Background
Methods
Study population
Population (length of service) | n | Mean age ±SD | Range |
---|---|---|---|
Sewers | 300 | 37.3±10.5 | 18-65 |
(0–7 years) | 150 | 25.2±6.3 | 18-35 |
(8–15 years) | 90 | 35.9±5.1 | 26-42 |
(> 15 years) | 60 | 53.6±7.7 | 46-65 |
Cutters | 50 | 35.9±10.5 | 22-65 |
(0–7 years) | 30 | 32.8±6.1 | 22-40 |
(8–15 years) | 12 | 40.4±6.8 | 30-48 |
(> 15 years) | 8 | 56.9±7.6 | 42-65 |
Participants in the MH program
Population (length of service) | n | Mean age ± SD | Range | Mean height, cm ± SD | Mean weight, kg ± SD | Mean BMI, kg/m2± SD | Mean RHR, beats/min ± SD |
---|---|---|---|---|---|---|---|
Sewers | 60 | 41.8±18.6 | 18-65 | 164.2±11.7 | 77.2±13.7 | 29.3±2.0 | 75.5±7.3 |
(0–7 years) | 20 | 22.7±5.2 | 18-35 | 159.3±10.7 | 73.1±12.1 | 26.1±1.9 | 59.7±9.6 |
(8–15 years) | 30 | 33.8±5.2 | 26-42 | 165.5±12.6 | 74.8±11.1 | 26.7±1.7 | 73.3±8.2 |
(> 15 years) | 10 | 52.8±8.9 | 46-65 | 162.1± 0.5 | 77.5±10.0 | 29.1±3.5 | 76.0±8.6 |
Cutters | 30 | 41.2±19.2 | 22-65 | 167.5±18.7 | 71.4±10.2 | 26.4±4.1 | 70.7±7.6 |
(0–7 years) | 12 | 27.8±6.6 | 22-40 | 170.6±14.8 | 69.5±9.8 | 25.8±3.3 | 55.7±8.8 |
(8–15 years) | 10 | 30.6±6.4 | 30-48 | 168.6±12.4 | 71.5±9.7 | 26.7±3.7 | 59.7±8.7 |
(> 15 years) | 8 | 56.9±7.6 | 42-65 | 166.6±11.9 | 73.5±11.3 | 27.2±3.8 | 63.7±7.8 |
Data collection
Extended version of Nordic musculoskeletal questionnaire (NMQ-E)
Brief pain inventory (BPI)
Sunnen trance scale (STS)
Quality of life scale (QOLS)
Objective investigations
Myotonometry (MYO)
Heart rate monitoring (HRM)
The MH program
Statistical analysis
Results
Multivariate analyses of the sewers and cutters with chronic pain
Sewers* (n = 300) | Reference groups (length of service, years) | |||||||
---|---|---|---|---|---|---|---|---|
I (0–7) (n = 150) | II (8–15) (n = 90) | III (> 15) (n = 60) | ||||||
Number | % | Number | % | Number | % | Number | % | |
PPR | (95% CI) | PPR | (95% CI) | PPR | (95% CI) | |||
Neck | 107 | 35.7 | 24 | 16.0 | 72 | 80.0 | 11 | 18.3 |
0.45 | (0.38-0.52) | 2.24 | (1.78-2.70) | 0.51 | (0.40-0.61) | |||
Shoulder | 130 | 43.3 | 46 | 30.6 | 67 | 74.4 | 17 | 28.3 |
0.71 | (0.59-0.82) | 1.72 | (1.36-2.07) | 0.65 | (0.51-0.78) | |||
Elbow | 28 | 9.3 | 4 | 2.6 | 14 | 15.5 | 10 | 16.6 |
0.28 | (0.23-0.32) | 1.66 | (1.31-2.00) | 1.78 | (1.41-2.15) | |||
Wrist/hands | 65 | 21.6 | 11 | 7.3 | 39 | 43.3 | 15 | 25.0 |
0.34 | (0.28-0.39) | 1.99 | (1.57-2.40) | 2.98 | (2.36-3.59) | |||
Upper back | 35 | 11.7 | 0 | 0 | 27 | 30.0 | 8 | 13.3 |
0 | 2.57 | (2.04-3.10) | 2.14 | (1.70-2.58) | ||||
Low back | 17 | 5.7 | 1 | 0.6 | 10 | 11.1 | 6 | 10.0 |
0.12 | (0.10-0.14) | 1.95 | (1.54-2.35) | 2.35 | (1.86-2.83) | |||
Hip/Thigh | 10 | 3.3 | 0 | 0 | 3 | 3.3 | 7 | 11.6 |
0 | 1.00 | (0.79-1.20) | 3.00 | (2.38-3.62) | ||||
Knee | 5 | 1.6 | 0 | 0 | 2 | 2.2 | 3 | 5.0 |
0 | 1.33 | (1.05-1.60) | 3.00 | (2.38-3.62) | ||||
Ankle/Shank/Feet | 7 | 2.3 | 2 | 1.3 | 2 | 2.2 | 3 | 5.0 |
0.57 | (0.48-0.66) | 0.95 | (0.75-1.14) | 2.14 | (1.70-2.58) |
Cutters* (n = 50) | Reference groups (length of service, years) | |||||||
---|---|---|---|---|---|---|---|---|
I (0–7) (n = 30) | II (8–15) (n = 12) | III (> 15) (n = 8) | ||||||
Number | % | Number | % | Number | % | Number | % | |
PPR | (95% CI) | PPR | (95% CI) | PPR | (95% CI) | |||
Neck | 27 | 54.0 | 9 | 30.0 | 10 | 83.3 | 8 | 100 |
0.55 | (0.35-0.75) | 1.54 | (0.67-2.41) | 1.85 | (0.56-3.13) | |||
Shoulder | 36 | 72.0 | 18 | 60.0 | 11 | 91.6 | 7 | 87.5 |
0.84 | (0.54-1.14) | 1.27 | (0.55-1.98) | 1,22 | (0.37-2.06) | |||
Elbow | 15 | 30.0 | 4 | 13.3 | 8 | 66.6 | 3 | 33.3 |
0.44 | (0.28-0.59) | 2.22 | (0.96-3.47) | 1.25 | (0.38-2.11) | |||
Wrist/hands | 24 | 48.0 | 6 | 20.0 | 10 | 83.3 | 8 | 100 |
0.42 | (0.27-0.57) | 1.73 | (0.75-2.71) | 2.08 | (0.64-3.52) | |||
Upper back | 8 | 16.0 | 0 | 0 | 5 | 41.6 | 3 | 37.5 |
0 | 2.60 | (1.13-4.07) | 2.35 | (0.72-3.98) | ||||
Low back | 7 | 14.0 | 0 | 0 | 2 | 16.6 | 5 | 62.5 |
0 | 1.19 | (0.51-1.86) | 4.46 | (1.37-7.55) | ||||
Hip/Thigh | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
0 | 0 | 0 | ||||||
Knee | 13 | 26.0 | 1 | 3.3 | 6 | 50.0 | 7 | 87.5 |
0.13 | (0.08-0.17) | 1.92 | (0.83-3.00) | 3.38 | (1.03-5.72) | |||
Ankle/Shank/Feet | 22 | 44.1 | 11 | 36.6 | 9 | 75.0 | 2 | 25.0 |
1.00 | (0.64-1.36) | 2.05 | (0.89-3.20) | 0.68 | (0.21-1.15) |
Sewers* (n = 300) | Reference groups (length of service, years) | |||||||
---|---|---|---|---|---|---|---|---|
I (0–7) (n = 150) | II (8–15) (n = 90) | III (> 15) (n = 60) | ||||||
Number | % | Number | % | Number | % | Number | % | |
PPR | (95% CI) | PPR | (95% CI) | PPR | (95% CI) | |||
Awkward posture | 275 | 91.6 | 141 | 94.0 | 79 | 87.7 | 55 | 91.6 |
1.02 | (0.85-1.18) | 0.96 | (0.76-1.15) | 1.00 | (0.74-1.25) | |||
Physical exhausting | 80 | 26.6 | 14 | 9.3 | 51 | 56.6 | 15 | 25,0 |
0.35 | (0.29-0.41) | 2.13 | (1.69-2.57) | 0.94 | (0.70-1.17) | |||
Extensivework | 20 | 6.6 | 8 | 5.3 | 7 | 7.7 | 5 | 1.6 |
0.80 | (0.67-0.92) | 1.67 | (1.32-2.01) | 1.25 | (0.93-1.56) | |||
High work speed | 222 | 74.0 | 110 | 73.3 | 72 | 80.0 | 40 | 66.6 |
1.00 | (0.84-1.16) | 1.08 | (0.85-1.30) | 0.90 | (0.67-1.13) | |||
Too manyjob tasks | 148 | 49.3 | 45 | 30.0 | 68 | 75.5 | 35 | 58.3 |
0.61 | (0.51-0.70) | 1.54 | (1.22-1.85) | 1.19 | (0.89-1.49) | |||
Colleagues’ support | 268 | 89.3 | 142 | 94.6 | 82 | 91.1 | 44 | 73.3 |
1.07 | (0.89-1.24) | 1.03 | (0.82-1.24) | 0.82 | (0.61-1.03) | |||
Supervisors’ support | 242 | 80.6 | 130 | 86.6 | 76 | 84.4 | 36 | 60.0 |
1.08 | (0.90-1.25) | 1.05 | (0.83-1.26) | 0.75 | (0.56-0.94) |
Cutters* (n = 50) | Reference groups (length of service, years) | |||||||
---|---|---|---|---|---|---|---|---|
I (0–7) (n = 30) | II (8–15) (n = 12) | III (> 15) (n = 8) | ||||||
Number | % | Number | % | Number | % | Number | % | |
PPR | (95% CI) | PPR | (95% CI) | PPR | (95% CI) | |||
Awkward posture | 47 | 94.0 | 28 | 93.3 | 11 | 91.6 | 8 | 100 |
0.99 | (0.63-1.34) | 0.97 | (0.42-1.51) | 1.06 | (0.32-1.79) | |||
Physical exhausting | 38 | 76.0 | 21 | 70.0 | 10 | 83.3 | 7 | 87.5 |
0.91 | (0.58-1.23) | 1.09 | (0.47-1.70) | 1.15 | (0.35-1.94) | |||
Extensivework | 45 | 90.0 | 27 | 90.0 | 10 | 83.3 | 8 | 100 |
1.00 | (0.64-1.35) | 0.92 | (0.40-1.44) | 1.11 | (0.34-1.88) | |||
High work speed | 20 | 40.0 | 12 | 40.0 | 4 | 33.3 | 4 | 50.0 |
1.00 | (0.64-1.35) | 0.83 | (0.36-1.29) | 1.25 | (0.38-2.12) | |||
Too manyjob tasks | 41 | 82.0 | 27 | 90.0 | 9 | 75.0 | 5 | 62.5 |
1.10 | (0.70-1.49) | 0.92 | (0.40-1.44) | 0.76 | (0.23-1.28) | |||
Colleagues’ support | 38 | 76.0 | 27 | 90.0 | 5 | 41.6 | 6 | 75.0 |
1.18 | (0.75-1.60) | 0.54 | (0.23-0.84) | 0.98 | (0.30-1.66) | |||
Supervisors’ support | 45 | 90.0 | 24 | 80.0 | 12 | 100 | 7 | 87.5 |
0.89 | (0.57-1.21) | 1.11 | (0.48-1.73) | 0.97 | (0.29-1.64) |
Analysis of the MH program results
CH and SH treatment
Items | Reference group | Before MH program | |||
---|---|---|---|---|---|
Number | Mean scores*±SD | CI | P0 | ||
0 - Immunity | Sewers | 6 | 15.9±3.7 | 11.8-19.9 | 0.96 |
Cutters | 5 | 20.0±5.9 | 12.8-27.1 | 0.89 | |
I - Light trance | Sewers | 34 | 33.0±8.8 | 24.6-41.3 | 0.88 |
Cutters | 12 | 40.3±8.3 | 25.8-54.3 | 0.78 | |
II - Medium trance | Sewers | 10 | 63.4±7.3 | 47.3-79.4 | 0.95 |
Cutters | 9 | 57.8±8.6 | 42.6-71.4 | 0.96 | |
III- Distinct trance | Sewers | 8 | 75.7±5.3 | 57.3-96.1 | 0.65 |
Cutters | 3 | 72.5±8.0 | 57.1-86.8 | 0.70 | |
IV - Very distinct | Sewers | 2 | 81.3±6.6 | 64.5-98.0 | 0.56 |
Cutters | 1 | 84.1±3.9 | 70.5-97.4 | 0.60 |
Brief Pain Inventory composite scores | ||||||||
---|---|---|---|---|---|---|---|---|
Variable | Pre-treatment (mean±SD) | CI | Post-treatment (mean±SD) | CI | Follow up (after CH and SH treatment session) | |||
After 3 months | CI | After 6 months | CI | |||||
Pain intensity | ||||||||
- sewers (n = 60) | 11.1±2.8 | 8.3-13.9 | 9.6±1.5 | 7.2-12.0 | 8.4±1.8 | 6.3-10.5 | 9.2±2.2 | 6.8-11.5 |
- cutters (n = 30) | 17.4±3.2 | 11.2-23.6 | 12.5±2.8 | 8.0-16.9 | 10.2±2.3 | 6.5-13.8 | 8.2±1.6 | 5.2-11.1 |
Pain interference | ||||||||
- sewers (n = 60) | 39.4±11.2 | 29.4-49.3 | 28.6±2.6 | 21.3-35.8 | 22.0±2.8 | 16.4-27.5 | 19.8±2.8 | 14.7-24.8 |
- cutters (n = 30) | 25.9±9.8 | 16.6-35.1 | 16.8±2.1 | 10.7-22.8 | 12.7±1.9 | 8.1-17.2 | 10.6±2.3 | 6.4-13.5 |
MYO
Before MH | After MH | ||
---|---|---|---|
Category | κ | Category | κ |
Sewers: | |||
I - 0% | 0.41 | I - 10.0% | 0.67 |
II - 70.0% | 0.78 | II - 83.3% | 0.86 |
III - 30.0% | 0.65 | III - 6.7% | 0.55 |
Cutters: | |||
I - 0% | 0.76 | I - 13.3% | 0.67 |
II - 73.3% | 0.88 | II - 80.1% | 0.86 |
III - 26.7% | 0.65 | III - 6.6% | 0.55 |
Length of service, years | Before MH | After MH | ||||||
---|---|---|---|---|---|---|---|---|
MYO Category | MYO Category | |||||||
I | II | III | I | II | III | |||
A 0-7 | Sewers (n = 20): | Sewers (n = 20): | ||||||
- females
| 0 | 16 | 2 |
- females
| 4 | 14 | 0 | |
- males | 0 | 2 | 0 | - males | 0 | 2 | 0 | |
Cutters (n = 12): | Cutters (n = 12): | |||||||
- females
| 0 | 9 | 0 |
- females
| 0 | 9 | 0 | |
- males | 0 | 3 | 0 | - males | 0 | 3 | 0 | |
B 8-15 | Sewers (n = 30): | Sewers (n = 30): | ||||||
- females
| 0 | 19 | 6 |
- females
| 2 | 21 | 2 | |
- males | 0 | 2 | 3 | - males | 0 | 4 | 1 | |
Cutters (n = 10): | Cutters (n = 10): | |||||||
- females
| 0 | 3 | 2 |
- females
| 0 | 5 | 0 | |
- males | 0 | 2 | 3 | - males | 0 | 4 | 1 | |
C > 15 | Sewers (n = 10): | Sewers (n = 10): | ||||||
- females
| 0 | 3 | 4 |
- females
| 0 | 6 | 1 | |
- males | 0 | 0 | 3 | - males | 0 | 3 | 0 | |
Cutters (n = 8): | Cutters (n = 8): | |||||||
- females
| 0 | 3 | 3 |
- females
| 0 | 5 | 1 | |
- males | 0 | 2 | 0 | - males | 0 | 2 | 0 |
HRM
Occupation | Mean HR ±SD, beats/min | Range HR, beats/min |
κ
| Mean E ± SD, kcal/min | WHC |
---|---|---|---|---|---|
Sewers (females, n = 50) | 79.5 ± 7.4 | 67-93 | 0.75 | 3.4 ± 0.5 | Light work |
Sewers (males, n = 10) | 84.8 ± 3.9 | 66-93 | 0.78 | 3.6 ± 0.6 | Light work |
Cutters (females, n = 20) | 120.3 ± 8.1 | 80-130 | 0.68 | 4.6 ± 0.5 | Moderate work |
Cutters (males, n = 10) | 118.3 ± 9.5 | 75-120 | 0.68 | 4.7 ± 0.5 | Light work |