Transactions of the Institute of British Geographers

Work related neck and upper limb symptoms have a multi-factorial origin Possible risk factors are of a physical, psychosocial or personal origin These factors can reinforce each other and their influence can also be mediated by cultural or societal factors Initially, most research on neck and upper limb symptoms focused on work-related physical exposure Nowadays, psychosocial work characteristics are recognized as important risk factors Various models have been developed to offer frameworks for possible pathways, but their empirical support is still not conclusive In part I of this paper an overview is presented of the results of recent epidemiological studies on work related psychosocial and personal risk factors for neck and upper limb symptoms In addition, the interplay between these factors and the possible intermediate role of an individuals work style in this process is explored In contrast to previous reviews, it is now possible to base the conclusions on the effect of work related psychosocial factors on neck and upper limb symptoms on quite a few longitudinal studies These studies show that high work demands or little control at work are often related to these symptoms However, this relationship is neither very strong nor very specific Perceived stress is studied in not as many studies but more consistently related to neck and upper limb symptoms This also applies to general distress or other pain (co-morbidity) Job dissatisfaction does not contribute to neck and upper limb symptoms Too little research on personal characteristics is available to draw any conclusions It is plausible that behavioural aspects, such as work style, are of importance in the etiology of work related upper limb symptoms However, studies concerning these factors are promising but too scarce to draw conclusions Future studies should address these behavioural aspects In part II, the recent studies on the effectiveness of preventive measures for work related neck and upper limb problems are discussed Few randomised or non randomised controlled trials have been carried out to evaluate the effectiveness of individual or organisational interventions to improve work related psychosocial factors Very few have reported on the preventive effect for work related neck and upper limb symptoms Therefore, there is a great need for additional high quality trials before any conclusions on effectiveness of bio-behavioural interventions for reduction of neck and upper limb problems and return to work after these symptoms can be made From the low back pain intervention research can be learned that interventions should best be targeted to both the worker and the organisation and that interventions will only be successful when all stakeholders are involved

Epidemiology of work related neck and upper limb problems: Psychosocial and personal risk factors (Part I) and effective interventions from a bio behavioural perspective (Part II)

Summary of the concepts of prevention in low back
pain (LBP):
• The general nature and course of commonly experienced LBP means that there is limited scope for preventing its incidence (first-time onset). Prevention, in the context of this guideline, is focused primarily on reduction of the impact and consequences of LBP.
• Primary causative mechanisms remain largely undetermined: risk factor modification will not necessarily achieve prevention.
• There is considerable scope, in principle, for prevention of the consequences of LBP – e.g. episodes (recurrence), care seeking, disability, and workloss.
• Different interventions and outcomes will be appropriate for different target populations (general population, workers, and children) yet inevitably there is overlap.
• Interventions that are essentially treatments in the clinical environment, focused on management of current symptoms, are not considered as ‘prevention’ for the purposes of this guideline: they are covered in the accompanying clinical guidelines

/pdf/chapter-2-european-guidelines-for-prevention-in-low-back-4ieldkjc0i.pdf

Chapter 2. European guidelines for prevention in low back pain : November 2004.

Perceptions of autonomous vehicles: Relationships with road users, risk, gender and age

Objective:To review structural interventions in public health, identify distinct approaches to structural interventions, and assess their implications for HIV-prevention interventions.Method:The MEDLINE, HealthStar, PsychInfo and Sociofile databases were searched on specific health issues, types of

Structural interventions in public health.

Hazard perception and driving experience among novice drivers.

Safety-in-numbers: a systematic review and meta-analysis of evidence

Risk compensation--the case of road lighting

Can road traffic law enforcement permanently reduce the number of accidents

Objectives To study cyclists’ share of transport modes (modal share) and single-bicycle crashes (SBCs) in different countries in order to investigate if the proportion of cyclist injuries resulting from SBCs is affected by variation in modal share. Methods A literature search identified figures (largely from western countries) on SBC casualties who are fatally injured, hospitalised or treated at an emergency department. Correlation and regression analyses were used to investigate how bicycle modal share is related to SBCs. Results On average, 17% of fatal injuries to cyclists are caused by SBCs. Different countries show a range of values between 5% and 30%. Between 60% and 95% of cyclists admitted to hospitals or treated at emergency departments are victims of SBCs. The proportion of all injured cyclists who are injured in SBCs is unrelated to the share of cycling in the modal split. The share of SBC casualties among the total number of road crash casualties increases proportionally less than the increase in bicycle modal share. Conclusions While most fatal injuries among cyclists are due to motor vehicle–bicycle crashes, most hospital admissions and emergency department attendances result from SBCs. As found in previous studies of cyclists injured in collisions, this study found that the increase in the number of SBC casualties is proportionally less than the increase in bicycle modal share.

https://injuryprevention.bmj.com/content/injuryprev/21/e1/e138.full.pdf

Torkel Bjørnskau

Papers

Hazard perception and driving experience among novice drivers.

Safety-in-numbers: a systematic review and meta-analysis of evidence

Risk compensation--the case of road lighting

Can road traffic law enforcement permanently reduce the number of accidents

An international review of the frequency of single-bicycle crashes (SBCs) and their relation to bicycle modal share