A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background, design and conceptual model of FINALE The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: results from a cluster randomized controlled trial. Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study A Participatory Return-to-Work Intervention for Temporary Agency Workers and Unemployed Workers Sick-Listed Due to Musculoskeletal Disorders: Results of a Randomized Controlled Trial The implementation of occupational health guidelines principles for reducing sickness absence due to musculoskeletal disorders. Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial. Job task and psychosocial risk factors for work-related musculoskeletal disorders among newspaper employees. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Association between clinical and work-related interventions and return-to-work for patients with musculoskeletal or mental disorders. A field study of supplementary rest breaks for data-entry operators Work-schedule characteristics and reported musculoskeletal disorders of registered nurses. A prospective study of psychosocial risk factors and absence due to musculoskeletal disorders--implications for occupational screening. Ergonomic Training Reduces Musculoskeletal Disorders among Office Workers: Results from the 6-Month Follow-Up. Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol Return to Work Expectations of Workers on Long-Term Non-Work-Related Sick Leave Effectiveness of early part-time sick leave in musculoskeletal disorders Coordinated and Tailored Work Rehabilitation: A Randomized Controlled Trial with Economic Evaluation Undertaken with Workers on Sick Leave Due to Musculoskeletal Disorders Effects of intensified work-related multidisciplinary rehabilitation on occupational participation: a randomized-controlled trial in patients with chronic musculoskeletal disorders Prevalence of back pain and characteristics of the physical workload of community nurses. High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: results of a prospective cohort study [An epidemiological study on the relationship between musculoskeletal disorders and work load]. Does an Exercise Intervention Improving Aerobic Capacity Among Construction Workers Also Improve Musculoskeletal Pain, Work Ability, Productivity, Perceived Physical Exertion, and Sick Leave?: A Randomized Controlled Trial
Objectives : To examine the efficacy of a participatory ergonomics intervention in preventing musculoskeletal disorders among kitchen workers .  Participatory ergonomics is commonly recommended to reduce musculoskeletal disorders , but evidence for its effectiveness is sparse . Methods : A cluster r and omised controlled trial among the 504 workers of 119 kitchens in Finl and was conducted during 2002–2005 . Kitchens were r and omised to an intervention ( n = 59 ) and control ( n = 60 ) group . The duration of the intervention that guided the workers to identify strenuous work tasks and to seek solutions for decreasing physical and mental workload , was 11 to 14 months . In total , 402 ergonomic changes were implemented . The main outcome measures were the occurrence of and trouble caused by musculoskeletal pain in seven anatomical sites , local fatigue after work , and sick leave due to musculoskeletal disorders . Individual level data were collected by a question naire at baseline and every 3 months during the intervention and 1-year follow-up period . All response rates exceeded 92 % . Results : No systematic differences in any outcome variable were found between the intervention and control groups during the intervention or during the 1-year follow-up . Conclusions : The intervention did not reduce perceived physical work load and no evidence was found for the efficacy of the intervention in preventing musculoskeletal disorders among kitchen workers . It may be that a more comprehensive re design of work organisation and processes is needed , taking more account of workers ’ physical and mental re sources Background A mismatch between individual physical capacities and physical work dem and s enhance the risk for musculoskeletal disorders , poor work ability and sickness absence , termed physical deterioration . However , effective intervention strategies for preventing physical deterioration in job groups with high physical dem and s remains to be established . This paper describes the background , design and conceptual model of the FINALE programme , a framework for health promoting interventions at 4 Danish job groups ( i.e. cleaners , health-care workers , construction workers and industrial workers ) characterized by high physical work dem and s , musculoskeletal disorders , poor work ability and sickness absence . Methods / Design A novel approach of the FINALE programme is that the interventions , i.e. 3 r and omized controlled trials ( RCT ) and 1 exploratory case-control study are tailored to the physical work dem and s , physical capacities and health profile of workers in each job-group . The RCT among cleaners , characterized by repetitive work tasks and musculoskeletal disorders , aims at making the cleaners less susceptible to musculoskeletal disorders by physical coordination training or cognitive behavioral theory based training ( CBTr ) . Because health-care workers are reported to have high prevalence of overweight and heavy lifts , the aim of the RCT is long-term weight-loss by combined physical exercise training , CBTr and diet . Construction work , characterized by heavy lifting , pushing and pulling , the RCT aims at improving physical capacity and promoting musculoskeletal and cardiovascular health . At the industrial work-place characterized by repetitive work tasks , the intervention aims at reducing physical exertion and musculoskeletal disorders by combined physical exercise training , CBTr and participatory ergonomics . The overall aim of the FINALE programme is to improve the safety margin between individual re sources ( i.e. physical capacities , and cognitive and behavioral skills ) and physical work dem and s , and thereby reduce the physical deterioration in a long term perspective by interventions tailored for each respective job-group . Discussion The FINALE programme has the potential to provide evidence -based knowledge of significant importance for public health policy and health promotion strategies for employees at high risk for physical deterioration . Trial registration sIS RCT N96241850 , NCT01015716 and OBJECTIVE This study aim ed to investigate the effectiveness of a prevention program on work ability , health , and sick leave targeted at construction worksites . METHODS A total of 15 departments ( N = 297 workers ) from 6 construction companies participated in this cluster r and omized controlled trial and were r and omly allocated to the intervention ( 8 departments ; N = 171 workers ) or control ( 7 departments ; N = 122 workers ) group . The intervention consisted of two individual training sessions with a physical therapist aim ed at lowering the physical workload , a rest-break tool to improve the balance between work and recovery , and two empowerment training sessions to increase the worker 's influence at the worksite . Data on work ability , physical and mental health status , and musculoskeletal symptoms were collected at baseline , and at 3 , 6 , and 12 months follow-up . Sick leave data were obtained from the companies . RESULTS Overall , no differences in work ability [ β 0.02 , 95 % confidence interval ( 95 % CI ) -0.34 - 0.37 ] or physical and mental health status ( β -0.04 , 95 % CI -1.43 - 1.35 , and β 0.80 95 % CI -0.51 - 2.11 , respectively ) were found between the intervention and control group . The intervention showed an overall decline in musculoskeletal symptoms ( ranging from OR 0.68 , 95 % CI 0.34 - 1.33 , to OR 0.86 , 95 % CI 0.47 - 1.57 ) and long-term sick leave ( OR 0.44 , 95 % CI 0.13 - 1.26 ) among construction workers . Both reductions were not statistically significant . CONCLUSION The prevention program seemed to result in a beneficial but not statistically significant decline in the prevalence of musculoskeletal symptoms and long-term sick leave among construction workers , but showed no effects with regard to work ability , physical health , and mental health Background Despite considerable knowledge about musculoskeletal disorders ( MSD ) and physical , psychosocial and individual risk factors there is limited knowledge about physical activity as a factor in preventing MSD . In addition , studies of physical activity are often limited to either leisure activity or physical activity at work . Studies among military personnel on the association between physical activity at work and at leisure and MSD are lacking . This study was conducted to find the prevalence of MSD among personnel in the Royal Norwegian Navy and to assess the association between physical activity at work and at leisure and MSD . Methods A question naire about musculoskeletal disorders , physical activity and background data ( employment status , age , gender , body mass index , smoking , education and physical stressors ) was completed by 2265 workers ( 58 % ) 18 to 70 years old in the Royal Norwegian Navy .  Multiple logistic regression with 95 % confidence intervals was used to assess the relationship between physical activity and musculoskeletal disorders . Results A total of 32 % of the workers reported musculoskeletal disorders often or very often in one or more parts of the body in the past year . The most common musculoskeletal disorders were in the lower back ( 15 % often or very often ) , shoulders ( 12 % often or very often ) and neck ( 11 % often or very often ) . After adjustment for confounders , physical activity was inversely associated with musculoskeletal disorders for all body sites except elbows , knees and feet . Conclusion The one-year prevalence of musculoskeletal disorders among workers in the Royal Norwegian Navy was rather low . A physically active lifestyle both at work and at leisure was associated with fewer musculoskeletal disorders  among personnel in the Royal Norwegian Navy . Prospect i ve studies are necessary to confirm the cause and effect in this association Introduction Within the labour force workers without an employment contract represent a vulnerable group . In most cases , when sick-listed , these workers have no workplace/employer to return to . Therefore , the aim of this study was to evaluate the effectiveness on return-to-work of a participatory return-to-work program compared to usual care for unemployed workers and temporary agency workers , sick-listed due to musculoskeletal disorders . Methods The workers , sick-listed for 2–8 weeks due to musculoskeletal disorders , were r and omly allocated to the participatory return-to-work program ( n = 79 ) or to usual care ( n = 84 ) . The new program is a stepwise procedure aim ed at making a consensus-based return-to-work plan , with the possibility of a temporary ( therapeutic ) workplace . Outcomes were measured at baseline , 3 , 6 , 9 and 12 months . The primary outcome measure was time to sustainable first return-to-work . Secondary outcome measures were duration of sickness benefit , functional status , pain intensity , and perceived health . Results The median duration until sustainable first return-to-work was 161 days in the intervention group , compared to 299 days in the usual care group . The new return-to-work program result ed in a non-significant delay in RTW during the first 90 days , followed by a significant advantage in RTW rate after 90 days ( hazard ratio of 2.24 [ 95 % confidence interval 1.28–3.94 ] P = 0.005 ) . No significant differences were found for the measured secondary outcomes . Conclusions The newly developed participatory return-to-work program seems to be a promising intervention to facilitate work resumption and reduce work disability among temporary agency workers and unemployed workers , sick-listed due to musculoskeletal disorders BACKGROUND Occupational health guidelines recommend a biopsychosocial approach to manage  sickness absence due to musculoskeletal disorders ( MSDs ) , with a primary focus on early intervention through provision of a supportive network . AIMS To investigate the implementation of a guidelines -based intervention ( early contact of absentees ; addressing psychosocial obstacles ; offering temporary modified work ; communicating among the players ) , and to determine whether this is effective for reducing return-to-work times and duration of future absence . METHODS A non-r and omized controlled trial was conducted within a UK company . Occupational health nurses at two experimental sites ( 1,435 workers ) were trained to deliver the intervention to workers taking absence due to MSDs ( low back and upper limb disorders ) , while usual care was delivered at three control sites ( 1,483 workers ) .  Company-recorded absence data were collected over a 12-month follow-up period . RESULTS The implementation of the experimental intervention was impeded by unforeseen organizational obstacles at one site ( policies , procedures and individual approaches ) which had a detrimental effect on uptake and delivery . At the site where the intervention was delivered per protocol , absence was significantly less compared with controls ; 6.5 and 10.8 days , respectively . However , the duration of future absence was not significantly different ( 13.0 and 25.1 days , respectively ) . CONCLUSIONS An early intervention addressing psychosocial obstacles to recovery can be effective for reducing absence due to MSDs . Successful implementation , where the key players are onside and organizational obstacles are overcome , is difficult to achieve OBJECTIVES The purpose of this study was to assess the effects of early part-time sick leave on return to work ( RTW ) and sickness absence among patients with musculoskeletal disorders . METHODS A r and omized controlled trial was conducted in six occupational health units of medium- and large-size enterprises . Patients aged 18 - 60 years with musculoskeletal disorders ( N=63 ) unable to perform their regular work were r and omly allocated to part- or full-time sick leave . In the former group , workload was reduced by restricting work time by about a half . Remaining work tasks were modified when necessary , as specified in a " fit note " from the physician . The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up . RESULTS Time to RTW sustained for ≥4 weeks was shorter in the intervention group ( median 12 versus 20 days , P=0.10 ) . Hazard ratio of RTW adjusted for age was 1.60 [ 95 % confidence interval ( 95 % CI ) 0.98 - 2.63 ] and 1.76 ( 95 % CI 1.21 - 2.56 ) after further adjustment for pain interference with sleep and previous sickness absence at baseline . Total sickness absence during the 12-month follow-up was about 20 % lower in the intervention than the control group . Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons . CONCLUSIONS Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders . This is the first study to show that work participation can be safely increased with early part-time sick leave OBJECTIVES A cross-sectional study was conducted to assess the association of upper extremity musculoskeletal disorders and work-related factors among employees using video display terminals at a large metropolitan newspaper . METHODS The study included 1050 r and omly selected workers from four departments . The workers were asked to complete question naires on symptoms , job tasks , and psychosocial and work organization conditions . Musculoskeletal disorders of the upper extremities were defined by frequency , duration , and intensity of symptoms not attributable to acute injury . Data were analyzed with the use of logistic regression . RESULTS A total of 973 workers completed the survey . The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 % . Neck symptoms ( 26 % ) were the most frequently reported , followed by h and or wrist ( 22 % ) , shoulder ( 17 % ) , and elbow ( 10 % ) symptoms . Greater time working at the video display station was associated with increased h and or wrist symptoms in a dose-response relationship . In addition , variables corresponding to increased work-load dem and s ( eg , increased time working under deadline and increased job pressure ) were associated with increased neck , shoulder , and h and or wrist disorders . Women were more likely to report symptoms in several areas , but this finding may reflect the concentration of women in jobs involving more risk factors . CONCLUSIONS The results suggest a high prevalence of musculoskeletal disorders of the upper extremities among newspaper employees , and they provide additional evidence that increased work load , time pressure , and greater hours of computer use are related to the occurrence of work-related musculoskeletal disorders among these workers , particularly for disorders in the h and or wrist area OBJECTIVE Since 2002 , an epidemiologic surveillance system of work-related , upper-limb musculoskeletal disorders ( MSDs ) has been implemented in France 's Pays de la Loire region to assess the prevalence of MSDs and their risk factors in the working population . METHODS The surveillance was based on a network of occupational physicians ( OPs ) and used the recommendations of a group of European experts ( criteria document consensus ) . In 2002 - 2003 , 80 of 400 OPs volunteered to participate . All underwent a training program to st and ardize the physical examination .  Health status was assessed by self-administered question naire and physical examination . Occupational risk factors were assessed by self-administered question naire .  Exposure scores were computed for each anatomic zone by summing the risk factors taken into account by the criteria document . RESULTS More than 50 % of the 2,685 men and women r and omly included in 2002 - 2003 experienced nonspecific musculoskeletal symptoms during the preceeding 12 months and approximately 30 % experienced them in the preceeding week . The prevalence of clinical ly diagnosed MSDs was high : approximately 13 % of workers experienced at least 1 of the MSDs . The most frequent disorder was rotator cuff syndrome followed by carpal tunnel syndrome and lateral epicondylitis . The prevalence of MSDs increased with age and varied widely across economic sectors and occupations . More than half of the workers were exposed to at least 2 risk factors of MSDs . Exposure varied according to industrial activity and occupation . According to the criteria document , a high percentage of MSD cases could be classified as probably work related ( 95 % in men and 89 % in women age < 50 , and 87 % in men and 69 % in women age > 50 ) . CONCLUSION Nonspecific upper-limb symptoms and specific upper-limb MSDs are common in the working population . These results show the need to implement prevention programs in most sectors to reduce the prevalence of MSDs OBJECTIVE The aim of this study was to explore what characterizes patients receiving clinical interventions vs combined clinical and work-related interventions in a cohort of sick-listed subjects with musculoskeletal or mental disorders . Factors associated with return-to-work were also analysed . DESIGN A prospect i ve cohort study . METHODS A total of 699 newly sick-listed patients responded to a question naire on sociodemographics , measures of health , functioning , work ability , self-efficacy , social support , work conditions , and expectations . The 3-month follow-up question naire included patients ' self-reported measures of return-to-work , work ability and type of interventions .  The most frequent International Classification of Diseases-10 diagnoses for patients ' musculoskeletal disorders were dorsopathies ( M50 - 54 ) and soft tissue disorders ( M70 - 79 ) , and for patients with mental disorders , depression ( F32 - 39 ) and stress reactions ( F43 ) . RESULTS Patients with mental disorders who received combined interventions  returned to work to a higher degree than those who received only clinical intervention . The prevalence of work-related interventions  was higher for those who were younger and more highly educated . For patients with musculoskeletal disorders better health , work ability and positive expectations of return-to-work were associated with return-to-work . However , combined interventions did not affect return-to-work in this group . CONCLUSION Receiving combined interventions increased the probability of return-to-work for patients with mental disorders , but not for patients with musculoskeletal disorders . Better health , positive expectations of return-to-work and better work ability were associated with return-to-work for patients with musculoskeletal disorders This study examined the effects of supplementary rest breaks on musculoskeletal discomfort , eyestrain , mood , and performance in data -entry workers . Two rest break schedules were compared in a within-subjects design . Workers alternated between a ‘ conventional ’ and a ‘ supplementary ’ schedule in 4-week intervals . The conventional schedule contained a 15-min break during the first half of the work shift and a 15-min break during the second half of the shift . The supplementary schedule contained the same two 15-min breaks , and a 5-min break during each hour which otherwise did not contain a break , for a total of 20 extra minutes of break time . Results are based on data from 42 workers . They indicated that discomfort in several areas of the body , and eyestrain , were significantly lower under the supplementary than under the conventional schedule . While symptoms increased from pre- to post-work periods under both schedules , the magnitude of the increases was significantly less under the supplementary schedule . In addition , increases in discomfort of the right forearm , wrist and h and over the course of the work week under the conventional schedule were eliminated under the supplementary schedule . These beneficial effects were obtained without reductions in data -entry performance OBJECTIVES The relationship between a combination of dem and ing work-schedule characteristics and reported  musculoskeletal disorders of the neck , shoulders , and back was examined . METHODS A probability sample of 1163 nurses , r and omly selected from the list of actively licensed nurses in two states of the United States , served as the sample for this cross-sectional study . Data were collected via an anonymous survey mailed to the participants ' homes from October 1999 through February 2000 . RESULTS Four of the nine work-schedule characteristics ( working full-time , > 8 hours/day , 2 - 4 weekends/month , and other than day shift ) were significantly related to musculoskeletal disorders in one or more body sites . When a work-schedule index was created by summing the nine characteristics , a dem and ing schedule was significantly associated with musculoskeletal disorders in the neck [ odds ratio ( OR ) 1.10 , 95 % confidence interval ( 95 % CI ) 1.00 - 1.21 ] , shoulder ( OR 1.12 , 95 % CI 1.01 - 1.23 ) , and back ( OR 1.16 , 95 % CI 1.06 - 1.27 ) . Adjustment for psychological and physical job dem and s reduced the odds ratios slightly and therefore suggested that some of the association between musculoskeletal disorders and schedule was due to increased exposure to these job dem and s. Working " long hours " ( > 12 hours/day , > 40 hours/week ) and " off hours " ( weekends and " other than day shifts " ) were associated with a 50 - 170 % increase in the age-adjusted odds ratio for musculoskeletal disorders in the three body sites . CONCLUSIONS The findings of this study suggest that preventing musculoskeletal disorders requires system-level approaches to scheduling that reduce the time of exposure to dem and ing work conditions and promote healthful work-rest patterns OBJECTIVES There is considerable evidence documenting the association between psychosocial risk factors and  work disability due to musculoskeletal disorders , and this has prompted suggestions that psychosocial screening should be administered in the workplace in order to identify individuals at risk of prolonged absence . However , the predictive value of psychosocial risk factors on return-to-work is largely unknown . The present study aim ed to explore the predictive relationship between psychosocial risk factors and absence due to musculoskeletal disorders of the lower back and upper limbs . METHODS A prospect i ve study of 4637 workers from a large , multi-site company in the UK was conducted in which a wide range of established question naires were used to collect baseline psychosocial data . Respondents were then followed over the ensuing 15 months , and absence due to musculoskeletal disorders was recorded . RESULTS 219 workers took absence due to musculoskeletal disorders . Detrimental cut-off scores ( risks ) on the psychosocial instruments were established , and it was found that work-related psychosocial risk factors predicted the likelihood of a future spell of absence ( odds ratios ranging between 1.6 and 3.2 ) , but not the duration of that absence . CONCLUSIONS Although work-related psychosocial factors were associated with the occurrence of absence due to musculoskeletal disorders , these findings do not lend support to the use of routine occupational psychosocial screening in order to predict prolonged absence BACKGROUND Musculoskeletal disorders are commonly reported among computer users . This study explored whether these disorders can be reduced by the provision of ergonomics education . METHODS A cluster r and omised controlled trial was conducted in which 3 units were r and omised for intervention and received training , and 3  units  were given a leaflet . The effect of intervention on workstation habits , musculoskeletal disorders , days and episodes of sick leave , and psychological well-being were assessed . RESULTS A significant improvement in workstation habits was found , and the differences remained significant at the follow-up time point for keyboard , mouse , chair , and desk use . The largest reduction in the percentage of musculoskeletal disorders was in the neck region ( -42.2 % , 95 % CI -60.0 to -24.4 ) . After adjusting for baseline values , significant differences were found at the follow-up time point in the neck , right shoulder , right and left upper limbs , lower back , and right and left lower limbs . No significant differences were found for the days and episodes of sick leave or the psychological well-being among workers after the intervention . CONCLUSION Consistent reductions were observed for all musculoskeletal disorders at the follow-up time point , although the difference was not statistically significant for the upper back . The improvements in the musculoskeletal disorders did not translate into fewer days lost from work or improved psychological well-being Background Musculoskeletal disorders ( MSDs ) are the leading cause of work disability and sickness absence worldwide . The prevalence of MSDs increases with age , consequently challenging sustainable employability among the growing ageing workforce . Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted . This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks , respectively . Methods We will search the following bibliographic data bases : PubMed ( including the data base ‘ MEDLINE ’ ) and Web of Science Core Collection ( including the data bases ‘ Science Citation Index Exp and ed ’ , ‘ Social Sciences Citation Index ’ and ‘ Arts & Humanities Citation Index ’ ) . Manual search es will also be performed . We will include r and omised controlled trials ( RCTs ) and non- RCTs reported in English in which ( 1 ) participants are adult workers with MSD , ( 2 ) interventions are aim ing at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and ( 3 ) interventions are initiated and /or carried out at the workplace . The review will adhere to the ‘ Preferred Reporting Items for Systematic review s and Meta-Analyses ’ ( PRISMA ) guidelines for reporting systematic review s and the Institute for Work and Health ( IWH ) guidelines for workplace-based interventions . For the primary evaluation of the review , the quality assessment and evidence synthesis will conform to the IWH guidelines . Secondary evaluation will include a meta- analysis ( unless the included studies do not allow this due to heterogeneity ) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations , Assessment , Development and Evaluations ( GRADE ) approach on the studies with pain intensity as an outcome . Discussion This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD . RCTs are considered the most powerful experimental design in clinical trials , but solely including these may be too restrictive to underst and effective workplace-based interventions where r and omised and carefully controlled trials ( RCTs ) are not always possible . In order to maximize practical relevance , the selection process will , therefore , include both RCTs and non- RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders . The result of this work will form the basis for industry-specific evidence -based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces . Systematic review registration International Prospect i ve Register of Systematic Review s ( PROSPERO ) number CRD42018116752 Introduction Despite suggestions that worker perception might be the best predictor of return to work ( RTW ) , there still is limited research on time to RTW in workers with lengthy non-work-related sick leave . Methods Prospect i ve cohort study of 663 workers with a current long-term non-work-related sick leave episode recruited during the first medical visit in a mutua ( Spanish health insurance company ) and followed until their sick leave episode ended . Workers completed a baseline question naire regarding their perceptions of sick leave episode and expectations of RTW ( i.e. , health status , work ability , expectations and time required to RTW , self-efficacy and self-perceived connection between health and job ) . Time to RTW  was established based on the mutua ’s register . Cox regression models were used to examine the associations of worker perception and expectation of  RTW  with time to RTW within the study population as a whole as well as in three diagnostic subgroups ( i.e. , musculoskeletal disorders , mental disorders and other physical conditions ) . Results As a whole , time to RTW was longer for workers reporting poor health [ hazard ratio ( HR ) = 0.71 , 95%CI 0.59–0.85 ] , extremely reduced work ability ( HR = 0.69 , 95%CI 0.53–0.88 ) , a longer period of time required to RTW ( HR = 0.36 , 95%CI 0.25–0.52 ) and lack of expectation of returning to the same job ( HR = 0.13 , 95%CI 0.06–0.31 ) . Workers with musculoskeletal and other physical conditions showed a similar pattern to whole study population , while workers with mental disorders did not . Conclusion Self-required time and RTW expectations are important prognostic factors in sick listed workers by all types of health conditions certified as non-work-related . Question ing the workers on their perceptions and expectations of RTW during medical visits could help health care professionals to identify individuals at risk of long-term sickness absence and facilitate triage and management of the patient Background The importance of staying active instead of bed rest has been acknowledged in the management of musculoskeletal disorders ( MSDs ) . This emphasizes the potential benefits of adjusting work to fit the employee 's remaining work ability . Despite part-time sick leave being an official option in many countries , its effectiveness has not been studied yet . We have design ed a r and omized controlled study to assess the health effects of early part-time sick leave compared to conventional full-day sick leave . Our hypothesis is that if work time is temporarily reduced and work load adjusted at the early stages of disability , employees with MSDs will have less disability days and faster return to regular work duties than employees on a conventional sick leave . Methods / Design The study population will consist of 600 employees , who seek medical advice from an occupational physician due to musculoskeletal pain . The inclusion requires that they have not been on a sick leave for longer than 14 days prior to the visit . Based on the physician 's judgement , the severity of the symptoms must indicate a need for conventional sick leave , but the employee is considered to be able to work part-time without any additional risk . Half of the employees are r and omly allocated to part-time sick leave group and their work time is reduced by 40–60 % , whereas in the control group work load is totally eliminated with conventional sick leave . The main outcomes are the number of days from the initial visit to return to regular work activities , and the total number of sick leave days during 12 and 24 months of follow-up . The costs and benefits as well as the feasibility of early part-time sick leave will also be evaluated . Conclusion This is the first r and omised trial to our knowledge on the effectiveness of early part-time sick leave compared to conventional full-time sick leave in the management of MSDs . The data collection continues until 2011 , but preliminary results on the feasibility of part-time sick leave will be available already in 2008 . The increased knowledge will assist in better decision making process regarding the management of disability related to MSDs . Trial Registration International St and ard R and omised Controlled Trial Number Register , register number IS RCT Introduction In Denmark , the magnitude and impact of work disability on the individual worker and society has prompted the development of a new “ coordinated and tailored work rehabilitation ” ( CTWR ) approach . The aim of this study was to compare the effects of CTWR with conventional case management ( CCM ) on return-to-work of workers on sick leave due to musculoskeletal disorders ( MSDs ) . Methods The study was a r and omized controlled trial with economic evaluation undertaken with workers on sick leave for 4–12 weeks due to MSDs . CTWR consists of a work disability screening by an interdisciplinary team followed by the collaborative development of a RTW plan . The primary outcome variable was registered cumulative sickness absence hours during 12 months follow-up . Secondary outcomes were work status as well as pain intensity and functional disability , measured at baseline , 3 and 12 months follow-up . The economic evaluation ( intervention costs , productivity loss , and health care utilization costs ) was based on administrative data derived from national registries . Results For the time intervals 0–6 months , 6–12 months , and the entire follow-up period , the number of sickness absence hours was significantly lower in the CTWR group as compared to the control group . The total costs saved in CTWR participants compared to controls were estimated at US $ 1,366 per person at 6 months follow-up and US $ 10,666 per person at 12 months follow-up . Conclusions Workers on sick leave for 4–12 weeks due to MSD who underwent “ CTWR ” by an interdisciplinary team had fewer sickness absence hours than controls . The economic evaluation showed that — in terms of productivity loss — CTWR seems to be cost saving for the society This study examined the effects of work-related multidisciplinary rehabilitation ( MR ) on occupational participation in patients with chronic musculoskeletal disorders . A r and omized-controlled trial was carried out . The sample included patients with chronic musculoskeletal disorders and severe restrictions of work ability ( n=222 ) . Participants in the intervention group received a work-related rehabilitation programme following a comprehensive functional capacity evaluation ( FCE MR ) . Controls completed a conventional MR . The analysis was based on 1-year follow-up data . The primary outcome was stable occupational participation ( SOP ) , defined as employment with at most 6 months of sick leave after rehabilitation . The secondary outcomes were the duration of sick leave , employment status and the Pain Disability Index .  We included 102 patients in our analysis ( intervention : n=55 ,  control : n=47 ) . Despite r and omization there were group differences . Adjusting these differences , patients of the FCE MR had 3.5 times higher odds of SOP [ 95 % confidence interval ( CI ) : 1.2–9.8 , P=0.018 ] . However , there was neither a significant difference in the duration of sick leave between both groups ( b=−8.0 weeks , 95 % CI : −17.4 to 1.4 , P=0.095 ) nor higher odds of employment in favour of the FCE MR after 1 year ( odds ratio=2.3 , 95 % CI : 0.9–5.8 , P=0.088 ) . Participants in the FCE MR reported less pain-related disabilities ( b=−6.5 , 95 % CI : −12.6 to −0.4 , P=0.038 ) . The study had a limitation in terms of group balance . However , the findings indicate that the work-related FCE MR was more effective for SOP , but did not significantly affect employment rate and sick leave duration A research project is described that analyses the back pain prevalence and physical working conditions of community nurses . The purpose was to compare the position of  nurses working in institutional care with the specific situation of nurses working in the private homes of their patients . The results of a question naire showed that the back pain prevalence was relatively high as compared to other occupations and also when compared to other health care sectors . The home care organization is influenced not only by sick leave due to back pain , but also its efficiency is hampered by nurses with back pain who continue to work . It appeared that the total sick leave incidence due to musculoskeletal disorders other than back pain exceeds that due to back pain alone . The physical exposure level not only consisted of frequent and heavy lifting and transferring of patients but also a substantial static workload was present . The onset of back pain seems to result from a gradual build up of overload reaching its maximum . A preventive approach should take these differential loading factors into account . The consequences for preventive interventions are discussed result ing in recommendations towards a ( participatory ) ergonomic approach . This material forms the baseline of a controlled prospect i ve trial in home care Objective : To determine whether physical and psychosocial load at work influence sickness absence due to low back pain . Methods : The research was a part of the study on musculoskeletal disorders , absenteeism , stress , and health ( SMASH ) , a 3 year prospect i ve cohort study on risk factors for musculoskeletal disorders . Workers from 21 companies located throughout The Netherl and s participated in the part of this study on sickness absence due to low back pain . The study population consisted of 732 workers with no sickness absences of 3 days or longer due to low back pain in the 3 months before the baseline survey and complete data on the reasons for absences during the follow up period . The mean ( range ) period of follow up in this group was 37 ( 7–44 ) months . Physical load at work was assessed by analyses of video recordings . Baseline information on psychosocial work characteristics was obtained by a question naire . Data on sickness absence were collected from company records . The main outcome measure was the rate of sickness absences of 3 days or longer due to low back pain during the follow up period . Results : After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants , significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion , trunk rotation , lifting , and low job satisfaction . A dose-response relation was found for trunk flexion , but not for trunk rotation or lifting . Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support . Quantitative job dem and s , conflicting dem and s , decision authority , and skill discretion showed no relation with sickness absence due to low back pain . Conclusions : Flexion and rotation of the trunk , lifting , and low job satisfaction are risk factors for sickness absence due to low back pain . Some indications of a relation between low social support , either from supervisors or coworkers , and sickness absence due to low back pain are also present 965 workers engaged in working tasks of work intensity grade 2 , 3 , 4 ( based on Chinese National St and ard ) were investigated on the musculoskeletal disorders with a question naire . The lumbar vertebra of 136 r and omly chosen workers were also radiologically examined . The result revealed that the prevalence of low-back disorders was 51.2 % on average and it was obviously correlated with such factors as age , st and ing , previous back injury , education level , sport activity , work intensity , working posture , satisfaction with the tools as well as work condition and house work . Heavy work load and unneutral working posture were proved to be the main factors as revealed by the multifactor analysis and further supported by the findings of X-ray examination Objective : To investigate whether an exercise intervention shown to increase aerobic capacity , would also lead to less musculoskeletal pain ; improved work ability , productivity , and perceived physical exertion ; and less sick leave . Methods : Sixty-seven construction workers were r and omized into an exercise group training 3 × 20 minutes per week and a control group . Question naires and text messages were completed before and after the 12-week intervention . Results : No significant changes were found in musculoskeletal pain , work ability , productivity , perceived physical exertion , and sick leave with the intervention . Question naires and text messages provided similar results of pain and work ability . Conclusions : Although the intervention improved aerobic capacity , it was not successful in improving musculoskeletal pain and other work-related factors . A detectable improvement presumably requires a more multifaceted intervention , larger sample size , or longer follow-up . Text messages may be a convenient data - collection method in future studies
We found low- quality evidence that different work-break frequencies may have no effect on participant-reported musculoskeletal pain , discomfort and fatigue .
For productivity and work performance , evidence was of very low- quality that different work-break frequencies may have a positive effect .
For different types of break , there may be no effect on participant-reported musculoskeletal pain , discomfort and fatigue according to low- quality evidence .
Furthermore , work-break interventions should be reconsidered , taking into account worker population s other than office workers , and taking into account the possibility of combining work-break intervention with other interventions such as ergonomic training or counselling , which may may possibly have an effect on musculoskeletal outcomes and work performance
BACKGROUND Work-related musculoskeletal disorders are a group of musculoskeletal disorders that comprise one of the most common disorders related to occupational sick leave worldwide .
Musculoskeletal disorders accounted for 21 % to 28 % of work absenteeism days in 2017/2018 in the Netherl and s , Germany and the UK .
There are several interventions that may be effective in tackling the high prevalence of work-related musculoskeletal disorders among workers , such as physical , cognitive and organisational interventions .
In this review , we will focus on work breaks as a measure of primary prevention , which are a type of organisational intervention .
OBJECTIVES To compare the effectiveness of different work-break schedules for preventing work-related musculoskeletal symptoms and disorders in healthy workers , when compared to conventional or alternate work-break schedules .