The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences.

This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression. Combined exposure to physical and psychosocial/organisational and/or environmental factors increased the odds of MSS in the neck/shoulder (OR 3.14, 95% CI 1.79-5.52), arms/elbow regions (OR 4.14, 95% CI 2.21-7.76) and low back (OR 1.74, 95% CI 1.28-2.37) and its consequences, i.e. reduced activities due to neck/shoulder symptoms (OR 5.45, 95% CI 2.28-13.00), absenteeism due to neck/shoulder symptoms (OR 5.19, 95% CI 2.24-12.01) and absenteeism due to low back symptoms (OR 4.37, 95% CI 2.92-6.53). In contrast, favourable psychosocial/organisational work conditions reduced the odds of wrist symptoms due to poor physical work conditions (OR 2.19, 95% CI 1.44-3.34). We conclude that to reduce MSS and its consequences, employers need to adopt a multifaceted approach: concentrate on improving physical conditions as well as the psychosocial/organisational and environmental aspects of the working environment.

[1]  G. Hagg,et al.  Static work loads and occupational myalgia a new explanation model , 1991 .

[2]  Marcus Smith,et al.  Heat stress, plasma concentrations of adrenaline, noradrenaline, 5-hydroxytryptamine and cortisol, mood state and cognitive performance. , 2006, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[3]  Thomas R. Waters,et al.  Trends in Work-Related Musculoskeletal Disorders: A Comparison of Risk Factors for Symptoms Using Quality of Work Life Data From the 2002 and 2006 General Social Survey , 2011, Journal of occupational and environmental medicine.

[4]  T. Armstrong,et al.  A conceptual model for work-related neck and upper-limb musculoskeletal disorders. , 1993, Scandinavian journal of work, environment & health.

[5]  H. Selye The Stress of Life , 1958 .

[6]  N. Pearce,et al.  Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms. , 2012, Applied ergonomics.

[7]  M Bovenzi,et al.  Low-back disorders in agricultural tractor drivers exposed to whole-body vibration and postural stress. , 1994, Applied ergonomics.

[8]  K. Palmer,et al.  Prevalence and correlates of regional pain and associated disability in Japanese workers , 2010, Occupational and Environmental Medicine.

[9]  W. E. Hoogendoorn,et al.  Systematic Review of Psychosocial Factors at Work and Private Life as Risk Factors for Back Pain , 2000, Spine.

[10]  J. Douwes,et al.  Determinants of non‐response in an occupational exposure and health survey in New Zealand , 2011, Australian and New Zealand journal of public health.

[11]  W. G. Allread,et al.  The Influence of Psychosocial Stress, Gender, and Personality on Mechanical Loading of the Lumbar Spine , 2000, Spine.

[12]  Ali Asghar Farshad,et al.  Low back pain among Iranian industrial workers. , 2006, Occupational medicine.

[13]  J. Winkel,et al.  Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort , 2005, Journal of Epidemiology and Community Health.

[14]  L. Punnett,et al.  Physical and psychosocial ergonomic risk factors for low back pain in automobile manufacturing workers , 2011, Occupational and Environmental Medicine.

[15]  E. Holmström,et al.  Dose-response associations between musculoskeletal disorders and physical and psychosocial factors among construction workers. , 2005, Scandinavian journal of work, environment & health.

[16]  Allard J van der Beek,et al.  Is there a gender difference in the effect of work-related physical and psychosocial risk factors on musculoskeletal symptoms and related sickness absence? , 2009, Scandinavian journal of work, environment & health.

[17]  Bente E. Moen,et al.  How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms , 1999 .

[18]  Roger Tourangeau,et al.  Survey research and societal change. , 2004, Annual review of psychology.

[19]  C. Blake,et al.  Low back pain and occupation among Irish health service workers. , 2006, Occupational medicine.

[20]  Samuel N Cheuvront,et al.  Mechanisms of aerobic performance impairment with heat stress and dehydration. , 2010, Journal of applied physiology.

[21]  Dave McLean,et al.  The New Zealand workforce survey I: self-reported occupational exposures. , 2010, The Annals of occupational hygiene.

[22]  C. Gotay,et al.  Physical posture: Could it have regulatory or feedback effects on motivation and emotion? , 1982 .

[23]  A. Holtermann,et al.  The greatest risk for low-back pain among newly educated female health care workers; body weight or physical work load? , 2012, BMC Musculoskeletal Disorders.

[24]  B. Jonsson,et al.  Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. , 1987, Applied ergonomics.

[25]  Epilogue: an integrated model for chronic work-related myalgia "Brussels Model" , 2003 .

[26]  P. Buckle,et al.  Interactions between physical and psychosocial risk factors at work increase the risk of back disorders: an epidemiological approach. , 1999, Occupational and environmental medicine.

[27]  Thomas R. Waters,et al.  A Cross-Sectional Study of Risk Factors for Musculoskeletal Symptoms in the Workplace Using Data From the General Social Survey (GSS) , 2007, Journal of occupational and environmental medicine.

[28]  Grant D. Huang,et al.  Individual and combined impacts of biomechanical and work organization factors in work-related musculoskeletal symptoms. , 2003, American journal of industrial medicine.

[29]  Ben-Tzion Karsh,et al.  Theories of work-related musculoskeletal disorders: Implications for ergonomic interventions , 2006 .

[30]  Neil Pearce,et al.  Gender differences in work-related risk factors associated with low back symptoms , 2012, Ergonomics.

[31]  Roland Kadefors,et al.  The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work , 2000, European Journal of Applied Physiology.

[32]  Alex Burdorf,et al.  Model for the work-relatedness of low-back pain. , 2003, Scandinavian journal of work, environment & health.

[33]  B E Moen,et al.  The impact of social and organizational factors on workers' coping with musculoskeletal symptoms. , 2001, Physical therapy.

[34]  A. Silman,et al.  Risk factors for new-onset low back pain amongst cohorts of newly employed workers. , 2003, Rheumatology.

[35]  Arend W A Van Gemmert,et al.  Forearm EMG response activity during motor performance in individuals prone to increased stress reactivity. , 2002, American journal of industrial medicine.

[36]  M Hagberg,et al.  Effects of exposure to excessive drafts on myoelectric activity in shoulder muscles. , 1992, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[37]  J. Douwes,et al.  Prevalence of musculoskeletal symptoms in relation to gender, age, and occupational/industrial group , 2011 .

[38]  D. Rempel,et al.  Effort-reward imbalance and one-year change in neck-shoulder and upper extremity pain among call center computer operators. , 2010, Scandinavian journal of work, environment & health.

[39]  L. Punnett,et al.  Physical and Psychosocial Factors Related to Low Back Pain During a 24-Year Period: A Nested Case–Control Analysis , 2000, Spine.

[40]  A. Burdorf,et al.  Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers , 2008, European Spine Journal.

[41]  J. Hoogstraten,et al.  Head position and spinal position as determinants of perceived emotional state. , 1995, Perceptual and motor skills.

[42]  H. C. D. de Vet,et al.  Prevalence of Musculoskeletal Disorders Is Systematically Higher in Women Than in Men , 2006, The Clinical journal of pain.

[43]  Pascale Carayon,et al.  Work Organization, Job Stress, and Work-Related Musculoskeletal Disorders , 1999, Hum. Factors.

[44]  H. Heneweer,et al.  Physical activity and low back pain: a systematic review of recent literature , 2011, European Spine Journal.

[45]  N. Stacchini,et al.  LOW BACK PAIN IN PORT MACHINERY OPERATORS , 2002 .

[46]  S J Linton,et al.  A review of psychological risk factors in back and neck pain. , 2000, Spine.

[47]  A. Feyer,et al.  Musculoskeletal discomfort and work-related stress in New Zealand dentists , 2005 .

[48]  E. Holmström,et al.  Musculoskeletal disorders in relation to age and occupation in Swedish construction workers. , 2003, American journal of industrial medicine.

[49]  P M Bongers,et al.  High Quantitative Job Demands and Low Coworker Support As Risk Factors for Neck Pain: Results of a Prospective Cohort Study , 2001, Spine.

[50]  S. Linton,et al.  Do psychological factors increase the risk for back pain in the general population in both a cross‐sectional and prospective analysis? , 2005, European journal of pain.

[51]  F. Carvalho,et al.  Interactions between physical and psychosocial demands of work associated to low back pain. , 2009, Revista de saude publica.

[52]  M Hagberg,et al.  Perceived muscular tension, job strain, physical exposure, and associations with neck pain among VDU users; a prospective cohort study , 2004, Occupational and Environmental Medicine.

[53]  R. Rugulies,et al.  Effort–reward imbalance and incidence of low back and neck injuries in San Francisco transit operators , 2007, Occupational and Environmental Medicine.

[54]  Richard E. Petty,et al.  Body posture effects on self‐evaluation: A self‐validation approach , 2009 .

[55]  Hugo Piedrahíta,et al.  Perception of Musculoskeletal Symptoms in Cold Exposed and Non-Cold Exposed Workers , 2004 .

[56]  J. Winkel,et al.  Self-assessed and directly measured occupational physical activities--influence of musculoskeletal complaints, age and gender. , 2004, Applied ergonomics.

[57]  Mark A Stevenson,et al.  Prevalence and risk factors associated with musculoskeletal discomfort in New Zealand veterinarians. , 2010, Applied ergonomics.

[58]  N. Kawakami,et al.  The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. , 1998, Journal of occupational health psychology.

[59]  P. Dempsey,et al.  Risk factors for the prevalence of musculoskeletal disorders among chinese foundry workers , 2005 .

[60]  J P Bonde,et al.  Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies , 2003, Occupational and environmental medicine.

[61]  V. H. Hildebrandt,et al.  Psychosocial factors at work and musculoskeletal disease , 1993 .

[62]  P. Buckle,et al.  Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb , 2002, Occupational and environmental medicine.

[63]  C. Brisson,et al.  Prevalence of musculoskeletal pain and associated factors in the Quebec working population , 2005, International archives of occupational and environmental health.

[64]  P M Bongers,et al.  Physical risk factors for neck pain. , 2000, Scandinavian journal of work, environment & health.

[65]  Birgitte M Blatter,et al.  Can favorable psychosocial work conditions and high work dedication protect against the occurrence of work-related musculoskeletal disorders? , 2008, Scandinavian journal of work, environment & health.

[66]  I. Yu,et al.  Impact of occupational stress and other psychosocial factors on musculoskeletal pain among Chinese offshore oil installation workers , 2005, Occupational and Environmental Medicine.

[67]  Alex Burdorf,et al.  Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence. , 2004, Scandinavian journal of work, environment & health.

[68]  D. Hosmer,et al.  Applied Logistic Regression , 1991 .

[69]  Sylvie Montreuil,et al.  Interaction between postural risk factors and job strain on self-reported musculoskeletal symptoms among users of video display units: a three-year prospective study. , 2009, Scandinavian journal of work, environment & health.

[70]  A. B. Hill,et al.  "The Environment and Disease: Association or Causation?" (1965), by Austin Bradford Hill , 2017 .

[71]  Toby Mündel,et al.  Human thermoregulatory behavior during rest and exercise — A prospective review , 2010, Physiology & Behavior.

[72]  C. Heaney,et al.  The relationship between psychosocial work characteristics and low back pain: underlying methodological issues. , 2000, Clinical biomechanics.

[73]  Alireza Choobineh,et al.  Musculoskeletal Problems among Workers of an Iranian Rubber Factory , 2007, Journal of occupational health.

[74]  S. Linton Occupational Psychological Factors Increase the Risk for Back Pain: A Systematic Review , 2001, Journal of Occupational Rehabilitation.