Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople.

Abstract

Objectives-To analyse the association between symptoms from the musculoskeletal system and many psychosocial and other physical stressors in the job demand-control-support model. Also to analyse the influence of personality characteristics. Methods-1306 salespeople answered a self administered questionnaire on job characteristics, exposures, personality characteristics, social network, smoking and drinking habits, and symptoms of the neck, shoulders, and low back. Results-In multivariate analyses, high job demands were related to neck and shoulder symptoms (ORs 1-43-1-47 in the highest exposure groups compared with the lowest), and tendency to become overworked and lack of social support from colleagues were related to back pain (OR 1*81-2*04 in the highest exposure groups compared with the lowest). Lack of variation in the job, low control over time, and high competition were related to neck symptoms, but there was an interaction so that both low control over time and high competition had to be present to increase the OR. Also, driving long distances and sedentary work were related to neck and low back pain, and time spent in the car to shoulder pain (ORs 1-64-2*80 in the three highest groups v the lowest exposure groups). Conclusion-Both psychosocial and physical factors were associated with musculoskeletal symptoms. During the past few years the contribution of psychosocial stressors to the occurrence of musculoskeletal disorders has become increasingly clear. The job demand-control-support model, which has been widely used as a model for relations between the psychosocial work environment and cardiovascular disease, has also been introduced in studies of musculoskeletal disorders. A recent review of publications on psychosocial factors at work and musculoskeletal disease4 concluded that high job demands have consistently been associated with musculoskeletal symptoms. Furthermore, the data indicated that lack of control and lack of social support at work are positively associated with musculoskeletal disorders.In most studies only one or a few psychosocial factors have been taken into account simultaneously. Bongers et a!4 noted that no studies existed of back trouble which analysed the effect of demands, control, and social support at the same time. It was also noted that several studies did not control appropriately for physical load. As high psychosocial job demands are often correlated with high physical load, it could be argued that the associations found for the psychosocial factors were due to residual confounding from the physical factors.

Psychosocial aspects of work and musculoskeletal disorders in nursing workers

“…Psychosocial variables (psychological demand and control) were more associated with pain in central regions (shoulders, thoracic spine and lumbar column) than in peripheral regions (upper and lower limbs), in line with other studies (3,7,11) . These results are coherent with others (1,12) showing that stress is one of the routes through which the psychosocial environment affects bone and muscle health, supposedly through muscle tension.…”

“…In line with the hypothesis about this relation, in a study with salesmen (11) , an association was found between high strain and neck pain. In a research among professionals from different areas (7) , sixty-percent higher prevalence levels were found for central region than for peripheral region pain among workers in the high strain group.…”

Basis for a Functional Capacity Evaluation Methodology for Patients with Work-related Neck Disorders

“…The time that position is held will be measured in seconds. Test-retest reliability: in healthy subjects ICC = 0.90 [59]. The risk factors covered by this test are awkward position of the shoulder on the transversal and sagittal axis and static contractions in the neck and shoulder both on the transversal and sagittal axis.…”

“…Time needed to remove 30 marbles is scored (s). Test-retest reliability: in patient's with chronic low back pain (CLBP), Intraclass Correlation (ICC) = 0.45-0.64 [58]; in healthy subjects ICC = 0.74-0.76 [59] and ICC = 0.54-0.72 [60]. The risk factors covered by this test are repetition and awkward positions in the neck and shoulder both in the longitudinal axis.…”

“…; in healthy subjects ICC = 0.89 [60] and 0.92 [59]. The risk factor covered by this test is forceful movements in the shoulder on the sagittal axis.…”