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Biomedical subjects

Alex Burdorf

Publications and source records attributed to Alex Burdorf.

At least 19 recordsLinked to original sources
PubMed2006

Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism.

BACKGROUND: It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD) also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. METHODS: A cross-sectional study was conducted among 853 shipyard employees. Data were collected by questionnaire on physical and psychosocial workload, need for recovery, perceived general health, occurrence of musculoskeletal complaints, and health care use during the past year. Retrospective data on absenteeism were also available from the company register. RESULTS: In total, 37%, 22%, and 15% of employees reported complaints of low back, shoulder/neck, and hand/wrist during the past 12 months, respectively. Among all employees with at least one MSD, 27% visited a physician at least once and 20% took at least one period of sick leave. Various individual and work-related factors were associated with the occurrence of MSD. Health care use and absenteeism were strongest influenced by chronicity of musculoskeletal complaints and comorbidity with other musculoskeletal complaints and, to a lesser extent, by work-related factors. CONCLUSION: In programmes aimed at preventing the unfavourable consequences of MSD in terms of sickness absence and health care use it is important to identify the (individual) factors that determine the development of chronicity of complaints. These factors may differ from the well-know risk factors for the occurrence of MSD that are targeted in primary prevention.

Absenteeism↗
PubMed2006

Qualitative evaluation of a form for standardized information exchange between orthopedic surgeons and occupational physicians.

BACKGROUND: Both occupational physicians and orthopedic surgeons can be involved in the management of work relevant musculoskeletal disorders. These physicians hardly communicate with each other and this might lead to different advice to the patient. Therefore, we evaluated a standardized information exchange form for the exchange of relevant information between the orthopedic surgeon and the occupational physician. The main goals of this qualitative study are to evaluate whether the form improved information exchange, whether the form gave relevant information, and to generate ideas to further improve this information exchange. METHODS: The information exchange form was developed in two consensus meetings with five orthopedic surgeons and five occupational physicians. To evaluate the information exchange form, a qualitative evaluation was set up. Structured telephone interviews were undertaken with the patients, interviews with the physicians were face-to-face and semi-structured, based on a topic list. These interviews were recorded and literally transcribed. Each interview was analyzed separately in Atlas-Ti. RESULTS: The form was used for 8 patients, 7 patients agreed to participate in the qualitative evaluation. All three orthopedic surgeons involved and three of the six involved occupational physicians agreed to be interviewed. The form was transferred to 4 occupational physicians, the other 3 patients recovered before they visited the occupational physician. The information on the form was regarded to be useful. All orthopedic surgeons agreed that the occupational physician should take the initiative. Most physicians felt that the form should not be filled out for each patient visiting an orthopedic surgeon, but only for those patients who do not recover as expected. Orthopedic surgeons suggested that a copy of the medical information provided to the general practitioner could also be provided to occupational physicians. CONCLUSION: The information exchange form was regarded to be useful and could be used in practice. The occupational physician should take the initiative for using this form and most physicians felt the information should only be exchanged for patients who do not recover as expected. That means that the advantage of giving information early in the treatment is lost.

Adolescent↗
PubMed2006

Exercise proves effective in a systematic review of work-related complaints of the arm, neck, or shoulder.

OBJECTIVE: Interventions such as physiotherapy and ergonomic adjustments play a major role in the treatment of most work-related complaints of the arm, neck, and/or shoulder (CANS). We evaluated whether conservative interventions have a significant impact on outcomes for work-related CANS. STUDY DESIGN AND SETTING: A systematic review was conducted. Only (randomized) trials studying interventions for patients suffering from work-related CANS were included. Interventions may include exercises, relaxation, physical applications, and workplace adjustments. Two authors independently selected the trials, assessed methodological quality, and extracted data. RESULTS: We included 26 studies (in total 2,376 patients); 23 studies included patients with chronic nonspecific complaints. Over 30 interventions were evaluated and 7 main subgroups of interventions could be determined, of which the subgroup "exercises" was the largest one. Overall, the quality of the studies appeared to be poor. CONCLUSION: There is limited evidence for the effectiveness of exercises when compared to massage, adding breaks during computer work, massage as add-on treatment to manual therapy, manual therapy as add-on treatment to exercises, and some keyboards in people with carpal tunnel syndrome when compared to other keyboards or placebo. For other interventions no clear effectiveness could be demonstrated.

Arm↗
PubMed2006

Treatment of arm, neck, and/or shoulder complaints in physical therapy practice.

STUDY DESIGN: This is a prospective cohort study with a follow-up period of 6 months. OBJECTIVE: To describe the interventions applied by physical therapists in treating patients with complaints of the arm, neck, and/or shoulder. SUMMARY OF BACKGROUND DATA: Complaints of the arm, neck, and/or shoulder occur frequently and are usually treated within primary care. Many patients with these complaints are treated with physical therapy. METHODS: During a 1-year period, the participating physiotherapists included new consulters with musculoskeletal complaints of the upper extremity. The patients completed a questionnaire at baseline, and the physical therapists completed a treatment record for up to 6 months. RESULTS: Of the 624 patients included in the cohort, physical therapists provided treatment data of 619 patients. The main treatment consisted of exercise therapy (93%) and massage (87%), or a combination of both. More patients with specific complaints received physical methods, and patients with nonspecific complaints were treated with manipulation techniques. CONCLUSIONS: The primary treatment of complaints the of arm, neck, and/or shoulder in physiotherapy practice consists of exercise therapy and massage therapy, mostly being a combination of both. Future studies should focus on the effectiveness of exercise therapies, combined or not combined with massage, for patients with complaints of the arm, neck, and/or shoulder.

Adult↗
PubMed2006

Determinants for improvement in different back pain measures and their influence on the duration of sickness absence.

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To identify the determinants for improvement in pain, functional limitations, and quality of life in low back pain (LBP) patients, and to evaluate whether return to work (RTW) can be predicted by these factors and associated improvement in health-related aspects. SUMMARY OF BACKGROUND DATA: It is unclear to what extent prognostic factors for the course of LBP and consequent functional limitations are similar to prognostic factors for RTW. METHODS: A total of 103 LBP patients on sickness absence for 3 to 12 weeks filled out three questionnaires: at inclusion, and after 3 and 6 months. Information on the duration of sickness absence was gathered from occupational health services. RESULTS: Different personal characteristics determined pain, functional limitations, and quality of life at baseline. These dimensions all improved over time, significantly during the first 3 months. Working at 3 months had a positive impact on all three dimensions. In the multivariate model, RTW was positively associated with male gender and recurrent LBP, whereas it was negatively associated with the level of functional limitations at baseline. CONCLUSION: Except for male gender, the primary determinants for improvement in pain, functional limitations, and quality of life were not associated with RTW. Although there is a large coherence in the improvement in the outcome measures, RTW seems primarily determined by the level of experienced functional limitations.

Absenteeism↗
PubMed2006

Treatment of impingement syndrome: a systematic review of the effects on functional limitations and return to work.

The goal of this systematic review is to evaluate the effectiveness of different treatments for impingement syndrome and rotator cuff tear on the improvement in functional limitations and concomitant duration of sick leave. A systematic search for clinical trials or controlled studies was conducted with the following text words: should*, rotator cuff, impingement, work, sick leave, disabilit*, function*. Nineteen articles were included in this review. For functional limitations, there is strong evidence that extracorporeal shock-wave therapy is not effective, moderate evidence that exercise combined with manual therapy is more effective than exercise alone, that ultrasound is not effective, and that open and arthroscopic acromioplasty are equally effective on the long term. For all other interventions there is only limited evidence. We found many studies using range of motion and pain as outcome measures but functional limitations were less often used as an outcome measure in this type of research. Duration of sick leave was seldom included as an outcome measure.

Adrenal Cortex Hormones↗
PubMed2006

Prognostic factors for duration of sickness absence due to musculoskeletal disorders.

OBJECTIVE: The purpose of this prospective cohort study with 1-year follow-up was to determine prognostic factors for duration of sickness absence due to musculoskeletal disorders. METHODS: Workers were included when on sickness absence of 2 to 6 weeks due to musculoskeletal disorders. A self-administered questionnaire was used to collect personal and work-related factors, pain, functional disability, and general health perceptions. Statistical analysis was done with Cox proportional hazard regression with an interaction variable with time for every risk factor of interest. Univariate and multivariate analyses were performed on musculoskeletal disorders and, separately, for low back pain. RESULTS: The main factors that were associated with longer sickness absence were older age, gender, perceived physical workload, and poorer general health for neck, shoulder and upper extremity disorders, and functional disability, sciatica, worker's own perception of the ability of return to work, and chronic complaints for low back pain. Workers with a high perceived physical work load returned to work increasingly slower over time than expected, whereas workers with a high functional disability returned to work increasingly faster over time. CONCLUSIONS: High pain intensity is a major prognostic factor for duration of sickness absence, especially in low back pain. The different disease-specific risk profiles for prolonged sickness absence indicate that low back pain and upper extremity disorders need different approaches when applying intervention strategies with the aim of early return to work. The interaction of perceived physical workload with time suggests that perceived physical workload would increasingly hamper return to work and, hence, supports the need for workplace interventions among workers off work for prolonged periods.

Absenteeism↗
PubMed2006

The relations between psychosocial factors at work and health status among workers in home care organizations.

A considerable proportion of sickness absence and disability pension is caused by subjective health complaints, especially low back pain (LBP). In recent years focus has been on psychosocial characteristics of work as potential risk factors. The aim of this study is to examine the relations between psychosocial work aspects and subjective health complaints, LBP, and need for recovery. A total of 779 employees working in home care participated in a cross-sectional study. Higher psychological demands were associated with subjective health complaints and need for recovery. However, decision authority, skill discretion, and the 2 aspects of social support did not seem to be important factors. Higher psychological demands do not seem to be associated with severity of LBP, but does show an association with sick leave.

Adolescent↗
PubMed2005

A comparative analysis on musculoskeletal disorders between Greek and Dutch nursing personnel.

OBJECTIVE: To analyse cross-cultural differences between Greek and Dutch nursing personnel in association with the risk factors and occurrence and consequences (absenteeism and medical care seeking) of musculoskeletal disorders. METHODS: This study was based on questionnaire surveys among 393 nurses and caregivers in nursing homes and homes for the elderly in The Netherlands and among 351 nurses in general hospitals in Athens, Greece. Logistic regression analysis was used to analyse associations between physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence and medical care seeking. RESULTS: Greek nurses reported significantly more back complaints in the past 12 months (75 vs. 62%) than the Dutch workers, but chronicity (11 vs. 12%) and sickness absence (17 vs. 15%) of these complaints did not differ. Similar differences were observed for neck complaints but not for shoulder complaints. Most Greek nurses with back complaints visited a medical specialist (40%) while Dutch nurses and caregivers sought care through a general practitioner (33%). Multivariate analyses showed that in both countries strenuous back postures (ORs 1.9 and 1.9) and especially a moderate general health (ORs 4.3 and 2.9) were the significant risk factors for back pain. CONCLUSIONS: In both countries similar risk factors were associated with the occurrence of low-back pain. Cross-national differences were less important for the risk factors and musculoskeletal complaints than for the consequences of these complaints and for medical care seeking.

Adult↗
PubMed2005

Health status, its perceptions, and effect on return to work and recurrent sick leave.

STUDY DESIGN: Prospective cohort study with 1-year follow-up. OBJECTIVES: The purpose of this study is to describe the improvement in several health outcomes during sick leave resulting from musculoskeletal disorders and in the first months after return to work (RTW), and to evaluate the personal and work-related factors associated with these health outcomes, in order to provide some insight in the timing of RTW. SUMMARY OF BACKGROUND DATA: Although improvements in pain perception and functional disability appear to be associated with time of RTW, little is known about the required improvement enabling RTW, the additional health improvement after RTW, and whether the health status at the time of RTW is associated with the probability of a recurrence of sick leave. METHODS: Workers were included when on sickness absence between 2 to 6 weeks due to musculoskeletal disorders. Self-administered questionnaires at baseline, after RTW, and at 12-month follow-up were used to collect information on changes in symptom status, functional status, and general health. RESULTS: All health outcomes were improved significantly at the time of RTW, whereas perceived pain, functional disability, and physical health also improved significantly in the first months after RTW. Previous sick leave 12 months before study entry was significantly associated with the level of functional disability and general health at time of RTW and also predictive for recurrence of sickness absence. Personal and work-related factors showed little, if any, association with health status at RTW and improvement thereafter. CONCLUSIONS: Being fully recovered is not a stipulation for regaining work activities. We hypothesize that workers with musculoskeletal disorders may need additional medical guidance shortly after RTW, especially those with a history of sick leave.

Adult↗
PubMed2005

An evaluation of methods assessing the physical demands of manual lifting in scaffolding.

Four methods assessing the physical demands of manual lifting were compared. The scaffolding job was evaluated and three distinct scaffolding tasks were ranked using: (1) the revised NIOSH lifting equation (NIOSH method), (2) lifting guidelines for the Dutch construction industry (Arbouw method), (3) rapid appraisal of the NIOSH lifting equation (practitioners' method), and (4) systematic observations. For the three first-mentioned methods the same dataset was used; observation took place in a different setting in the same company. At job level, all methods indicated that ergonomic interventions are required to protect scaffolders from an increased risk for low back pain. The NIOSH, Arbouw and practitioners' method resulted in a similar ranking order of tasks (transport>construction>dismantlement). In contrast, the observational method gave transport the lowest ranking. The underlying cause was probably that the observational method is more sensitive to durations of tasks and lifting within tasks than the three other methods.

Adult↗
PubMed2005

Explaining differences in incidence rates of pleural mesothelioma between Sweden and the Netherlands.

In recent years in several countries a deceleration or leveling off of pleural mesothelioma rates has been observed. The impact of asbestos used was analysed by comparing a country with a relative modest incidence rate of mesothelioma (Sweden) and an early response to asbestos use with a country with one of the highest incidence rates of mesothelioma in Western Europe (The Netherlands). In Sweden the Cancer Register provided information on the annual incidence of pleural mesothelioma, whereas in The Netherlands mortality data were provided by Statistics Netherlands for the period 1969-2001. In The Netherlands among men the incidence rate was consistently higher (1.5-2 times) than in Sweden, whereas among women similar rates were observed. Assuming that none of the female cases was caused by occupational exposure to asbestos, minimum estimates of the etiologic fraction for occupational exposure to asbestos in men would be 82% in Sweden and 92% in The Netherlands. Possible explanations for the consistently higher incidence rates in the Netherlands than in Sweden include differences in exposure levels, the proportion of exposed subjects in the workforce and types of asbestos fibres used. Measures to decrease the exposure to asbestos seem to have decreased the risk of pleural mesothelioma in both countries among age groups below 60 years. This effect will result in a leveling off of the increase in pleural mesothelioma in both countries in the next decade.

Adult↗
PubMed2005

High incidence and recurrence of shoulder and neck pain in nursing home employees was demonstrated during a 2-year follow-up.

OBJECTIVE: This study describes the course of shoulder and neck complaints in a working population over time. STUDY DESIGN AND SETTING: Questionnaires were administered on neck and shoulder complaints over 3 consecutive years. RESULTS: We observed 12-month incidence rates for neck and shoulder complaints of 16% to 18%, 12-month prevalence rates roughly twice as high, and 12-month recurrence rates approximately twice the prevalence rates. Each year, medical care was sought by 21% to 38% of the subjects with neck or shoulder pain, and 13% to 21% were absent from work. Although at the population level the occurrence of neck and shoulder complaints remained constant, the course of complaints within individuals demonstrated a strong episodic nature of neck and shoulder pain. Results from this study suggest that neck and shoulder complaints for most subjects run a recurrent course characterized by a strong variation in occurrence and a self-limiting course. CONCLUSION: These findings suggest that clinical trials should have a sufficiently long follow-up period to demonstrate sustainability of the therapeutic results.

Absenteeism↗
PubMed2005

Influence of modified work on return to work for employees on sick leave due to musculoskeletal complaints.

OBJECTIVE: To determine which individual and work-related factors are associated with performing modified work and to evaluate the influence of modified work on the duration of sick leave and health-related outcomes among employees with musculoskeletal complaints. STUDY DESIGN: A prospective study with 12 months follow-up. METHODS: In this prospective study a total of 164 employees on sick leave for 2-6 weeks due to musculoskeletal complaints completed 2 questionnaires. At baseline we gathered information about individual characteristics, physical and psychosocial workload, and disease specific and general health. The follow-up questionnaire, sent to respondents who returned to their original job on full duty, collected information about having performed modified work, and disease-specific and general health. RESULTS: Employees were less likely to perform modified work when their regular work was characterized by frequent lifting and their relationship with colleagues was less than good. Employees were more likely to return to modified work when they had a better mental health, had prolonged periods of standing in their regular job and had less skill discretion. Duration of sick leave was influenced by chronicity of complaints and disability, but not by modified work. CONCLUSION: Modified work, as the only advice given by a occupational health physician, did not influence the total duration of sick leave nor the improvement in health during sick leave for employees on sick leave due to musculoskeletal complaints.

Adult↗
PubMed2005

The cryptorchidism prevalence among infants in the general population of Rotterdam, the Netherlands.

Published trends and geographical differences in cryptorchidism rates are almost exclusively derived from hospital-based birth defect registers, which are sensitive to selection bias and incomplete reporting. This study aimed to accurately assess the cryptorchidism prevalence in the general population of Rotterdam. Of 7652 consecutive male live births, 7292 (95%) were examined for cryptorchidism at Child Healthcare Centres around the age of 1 month. In a subgroup of cases, the persistence of cryptorchidism was re-assessed during a follow-up examination by expert specialists. The cryptorchidism rate at the median age of 35 days was 1.2% (89/7292). In the re-examined subgroup (median age 95 days) 69% of the boys (24/35) had persistent cryptorchidism, of which 20 were unilateral and four bilateral. The population rate of 1.2% falls within the range of 0.9-9% reported by others. Differences in case ascertainment and population characteristics probably explain part of the differences between studies. Our cross-sectional design does not allow for analysis of a temporal trend, but provides a baseline for future trend studies. To study cryptorchidism rates, trends, and risk factors, a systematic case ascertainment is warranted.

Cryptorchidism↗
PubMed2005

Measuring productivity changes in economic evaluation: setting the research agenda.

Productivity costs related to illness may be relevant in assessing healthcare programmes for patients, as well as occupational interventions for workers. When performing an economic evaluation for both types of programmes, a sound methodology for measuring and valuing these productivity costs is essential. This article reviews research questions related to productivity and health, focusing on the costs of short-term absence from work, productivity costs without absence ('presenteeism') and possible compensation mechanisms and circumstances that may affect productivity costs. Furthermore, the important but under-explored relationship between productivity and QOL is analysed. Strategies for better answers on these research questions, such as developing more valid measurement instruments, are discussed. It is stressed that the analysis of productivity costs should not be restricted to the level of the individual patient and worker but extended to the level of teams of workers and firms. It may be advisable to explore several issues such as compensation mechanisms and efficiency losses in detail using employee questionnaires and consecutively applying the key elements in patient settings. It seems advisable to develop flexible, modular instruments for measuring and valuing absence from work, compensation mechanisms, efficiency loss and details of jobs and organisation in an integrative and consistent way. Further, it seems crucial to identify what determinants of jobs and organisations are the key factors in estimating productivity costs. This list of determinants could be mapped with a classification of jobs, to be used as a screener in patient questionnaires.

Absenteeism↗