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Biomedical subjects

A Kilbom

Publications and source records attributed to A Kilbom.

At least 37 records · Page 2Linked to original sources
PubMed1999

Possibilities for regulatory actions in the prevention of musculoskeletal disorders.

This review argues that there is a need for regulatory action against work-related musculoskeletal disorders. Designing such regulation is fraught with problems, such as insufficient knowledge about mechanisms and exposure-dose-response relationships, and lack of consensus on definitions. The multifactorial character of the disorders, especially risks involving work organization, further increases the problems. Nevertheless, regulation is necessary because of the poor results of voluntary prevention and the large costs of these disorders. Some major regulations are reviewed, and it is argued that there is insufficient scientific support for quantitative regulations proposed for some European norms. The recent Nordic ergonomic regulations for the prevention of work-related musculoskeletal disorders is a step forward, since they succeed in providing guidance, including some on work organizational issues, with only few quantitative measures. Researchers should become more involved in these activities, and priorities in future research that would benefit a more scientific approach to ergonomic regulation are indicated.

Ergonomics↗
PubMed1998

Ultrasound-Doppler technique for monitoring blood flow in the brachial artery compared with occlusion plethysmography of the forearm.

Blood flow changes in the brachial artery of seven subjects during and after submaximal static handgrip contractions were measured by duplex Doppler ultrasound technique. These measurements were compared with the results of occlusion plethysmography, measured immediately (2-3 heartbeats) after. For the combined data from all measurements, a common calibration line could be drawn (linear regression, r=0.92). The flow measurements from the two methods were tested by a four-way analysis of variance and there was no significant difference between the methods during (static) exercise, indicating acceptable coherence. Occlusion plethysmography may well be used for monitoring forearm blood flow during conditions of static exercise. In addition, the cuff occlusion pressure of the plethysmograph (50 mmHg) decreased the blood flow of the brachial artery by approximately 28% as measured by duplex Doppler ultrasound.

Adult↗
PubMed1998

Psychosocial and physical risk factors associated with low back pain: a 24 year follow up among women and men in a broad range of occupations.

OBJECTIVES: To investigate the relation between psychosocial and physical factors at work, as well as conditions during leisure time, and low back pain (LBP) over 24 years. METHODS: The study group consisted of 252 women and 232 men. From a previous study conducted in 1969, data on psychosocial and physical conditions and LBP were available. Data on LBP for 1971-93 were obtained retrospectively in 1993. RESULTS: The prevalence of LBP in 1969 among women and men were 34% and 24%, the cumulative incidences of LBP during 1970-92 were 38% and 43%, and the prevalences in 1993 of having had LBP during the past 12 months were 44% and 39%, respectively. Monotonous work and few or unsatisfactory social contacts outside work were risk factors for LBP in 1969 among women. LBP in 1969 and dissatisfaction with leisure time were risk factors among both sexes for LBP in 1970-92. LBP in 1969 was a risk factor for LBP in 1993 among women and dissatisfaction with leisure time a risk factor among men. Interactions between few or unsatisfactory social contacts outside work, as well as dissatisfaction with leisure time, and several factors related to work were found to increase the risk of LBP among both sexes during the studied periods. CONCLUSIONS: Conditions in leisure time exert a long term influence on LBP. In this study factors related to work had a long term effect only in interaction with leisure time factors.

Adult↗
PubMed1998

Validity and reliability of self-reported retrospectively collected data on sick leave related to musculoskeletal diseases.

OBJECTIVES: The aim was to study the reliability and validity of retrospective data, collected by self-report, on sick leave related to musculoskeletal diseases. METHODS: The study groups consisted of 66 and 306 subjects, for the reliability and validity studies, respectively. They were all part of a wider study of risk factors for musculoskeletal disorders, the REBUS study, conducted in Stockholm in 1993. Reliability was tested using a test-retest design regarding self-reported sick leave related to musculoskeletal diseases in 1970-1993. The validity study comprised the period 1990-1994. Self-reported and registered sick-leave data related to musculoskeletal diseases were collected and analyzed regarding concordance. Data about current musculoskeletal disorders and different work-related conditions were collected and analyzed regarding possible effect- and exposure-dependent misclassification. RESULTS: The test-retest reliability study showed the percentage of agreement to be between 0.88 and 0.97, and the kappa values were between 0.73 and 0.93. The validity study of the concordance between the self-reported and registered data showed high agreement and specificity, but the sensitivity was sometimes lower. All the kappa values exceeded 0.50. No effect- or exposure-dependent misclassification was found. CONCLUSIONS: The validity of retrospectively collected self-reported sick-leave data was sufficient for use as a measure of musculoskeletal morbidity in the analyses of associations with work-related conditions. Because of the relatively low sensitivity, such data will underestimate the prevalence of sick leave and should not be used for surveys of morbidity.

Female↗
PubMed1997

Reproducibility of a questionnaire for assessment of present and past physical activities.

OBJECTIVE: The aim of this study was to evaluate the reproducibility of a self-administered questionnaire about present and past physical activities at work and during leisure time. METHODS AND DESIGN: The questionnaire, covering the period 1970-1993, comprised 12 questions on physical activities at work, and 12, with similar wording, for such activities in leisure time. There were also four questions on physical training. Two-week reproducibility (test-retest reliability) concerning the period 1970-1993 was analysed in a group of 44 subjects, and 1-year reproducibility, concerning current activities in 1993, was analysed in a second group of 123 subjects in relation to gender, age and low-back health. RESULTS: Test-retest reliability calculated as intraclass correlation coefficients (ri) for physical activities at work (ri 0.41-0.98) exceeded that for leisure time and physical training activities (ri 0.33-0.68). Calculated correlations did not differ markedly between past and present activities. No distinct influence of gender or low back health on 1-year reproducibility was found, in contrast to a slight tendency towards higher reproducibility among subjects of 50 years and older compared with younger subjects. CONCLUSIONS: Reproducibility of this questionnaire about physical activities at work showed no clear tendency to deteriorate regarding activities during the immediately preceding two decades. The questions about physical activities during leisure time have to be revised. Reliable retrospective information about physical activities in leisure time could perhaps not be collected by self-administered questionnaires and other methods, e.g. interview-based questionnaires, may be more suitable.

Adult↗
PubMed1997

A 33-yr follow-up of peak oxygen uptake and related variables of former physical education students.

In 1949, 27 female and 26 male physical education students were studied at a mean age of 22 and 25 yr, respectively. They were restudied in 1970 and 1982. Measurements included oxygen uptake, heart rate, and pulmonary ventilation during submaximal and maximal exercise on a cycle ergometer and treadmill. After 21 yr, peak aerobic power was significantly reduced, from 2.90 to 2.18 l/min and from 4.09 to 3.28 l/min for women and men, respectively. After another 12 yr, the 1970 maxima were not reduced further. From 1949 to 1982 there was a decrease in peak heart rate from 196 to 177 beats/min in women and from 190 to 175 beats/min in men (P < 0.05). Highest pulmonary ventilation did not change significantly. At an oxygen uptake of 1.5 l/min, the heart rate was the same in 1949 as in 1982. In conclusion, the physical fitness level of the subjects was well above average for these ages. From 1970 to 1982 there was no decline in the average peak aerobic power, a finding possibly related to increased habitual physical activity.

Adult↗
PubMed1997

Possible bias from rating behavior when subjects rate both exposure and outcome.

OBJECTIVES: In many epidemiologic studies the subjects rate both the exposure and the outcome, assigning numerical values to the variables according to their perceptions and judgments. Hypothetically, subjects who tend to overestimate, exaggerate, or use high numerical values in rating tasks would rate both exposure and outcome higher than subjects who tend to underestimate, dissimulate, or use low numerical values. A range of such rating behaviors among the subjects would introduce uncontrollable bias to relative risk estimates, in most cases an overestimation. The aim of this study was to assess the possible presence of and effects on relative risk estimates of such high and low rating behavior among subjects in an epidemiologic study of musculoskeletal disorders. METHODS: Rating behavior was analyzed by intercorrelating the ratings of 19 different stimuli. High positive correlations would indicate the presence of high and low rating behavior. RESULTS: The correlations were, however, both positive and negative and close to zero. Adjusting for rating behavior did not affect relative risk estimates, based on subjective ratings of both exposure and outcome. CONCLUSION: There is no support in this study for the existence of a range of high and low rating behavior among subjects who rate neutral and nonaffective stimuli, such as time, weight, number and physical exposure, as well as pain and other symptoms. There is therefore no support for the idea of a bias to relative risk estimates from such rating behavior in studies where subjects rate both exposure and outcome variables of this kind.

Adult↗
PubMed1996

Characteristics of forearm-hand exposure in relation to symptoms among automobile assembly line workers.

The aims of this paper are to present a new computerized observation method, HandPEO (portable ergonomic observation), which quantifies duration, frequency, and holding time of work operations and hand grips, and to measure the physical exposure of the forearm-hand among automobile assembly line workers by using HandPEO registrations of video recordings in simulated real-time. Agreement between two recordings was tested for five subjects by calculating the proportion of specific intrarater agreement; it was approximately 70% for hand grips and 60-80% for work operations. Registrations were made on work stations with high (HS) and low (LS) prevalence of symptoms. The major differences were longer holding times per operation and a larger proportion of power tool usage for HS. The HandPEO method may be used to describe the characteristics of the work studied and may serve as basis for job redesign. The results suggest an association between holding time, certain work operations, and prevalence of symptoms.

Automobiles↗
PubMed1996

Evaluation of perceived and self-reported manual forces exerted in occupational materials handling.

The main objective of the study was to evaluate the ability of workers to reproduce simulated manual work forces correctly and to quantify these forces in Newtons (N) by means of self-reports. Fourteen male and 14 female workers participated in the study. Three experiments were carried out. In the first experiment, the ability to reproduce the magnitudes of simulated manual forces occurring in daily work and to estimate these forces in Newtons was tested. A specially designed force-measuring device was used for this purpose. In the second experiment, the subjects estimated the weights of five boxes ranging from 1 to 30 kg. In the third experiment, the subjects were asked to produce five predetermined push and pull forces ranging in magnitude from 10 to 300 N on to the handle of the force-measuring device. The ability to reproduce the magnitudes of manual forces when simulating four familiar work tasks was good (the intraclass correlation coefficients ranged from 0.75 to 0.95). The ability to quantify these forces in Newtons was not as good (the product moment correlation coefficients ranged from 0.21 to 0.69). When the subjects estimated the weights of boxes they underestimated the weights. When they produced predetermined push and pull forces they exerted higher forces than expected when low force levels were requested and lower forces when high force levels were requested. However, the forces were correctly ranked. In summary, simulation of the manual push/pull forces used in familiar work tasks seemed to offer sufficient reproducibility to be worth testing for validity. Self-reports, used without previous training or without known 'reference forces', seemed to be very rough when the aim was to estimate in kg or Newtons. However, the fact that individuals could rank the forces correctly opens a potential for refinement of self-reports as a method for quantifying manual forces in objective terms, e.g. kg or Newtons.

Journal Article↗
PubMed1995

Physical work load, physical capacity and strain among elderly female aides in home-care service.

A study was undertaken to investigate physical work load, physical capacity, physical strain and perceived health among elderly aides in home-care service. A secondary aim was to compare the work load and strain between the two main types of home-care service available in Sweden today. Work tasks and their distribution among 20 elderly aides (aged 45-65 years), working in open home-care service (clients living in their original flats or houses) and at service apartment houses (clients living in private flats constructed for the elderly and handicapped with service functions) were observed during whole work days. Heart rate and number of steps taken were also measured continuously during the whole work day. Oxygen consumption and work postures for upper arm and back were measured during parts of the work day. The results showed that home-care work is characterised by long periods of standing and walking and that postures potentially harmful for the low back and shoulders occurred frequently. Average physiological strain measured as relative oxygen consumption and heart rate during the work day did not exceed present recommendations. Average physical work load and strain in open home-care service slightly exceeded those in service apartment houses because of more frequent cleaning and walking outdoors. Many aides in this study showed slightly reduced physical capacity, and musculoskeletal problems were common. Many elderly aides in home-care service are probably exposed at work to high risks of overexertion and impaired health as a result of high postural loads in combination with other known important factors, such as time stress and lack of equipment.

Aged↗
PubMed1995

A portable ergonomic observation method (PEO) for computerized on-line recording of postures and manual handling.

A new portable ergonomic observation method (PEO) is presented. It is applicable to most professions and work tasks and requires only moderate human resources for data collection and analysis. Observations are made in real time directly at the workplace using a portable personal or hand-held computer, and data are accessible for immediate analysis and presentation. Duration and number of events are calculated for postures at four body regions (arms, neck, trunk and knee) as well as for manual handling. An evaluation of the PEO method, assessing some important aspects of internal validity as well as intra- and inter-observer reliability, was carried out using video recordings. It showed acceptable validity for some types of physical exposure, and high intra- and inter-observer reliability. Practical experiences from using the PEO method in a field study and further improvements of the method are discussed.

Journal Article↗
PubMed1995

Clinical disorders and pressure-pain threshold of the forearm and hand among automobile assembly line workers.

The prevalence of forearm and hand disorders was examined by questionnaire and clinical examination in 199 automobile assembly line workers and in 186 controls. The pressure-pain threshold, hand grip force and hand anthropometry were also studied. There was an increased prevalence of de Quervain's disease for male automobile assembly line workers, and of carpal tunnel syndrome in female workers. The prevalence of symptoms in the forearm and hand during the last 7 days were twice as high among automobile assembly line workers than controls for both men and women. The occurrence of symptoms in the last 7 days was associated with de Quervain's disease, carpal tunnel syndrome and sick-leave due to forearm or hand problems, and it also influenced activities of daily living. Hand grip strength and anthropometrics were not associated with findings in the clinical examination or the occurrence of symptoms in the last 7 days. Low pressure-pain threshold was not associated with findings in the clinical examination, except for reported occurrence of symptoms in the last 7 days for women. Pressure-pain threshold as an indicator of tissue damage is discussed.

Adolescent↗
PubMed1995

Self-reported physical exposure and musculoskeletal symptoms of the forearm-hand among automobile assembly-line workers.

The aim was to study the prevalence of physical exposures and symptoms of the forearm-hand in a population with highly repetitive jobs. Automobile assembly-line workers (ALWs) (n = 521) and a control group (CG) from the general population answered a questionnaire. Consistent differences were found between the groups. ALWs reported more symptoms from the forearm-hand and higher exposure to repetitive movements, precision movements, and manual handling (< or = 15 kg) than the CG. Female ALWs reported more symptoms and higher exposure to known risk factors for work-related forearm-hand disorders than their male colleagues. In conclusion, automobile assembly-line workers appear to be a high-risk group for work-related symptoms from the forearm-hand. Also, exposure to physical load should be conscientiously analyzed, since women may perform different tasks than men.

Adolescent↗
PubMed1995

HARBO, a simple computer-aided observation method for recording work postures.

OBJECTIVES: The aim of the study was to present an observation method focusing on the positions of the hands relative to the body and to evaluate whether this simple observation technique gives a reliable estimate of the total time spent in each of five work postures during one workday. METHODS: In the first part of the study the interobserver reliability of the observation method was tested with eight blue-collar workers. In the second part the observed time spent with work above the shoulder level was tested in relation to an upper-arm position analyzer, and observed time spent in work below knuckle level was tested in relation to a trunk flexion analyzer, both with 72 blue-collar workers. RESULTS: The interobserver reliability for full-day registrations was high. The intraclass correlation coefficients ranged from 0.99 to 1.00. The observed duration of work with hands above shoulder level correlated well with the measured duration of pronounced arm elevation (> 75 degrees). The product moment correlation coefficient was 0.97. The observed duration of work with hands below knuckle level correlated well with the measured duration of pronounced trunk flexion angles (> 40 degrees). The product moment correlation coefficient was 0.98. CONCLUSION: The present observation method, designed to make postural observations continuously for several hours, is easy to learn and seems reliable.

Adult↗
PubMed1994

Assessment of physical exposure in relation to work-related musculoskeletal disorders--what information can be obtained from systematic observations?

Establishing an association between physical work load and work-related musculoskeletal disorders requires a quantitative assessment of exposure to the main risk factors. Commonly used methods are questionnaires, diaries, interviews, systematic observations, and direct measurements. While questionnaires provide subjective information and have low reliability, measurements are technically sophisticated, expensive, and unable to identify some important risk factors. Systematic observations offer a compromise. The observation methods devised during the past 15 years are described, together with their reliability and validity. Most of them use duration or frequency of certain postures or events as the main measure of exposure. Their ability to quantify the main risk factors posture, manual handling, and repetitive work differs. All available methods have drawbacks and have been used to a limited extent in epidemiologic studies. There have been improvements however, and it is concluded that observation methods will have a place in epidemiologic studies on musculoskeletal disorders.

Humans↗