Search PubMed⌕ Search

Biomedical subjects

E Viikari-Juntura

Publications and source records attributed to E Viikari-Juntura.

At least 19 recordsLinked to original sources
PubMed2003

Work related and individual predictors for incident neck pain among office employees working with video display units.

AIMS: To investigate work related and individual factors as predictors for incident neck pain among office employees working with video display units (VDUs). METHODS: Employees in three administrative units of a medium sized city in Finland (n = 515) received mailed questionnaires in the baseline survey in 1998 and in the follow up survey in 1999. Response rate for the baseline was 81% (n = 416); respondents who reported neck pain for less than eight days during the preceding 12 months were included into the study cohort as healthy subjects (n = 232). The follow up questionnaire 12 months later was completed by 78% (n = 180). Incident neck cases were those reporting neck pain for at least eight days during the preceding 12 months. RESULTS: The annual incidence of neck pain was 34.4% (95% CI 25.5 to 41.3). Poor physical work environment and poor placement of the keyboard increased the risk of neck pain. Among the individual factors, female sex was a strong predictor. Smoking showed a tendency for an increased risk of neck pain. There was an interaction between mental stress and physical exercise, those with higher mental stress and less physical exercise having especially high risk. CONCLUSION: In the prevention of neck disorders in office work with a high frequency of VDU tasks, attention should be given to the work environment in general and to the more specific aspects of VDU workstation layout. Physical exercise may prevent neck disorders among sedentary employees.

Adult↗
PubMed2002

A prospective study on knee pain and its risk factors.

OBJECTIVES: To evaluate the effects of work-related and individual factors as well as physical activity and sports on the incidence and persistence of knee pain among a working population. DESIGN: Employees of a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic Questionnaire) on musculoskeletal pain and its possible risk factors at the baseline of this study. A cohort of 2122 workers free of knee pain and another cohort of 333 workers with severe knee pain were followed up for one year. The effects of the risk factors on the incidence and persistence of knee pain were studied using multivariable logistic regression models. RESULTS: A total of 214 (10%) workers developed knee pain during the follow-up. Significant predictors of incident knee pain in the multivariable model were higher age, overweight, smoking, and previous knee injuries. Also, working with the trunk forward flexed in kneeling or standing position and physically strenuous work were non-significant predictors of incident knee pain. Of those 333 workers with severe knee pain at baseline, 220 (66%) still reported severe knee pain after one year. Higher age and job dissatisfaction increased the risk of persistent symptoms. General physical exercise and different sports activities did not predict the incidence or persistence of knee pain. CONCLUSIONS: In this large prospective study, the risk factors for self-reported knee pain seemed to be highly similar to the risk factors for knee osteoarthritis (OA) reported in other papers. Age, previous knee injuries, overweight, and knee-straining work were those risk factors, which contributed to the incidence of knee pain. Psychosocial elements of work were more involved in the persistence of the symptoms in the knee.

Adult↗
PubMed2001

Interobserver repeatability and validity of an observation method to assess physical loads imposed on the upper extremities.

Interobserver repeatability and validity were assessed for a new semiquantitative, time-based observation method for the estimation of physical loads imposed on the upper extremities. Six risk factors of upper extremity disorders were included in the method: repetitive use of hand, use of hand force, pinch grip, non-neutral wrist posture, elevation of upper arm, local mechanical pressure. Two occupational health nurses were trained to use the method. They observed 127 work cycles at a food-processing plant and a paper mill. The method was validated against expert observations from the video, continuous recordings of myoelectric activity (EMG) of forearm muscles, and wrist posture measured with goniometers. Interobserver repeatability was good or moderate for repetitive use of hand, hand force, pinch grip (range kappa = 0.58-0.71 on the right; 0.60-0.61 on the left side). Interobserver repeatability was moderate or poor for non-neutral wrist posture, elevation of the upper arm and local mechanical pressure. Validity ranged from moderate to good for repetitive use of hand, use of hand force, pinch grip and non-neutral wrist posture when expert observation was used as reference standard. When observations were validated against force estimations (EMG) and wrist goniometer data, validity was poor. In the absence of generally accepted reference values, arbitrarily chosen limits were used for the proportional duration of some physical load factors. Studies should be carried out to assess the limits that best differentiate between safe and hazardous jobs.

Adult↗
PubMed2001

Physical exercise and musculoskeletal pain among forest industry workers.

The study investigated the relations between physical exercise and musculoskeletal pain among forest industry workers. We studied a population of 3312 Finnish forest industry workers, who replied to a questionnaire survey in 1994 (response rate 77%). The outcome variables in this cross-sectional study were the number of days with pain in the low back, neck, shoulder and knee during the preceding 12 months. Multivariable logistic regression models were used in statistical analyses. Active walkers had more sciatic pain, active volleyball players had more shoulder pain and those who practiced trekking actively had more knee pain than those who practiced these activities less. The risk of shoulder pain was more than three times higher for those who played volleyball actively compared to those who played less. In addition, age, mental stress and work-related physical loading were strongly associated with musculoskeletal pain. When studying the relations between physical exercise and musculoskeletal pain in a working population, it is important to not only detect the general physical activity but also to specify the different modes of exercise. In addition, the other factors which are strongly related to pain (such as mental stress and work-related physical loading) should be taken into account.

Adult↗
PubMed2001

Job experience, work load, and risk of musculoskeletal disorders.

OBJECTIVES: To investigate the effects of physical work load and job experience on morbidity from musculoskeletal disorders among trailer assembly workers. METHODS: A longitudinal study was carried out in a trailer assembly factory with many new workers employed during the follow up. The sickness absence of 532 workers (160 experienced and 372 new (separately for the first year of employment and from the second year on)) was followed up. Exposure was assessed by job titles, visits, task descriptions, and some direct measurements. The associations between the explanatory variables and sick leave were assessed by log linear models. RESULTS: A higher rate of sick leave due to disorders of the upper limbs was found for new workers compared with experienced ones, especially in the high work load group. Women had a higher rate than men. New male workers in physically strenuous tasks had a high rate of sick leave due to neck and shoulder disorders. CONCLUSIONS: As being unaccustomed to work seems to increase the risk of musculoskeletal disorders, special attention should be paid to newly employed workers.

Adult↗
PubMed2001

Longitudinal study on work related and individual risk factors affecting radiating neck pain.

OBJECTIVES: To study the effects of work related and individual factors affecting radiating neck pain. METHODS: A longitudinal study was carried out with repeated measurements. A total of 5180 Finnish forest industry workers replied to a questionnaire survey in 1992 (response rate 75%). Response rates to follow up questionnaires in 1993, 1994, and 1995 were 83%, 77%, and 90%, respectively. The outcome variable was the number of days with radiating neck pain during the preceding 12 months with three levels (<8, 8-30, >30 days). The generalised estimating equations method was used to fit a marginal model and a transition model was used in a predictive analysis. RESULTS: Items showing associations with radiating neck pain in both analyses were sex, age, body mass index, smoking, duration of work with a hand above shoulder level, mental stress, and other musculoskeletal pains. In the transition model, radiating neck pain in a previous questionnaire was included in the model. Although it was a strong predictor, the variables already mentioned retained their significance. CONCLUSION: Programmes targeted to reduce physical load at work, mental stress, being overweight, and smoking could potentially prevent radiating neck pain.

Adult↗
PubMed2001

A prospective study of work related factors and physical exercise as predictors of shoulder pain.

OBJECTIVES: To evaluate the effects of work related and individual factors as well as physical activity and sports on the incidence and persistence of shoulder pain among forestry workers. METHODS: Workers in a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic questionnaire) on musculoskeletal pain and its possible risk factors for 4 consecutive years 1992-5. This 1 year follow up study covers the time 1994-5. Year 1994 was chosen as baseline because in that year the questionnaire contained for the first time more detailed questions about different sports. The response rate in 1995 was 90%. The effects of the predictors on 1 year incidence and persistence of shoulder pain were studied with multivariate logistic regression modelling. RESULTS: At baseline, 2094 subjects had been free of shoulder pain during the preceding 12 months. After 1 year, 14% (n=285) reported having mild or severe shoulder pain. Higher age, obesity, and mental stress as well as physically strenuous work and working with trunk forward flexed or with a hand above shoulder level increased the risk of incident shoulder pain. Of the different sports activities, dancing increased the risk of incident pain whereas jogging decreased the risk significantly. Of those 419 workers who had severe shoulder pain at baseline, 55% (n=230) still had severe pain 1 year later. Higher age, overload at work, and working with a hand above shoulder level increased the risk of persistent severe shoulder pain whereas cross country skiing and general sports activity decreased the risk. CONCLUSION: Our results support the current view that shoulder pain is the result of many factors, including occupational and individual factors. In this longitudinal study, physical work with a heavy load, awkward work postures, mental stress, and obesity were the risk factors at which preventive measures could be aimed. As a new finding, physical exercise had more protective than impairing effects on the shoulders.

Adult↗
PubMed2001

Incidence of musculoskeletal disorders among newly employed manufacturing workers.

OBJECTIVES: The incidence of upper-limb, neck-shoulder, and low-back disorders and their induction times were investigated among new workers in tasks with various physical workloads. METHODS: New trailer assemblers (N=364) were followed prospectively for 45 months--the workers' health status via medical records and exposure to physical workload factors via job titles, walk-throughs, task descriptions, and some direct measurements. The incidence rate of first sick leave due to such disorders was calculated for different workload groups. The proportion of workers surviving without musculoskeletal disorders was estimated by the Kaplan-Maier product-limit estimator, and the effect of the exposure on the risk of incident disorders was estimated with the Cox proportional hazards model. RESULTS: The highest annual incidences were observed for strenuous tasks, the incidence rate for men being 16.8 per 100 person-years [95% confidence interval (95% CI) 8.0-30.9] for upper-limb disorders in strenuous tasks and 6.1 (95% CI 2.0-14.1) in nonstrenuous tasks and that for women being 32.0 (95% CI 11.7-69.7) and 9.9 (95% CI 0.2-54.9), respectively. The men's risk of contracting an upper-limb or neck-shoulder disorder in strenuous tasks was about threefold [hazard ratio (HR) 3.2 (95% CI 1.1-9.4) for upper-limb disorders and 2.7 (95% CI 0.9-8.1) for neck-shoulder disorders] that of nonstrenuous tasks, whereas workload seemed not to affect low-back disorders. The workers first sought medical advice for their disorders typically some months after employment began. CONCLUSIONS: Newly employed workers in hand-intensive tasks have a high risk of upper-limb and neck-shoulder disorders. An etiologic role for activities involving high force demands in upper-limb and neck-shoulder disorders is possible.

Adult↗
PubMed2000

Do functional tests predict low back pain?

STUDY DESIGN: A cohort of 307 nonsymptomatic workers and another cohort of 123 workers with previous episodes of low back pain were followed up for 2 years. The outcomes were measured by symptoms, medical consultations, and sick leaves due to low back disorders. OBJECTIVES: To study the predictive value of a set of tests measuring the physical performance of the back in a working population. The hypothesis was that subjects with poor functional capacity are liable to back disorders. SUMMARY OF BACKGROUND DATA: Reduced functional performance has been associated with back pain. There are few data to show whether reduced functional capacity is a cause or a consequence of pain. METHODS: Mobility of the trunk in forward and side bending, maximal isokinetic trunk extension, flexion and lifting strength, and static endurance of back extension were measured. Standing balance and foot reaction time were recorded with a force plate. Clinical tests for the provocation of back or leg pain were performed. Gender, workload, age, and anthropometrics were managed as potential confounders in the analysis. RESULTS: Marked overlapping was seen in the measures of the subjects with different outcomes. Among the nonsymptomatic subjects, low performance in tests of mobility and standing balance was associated with future back disorders. Among workers with previous episodes of back pain, low isokinetic extension strength, poor standing balance, and positive clinical signs predicted future pain. CONCLUSIONS: Some associations were found between the functional tests and future low back pain. The wide variation in the results questions the value of the tests in health examinations (e.g., in screening or surveillance of low back disorders).

Adult↗
PubMed2000

Low back pain in relation to lumbar disc degeneration.

STUDY DESIGN: Cross-sectional magnetic resonance imaging (MRI) study. OBJECTIVES: To study the relation of low back pain (LBP) to disc degeneration in the lumbar spine. BACKGROUND DATA: Controversy still prevails about the relationship between disc degeneration and LBP. Classification of disc degeneration and symptoms varies, hampering comparison of study results. METHODS: Subjects comprised 164 men aged 40-45 years-53 machine drivers, 51 construction carpenters, and 60 office workers. The data of different types of LBP, individual characteristics, and lifestyle factors were obtained from a questionnaire and a structured interview. Degeneration of discs L2/L3-L5/S1 (dark nucleus pulposus and posterior and anterior bulge) was assessed with MRI. RESULTS: An increased risk of LBP (including all types) was found in relation to all signs of disc degeneration. An increased risk of sciatic pain was found in relation to posterior bulges, but local LBP was not related to disc degeneration. The risks of LBP and sciatic pain were strongly affected by occupation. CONCLUSIONS: Low back pain is associated with signs of disc degeneration and sciatic pain with posterior disc bulges. Low back pain is strongly associated with occupation.

Adult↗
PubMed2000

Predictive validity of symptoms and signs in the neck and shoulders.

A standardized examination protocol was developed for the assessment of neck and shoulder disorders in primary health care. We investigated to what extent the symptoms and signs can predict sick leave due to neck and shoulder disorders. Our study involved 474 patients seeking medical advice from an occupational health service. Most of the 20 symptoms and 15 signs of the protocol were associated with the number of sick leave days within the 60-day postexamination period, but only three symptoms (short duration, high pain intensity, and continuous pain) and two signs (pain in the upper limb during rotation of head and pain in the shoulder during abduction of arm) retained their significance in a multivariate model. No unambiguous subset of protocol items can be suggested for general use. The predictive validity should be tested in other populations and settings before a conclusion is drawn about the external validity of the results.

Adult↗
PubMed2000

Assessment of duration and frequency of work tasks by telephone interview: reproducibility and validity.

Quantitative estimation of physical work load requires breakdown of jobs into smaller entities. The objective was to study the inter-rater reproducibility of the contents, frequency and duration of work tasks assessed by telephone interview. Two researchers interviewed 18 industrial workers with an interval of from 2 to 3 weeks in a balanced and blinded design. Altogether 114 tasks were identified, 68 of which were recorded by both interviewers. The tasks were classified into regularly occurring (n = 34) and occasional (n = 80). The outcome was the total duration of the tasks per day computed from the data on frequency and duration. Validity of the interview was studied against prestructured diaries filled in by nine workers. The interviewers' assessments of the overall contents of the tasks were rated as 'similar' or 'very similar' for 17 of the 18 workers. Both interviewers detected all 34 regularly occurring tasks. The intraclass correlation coefficient (ICC) of the total duration between the interviewers was 0.81 for regularly occurring tasks. ICCs of the total duration between the diary and the two interviewers were 0.90 and 0.91. However, in many cases the workers could not give a numerical value for duration or frequency. A telephone interview can be used as a first step in exposure assessment in epidemiological studies on risk factors of musculoskeletal disorders. These results show that a single telephone interview can give reproducible and valid information of the frequency and duration of tasks occurring daily. For occasional tasks interview methods should be developed further.

Adult↗
PubMed1999

Role of physical load factors in carpal tunnel syndrome.

Epidemiologic and experimental studies were reviewed to assess the role of postural factors, high handgrip and pinch forces, repetitive hand and wrist movements, external pressure, and vibration in the occurrence of carpal tunnel syndrome (CTS). Forceful repetitive work, vibration, and extreme wrist postures have been associated with CTS in several epidemiologic studies. Experimental studies have shown that certain forearm, wrist, and finger postures, even moderate hand loads and external pressure on the palm, can increase carpal tunnel pressure (CTP) at least temporarily to levels at which nerve viability is threatened. It is concluded that while more research is needed, there is sufficient information to suggest that reducing the duration, frequency or intensity of exposure to forceful repetitive work, extreme wrist postures and vibration is likely to result in a reduction of the incidence or severity of CTS in working populations.

Animals↗
PubMed1999

New avenues in research on musculoskeletal disorders.

Recent reviews on musculoskeletal disorders have clearly pointed out the need for more good-quality original research. Both symptom-based and objective outcome assessment methods should be improved. A variety of methods exists to assess exposure for short-term outcomes, whereas exposure assessment strategies for outcomes with long induction times should be developed. The change in exposure patterns--less force demands, more static, visual, cognitive, psychological and social load--will continue during the next millennium, and a likely result is a change in the disease panorama. The pathomechanisms of the effects of low-level static contractions and adverse psychosocial conditions need clarification. Genetic epidemiology is an emerging field of research, and it will be particularly interesting to study the interaction between genetically determined susceptibility and occupational risk factors. Because degeneration of the spine starts in adolescence, the importance of studying the etiology of degenerative disorders among young populations is emphasized.

Humans↗
PubMed1998

Standardized physical examination protocol for low back disorders: feasibility of use and validity of symptoms and signs.

A standardized examination protocol was developed for the assessment of low back disorders in primary care. The protocol was found feasible in the occupational health service setting. The interexaminer repeatability between an occupational physician and an occupational physiotherapist was good for most items. The predictive validity of different symptoms and signs was investigated with regard to future sick leaves due to low back disorders. Relief of pain when lying, severe trouble at work caused by pain, continuous pain, and pain in the leg or numbness or diminished sensitivity in the foot predicted sick leaves. Of physical signs, pain in the low back or buttock during lateral flexion and a side difference > or = 20 degrees in the straight-leg-raising angle were predictors for sick leaves. The predictive validity of the protocol items should be tested in another patient population before conclusions can be drawn concerning the external validity of our results.

Adult↗