Suchergebnisse

Abstract

Objectives
Job-exposure matrices (JEMs) were developed to allow assessment of past work exposure for large population-based studies where better exposures data are unavailable. Few studies have directly compared biomechanical JEMs to self-administered questionnaires. We compared assessments of cumulative exposure to carrying heavy loads based on 'JEM Constances' to individually self-reported (SR) exposures.


Methods
In the French CONSTANCES cohort at inception, past SR exposure to carrying heavy loads (ever/never and durations) and a detailed job history were available for 26 929 subjects. JEM Constances, an existing biomechanical JEM based on SR current exposures from 26 821 asymptomatic workers, was combined with job history to build a cumulative biomechanical exposure score. Using individual SR exposure as the reference, Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curves, sensitivity, and specificity were calculated. For both methods, associations with low back pain and knee pain were computed using multinomial logistic models. Additional analyses compared older (>10 years) to more recent (≤10 years) exposures.


Results
AUCs ranged from 0.795 (0.789–0.800) when all periods were considered, to 0.826 (0.820–0.833) for more recent biomechanical exposure (≤10 years). Associations between carrying heavy loads and low back pain or knee pain were less strong using JEM assessment than individually SR exposure: for low back pain ORSR = 3.02 (2.79–3.26) versus ORJEM = 1.70 (1.59–1.82) and for knee pain ORSR = 2.27 (2.10–2.46) versus ORJEM = 1.64 (1.53–1.77).


Conclusions
JEM Constances' assessment of cumulative exposure of carrying heavy loads seems to be a useful method compared to a self-administrated questionnaire for large population-based studies where other methods are not available.

Purpose: To explore the availability and utilization of workplace health supports by employees of small and large-sized employers. Design: Cross-sectional, telephone-based interviews collected on 16 workplace health supports for physical activity and diet. Setting: Participants selected by random-digit-dialing from 4 metropolitan areas of Missouri employees from 2012 to 2013. Participants: Two thousand fifteen working adults. Methods: We explored the availability and use of supports by employer size (<100 employees vs ≥100 employees), accounting for industry and personal factors. Analysis: We examined distributions and Poisson regression models of availability for supports by employer size and by industry and use of supports by employer size and personal factors. Results: One-fifth of the 1796 employees were employed by small-sized employers. Large employers offered more supports than small (mean: 6 vs 3), but a higher proportion of employees of small-sized employers used supports when available (59% vs 47%). The differences in offered supports between industries were not due to size alone. In regard to the determinants of participation, the personal factors of gender, age, weight, and income were associated with participation in 10 of the supports. Employer size was also associated with participation in 10 supports. No associations were found between personal factors or workplace size and participation for 3 supports. Conclusion: A higher proportion of employees working for smaller businesses use available supports than employees of larger businesses. Supports offered by employers should target the needs and interests of the workforce, particularly for the higher risk low-income employees.