Medium- and long-term reproducibility of self-reported exposure to physical ergonomics factors at work.

INTRODUCTION The literature is sparse on reproducibility of self-reported exposure to physical ergonomics risk factors for musculoskeletal disorders (MSDs). Aims of this study were to evaluate, in a cohort of workers interviewed up to three times: 1-year test-retest reliability; and 5- and 6-year recall of physical exposures. We also examined whether reproducibility was influenced by the presence of UE MSD or by technological changes introduced between the last two surveys. METHODS A cohort of automobile manufacturing employees was interviewed at baseline, one and six years later about work history, physical and psychosocial exposures at work, upper limb symptoms, injury and medical history, and demographics. Agreement between interviews was evaluated by intraclass correlation and Spearman coefficients. Differences in exposure between 1- and 6-year follow-up were analyzed by Wilcoxon matched-pairs signed-ranks test. RESULTS Large and significant decreases in work pace and physical effort were observed from baseline, although an upper extremity composite index was quite stable in the total population. One-year test-retest reliability was fair to good for the composite exposure index (ICC=0.58), whole-body vibration, handling parts, and tool use, but poor for the other variables considered. Long-term reproducibility, from baseline or 1-year follow-up to 6-year follow-up, was poor for the composite index and almost all single items. UE MSD case status influenced 1-year test-retest reliability, with subjects who changed case status from baseline displaying higher reliability, but not reproducibility of recalled exposures. A strong regression to the mean effect was observed on exposures reported at follow-up surveys. CONCLUSIONS Recalled ergonomics exposures could be employed in retrospective cohort studies as a somewhat reliable and unbiased estimate of the self-reported exposures that would have been obtained up to one year earlier, but not over a longer period (5-6 years). These longer-term results may have been limited by difficulty in matching jobs between interviews; also the regression to the mean effect likely contributed to reduce agreement. Changes in production technology and work organization produced a decrease in physical workload intensity and job pace, but did not have a substantial impact on an exposure index for the upper limb.

[1]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[2]  C Wiktorin,et al.  An interview technique for recording work postures in epidemiological studies. Music-Norrtälje Study Group. , 1996, International journal of epidemiology.

[3]  Å. Kilbom,et al.  Retrospective versus original information on physical and psychosocial exposure at work. , 1999, Scandinavian journal of work, environment & health.

[4]  P Spielholz,et al.  Reproducibility of a self-report questionnaire for upper extremity musculoskeletal disorder risk factors. , 1999, Applied ergonomics.

[5]  Laura Punnett,et al.  A comparison of approaches to modeling the relationship between ergonomic exposures and upper extremity disorders , 2000 .

[6]  D Goldsheyder,et al.  The test-retest reliability of a new occupational risk factor questionnaire for outcome studies of low back pain. , 2001, Applied ergonomics.

[7]  L Punnett,et al.  Covariation between workplace physical and psychosocial stressors: evidence and implications for occupational health research and prevention , 2001, Ergonomics.

[8]  C Wiktorin,et al.  Reproducibility of a questionnaire for assessment of physical load during work and leisure time. Stockholm MUSIC I Study Group. MUSculoskeletal Intervention Center. , 1996, Journal of occupational and environmental medicine.

[9]  Å. Kilbom,et al.  Assessment of physical exposure in relation to work-related musculoskeletal disorders--what information can be obtained from systematic observations? , 1994, Scandinavian journal of work, environment & health.

[10]  Jörgen Winkel,et al.  Validity of self-reported exposures to work postures and manual materials handling , 1993 .

[11]  H J Montoye,et al.  Assessment of the accuracy of physical activity questionnaire occupational data. , 1993, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[12]  Adrian G Barnett,et al.  Regression to the mean: what it is and how to deal with it. , 2004, International journal of epidemiology.

[13]  G. Borg Psychophysical scaling with applications in physical work and the perception of exertion. , 1990, Scandinavian journal of work, environment & health.

[14]  S E Mathiassen,et al.  Assessment of physical work load in epidemiologic studies: concepts, issues and operational considerations. , 1994, Ergonomics.

[15]  K Ohlsson,et al.  Questionnaire-based mechanical exposure indices for large population studies--reliability, internal consistency and predictive validity. , 2001, Scandinavian journal of work, environment & health.

[16]  A. Grieco,et al.  Epidemiology of musculoskeletal disorders due to biomechanical overload. , 1998, Ergonomics.

[17]  L Punnett,et al.  Ergonomic stressors and upper extremity disorders in vehicle manufacturing: cross sectional exposure-response trends. , 1998, Occupational and environmental medicine.

[18]  Bruce K. Armstrong,et al.  Principles of Exposure Measurement in Epidemiology , 1992 .

[19]  Christina Wiktorin,et al.  Validity of a Self-Administered Questionnaire for Assessing Physical Work Loads in a General Population , 2002, Journal of occupational and environmental medicine.

[20]  Alain Delisle,et al.  Reproducibility and validity of workers' self-reports of physical work demands. , 2005, Scandinavian journal of work, environment & health.

[21]  A. Genaidy,et al.  Reliability and validity of self-reported assessment of exposure and outcome variables for manual lifting tasks: a preliminary investigation. , 2002, Applied ergonomics.

[22]  Göran M Hägg,et al.  The impact on musculoskeletal disorders of changing physical and psychosocial work environment conditions in the automobile industry , 2001 .

[23]  Laura Punnett,et al.  Work routinization and implications for ergonomic exposure assessment , 2006, Ergonomics.

[24]  F Gamberale Maximum acceptable work loads for repetitive lifting tasks. An experimental evaluation of psychophysical criteria. , 1988, Scandinavian journal of work, environment & health.

[25]  L. Punnett,et al.  Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. , 2004, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[26]  Ekkehart Frieling,et al.  Effects of team work on the working conditions of short cycled track work: A case study from the European automobile industry , 1997 .

[27]  A. Burdorf,et al.  Exposure assessment of risk factors for disorders of the back in occupational epidemiology. , 1992, Scandinavian journal of work, environment & health.

[28]  A Kilbom,et al.  Interview versus questionnaire for assessing physical loads in the population-based MUSIC-Norrtälje Study. , 1999, American journal of industrial medicine.

[29]  Satterthwaite Fe An approximate distribution of estimates of variance components. , 1946 .

[30]  L. Forcier,et al.  Work related musculoskeletal disorders (WMSDs) : a reference book for prevention , 1995 .

[31]  D H Wegman,et al.  Ergonomic stressors and upper extremity musculoskeletal disorders in automobile manufacturing: a one year follow up study , 2004, Occupational and Environmental Medicine.

[32]  A Kilbom,et al.  Evaluation of questionnaire-based information on previous physical work loads. Stockholm MUSIC 1 Study Group. Musculoskeletal Intervention Center. , 1999, Scandinavian journal of work, environment & health.

[33]  Christina Wiktorin,et al.  Reproducibility of a questionnaire for assessment of present and past physical activities , 1997, International archives of occupational and environmental health.

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

[35]  A. Silman,et al.  Occupational risk factors for shoulder pain: a systematic review , 2000, Occupational and environmental medicine.

[36]  C Wiktorin,et al.  Physical work load in physical education teachers. , 1999, Applied ergonomics.

[37]  C. Wiktorin,et al.  Validity of self-reported exposures to work postures and manual materials handling. Stockholm MUSIC I Study Group. , 1993, Scandinavian journal of work, environment & health.

[38]  P. Landsbergis,et al.  The impact of lean production and related new systems of work organization on worker health. , 1999, Journal of occupational health psychology.