The development and validation of the Office Work Screen.

BACKGROUND: The prevalence and costs to both employers and individuals of musculoskeletal disorders and associated psychosocial factors are well documented. There is increasing evidence that early identification is the key to the prevention of chronicity and sickness absence. AIMS: The study aimed to develop and validate a screening questionnaire, capturing relevant psychosocial issues and musculoskeletal symptoms, to measure work instability (WI) in office workers. METHODS: The staged methodology was based upon Rasch analysis and included item banking from existing Work Instability scales and analysis of new data from postal surveys. The criterion validity of the emerging scale was examined using vocational assessments by occupational physiotherapists. RESULTS: A 62-item questionnaire was returned by 153 employees from two different settings. The data were fitted to the Rasch model and 26 items were found to fit model expectations (chi-square P= 0.07), satisfy strict requirements for unidimensionality and discriminate across expert defined levels of WI. Reliability was 0.9, indicating suitability for use at the individual level. Absence of item bias was shown for age, gender and if the individual had been off sick from work in the past 3 months, suggesting the scale is robust to variations in workforce composition and sickness absence rates. CONCLUSIONS: The Office Work Screen is a short questionnaire incorporating both musculoskeletal symptoms and relevant psychosocial factors in one dimension. This new questionnaire may facilitate workforce screening, individual monitoring and proactive targeting of interventions (for example, vocational rehabilitation) to prevent or minimize sickness absence in office workers.

Occupational disorders: non-specific forearm pain.

Work-related upper limb disorder is a non-specific diagnosis for pain in the hand, wrist or, in particular, forearm once more discrete clinical conditions such as epicondylitis, tenosynovitis and carpal tunnel syndrome have been excluded. The pathophysiology of the condition is uncertain, although it is normally held to be related to an ergonomic incident. Ergonomic factors either at work or at home remain important and are discussed. Initial management is based on modification of ergonomics with appropriate periods of rest and job rotation. Treatment, however, remains somewhat unfocused and unsatisfactory. Much can be learnt from the ergonomic study of musicians, where the condition is perhaps at its most refined. Medico-legal aspects and recent thoughts on pathogenesis are also discussed.