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Logo of oenvmedOccupational and Environmental MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
Occup Environ Med. 2007 December; 64(12): e42.
PMCID: PMC2095401

Musculoskeletal and injury 4

220 Work‐related injury trends among high risk industries in British Columbia (BC)

C. McLeod1, F. Xu1, E. Lorenz1, M. Koehoorn2. 1Centre for Health Services and Policy Research, University of British Columbia; 2Department of Health Care and Epidemiology, University of British Columbia

ObjectivesTo estimate trends in work‐related injuries in high‐risk industries in BC for the years 1987–2005; to examine demographic and occupational risk factors that may explain variation in these trends.

MethodsThe BC Linked Health Database was used to identify workers who had at least one accepted worker's compensation claim between 1987 and 2005 in three high‐risk industry sectors – health care, construction and forestry. Using census workforce estimates and data from Statistics Canada's Labour Force Surveys, injury rates were calculated for each year by age, occupation, nature of injury, geographical area and sex.

ResultsHealth Care: The overall claim rate was relatively constant between 1987 and 2001, ranging between 6.3% and 7.5%, with a recent drop from 2002 onwards to 4.7%. Claim rates for younger workers (ages 15–24) were similar compared to adult workers. Nursing support workers, cleaning and service staff had the highest rate of claims in hospital settings and residential care facilities (11.0% and 13.1%, respectively, for hospitals and 18.0% and 7.1% for care facilities). Construction: The overall claim rate in construction fell by around 50% during the study time period from a high of 19.7% in 1989 and 1990 to below 10% from 2002 onwards. Young workers had on average a 33% higher injury rate compared to mid‐career adult workers (25–54), however the difference between the young worker injury rate and older age groups decreased by the end of the study period. Forestry: Forestry experienced a 50% drop in claim rates from a high of 25.2% in 1987 to a low of 9.3% in 2003; this was particularly concentrated among younger workers.

ConclusionWhile work‐related injury trends have declined in British Columbia, there is significant variation among these trends by industrial sectors, age and occupation. In particular, injury rates decreased more in the construction and forest sectors than in the health care sector. The differential decline in the younger worker injury rate in construction and forestry may indicate that the prevention focus on young worker has yielded some success.

Key wordsoccupational injury; young workers; administrative data

221 Physical activity associated with different health factors among men and women in two different occupational settings

J. Klavestrand. Department of Occupational Medicine, Faculty of Medical Science, Uppsala University

ObjectivesThe aim of this study was to examine the association between physical activity and different health factors (BMI, work demands, health, gender and socio‐demographic factors) among men and women in public and private sector employment.

MethodsThe study builds on cross‐sectional data from two prospective cohorts. The HAKuL (public sector, n = 6117) and AHA study (private sector, n = 3479). A series of multinomial logistic regression analyses were conducted to examine the association between physical activity and BMI, work demands, health, gender and socio‐demographic factors. The models were used to assess the likelihood of having a low status of physical activity (eg, models compare the probability of falling into the following categories: normal weight vs overweight/obese). The results are presented as odds ratio (ORs) and their 95% confidence intervals (CIs).

ResultsRegression models showed that physical activity was associated with several of the variables. High physical work demands was among public sector men associated with a 2.4‐fold likelihood of being sedentary. Also a high psychological work load was associated with a 1.8‐fool likelihood of being sedentary. Smoking showed an increased risk of being sedentary in both men and women. Not surprisingly level of physical activity varies by age, however there was a higher risk of being sedentary among older men.

ConclusionEvidence from the two cohorts extends our knowledge on associations between level of physical activity and different health factors, some less marked, but others more distinct. Overall, there was significant indication of association between self reported health and status of physical activity.

Key wordsphysical activity; health; occupational medicine

222 Similarities and differences between household work and tasks in selected comparable occupations

R. R. Habib1, F. A. Fathallah2, K. Messing3. 1American University of Beirut; 2University of California, Davis; 3Université de Québec à Montréal

ObjectivesMusculoskeletal disorders (MSDs) have been identified as a major health concern throughout the world. Many MSDs and musculoskeletal symptoms are more common among women than among men. It has been suggested that constraints found in women's household tasks may account for some of this gender difference. In a pilot study conducted in suburban Beirut, Lebanon, MSDs were identified as one of the top health problems facing full‐time homemakers. This paper examines the MSD literature for the way homemakers have been studied in various fields and compares the physical and psychosocial demands of household work and paid work from selected professions.

MethodsElectronic database searches were performed for papers published on adults in a number of relevant sources, which included PubMed, Ergonomics Abstracts, Sociofile and PsycINFO databases. Furthermore, physical and psychosocial factors identified in studies of cleaners, food service workers, child care workers and home health care workers were compared with the basic exposures obtained from observations of four Beirut households.

ResultsA very limited number of studies systematically examined associations between MSDs and risk factors during housework. Most often, housework was considered in conjunction with factors in paid work. A number of studies identified extended work duration, repetitive movements, heavy lifting as well as psychological stress as important MSD risk factors, which were also observed in the Beirut homes. However, due to the uniqueness of the home environment, there are distinct disparities in exposures between housework and paid work.

ConclusionMSDs are clearly an important health problem for many women workers, and are likely to be related to the frequent physical demands of housework among the observed women in Beirut. However, more data are needed to ascertain the association between housework and MSDs among women in a variety of cultures, keeping in mind the important potential interaction between housework and paid work.

Key wordsmusculoskeletal disorders; paid work; unpaid work

223 Low‐back pain presenting for MRI: a case‐control study with special relation to whole‐body vibration

E. C. Harris1, M. J. Griffin2, I. Reading1, D. Coggon1, K. T. Palmer1. 1MRC Epidemiology Resource Centre; 2Institute of Sound and Vibration Research, University of Southampton, Southampton, UK

ObjectivesTo investigate risk factors for low‐back pain (LBP) presenting for magnetic resonance imaging (MRI), with focus on whole‐body vibration (WBV).

MethodsA case‐control approach was used. The study population comprised working‐aged subjects from the catchment area of Southampton radiology services. Cases were a consecutive series referred for lumbar MRI because of LBP. Controls were age‐ and sex‐matched subjects x rayed for other reasons. Details were collected on occupation, physical factors loading the spine, psychosocial factors, driving and exposure to WBV (vehicle types, duration, intensity), personal characteristics (eg, height, weight, smoking habits), mental health (low mood, somatising tendency), fear‐avoidance beliefs, and beliefs regarding work as a cause/aggravation of LBP. Exposure to WBV was assessed by six measures: professional driving ([gt-or-equal, slanted]1 h/day); professional driving ([gt-or-equal, slanted]3 h/spell); hours driven/week for the commonest source of exposure; hours driven/week for all sources; maximum rms acceleration of any machine; and current rms. Analysis focused on cases with symptom onset in their current/most recent job and controls who gave a current/most recent job history. Associations with WBV were examined with adjustment for age, sex and other potential confounders.

ResultsAltogether, 271 cases and 809 controls were studied, including 200 professional drivers. Strong associations were found with somatising tendency, low mood and belief in work as a causal/aggravating factor for LBP. Associations were also seen with stature, consulting propensity, BMI, smoking status and fear‐avoidance beliefs. Occupational risk factors were only weakly associated with LBP, associations being found with frequent twisting, sitting for [gt-or-equal, slanted]3 h while not driving, low decision latitude and low support at work. Associations with the six metrics of WBV were weak; none was significant at the 5% level and no evidence was found for any exposure–response relationship.

ConclusionAlthough we found positive associations with mental health, health beliefs, consulting attitudes and certain personal and occupational factors, there was little evidence of a risk from professional driving or WBV. Drivers in this sample were less heavily exposed to WBV than in some earlier occupational surveys. Nonetheless, it seems at the population level that WBV is not an important cause of LBP referred for MRI.

Key wordsback pain; psychological; vibration

224 Musculoskeletal disorders in ski workers: a cross‐sectional survey

M. A. Foster. University of Birmingham, UK

ObjectivesTo determine the period and point prevalence of musculoskeletal disorders in ski workers in Canada and Scotland. To examine the associations between the presence of musculoskeletal disorders and both individual and job characteristics.

MethodsA convenience sample of ski workers (instructors and patrollers) employed at ski resorts in Canada and Scotland were recruited into the study. A self‐administered questionnaire based upon the validated Nordic Musculoskeletal Questionnaire (NMQ) was used to determine the prevalence of MSD in nine different anatomical areas. Odds ratios (OR) with 95% confidence intervals (CI) and p values were the measure of association between prevalent musculoskeletal symptoms and individual or job factors. They were determined by logistic regression. Approval for the conduct of the study was given by the Community Research Ethics Board of Alberta (CREBA).

ResultsA total of 340 ski workers were recruited into the study representing an estimated 74% of the potential participants. 96% reported one or more musculoskeletal disorders in the previous 12 months and 68% reported one or more musculoskeletal disorder in the previous 7 days. The knee (68.2%) was the most commonly reported area followed by the lower back (64.7%), the shoulder (52.9%) and the neck (46.5%). Ski workers in Canada had a significantly higher risk of musculoskeletal disorders both in the previous 12 months and 7 days compared to those in Scotland.

ConclusionThis study provides evidence of the exceptionally high prevalence of musculoskeletal disorders in ski workers. The high prevalence in the previous 7 days indicates that many ski workers are continuing to work despite symptoms. Ski workers of Canada were at significantly higher risk compared to Scottish ski workers. Effective interventions such as prevention training could be introduced by ski resorts to help reduce the prevalence of musculoskeletal disorders. This may decrease costs and increase revenue for the employer.

Key wordsmusculoskeletal; ski workers; occupation

225 The attributable burden of injuries at work

M. Concha1, S. Mansilla2, J. Giaconi1. 1Asociacion Chilena de Seguridad; 2Ministerio de Salud

ObjectivesTo estimate the global and occupational burden of injuries using disability adjusted life years (DALY). To assess the importance of mortality and disability due to injuries in the workplace among the overall burden of injuries.

MethodsPopulation and mortality data were retrieved from government registries. Disability from injuries was based on WHO estimation. The burden of injuries for Chile was estimated using DALYs and its components: years lost due to premature mortality (YLL) and years expected to live with disability (YLD). The methodology used is reported elsewhere. The population attributable fraction (PAF) was calculated by sex and age using the following formula: PAFi = ODi/TDi, where OD = DALYs due to occupational injuries, D = DALYs due to injuries (including occupational injuries) and i = external causes of injuries.

ResultsOccupational injuries result in about 300 deaths per year for 5 million Chilean workers. Estimates of the burden of injuries demonstrate the contribution of occupation, which accounts for 48 954 DALYs and 3% of unintentional injuries and violence. 6.2% of the YLL and 2.8% of the disability burden are due to occupational injuries. In males, fatal injuries produce 7.5% of the mortality burden and 3.4% of the burden of disability. In females, the burden is lower (about 0.4%) but nonetheless important, considering the proportion of females that work and the “less risky” types of activities that they perform in the work place. Falls at work are responsible for 10.7% of the burden, followed by road traffic accidents which produce 7.9%. In contrast, poisoning and violence produce only 0.1% and 0.7% of the burden, respectively.

ConclusionIn Chile PAF due to occupational injuries is lower than in other countries of similar development. This is not explained by mortality under registration because it is negligible. Higher rates of male participation in the labour force occupationally exposed to potentially hazardous conditions, and higher rates of female employment in the services sector explain the consistently higher proportions of injured males.

Key wordsinjury burden; occupation; attributable fraction

226 Risk factors for occupational injuries: a comparison of older and younger workers in Korea

S. Y. Park, Y. K. Kim, H. R. Kim, J. W. Koo. Catholic Industrial Medical Center, The Catholic University of Korea

ObjectivesThe increase in life expectancy and the decrease in the workforce which has resulted from declining birth rates have been increasing the economic participation of older workers. As the workforce is aging, concerns about occupational injuries in older workers are also increasing. Therefore, this study examined the risk factors related to occupational injuries in older workers (over the age of 50) in Korea.

MethodsSubjects were 18 617 workers with disease code S out of 22 998 workers who were compensated from May to July 2006. Telephone interviews were randomly conducted with 200 people over the age of 50, and another 200 people younger than 50. Initially, hospitalised workers were interviewed in order to develop questionnaire. The questionnaire focused on work characteristics (work hours, shift work, irregular schedule, noise, abnormal temperatures), working conditions immediately before the accident occurred (particulars, complexity, the speed of work, urgency) and personal conditions (drinking, fatigue, personal problems, sleep deficiency, lack of judgment, imbalance) and so on. The χ2 test was used to assess the difference among the two groups.

ResultsAmong work characteristics, older workers, compared to young workers, had a higher rate of noise at 47.5% (young workers 39.5%), living apart from the family at 22.0% (young workers 15.5%) and working more than 70 h a week at 21% (young worker 14.5%), but they were not statistically significant. Detailed work using the finger tips, among work conditions, was higher in older workers at 38.5% (young workers 25.5%) (p<0.01). Among personal conditions, working when tired was lower in older workers at 3.5% (young workers 11.5%) (p<0.01).

ConclusionThe results can be used to develop policies to prevent occupational injuries in older workers.

Key wordsolder workers; occupational injury; risk factors

227 Descriptive epidemiology of a cohort of injured workers that underwent knee meniscus surgery between 2001 and 2005 in British Columbia

M. Koehoorn1, T. Bogyo2, R. Chhokar3, E. McCloskey2, C. McLeod3. 1University of British Columbia; 2WorkSafeBC; 3Centre for Health Services and Policy Research

ObjectivesIn an effort to reduce disability time, the British Columbia workers' compensation system began paying for surgeries for work‐related injuries in private surgical centres in 1996 and providing payments for expedited surgical care in 2001 (defined as surgeries performed within 20 days of approval and where a higher fee is paid for surgical services). This creates a unique opportunity within the Canadian context (defined primarily as a universal, public healthcare system) to study outcomes among an injured worker population by different care settings and by wait time incentive. The objective of this study is to describe the distribution of musculoskeletal surgeries in a cohort of injured workers by health care, demographic and geographical characteristics; and to investigate the feasibility of conducting a larger epidemiological study of disability outcomes.

MethodsInjured workers who underwent musculoskeletal surgery between 2001 and 2005 were identified by surgical procedural codes from workers' compensation records. Data on surgical setting (public hospital versus private surgical centre), expedited status, geographical area (BC health authority regions), age, and gender were extracted for each surgery.

ResultsBased on yearly data, the knee was the most frequent surgical site (25% of all procedures) and knee meniscectomy the most frequent surgical procedure (15% of all procedures). For knee meniscectomies conducted between 2001 and 2005, 540 surgeries (19.9%) were performed in public facilities on an expedited basis, 438 surgeries (16.1%) were performed in public hospitals on a non‐expedited basis, and 1742 surgeries were performed (64.0%) in private surgical centres on an expedited basis (no surgeries are performed in private facilities on a non‐expedited basis). No significant differences were found by surgical setting for age, gender or geographical location.

ConclusionThis descriptive study is the first research output from a larger analytical study investigating health care setting and expedited status on return‐to‐work and disability outcomes. These descriptive results indicate that there are sufficient numbers of knee meniscectomies to investigate differences in return‐to‐work outcomes by surgical setting (comparing expedited private to expedited hospital sub‐groups) and by expedited setting (comparing expedited hospital to non‐expedited hospital sub‐groups).

Key wordsknee meniscectomy; return to work; occupational injury


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