BackgroundIt is usually assumed that musculoskeletal pain is associated with both the physical workload and the psychosocial work environment, as well as with personal and lifestyle factors. This study aims to ascertain the prevalence of musculoskeletal pain in women with varying or different occupational exposures, and to explore the associations between musculoskeletal pain and the occupational and personal factors.MethodsA questionnaire on physical, psychosocial and individual factors was answered by 1591 women in five occupational groups with contrasting occupational exposures (teachers, anaesthetic, theatre, and assistant nurses, and sonographers). The outcome measure was musculoskeletal pain (in a new model based on frequency and intensity of complaints the preceding year) from the neck, shoulders, hands, lower back and feet.ResultsNeck pain was equally frequent among teachers, assistant nurses and sonographers, and less frequent in anaesthetic and theatre nurses. The sonographers experienced the highest prevalence of shoulder pain, while the assistant nurses were the most affected in the wrists and hands, lower back, and feet.The teachers reported the highest scores in most of the psychosocial dimensions. The theatre nurses scored highest in strenuous work postures and movements (mechanical exposure index, MEI), and the assistant nurses in physical activity and lifting (physical exposure index, PHYI). Multivariable models in the total population showed that both the physical workload and the psychosocial work environment were associated with pain in all body regions, though different factors affected different regions. Pain in the neck, shoulders, hands and lower back was strongly associated with a high MEI and high job demands, while pain in the feet was associated with a high PHYI and a high BMI. A young age was associated with pain in the neck, and an older age was associated with pain in the hands and feet. Lack of time for personal recovery was associated with pain in the shoulders and lower back.ConclusionsThe occupational groups were affected differently and need different protective measures. For the teachers, the psychosocial work environment should be improved. The surgical staff and sonographers require measures to mitigate lifting and constrained postures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0883-4) contains supplementary material, which is available to authorized users.

Sonographers have a high risk of musculoskeletal disorders. This study explores the associations between working conditions and musculoskeletal pain based on the frequency and intensity of pain in the neck and upper extremities. A questionnaire was answered by 291 female sonographers. High prevalence of neck/shoulder pain was associated with eye complaints and headache related to work on the computer, dissatisfaction with the computer workstation, high mechanical exposure index (MEI) and high demands. The possibility to adjust the keyboard and chair, and adequately corrected eyesight were positive factors. High prevalence of elbow/hand pain was associated with performing echocardiography, computerrelated eye complaints, high MEI and high job and sensory demands. In echocardiography, working with a straight wrist and holding the transducer with a two-handed grip or alternating hands was associated with a low prevalence of elbow/hand pain. Thus, further improvements in the working conditions are possible and are recommended.

BackgroundSonographers’ perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers’ perceptions of ergonomic problems at work, and their suggestions for improvement strategies.MethodsTwenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied.ResultsThe sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient’s physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills.ConclusionSonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable.

Background Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. The aim of this study was to explore the relative importance of physical, psychosocial and personal factors, in number of pain sites and in five specific pain sites, among women in common professions with a broad variety of occupational exposures. Methods A cohort of 1115 women responded to a questionnaire on ergonomic, psychosocial, personal and life-style factors, and the outcome measure of musculoskeletal pain (based on frequency and intensity of complaints at nine anatomical sites), at baseline and at follow-up. Sum scores of ergonomic and psychosocial factors were created. The importance of exposure at baseline for the number of pain sites at follow-up were estimated using ordinal regression. The importance of exposure at baseline for pain in the neck, shoulders, hands, lower back and feet at follow-up were estimated using multi-exposure Poisson regression models. Results High sum scores for ergonomic and psychosocial factors were of importance for a high number of pain sites, although the strongest risk factor was a high number of pain sites already at baseline. On the individual level, there was a large fluctuation in number of pain sites between the two time points. Eighteen percent reported persistent (or recurrent) ≥ four pain sites, while only 11 % did not report any pain at baseline or at follow-up. Among the specific pain sites, a high sum score of ergonomic factors was associated with pain in the neck, hands and feet. A high sum score of psychosocial factors was associated with neck and shoulder pain. The strongest risk factor was, however, pain at that specific anatomical site at baseline. Only a few of the personal and life-style factors were associated with pain. Conclusions An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic and psychosocial factors were predictive of a high number of pain sites and of specific pain sites. These findings indicate the need for preventive measures on the individual, organizational and societal level.

BackgroundEchocardiography involves strenuous postures of the upper limbs. This study explored the physical workload in the neck and upper limbs in sonographers performing echocardiography, and the extent to which the workload differs from than in other work tasks (other sonographic examinations, and nonsonographic tasks).MethodsThe physical load was assessed by inclinometry, goniometry, and electromyography methods in 33 female sonographers during authentic work using three different echocardiography techniques and other work tasks.ResultsEchocardiography was characterized by low velocities of the head, arms, and wrists, and a low proportion of muscular resting time in the forearms, in the transducer limb, and the computer limb. The transducer limb was more elevated in one of the techniques, but this technique also involved a higher proportion of muscular resting time of the trapezius muscle. We also found a high proportion of awkward wrist postures in the transducer wrist in all three techniques; in one due to prolonged flexion, and in the others due to prolonged extension. Other work tasks were less static, and were performed with higher upper arm and wrist velocities.ConclusionNone of the three echocardiography techniques was optimal concerning physical workload. Thus, to achieve more variation in physical load we recommend that the equipment be arranged so that the sonographer can alternate between two different techniques during the workday. We also propose alternation between echocardiography and nonsonographic tasks, in order to introduce variation in the physical workload. Clinical expertise should be used to achieve further improvements.

Background: Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/ hand pain at follow-up. Methods: A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up. Results: Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50-2.76], for neck/shoulders and (PR 3.45; CI 2.29-5.22) for elbows/ hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05-1.49), a high mechanical exposure index (PR 1.66; CI 1.09-2.52), and adverse visual conditions (PR 1.24; CI 1.00-1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01-3.12), and a high mechanical exposure index (PR 2.0; CI 0.98-4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08-2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53-7.31). Conclusion: Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.

Disorders in the musculoskeletal system have been associated with a high physical workload as well as psychosocial and individual factors. It is however not obvious which of these factors that is most important to prevent. Musculoskeletal disorders in neck and upper extremity was assessed by interview and clinical examination in 79 teachers and 93 assisting nurses, all females. Psychosocial work environment was assessed by questionnaire. The physical workload was recorded by technical measurements of postures, movements and muscular load, in 9 teachers and 12 nurses. The physical workload was lower among the teachers, but they had a more demanding psychosocial work environment. Among the nurses, but not in the teachers, the neck-shoulder disorders were associated with a high body mass index (BMI). The teachers reported neck-shoulder complaints to a higher extent than the nurses, but had much lower prevalence of diagnoses in the clinical examination (12% vs. 25%; POR 0.3 CI 0.1 -1.2; adjusted for age and BMI). The results suggest that adverse psychosocial conditions among the teachers give rise to a different kind of pain in the neck-shoulder region than from physical overload, troublesome but not as severe as the one afflicting the nurses.

Background: Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. The aim of this study was to explore the relative importance of physical, psychosocial and personal factors, in single- and multisite musculoskeletal pain, among women in common professions with a broad variety of occupational exposures. Methods: A cohort of 1115 women responded to a questionnaire on ergonomic, psychosocial, personal and life-style factors, and the outcome measure of musculoskeletal pain (based on frequency and intensity of complaints at nine anatomical sites), at baseline and at follow-up (mean 28 months later). Sum scores of ergonomic and psychosocial factors were created. The importance of exposure at baseline for multisite pain (number of pain sites) at follow-up were estimated using ordinal regression. The importance of exposure at baseline for single-site pain in the neck, shoulders, hands, lower back and feet at follow-up were estimated using multi-exposure Poisson regression models. Results: High sum scores for ergonomic and psychosocial factors at baseline were found to be of importance for multisite pain at follow-up, although the strongest risk factor was the presence of multisite pain at baseline. A large fluctuation was seen in the number of pain sites between the two time points, on the individual level. Eighteen percent of the study population reported ≥four pain sites at both baseline and follow-up, while only eleven percent did not report any pain at baseline or at follow-up. Among the single-site outcomes, a high sum score of ergonomic factors was a risk factor for pain in the neck, hands and feet. A high sum score of psychosocial factors was a risk factor for neck and shoulder pain. The strongest risk factor was, however, pain at that specific anatomical site at baseline. Only a few of the personal and life-style factors were found to be of importance for subsequent single- and multisite pain.Conclusions: An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic and psychosocial factors were predictive of single- and multisite pain. These findings indicate the need for preventive measures on the individual, organizational and societal level.