Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol Early Workplace Intervention for Employees With Musculoskeletal-Related Absenteeism: A Prospective Controlled Intervention Study Work status and health-related quality of life following multimodal work hardening: a cluster randomised trial. Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace Workplace Prevention and Musculoskeletal Injuries in Nurses Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background, design and conceptual model of FINALE Musculoskeletal disorders and occupational exposures: How should we judge the evidence concerning the causal association? Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial When Intervention Meets Organisation, a Qualitative Study of Motivation and Barriers to Physical Exercise at the Workplace Psychosocial effects of workplace exercise - A systematic review. Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study Effectiveness of early part-time sick leave in musculoskeletal disorders The impact of work environment on mood disorders and suicide: Evidence and implications Thoughts and feelings of future working life as a predictor of return to work: a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders Effectiveness of participatory training for prevention of musculoskeletal disorders: a randomized controlled trial Physical and psychosocial risk factors for musculoskeletal disorders in New Zealand nurses, postal workers and office workers Evaluation of ‘I-Preventive’: a digital preventive tool for musculoskeletal disorders in computer workers—a pilot cluster randomised trial The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial. Work-schedule characteristics and reported musculoskeletal disorders of registered nurses. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Reduction of Pain-Related Disability in Working Populations: A Randomized Intervention Study of the Effects of an Educational Booklet Addressing Psychosocial Risk Factors and Screening Workplaces for Physical Health Hazards
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 Sickness absenteeism caused by musculoskeletal disorders ( MSDs ) is a persistent and costly occupational health challenge . In a prospect i ve controlled trial , we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management .  Patients with physician-diagnosed MSDs were r and omized either to the  intervention group or  the reference group offered the traditional case management routines . Participants filled out a comprehensive question naire at the initiation of the study and after 6 months . In addition , administrative data were collected at 0 , 6 , and 12 months after the initiation of the project . For the entire 12-month period , the total mean number of sick days for the intervention group was 144.9 ( SEM 11.8 ) days/person as compared to 197.9 ( 14.0 ) days in the reference group ( P < 0.01 ) . Compared with the reference group , employees in the intervention group significantly more often received a complete rehabilitation investigation ( 84 % versus 27 % ) . The time for doing this was reduced by half ( 59.4 ( 5.2 ) days versus 126.8 ( 19.2 ) , P < .01 ) . The odds ratio for returning to work in the intervention group was 2.5 ( 95 % confidence interval 1.2–5.1 ) as compared with the reference group . The direct cost savings were USD 1195 per case , yielding a direct benefit-to-cost ratio of 6.8 . It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability . Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial BACKGROUND Systematic review s have confirmed the effectiveness of work-related rehabilitation with significant cognitive-behavioural components for patients with musculoskeletal disorders ( MSDs ) . In Germany , however , work-related rehabilitation focuses mainly on functional capacity training and less on psychosocial work dem and s. OBJECTIVE To evaluate the efficacy of multimodal work hardening ( MWH ) with a cognitive-behavioural approach . METHODS Patients with MSDs result ing in severe restriction of work ability were r and omly assigned to treatment by either  MWH or conventional musculoskeletal rehabilitation ( controls ) . The primary outcome was work status . The work status at 6 months of follow-up was defined as positive if the patient was working and had ≤ 6 weeks of sick leave , and that at 12 months was defined as positive if the patient was working and had ≤12 weeks of sick leave . Follow-up data were collected by postal question naires . RESULTS 236 patients consented to participate . Follow-up data were obtained from 169 ( 71.6 % ) participants at 6 months and 146 ( 61.9 % ) participants at 12 months . At 6 months , participants in the MWH group had a 2.4 times higher chance of a positive work status than the controls ( OR=2.363 ; 95 % CI : 1.266 to 4.410 ; p=0.007 ) . At 12 months , the chances of a positive work status were still higher , but this difference was not statistically significant ( OR=1.914 ; 95 % CI : 0.849 to 4.317 ; p=0.118 ) . Significance of the interaction term of treatment and time indicated more favourable outcomes for depression and anxiety , mental and physical health-related quality of life , and pain management in the MWH group .  CONCLUSIONS MWH  improves health-related quality of life and is able to enhance the mid-term chances of work-life participation Typing is associated with musculoskeletal disorders ( MSDs ) caused by multiple risk factors . This control study aim ed to evaluate the efficacy of a workplace intervention for reducing  MSDs among computer workers . Sixty-six subjects with and without MSD were assigned consecutively to one of three groups : ergonomics intervention ( work site and body posture adjustments , muscle activity training and exercises ) accompanied with biofeedback training , the same ergonomics intervention without biofeedback and a control group . Evaluation of MSDs , body posture , psychosocial status , upper extremity ( UE ) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab . Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed ( χ2 = 13.3 ; p = 0.001 ) . Significant changes were found in UE kinematics and posture as well . Both ergonomics interventions effectively reduced MSD and improved body posture . Practitioner Summary : This study aim ed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders ( MSDs ) , body posture , upper extremity kinematics , muscle activity and psychosocial factors were tested . The proposed ergonomics interventions effectively reduced MSDs and improved body posture Objective The purpose of this study was to describe the availability of preventive devices and training in relation to neck , shoulder , and back musculoskeletal injuries/disorders ( MSD ) in registered nurses . Summary background data Nurses have one of the highest rates of MSD of any occupation . Studies have shown that mechanical lifting devices and lifting teams can reduce MSD rates and associated costs . Methods Data from 1163 r and omly selected currently working nurses ( 1 + years on the current job ) were collected in anonymous mailed surveys ( 74 % response rate ) . MSD cases had neck , shoulder , and /or back symptoms for at least 1 week , or at least monthly , and moderate or more pain , in the past year . Results Nurses with mechanical lifting devices available were significantly less likely to have neck or back MSDs . Back injury was less likely when lifting teams were available . However , adjustable beds and transfer sheets were associated with greater odds of back MSD . Training in workstation adjustment was associated with significantly lower MSD prevalence , though postural training was not . Conclusions Though use of mechanical devices and lifting teams was limited in nursing workplaces , these prevention strategies were related to reduced odds of MSD . Nursing administrators can use these findings to consider workplace changes 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 Musculoskeletal disorders ( MSDs ) affecting the back , upper and lower extremities are widespread in the general population , implying a variety of causal factors . Multiple causes are not mutually exclusive , and a high background rate does not preclude associations with specific factors that are uncommon in the general population . MSDs have well-documented associations with occupational ergonomic stressors such as repetitive motion , heavy lifting , non-neutral postures , and vibration . Organizational features of the work environment , such as time pressure and low decision latitude , may also play a role , at least by potentiating the effects of physical loading . Numerous systematic review s have mostly concurred with these overall findings . Nevertheless , some continue to debate whether MSDs are sometimes work-related , even for those performing jobs with repetitive and routinized tasks , heavy lifting , and /or pronounced postural strain . This article discusses ( 1 ) some epidemiologic features of MSDs that underlie that debate ; and ( 2 ) the question of what should appropriately be considered a gold st and ard for scientific evidence on an etiological question such as the health effects of a non-voluntary exposure , such as an occupational or environmental agent . In particular , r and omized clinical trials have little relevance for determining the health effects of non-therapeutic risk factors Background The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers , allegedly due to high physical work dem and s of healthcare work . Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups , but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise . Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence . On the other h and , physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend . Thus , it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain . This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers . Methods / Design This study was design ed as a cluster r and omized controlled trial performed at 3 hospitals in Copenhagen , Denmark . Clusters are hospital departments and hospital units . Cluster r and omization was chosen to increase adherence and avoid contamination between interventions . Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1 ) workplace based physical exercise performed during working hours ( using kettlebells , elastic b and s and exercise balls ) for 5 × 10 minutes per week and up to 5 group-based coaching sessions , or 2 ) home based physical exercise performed during leisure time ( using elastic b and s and body weight exercises ) for 5 × 10 minutes per week . Both intervention groups will also receive ergonomic instructions on patient h and ling and use of lifting aides etc . Inclusion criteria are female healthcare workers working at a hospital . Average pain intensity ( VAS scale 0 - 10 ) of the back , neck and shoulder ( primary outcome ) and physical exertion during work , social capital and work ability ( secondary outcomes ) is assessed at baseline and 10-week follow-up . Further , postural balance and mechanical muscle function is assessed during clinical examination at baseline and follow-up . Discussion This cluster r and omized trial will investigate the change in self-rated average pain intensity in the back , neck and shoulder after either 10 weeks of physical exercise at the workplace or at home . Trial registration Clinical Trials.gov ( NCT01921764 ) Objective . To provide a comprehensive underst and ing of the motivational factors and barriers that are important for compliance with high-intensity workplace physical exercise that is aim ed at reducing musculoskeletal disorders . Method . The present study , which used semideductive , thematic , and structured in-depth interviews , was nested in a 20-week cluster r and omised controlled trial among office workers .  Interviews were conducted with 18 informants with diverse fields of sedentary office work who participated in strength training at the workplace for 20 minutes , three times per week . Organisational , implementational , and individual motives and barriers were explored . Results & Discussion . The results show that attention should be given to the interaction between the management , the employees , and the intervention , as the main barrier to compliance was the internal working culture . The results emphasised the need for a clear connection between the management 's implementational intentions and the actual implementation . The results emphasise the importance of ensuring the legitimacy of the intervention among managers , participants , and colleagues . Moreover , it is important to central ly organise , structure , and ensure flexibility in the working day to free time for participants to attend the intervention . Recommendations from this study suggest that a thorough intervention mapping process should be performed to analyse organisational and implementational factors before initiating workplace physical exercise training Objectives Workplace exercise interventions are known to reduce musculoskeletal complaints and are widely offered to promote employee`s health . The psychosocial effects of such interventions are not clear . This review evaluates the effects of workplace exercise interventions on the psychosocial work environment and mental health . Methods A systematic review was performed by screening four scientific data bases ( Pubmed , Cochrane Data base , PsycINFO and Web of Science ) for published r and omized controlled trials in English from 1998 - 2018 . The review followed the PRISMA statement guidelines using the Cochrane tool for assessing risk of bias and the GRADE approach for assessment of quality . Two research ers independently performed data base search , study screening , and evaluation . Results Twenty two r and omized controlled trials met the inclusion criteria . Substantial heterogenicity in the studies included was found in study population s , types of intervention , and outcome measures performed . Quality assessment revealed a generally low level of quality in the studies included . This was partly the result of the limited possibilities for blinding and the self-reported outcome measures . Conclusion Workplace exercise interventions seem to have limited effects on mental health and the psychosocial work environment . Future studies should incorporate blinding and independent outcome measures 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 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 The purpose of this paper is to review the evidence estimating an impact of occupational factors on  mood disorders and suicide  , and the efficacy of interventions . This review is based on literature search es using Medline and Psych INFO from 1966 to 2007 ( keywords : work stress , job insecurity , job strain , shift work , violence , occupational health , mood disorders , depression , and suicide ) . To establish the relationship between occupational variables and mood disorders , we focused on clinical ly significant disorders rather than depressive symptoms . During the last decade , prospect i ve epidemiological studies have suggested a predictive association between the work environment and mood disorders . Recently , increasing numbers of clinical trials have shown favorable effect size of intervention and suggested preferable return-on-investment results . However , low awareness and social stigma still decrease workers access to treatment . Mental health professionals in conjunction with employers have to devise a creative system to make the quality care being offered more accessible to employees . In addition , further outcome data is needed to evaluate the benefit of managing mood disorders in the workplace , and to foster awareness of positive implication s for employees , employers , their families , and the society at large . In addition , the work environment , with its chemical ( e.g. chemosensory factors , pollutants ) , physical ( e.g. lighting , noise , temperature , outdoor views and activities ) , biological ( e.g. , chronobiological factors , allergens , infectious agents ) , psychological ( e.g. dem and -control , effort-reward balance ) , social ( e.g. cohesiveness , support ) , and organizational ( e.g. leadership styles ) component should meet minimal st and ards , and may improve with striving towards the optimum Purpose . The main aim of this study was to describe the thoughts and feelings of future working life related to return to work ( RTW ) in sick-listed persons due to musculoskeletal disorders ( MSD ) . Further aim was to compare these descriptions with the person 's actual working situation 1 , 5 and 10 years after a rehabilitation period . Methods . This study consisted of two parts . The first part had an explorative design , and qualitative content analysis was chosen in order to analyse the response to an open question regarding future working life answered before , persons sick-listed due to MSD ( n = = 320 ) , took part in a rehabilitation programme 10 years ago . The second part had a prospect i ve design and quantitative analysis was used to compare the results of the qualitative analysis with RTW and the working situation 1 , 5 and 10 years after baseline . Results . Three categories emerged from the data with a total of nine subcategories . In the categories Motivation and optimism and Limitations to overcome , there were significantly more persons who had RTW 1 year after baseline when compared with the category Hindrance and hesitation . There were also some significant differences between the subcategories . Conclusions . The question , regarding thoughts and feelings of future working life , may be a simple screening method to predict RTW in persons sick-listed with MSD . This will guide the rehabilitation team to adjust the rehabilitation to each person 's needs and facilitating RTW Purpose Health and safety training program has been applied to prevent work-related  musculoskeletal disorders ( MSDs ) in workplace . We evaluated the effectiveness of participatory training and didactic training programs on MSD prevention among frontline workers in Shenzhen , China . Methods The authors r and omly assigned 918 workers from intervention factories to receive participatory training ( intervention group ) , and 907 workers from intervention factories and 1,654 workers from control factories to receive didactic training ( control_1 group , control_2 group , respectively ) from June 1 , 2008 to November 30 , 2009 . Participants were asked to report experience of ache , pain or discomfort in 10 body parts at baseline and 1 year after training . Data were analyzed to compare the MSD prevalence 1 year before and 1 year after training in different groups from 2009 to 2010 . Results The follow-up rate was 61 % ( 2,120/3,479 ) at 1 year after training . In the year after training , there were no statistically significant changes in the proportion of workers who reported MSD in any body part . MSD prevalence rates in the intervention group reduced from 16.8 to 9.9 % for lower extremities ( χ2 = 13.102 , p < 0.001 ) and from 12.9 to 8.3 % ( χ2 = 9.433 , p = 0.002 ) for wrist and finger at 1 year after training . However , the rates did not change significantly for upper back , lower back , neck , shoulder and elbow in the intervention group and for all 10 body parts in two control groups . Conclusions Overall , the training programs did not seem to prevent the occurrence of MSD among frontline workers . However , participatory training might be effective to reduce MSD in the lower extremities and wrist and finger Objective To investigate the association of physical and psychosocial risk factors with musculoskeletal disorders ( MSDs ) in New Zeal and nurses , postal workers and office workers . Design A cross-sectional postal survey asking about demographic , physical and psychosocial factors and MSDs . Participants A total of 911 participants was r and omly selected ; nurses from the Nursing Council of New Zeal and data base ( n=280 ) , postal workers from their employer 's data base ( n=280 ) and office workers from the 2005 electoral roll ( n=351 ) . Outcome Measures Self-reported pain in the low back , neck , shoulder , elbow , wrist/h and or knee lasting more than 1 day in the month before the survey . Results The response rate was 58 % , 443 from 770 potential participants . 70 % ( n=310 ) reported at least one MSDs . Physical work tasks were associated with low back ( odds ratio ( OR ) 1.35 , 95 % CI 1.14 to 1.6 ) , shoulder ( OR 1.41 , 95 % CI 1.17 to 1.69 ) , elbow ( OR 1.14 , 95 % CI 1.13 to 1.83 ) and wrist/h and pain ( OR 1.39 , 95 % CI 1.15 to 1.69 ) . Job strain had the strongest association with neck pain ( OR 3.46 , 95 % CI 1.30 to 9.21 ) and wrist/h and pain . Somatisation was weakly associated with MSDs at most sites . Better general and mental health status were weakly associated with lower odds of MSDs . Conclusions In injury prevention and rehabilitation the physical nature of the work needs to be addressed for most MSDs , with modest decreases in risk seemingly possible . Addressing job strain could provide significant benefit for those with neck and wrist/h and pain , while the effects of somatisation and the promotion of good mental health may provide smaller but global benefits Objectives I-Preventive is a digital preventive tool for musculoskeletal disorders ( MSDs ) in computer workers . We sought to determine its impact on pain in computer workers with upper limb MSDs and visual discomfort . Methods We conducted a pilot cluster r and omised trial in 2 different sites of a tyre factory in France . We r and omised 200 employees to either an  intervention group ( I-Preventive ) or control group  , each comprising symptomatic and asymptomatic employees . The workers were followed up for 5 months . The main outcome was overall recovery from symptoms following 1 month 's intervention based on Nordic-style and eyestrain question naires . Results We included 185/200 workers : 96 in the intervention group ( mean age 41.8±1.4 years ; 88.5 % males ) and 79 in the control group ( mean age 42.9±12.0 years ; 94.5 % males ) . The most painful areas ( numerical scale ≥2 ) were the neck ( 40.0 % ) , upper back ( 18.8 % ) and shoulders ( 15.7 % ) . For the most painful anatomical area , the Nordic score significantly decreased after 1 month in the intervention group ( p=0.038 ) ; no change was observed in the control group ( p=0.59 ) . After 1 month 's use , the intervention group reported less pain in the painful area and less visual discomfort symptoms ( p=0.02 ) . Adherence to the I-Preventive program was 60 % . Conclusions I-Preventive is effective in the short term on musculoskeletal symptoms and visual discomfort by promoting active breaks and eyestrain treatment . This easy-to-use digital tool allows each worker to focus on areas of their choice via personalised , easy exercises that can be performed in the workplace . Trial registration number NCT02350244 ; Pre- results STUDY DESIGN Systematic review and best evidence synthesis . OBJECTIVES To describe the prevalence and incidence of  neck pain and disability in workers ; to identify risk factors for neck pain in workers ; to propose an etiological diagram ; and to make recommendations for future research . SUMMARY OF BACKGROUND DATA Previous review s of the etiology of neck pain in workers relied on cross-sectional evidence . Recently published cohorts and r and omized trials warrant a re- analysis of this body of research . METHODS We systematic ally search ed Medline for literature published from 1980 - 2006 . Retrieved articles were review ed for relevance . Relevant articles were critically appraised . Articles judged to have adequate internal validity were included in our best evidence synthesis . RESULTS One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible . The annual prevalence of neck pain varied from 27.1 % in Norway to 47.8 % in Québec , Canada . Each year , between 11 % and 14.1 % of workers were limited in their activities because of neck pain . Risk factors associated with neck pain in workers include age , previous musculoskeletal pain , high quantitative job dem and s , low social support at work , job insecurity , low physical capacity , poor computer workstation design and work posture , sedentary work position , repetitive work and precision work . We found preliminary evidence that gender , occupation , headaches , emotional problems , smoking , poor job satisfaction , awkward work postures , poor physical work environment , and workers ' ethnicity may be associated with neck pain . There is evidence that interventions aim ed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers . CONCLUSION Neck disorders are a significant source of pain and activity limitations in workers . Most neck pain results from complex relationships between individual and workplace risk factors . No prevention strategies have been shown to reduce the incidence of neck pain in workers Background Imbalance between individual re sources and work dem and s can lead to musculoskeletal disorders and reduced work ability . The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers . Methods Two hundred female healthcare workers ( Age : 42.0 , BMI : 24.1 , work ability index [ WAI ] : 43.1 ) from 18 departments at three Danish hospitals participated ( Copenhagen , Denmark , Aug 2013—Jan 2014 ) . Participants were r and omly allocated at the cluster level to 10 weeks of : 1 ) workplace physical exercise ( WORK ) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise , or 2 ) home-based physical exercise ( HOME ) performed during leisure time for 5x10 min per week . Both groups received ergonomic counseling on patient h and ling and use of lifting aides . The main outcome measure was the change from baseline to 10-week follow-up in WAI . Results Significant group by time interaction was observed for WAI ( p < 0.05 ) . WAI at follow-up was 1.1 ( 0.3 to 1.8 ) higher in WORK compared with HOME corresponding to a small effect size ( Cohens’d = 0.24 ) . Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in HOME . Of the seven items of WAI , item 2 ( work ability in relation to the dem and s of the job ) and item 5 ( sickness absence during the past year ) were improved in WORK compared with HOME ( P < 0.05 ) . Conclusions Performing physical exercise together with colleagues at the workplace prevents deterioration of work ability among female healthcare workers . Trial registration number Clinical Trials.gov NCT01921764 . Registered 10 August 2013 OBJECTIVE Previously we reported that early part-time sick leave enhances return to work ( RTW ) among employees with musculoskeletal disorders ( MSD ) . This paper assesses the health-related effects of this intervention . METHODS Patients aged 18 - 60 years who were unable to perform their regular work due to MSD were r and omized to part- or full-time sick leave groups . In the former , workload was reduced by halving working time . Using vali date d question naires , we assessed pain intensity and interference with work and sleep , region-specific disability due to MSD , self-rated general health , health-related quality of life ( measured via EuroQol ) , productivity loss , depression , and sleep disturbance at baseline , 1 , 3 , 8 , 12 , and 52 weeks . We analyzed the repeated measures data ( 171 - 356 observations ) with the generalized estimating equation approach . RESULTS The intervention ( part-time sick leave ) and control ( full-time sick leave ) groups did not differ with regard to pain intensity , pain interference with work and sleep , region-specific disability , productivity loss , depression , or sleep disturbance . The intervention group reported better self-rated general health ( adjusted P=0.07 ) and health-related quality of life ( adjusted P=0.02 ) than the control group . In subgroup analyses , the intervention was more effective among the patients whose current problem began occurring < 6 weeks before baseline and those with ≤30 % productivity loss at baseline . CONCLUSIONS Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability , but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD 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 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 Study Design . Cluster r and omized controlled trial with 6 and 8 quarters of follow-up . Objective . To test the effects of giving evidence -based information addressing psychosocial risk factors for pain-related disability and of screening workplaces for physical health hazards at work on reducing new episodes and duration of pain-related and general absence taking . Summary of Background Data . The “ flag strategy ” for h and ling low back pain problems is recommended in many Western countries but , so far , r and omized intervention studies addressing psychosocial risk factors for disability related to low back pain show mixed results . Methods . We followed employees from 39 different work sites in western Denmark , who had received interventions consisting of either a carefully prepared booklet providing evidence -based information on common musculoskeletal pain problems alone or in combination with systematic workplace screening for physical work hazards .  Absence due to pain for at least 7 days and the cumulative numbers of absence days were the main outcome measures . General absence taking was analyzed , too . Company registration s of sickness absence in combination with self-report on the cause of a given absence spell was used to inform absence spells . Results . A total of 3808 of 4006 eligible employees provided information . Among 1063 participants in the control arm , 1458 in the information arm , and 1287 in the  information and workplace screening  arm , 4.6 % , 6.9 % , and 4.6 % , respectively , experienced pain-related absence , and 27.8 % , 27.2 % , and 24.0 % , respectively , experienced general absence taking during follow-up . No positive effect on the risk of the 2 measures of absence or on the cumulative duration of absence among cases was seen . Conclusion . Results did not support population -based interventions addressing psychosocial risk factors for pain-related disability alone or in combination with workplace screening as effective in reducing the risk of pain-related absence taking or the duration of absence
Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise .
Within this domain , there was strong evidence of a positive effect of workplace strength training .
There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics , multifaceted interventions , and stress management .
No intervention domains were associated with “ negative effects ” .
Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD  among workers with physically dem and ing work .
In regard to workplace ergonomics , there was not enough evidence from the scientific literature to guide current practice s. Based on the scientific literature , participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers .
Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders ( MSDs ) among employees with physically dem and ing work .