Publications by authors named "Anette Kærgaard"

19 Publications

  • Page 1 of 1

Mental disorders following electrical injuries-A register-based, matched cohort study.

PLoS One 2021 22;16(2):e0247317. Epub 2021 Feb 22.

Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Herning, Denmark.

Introduction: Electrical injuries happen every day in homes and workplaces. Not only may these injuries cause physical damage and disability, they may also cause mental disorders. The aim of this study was to investigate if persons with an electrical injury suffer from mental disorders in the following years.

Material And Methods: In a prospective matched cohort design, we identified 14.112 electrical injuries in two Danish registries and matched these with persons with dislocation/sprain injuries or eye injuries, respectively, as well as with persons from the workforce from the same occupation, using year of injury, sex and age as matching variables. We identified possible outcomes in terms of mental diagnoses in the Danish National Patient registry, based on literature, including reviews, original studies and case-reports as well as experiences from clinical praxis. The associations were analyzed using conditional cox- and logistic regression.

Results: We found that the following of the examined outcomes were associated with exposure to an electrical injury compared to the matched controls. Some of the outcomes showed the strongest associations shortly after the injury, namely 'mental disorders due to known physiological condition', 'anxiety and adjustment disorders', and especially the 'Post Traumatic Stress Disorder (PTSD)' subgroup. The same pattern was seen for 'Depression' although the associations were weaker. Other conditions took time to develop ('Somatoform disorders'), or were only present in the time to event analysis ('other non-psychotic mental disorders' and 'sleep disorders'). The findings were consistent in all three matches, with the highest risk estimates in the occupation match.

Conclusion: Electrical injuries may result in mental disorders, both acute and several years after. However, the absolute risk is limited as most of the outcomes are rare.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247317PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899322PMC
February 2021

Contacts with general practitioner, sick leave and work participation after electrical injuries: a register-based, matched cohort study.

Occup Environ Med 2021 01 2;78(1):54-60. Epub 2020 Nov 2.

Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, Herning, Denmark.

Objective: Exposure to electrical current may cause injury with both mental and physiological consequences. This may lead to increased contacts with general practitioners (GP) and the injured person may develop reduced ability to work. We aimed to examine these outcomes in terms of work-participation, long-term sick leave and contacts with GPs.

Methods: In a matched cohort design, we identified 14 112 electrical injuries in two registries and matched these with both patients with distorsion injuries or eye injuries, and with persons from the same occupation, using year of injury, sex and age for matching. We defined the outcomes based on register information regarding contacts with GPs and public transfer income. After the injury, we determined if the person had a long-term sick leave episode during the first 6, 12 months and 5 years. We calculated work participation during the year and 5 years and the number of GP contacts in the year of the injury, the year after and 5 years after the injury and dichotomised this at twice the mean number of contacts in the study population. The associations were analysed using conditional logistic regression.

Results: We found increased risk for all defined outcomes, with the highest estimates in the occupation match. The risk estimates were similar over time. Adjusting for previous work participation increased the estimates slightly, whereas adjusting for previous contacts with GPs reduced the estimates. Restricting to those with at longer hospitalisation increased the estimates.

Conclusion: Electrical injuries increase risk of long-term sick leave, low work participation and increased contacts with GPs.
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http://dx.doi.org/10.1136/oemed-2020-106858DOI Listing
January 2021

Long-term prognosis for neck-shoulder pain and disorders: a 14-year follow-up study.

Occup Environ Med 2018 02 23;75(2):90-97. Epub 2017 Aug 23.

Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.

Objectives: The long-term prognosis for neck-shoulder pain and disorders and the impact of shoulder exposure among former sewing machine operators were investigated in a 14-year follow-up study.

Methods: Information on neck-shoulder pain and disorders was collected by questionnaire and clinical examination at baseline in 243 female sewing machine operators and by questionnaire 14 years later. During follow-up, information on comorbidity and job exposures was obtained from registers and by linking register-based D-ISCO 88 codes with a job exposure matrix. Logistic regression analyses were performed to examine associations between neck-shoulder pain and disorders at baseline and neck-shoulder pain and physical functioning at follow-up.

Results: We found an association between neck-shoulder disorders at baseline and neck-shoulder pain at follow-up (OR 5.9;95% CI 1.9 to 17.7), and between neck-shoulder pain at baseline and neck-shoulder pain at follow-up (OR 8.2;95% CI 3.5 to 19.2). Associations between neck-shoulder disorders and pain at baseline and limited physical functioning at follow-up had ORs of 5.0 (95% CI 1.5 to 16.1) and 2.2 (95% CI 1.1 to 4.6), respectively. In women still working in 2008, the association between neck-shoulder pain in 1994 and in 2008 seemed to be stronger for those in jobs with high job shoulder exposure.

Conclusions: The results suggest a long-term adverse prognosis for neck-shoulder pain. High job shoulder exposure can worsen this prognosis for those who continue working. This knowledge could influence the counselling given to similar workers and emphasises the need to prevent neck-shoulder pain.
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http://dx.doi.org/10.1136/oemed-2017-104422DOI Listing
February 2018

Neck-Shoulder Pain and Work Status among Former Sewing Machine Operators: A 14-year Follow-up Study.

J Occup Rehabil 2018 03;28(1):80-88

Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.

Purpose A total of 243 Danish female sewing machine operators lost their jobs in 1996 because of outsourcing. The aim was to investigate the employment status during follow-up from 1996 to 2008, and to estimate to what extent former neck-shoulder pain had an impact on later work participation. Methods Assessment of neck-shoulder pain was based on questionnaires completed in 1994. The Danish Register-Based Evaluation of Marginalization (DREAM) register was used to describe employment status during the follow-up period. Register data were explored by sequence analyses and graphics, and the association between neck-shoulder pain and work participation was analyzed by logistic regression analysis. Results In all, 987 working years were lost during follow-up, and a sequence index plot revealed interrupted and heterogeneous courses of incomes. The odds ratio between neck and shoulder pain and a work participation score less than 75% was 1.49 (95% CI 0.84-2.67). Conclusions After outsourcing of the textile industry, the former sewing machine operators had decreased work participation and frequent transitions between different income types. Previous neck-shoulder pain tended to be associated with poor work participation. The results suggest that increased attention should be to given to dismissed workers from other industries that become outsourced, especially unskilled workers with similar work-related health limitations. Additionally, we concluded that time-to-event measures in research involving employment status are insufficient because of the many transitions that take place in working life.
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http://dx.doi.org/10.1007/s10926-017-9702-5DOI Listing
March 2018

Salivary cortisol and depression in public sector employees: cross-sectional and short term follow-up findings.

Psychoneuroendocrinology 2014 Mar 16;41:63-74. Epub 2013 Dec 16.

Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.

Introduction: Increased cortisol levels have been suggested to play a role in the development of depression. An association has been shown in some studies but not consistently. The timing of an association is uncertain, and long-term follow-up studies may miss associations in narrower time windows. In the present study, we examined the association of several cortisol measures and depression in a repeated cross-sectional and short-term follow-up design. Depression was assessed by both self-reported symptoms of depression and clinical interviews.

Method: In 2007, 10,036 public sector employees received a questionnaire along with salivary cortisol test tubes for home administration. Morning (30min after awakening) and evening (2000h) salivary samples were collected. Questionnaires and valid saliva samples were returned from 3536 employees. Approximately 3.6 months later a subsample of the participants collected three morning saliva samples (at awakening, 20min and 40min after awakening) plus an evening sample (2000h); participants with high baseline scores of self-reported depressive symptoms, burnout and perceived stress were invited to a standardized interview (SCAN) to detect clinical depression; and the symptom questionnaire was repeated for subsample participants. The study was repeated in 2009 with questionnaires and salivary test tubes (n=2408). In four cross-sectional and two short-term follow-up analyses odds ratios of depressive symptoms and of clinical depression were estimated by logistic regression for morning, evening, mean and the difference between morning and evening cortisol (slope). For the subsample, awakening response (CAR) and area under the curve (AUC) cortisol measures were calculated. We adjusted for sex, age, income, education, family history of depression, physical activity and alcohol consumption.

Results: None except one of the measures of salivary cortisol were associated with self-reported depressive symptoms or clinical depression, neither in the four cross-sectional analyses nor in the two short term follow-up analyses. E.g. in 2007, the adjusted odds ratios (OR) of depressive symptoms by a one unit increase in morning and evening cortisol (ln(nmol/litre saliva)) were 1.01 (95% CI: 0.88-1.17) and 1.05 (0.93-1.18), respectively. The one exception was significant at p=0.04 and was considered as due to chance.

Conclusion: In this large study, salivary cortisol was not associated with self-reported symptoms of depression or with clinical depression.
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http://dx.doi.org/10.1016/j.psyneuen.2013.12.006DOI Listing
March 2014

A two-year follow-up study of salivary cortisol concentration and the risk of depression.

Psychoneuroendocrinology 2013 Oct 15;38(10):2042-50. Epub 2013 Apr 15.

Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address:

Stress is a suspected cause of depression. High cortisol concentration, a biomarker of an activated stress response, has been found in depressed patients. The aim of this study was to determine if a high level of salivary cortisol is a risk factor of depression. In 2007, we enrolled 4467 public employees. Morning and evening salivary cortisol concentration were measured for each participant. Participants reporting high levels of depressive, burnout, or stress symptoms, assessed by questionnaires were assigned to a psychiatric interview. In this interview 98 participants were diagnosed with depression and subsequently excluded. Two years later in 2009, 2920 participants who had provided at least one valid saliva cortisol measurement at baseline participated at follow up. The psychiatric interviews were repeated and 62 cases of newly onset depression were diagnosed. Odds ratios of depression were estimated for every 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration, as well as for the difference between morning and evening cortisol concentration. The risk of depression decreased by increasing daily mean cortisol concentration and by increasing difference between morning and evening concentrations, while morning and evening cortisol concentrations were not significantly associated with depression. The adjusted odds ratios for 1.0nmol/l increase in morning, evening, and daily mean cortisol concentration were 0.69 (95% CI: 0.45, 1.05), 0.87 (95% CI: 0.59, 1.28), and 0.53 (95% CI: 0.32, 0.90), respectively. The adjusted odds ratio for 1.0nmol/l increase in difference between morning and evening concentration were 0.64 (95% CI: 0.45, 0.90). This study did not support the hypothesis that high salivary cortisol concentration is a risk factor of depression, but indicate that low mean salivary cortisol concentration and a small difference between morning and evening cortisol concentration may be risk factors of depression.
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http://dx.doi.org/10.1016/j.psyneuen.2013.03.013DOI Listing
October 2013

Work-unit measures of organisational justice and risk of depression--a 2-year cohort study.

Occup Environ Med 2013 Jun 8;70(6):380-5. Epub 2013 Mar 8.

Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark.

Objectives: The aim of this study is to analyse if low justice at work, analysed as aggregated workplace means, increases the risk of depression.

Methods: A total of 4237 non-depressed Danish public employees within 378 different work units were enrolled in 2007. Mean levels of procedural and relational justice were computed for each work unit to obtain exposure measures that were robust to reporting bias related to depression. Two years later in 2009, 3047 (72%) participated at follow-up. Those reporting high levels of depressive, burn-out or stress symptoms were assigned to a psychiatric diagnostic interview. In the interview 58 cases of new onset depression were identified. Depression ORs by work unit level of procedural and relational justice were estimated by multivariable logistic regression accounting for established risk factors for depression.

Results: Working in a work unit with low procedural justice (adjusted ORs of 2.50, 95% CI 1.06 to 5.88) and low relational justice (3.14, 95% CI 1.37 to 7.19) predicted onset of depression.

Conclusions: Our results indicate that a work environment characterised by low levels of justice is a risk factor for depression.
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http://dx.doi.org/10.1136/oemed-2012-101000DOI Listing
June 2013

A two-year follow-up study of risk of depression according to work-unit measures of psychological demands and decision latitude.

Scand J Work Environ Health 2012 Nov 10;38(6):527-36. Epub 2012 Aug 10.

Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade 44 byg. 2C, 8000 Aarhus, Denmark.

Objectives: The aim of this study was to examine if high psychological demands and low decision latitude at work increase the risk of depression.

Methods: In 2007, 4237 non-depressed Danish public employees within 378 different work units were enrolled in the study. Mean levels of psychological demands and decision latitude were computed for each work unit to obtain exposure measures that were robust to reporting bias. In 2009, 3046 (72%) participated at follow-up, and those reporting high levels of depressive, burnout or stress symptoms went through a psychiatric interview by which 58 cases of new onset depression were diagnosed. Odds ratios (OR) of depression for different levels of work unit mean psychological demands and decision latitude were estimated by logistic regression taking established risk factors into account.

Results: The OR for depression according to psychological demands was 1.07 [95% confidence interval (95% CI) 0.42-2.49] for every unit of change on a 5-point scale. The corresponding OR for decision latitude was 1.85 (95% CI 0.55-6.26). No interactive effects of psychological demands and decision latitude were observed.

Conclusion: These findings suggest that low decision latitude may predict depression, but confidence intervals are wide and findings are also compatible with no increased risk.
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http://dx.doi.org/10.5271/sjweh.3316DOI Listing
November 2012

Salivary cortisol and sleep problems among civil servants.

Psychoneuroendocrinology 2012 Jul 29;37(7):1086-95. Epub 2011 Dec 29.

The National Research Centre for Working Environment, Copenhagen, Denmark.

Objective: The present study used information from a field study conducted among 4489 civil servants (70% women) in Denmark in 2007. The purpose was to examine the association between sleep problems and salivary cortisol by using a cross-sectional design with repeated measures in a subsample three-month later.

Methods: Sleep problems during the past night and the past 4 weeks were assessed by a self-administered questionnaire on overall sleep quality, disturbed sleep, sleep length and awakening problems. Saliva samples were collected in a single day, using cotton tubes, 30 min after awakening and again at 2000 h. A subsample of 387 participants collected saliva samples three-month later at awakening, +20 min and +40 min after awakening and at 2000 h. We adjusted for confounders related to sampling time, life style and personal characteristics, socioeconomic status and work aspects.

Results: Sleep problems during the past four weeks were associated with low morning and evening saliva cortisol concentrations: [-3.1% per score of disturbed sleep (p=.009); and -4.7% per score of awakening problems (p<.001)]. Whereas sleep problems were not related with slope (the morning to evening change in cortisol levels). Awakening problems predicted lower cortisol (-7.51% per score; p=.003) three-month later. Cortisol awakening response (CAR) and slope three-month later were significantly associated with disturbed sleep (-7.84% and -8.24%) and awakening problems (-6.93). Area under the curve (AUC(morning)) increased with disturbed sleep (3.77%).

Conclusion: Surprisingly, low morning cortisol was associated with increased sleep problems during a four-week period prior to sampling among 4066 Danish civil servants. At follow-up three-month later, those with sleep problems had a flattened cortisol profile. Those with awakening problems also had low salivary cortisol in general.
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http://dx.doi.org/10.1016/j.psyneuen.2011.12.005DOI Listing
July 2012

Effects of psychosocial work factors on lifestyle changes: a cohort study.

J Occup Environ Med 2011 Dec;53(12):1364-71

Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark.

Objective: To evaluate the effect of the demand-control-support model, the effort-reward imbalance model, and emotional demands on smoking, alcohol consumption, physical activity, and body mass index.

Methods: This is a 2-year prospective cohort study of 3224 public sector employees. Measures were assessed with questionnaires. Multiple regression analyses were used to predict changes in lifestyle factors.

Results: Low reward predicted smoking, low-decision latitude predicted being inactive, and high demands predicted high-alcohol consumption but only for men at follow-up even after controlling for potential confounders. There were no other significant findings in the expected direction except for some of the confounders.

Conclusions: We found only limited and inconsistent support for the hypothesis that a poor psychosocial work environment is associated with an adverse lifestyle.
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http://dx.doi.org/10.1097/JOM.0b013e3182363bdaDOI Listing
December 2011

Are risk estimates biased in follow-up studies of psychosocial factors with low base-line participation?

BMC Public Health 2011 Jul 8;11:539. Epub 2011 Jul 8.

Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital and Regional Hospital Herning, Aarhus C, Denmark.

Background: Low participation in population-based follow-up studies addressing psychosocial risk factors may cause biased estimation of health risk but the issue has seldom been examined. We compared risk estimates for selected health outcomes among respondents and the entire source population.

Methods: In a Danish cohort study of associations between psychosocial characteristics of the work environment and mental health, the source population of public service workers comprised 10,036 employees in 502 work units of which 4,489 participated (participation rate 45%). Data on the psychosocial work environment were obtained for each work unit by calculating the average of the employee self-reports. The average values were assigned all employees and non-respondent at the work unit. Outcome data on sick leave and prescription of antidepressant medication during the follow-up period (1.4.2007-31.12.2008) was obtained by linkage to national registries.

Results: Respondents differed at baseline from non-respondents by gender, age, employment status, sick leave and hospitalization for affective disorders. However, risk estimates for sick leave and prescription of antidepressant medication, during follow-up, based on the subset of participants, did only differ marginally from risk estimates based upon the entire population.

Conclusions: We found no indications that low participation at baseline distorts the estimates of associations between the work unit level of psychosocial work environment and mental health outcomes during follow-up. These results may not be valid for other exposures or outcomes.
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http://dx.doi.org/10.1186/1471-2458-11-539DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146871PMC
July 2011

Does outdoor work during the winter season protect against depression and mood difficulties?

Scand J Work Environ Health 2011 Sep 1;37(5):446-9. Epub 2011 Mar 1.

Danish Ramazzini Centre, Department of Occupational Medicine, Århus University Hospital, Århus, Denmark.

Objective: At temperate latitudes, 1-5% of the population suffer from winter depression; during winter, mood difficulties tend to increase but may be alleviated by bright light therapy. Unlike indoor workers, outdoor workers are exposed to therapeutic levels of sunlight during winter. We hypothesized that outdoor work may protect against mood difficulties and depression.

Method: We studied this hypothesis among 2910 civil servants from Århus, Denmark, who participated in a survey in January-February 2009. Mental symptoms (N=422) defined a common case category that we broke down into two parts: depression (N=66) and mood difficulties but no depression (N=356). A total of 222 controls were also sampled from the study population. All 644 participants reported the extent of outdoor work.

Results: The confounder-adjusted odds ratio (OR) of mood difficulties showed a decreasing trend by increasing hours of outdoor work of borderline statistical significance. The OR was 0.63 [95% confidence interval (95% CI) 0.34-1.18)] for those working outdoors for >2 hours a day. No such effect was suggested for depression.

Conclusion: Our study is limited by its cross-sectional design and low statistical power but nevertheless suggests that outdoor work during winter may protect against mood difficulties. If this finding holds true it may have significant impact on workers' health as well as public health in general. Therefore, further studies are recommended.
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http://dx.doi.org/10.5271/sjweh.3155DOI Listing
September 2011

Job strain and the risk of depression: is reporting biased?

Am J Epidemiol 2011 Jan 11;173(1):94-102. Epub 2010 Nov 11.

Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Arhus, Denmark.

It is unknown whether the relation between job strain and depression reflects causal characteristics of the working environment or reporting bias. The authors investigated reporting bias by analyzing individual versus work-unit measures of job strain and the risk of depressive symptoms (n = 287) and a diagnosis of depression (n = 97) among 4,291 employees within 378 work units in Aarhus, Denmark, 2007. All participants reported psychological demands and decision latitude, and the authors estimated mean values for each work unit. The odds ratios predicting depressive symptoms or a diagnosis of depression for the highest versus the lowest levels of individual, self-reported high psychological demands and low decision latitude were significantly increased above 2.5. When participants were classified by the work-unit mean levels, these associations were substantially smaller. For depressive symptoms, the odds ratios were 1.49 (95% confidence interval (CI): 0.88, 2.53) and 1.08 (95% CI: 0.84, 1.39), respectively, for psychological demands and decision latitude. For a diagnosis of depression, the odds ratios were 1.33 (95% CI: 0.57, 3.09) and 1.02 (95% CI: 0.68, 1.56), respectively, for psychological demands and decision latitude. These findings indicate that reporting bias inflates associations between job strain and the occurrence of depression, if studies rely on individual self-reports.
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http://dx.doi.org/10.1093/aje/kwq318DOI Listing
January 2011

[Late sequelae following electrical accidents].

Authors:
Anette Kaergaard

Ugeskr Laeger 2009 Mar;171(12):993-7

Arbejdsmedicinsk Klinik, Regionshospitalet Herning, DK-7400 Herning.

A literature review of non-acute pain, neurological and psycho-neurological impairments in relation to electrical accidents is performed. Pain in extremities is frequent. Neurological and psycho-neurological symptoms can arise days or months after an electrical accident. The causal mechanisms are not known. The best known non-organic effect is post-traumatic stress disorder. The existing knowledge of long-term consequences of electrical accidents is generally based on cases and patient summaries. There is serious lack of longitudinal studies describing delayed or progressive non-acute symptoms.
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March 2009

[Health examinations in connection with night work].

Ugeskr Laeger 2007 May;169(21):2005-7

Arhus Universitetshospital, Arbejdsmedicinsk Klinik.

Some 10% of the labour force work during night hours. According to an EU directive night workers should be offered preventive health examinations. It is well known that night work is related to sleep disorders but the epidemiologic evidence linking night work with increased occurrence of peptic ulcers, breast cancer, cardiovascular disease and spontaneous abortions is still limited and provides no strong rationale for preventive health examinations. This article argues that individual health examinations should be integrated into primary preventive activities at the workplace.
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May 2007

Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work.

Spine (Phila Pa 1976) 2002 Mar;27(6):660-7

Department of Occupational Medicine, Herning Hospital, Herning, Denmark.

Study Design: Cross-sectional study.

Objectives: To evaluate the effect of individual characteristics and physical and psychosocial workplace factors on neck/shoulder pain with pressure tenderness in the muscles.

Summary Of Background Data: Controversy prevails about the importance of workplace factors versus individual factors in the etiology of pain in the neck and/or shoulders.

Methods: Study participants were 3123 workers from 19 plants. Physical risk factors were evaluated via video observations, and psychosocial risk factors were assessed with the job content questionnaire. Other procedures included symptom survey, clinical examination, and assessment of health-related quality of life (SF-36). The main outcome variable, neck/shoulder pain with pressure tenderness, was defined on the basis of subjective pain score and pressure tenderness in muscles of the neck/shoulder region.

Results: The prevalence of neck/shoulder pain with pressure tenderness was 7.0% among participants performing repetitive work and 3.8% among the referents. We found an association with high repetitiveness (prevalence ratio 1.8, 95% confidence interval 1.1-2.9), high force (2.0, 1.2-3.3), and high repetitiveness and high force (2.3, 1.4-4.0). The strongest work-related psychosocial risk was high job demands (1.8, 1.2-2.7). Increased risk was also associated with neck/shoulder injury (2.6, 1.6-4.1), female gender (1.8, 1.2-2.8), and low pressure pain threshold (1.6, 1.1-2.3). Neck/shoulder pain was strongly associated with reduced health-related quality of life.

Conclusions: Work-related physical and psychosocial factors, as well as several individual risk factors, are important in the understanding of neck/shoulder pain. The findings suggest that neck/shoulder pain has a multifactorial nature. Reduced health-related quality of life is associated with subjective pain and clinical signs from the neck and shoulders. The physical workplace factors were highly intercorrelated, and so the effect of individual physical exposures could only be disentangled to a minor degree.
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http://dx.doi.org/10.1097/00007632-200203150-00017DOI Listing
March 2002

Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work.

Am J Ind Med 2002 Jan;41(1):11-8

Department of Occupational Medicine, Aarhus University Hospital, Denmark.

Background: Few studies relate the occurrence of shoulder disorders to quantified ergonomic exposures. This study evaluates the hypothesis that shoulder loads in repetitive work might contribute to the occurrence of shoulder tendinitis.

Methods: This is a cross-sectional study of 1961 workers in repetitive work and 782 referents. Shoulder loads were quantified at task level and measures of exposures were assigned based on task distribution. Symptoms in combination with clinical criteria defined shoulder tendinitis.

Results: The prevalence of shoulder tendinitis was higher among exposed workers (adjusted OR 3.1, 95% CI 1.3-3). Neither frequency of movements (ranging 1-36/min) nor lack of micro-pauses in shoulder flexion (ranging 0-100% of cyclus time) was related to disease prevalence. Increasing force requirements (categorized as light = 1, somewhat hard = 2, hard = 3 or very hard = 4) increased risk slightly (OR 1.6, 95% CI 1.0-2.6 per unit).

Conclusions: The results indicate that workers with repetitive tasks have increased risk of shoulder tendinitis, which partially can be attributed to force requirements.
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http://dx.doi.org/10.1002/ajim.10019DOI Listing
January 2002

Identification of neck-shoulder disorders in a 1 year follow-up study. Validation Of a questionnaire-based method.

Pain 2000 Jun;86(3):305-310

Department of Occupational Health, Herning Hospital, DK-7400 Herning, Denmark Department of Occupational Medicine, Copenhagen County Hospital, DK-2600 Glostrup, Denmark.

A cohort of 243 female sewing machine operators were studied by questionnaire and clinical examinations with the purpose to study the efficiency of a screening questionnaire-based method to identify prevalent and incident cases of neck-shoulder disorders. The cross-sectional correlation between self-reported neck-shoulder complaints scores and clinical signs of a neck-shoulder disorder was high. An assessed cut-of point of complaints could identify 90% of all cases fulfilling the criteria of rotator cuff tendinitis, while the complaint score with regard to clinical signs of myofascial pain syndrome was about 67%. In the follow-up analyses, incident clinical signs of disorders at 1 year follow-up were used as 'golden standard' in the validation of screening criteria, which included a defined increase of symptoms. Apparently increase of symptoms did not seem to be the optimal criteria for identification of incident cases. Alternatively a cut-of point of regional complaints in close relation to clinical examinations is recommended.
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http://dx.doi.org/10.1016/S0304-3959(00)00261-XDOI Listing
June 2000