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Herning, Denmark

Svendsen S.W.,Danish Ramazzini Center | Johnsen B.,Aarhus University Hospital | Fuglsang-Frederiksen A.,Aarhus University Hospital | Frost P.,Aarhus University Hospital
Occupational and Environmental Medicine | Year: 2012

Objectives: We aimed to evaluate relations between occupational biomechanical exposures and (1) ulnar neuropathy con firmed by electroneurography (ENG) and (2) ulnar neuropathy-like symptoms with normal ENG. Methods: In this triple case-referent study, we identified all patients aged 18-65 years, examined with ENG at a neurophysiological department on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms and two separate groups of community referents, matched on sex, age and primary care centre (risk set sampling). The two patient groups were also compared to each other directly. We constructed a Job Exposure Matrix to provide estimates of exposure to non-neutral postures, repetitive movements, hand-arm vibrations and forceful work. Conditional and unconditional logistic regressions were used. Results: The proportion who responded was 59%. Ulnar neuropathy was related to forceful work with an exposure-response pattern reaching an OR of 3.85 (95% CI 2.04 to 7.24); non-neutral postures strengthened effects of forceful work. No relation was observed with repetitive movements. Ulnar neuropathy-like symptoms were related to repetitive movements with an OR of 1.89 (95% CI 1.01 to 3.52) in the highest-exposure category (≥2.5 h/day); forceful work was unrelated to the outcome. Conclusions: Ulnar neuropathy and ulnar neuropathy-like symptoms differed with respect to associations with occupational biomechanical exposures. Findings suggested specific effects of forceful work on the ulnar nerve. Thus, results corroborated the importance of an electrophysiological diagnosis when evaluating risk factors for ulnar neuropathy. Preventive effects may be achieved by reducing biomechanical exposures at work. Source

Rubak T.S.,Slagelse Hospital | Svendsen S.W.,University Research Clinic | Soballe K.,Aarhus University Hospital | Frost P.,Aarhus University Hospital | Frost P.,Danish Ramazzini Center
Arthritis Care and Research | Year: 2014

Objective. To investigate the risk of total hip replacement (THR) due to primary osteoarthritis in relation to cumulative occupational mechanical exposures and lifestyle factors.Methods. Using register information, we identified first-time THR cases within the Danish working population in 2005-2006. For each case, 2 age-and sex-matched controls were drawn. Persons within 2,500 randomly selected case-control sets received a questionnaire about job history, weight at age 25 years, present weight and height, smoking, and sports activities at age 25 years. The job history was combined with a job exposure matrix. Cumulative exposure estimates were expressed according to the pack-year concept of smoking (e.g., cumulative lifting was expressed as ton-years). We used conditional logistic regression for statistical analyses.Results. In total, 1,776 case-control sets (71%) were available for analysis. The adjusted odds ratio (OR) for exposure to ≥20 ton-years was 1.35 (95% confidence interval [95% CI] 1.05-1.74) for men and 1.00 (95% CI 0.73-1.41) for women. Standing/walking and whole body vibration showed no associations. The adjusted OR for body mass index (BMI) ≥30 kg/m2 at age 25 years was 2.44 (95% CI 1.38-4.32) for men and 5.12 (95% CI 2.30-11.39) for women. The corresponding adjusted ORs for an increase in BMI of ≥10 kg/m2 since age 25 years were 2.16 (95% CI 1.25-3.70) and 2.46 (95% CI 1.47-4.13). Sports participation showed weak positive associations, while pack-years of smoking showed no associations.Conclusion. The results indicated a modest increase in risk of THR in relation to cumulative lifting among men and an increased risk in relation to a high BMI at age 25 years and to a gain in BMI in both sexes. © 2014, American College of Rheumatology. Source

Nielsen K.J.,Danish Ramazzini Center
Journal of Safety Research | Year: 2014

Introduction International research indicates that internal health and safety organizations (HSO) and health and safety committees (HSC) do not have the intended impact on companies' safety performance. The aim of this case study at an industrial plant was to test whether the HSO can improve company safety culture by creating more and better safety-related interactions both within the HSO and between HSO members and the shop-floor. Methods A quasi-experimental single case study design based on action research with both quantitative and qualitative measures was used. Intervention Based on baseline mapping of safety culture and the efficiency of the HSO three developmental processes were started aimed at the HSC, the whole HSO, and the safety representatives, respectively. Results Results at follow-up indicated a marked improvement in HSO performance, interaction patterns concerning safety, safety culture indicators, and a changed trend in injury rates. These improvements are interpreted as cultural change because an organizational double-loop learning process leading to modification of the basic assumptions could be identified. Practical applications The study provides evidence that the HSO can improve company safety culture by focusing on safety-related interactions. © 2013 Elsevier Ltd. Source

Andersen J.H.,Danish Ramazzini Center | Fallentin N.,Liberty Mutual Research Institute for Safety | Thomsen J.F.,Copenhagen University | Mikkelsen S.,Copenhagen University
PLoS ONE | Year: 2011

Background: To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. Methodology/Principal Findings: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Conclusions/Significance: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented. © 2011 Andersen et al. Source

Pedersen L.M.,Danish Ramazzini Center | Nielsen K.J.,Danish Ramazzini Center | Kines P.,Helmholtz Center Munich
Safety Science | Year: 2012

Recent debates regarding the criteria for evaluating occupational health and safety interventions have focused on the need for incorporating qualitative elements and process evaluation, in addition to attempting to live up to the Cochrane criteria. Reflecting fundamental epistemological conflicts and shortcomings of the Cochrane criteria in evaluating intervention studies, the debate challenges the traditional (quasi-) experimental design and methodology, which are often used within safety research. This article discusses a revised 'realistic evaluation' approach as a way to meet these challenges. Evidence from the literature as well as examples from an integrated (leader-based/worker-based) safety intervention study (2008-2010) in a large wood manufacturing company are presented, with focus on the pros and cons of using randomised-controlled-trials and a revised realistic evaluation model.A revised realistic evaluation model is provided which includes factors such as role behaviour, leader and worker motivation, underreporting of accidents/injuries, production pressure, unplanned organisational change and accounting for multilayer effects. These can be attained through qualitative and/or quantitative methods, allowing for the use of realistic evaluation in both large and small scale studies, as well as in systematic reviews. The revised realistic evaluation model offers a promising new way of designing and evaluating occupational safety research. This model can help safety science move forward in setting qualitative and/or quantitative criteria regarding context, mechanisms and processes for single studies and for reviews. Focus is not limited to whether the expected results appear or not, but include suggestions for what works for whom, under what circumstances, in what respects and how. © 2011 Elsevier Ltd. Source

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