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Biomedical subjects

A Burdorf

Publications and source records attributed to A Burdorf.

At least 19 recordsLinked to original sources
PubMed2006

The role of physical workload and pain related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow up.

AIMS: To study the influence of work related physical and psychosocial factors and individual characteristics on the occurrence of low back pain among young and pain free workers. METHODS: The Belgian Cohort Back Study was designed as a prospective cohort study. The study population of this paper consisted of 716 young healthcare or distribution workers without low back pain lasting seven or more consecutive days during the year before inclusion. The median age was 26 years with an interquartile range between 24 and 29 years. At baseline, these workers filled in a questionnaire with physical exposures, work related psychosocial factors and individual characteristics. One year later, the occurrence of low back pain lasting seven or more consecutive days and some of its characteristics were registered by means of a questionnaire. To assess the respective role of predictors at baseline on the occurrence of low back pain in the following year, Cox regression with a constant risk period for all subjects was applied. RESULTS: After one year of follow up, 12.6% (95% CI 10.1 to 15.0) of the 716 workers had developed low back pain lasting seven or more consecutive days. An increased risk was observed for working with the trunk in a bent and twisted position for more than two hours a day (RR 2.2, 95% CI 1.2 to 4.1), inability to change posture regularly (RR 2.1, 95% CI 1.3 to 3.5), back complaints in the year before inclusion (RR 1.7, 95% CI 1.1 to 2.8), and high scores of pain related fear (RR 1.8, 95% CI 1.0 to 3.1). Work related psychosocial factors and physical factors during leisure time were not predictive. CONCLUSION: This study highlighted the importance of physical work factors and revealed the importance of high scores of pain related fear in the development of low back pain among young workers.

Adult↗
PubMed2005

Risk factors for musculoskeletal symptoms and ensuing health care use and sick leave.

STUDY DESIGN: Longitudinal study with a 6-month follow-up. OBJECTIVE: To investigate whether demographic, work-related physical and psychosocial risk factors involved in the occurrence of musculoskeletal symptoms also determine subsequent health care use and sick leave. SUMMARY OF BACKGROUND DATA: Preventing the socioeconomic consequences of disability from musculoskeletal symptoms may be a goal separate from that of eliminating the symptoms themselves; thus, other factors may need to be addressed in intervention. METHODS: A questionnaire provided data on demographics and work-related factors, musculoskeletal symptoms, and ensuing health care use and sick leave among 407 industrial workers. RESULTS: The 12-month prevalence of low back pain (LBP) and neck/upper extremity symptoms was 52% and 56%, respectively. Of those individuals with symptoms at baseline, 68% had a recurrence of LBP, and 62% a recurrence of neck/upper extremity symptoms during a 6-month follow-up. The recurrence of sick leave for a particular musculoskeletal complaint was approximately 30%, while recurrence of health care use was more than 40%. Recurrence of symptoms, health care use, and sick leave were strongly associated with a history of severe symptoms. Physical load, high job strain, and low social support at work determined the occurrence of LBP, related health care use, and sick leave. Older age and living alone were also important risk factors, especially for sick leave. High job strain determined the occurrence of neck/upper extremity symptoms, related health care use, and sick leave. Being female and living alone increased the probability of the occurrence of all 3 endpoints, especially the occurrence of sick leave. CONCLUSIONS: Work-related factors that were associated with the occurrence of musculoskeletal symptoms were quite similar to those associated with health care use and sick leave. However, for LBP, older age and living alone, and, for neck/upper extremity symptoms, living alone and being female more strongly determined whether subjects with these complaints took sick leave. These results imply that prevention strategies aimed at minimizing the risks of the occurrence of work-related musculoskeletal symptoms and prevention programs aimed at reducing sick leave may need to emphasize different sets of risk factors.

Adolescent↗
PubMed2005

In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain.

OBJECTIVE: The objective of this study was to determine the effectiveness of a training to increase collaboration between general practitioners and occupational health physicians in the treatment of patients with low back pain (LBP) because more collaboration might improve a patient's recovery and shorten sick leave. METHODS: In a controlled trial, the intervention in one region was compared with usual care in a control region. Participating physicians enrolled patients with LBP on sick leave for 3-12 weeks. Patients filled out three questionnaires: at inclusion, at 3 months, and at 6 months. Information on sick leave was gathered from occupational health services. All analyses were performed on an intention-to-treat basis. RESULTS: Fifty-six patients with LBP were enrolled in each region. There was little collaboration between physicians during the project. Patients in the intervention region returned to work significantly later (P=.005) but were significantly more satisfied with their occupational health physician (P=.01). No differences were found between the intervention and control patients for pain, disability, quality of life, and medical consumption. CONCLUSION: Our study does not show a positive effect of the training to increase collaboration between general practitioners and occupational health physicians. The training may not have improved collaboration enough to influence the prognosis of LBP.

Adult↗
PubMed2005

Health problems lead to considerable productivity loss at work among workers with high physical load jobs.

OBJECTIVE: To assess the feasibility and validity of two instruments for the measurement of health-related productivity loss at work. STUDY DESIGN AND SETTING: A cross-sectional study was conducted in two occupational populations with a high prevalence of health problems: industrial workers (n=388) and construction workers (n=182). We collected information on self-reported productivity during the previous 2 weeks and during the last work day with the Health and Labor Questionnaire (HLQ) and the Quantity and Quality instrument (QQ), with added data on job characteristics, general health, presence of musculoskeletal complaints, sick leave, and health-care consumption. For construction workers, we validated self-reported productivity with objective information on daily work output from 19 work site observations. RESULTS: About half the workers with health problems on the last working day reported reduced work productivity (QQ), or 10.7% of all industrial workers and 11.8% of all construction workers, resulting in a mean loss of 2.0 hr/day per worker with reduced work productivity. The proportion of workers with reduced productivity was significantly lower on the HLQ: 5.3% of industrial workers and 6.5% of construction workers. Reduced work productivity on the HLQ and the QQ was significantly associated with musculoskeletal complaints, worse physical, mental and general health, and recent absenteeism. The QQ and HLQ questionnaires demonstrated poor agreement on the reporting of reduced productivity. Self-reported productivity on the QQ correlated significantly with objective work output (r=.48). CONCLUSION: Health problems may lead to considerable sickness presenteeism. The QQ measurement instrument is better understandable, and more feasible for jobs with low opportunities for catching up on backlogs.

Adult↗
PubMed2004

Occupational exposure to chemical agents in the paper industry.

As part of an International Agency for Research on Cancer (IARC) international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article summarizes the results of 3,873 measurements carried out in the production departments of paper and paperboard mills and recycling plants in 12 countries. In the paper and paperboard mills, most of the agents were measured in the pulping and refining departments and in on-machine coating and winding of paper/paperboard. Exposures to asbestos, carbon monoxide, formaldehyde, fungal spores, bacteria, nitrogen dioxide, minerals dusts, paper dust, sulphuric acid and different solvents sometimes exceeded exposure limit values. In the re-pulping and de-inking departments of recycling plants high exposures to formaldehyde, fungal spores, bacteria and paper dust were observed. High exposures to asbestos, bioaerosols, carbon monoxide and paper dust were found in many departments; ammonia, formaldehyde, mineral and paper dust and solvents were found in coating machines; and diphenyl and polychlorobiphenyls (PCBs) were found in some special circumstances. Measurements in the newsprint and uncoated paper machine departments revealed only a few elevated exposures. In nearly all departments, measurements of epichlorohydrin, PCBs, sulphur dioxide, hydrogen sulphide and mercaptans tended to be low, often even below their detection limits. In spite of some uncertainties in the measurement data, the study provides new insights into the level and variation of occupational exposures of production workers in the paper and paperboard industry.

Europe↗
PubMed2004

[Pleural mesothelioma in women is associated with environmental exposure to asbestos].

OBJECTIVE: To determine whether local environmental exposure to asbestos in the community of Hof van Twente, The Netherlands (which houses a large asbestos cement facility and has a serious environmental asbestos pollution problem), is accompanied by an increased mortality due to pleural mesothelioma among women. DESIGN: A descriptive, ecologic-epidemiological study. METHOD: Twenty-nine women with a verified diagnosis of pleural mesothelioma were selected from 810 requests for compensation submitted to a specialised lawyers' office in the period 1990-2002. Information on asbestos exposure from occupational, household, environmental or unknown sources was obtained. The place of residence was compared to information on sources of asbestos in the immediate environment derived from the settlement 'Asbestos removal in the environment'. The expected number of cases of pleural mesothelioma among women was estimated on the basis of the observed mortality in The Netherlands in the period 1996-2002. A standardised mortality ratio (SMR) was calculated as the ratio of observed cases divided by the number of expected cases of pleural mesothelioma x 100. RESULTS: In total, 5 cases of pleural mesothelioma were identified among women without occupational or household exposure to asbestos. The age at diagnosis varied from 38 to 81 years. Each case was exposed to asbestos in the direct vicinity of the residence through walking and cycling over local roads metalled with asbestos cement scrap material. The expected number of cases of mortality due to pleural mesothelioma in the town of Hof van Twente for the period 1996-2002 was about 0.46. The SMR was 1090 (95% CI: 465-2551), indicating a 10-fold increase in risk. CONCLUSION: The increased mortality of pleural mesothelioma was most probably due to environmental exposure to asbestos. This finding agrees with comparable studies in other countries.

Adult↗
PubMed2004

Barriers for early return-to-work of workers with musculoskeletal disorders according to occupational health physicians and human resource managers.

Recent studies have indicated positive effects of modified work for workers with musculosceletal complaints. The question remains how effectively modified work can be implemented in companies. This study describes barriers for introducing modified work for workers on sickness absence due to musculoskeletal complaints. Modified work was defined as gradually increasing the physical demands at work until the worker is ready for full duty in his regular job. In order to describe barriers in implementation of modified work, a model based on health education was used, consisting of six successive stages. A questionnaire derived from this model was sent to human resource managers of different companies and their occupational health physicians. The internal consistency was estimated with the Cronbach's alpha. The results showed a large number of barriers for modified work. According to 52% of the company management and 54% of the occupational health physicians evident barriers were found due to lack of knowledge on modified work and negative attitudes of the employees. Both companies and physicians reported a barrier in the possibilities to change the work tasks (45-54%) or the organization of the work (45-38%). About 62% of the companies reported barriers due to a mismatch between the education of the sick worker and the specific requirements of modified work. Despite the assumed positive effects of modified work, the implementation process is hampered by a large number of barriers. A maximum effort from all parties involved is required for a successful rehabilitation process.

Health Education↗
PubMed2004

Prevalence and incidence of shoulder pain in the general population; a systematic review.

OBJECTIVE: To investigate the incidence and prevalence of shoulder complaints in the general population. METHOD: A systematic review of the literature was conducted. Medline, Embase, and Cinahl were searched for relevant studies. RESULTS: Eighteen studies on prevalence and one study on incidence met the inclusion criteria. Incidence figures of 0.9-2.5% were found for different age groups. Prevalence figures differed from 6.9 to 26% for point prevalence, 18.6-31%, for 1-month prevalence, 4.7-46.7% for 1-year prevalence and 6.7-66.7% for lifetime prevalence. Prevalence rates decreased when the case definition was restricted, in terms of duration of pain or the presence of limited movements, and increased when the location for pain was enlarged. CONCLUSION: The reported prevalence figures on shoulder complaints diverged strongly. Health professionals and policymakers who estimate the amount of medical care needed and related costs should be aware of the variations in prevalence rate and the underlying reasons for these differences.

Adult↗
PubMed2004

Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain.

AIMS: To describe the presence of musculoskeletal co-morbidity of the neck and upper extremities among industrial workers with low back pain, and to examine whether it has an impact on healthcare utilisation and sickness absence for low back pain. METHODS: A self administered questionnaire was used to collect data from 505 industrial workers (response 86%). RESULTS: The 12 month prevalence of low back pain was 50%. Among subjects with low back pain the 12 month prevalence of musculoskeletal co-morbidity of the neck and upper extremities was 68%. Among workers with low back pain, subjects with high pain intensity or disabling low back pain were more likely to have musculoskeletal co-morbidity. In comparison to the subjects who report back pain only, subjects with co-morbidity showed worse general health and health related quality of life. No impact of upper extremity co-morbidity was found on healthcare utilisation, and sickness absence due to low back pain. CONCLUSIONS: This study provides no evidence that musculoskeletal co-morbidity of the neck and upper extremities influences the choice to seek care or take sick leave due to low back pain among industrial manual workers. For occupational health practitioners the finding of a high co-morbidity is important to consider when implementing workplace interventions aimed at the reduction of specific musculoskeletal complaints, since the controls for one musculoskeletal complaint may impact adversely on another musculoskeletal complaint. Researchers who perform low back pain intervention studies using generic health measures, should take into account the impact of musculoskeletal co-morbidity on these measures.

Absenteeism↗
PubMed2004

Dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain.

AIMS: To assess dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain. METHODS: A cohort of 523 subjects, working in nursing homes and homes for the elderly, was followed prospectively for one year. Physical load for different occupations was assessed by quantitative observations at the workplace. Information on low back pain and other factors was gathered with questionnaires administered at baseline and at one year. Two outcome measures of low back pain incidence were used: any new episode of pain lasting for at least a few hours during follow up (LBP); and any new episode of disabling pain that interfered with daily activities during follow up (LBP/D). Hierarchical regression analysis with a spline function was used to estimate dose-response relations. RESULTS: The risk of LBP was not associated with physical factors, controlling for confounders; but this outcome was inversely associated with age and weakly, though imprecisely, associated with two psychosocial factors--low decision authority and high work demands. In contrast, the risk of LBP/D was positively associated with age and not associated with the psychosocial factors. Trunk flexion over 45 degrees was monotonically associated with the risk of LBP/D; the estimated relative risk was 3.18 (95% CI 1.13 to 9.00) for 1 hour and 45 minutes of bending per week (90th centile), relative to 30 minutes per week. The hierarchical estimates of effect were more stable than were the maximum likelihood estimates. CONCLUSION: Occupational exposure to trunk flexion over 45 degrees appears to be a risk factor for low back pain with disability among persons employed in nursing homes and homes for the elderly in the Netherlands.

Aged↗
PubMed2004

Ethnic differences in disability risk between Dutch and Turkish scaffolders.

The number of native Dutch and Turkish workers receiving a permanent disability pension in the Netherlands is still rising. To assess ethnic differences in disability risk between Dutch and Turkish scaffolders, a retrospective study was conducted within a large scaffolding company. Medical files for the period 1981-2000 were used to gather information on ethnicity, age at entering service, age at becoming disabled, years of employment, the year to receive a disability pension, the disability diagnosis, and the percentage rating of the disability pension. In the past 20 yr, 131 Turkish and 125 Dutch scaffolders have become disabled. Musculoskeletal disorders were the primary reason for the diagnosis. No differences in diagnoses were observed, except for a small difference in cardiovascular disease. Turkish scaffolders started their work at an older age, received the disability pension at an older age, and had a longer duration of employment. Turkish scaffolders faced disability 2.48 (95% confidence interval 1.94-3.18) times more often than their Dutch colleagues, adjusted for age. Explanations for the differences in disability risk between Dutch and Turkish scaffolders are sought in the older age at start of employment, lower mobility in the labour market, and less access to medical and social care. In future, employers, general practitioners, occupational health physicians and social security workers, as stakeholders in reintegration, should sufficiently attune their activities concerning care and cure for Turkish construction workers on long-term sick leave or during reintegration into other work.

Adult↗
PubMed2003

Update of predictions of mortality from pleural mesothelioma in the Netherlands.

AIMS: To predict the expected number of pleural mesothelioma deaths in the Netherlands from 2000 to 2028 and to study the effect of main uncertainties in the modelling technique. METHODS: Through an age-period-cohort modelling technique, age specific mortality rates and cohort relative risks by year of birth were calculated from the mortality of pleural mesothelioma in 1969-98. Numbers of death for both sexes were predicted for 2000 to 2028, taking into account the most likely demographic development. In a sensitivity analysis the relative deviation of the future death toll and peak death number were studied under different birth cohort risk assumptions. RESULTS: The age-cohort model on mortality 1969-98 among men showed the highest age specific death rates in the oldest age group (79 per 100 000 person-years in the age group 80-84 years) and the highest relative risks for the birth cohorts of 1938-42 and 1943-47. Among men a small period effect was observed. The age-cohort model was considered the best model for predicting future mortality. The most plausible scenario predicts an increase in pleural mesothelioma mortality up to 490 cases per year in men, with a total death toll close to 12 400 cases during 2000-28. However, using different assumptions this death toll could rise to nearly 15 000 in men (20% increase). Mortality among women remains low, with a total death toll of about 800 cases. It is predicted that the total death toll in the period 2000-28 is 44% lower than previous predictions using mortality data from 1969 to 1993. CONCLUSION: Adding five recent years of observed mortality in an age-cohort model resulted in a 44% lower prediction of the future death toll of pleural mesothelioma. A statistically significant period effect was observed, possibly influenced by initial asbestos safety guidelines in the 1970s and introduction of the ICD-10 codification.

Adult↗
PubMed2003

Effects of measurement strategy and statistical analysis on dose-response relations between physical workload and low back pain.

BACKGROUND: In epidemiological studies on physical workloads and back complaints, among the important features in modelling dose-response relations are the measurement strategy of the exposure and the nature of the dose-response relation that is assumed. AIM: To evaluate the effect of these two features on the strength of the dose-response relation between physical load and severe low back pain. METHODS: The study population consisted of 769 workers in nursing homes and homes for the elderly. Observations at the workplace were made of 212 subjects. These observations were analysed to determine exposure to physical load according to two measurement strategies: the individual approach and the group approach. The nature of the dose-response relation was evaluated with nested logistic regression models. RESULTS: The group approach resulted in higher odds ratios for the associations between physical load and low back pain than the individual approach. Spline logistic regression models appeared to describe the dose-response relation between physical load and low back pain best. The corresponding curve showed small changes in risk for small changes in exposure, whereas the categorical model only showed sudden large changes in risk at predefined exposure values. CONCLUSION: The choice for a particular measurement strategy of physical load influences the strength of the associations between physical load and severe low back pain. Spline models allow changes in risk over the whole exposure range and are therefore a promising approach to identify quantitative dose-response patterns between physical load and low back pain.

Health Surveys↗
PubMed2003

Radiographic abnormalities among construction workers exposed to quartz containing dust.

BACKGROUND: Construction workers are exposed to quartz containing respirable dust, at levels that may cause fibrosis in the lungs. Studies so far have not established a dose-response relation for radiographic abnormalities for this occupational group. AIMS: To measure the extent of radiographic abnormalities among construction workers primarily exposed to quartz containing respirable dust. METHODS: A cross sectional study on radiographic abnormalities indicative of pneumoconiosis was conducted among 1339 construction workers mainly involved in grinding, (jack)-hammering, drilling, cutting, sawing, and polishing. Radiological abnormalities were determined by median results of the 1980 International Labour Organisation system of three certified "B" readers. Questionnaires were used for assessment of occupational history, presence of respiratory diseases, and symptoms and smoking habits. RESULTS: An abnormality of ILO profusion category 1/0 and greater was observed on 10.2% of the chest radiographs, and profusion category of 1/1 or greater on 2.9% of the radiographs. The average duration of exposure of this group was 19 years and the average age was 42. The predominant type of small opacities (irregularly shaped) is presumably indicative of mixed dust pneumoconiosis. The prevalence of early signs of nodular silicosis (small rounded opacities of category 1/0 or greater) was low (0.8%). CONCLUSIONS: The study suggests an elevated risk of radiographic abnormalities among these workers with expected high exposure. An association between radiographic abnormalities and cumulative exposure to quartz containing dust from construction sites was observed, after correction for potentially confounding variables.

Adult↗
PubMed2002

Prevalence of sensitization to the predatory mite Amblyseius cucumeris as a new occupational allergen in horticulture.

BACKGROUND: Protection against thrips, a common pest in bell pepper horticulture is effectively possible without pesticides by using the commercially available predatory mite Amblyzeius cucumeris (Ac). The prevalence of sensitization to Ac among exposed greenhouse employees and its clinical relevance was studied. METHODS: Four hundred and seventytwo employees were asked to fill in a questionnaire and were tested on location. Next to RAST, skin prick tests (SPTs) were performed with common inhalant allergens, the storage mite Tyrophagus putrescentiae (Tp) which serves as a temporary food source during the cultivation process and Ac. Furthermore, nasal challenge tests with Ac were carried out in 23 sensitized employees. RESULTS: SPTs positive to Ac were found in 109 employees (23%). Work-related symptoms were reported by 76.1%. Sensitization to Tp was found in 62 employees of whom 48 were also sensitized to Ac. Immunoglobulin (Ig)E-mediated allergy to inhalant allergens appeared to be an important risk factor for sensitization to Ac. Employees with rhinitis symptoms showed a significantly higher response to all Ac doses during the nasal challenge test compared with employees without rhinitis symptoms. CONCLUSIONS: The predatory mite Ac is a new occupational allergen in horticulture which can cause an IgE-mediated allergy in exposed employees. It is biologically active on the mucous membranes of the nose and therefore clinically relevant for the development of work-related symptoms.

Agricultural Workers' Diseases↗
PubMed2002

Prevalence of occupational allergy to Chrysanthemum pollen in greenhouses in the Netherlands.

BACKGROUND: An increasing number of allergic complaints appear to have occurred among Chrysanthemum greenhouse employees. The aim of this study was to estimate the prevalence of work-related allergic symptoms and the prevalence of sensitization to pollen of different members of the Chrysanthemum family. METHODS: We studied 104 employees who were invited to answer an extensive questionnaire and to complete a rhinitis quality of life questionnaire. In addition, they were skin prick tested on location with inhalant allergens and home-made pollen extracts of seven different members of the Chrysanthemum family. Radio-allergo-sorbent tests were performed to confirm IgE-mediated reactions. RESULTS: Work-related symptoms were reported in 56.7% of all cases, with the main symptom being rhinitis. Sensitization to Chrysanthemum pollen was found in 20.2% of the employees without one member of the Chrysanthemum family in particular being most prevalent. Sensitization to Chrysanthemum pollen was considered to be an important risk factor for the occurrence of work-related symptoms of the upper airways. Furthermore, inhalant atopy as well as sensitization to common airborne pollen including mugwort were closely associated with sensitization to Chrysanthemum what might be suggestive for cross-sensitization. CONCLUSIONS: There is a high prevalence of work-related symptoms in Chrysanthemum greenhouses. In one-third of the employees these symptoms were caused by an IgE-mediated allergy caused by the pollen of the flowers. Inhalant atopy appeared to have a great impact on the development of such a sensitization. Measurements to reduce the pollen exposure are necessary to prevent a further increase of this occupational allergy.

Adolescent↗