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author:("nardal, Stein")
1.  Musculoskeletal health and work ability in physically demanding occupations: study protocol for a prospective field study on construction and health care workers 
BMC Public Health  2014;14(1):1075.
Musculoskeletal disorders have a profound impact on individual health, sickness absence and early retirement, particularly in physically demanding occupations. Demographics are changing in the developed countries, towards increasing proportions of senior workers. These senior workers may have particular difficulties coping with physically demanding occupations while maintaining good health.
Previous studies investigating the relationship between physical work demands and musculoskeletal disorders are mainly based on self-reported exposures and lack a prospective design. The aim of this paper is to describe the background and methods and discuss challenges for a field study examining physical demands in construction and health care work and their prospective associations with musculoskeletal disorders, work ability and sickness absence.
Methods and design
This protocol describes a prospective cohort study on 1200 construction and health care workers. Participants will answer a baseline questionnaire concerning musculoskeletal complaints, general health, psychosocial and organizational factors at work, work demands, work ability and physical activity during leisure. A shorter questionnaire will be answered every 6th months for a total of two years, together with continuous sickness absence monitoring during this period. Analysis will prospectively consider associations between self-reported physical demands and musculoskeletal disorders, work ability and sickness absence. To obtain objective data on physical exposures, technical measurements will be collected from two subgroups of N = 300 (Group A) and N = 160 (Group B) during work and leisure. Both group A and B will be given a physical health examination, be tested for physical capacity and physical activity will be measured for four days. Additionally, muscle activity, ground reaction force, body positions and physical activity will be examined during one workday for Group B. Analysis of associations between objectively measured exposure data and the outcomes described above will be done separately for these subpopulations.
The field study will at baseline produce objectively measured data on physical demands in the construction and health care occupations. In combination with clinical measurements and questionnaire data during follow-up, this will provide a solid foundation to prospectively investigate relationships between physical demands at work and development of musculoskeletal disorders, work ability and sickness absence.
PMCID: PMC4203897  PMID: 25318646
Physical exposures; Work ability; Musculoskeletal disorders; Accelerometer; Heart rate monitoring; Electromyography; Ground reaction force
2.  Psychological and Social Work Factors as Predictors of Mental Distress: A Prospective Study 
PLoS ONE  2014;9(7):e102514.
Studies exploring psychological and social work factors in relation to mental health problems (anxiety and depression) have mainly focused on a limited set of exposures. The current study investigated prospectively a broad set of specific psychological and social work factors as predictors of potentially clinically relevant mental distress (anxiety and depression), i.e. “caseness” level of distress. Employees were recruited from 48 Norwegian organizations, representing a wide variety of job types. A total of 3644 employees responded at both baseline and at follow-up two years later. Respondents were distributed across 832 departments within the 48 organizations. Nineteen work factors were measured. Two prospective designs were tested: (i) with baseline predictors and (ii) with average exposure over time ([T1+T2]/2) as predictors. Random intercept logistic regressions were conducted to account for clustering of the data. Baseline “cases” were excluded (n = 432). Age, sex, skill level, and mental distress as a continuous variable at T1 were adjusted for. Fourteen of 19 factors showed some prospective association with mental distress. The most consistent risk factor was role conflict (highest odds ratio [OR] 2.08, 99% confidence interval [CI]: 1.45–3.00). The most consistent protective factors were support from immediate superior (lowest OR 0.56, 99% CI: 0.43–0.72), fair leadership (lowest OR 0.52, 99% CI: 0.40–0.68), and positive challenge (lowest OR 0.60, 99% CI: 0.41–0.86). The present study demonstrated that a broad set of psychological and social work factors predicted mental distress of potential clinical relevance. Some of the most consistent predictors were different from those traditionally studied. This highlights the importance of expanding the range of factors beyond commonly studied concepts like the demand-control model and the effort-reward imbalance model.
PMCID: PMC4105444  PMID: 25048033
3.  Coffee intake and development of pain during computer work 
BMC Research Notes  2012;5:480.
The present study sought to determine if subjects who had consumed coffee before performing a simulated computer office-work task found to provoke pain in the neck and shoulders and forearms and wrists exhibited different time course in the pain development than the subjects who had abstained from coffee intake.
Forty eight subjects all working fulltime, 22 with chronic shoulder and neck pain and 26 healthy pain-free subjects, were recruited to perform a computer-based office-work task for 90 min. Nineteen (40%) of the subjects had consumed coffee (1/2 -1 cup) on average 1 h 18 min before start. Pain intensity in the shoulders and neck and forearms and wrists was rated on a visual analogue scale every 15 min throughout the work task.
During the work task the coffee consumers exhibited significantly lower pain increase than those who abstained from coffee.
Subjects who had consumed coffee before starting a pain provoking office work task exhibited attenuated pain development compared with the subjects who had abstained from coffee intake. These results might have potentially interesting implications of a pain-modulating effect of caffeine in an everyday setting. However, studies with a double blind placebo controlled randomized design are needed.
PMCID: PMC3476989  PMID: 22943590
Computer work; Muscle; Pain; Coffee
4.  Work factors and psychological distress in nurses' aides: a prospective cohort study 
BMC Public Health  2006;6:290.
Nurses' aides (assistant nurses), the main providers of practical patient care in many countries, are doing both emotional and heavy physical work, and are exposed to frequent social encounters in their job. There is scarce knowledge, though, of how working conditions are related to psychological distress in this occupational group. The aim of this study was to identify work factors that predict the level of psychological distress in nurses' aides.
The sample of this prospective study comprised 5076 Norwegian nurses' aides, not on leave when they completed a mailed questionnaire in 1999. Of these, 4076 (80.3 %) completed a second questionnaire 15 months later. A wide spectrum of physical, psychological, social, and organisational work factors were measured at baseline. Psychological distress (anxiety and depression) was assessed at baseline and follow-up by the SCL-5, a short version of Hopkins Symptom Checklist-25.
In a linear regression model of the level of psychological distress at follow-up, with baseline level of psychological distress, work factors, and background factors as independent variables, work factors explained 2 % and baseline psychological distress explained 34 % of the variance. Exposures to role conflicts, exposures to threats and violence, working in apartment units for the aged, and changes in the work situation between baseline and follow-up that were reported to result in less support and encouragement were positively associated with the level of psychological distress. Working in psychiatric departments, and changes in the work situation between baseline and follow-up that gave lower work pace were negatively associated with psychological distress.
The study suggests that work factors explain only a modest part of the psychological distress in nurses' aides. Exposures to role conflicts and threats and violence at work may contribute to psychological distress in nurses' aides. It is important that protective measures against violent patients are implemented, and that occupational health officers offer victims of violence appropriate support or therapy. It is also important that health service organisations focus on reducing role conflicts, and that leaders listen to and consider the views of the staff.
PMCID: PMC1693921  PMID: 17132172

Results 1-4 (4)