Hand Function After an Electrical Accident-A Case-Control Study.

OBJECTIVE: Electrical accidents cause both acute and long-term injuries. The care of acute injuries is somewhat standardized, but currently recommendations or assessment tools are not available for assessing the long-term effects of an accident on hand function. METHODS: A case-control study of 24 healthy controls and 24 cases, 1 to 5 years after an electrical accident and with self-reported neurosensory symptoms, was performed using three hand-function tests: the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Purdue Pegboard test, and the Shape and Texture Identification test. RESULTS: Compared with the control group, patients received statistically significantly lower scores for the Disabilities of the Arm, Shoulder, and Hand outcome measure and the Purdue Pegboard and for one finger on the Shape and Texture Identification test. CONCLUSION: Hand function is affected after an electrical accident in individuals with self-reported neurosensory symptoms.

Clinical Evaluation of Nerve Function in Electrical Accident Survivors with Persisting Neurosensory Symptoms.

OBJECTIVE: Work related electrical accidents are prevalent and can cause persisting symptoms. We used clinical neurophysiological techniques to assess neurosensory function following electrical accidents and correlated test results with the patients' symptoms. METHODS: We studied 24 patients who reported persisting neurosensory symptoms following a workplace electrical accident. We assessed nerve function using quantitative sensory testing (QST), thermal roller testing, laser evoked potential (LEP), and electroneurography. The patients' results were compared with previously established normative data. RESULTS: Altogether, 67% of the patients showed at least one neurosensory impairment with a large heterogeneity in test results across patients. At a group level, we observed significant deviations in in QST, LEP, and sensory and motor neurography. Overall, we found a weak correlation between test results and self-reported symptoms. CONCLUSIONS: In a majority of patients with neurosensory symptoms after a workplace electrical accident, neurosensory testing confirmed the existence of an underlying impairment of the nervous system.

Early Childhood Outcomes After Neonatal Encephalopathy in Uganda: A Cohort Study.

BACKGROUND: Neonatal encephalopathy (NE) is a leading cause of global child mortality. Survivor outcomes in low-resource settings are poorly described. We present early childhood outcomes after NE in Uganda. METHODS: We conducted a prospective cohort study of term-born infants with NE (n = 210) and a comparison group of term non-encephalopathic (non-NE) infants (n = 409), assessing neurodevelopmental impairment (NDI) and growth at 27-30 months. Relationships between early clinical parameters and later outcomes were summarised using risk ratios (RR). FINDINGS: Mortality by 27-30 months was 40·3% after NE and 3·8% in non-NE infants. Impairment-free survival occurred in 41·6% after NE and 98·7% of non-NE infants. Amongst NE survivors, 29·3% had NDI including 19·0% with cerebral palsy (CP), commonly bilateral spastic CP (64%); 10·3% had global developmental delay (GDD) without CP. CP was frequently associated with childhood seizures, vision and hearing loss and mortality. NDI was commonly associated with undernutrition (44·1% Z-score < - 2) and microcephaly (32·4% Z-score < - 2). Motor function scores were reduced in NE survivors without CP/GDD compared to non-NE infants (median difference - 8·2 (95% confidence interval; - 13·0, - 3·7)). Neonatal clinical seizures (RR 4.1(2.0-8.7)), abnormalities on cranial ultrasound, (RR 7.0(3.8-16.3), nasogastric feeding at discharge (RR 3·6(2·1-6·1)), and small head circumference at one year (Z-score < - 2, RR 4·9(2·9-5·6)) increased the risk of NDI. INTERPRETATION: In this sub-Saharan African population, death and neurodevelopmental disability after NE were common. CP was associated with sensorineural impairment, malnutrition, seizures and high mortality by 2 years. Early clinical parameters predicted impairment outcomes.

Stress, energy and psychosocial conditions in different types of call centres.

OBJECTIVE: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. PARTICIPANTS: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. METHOD: A cross sectional questionnaire study. RESULTS: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. CONCLUSIONS: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work.

Working conditions in a selected sample of call centre companies in Sweden.

BACKGROUND: Call centres (CCs) are among the most rapidly growing forms of workplaces in Sweden. The purpose of the study was to describe and compare working conditions between operators at internal and external CC companies and work tasks of different complexity. METHOD: A questionnaire was answered by 1183 operators, 848 women and 335 men, from 28 different CCs. The questionnaire covered background factors, employment, working hours and remuneration, call logging and monitoring, duties, computer work and workplace design during the previous month. RESULTS: Operators at external companies and operators with low-complexity work tasks were younger, more often employed by the hour and worked on a varying roster. They spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring were more common at external companies and among operators with low-complexity work tasks. CONCLUSION: The working conditions varied between internal and external CCs. There was also a variation in working conditions between work tasks of different complexity. There were aspects of supervision style and organization of work at CCs, especially at external ones and those with low-complexity tasks that could introduce stress and lack of well being among the staff.

Musculoskeletal symptoms in relation to work exposures at call centre companies in Sweden.

OBJECTIVES: Call centres (CCs) are one of the most rapidly growing types of workplaces in Sweden. The purpose of the study was to assess associations between exposures at CC work and symptoms in the Neck/shoulders and Arm/hand. Comparisons were made between internal and external CCs. An internal CC is a department or separate unit within a larger company with another main core business, while an external CC is a free-standing company. METHODS: A cross-sectional study of a selected sample of CCs was conducted. A questionnaire, covering characteristics of work and management, physical and psychosocial exposures and symptoms during the last month, was answered by 1,183 operators from 28 CCs. RESULTS: Three out of four operators reported pain or aches in one or more of the requested body regions, with no major difference between internal and external CC operators. Comfort of the work environment, showed the strongest association with symptoms in the Neck/shoulder and Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and supervisor. CONCLUSIONS: The study is unique in that there are no previous studies focusing on a large variety of exposures specific to CC work, based on a large number of workers from different types of CCs. The study confirms previously suggested associations between unfavourable work characteristics and management, a poor physical and psychosocial environment, and musculoskeletal symptoms in computer-telephone interactive tasks. The nature of calls during work were related to symptoms of persons working in internal CCs, whereas the time spent seated and continuous computer work were related to symptoms of those in external CCs.

Reliability of a questionnaire and an ergonomic checklist for assessing working conditions and health at call centres.

BACKGROUND: The purpose was to study the test-retest reliability and internal consistency of questions in a questionnaire concerning working conditions and health and the inter-rater reliability of observations and measurements according to an ergonomic checklist. METHOD: Fifty-seven operators participated in a retest questionnaire and 58 operators participated in an inter-observer test. RESULTS: The questions had fair to good or higher reliability in 142 of the total of 312. Twenty-seven of the total of 44 variables in the ergonomic checklist were classified as having fair to good or higher reliability. CONCLUSIONS: About half of the questions had fair to good or higher reliability and can be recommended for further analyses. The majority of variables in the ergonomic checklist were classified as having fair to good or higher reliability. Low reliability does not necessarily indicate that the reliability of the test, per se, is low but may signify that the conditions measured vary over time or that the answers are aggregated in one part of the scale.

Working conditions and health among female and male employees at a call center in Sweden.

BACKGROUND: The call center industry is one of the most expansive labor market sectors in Sweden today. The purpose of this study was to investigate the working conditions and symptoms among employees at a call center in Sweden. METHODS: This study represents the cross-sectional baseline survey, which was part of a prospective cohort study. Fifty-seven call center workers were compared with a reference group of 1,459 professional computer users from other occupations. A questionnaire covered physical and psychosocial working conditions and symptoms during the last month. Structured observations in accordance with an ergonomic checklist were used to assess workstation design during the subject's ordinary work. RESULTS: The call center group had worked for a shorter time in their present tasks and spent longer continuous time in front of the computer than the reference group. There were deficiencies in workspace, keyboard- and input device placement. The subjects reported poor support from their immediate supervisor, low control and limited opportunities to influence their work. A higher proportion of the call center group reported musculoskeletal symptoms. CONCLUSION: The call center operators were exposed to working conditions that in other studies have indicated an increased risk of developing musculoskeletal disorders. The study also shows that young computer operators in the call center group with a short working career had a higher prevalence of neck- and upper extremity symptoms than older computer workers in other labor market sectors.