title: Environmental discomfort and musculoskeletal disorders.
abstract: BACKGROUND
  Musculoskeletal disorders (MSDs) are the most common occupational disease in Europe, with high prevalence among hospital workers. Both environmental and psychosocial work factors may impact significantly on the development and exacerbation of MSDs.
  
  
  OBJECTIVE
  To evaluate whether environmental factors at work are associated with MSDs in hospital workers and to investigate potential interactions between environmental and psychosocial risk factors in the workplace that are associated with MSDs.
  
  
  METHODS
  A cross-sectional investigation was performed using the Nordic questionnaire to assess MSDs, the IAQ/MM-040 indoor air questionnaire for environmental factors, the demand-control model for job strain and the Goldberg questionnaire for anxiety and depression. The association between environmental factors and MSDs was studied using logistic regression analysis. In addition, the interactions of environmental factors with strain, anxiety and depression for MSDs were examined.
  
  
  RESULTS
  Environmental complaints were associated with MSDs. The strongest associations were found between temperature complaints (OR 2.73), noise and light complaints (OR 2.22), other environmental complaints (OR 3.12) and upper limb disorders. A significant interaction between temperature complaints and strain for upper limb disorders (F = 9.52, P < 0.05) was found.
  
  
  CONCLUSIONS
  To prevent MSDs, a multi-level approach is needed, including environmental measures and interventions directed to both psychosocial and organizational factors.
authors.affiliation: Institute of Occupational Medicine, Catholic University School of Medicine, Largo Gemelli 8, 00168 Rome, Italy. nicolamagnavita@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Magnavita
authors.forename: M
authors.initials: M
authors.lastname: Elovainio
authors.forename: I
authors.initials: I
authors.lastname: De Nardis
authors.forename: T
authors.initials: T
authors.lastname: Heponiemi
authors.forename: A
authors.initials: A
authors.lastname: Bergamaschi
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D010564:Personnel, Hospital / Q000523:psychology; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace / Q000592:standards