title: Differences in physical workload, psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models.
abstract: OBJECTIVE
  To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors.
  
  
  METHODS
  The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination.
  
  
  RESULTS
  The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P<0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35 degrees/s vs 71 degrees/s; P<0.001) and wrist movements (20 degrees/s vs 27 degrees/s; P=0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P=0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P<0.001).
  
  
  CONCLUSIONS
  Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.
authors.affiliation: Department of Occupational and Environmental Medicine, University Hospital Lund, Lund, Sweden. jeannette.unge@med.lu.se
authors.forename: Jeannette
authors.initials: J
authors.lastname: Unge
authors.forename: Kerstina
authors.initials: K
authors.lastname: Ohlsson
authors.forename: Catarina
authors.initials: C
authors.lastname: Nordander
authors.forename: Gert-Ake
authors.initials: GA
authors.lastname: Hansson
authors.forename: Staffan
authors.initials: S
authors.lastname: Skerfving
authors.forename: Istvan
authors.initials: I
authors.lastname: Balogh
mesh_terms: D000328:Adult; D005260:Female; D006797:Housekeeping, Hospital; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D008962:Models, Theoretical; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011584:Psychology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D000078329:Workforce; D016526:Workload