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Gou L, Zheng Q. How to reduce the risk of cervicalgia and low back pain in obese individuals: A mendelian randomization study. Medicine (Baltimore) 2023; 102:e33710. [PMID: 37144993 PMCID: PMC10158894 DOI: 10.1097/md.0000000000033710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
Obesity is associated with cervicalgia and low back pain (LBP), but the specific role and how to reduce the risk of neck pain and low back pain are not clear. The Mendelian randomization analysis was used to investigate the causal relationship between obesity and cervicalgia and LBP, as well as the effect of possible mediating factors. Then, causal associations were estimated using sensitivity analysis. Educational level (odds ratio (OR) = 0.30, 0.23) was negatively associated with cervicalgia and LBP; Heavy physical work (HPW) (OR = 3.24, 2.18), major depression (MD) (OR = 1.47, 1.32), body mass index (BMI) (OR = 1.36, 1.32), and waist circumference (WC) (OR = 1.32, 1.35) were positively associated with cervicalgia and LBP; Leisure sedentary behavior (LSB) (OR = 1.96), smoking (OR = 1.32), and alcohol intake frequency (OR = 1.34) were positively associated only with LBP, but not with cervicalgia. Ranked by mediated proportions of selected mediators, the largest causal mediator from BMI and WC to cervicalgia was educational level (38.20%, 38.20%), followed by HPW (22.90%, 24.70%), and MD (9.20%, 17.90%); However, the largest causal mediator from BMI and WC to LBP was LSB (55.10%, 50.10%), followed by educational level (46.40%, 40.20%), HPW (28.30%, 20.90%), smoking initiation (26.60%, 32.30%), alcohol intake frequency (20.40%, 6.90%), and MD (10.00%, 11.40%). For obese individuals, avoiding HPW and maintaining a stable mood may be an effective approach to prevent cervicalgia; Additionally, reducing LSB, avoiding HPW, quitting smoking and drinking, and maintaining a stable mood may be an effective approach to prevent LBP.
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Affiliation(s)
- Li Gou
- Operation Room, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
| | - Qiang Zheng
- Emergency Department, The First Hospital of Jilin University, Changchun, China
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Rydström K, Jackson J, Johansson K, Mathiassen SE. A Systematic Review of Work Organization, Work Environment, and Employment Conditions in Warehousing in Relation to Gender and Race/Ethnicity. Ann Work Expo Health 2023; 67:430-447. [PMID: 36715660 PMCID: PMC10119697 DOI: 10.1093/annweh/wxac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Studies in the goods supply chain in areas outside of warehousing show evidence of gender and racial/ethnic inequalities in working conditions (i.e. in work organization, work environment, and employment conditions). This review aimed to identify, summarize, and discuss research focused on inequality in warehousing and its effects on warehouse working conditions. In the review, racial/ethnic inequality includes inequality related to country of birth and (im)migration status. METHODS We performed a systematic search in the Scopus and Web of Science databases to identify warehouse studies that addressed working conditions and (in)equality at a workplace level. Screening of records was performed using the Rayyan systematic review tool. Risk of bias was assessed according to established methods and checklists. RESULTS Database searches yielded 4910 articles. After title-abstract-keyword and full-text screenings, 21 articles were included. Results showed inequality based on gender and race/ethnicity in both work organization (different tasks were performed by different groups of employees), work environment conditions (physical and psychosocial aspects differed), and employment conditions (disparate employment types and incomes between groups of employees). Health differences, as a possible result of unequal working conditions, were evident between different racial/ethnic groups of employees. A hierarchy that included both gender and race/ethnicity was found, with (im)migrant and racialized women positioned at the bottom. CONCLUSIONS We found evidence that gender and race/ethnicity influenced work organization, work environment conditions, and employment conditions. Evidence was found for an intersection between gender and race/ethnicity. To improve working conditions, and subsequently occupational health, we encourage researchers to simultaneously consider gender and race/ethnicity factors at work, and to consider both why inequality is present and how it impacts working conditions in future studies of warehousing, particularly in online retailing.
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Affiliation(s)
- Klara Rydström
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Jennie Jackson
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - Kristina Johansson
- Department of Social Sciences, Technology and Arts, Luleå University of Technology, Laboratorievägen 14, 971 87 Luleå, Sweden
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
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Jackson JA, Liv P, Sayed-Noor AS, Punnett L, Wahlström J. Risk factors for surgically treated cervical spondylosis in male construction workers: a 20-year prospective study. Spine J 2023; 23:136-145. [PMID: 36028215 DOI: 10.1016/j.spinee.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT Degenerative changes due to cervical spondylosis (CS) can detrimentally affect work ability and quality of life yet understanding of how physical exposure affects disease progression is limited. PURPOSE To assess the associations between occupational physical exposures and occurrence of surgically treated cervical spondylosis (ST-CS) and early exit from the labor market via disability pension. STUDY DESIGN/SETTING Prospective register study with 20 years follow-up period. PATIENT SAMPLE Swedish construction workers participating in a national health surveillance project conducted between 1971 and 1993. OUTCOME MEASURES Surgically treated cervical spondylosis (ST-CS) and early labor market exit at a minimum rate of 25% time on disability pension. METHODS Associations between occupational physical exposures (job exposure matrix) and subsequent ST-CS (National Hospital in-patient register) and early labor market exit via disability pension (Swedish Social Insurance Agency register) were assessed in a cohort of male construction workers (n=237,699). RESULTS A total of 1381 ST-CS cases were present and a 20 years incidence rate of 35.1 cases per 100,000 person years (95% confidence interval (CI) 33.2-36.9). Increased relative risk (RR) for ST-CS was found for workers exposed to non-neutral (RR 1.40, 95% CI 1.15-1.69), and awkward neck postures (1.52, 1.19-1.95), working with the hands above shoulder height (1.30, 1.06-1.60), and high upper extremity loading (1.35, 1.15-1.59). Increased risk was also present for workers who reported frequent neck (3.06, 2.18-4.30) and upper back (3.84, 2.57-5.73) pain in the 12 months prior to survey. Among workers with elevated arm exposure, higher risk was seen in those who also had more frequent neck pain. ST-CS cases took early retirement more often (41.3%) and at a younger age (53 years) than the total study cohort (14.8% and 56 years of age, respectively). CONCLUSIONS Occupational exposure to non-neutral neck postures, work with hands above shoulders and high loads born through the upper extremities increased the risk for ST-CS and early retirement due to disability. Decreasing postural and load exposure is salient for primary, secondary, and tertiary prevention of CS. Neck pain was shown to be a prognostic factor for ST-CS, which stresses the importance of acting early and taking preventative action to reduce workplace exposure, and the need for systematic medical check-ups within primary or occupational care to mitigate disease progression and early labour market exit due to disability.
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Affiliation(s)
- Jennie A Jackson
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
| | - Per Liv
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Arkan S Sayed-Noor
- Deparment of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jens Wahlström
- Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
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Rolander B, Forsman M, Ghafouri B, Abtahi F, Wåhlin C. Measurements and observations of movements at work for warehouse forklift truck operators. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1840-1848. [PMID: 34193025 DOI: 10.1080/10803548.2021.1943866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Inclinometry and video analyses can provide objective measures of physical workloads. The study aim was to measure and observe arm, back and head postures and movements among forklift truck operators (FLTOs) during a working day, analyzing differences between types of forklift trucks and to assess reported workload and health. Twenty-five male FLTOs in a high-level warehouse were randomly included. The data collected comprised technical measurements, video analyses of postures and movements, and a questionnaire measuring health, pain and workload. On average, the FLTOs rotated their head more than 45°, in total, 232 times/h. Video analysis revealed that FLTOs periodically drive the forklift truck sideways with the head rotated in the direction of travel, and in periods look upwards, in which the head is highly rotated and extended. Inclinometry and observations during the working day has the potential to be a valuable part of risk assessment promoting occupational safety and health.
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Affiliation(s)
- Bo Rolander
- School of Health and Welfare, Jönköping University, Sweden.,Futurum, Academy for Health and Care, Region Jönköping, Sweden
| | - Mikael Forsman
- Institute of Environmental Medicine, Karolinska Institutet, Sweden.,Division of Ergonomics, KTH Royal Institute of Technology, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
| | - Farhad Abtahi
- Division of Ergonomics, KTH Royal Institute of Technology, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden.,Department of Clinical Physiology, Karolinska University Hospital Huddinge, Sweden
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Rabal-Pelay J, Cimarras-Otal C, Marcen-Cinca N, Alcázar-Crevillén A, Laguna-Miranda C, Bataller-Cervero AV. Assessment of Spinal Range of Motion and Musculoskeletal Discomfort in Forklift Drivers. A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062947. [PMID: 33805655 PMCID: PMC7998771 DOI: 10.3390/ijerph18062947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Abstract
Forklifts are commonly used in industrial supply chains to transport heavy loads. Forklift drivers have the risk of developing musculoskeletal discomfort derived from the movement pattern required at work. This research aimed to investigate the spinal range of motion (ROM) and musculoskeletal discomfort of forklift drivers and compare it with a control group. Forklift drivers (39 males) and office workers (31 males) were recruited to assess cervical, thoracic, and lumbar ROM with an electronic double inclinometer. Additionally, musculoskeletal discomfort was registered with the Cornell Discomfort Musculoskeletal Questionnaire. Forklift drivers showed a higher cervical discomfort and ROM of lateral lumbar bending than office workers. Both groups reported lower ROM in cervical and lumbar lateral bending on the right side versus the left side. No differences of asymmetry were reported for any variable between groups. Specific exercise programs may correct these mobility imbalances.
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Affiliation(s)
- Juan Rabal-Pelay
- Faculty of Health Science, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km. 299, 50830 Villanueva de Gállego, Spain; (J.R.-P.); (N.M.-C.); (A.V.B.-C.)
| | - Cristina Cimarras-Otal
- Faculty of Health Science, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km. 299, 50830 Villanueva de Gállego, Spain; (J.R.-P.); (N.M.-C.); (A.V.B.-C.)
- Correspondence:
| | - Noel Marcen-Cinca
- Faculty of Health Science, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km. 299, 50830 Villanueva de Gállego, Spain; (J.R.-P.); (N.M.-C.); (A.V.B.-C.)
| | | | - Carmen Laguna-Miranda
- BSH Electrodomésticos España S.A., Pol. Industrial Otallana, Avenida La Industria, 49, 50016 Zaragoza, Spain;
| | - Ana Vanessa Bataller-Cervero
- Faculty of Health Science, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km. 299, 50830 Villanueva de Gállego, Spain; (J.R.-P.); (N.M.-C.); (A.V.B.-C.)
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Tani N, Ohta M, Higuchi Y, Akatsu J, Kumashiro M. Lifestyle and subjective musculoskeletal symptoms in young male Japanese workers: A 16-year retrospective cohort study. Prev Med Rep 2020; 20:101171. [PMID: 32904206 PMCID: PMC7452148 DOI: 10.1016/j.pmedr.2020.101171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/14/2020] [Accepted: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
The SN/S and LBP risk was higher in the PL than in the GL group. Four positive predictors (life satisfaction, hours of sleep, exercise habits, physical fitness) are important factors. Health staff should advise on workers’ individual lifestyle.
This longitudinal study was conducted from 2002 to 2018 and aimed to investigate predictive lifestyle factors for the occurrence of subjective musculoskeletal symptoms. The participants came from several employers in Japan. Setting 2002 as the baseline, we performed logistic regression analyses using lifestyle questionnaire items as explanatory variables and Stiff neck/shoulders (SN/S) and Lower back pain (LBP) as objective variables (n = 16,748). Workers who responded positively to good lifestyle items with an odds ratio < 1.0 and those who did not were classified in the Good (GL) and Poor lifestyle groups (PL), respectively. The survival period between the groups was compared using the log-rank test and Cox hazard regression analysis with propensity score matching (n = 3,593). Based on the Cox hazard regression analysis results, the risk of SN/S was about 2.54 (95% confidence interval [CI]: 1.80–3.59) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 2.33 (95% CI: 1.07–5.10) times higher for PL than for GL (p < 0.05). Further, LBP risk was about 2.45 (95% CI: 1.67–3.58) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 3.50 (95% CI: 1.60–7.68) times higher for PL than for GL (p < 0.01). This study highlighted that workers with four good lifestyle factors (life satisfaction, hours of sleep, exercise habits, and physical fitness) presented reduced risk of subjective musculoskeletal symptom occurrence. To prevent musculoskeletal symptoms, physicians and occupational health staff should advise on workers’ individual lifestyle.
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Affiliation(s)
- Naomichi Tani
- OH Solution Group, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | | | | | - Junichi Akatsu
- Wellbeing Mori Clinic, The Association for Preventive Medicine of Japan, Tokyo, Japan.,University of Occupational and Environmental Health, Japan
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Golabchi FN, Sapienza S, Severini G, Reaston P, Tomecek F, Demarchi D, Reaston M, Bonato P. Assessing aberrant muscle activity patterns via the analysis of surface EMG data collected during a functional evaluation. BMC Musculoskelet Disord 2019; 20:13. [PMID: 30611235 PMCID: PMC6320612 DOI: 10.1186/s12891-018-2350-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Surface electromyographic (EMG) recordings collected during the performance of functional evaluations allow clinicians to assess aberrant patterns of muscle activity associated with musculoskeletal disorders. This assessment is typically achieved via visual inspection of the surface EMG data. This approach is time-consuming and leads to accurate results only when the assessment is carried out by an EMG expert. METHODS A set of algorithms was developed to automatically evaluate aberrant patterns of muscle activity. EMG recordings collected during the performance of functional evaluations in 62 subjects (22 to 61 years old) were used to develop and characterize the algorithms. Clinical scores were generated via visual inspection by an EMG expert using an ordinal scale capturing the severity of aberrant patterns of muscle activity. The algorithms were used in a case study (i.e. the evaluation of a subject with persistent back pain following instrumented lumbar fusion who underwent lumbar hardware removal) to assess the clinical suitability of the proposed technique. RESULTS The EMG-based algorithms produced accurate estimates of the clinical scores. Results were primarily obtained using a linear regression approach. However, when the results were not satisfactory, a regression implementation of a Random Forest was utilized, and the results compared with those obtained using a linear regression approach. The root-mean-square error of the clinical score estimates produced by the algorithms was a small fraction of the ordinal scale used to rate the severity of the aberrant patterns of muscle activity. Regression coefficients and associated 95% confidence intervals showed that the EMG-based estimates fit well the clinical scores generated by the EMG expert. When applied to the clinical case study, the algorithms appeared to capture the characteristics of the muscle activity patterns associated with persistent back pain following instrumented lumbar fusion. CONCLUSIONS The proposed approach relies on EMG-based measures to generate accurate estimates of the severity of aberrant patterns of muscle activity. The results obtained in the case study suggest that the proposed technique is suitable to derive clinically-relevant information from EMG data collected during functional evaluations.
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Affiliation(s)
- Fatemeh Noushin Golabchi
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300 First Ave, Charlestown, MA 02129 USA
| | - Stefano Sapienza
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300 First Ave, Charlestown, MA 02129 USA
| | - Giacomo Severini
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300 First Ave, Charlestown, MA 02129 USA
- School of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland
| | | | | | - Danilo Demarchi
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | | | - Paolo Bonato
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300 First Ave, Charlestown, MA 02129 USA
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