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.

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Objectives-To investigate associations between diVerent potential risk factors, related and not related to work, and disorders of the neck and upper extremities occurring up to 24 years later. Methods-The study comprised 252 women and 232 men, Swedish citizens, 42-59 years of age and in a broad range of occupations. Information about potential risk factors was available from a former study conducted in 1969. Data on disorders of the neck, shoulder, and hand-wrist disorders were obtained retrospectively for the period 1970-93. Results-Risk factors were found to diVer between the sexes. Among women overtime work, high mental workload, and unsatisfactory leisure time were associated with disorders in the neck-shoulder region. Interaction was found between high mental workload and unsatisfactory leisure time. Neck symptoms earlier in life were associated with recurrent disorders. Hand and wrist disorders were associated mainly with physical demands at work. Among men blue collar work and a simultaneous presence of high mental workload and additional domestic workload predicted disorders in the neck-shoulder region. Conclusions-Factors related and not related to work were associated with disorders of the neck, shoulders, and hands and wrists up to 24 years later in life. These included factors related to working hours which previously have not been noted in this context. Interactions between risk factors both related and not related to work were commonly found. (Occup Environ Med 1999;56:59-66)

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Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs by Toomingas A, Theorell T, Michélsen H, Nordemar R, Stockholm MUSIC I Study GroupThe following articles refer to this text: 2001;27 suppl 1: 1-102; 2008;34(6):430-437 Key terms: body regions; epidemiology; job strain; medical examination; nerve compression; psychological demand; risk estimate; social support; syndrome; tenderness This article in PubMed: www.ncbi.nlm.nih.gov/pubmed/9167236 Scand J Work Environ Health 1997;23: 130-9 Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs by Allan Toomingas, MD,t2 Tores Theorell, MD,[3][4][5] PhD,Wolf Nordemar, MD, Objectives The aim was to study the associations between self-rated psychosocial work conditions and the characteristics and location of musculoskeletal symptoms, signs, and syndromes.Methods Perceived psychosocial work conditions were recorded in a cross-sectional study with 358 men and women in various occupations. Symptoms were recorded from the musculoskeletal system with a questionnaire, and signs were detected in a medical examination of all body regions. The analyses of statistical associations between the psychosocial factors and musculoskeletal disorders were performed with control for age, gender, and physical load. ResultsThe most consistent and pronounced associations were mainly seen between poor psychosocial work conditions and coexisting symptoms and signs of the neck and back regions. Poor psychosocial work conditions were more consistently and strongly associated with signs of muscular (soft tissue) tenderness than with signs of tenderness in the joints, tendons, or muscular insertions or signs in nerve compression tests. Mainly low social support at work, but also high psychological demands and high job strain, were associated with such symptoms and signs, whereas decision latitude at work showed few associations with musculoskeletal disorders. Many different risk factors have been described for the development of work-related musculoskeletal disorders in the neck and upper extremities (1, 2). There is a growing awareness of the ilnportance of psychosocial work conditions (3). C O~C I U S~O~S

BackgroundThe dose and time-pattern of sitting has been suggested in public health research to be an important determinant of risk for developing a number of diseases, including cardiovascular disorders and diabetes. The aim of the present study was to assess the time-pattern of seated and standing/walking postures amongst male and female call centre operators, on the basis of whole-shift posture recordings, analysed and described by a number of novel variables describing posture variation.MethodsSeated vs. standing/walking was recorded using dichotomous inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analysed using an extensive set of variables describing occurrence of and switches between seated and standing/walking, posture similarity across the day, and compliance with standard recommendations for computer work.ResultsThe majority of the operators, both male and female, spent more than 80% of the shift in a seated posture with an average of 10.4 switches/hour between seated and standing/walking or vice versa. Females spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; males 4.6% (p = 0.013). Only 38% and 11% of the operators complied with standard recommendations of getting an uninterrupted break from seated posture of at least 5 or 10 minutes, respectively, within each hour of work. Two thirds of all investigated variables showed coefficients of variation between subjects above 0.5. Since work tasks and contractual break schedules were observed to be essentially similar across operators and across days, this indicates that sedentary behaviours differed substantially between individuals.ConclusionsThe extensive occurrence of uninterrupted seated work indicates that efforts should be made at call centres - and probably in other settings in the office sector - to introduce more physical variation in terms of standing/walking periods during the work day. We suggest the metrics used in this study for quantifying variation in sedentary behaviour to be of interest even for other dichotomous exposures relevant to occupational and public health, for instance physical activity/inactivity.

The call center operators were exposed to working conditions that in other studies have indicated an increased risk of developing musculoskeletal disorders. The study 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.

Objectives: Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems. Methods: This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992-95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095). Results:The results showed that nursing personnel reporting musculoskeletal problems of the neck/ shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care. Conclusions: The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel. L ack of nursing personnel is a serious problem in several countries and will continue to be so because of the aging nursing workforce and a decline in the number of young people entering the profession.1 In order to develop recruitment strategies and to prevent nursing personnel from leaving their jobs, the importance of investigating reasons for leaving nursing care has been emphasised. 2Extensive research on turnover among nursing personnel exists, but there are few consistent results on the causes underlying the turnover. Large numbers of the studies conducted are cross sectional, based on small study samples, and have mainly focused on the relation between intentions to leave or stay and job attitudes, such as job satisfaction. 3Although a relation between intention to leave and actual turnover has been reported, the strength of association differs across studies. 4 Factors that have been proved to predict turnover intentions or turnover include low job satisfaction, work related distress and role conflicts, lack of career prospects, poor salary, managerial environment, employment conditions, as well as individual characteristics such as being young and having short job tenure. 5-11