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      Factors associated with musculoskeletal symptoms in professionals working in sitting position Translated title: Fatores associados a sintomas osteomusculares em profissionais que trabalham sentados

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          Abstract

          ABSTRACT OBJECTIVE To estimate the prevalence of musculoskeletal symptoms and analyze their associated factors in professionals from administrative sectors working predominantly in sitting position. METHODS This is a cross-sectional study with data obtained from 451 workers from a federal public institution in Southern Brazil. The dependent variable was the number of musculoskeletal symptoms in the prior 12 months, measured using the Nordic Musculoskeletal Questionnaire. In the analyses, 19 independent variables were investigated, divided into four categories: sociodemographic, behavioral, occupational and health characteristics. Univariate analysis and multiple Poisson regression with robust variance were performed. The independent variables were inserted into blocks with stepwise backward criterion, considering the value for Wald statistics equal to 0.20. The effect measures were expressed in a relative increase (RI) in the mean value, and the data were analyzed for a 5% significance level. RESULTS The estimated prevalence of musculoskeletal symptoms in the prior 12 months was 90% (confidence interval – 95%CI 87–93). In the final model of regression analysis, the variables female gender (RI = 14.75%), low (RI = 100.02%) and moderate (RI = 64.06%) work ability index, use of medications (RI = 48.06%) and waist circumference at risk (RI = 15.59%) had a significant association with the increase in the mean number of symptoms; schooling with technical education acted as a protective factor, reducing the mean by 36.46%. CONCLUSIONS The high prevalence of musculoskeletal symptoms found and the associated factors indicate the need to propose specific actions and care for this population, such as immediate treatment of symptoms and changes in the organization and work environment, to achieve balance and harmony in the demands of prolonged sitting work and avoid its impact effect of this condition on public health.

          Translated abstract

          RESUMO OBJETIVOS Estimar a prevalência de sintomas osteomusculares e analisar os fatores a eles associados em profissionais de setores administrativos que trabalham predominantemente na postura sentada. MÉTODOS Trata-se de estudo transversal com dados obtidos de 451 trabalhadores de instituição pública federal na região Sul do país. A variável dependente foi o número de sintomas osteomusculares nos últimos 12 meses, aferido utilizando-se o Questionário Nórdico de Sintomas Osteomusculares. Foram investigadas 19 variáveis independentes, divididas em quatro categorias: características sociodemográficas, comportamentais, ocupacionais e de saúde. Foi realizada análise univariada e, na sequência, regressão múltipla de Poisson com variância robusta. As variáveis independentes foram inseridas em blocos com critério backward stepwise, considerando o valor para estatística de Wald igual a 0,20. As medidas de efeito foram expressas em aumento relativo (AR) no valor médio, sendo os dados analisados para um nível de significância de 5%. RESULTADOS A prevalência estimada de sintomas osteomusculares nos últimos 12 meses foi de 90% (intervalo de confiança – IC95% 87–93). No modelo final da análise de regressão, as variáveis sexo feminino (AR = 14,75%), índice de capacidade para o trabalho baixo (AR = 100,02%) e moderado (AR = 64,06%), uso de medicamentos (AR = 48,06%) e circunferência da cintura em risco (AR = 15,59%) tiveram associação significativa com o aumento da média de sintomas; já a escolaridade com ensino técnico atuou como fator de proteção, reduzindo a média em 36,46%. CONCLUSÕES A alta prevalência de sintomas osteomusculares encontrada e os fatores associados indicam a necessidade de propor ações e cuidados específicos para essa população, como tratamento imediato dos sintomas e mudanças na organização e no ambiente laboral, a fim de alcançar equilíbrio e harmonia nas exigências do trabalho sentado prolongado e evitar o impacto dessa condição na saúde pública.

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          Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio

          Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.
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            Sitting time and all-cause mortality risk in 222 497 Australian adults.

            Prolonged sitting is considered detrimental to health, but evidence regarding the independent relationship of total sitting time with all-cause mortality is limited. This study aimed to determine the independent relationship of sitting time with all-cause mortality. We linked prospective questionnaire data from 222 497 individuals 45 years or older from the 45 and Up Study to mortality data from the New South Wales Registry of Births, Deaths, and Marriages (Australia) from February 1, 2006, through December 31, 2010. Cox proportional hazards models examined all-cause mortality in relation to sitting time, adjusting for potential confounders that included sex, age, education, urban/rural residence, physical activity, body mass index, smoking status, self-rated health, and disability. During 621 695 person-years of follow-up (mean follow-up, 2.8 years), 5405 deaths were registered. All-cause mortality hazard ratios were 1.02 (95% CI, 0.95-1.09), 1.15 (1.06-1.25), and 1.40 (1.27-1.55) for 4 to less than 8, 8 to less than 11, and 11 or more h/d of sitting, respectively, compared with less than 4 h/d, adjusting for physical activity and other confounders. The population-attributable fraction for sitting was 6.9%. The association between sitting and all-cause mortality appeared consistent across the sexes, age groups, body mass index categories, and physical activity levels and across healthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus. Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity. Public health programs should focus on reducing sitting time in addition to increasing physical activity levels.
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              The evolving definition of "sedentary".

              Studies that did not directly measure sedentary behavior often have been used to draw conclusions about the health effects of sedentariness. Future claims about the effects of sedentary, light, and moderate-to-vigorous activities on health outcomes should be supported by data from studies in which all levels of physical activity are differentiated clearly and measured independently.
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                Author and article information

                Journal
                rsp
                Revista de Saúde Pública
                Rev. Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo (São Paulo, SP, Brazil )
                0034-8910
                1518-8787
                2021
                : 55
                : 2
                Affiliations
                [2] Londrina Paraná orgnameUniversidade Estadual de Londrina orgdiv1Departamento de Fisioterapia Brazil
                [3] Ribeirão Preto orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem de Ribeirão Preto orgdiv2Departamento de Enfermagem Geral e Especializada Brazil
                [5] Ribeirão Preto São Paulo orgnameUniversidade de Ribeirão Preto orgdiv1Programa de Mestrado Profissional Educação em Saúde Brazil
                [6] Ribeirão Preto orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem de Ribeirão Preto orgdiv2Departamento de Enfermagem Materno Infantil e Saúde Pública Brazil
                [1] Foz do Iguaçu Paraná orgnameUniversidade Federal da Integração Latino-Americana orgdiv1Instituto Latino-Americano de Ciências da Vida e da Natureza Brazil
                [4] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Faculdade de Odontologia orgdiv2Departamento de Odontologia Preventiva e Social Brazil
                Article
                S0034-89102021000100200 S0034-8910(21)05500000200
                10.11606/s1518-8787.2021055002617
                6441e04f-1479-4740-ab76-3b55ffdcba61

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 May 2020
                : 01 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 0
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                Categories
                Original Articles

                Saúde do Trabalhador,Medidas de Associação, Exposição, Risco ou Desfecho,Transtornos Traumáticos Cumulativos,Postura,Estilo de Vida Sedentário,Occupational Health,Measures of Association, Exposure, Risk or Outcome,Cumulative Trauma Disorders,Posture,Sedentary Lifestyle

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