorespiratory fitness, and body mass index), work productivity, and sickness absence in computer workers. Methods: All participants were computer workers with neck and upper limb symptoms in the preceding 6 months, the last 2 weeks, or both. Productivity and sickness absence were assessed with the Health and Performance Questionnaire (HPQ). Results: Physical activity and cardiorespiratory fitness were not associated with work productivity or sickness absence. Obese male workers reported lower absolute productivity than lean workers. Lean and overweight workers reported similar productivity levels. Body mass index was not associated with sickness absence. Conclusions: In a population of white-collar workers with neck and upper limb symptoms, obese male workers showed significantly lower productivity than did lean or overweight workers. ©Medline

Introduction: The goal of this study was to assess the effectiveness of a group-based interactive work style intervention in improving work style behavior. Methods: Computer workers with neck and upper limb symptoms were randomised into the work style group (WS, N = 152), the work style and physical activity group (WSPA, N = 156), or the usual care group (N = 158). Both intervention groups received the same work style intervention but the WSPA group also received a lifestyle physical activity intervention. Participants from the intervention groups attended six group meetings which focused on behavioral change with regard to body posture and workstation adjustment, breaks, and coping with high work demands in order to reduce work stress. Stage of change, breaks and exercise behavior, and stress outcomes were assessed by questionnaire at baseline (T0) and after 6 (T1) and 12 months (T2). Body posture and workstation adjustment were assessed by observation and by questionnaire at T0, T1, and T2. Multilevel analyses were used to study differences in work style behavior between study groups. Results: The work style intervention was effective in improving stage of change with regard to body posture, workstation adjustment, and the use of sufficient breaks during computer work. These findings were confirmed by higher self-reported use of breaks and exercise reminder software and less working hours without breaks. However, self-reported changes in body posture and workstation adjustment were less consistent. The work style intervention was ineffective in changing stress outcomes. Conclusion: A group-based work style intervention seems to be effective in improving some elements of work style behavior. Future studies should investigate the effectiveness of work style interventions on all dimensions of the Feuerstein work style model. © 2007 Springer Science+Business Media, LLC.

Veel mensen willen meer gaan bewegen. Toch lukt dit vaak niet. Wat denken mensen nodig te hebben om daadwerkelijk meer in beweging te komen? Deze vraag stond centraal in de Nationale Gezondheidstest 2004. Aan drie groepen (onvoldoende beweging, geen overgewicht (n=223), onvoldoende beweging, overgewicht (n=825), voldoende beweging, overgewicht (n=1013)) is gevraagd welke beweegactiviteiten favoriet zouden zijn en wat hen zou stimuleren om te gaan bewegen of sporten, indien ze het advies zouden krijgen om meer te gaan bewegen. De favoriete beweegactiviteiten waren: fietsen (83%), lopen (77%), huishoudelijke klussen (76%) en recreatief sporten (66%). Om meer in beweging te komen zouden de deelnemers minder tv willen gaan kijken (60%) of minder gaan computeren (37%). De meest genoemde stimulerende factoren waren informatie en persoonlijk (medisch) advies over geschikte beweeg- en sportmogelijkheden (62-81%). Verder was er een grote behoefte aan een maatje om gezamenlijk te gaan bewegen of sporten (66-76%). Deze stimulerende factoren werden het vaakst genoemd door de deelnemers met overgewicht en onvoldoende beweging.

An important challenge in Web-based health promotion is to increase the reach of the target audience by taking the target groups' desires into consideration. Data from 505 members of a Dutch Internet panel (representative for Dutch Internet users) were used to asses the target group's interests and needs. 28% participated in Web-based tailored lifestyle programs, 57% expressed an interest in such programs, and 15% expressed no interest. Interest in Web-based programs was predominantly caused by a general interest in lifestyle and online tests. Participation in Web-based tailored lifestyle programs should not take more than 17 minutes per occasion. 84% were interested in follow-up testing after the initial participation. Responders were particularly interested in physical activity and nutrition. Hardly anyone was willing to pay for participation. The results from this study support the use of Web-based tailored lifestyle programs in behavior change efforts.

In dit literatuuronderzoek is bekeken of bewegingsstimulering arbeidsrelevante klachten aan het bewegingsapparaat (rug- en arm-nek-schouderklachten) kan voorkómen en verminderen. Het blijkt dat overtuigend effect van bewegingsstimulering op dit moment alleen is aangetoond voor de preventie van rugklachten. Daarnaast lijkt een effect op het verminderen van chronische rugklachten erg waarschijnlijk. Bewegingsstimulering lijkt ook het arbeidsverzuim ten gevolge van chronische rug- en arm-nek-schouderklachten te kunnen terugdringen. Verder zijn er wel aanwijzingen voor positieve effecten van bewegingsstimulering op de preventie van arm-nek-schouderklachten, maar vertonen de beschikbare onderzoeken nog veel inconsistente resultaten. De conclusie is dat bewegingsstimulering een belangrijk middel kan zijn om klachten aan het bewegingsapparaat te voorkómen of te verminderen.

Objective: To investigate the dose-response relation between moderate and vigorous physical activity and sick leave in a working population. Methods: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one prospective cohort study. A distinction was made between duration, frequency and intensity of physical activity. The outcome measure was the number of days of sick leave. Analyses of variance were used to compare sick leave (in days) for workers with different amounts of physical activity, in particular workers meeting the physical activity recommendations v those who did not. Linear and logistic regression analyses were used to obtain effect estimates in the prospective cohort study, with the generalised estimating equation (GEE) method. Results: No relation was round between moderate physical activity and sick leave. In two databases, workers meeting the recommendation of vigorous physical activity (active at a vigorous level for at least three times a week) had significantly less sick leave: more than one day over two months and more than four days over a year. The duration of vigorous physical activity was not associated with sick leave. Conclusion: Physical activity at a vigorous intensity level for at least three times a week, as in the CDC/ACSM recommendation, has a positive effect on sick leave.

Objective.: This study describes the total physical activity and the contribution of work to total physical activity among Dutch workers. The study was conducted in the Netherlands in the years 2000-2002. Methods.: 2,417 respondents of a cross-sectional survey representing the Dutch adult working population were included. Physical activity was measured by the proportion meeting the current public health physical activity recommendations and by total physical activity (in minutes per week). Seven occupational groups and 28 sectors were distinguished. Unadjusted analyses were carried out using chi-square test and one-way analysis of variance. Results.: On average, 53.7% was sufficiently active according to the recommended levels. Work contributed for 30% to total physical activity. There were significant differences between the occupations and sectors in total physical activity levels as well as in the amount of work-related physical activity. Those in policy and higher executive functions were least active at work with work contributing for 19.5% to total physical activity, whereas those working in agricultural occupations were most active at work with work contributing for 55.1% to total physical activity. Conclusions.: Work is still an important source of total physical activity among workers. Based on the differences observed, branch-specific strategies to enhance work-related physical activity are recommended. © 2006 Elsevier Inc. All rights reserved.

In dit literatuuronderzoek is bekeken of bewegingsstimulering psychische klachten kan voorkomen en verminderen. Er zijn sterke aanwijzingen dat bewegingsstimulering psychische klachten kan verminderen. Verder zijn er wel aanwijzingen voor positieve effecten van bewegingsstimulering op de preventie van psychische klachten, maar vertonen de beschikbare onderzoeken nog veel inconsistente resultaten. Het is onduidelijk of bewegingsstimulering verzuim vanwege psychische klachten kan reduceren. De conclusie is dat bewegingsstimulering een belangrijk middel kan zijn om arbeidsrelevante psychische klachten te voorkomen of te verminderen.

The Dutch Musculoskeletal Questionnaire (DMQ) is the subject of the 5th chapter of the Handbook of human factors and ergonomics methods. The DMQ allows ergonomists and occupational health professionals to measure work-related musculoskeletal risk factors and symptoms in worker populations in a quick yet standardized way. There are a standard version, a short version and an extended version. The questionnaire includes the following sections: background variables, tasks, musculoskeletal workload, work pace and psychosocial working conditions, health, lifestyle, perceived bottlenecks and ideas for improvements. This chapter gives background information (including an internetlink to download the DMQ), information about application and procedure.

Objectives. This study evaluated the impact of worksite physical activity counseling using cost-benefit and cost-effectiveness analyses. Methods. Civil servants (N=299) were randomly assigned to an intervention (N=131) or control (N=168) group for 9 months. The intervention costs were compared with the monetary benefits gained from reduced sick leave. In addition, the intervention costs minus the monetary benefits from sick leave reduction were compared with the effects (percentage meeting the public health recommendation for moderate-intensity physical activity, energy expenditure, cardiorespiratory fitness, and upper extremity symptoms). Results. The intervention costs were EUR 430 per participant, and the benefits were EUR 125 due to sick leave during the intervention period, for net total costs of EUR 305 for the intervention. During the same 9-month period the year after the intervention, the benefits from sick leave reduction were EUR 635. No statistically significant differences in costs and benefits were found between the groups. As to the cost-effectiveness, improvement in energy expenditure and cardiorespiratory fitness was observed at higher costs. The point estimates of the cost-effectiveness ratios were EUR 5.2 (without imputation of effect data) and EUR 2.7 (with imputation of effect data) per extra kilocalorie of energy expenditure per day and EUR 235 (without imputation of effect data) and EUR 45.9 (with imputation of effect data) per beat per minute of decrease in submaximal heart rate. Conclusions. This study does not provide a financial reason for implementing worksite counseling intervention on physical activity on the short-term. However, positive effects were shown for energy expenditure and cardiorespiratory fitness. This work is licensed under a Creative Commons Attribution 4.0 International License.

Objectives. This study evaluated the effects on work-related neck and upper-limb disorders among computer workers stimulated (by a software program) to take regular breaks and perform physical exercises. Possible effects on sick leave and productivity were studied as well. Methods. A randomized controlled design was used with cluster randomization. Altogether 268 computer workers with complaints in the neck or an upper limb from 22 office locations were randomized into a control group, one intervention group stimulated to take extra breaks and one intervention group stimulated to perform exercises during the extra breaks during an 8-week period. Questionnaires were administered before and after the intervention, and questions were generated by the software during the intervention period. Computer usage was recorded online. Results. The data on self-reported recovery suggested a favorable effect; more subjects in the intervention groups than in the control group reported recovery (55% versus 34%) from their complaints and fewer reported deterioration (4% versus 20%). However, a comparison between the reported pre- and postintervention scores on the severity and frequency of the complaints showed no significant differences in the change among the three groups. No effects on sick leave were observed. The subjects in the intervention groups showed higher productivity. Conclusions. The use of a software program stimulating workers to take regular breaks contributes to perceived recovery from neck or upper-limb complaints. There seems to be no additional effects from performing physical exercises during these breaks. This work is licensed under a Creative Commons Attribution 4.0 International License.

Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program.A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol.There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure.Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted.

This paper systematically reviews the literature on the effectiveness of physical activity programs at worksites with respect to work-related outcomes. A computerized literature search, a reference search, and a manual search of personal databases were performed using the following inclusion criteria: randomized controlled or controlled trial, working population, worksite intervention program to promote physical activity or physical fitness, and work-related outcomes. The study quality was evaluated using nine methodological criteria. Conclusions were based on a 5-level rating system of evidence. Eight studies (4 randomized controlled trials and 4 controlled trials) were identified, but their methodological quality was generally poor. The outcomes were absenteeism, job satisfaction, job stress, productivity, and employee turnover. The evidence of an effect was limited for absenteeism, inconclusive for job satisfaction, job stress and employee turnover, and nil for productivity. The scientific evidence on the effectiveness of physical activity programs at worksites is still limited. Because of the few high-quality randomized controlled trials, it is strongly suggested that this type of study be carried out. Future randomized controlled trials should pay special attention to the description of randomization, inclusion criteria, compliance, and analyses according to intention to treat. This work is licensed under a Creative Commons Attribution 4.0 International License.

To determine priorities for ergonomic improvements in five maintenance departments of a steel company, a study was carried out to identify groups with a high prevalence of musculoskeletal problems or a high exposure to unfavourable musculoskeletal workload. All workers were asked to complete a standardized questionnaire on musculoskeletal symptoms and musculoskeletal workload. Response rate in the five departments varied between 60 and 80% (n = 436). Symptoms of low back and neck-shoulder (12-month prevalence rates of 53% and 36%, respectively) were most common, but not higher in comparison with a reference group of 396 non-sedentary workers. Self-reported exposure rates to physical and psychosocial loads as well as poor climatic conditions were comparable with the reference group; only exposure to vibration was higher. Significant differences were seen between the five departments as well as between task groups with the departments. Several task groups with relatively high symptom rates and high exposure levels could be identified. It is concluded that a questionnaire survey can constitute a valuable contribution to the selection of high-risk task groups that need ergonomic intervention. Chemicals/CAS: Steel, 12597-69-2