This paper combines epidemiological data on musculoskeletal morbidity in 40 female and 15 male occupational groups (questionnaire data 3720 females, 1241 males, physical examination data 1762 females, 915 males) in order to calculate risk for neck and upper limb disorders in repetitive/constrained vs. varied/mobile work and further to compare prevalence among office, industrial and non-office/non-industrial settings, as well as among jobs within these. Further, the paper aims to compare the risk of musculoskeletal disorders from repetitive/constrained work between females and males. Prevalence ratios (PR) for repetitive/constrained vs. varied/mobile work were in neck/shoulders: 12-month complaints females 1.2, males 1.1, diagnoses at the physical examination 2.3 and 2.3. In elbows/hands PRs for complaints were 1.7 and 1.6, for diagnoses 3.0 and 3.4. Tension neck syndrome, cervicalgia, shoulder tendonitis, acromioclavicular syndrome, medial epicondylitis and carpal tunnel syndrome showed PRs > 2. In neck/shoulders PRs were similar across office, industrial and non-office/non-industrial settings, in elbows/hands, especially among males, somewhat higher in industrial work. There was a heterogeneity within the different settings (estimated by bootstrapping), indicating higher PRs for some groups. As in most studies, musculoskeletal disorders were more prevalent among females than among males. Interestingly, though, the PRs for repetitive/constrained work vs. varied/mobile were for most measures approximately the same for both genders. In conclusion, repetitive/constrained work showed elevated risks when compared to varied/mobile work in all settings. Females and males showed similar risk elevations. This article enables comparison of risk of musculoskeletal disorders among many different occupations in industrial, office and other settings, when using standardised case definitions. It confirms that repetitive/constrained work is harmful not only in industrial but also in office and non-office/non-industrial settings. The reported data can be used for comparison with future studies.

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Artificial neural networks can be used to improve automated ECG interpretation for acute myocardial infarction. The networks may be useful as decision support even for the experienced ECG readers.

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Objectives To characterise geographical distribution and time trends of chronic kidney disease (CKD) mortality in the context of the epidemic of Mesoamerican nephropathy (MeN), likely related to occupational heat stress and other, unknown, factors. Method Vital statistics (1970-2012) provided deaths from CKD and unspecified renal failure. Data of four censuses were extrapolated to derive person-years by sex and 10-year age groups for the seven provinces and 81 counties. SMRs were compared for three time periods between provinces and between counties, with national rates as reference. To assess time trends, age-specific and age-standardised mortality rates were computed for 5-year periods. Results During 1970-2012, 3843 men and 2452 women died from CKD. In the Guanacaste province, the SMR for 1997-2012 was four-fold in men and twofold in women. In Guana-caste, CKD mortality increased from the mid-1970s in men, and mid-1980s in women. Age-standardised rates per 100.000 in men aged ≥30 increased from 5.8 in the early seventies to 75.0 in 2007-2012, compared to 5.9 to 16.2 in the rest of Costa Rica. For women, rates increased from 4.5 to 20.7 in Guana-caste versus 4.2 to 9.7 in the rest of the country. Within Guana-caste, there was marked spatial variation in mortality between counties, with patterns being consistent between time periods but different for men and women. Conclusions Guanacaste is a heterogeneous CKD "hot spot," affecting mostly men, but to lesser extent also women. CKD seemed high already four decades ago in the province. These findings are pertinent for etiologic research.

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BackgroundTo assess the annual consultation prevalence and new onset consultation rate for doctor-diagnosed shoulder pain conditions.MethodsWe identified all residents in the southernmost county in Sweden who received a shoulder pain diagnosis during 2006 (ICD-10 code M75). In subjects who did not consult due to such disorders during 2004 and 2005, we estimated the new onset consultation rate. The distribution of specific shoulder conditions and the length of the period of repeated consultation were calculated.ResultsAnnual consultation prevalence was 103/10 000 women and 98/10 000 men. New onset consultation rate was 80/10 000 women (peak in age 50–59 at 129/10 000) and 74/10 000 men (peak in age 60–69 at 116/10 000). About one fifth of both genders continued to consult more than three months after initial presentation, but only a few percent beyond two years. Rotator cuff - and impingement syndromes were the most frequent diagnoses.ConclusionThe annual consultation prevalence for shoulder pain conditions (1%) was similar in women and men, and about two thirds of patients consulted a doctor only once. Impingement and rotator cuff syndromes were the most frequent diagnoses.