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  • 1. Eklof, M.
    et al.
    Hagberg, M.
    Toomingas, Allan
    Wigaeus Tornqvist, Ewa
    Feedback of workplace data to individual workers, workgroups or supervisors as a way to stimulate working environment activity: a cluster randomized controlled study2004Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 77, nr 7, s. 505-514Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To test whether feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers had an effect on activity to modify workplace design, working technique and psychosocial aspects of work. Methods: A total of 36 workgroups from nine organizations representing different trades was randomized (stratified for organization) to three feedback conditions or control with no feedback. Data were collected I month before and 6 months after feedback sessions. The effects studied were: (1) change in the proportion of workgroup members who reported any modification regarding workplace design or working technique; (2) change in the proportion of workgroup members who reported any modification regarding psychosocial aspects; (3) average number of modification types regarding workplace design or working technique per individual in a workgroup; (4) average number of modification types regarding psychosocial aspects per individual in a workgroup. Results: All feedback conditions differed positively from controls regarding change in the proportion of workgroup members who reported any modification in workplace design or working technique. No such effect was found for psychosocial aspects. For change in average number of psychosocial modification types per individual in a workgroup an effect was observed for feedback to supervisors. No intervention effect was observed for the average number of modifications in workplace design or working technique per individual in a workgroup. Conclusion: Feedback and discussion of ergonomic and psychosocial working-environment data during one short session with individual, groups or supervisors of white-collar computer workers may have a positive effect on how many people in a workgroup modify (or have modifications done regarding) workplace design and working technique. Feedback to supervisors may have an effect on the average number of psychosocial modification types per individual in a workgroup. Feedback to group supervisors appeared to be the most cost-effective variant.

  • 2. Hagberg, M.
    et al.
    Vilhelmsson, R.
    Wigaeus Tornqvist, Ewa
    Toomingas, Allan
    Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users2007Ingår i: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 50, nr 11, s. 1820-1834Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to assess the incidence and identify possible risk factors for self-reported reduced productivity owing to musculoskeletal symptoms among computer users. Design: a cohort study with a baseline questionnaire and monthly follow ups during 10 months. Methods: the study base consisted of 1283 computer users, 636 men and 896 women. Ergonomists observed workstation characteristics before entering the cohort. Cases were defined as subjects reporting reduced productivity or reporting being on sick leave owing to musculoskeletal symptoms. Results: women had approximately two times the incidence of self-reported reduced productivity owing to symptoms in the neck, shoulder and in the forearm/hand than men. There was no difference in gender for the incidence of self-reported reduced productivity owing to back symptoms. Working overtime and job demands were risk factors for self-reported reduced productivity owing to neck and back symptoms. Physical exercise fewer than 8 times the last month was a risk factor for self-reported reduced productivity owing to neck, shoulder and forearm/hand symptoms. Computer mouse use for more than 0.5 h/day was a risk factor for self-reported reduced productivity owing to shoulder and forearm/hand symptoms. Conclusions: risk factors for self-reported reduced productivity owing to musculoskeletal symptoms included life style factors, such as overweight and low physical exercise, occupational factors, such as overtime, job demands and computer mouse operating time.

  • 3. Karlqvist, L.
    et al.
    Wigaeus Tornqvist, Ewa
    Hagberg, M.
    Toomingas, Allan
    Self-reported working conditions of VDU operators and associations with musculoskeletal symptoms: a cross-sectional study focussing on gender differences2002Ingår i: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 30, nr 4-5, s. 277-294Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to describe working conditions and the prevalence of musculoskeletal symptoms among male and female VDU operators, and to assess associations between work-related physical and psychosocial exposures and neck and upper limb symptoms by gender. The study population comprised a variety of occupations from both private and public sectors. Data on physical and psychosocial exposures were collected by questionnaires, as were data on musculoskeletal symptoms. Univariate associations between exposures and symptoms affecting the neck and upper limbs were estimated by calculating the prevalence ratios with 95% confidence intervals. We also assessed the potential excess odds ratio attributable to interaction between gender and, one by one, exposure variable. Women (n = 785) used the computer on average 3.9 h/day and men (n = 498) 3.6. Variation of different work tasks was lower among females than among males. Nineteen per cent of the women and 12% of the men did > 3 h of continued computer work without breaks (> 10 min) at least twice a week. Twice as many women as men experienced high job strain (high demands and low decision latitude). A higher proportion of women than men reported symptoms greater than or equal to 3 days the preceding month from the upper body, irrespective of body region. For many of the studied exposures the prevalence of symptoms in one or several body regions was increased with increasing exposure, indicating exposure-response relationships. Duration of computer work was associated with symptoms among both men and women. Only among men, duration of work with a non-keyboard computer input device was associated with symptoms. Only among women, job strain was associated with symptoms. Time pressure was associated with higher prevalence of symptoms among women. Among men, time pressure was associated with lower prevalence of symptoms. Thus, the associations differed between the genders. Women experienced higher prevalence of symptoms than men in all body regions and they were more often exposed to physical and psychosocial conditions that in previous studies have been considered harmful, than men.

  • 4. Kjellberg, Anders
    et al.
    Toomingas, Allan
    Norman, Kerstin
    Hagman, Maud
    Herlin, Rose-Marie
    Wigaeus Tornqvist, Ewa
    KTH, Skolan för teknik och hälsa (STH), Ergonomi.
    Stress, energy and psychosocial conditions in different types of call centres2010Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 36, nr 1, s. 9-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. Participants: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. Method: A cross sectional questionnaire study. Results: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. Conclusions: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work.

  • 5. Lindegard, A.
    et al.
    Karlberg, C.
    Wigaeus Tornqvist, Ewa
    Toomingas, Allan
    Hagberg, M.
    Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures2005Ingår i: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 36, nr 3, s. 319-325Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The Study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working Postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures. © 2005 Elsevier Ltd. All rights reserved.

  • 6. Lindegard, A.
    et al.
    Wahlström, J.
    Hagberg, M.
    Hansson, G. A.
    Jonsson, P.
    Wigaeus Tornqvist, Ewa
    The impact of working technique on physical loads - an exposure profile among newspaper editors2003Ingår i: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 46, nr 6, s. 598-615Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p =0.03) and in the trapezius muscle on the mouse operating side ( p =0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p =0.006, peak force p =0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.

  • 7. Norman, Kerstrin
    et al.
    Flodreus, B.
    Hagman, Maud
    Toomingas, Allan
    Wigaeus Tornqvist, Ewa
    Musculoskeletal symptoms in relation to work exposures at call centre companies in Sweden2008Ingår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 30, nr 2, s. 201-214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. Methods: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1183 operators from 28 CCs. Results: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. Conclusions: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs.

  • 8. Norman, Kerstrin
    et al.
    Wigaeus Tornqvist, Ewa
    Toomingas, Allan
    Working conditions and health among female and male employees at a call center in Sweden2004Ingår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 46, nr 1, s. 55-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The call center industry is one of the most expansive labor market sectors in Sweden today. The purpose of this study was to investigate the working conditions and symptoms among employees at a call center in Sweden. Methods This study represents the cross-sectional baseline survey, which was part of a prospective cohort study. Fifty-seven call center workers were compared with a reference group of 1,459 professional computer users from other occupations. A questionnaire covered physical and psychosocial working conditions and symptoms during the last month. Structured observations in accordance with an ergonomic checklist were used to assess workstation design during the subject's ordinary work. Results The call center group had worked for a shorter time in their present tasks and spent longer continuous time in front of the computer than the reference group. There were deficiencies in workspace, keyboard- and input device placement. The subjects reported poor support from their immediate supervisor, low control and limited opportunities to influence their work. A higher proportion of the call center group reported musculoskeletal symptoms. Conclusion The call center operators were exposed to working conditions that in other studies have indicated an increased risk of developing musculoskeletal disorders. The stud), also shows that young computer operators in the call center group with a short working career had a higher prevalence of neck- and upper extremity symptoms than older computer workers in other labor market sectors.

  • 9. Norman, Kerstrin
    et al.
    Wigaeus Tornqvist, Ewa
    KTH, Skolan för teknik och hälsa (STH), Ergonomi.
    Toomingas, Allan
    Working conditions in a selected sample of call centre companies in Sweden2008Ingår i: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 14, nr 2, s. 177-194Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Call centres (CCs) are among the most rapidly growing forms of workplaces in Sweden. The purpose of the study was to describe and compare working conditions between operators at internal and external CC companies and work tasks of different complexity. Method. A questionnaire was answered by 1183 operators, 848 women and 335 men, from 28 different CCs. The questionnaire covered background factors, employment, working hours and remuneration, call logging and monitoring, duties, computer work and workplace design during the previous month. Results. Operators at external companies and operators with low-complexity work tasks were younger, more often employed by the hour and worked on a varying roster. They spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring were more common at external companies and among operators with low-complexity work tasks. Conclusion. The working conditions varied between internal and external CCs. There was also a variation in working conditions between work tasks of different complexity. There were aspects of supervision style and organization of work at CCs, especially at external ones and those with low-complexity tasks that could introduce stress and lack of well being among the staff.

  • 10. Palm, P.
    et al.
    Risberg, Eva Hansson
    Mortimer, Monica
    Palmerud, Gunnar
    Toomingas, Allan
    Wigaeus Tornqvist, Ewa
    Computer use, neck and upper-extremity symptoms, eyestrain and headache among female and male upper secondary school students2007Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, s. 33-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives Computer use, neck and upper-extremity symptoms, headache, and eyestrain were studied in upper secondary school students. Methods A questionnaire was completed by 1575 female and 1251 male students. Associations between computer use and health problems were analyzed by calculating the prevalence ratios for the health variables, considering computer use for >14-56 or >56 hours/week as compared with <= 14 hours/week (reference). Health problems were defined as aches or pain or other trouble at least three days in the preceding month. Results Computer use (median) was reported to be 31 hours/week by the male students and 19 hours/week by the females. Most computer use (about 90%) took place outside school (eg, for entertainment). Headache was reported by 51% and 24%, and neck or shoulder symptoms by 31% and 15%, of the females and mates, respectively. More than 50% of the females with health complaints indicated that their problems had disturbed their sleep, and they used painkillers to handle them. Between 10% and 43% experienced their health complaints as being related to computer use. For those using computers >56 hours/week, the prevalence ratios were significantly increased for neck or shoulder symptoms among both the females and the males, and for eyestrain and forearm symptoms among the females. Exposure-response relationships were indicated for the aforementioned associations. Approximately two-thirds of the students reported that they had not received any information in school about appropriate workplace layout and techniques for computer work. Conclusions Despite their young age, the students were not protected from computer-related health complaints. Therefore, providing adolescents with information about proper computer ergonomics may help prevent such health problems.

  • 11. Pernold, G.
    et al.
    Mortimer, M.
    Wictorin, C.
    Wigaeus Tornqvist, Ewa
    Vingard, E.
    Neck/shoulder disorders in a general population. Natural course and influence of physical exercise: A 5-year follow-up2005Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 30, nr 13, s. E363-E368Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Design. A 5-year follow-up study was conducted of men and women seeking care for new incidents of neck/shoulder disorders (NSD). Objectives. To study the natural course of pain and disability caused by NSD during a 5-year follow-up and to investigate the possible influence of regular physical exercise on recovery. Summary of Background Data. NSD are a major health problem, but their natural course is not very well studied. Several studies have investigated the role of physical exercise on NSD, with inconsistent results. Methods. At baseline, a total of 439 subjects seeking care for NSD completed a questionnaire, and were interviewed about personal, medical, and occupational history, as well as physical exercise during leisure time. Over 5 years, 4 follow-up assessments were made by postal questionnaire. At all measuring points, pain intensity ratings and disability scores were compared between men and women, and between 3 exercise categories. Results. The highest improvements in pain and disability, both in men and in women, were seen after 3 months. After that, only minor improvements were seen. In some cases, there was deterioration. However, after 5 years, both men and women had significant improvements, men more than women. Only the women were analyzed concerning physical exercise and were pooled into 3 categories according to intensity of exercise. There were no differences in changes in pain intensity and disability scores from baseline between the groups. Conclusions. A gender difference was seen in the change of pain and disability, with men having higher improvement than women over 5 years. Self-reported physical exercise of any intensity was not associated with higher recovery in women.

  • 12. Wahlström, J.
    et al.
    Hagberg, M.
    Toomingas, Allan
    Wigaeus Tornqvist, Ewa
    Perceived muscular tension, job strain, physical exposure, and associations with neck pain among VDU users; a prospective cohort study2004Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 61, nr 6, s. 523-528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To determine whether perceived muscular tension, job strain, or physical exposure are associated with increased risk of developing neck pain among VDU users. Methods: A baseline questionnaire was answered by 1283 respondents, of whom 671 were free from neck pain at baseline. Perceived muscular tension, job strain, and physical exposure were assessed at baseline. Information about newly developed neck pain was collected in 10 follow up questionnaires and the case definition was the first report of such pain in any of the follow up questionnaires. Median follow up time was 10.9 months. Results: Both men and women who perceived muscular tension at least a few times per week, compared to those who had not perceived muscular tension the preceding month, had an incidence rate ratio (IRR) of 1.9 (95% CI 1.25 to 2.93) for developing neck pain, when stratifying for sex. High perceived muscular tension was associated with an increased risk (IRR 1.6, 95% CI 1.02 to 1.91), even when controlling for job strain, physical exposure, and age in the model stratified by sex. Conclusions: Perceived muscular tension was associated with an increased risk of developing neck pain among VDU users. The combination of high job strain and high perceived muscular tension was associated with higher risk of developing neck pain than the combination of high physical exposure and high perceived muscular tension. There was an indication of an excess risk due to interaction between high physical exposure and high job strain.

  • 13.
    Wigaeus Tornqvist, Ewa
    et al.
    KTH, Skolan för teknik och hälsa (STH), Ergonomi.
    Hagberg, Mats
    Hagman, Maud
    Risberg, Eva Hansson
    Toomingas, Allan
    The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users2009Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, nr 6, s. 689-702Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To assess the influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. The study is a prospective cohort study with an observation period of 10 months. A baseline questionnaire about symptoms in the neck, shoulder and arm/hand during previous month, individual factors, work content, physical and psychosocial work-related exposures was answered by 1,283 computer operators (response rate 84%). Incidence data were collected by ten monthly questionnaires regarding the occurrence of symptoms categorized into three gross body regions: neck, shoulders and arms/hands. A case, in the specific gross body region, was defined as a subject who was classified as non-symptomatic in that region at baseline or during minimum one follow-up period and later reported symptoms (a parts per thousand yen3 days). Univariable and multivariable incidence rate ratios with 95% confidence intervals for first occurrence of neck, shoulder and arm/hand cases, respectively, were calculated with Cox regression analysis. The incidence rate was 67, 41 and 47 cases per 100 person years for neck, shoulder and arm/hand symptoms, respectively. In the multivariable analyses, comfort of the computer work environment and gender were related to the incidence of symptoms in all body regions (RR = 1.5-1.9 for low comfort and 1.8-2.1 for females, respectively). Duration of mouse use predicted arm/hand symptoms (RR = 1.7 for a parts per thousand yen3 h/day) and job strain (high demands and low decision latitude) predicted neck symptoms (RR = 1.6 and 2.2 for medium and high strain, respectively). Additionally, age was related to neck and shoulder symptoms. Preventive strategies to reduce neck and upper limb symptoms among computer users should include measures to reduce mouse use, to increase the comfort of the work environment and to reduce job strain. Although the effect estimates were relatively weak to moderate, preventive measures may have a marked impact on the incidence of neck and upper limb symptoms in the general population because of the widespread use of computers in working life as well as at home.

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