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Factors related to musculoskeletal disorders in Swedish police
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.ORCID iD: 0000-0001-7389-7080
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Police working in active duty are subject to occupation-specific exposures in the workplace which could place them at an increased risk of developing musculoskeletal disorders. These exposures include the requirement to wear a duty belt and body armour as well as sitting for long periods in fleet vehicles. It is well recognised that the development of musculoskeletal disorders is multifactorial and that both physical and psychosocial workplace factors must be considered when addressing this issue.

Aim: The overall aim of this thesis was to increase knowledge related to musculoskeletal disorders in Swedish police by exploring the prevalence of pain and its relationship to physical and psychosocial factors in the work environment.

Methods: Studies included in this thesis were conducted using different quantitative methods. Studies I and II were based on data from a self-administered online survey, distributed to all police officers working in active duty. Descriptive statistics and regression analyses were used to document the prevalence of musculoskeletal pain and the effects of exposure variables (physical and psychosocial) and covariates on multi-site pain. Study III was conducted using a three-dimensional gait analysis system incorporating two force plates to explore the effect of different load carriage systems on kinematic and kinetic variables. Study IV included the same three conditions as in Study III but investigated sitting postures and comfort. A pressure mat was utilised to determine contact pressure and contact area while sitting in and driving police vehicles while a survey was used to measure experienced discomfort related to the vehicle seat. Non-parametric statistical tests were used to investigate differences between load carriage conditions in Studies III and IV.

Results: The results of this thesis revealed that the most frequently reported musculoskeletal disorder among Swedish police working in active duty was lower back pain (43.2%) and that multi-site musculoskeletal pain (41.3%) was twice as prevalent as single-site pain (19.7 The physical workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting discomfort experienced from wearing duty belts (OR 5.42 (95% CI 4.56 – 6.43)). The psychosocial workplace factor with the greatest association to multi-site musculoskeletal pain was found for individuals reporting high-strain jobs (OR 1.84 (95% CI 1.51 – 2.24)). Wearing body armour, or body armour combined with a load-bearing vest, resulted in less rotation of the trunk when compared to not wearing any equipment. Wearing a thigh holster and load-bearing vest allowed for a greater range of rotation in the right hip compared to the standard load-bearing condition, which incorporated a belt-mounted hip holster. Kinetics of the ankle joints were greater for both load carriage conditions compared to the control condition. Discomfort ratings revealed a clear preference for the alternate load-carriage condition. The lower back was found to be the body region with most experienced discomfort (30.5; IQR 11 - 42 mm). Pressure data demonstrated that wearing a thigh holster and load-bearing vest resulted in less pressure in the lower back when compared to the standard load carriage condition. At the same time, contact pressure in the upper back increased followed by a decrease in contact area.

Conclusion: Musculoskeletal pain is a considerable problem among Swedish police with lower back pain being the most frequently reported pain site. Multi-site musculoskeletal pain was found to be more common than single-site pain and both physical and psychosocial factors were associated to multi-site musculoskeletal pain. Of the exposures studied in this thesis, duty belts and high strain jobs were found to have the greatest association to musculoskeletal pain. The use of load-bearing vest and thigh holster were found to affect levels of discomfort, especially while driving. Also, range of motion in the trunk and right hip was affected by wearing mandatory equipment.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare , 2018. , p. 80
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 088
Keywords [en]
Load carriage, Musculoskeletal pain, Occupational health, Police
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:hj:diva-39061ISBN: 978-91-85835-87-4 (print)OAI: oai:DiVA.org:hj-39061DiVA, id: diva2:1193734
Public defence
2018-04-27, Forum Humanum, School of Health and Welfare, Jönköping, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-03-27Bibliographically approved
List of papers
1. Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting
Open this publication in new window or tab >>Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting
2018 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, p. 1-9Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: Musculoskeletal disorders are considered as a major issue affecting the health and well-being of active duty police. Discomfort from wearing mandatory equipment and sitting for long periods of time in fleet vehicles are workload factors linked to musculoskeletal disorders in police. This study aims to determine the prevalence of multi-site musculoskeletal pain among Swedish police and to explore the possible association to discomfort experience when wearing mandatory equipment and sitting for long periods in fleet vehicles.

Methods: In this cross-sectional study responses from 4185 police were collected through a self-administered online survey including questions about physical work environment, mandatory equipment and musculoskeletal pain. Multi-site pain was determined through summing pain sites from four body regions. Binomial logistic regression was performed to explore the association between multi-site musculoskeletal pain: (1) discomfort from wearing mandatory equipment and (2) sitting for long periods in fleet vehicles.

Results: The prevalence of multi-site musculoskeletal pain at least 1 day per week within the previous 3 months was 41.3%. A statistically significant association between discomfort from wearing mandatory equipment and multi-site musculoskeletal pain was found; duty belt [OR 5.42 (95% CI 4.56–6.43)] as well as body armour [OR 2.69 (95% CI 2.11–3.42)]. Sitting for long periods in fleet vehicles was not significantly associated to multi-site musculoskeletal pain.

Conclusion: Multi-site musculoskeletal pain is a considerable problem among Swedish police and modifying mandatory equipment to decrease discomfort is suggested as a potential means of decreasing the musculoskeletal pain experienced by many police officers. 

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Body armour, Cross-sectional study, Duty belt, Law enforcement, Multi-site musculoskeletal pain
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hj:diva-38891 (URN)10.1007/s00420-018-1292-9 (DOI)29411113 (PubMedID)2-s2.0-85041609300 (Scopus ID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-03-27
2. Psychosocial job demand and control: multi-site musculoskeletal pain in Swedish police
Open this publication in new window or tab >>Psychosocial job demand and control: multi-site musculoskeletal pain in Swedish police
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aims

Police have a high prevalence of musculoskeletal disorders. While physical factors contributing to this have been explored, little is known regarding the contribution of the psychosocial work environment. This study explores the association between elements of the JDC model, social support and multi-site musculoskeletal pain among Swedish police.

Methods

In this cross-sectional study, response from 4185 police were collected using a self-administered online survey. The survey included questions on psychosocial work environment and musculoskeletal pain, as well as several potential confounding factors. Binominal regression analyses were performed to explore the degree of association between 1) the indices for job demands, job control, social support and multi-site musculoskeletal pain and 2) the four categories of the JDC model, social support and multi-site musculoskeletal pain.

Results

The overall psychosocial work environment of Swedish police was characterised by low control and high social support. Police who reported active and high strain jobs were found to have an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.45 (95% CI 1.08-1.94), and 1.84 (1.51-2.24) respectively). High demands, which is a component in the categories for active and high strain jobs, was also found to be associated with an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.66 (1.45-1.91)). High social support was associated with a decrease in the odds ratio formulti-site musculoskeletal pain (OR 0.72 (0.57-0.86)).

Conclusions

Psychosocial work environment should be considered when investigating factors related to the health and wellbeing of police.

Keywords
JDC model; Law enforcement; Musculoskeletal disorders; Occupational epidemiology; SWES
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hj:diva-39058 (URN)
Note

Submitted to journal

Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-03-27
3. Effects of thigh holster use on kinematics and kinetics of active duty police officers
Open this publication in new window or tab >>Effects of thigh holster use on kinematics and kinetics of active duty police officers
2016 (English)In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 37, p. 77-82Article in journal (Refereed) Published
Abstract [en]

Background: Body armour, duty belts and belt mounted holsters are standard equipment used by the Swedish police and have been shown to affect performance of police specific tasks, to decrease mobility and to potentially influence back pain. This study aimed to investigate the effects on gait kinematics and kinetics associated with use of an alternate load carriage system incorporating a thigh holster.

Methods: Kinematic, kinetic and temporospatial data were collected using three dimensional gait analysis. Walking tests were conducted with nineteen active duty police officers under three different load carriage conditions: a) body armour and duty belt, b) load bearing vest, body armour and thigh holster and c) no equipment (control).

Findings: No significant differences between testing conditions were found for temporospatial parameters. Range of trunk rotation was reduced for both load carriage conditions compared to the control condition (p < 0.017). Range of hip rotation was more similar to the control condition when wearing thigh holster rather than the belt mounted hip holster (p < 0.017). Moments and powers for both left and right ankles were significantly greater for both of the load carriage conditions compared to the control condition (p < 0.017).

Interpretation: This study confirms that occupational loads carried by police have a significant effect on gait kinematics and kinetics. Although small differences were observed between the two load carriage conditions investigated in this study, results do not overwhelmingly support selection of one design over the other.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Gait analysis, Kinematics, Kinetics, Load carriage, Police, Thigh holster, Armor, Enzyme kinetics, Effect on gaits, Gait kinematics, Police officers, Specific tasks, Standard equipments, Testing conditions, Law enforcement
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-31264 (URN)10.1016/j.clinbiomech.2016.06.009 (DOI)000382798500012 ()27380202 (PubMedID)2-s2.0-84976884549 (Scopus ID)
Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2018-06-19Bibliographically approved
4. Duty belt or load-bearing vest?: Discomfort and pressuredistribution for police driving standard fleet vehicles
Open this publication in new window or tab >>Duty belt or load-bearing vest?: Discomfort and pressuredistribution for police driving standard fleet vehicles
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Police working in active duty have a high prevalence of musculoskeletal pain, with lower back pain being the most frequently reported. As a part of uniform regulations, Swedish police are mandated to wear body armour and duty belts at all times during work. This study aimed to investigate the effect of different load carriage designs on in-vehicle sitting pressure and self-rated discomfort among police. Results showed less discomfort when wearing the alternate load carriage system incorporating a load-bearing vest and thigh holster compared to the standard load carriage system consisting of a duty belt. Pressures in the lower back were reduced when wearing the load-bearing vest whereas pressures in the upper back region increased. Relocating appointments away from the waist has the potential to improve sitting positions and the ergonomic situation for police when driving fleet vehicles.

Keywords
Driving, Law enforcement, Lower back, Occupational health, Protective equipment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hj:diva-39059 (URN)
Note

Submitted to journal

Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-06-19

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