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Appelbom S, Nordström A, Finnes A, Wicksell RK, Bujacz A. Healthcare worker burnout during a persistent crisis: a case-control study. Occup Med (Lond) 2024:kqae032. [PMID: 38738440 DOI: 10.1093/occmed/kqae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND During the immediate outbreak of the COVID-19 pandemic, burnout symptoms increased among healthcare workers. Knowledge is needed on how early symptoms developed during the persistent crisis that followed the first pandemic wave. AIMS To investigate if high levels of burnout symptoms during the first pandemic wave led to high burnout and depressive symptoms up to a year later, and if participation in psychological support was related to lower levels of symptoms. METHODS A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group was participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case-control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks and psychological support participation. RESULTS One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depressive symptoms at all follow-ups. Participation in psychological support was unrelated to decreased burnout and depressive symptoms at any of the follow-ups. CONCLUSIONS During a persistent crisis, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis. To better prepare for future healthcare crises, preventive measures on burnout are needed, both at workplaces and as part of the curricula in medical and nursing education.
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Affiliation(s)
- S Appelbom
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - A Nordström
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - A Finnes
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R K Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Pain Clinic, Capio St Göran Hospital, Stockholm, Sweden
| | - A Bujacz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Ljungberg Silic L, Persson C, Pesonen M, Suuronen K, Svedman C, Bergendorff O. 2-Cyanoethyl dimethyldithiocarbamate, a new contact allergen found in accelerator-free nitrile gloves. Contact Dermatitis 2024. [PMID: 38602297 DOI: 10.1111/cod.14553] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Allergic contact dermatitis (ACD) from rubber glove usage is usually caused by rubber additives such as the accelerators. However, in analyses of the suspected gloves, ordinary rubber allergens are not always found. Accelerator-free rubber gloves are available, but some patients with accelerator allergy do not tolerate them and might also be patch test positive to them. OBJECTIVES To identify and chemically characterize a new allergen, 2-cyanoethyl dimethyldithiocarbamate (CEDMC), in rubber gloves. We describe two patient cases: patient 1 that led us to the identification of CEDMC and patient 2 with occupational ACD caused by CEDMC. METHODS The patients were examined with patch testing including baseline and rubber series, and their own rubber gloves. High-performance liquid chromatography (HPLC) was used for chemical analysis of rubber gloves. The allergen was synthesized and identified by nuclear magnetic resonance, mass spectrometry and infrared spectrometry, and tested on patient 2. RESULTS CEDMC was identified by HPLC in a nitrile glove associated with hand eczema in patient 1. Patient 2 whose nitrile gloves contained CEDMC was patch test positive to CEDMC. CONCLUSIONS CEDMC is a new contact allergen in nitrile gloves and probably forms during vulcanization from residual monomer acrylonitrile and rubber additives.
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Affiliation(s)
- Linda Ljungberg Silic
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Christina Persson
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Maria Pesonen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Katri Suuronen
- Occupational Health Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Bergendorff
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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Sharma S, Bennet L, Laucyte-Cibulskiene A, Christensson A, Nilsson PM. Associations between birth weight and adult apolipoproteins: The LifeGene cohort. PLoS One 2024; 19:e0299725. [PMID: 38427666 PMCID: PMC10906835 DOI: 10.1371/journal.pone.0299725] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 06/27/2023] [Accepted: 02/14/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Early life factors may predict cardiovascular disease (CVD), but the pathways are still unclear. There is emerging evidence of an association of early life factors with apolipoproteins, which are linked to CVD. The study objective was to assess the associations between birth variables and adult apolipoproteins (apoA1 and apoB, and their ratio) in a population-based cohort. METHODS The LifeGene Study is a prospective cohort comprising index participants randomly sampled from the general population. Blood samples were collected between 2009 and 2016. In this sub-study, we used birth variables, obtained from a national registry for all participants born 1973 or later, including birth weight and gestational age, while adult CVD risk factors included age, sex, body mass index (BMI), lipids, and smoking history. We employed univariate and multivariate general linear regression to explore associations between birth variables, lipid levels and other adult CVD risk factors. The outcomes included non-fasting apoA1 and apoB and their ratio, as well as total cholesterol and triglycerides. A total of 10,093 participants with both birth information and lipoprotein levels at screening were included. Of these, nearly 42.5% were men (n = 4292) and 57.5% were women (n = 5801). RESULTS The mean (standard deviation) age of men was 30.2 (5.7) years, and for women 28.9 (5.8) years. There was an increase of 0.022 g/L in apoA1 levels per 1 kg increase in birth weight (p = 0.005) after adjusting for age, sex, BMI, gestational age, and smoking history. Similarly, there was a decrease of 0.023 g/L in apoB levels per 1 kg increase in birth weight (p<0.001) after adjusting for the same variables. There were inverse associations of birth weight with the apoB/apoA1 ratio. No independent association was found with total cholesterol, but with triglyceride levels (ẞ-coefficient (95% Confidence Interval); -0.067 (-0.114, -0.021); p-value 0.005). CONCLUSIONS Lower birth weight was associated with an adverse adult apolipoprotein pattern, i.e., a higher apoB/apoA1 ratio, indicating increased risk of future CVD manifestations. The study highlights the need of preconception care and pregnancy interventions that aim at improving maternal and child outcomes with long-term impacts for prevention of cardiovascular disease by influencing lipid levels.
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Affiliation(s)
- Shantanu Sharma
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Louise Bennet
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Clinical Trials Unit, Skåne University Hospital, Lund, Sweden
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Christensson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Research Unit, Skåne University Hospital, Malmö, Sweden
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László KD, Svedberg P, Lindfors P, Lidwall U, Alexanderson K. Sickness absence and disability pension three years before and seven years after first childbirth: A Swedish population-based cohort study. Scand J Public Health 2024; 52:80-88. [PMID: 36286644 PMCID: PMC10845816 DOI: 10.1177/14034948221125153] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/19/2022] [Accepted: 08/19/2022] [Indexed: 02/06/2024]
Abstract
AIMS There is a widely held belief, in Sweden and internationally, that women with children are more likely to be on sickness absence (SA) than their nulliparous counterparts. However, empirical findings in the field are limited and inconsistent. We aimed to explore initially nulliparous women's patterns of SA and disability pension (DP) three years before and seven years after 2009, by later parity. METHODS We conducted a longitudinal cohort study of nulliparous women in Sweden on 31 December 2009 (N=426,918). We compared crude and standardized numbers of SA/DP net days in the three years before (Y-3 to Y-1) and the seven years (Y+1 to Y+7) after the date of the first birth in 2010 or 2 July 2010 in the following three groups: (1) women with no childbirth during the seven-year follow-up and an additional nine months (i.e. 7.8 years), (2) women with a first childbirth in 2010 and no additional childbirth during the next 7.8 years, and (3) women with their first childbirth in 2010 and minimum one more during the next 7.8 years. RESULTS Women remaining nulliparous had consistently more standardized mean SA/DP days than women giving birth. Compared with women with one birth, women with several births had similar mean numbers of standardized SA/DP days during Y-3 and Y-2, more during Y+1 to Y+3 and fewer during Y+4 to Y+7. CONCLUSIONS In contrast to the widely held societal belief, we found that in all years women who gave birth had fewer SA/DP days than those remaining nulliparous.
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Affiliation(s)
- Krisztina D. László
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department for Analysis, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Abzhandadze T, Westerlind E, Palstam A, Sunnerhagen KS, Persson HC. Sick leave one year after COVID-19 infection: a nationwide cohort study during the first wave in Sweden. Sci Rep 2024; 14:572. [PMID: 38177214 PMCID: PMC10766961 DOI: 10.1038/s41598-023-50413-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
This study aimed to investigate the patterns of sick leave, as well as factors associated with sick leave due to COVID-19 during one year after the COVID-19 diagnosis, and sex-related aspects on sick leave. This nationwide study involved 11,902 individuals who received sickness benefits for COVID-19 during the first wave of the pandemic. Data from three Swedish registries were analyzed for sick leave that commenced between March 1 and August 31, 2020, with a follow-up period of 12 months. Sick leave due to COVID-19 was counted as the number of days with sickness benefits and required to include at least one registered COVID-19 diagnosis. The median duration of sick leave was 35 days, and 347 (2.9%) individuals continued their sick leave during the entire follow-up period. Furthermore, 1 year later, the cumulative incidence of sick leave was slightly higher in males (3.5%) compared to females (2.7%). Older age, being single with no children, diagnosed with the virus, medium income level, history of sick leave, and need for inpatient care were significantly associated with a higher duration of sick leave due to COVID-19, both in the total population and when stratified by sex. These results indicated that three out of 100 (3%) patients were still on sick leave 1 year after their COVID-19 diagnosis. Aspects regarding the importance of sick leave duration differed between males and females and comprised sociodemographic characteristics and need for inpatient care. The results indicated the complexity of sick leave due to COVID-19.
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Affiliation(s)
- Tamar Abzhandadze
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Emma Westerlind
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annie Palstam
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna C Persson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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Lindsäter E, Svärdman F, Rosquist P, Wallert J, Ivanova E, Lekander M, Söderholm A, Rück C. Characterization of exhaustion disorder and identification of outcomes that matter to patients: Qualitative content analysis of a Swedish national online survey. Stress Health 2023; 39:813-827. [PMID: 36645034 DOI: 10.1002/smi.3224] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/06/2022] [Accepted: 01/12/2023] [Indexed: 01/17/2023]
Abstract
Fatigue is a common presenting problem in healthcare settings, often attributed to chronic psychosocial stress. Understanding of fatigue and development of evidence-based treatments is hampered by a lack of consensus regarding diagnostic definitions and outcomes to be measured in clinical trials. This study aimed to map outcome domains of importance to the Swedish diagnosis stress-induced exhaustion disorder (ED; ICD-10, code F43.8 A). An online survey was distributed nationwide in Sweden to individuals who reported to have been diagnosed with ED and to healthcare professionals working with ED patients. To identify outcome domains, participants replied anonymously to four open-ended questions about symptoms and expectations for ED-treatment. Qualitative content analysis was conducted of a randomized subsample of respondents, using a mathematical model to determine data saturation. Six hundred seventy participants (573 with reported ED, 97 healthcare professionals) completed the survey. Qualitative content analysis of answers supplied by 105 randomized participants identified 87 outcomes of importance to ED encompassing physical, cognitive, and emotional symptoms as well as functional disability. Self-rating scales indicated that many ED participants, beyond reporting fatigue, also reported symptoms of moderate to severe depression, anxiety, insomnia, poor self-rated health, and sickness behavior. This study presents a map of outcome domains of importance for ED. Results shed light on the panorama of issues that individuals with ED deal with and can be used as a step to further understand the condition and to reach consensus regarding outcome domains to measure in clinical trials of chronic stress and fatigue. Preregistration: Open Science Framework (osf.io) with DOI https://doi.org/10.17605/OSF.IO/4VUAG.
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Affiliation(s)
- Elin Lindsäter
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Frank Svärdman
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Patrik Rosquist
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - John Wallert
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Ekaterina Ivanova
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Söderholm
- Department of Psychology, Umeå Universitet, Umeå, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
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Höglund P, Hakelind C, Nordin M, Nordin S. Risk factors for insomnia and burnout: A longitudinal population-based cohort study. Stress Health 2023; 39:798-812. [PMID: 36634111 DOI: 10.1002/smi.3218] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 12/13/2022] [Accepted: 01/01/2023] [Indexed: 01/13/2023]
Abstract
Insomnia and burnout are highly prevalent in the general population, calling for understanding of its causes. Taking a broad approach, the aim of this study was to determine various mental and somatic risk factors for development of insomnia and burnout and stratifying for sex and age group. Questionnaire data were used from a Swedish population-based sample aged 18-79 years, from which cohorts without insomnia (n = 1702) and without burnout (n = 1972) at baseline were followed-up after 3 years. Self-reports of eight mental and somatic conditions at baseline were used as independent variables in logistic regression analyses to predict development of insomnia and burnout at 3-year follow-up. All eight studied conditions were significant risk factors for development of both insomnia (odds ratio, OR = 1.62-2.73) and burnout (OR = 2.20-3.21). Burnout and poor self-rated health had the highest ORs for insomnia, and poor self-rated health, anxiety and somatic symptoms had the highest ORs for burnout. The ORs were generally similar between men and women, whereas age groups tended to differ in some of the risk factors. The study highlights the importance of a broad assessment of both mental and somatic conditions in the prevention of insomnia and burnout.
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Affiliation(s)
- Per Höglund
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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Dahlgren G, Liv P, Öhberg F, Slunga Järvholm L, Forsman M, Rehn B. Correlations between Ratings and Technical Measurements in Hand-Intensive Work. Bioengineering (Basel) 2023; 10:867. [PMID: 37508893 PMCID: PMC10376394 DOI: 10.3390/bioengineering10070867] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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Affiliation(s)
- Gunilla Dahlgren
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Radiation Physics, Department of Radiation Sciences, Umeå University, S-901 87 Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, S-141 57 Huddinge, Sweden
| | - Börje Rehn
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden
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Fisk K, Nordander C, Ek Å. Hand-arm vibration: Swedish carpenters' perceptions of health and safety management. Occup Med (Lond) 2023; 73:85-90. [PMID: 36745447 PMCID: PMC10016033 DOI: 10.1093/occmed/kqad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Workers in the construction industry are highly exposed to vibration from handheld equipment, which can have negative effects on the nerves and blood vessels in the hands. Employers in this industry often fail to comply with legislation regarding vibration exposure. AIMS To assess carpenters' perceptions of proactive health and safety (H&S) management regarding hand-arm vibration exposure at construction sites in Sweden. METHODS The carpenters answered a questionnaire on their perception of the implementation of H&S management, on symptoms indicating injury and on the use of vibrating equipment. RESULTS One hundred and ninety-four carpenters from 4 construction companies and 18 construction sites completed the questionnaire. Attitudes to H&S management were generally positive. However, 36% of the carpenters reported that the H&S regulations and routines did not function in practice, and 40% claimed they did not receive necessary information on the exposure and effects of vibration. Most respondents (74%) perceived a high risk of injury in general in their work. Younger carpenters, carpenters employed at smaller companies and carpenters with symptoms indicating injury or with higher vibration exposure reported more negative perceptions. CONCLUSIONS In general, the carpenters were positive about management's commitment to H&S management. However, the results indicate deficiencies in the way in which this commitment is applied in practice at the workplace. This highlights the importance of raising awareness concerning vibration exposure and possible injuries, and strengthening proactive H&S programmes, especially in smaller companies.
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Affiliation(s)
- K Fisk
- Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering LTH, Lund University, SE-221 00 Lund, Sweden
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, SE-223 63 Lund, Sweden
| | - C Nordander
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, SE-223 63 Lund, Sweden
| | - Å Ek
- Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering LTH, Lund University, SE-221 00 Lund, Sweden
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Kathare M, Julander A, Erfani B, Schenk L. OUP accepted manuscript. Ann Work Expo Health 2022; 66:741-753. [PMID: 35217863 PMCID: PMC9250289 DOI: 10.1093/annweh/wxac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.
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Affiliation(s)
- Maitreyi Kathare
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Julander
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sustainable work and management, IVL Swedish Environmental Research Institute, Stockholm, Sweden
| | - Behnaz Erfani
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Schenk
- Author to whom correspondence should be addressed. Tel: +46-8-5248-7968; fax: +46-8-33-69-81; e-mail:
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Hedmer M, Lovén K, Martinsson J, Messing ME, Gudmundsson A, Pagels J. OUP accepted manuscript. Ann Work Expo Health 2022; 66:878-894. [PMID: 35297480 PMCID: PMC9357347 DOI: 10.1093/annweh/wxac015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/27/2021] [Accepted: 02/18/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maria Hedmer
- Author to whom correspondence should be addressed. Tel: +46-46173193; e-mail:
| | - Karin Lovén
- NanoLund, Center for Nanoscience, Lund University, 22100 Lund, Sweden
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden
| | - Johan Martinsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, SE-22100 Lund, Sweden
| | - Maria E Messing
- NanoLund, Center for Nanoscience, Lund University, 22100 Lund, Sweden
- Solid State Physics, Department of Physics, Lund University, SE-22100 Lund, Sweden
| | - Anders Gudmundsson
- NanoLund, Center for Nanoscience, Lund University, 22100 Lund, Sweden
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden
| | - Joakim Pagels
- NanoLund, Center for Nanoscience, Lund University, 22100 Lund, Sweden
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, SE-22100 Lund, Sweden
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12
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Arvidsson I, Dahlqvist C, Enquist H, Nordander C. Action Levels for the Prevention of Work-Related Musculoskeletal Disorders in the Neck and Upper Extremities: A Proposal. Ann Work Expo Health 2021; 65:741-747. [PMID: 33831146 PMCID: PMC8341001 DOI: 10.1093/annweh/wxab012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 09/07/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 01/22/2023] Open
Abstract
There are several well-known risk factors for work-related musculoskeletal disorders (MSDs). Despite this knowledge, too many people still work in harmful conditions. The absence of occupational exposure limits (OELs) for physical workload impedes both supervision and preventive work. To prevent myalgia, tendon disorders, and nerve entrapments in the upper musculoskeletal system, we propose action levels concerning work postures, movement velocities and muscular loads recorded by wearable equipment. As an example, we propose that wrist velocity should not exceed 20°/s as a median over a working day. This has the potential to reduce the prevalence of carpal tunnel syndrome (CTS) in highly exposed male occupational groups by 93%. By reducing upper arm velocity in highly exposed female groups to the suggested action level 60°/s, the prevalence of pronounced neck/shoulder myalgia with clinical findings (tension neck syndrome) could be reduced by 22%. Furthermore, we propose several other action levels for the physical workload. Our ambition is to start a discussion concerning limits for physical workload, with the long-term goal that OELs shall be introduced in legislation. Obviously, the specific values of the proposed action levels can, and should, be discussed. We hope that quantitative measurements, combined with action levels, will become an integral part of systematic occupational health efforts, enabling reduction and prevention of work-related MSDs.
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Affiliation(s)
- Inger Arvidsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81, Lund, Sweden
| | - Camilla Dahlqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81, Lund, Sweden
| | - Henrik Enquist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Medicon Village, SE-223 81, Lund, Sweden
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Gebhardt A, Langius-Eklöf A, Andermo S, Arman M. Health and suffering are associated with social support: a cross-sectional study of women and mothers with exhaustion and pain. BMC Womens Health 2021; 21:259. [PMID: 34174840 PMCID: PMC8235816 DOI: 10.1186/s12905-021-01398-y] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite women are generally overrepresented in behavioral, mental, and musculoskeletal disorders, motherhood as a central part of women's life is poorly understood in relation to exhaustion and long-lasting pain. Mothers' health impairments imply suffering both for herself and her family. A profound understanding of health is needed taking mothers' subjective health experience, their suffering and life situation into account to give women, their families and society better prerequisites to alleviate exhaustion and long-lasting pain. The aim of the study was to describe health and suffering of women and mothers undergoing rehabilitation for long-lasting pain and exhaustion and its correlation with perceived social support. METHODS The study had a cross-sectional design with an exploratory approach. A main sample consisted of 166 women undergoing rehabilitation for exhaustion and long-lasting pain and a reference sample included 129 women working and studying within health care professions. Both samples included women with and without children. Women's subjective health and suffering was assessed from a caring science perspective using the recently developed and validated Health and Suffering Scale. Two additional scales measuring exhaustion and social support were distributed among the two samples. Descriptive statistics and multiple linear regression models, including health and suffering and perceived social support, were analyzed. RESULTS Mothers undergoing rehabilitation for pain and exhaustion reported significantly poorer health and more suffering compared to healthy mothers, but similar health and suffering when compared with childless women in rehabilitation. Health and suffering were correlated with perceived social support among both healthy and exhausted mothers. In both samples, the correlation between health and suffering and social support was stronger among mothers than among women without children. CONCLUSIONS Women and mothers living with exhaustion and long-lasting pain show signs of unbearable suffering and perceived insufficient social support. Social support from various sources particularly helps mothers to create meaning in life and make their suffering bearable. Hence, health care must address the fact that mothers are dependent on their immediate social environment and that this dependency interacts with their health and suffering on an existential level.
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Affiliation(s)
- Anja Gebhardt
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden.
| | - Ann Langius-Eklöf
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
| | - Susanne Andermo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
- Department of Global Public Health, Karolinska Institutet, 17165, Solna, Sweden
| | - Maria Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
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14
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Björkenstam C, Orellana C, László KD, Svedberg P, Voss M, Lidwall U, Lindfors P, Alexanderson K. Sickness absence and disability pension before and after first childbirth and in nulliparous women: longitudinal analyses of three cohorts in Sweden. BMJ Open 2019; 9:e031593. [PMID: 31501131 PMCID: PMC6738681 DOI: 10.1136/bmjopen-2019-031593] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Childbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, detailed knowledge about SA/DP patterns around childbirth is lacking. We aimed to compare SA/DP across different time periods among women according to their childbirth status. DESIGN Register-based longitudinal cohort study. SETTING Sweden. PARTICIPANTS Three population-based cohorts of nulliparous women aged 18-39 years, living in Sweden 31 December 1994, 1999 or 2004 (nearly 500 000/cohort). PRIMARY AND SECONDARY OUTCOME MEASURES Sum of SA >14 and DP net days/year. METHODS We compared crude and standardised mean SA and DP days/year during the 3 years preceding and the 3 years after first childbirth date (Y-3 to Y+3), among women having (1) their first and only birth during the subsequent 3 years (B1), (2) their first birth and at least another delivery (B1+), and (3) no childbirths during follow-up (B0). RESULTS Despite an increase in SA in the year preceding the first childbirth, women in the B1 group, and especially in B1+, tended to have fewer SA/DP days throughout the years than women in the B0 group. For cohort 2005, the mean SA/DP days/year (95% CIs) in the B0, B1 and B1+ groups were for Y-3: 25.3 (24.9-25.7), 14.5 (13.6-15.5) and 8.5 (7.9-9.2); Y-2: 27.5 (27.1-27.9), 16.6 (15.5-17.6) and 9.6 (8.9-10.4); Y-1: 29.2 (28.8-29.6), 31.4 (30.2-32.6) and 22.0 (21.2-22.9); Y+1: 30.2 (29.8-30.7), 11.2 (10.4-12.1) and 5.5 (5.0-6.1); Y+2: 31.7 (31.3-32.1), 15.3 (14.2-16.3) and 10.9 (10.3-11.6); Y+3: 32.3 (31.9-32.7), 18.1 (17.0-19.3) and 12.4 (11.7-13.0), respectively. These patterns were the same in all three cohorts. CONCLUSIONS Women with more than one childbirth had fewer SA/DP days/year compared with women with one childbirth or with no births. Women who did not give birth had markedly more DP days than those giving birth, suggesting a health selection into childbirth.
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Affiliation(s)
- Charlotte Björkenstam
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Orellana
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Margaretha Voss
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Analysis and Forecast, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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15
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Bennet SMP, Palsson O, Whitehead WE, Barrow DA, Törnblom H, Öhman L, Simrén M, van Tilburg MAL. Systemic cytokines are elevated in a subset of patients with irritable bowel syndrome but largely unrelated to symptom characteristics. Neurogastroenterol Motil 2018; 30:e13378. [PMID: 29797382 DOI: 10.1111/nmo.13378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/18/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serum levels of pro-inflammatory cytokines tend to be increased in irritable bowel syndrome (IBS) patients, or subgroups thereof. Still, the link between cytokine levels and IBS symptoms is unclear. We aim to determine systemic cytokine levels in IBS patients and healthy subjects (HS), confirm the presence of a subset of patients with an increased immune activity and to establish if cytokines are linked to IBS symptoms and pathophysiological factors. METHODS Serum levels of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF), and IL-10 were measured. All subjects reported IBS symptoms using validated questionnaires and underwent colonic sensorimotor testing. Multivariate supervised orthogonal partial least squares-discriminant analysis (OPLS-DA) and unsupervised principal component analysis (PCA) and hierarchical cluster analysis (HCA) were implemented. KEY RESULTS Irritable bowel syndrome patients (n = 246) had higher serum levels of IL-1β, IL-6, IL-8, TNF, and IL-10 compared to HS (n = 21); however, serum cytokine profiles could not discriminate patients from HS. Moreover, cytokine levels were not correlated with symptoms among patients. Supervised OPLS-DA identified 104 patients (40% of patients) and unsupervised HCA analysis identified 49 patients (20%) with an increased immune activity indicated by elevated levels of serum cytokines compared to HS and the other patients. However, irrespective of how patients with increased immune activity were identified they were symptomatically similar to patients with no indication of increased immune activity. CONCLUSIONS & INFERENCES Serum cytokines are elevated in IBS patients compared to HS. Immune activation characterizes a subset of patients, but modest associations between cytokine profile and symptoms suggest immune activity does not directly influence symptoms in IBS.
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Affiliation(s)
- S M P Bennet
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - O Palsson
- Center for Functional Gastrointestinal and Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
| | - W E Whitehead
- Center for Functional Gastrointestinal and Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
| | - D A Barrow
- Center for Oral and Systemic Diseases, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - H Törnblom
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Öhman
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - M Simrén
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Center for Functional Gastrointestinal and Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
| | - M A L van Tilburg
- Center for Functional Gastrointestinal and Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
- School of Social Work, University of Washington, Seattle, WA, USA
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, USA
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16
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Rudolfsson T, Björklund M, Svedmark Å, Srinivasan D, Djupsjöbacka M. Direction-Specific Impairments in Cervical Range of Motion in Women with Chronic Neck Pain: Influence of Head Posture and Gravitationally Induced Torque. PLoS One 2017; 12:e0170274. [PMID: 28099504 PMCID: PMC5242513 DOI: 10.1371/journal.pone.0170274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 01/02/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine. METHODS Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure. FINDINGS Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour. INTERPRETATION The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.
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Affiliation(s)
- Thomas Rudolfsson
- Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- * E-mail: (MD); (TR); (MB)
| | - Martin Björklund
- Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- * E-mail: (MD); (TR); (MB)
| | - Åsa Svedmark
- Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Divya Srinivasan
- Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
| | - Mats Djupsjöbacka
- Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden
- * E-mail: (MD); (TR); (MB)
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