28 research outputs found
Musculoskeletal pain and effort-reward imbalance- a systematic review
BACKGROUND: Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question. METHODS: A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180â193, 2001). RESULTS: After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one caseâcontrol study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively. CONCLUSIONS: On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified
Cross-cultural adaptation of the delphi definitions of low back pain prevalence (German DOLBaPP)
Background Assessed dimensions of low back pain (LBP) vary in prevalence
studies. This may explain the heterogeneity in frequency estimates. To
standardize definitions of LBP, an English consensus with 28 experts from 12
countries developed the âDelphi Definitions of Low Back Pain Prevalenceâ
(DOLBaPP). The optimal definition and the shorter minimal definition with the
related questionnaires for online, paper, and face-to-face use and telephone
surveys are suitable for population-based studies. The definitions have to be
adapted to different languages and cultures to provide comparable frequency
estimates. The objective was to culturally adapt and pre-test the English
definitions and corresponding Delphi DOLBaPP questionnaire forms into German.
Methods The German DOLBaPP adaptation was conducted using the systematic
approach suggested by Beaton et al. A pre-test of the Delphi DOLBaPP optimal
paper questionnaire including an additional evaluation form was conducted in a
sample of 121 employees (mainly office workers). In order to evaluate the
comprehensibility, usability, applicability, and completeness of the adapted
questionnaire, response to the questionnaire and 6 closed evaluation questions
were analyzed descriptively. Qualitative methods were used for the 3 open
questions of the evaluation form. Results The cultural adaptation of the
DOLBaPP for a German-speaking audience required little linguistic adaptation.
Conceptual equivalence was difficult for the expression âlow back painâ. The
expert committee considered the face validity of the pre-final version of the
related Delphi DOLBaPP questionnaires as good. In the pre-test, most
participants (95%) needed less than 5 minutes to fill in the optimal Delphi
DOLBaPP questionnaire. They were generally positive regarding length, wording,
diagram, and composition. All subjects with LBP (nâ=â61 out of 121 â 50.4%)
answered the questions on functional limitation, sciatic pain, frequency and
duration of symptoms as well as pain severity. Conclusion The results indicate
that the cross-cultural German adaptation of the DOLBaPP Definitions and the
corresponding questionnaires was successful. The definitions can be used in
epidemiological studies to measure the prevalence of LBP. Some critical issues
were raised regarding the general features of the Delphi DOLBaPP
questionnaires. Future research is needed to evaluate these instruments
The risk of coronary heart disease of seafarers on vessels sailing under a German flag
Background. This study aimed to predict the risk of coronary heart disease (CHD) among seafarers
on German-flagged vessels and to assess the association of shipboard job duration at sea
with the risk of CHD.
Material and methods. During the legally required medical fitness test for nautical service, 161
seafarers in Hamburg participated in a cross-sectional study which included an interview, blood
sampling, and blood pressure measurements (response 84.9%). The predicted 10-year risk of
an acute coronary event of the examined German seafarers aged 35 to 64 years (n = 46) was
assessed in comparison with a sample of male German employees of the same age working
ashore (PROCAM study). The number of independent CHD risk factors (according to the PROCAM
study) was compared in the groups with ‘shorter’ and ‘longer’ median shipboard job duration
at sea (15.0 years).
Results. The examined German seafarers had a similar age-standardized predicted 10-year
CHD risk as the German reference population. Nearly all independent CHD risk factors were
significantly more frequent in seamen with job duration at sea of ≥ 15 years than in those with
< 15 years. After adjusting for age, the number of CHD risk factors was associated with job
duration (OR 1.08 [95% CI 1.02-1.14] per year).
Conclusions. Seafarers on German-flagged ships have to attend a medical fitness test for nautical
service every 2 years. Thus, it can be assumed that seafarers present a healthier population
than employees ashore. In this study, however, CHD risk of seafarers was similar to that of the
reference population. This may indicate that working onboard implies a high coronary risk.
Furthermore, the study results suggest a tendency of increased risk of CHD among seafarers
with longer job duration at sea
Hepatitis-B-Virus-Infektionen und impfinduzierte ImmunitÀt: die Rolle von soziodemografischen Determinanten
Hintergrund und Ziel:
Trotz niedriger PrĂ€valenz der Hepatitis-B-Virus-(HBV-)Infektion in Deutschland ist es wichtig, vulnerable Gruppen und Ansatzpunkte fĂŒr die PrĂ€vention zu identifizieren. In ersten Analysen der âStudie zur Gesundheit Erwachsener in Deutschlandâ (DEGS1, 2008â2011) waren HBV-Infektion und -Impfung mit sozidemografischen Determinanten assoziiert. In dieser Arbeit werden die Ergebnisse im Detail untersucht.
Material und Methoden:
In DEGS1 lag fĂŒr 7046 Teilnehmende (Alter: 18â79 Jahre) eine HBV-Serologie vor. Die stattgehabte HBV-Infektion war durch Antikörper gegen das Hepatitis-B-Core-Antigen (Anti-HBc) definiert, die impfinduzierte ImmunitĂ€t durch alleinigen Nachweis von Antikörpern gegen das Hepatitis-B-Surface-Antigen (Anti-HBs). SeroprĂ€valenzen von HBV-Infektions- und -Impfstatus wurden geschlechtsstratifiziert geschĂ€tzt und Assoziationen mit Alter, GemeindegröĂe, Einkommen, formaler Bildung, Krankenversicherung und Migrationsgeneration in logistischen Regressionen analysiert.
Ergebnisse:
Die HBV-Infektion war bei MĂ€nnern und Frauen unabhĂ€ngig mit den Altersgruppen 34â64 und â„âŻ65 Jahre, erster Migrationsgeneration und Leben in gröĂeren Gemeinden assoziiert, zudem bei MĂ€nnern mit niedrigem Einkommen und bei Frauen mit niedriger Bildung. Die impfinduzierte ImmunitĂ€t war bei MĂ€nnern und Frauen unabhĂ€ngig mit den Altersgruppen 18â33 und 34â64 Jahre, mittlerer und hoher Bildung und hohem Einkommen assoziiert, darĂŒber hinaus bei MĂ€nnern mit mittlerem Einkommen und privater Krankenversicherung und bei Frauen mit fehlendem Migrationshintergrund.
Diskussion:
Die BerĂŒcksichtigung von Migrationsstatus, Einkommen und Bildung könnte zur zielgenauen Ausrichtung der HBV-PrĂ€vention beitragen.Background and objective:
Even though the prevalence of hepatitis B virus (HBV) infection in Germany is low, it is important to identify vulnerable groups and targeted approaches for infection prevention. Previous analyses from the âGerman Health Interview and Examination Survey for Adultsâ (DEGS1, 2008â2011) have shown that HBV infections and vaccination are associated with sociodemographic determinants. This paper examines the results in detail.
Materials and methods:
In the DEGS1, HBV serology was available for 7046 participants aged 18â79 years. HBV infection was defined by antibodies to hepatitis B core antigen (anti-HBc), vaccine-induced immunity by antibodies to hepatitis B surface antigen (anti-HBs) in the absence of other markers. Seroprevalences of HBV infection and vaccine-induced immunity were estimated stratified by sex, and associations with age, municipality size, income, formal education, health insurance and migration generation were analysed by logistic regression.
Results:
In both sexes, HBV infection was independently associated with age groups 34â64 and â„âŻ65 years, first migrant generation and living in larger municipalities as well as low income in men and low education in women. Vaccine-induced immunity was independently associated with age groups 18â33 and 34â64 years, middle and high education and high income in both sexes, middle income and private health insurance in men and having no migration background in women.
Conclusions:
HBV prevention measures should take into account migration status, income and education in order to focus prevention measures.Peer Reviewe
Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996â2005
Objective: The aim of the present work was to establish whether or not prescribed medication is a usable risk indicator for workârelated ischaemic heart disease (IHD), in Denmark. Material and Methods: Weighted Spearman rank correlation coefficients (rho) were used to evaluate the agreement between Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people in Danish national registers 1996â2005. Results: We found approximately 7 times more cases of medicine usage (N = 411 651) than we did for hospital treatment or death (N = 55 684). The correlations between the 2 types of SHR were strong (rho = 0.94 for the socio-occupational groups; rho = 0.74 for the economic activities groups). We observed, however, one markedly contradictive result; the industrial group entitled âgeneral practitioner, dentists etc.â was associated both with significantly high rates of medicine usage (SHR = 1.15, 95% CI: 1.12â1.19) and significantly low rates of hospital treatment or death due to IHD (SHR = 0.80, 95% CI: 0.71â0.91). Conclusion: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine data in addition to or instead of the use of death or hospital data in epidemiological studies on work-related IHD risk will bring about a tremendous increase in statistical power
Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996â2005
Objective: The aim of the present work was to establish whether or not prescribed medication is a usable risk indicator for workârelated ischaemic heart disease (IHD), in Denmark. Material and Methods: Weighted Spearman rank correlation coefficients (rho) were used to evaluate the agreement between Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people in Danish national registers 1996â2005. Results: We found approximately 7 times more cases of medicine usage (N = 411 651) than we did for hospital treatment or death (N = 55 684). The correlations between the 2 types of SHR were strong (rho = 0.94 for the socio-occupational groups; rho = 0.74 for the economic activities groups). We observed, however, one markedly contradictive result; the industrial group entitled âgeneral practitioner, dentists etc.â was associated both with significantly high rates of medicine usage (SHR = 1.15, 95% CI: 1.12â1.19) and significantly low rates of hospital treatment or death due to IHD (SHR = 0.80, 95% CI: 0.71â0.91). Conclusion: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine data in addition to or instead of the use of death or hospital data in epidemiological studies on work-related IHD risk will bring about a tremendous increase in statistical power
Verwendung des Nordischen Fragebogens zu Muskel-Skelett-Beschwerden
<jats:title>Zusammenfassung</jats:title><jats:sec>
<jats:title>Hintergrund</jats:title>
<jats:p>Die PrĂ€valenzerhebung von Muskel-Skelett-Beschwerden im betrieblichen Kontext basiert oft auf dem Nordischen Fragebogen (NMQ) von Kuorinka et al. (1987). Derzeit existiert keine einheitliche deutschsprachige, validierte Ăbersetzung, zudem weist die Originalversion Unstimmigkeiten auf. Vor dem Hintergrund, dass entsprechend der Verordnung zur arbeitsmedizinischen Vorsorge (ArbMedVV) bei Belastungen des Muskel-Skelett-Systems arbeitsmedizinische Vorsorge angeboten werden muss, besteht Bedarf, eine deutsche Version des NMQ zu erarbeiten und zu validieren.</jats:p>
</jats:sec><jats:sec>
<jats:title>Ziel</jats:title>
<jats:p>Anliegen der Arbeit ist die Analyse des Ist-Zustands, wie der NMQ in internationalen Studien derzeit eingesetzt wird. Anforderungen fĂŒr eine deutschsprachige Version des NMQ sind daraus abzuleiten.</jats:p>
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<jats:title>Material und Methoden</jats:title>
<jats:p>DurchgefĂŒhrt wurde ein narratives Review. Recherchiert wurde in der Datenbank PubMed nach Studien, in denen der NMQ zur Erhebung der PrĂ€valenz von Muskel-Skelett-Beschwerden bei Personen im erwerbsfĂ€higen Alter eingesetzt wurde. Die Ergebniszusammenfassung ist deskriptiv.</jats:p>
</jats:sec><jats:sec>
<jats:title>Ergebnisse</jats:title>
<jats:p>Es wurden 132 Publikationen identifiziert. Mehrheitlich wurde eine modifizierte Version des NMQ verwendet. Am hĂ€ufigsten wurde die 12-Monats- und 7âTages-PrĂ€valenz erhoben. Die BeschwerdeprĂ€valenz von Schulterâ, Ellenbogen- und Handgelenken sowie des Nackens und unteren RĂŒckens wurde am hĂ€ufigsten erfragt. Modifikationen erfolgten insbesondere hinsichtlich der Abfragelogik sowie bei den zu untersuchenden Körperregionen.</jats:p>
</jats:sec><jats:sec>
<jats:title>Diskussion</jats:title>
<jats:p>Der NMQ ist ein international vielgenutztes Instrument, das mehrheitlich an die jeweiligen Erfordernisse des Untersuchungskontextes angepasst wird. Eine Neuformulierung des NMQ sollte kurz und modular sein, eine einfache Abfragelogik enthalten und sowohl in betriebsepidemiologischen Studien als auch in der arbeitsmedizinischen Vorsorge anwendbar sein.</jats:p>
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