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Munch PK, Espenhain L, Hansen CH, Krause TG, Ethelberg S. Case-control study of activities associated with SARS-CoV-2 infection in an adult unvaccinated population and overview of societal COVID-19 epidemic counter measures in Denmark. PLoS One 2022; 17:e0268849. [PMID: 36383627 PMCID: PMC9668151 DOI: 10.1371/journal.pone.0268849] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Measures to restrict physical inter-personal contact in the community have been widely implemented during the COVID-19 pandemic. We studied determinants for infection with SARS-CoV-2 with the aim of informing future public health measures. We conducted a national matched case-control study among unvaccinated not previously infected adults aged 18-49 years. Cases were selected among those testing positive for SARS-CoV-2 by RT-PCR over a five-day period in June 2021. Controls were selected from the national population register and were individually matched on age, sex and municipality of residence. Cases and controls were interviewed via telephone about contact with other persons and exposures in the community. We determined matched odds ratios (mORs) and 95% confidence intervals (95%CIs) by conditional logistical regression with adjustment for household size and immigration status. For reference, we provide a timeline of non-pharmaceutical interventions in place in Denmark from February 2020 to March 2022. We included 500 cases and 529 controls. We found that having had contact with another individual with a known infection was the main determinant for SARS-CoV-2 infection: reporting close contact with an infected person who either had or did not have symptoms resulted in mORs of 20 (95%CI:9.8-39) and 8.5 (95%CI 4.5-16) respectively. Community exposures were generally not associated with disease; several exposures were negatively associated. Consumption of alcohol in restaurants or cafés, aOR = 2.3 (95%CI:1.3-4.2) and possibly attending fitness centers, mOR = 1.4 (95%CI:1.0-2.0) were weakly associated with SARS-CoV-2 infection. Apart from these two factors, no community activities were more common amongst cases under the community restrictions in place during the study. The strongest risk factor for transmission was contact to an infected person. Results were in agreement with findings of our similar study conducted six month earlier.
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Affiliation(s)
- Pernille Kold Munch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Laura Espenhain
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Tyra Grove Krause
- Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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Munch PK, Espenhain L, Hansen CH, Müller L, Krause TG, Ethelberg S. Societal activities associated with SARS-CoV-2 infection: a case-control study in Denmark, November 2020. Epidemiol Infect 2021; 150:e9. [PMID: 34784997 PMCID: PMC8755547 DOI: 10.1017/s0950268821002478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Identification of societal activities associated with SARS-CoV-2 infection may provide an evidence base for implementing preventive measures. Here, we investigated potential determinants for infection in Denmark in a situation where society was only partially open. We conducted a national matched case-control study. Cases were recent RT-PCR test-positives, while controls, individually matched on age, sex and residence, had not previously tested positive for SARS-CoV-2. Questions concerned person contact and community exposures. Telephone interviews were performed over a 7-day period in December 2020. We included 300 cases and 317 controls and determined odds ratios (ORs) and 95% confidence intervals (95% CI) by conditional logistical regression with adjustment for household size and country of origin. Contact (OR 4.9, 95% CI 2.4-10) and close contact (OR 13, 95% CI 6.7-25) with a person with a known SARS-CoV-2 infection were main determinants. Contact most often took place in the household or work place. Community determinants included events with singing (OR 2.1, 95% CI 1.1-4.1), attending fitness centres (OR 1.8, 95% CI 1.1-2.8) and consumption of alcohol in a bar (OR 10, 95% CI 1.5-65). Other community exposures appeared not to be associated with infection, these included shopping at supermarkets, travel by public transport, dining at restaurants and private social events with few participants. Overall, the restrictions in place at the time of the study appeared to be sufficient to reduce transmission of disease in the public space, which instead largely took place following direct exposures to people with known SARS-CoV-2 infections.
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Affiliation(s)
- Pernille Kold Munch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
| | - Laura Espenhain
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
| | - Luise Müller
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
| | - Tyra Grove Krause
- Division of Infectious Disease Preparedness, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 5 Artillerivej, 2300, Copenhagen S, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
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Munch PK, Nørregaard Rasmussen CD, Jørgensen MB, Larsen AK. Which work environment challenges are top of mind among eldercare workers and how would they suggest to act upon them in everyday practice? Process evaluation of a workplace health literacy intervention. Appl Ergon 2021; 90:103265. [PMID: 32905984 DOI: 10.1016/j.apergo.2020.103265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 08/19/2020] [Accepted: 08/29/2020] [Indexed: 06/11/2023]
Abstract
The purpose of this study was to identify challenges and action plans from 2.497 structured communication sessions between employee and supervisor and to gain insight into the processes of a quasi-experimental stepped wedge clustered intervention, which implemented workplace health literacy for reducing musculoskeletal pain among eldercare workers. Most challenges concerned staffing (17%), organisation of tasks (15%) and team work (14%). Most action plans concerned communication (18%), team-work (16%) and handling residents (14%). Half of the plans were solved at another level in the organisation than the challenge appeared. Actions planned on the individual level had the highest implementation rate (52%). The results underline the advantages in considering solutions to work environment and health challenges broadly at all levels in the organisation and the relevance of involving both the employee and the organisation/management in identifying and implementing solutions.
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Affiliation(s)
- Pernille Kold Munch
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | | | - Marie Birk Jørgensen
- Health and Safety, Municipality of Copenhagen, Enghavevej 82, 2450, Copenhagen SV, Denmark
| | - Anne Konring Larsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
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Munch PK, Jørgensen MB, Højberg H, Rasmussen CDN. Nation-Wide Dissemination of a Digital Checklist to Improve Work Environment in the Eldercare Sector in Denmark. Front Public Health 2020; 8:502106. [PMID: 33344392 PMCID: PMC7744467 DOI: 10.3389/fpubh.2020.502106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/12/2020] [Indexed: 12/01/2022] Open
Abstract
In this study, we evaluated the dissemination of a digital checklist for improving implementation of work environment initiatives in the Danish eldercare sector. We evaluated the impact of the checklist using the RE-AIM framework. Initiated in 2016, researchers and relevant stakeholders were responsible for disseminating the checklist to all workplaces in the eldercare sector in Denmark through a national campaign. The checklist guided the user to define an action plan to implement, and the checklist covered 11 implementation concept points that should be addressed to reach full implementation of the action in focus. One year after the launch of the campaign almost all municipalities in Denmark had visited the website hosting the checklist (96%), 17% of individual workers within the eldercare responding to a union survey was reached, 4% (n = 199) of all eligible eldercare workplaces in Denmark and 8% of all nursing homes had adopted the checklist. Of the workplaces that used the checklist, 46% typed an action in the checklist. There were 13% of the first time users that used the checklist twice and 29% of the actions were revised (maintenance) after working with the implementation. Finally, the workplaces that had used the checklist showed a higher prioritization of work environment compared to workplaces not using the checklist both at baseline and at follow up. In conclusion, this study employing various strategies, including a 1-year national campaign to disseminate a checklist shows potential to impact implementation of work environment initiatives in the Danish eldercare sector. While dissemination is satisfactory and likely to increase further with time, more efforts is needed to ensure maintenance.
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Affiliation(s)
| | | | - Helene Højberg
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Lerche AF, Vilhelmsen M, Schmidt KG, Kildedal R, Launbo N, Munch PK, Lidegaard M, Jacobsen SS, Rasmussen CL, Mathiassen SE, Straker L, Holtermann A. Can Childcare Work Be Designed to Promote High Intensity Physical Activity for Improved Fitness and Health? A Proof of Concept Study of the Goldilocks Principle. Int J Environ Res Public Health 2020; 17:ijerph17207419. [PMID: 33053791 PMCID: PMC7600739 DOI: 10.3390/ijerph17207419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
Childcare workers are reported to have high variation in physical activity during work hours, but also to sit for about half of the workday and have almost no high intensity physical activity (HIPA). No study has investigated if their work can be re-designed to introduce HIPA, thus promoting fitness and health according to the Goldilocks principle. This study investigated the feasibility of designing pedagogical games (‘Goldilocks-games’) intended to lead to more HIPA. Heart rate was measured in nineteen childcare workers during Goldilocks-games, and compared to measurements during a regular workday. Worker perceptions of feasibility, and researcher observations of contextual factors were also collected. The Goldilocks-games (33 min) elicited significantly more HIPA (18/33 min) compared to the most active period of equal length on a regular workday (0.5/33 min). Seventy-four-percent of the childcare workers reported that it was feasible to integrate the Goldilocks-games pedagogically, and seventy-two-percent could see themselves using them. Thus, we found it possible to re-design a work task in childcare according to the Goldilocks principle so that it leads to substantial time with HIPA. The sustainability of Goldilocks-games in childcare, and their effectiveness in improving fitness and health among childcare workers, needs to be tested in further studies.
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Affiliation(s)
- Anders Fritz Lerche
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence:
| | - Maja Vilhelmsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Kathrine Greby Schmidt
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Rasmus Kildedal
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Natja Launbo
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Mark Lidegaard
- Novo Nordisk Health & Safety, Novo Nordisk A/S, 2880 Bagsværd, Denmark;
| | - Sandra Schade Jacobsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Charlotte Lund Rasmussen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden;
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia;
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
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Rasmussen CDN, Højberg H, Larsen AK, Munch PK, Osborne R, Kwak L, Jensen I, Linnan L, Jørgensen MB. Evaluation and Dissemination of a Checklist to Improve Implementation of Work Environment Initiatives in the Eldercare Sector: Protocol for a Prospective Observational Study. JMIR Res Protoc 2020; 9:e16039. [PMID: 32401212 PMCID: PMC7254284 DOI: 10.2196/16039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/13/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023] Open
Abstract
Background To measure sustainable improvements in the work environment, a flexible and highly responsive tool is needed that will give important focus to the implementation process. A digital checklist was developed in collaboration with key stakeholders to document the implementation of changes in eldercare sector workplaces. Objective This paper describes the study protocol of a dissemination study that aims to examine when, why, and how the digital checklist is spread to the Danish eldercare sector following a national campaign particularly targeting nursing homes and home care. Methods This prospective observational study will use quantitative data from Google Analytics describing use of the checklist as documented website engagement, a survey among members in the largest union in the sector, information from a central business register, and monitoring of campaign activities. The evaluation will be guided by the five elements of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. Results The study was approved in June 2016 and began in October 2018. The campaign that is the foundation for the evaluation began in 2017 and ended in 2018. However, the webpage where we collect data is still running. Results are expected in 2020. Conclusions This protocol provides a working example of how to evaluate dissemination of a checklist to improve implementation of work environment initiatives in the eldercare sector in Denmark. To our knowledge, implementation in a nationwide Danish work environment has not been previously undertaken. Given that the checklist is sector-specific for work environment initiatives and developed through systematic collaboration between research and practice, it is likely to have high utility and impact; however, the proposed evaluation will determine this. This study will advance dissemination research and, in particular, the evaluation of the impact of these types of studies. Finally, this study advances the field through digital tools that can be used for evaluation of dissemination efforts (eg, Google Analytics associated with website) in the context of a rigorous research design activity. International Registered Report Identifier (IRRID) DERR1-10.2196/16039
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Affiliation(s)
| | - Helene Højberg
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Anne Konring Larsen
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Richard Osborne
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Lydia Kwak
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Laura Linnan
- Carolina Collaborative for Research on Work & Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Lidegaard M, Lerche AF, Munch PK, Schmidt KG, Rasmussen CL, Rasmussen CDN, Mathiassen SE, Straker L, Holtermann A. Can childcare work be designed to promote moderate and vigorous physical activity, cardiorespiratory fitness and health? Study protocol for the Goldilocks-childcare randomised controlled trial. BMC Public Health 2020; 20:237. [PMID: 32066404 PMCID: PMC7026977 DOI: 10.1186/s12889-020-8291-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite extensive efforts, issues like obesity and poor physical capacity remain challenges for a healthy work life in several occupations. The Goldilocks work principle offers a new approach, encouraging design of productive work to promote physical capacity and health. This paper presents the protocol for the Goldilocks-childcare study, a randomised controlled intervention trial aiming to evaluate the effectiveness of implementing the Goldilocks work principle in childcare. The primary aim of the intervention is to increase time in moderate to vigorous physical activity (MVPA) by having the childcare workers act as active role models for children in daily playful physical activities, and thereby improve cardiorespiratory fitness and health of the workers. METHODS The study is a cluster-randomised trial with a usual-practice wait-list control group. The 10-week intervention consists of two phases. In the first, the childcare workers will participate in two participatory workshops aiming to a) develop playful physical activities ('Goldilocks-games') for children in which childcare workers participate as active role models at MVPA intensity, and b) develop action plans for implementation of the Goldilocks-games in daily work routines. In the second phase, childcare institutions will implement the Goldilocks-games. The primary outcome is working time spent in MVPA, and secondary outcomes are cardiorespiratory fitness, sleeping heart rate, perceived need for recovery, and productivity. Primary outcome and process evaluation will be based on direct measurements of physical activity and heart rate, determination of cardiorespiratory fitness, and questionnaires. DISCUSSION If proven effective, the Goldilocks work principle has a large potential for promoting sustainable health and working lives of childcare workers. TRIAL REGISTRATION ISRCTN, ISRCTN15644757, Registered 25th December 2019.
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Affiliation(s)
- Mark Lidegaard
- National Research Centre for the Working Environment, Copenhagen, Denmark.
- Novo Nordisk A/S, Novo Nordisk Health & Safety, Bagsværd, Denmark.
| | | | | | | | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Svend Erik Mathiassen
- Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Karstad K, Rugulies R, Skotte J, Munch PK, Greiner BA, Burdorf A, Søgaard K, Holtermann A. Inter-rater reliability of direct observations of the physical and psychosocial working conditions in eldercare: An evaluation in the DOSES project. Appl Ergon 2018; 69:93-103. [PMID: 29477334 DOI: 10.1016/j.apergo.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/31/2017] [Accepted: 01/06/2018] [Indexed: 05/14/2023]
Abstract
The aim of the study was to develop and evaluate the reliability of the "Danish observational study of eldercare work and musculoskeletal disorders" (DOSES) observation instrument to assess physical and psychosocial risk factors for musculoskeletal disorders (MSD) in eldercare work. During 1.5 years, sixteen raters conducted 117 inter-rater observations from 11 nursing homes. Reliability was evaluated using percent agreement and Gwet's AC1 coefficient. Of the 18 examined items, inter-rater reliability was excellent for 7 items (AC1>0.75) fair to good for 7 items (AC1 0.40-0.75) and poor for 2 items (AC1 0-0.40). For 2 items there was no agreement between the raters (AC1 <0). The reliability did not differ between the first and second half of the data collection period and the inter-rater observations were representative regarding occurrence of events in eldercare work. The instrument is appropriate for assessing physical and psychosocial risk factors for MSD among eldercare workers.
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Affiliation(s)
- Kristina Karstad
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Reiner Rugulies
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Jørgen Skotte
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Pernille Kold Munch
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Road, Cork, Ireland
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense C, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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