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Jonker, Dirk
Publications (10 of 16) Show all publications
Jonker, D., Rolander, B., Balogh, I., Sandsjo, L., Ekberg, K. & Winkel, J. (2013). Rationalisation in public dental care - impact on clinical work tasks and mechanical exposure for dentists - a prospective study. Ergonomics, 56(2), 303-313
Open this publication in new window or tab >>Rationalisation in public dental care - impact on clinical work tasks and mechanical exposure for dentists - a prospective study
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2013 (English)In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 2, p. 303-313Article in journal (Refereed) Published
Abstract [en]

Swedish dentistry has been exposed to frequent rationalisation initiatives during the last half century. Previous research has shown that rationalisation often results in increased risk of developing work-related musculoskeletal disorders, thus reducing sustainability in the production system. In this prospective study, we assessed mechanical exposures among Swedish dentists in relation to specific rationalisations of clinical dental work during a six-year period. Body postures and movements of 12 dentists were assessed by inclinometry synchronised to video recordings of their work. No rationalisation effects could be shown in terms of a reduction in non-value-adding work (waste), and at job level, no major differences in mechanical exposure could be shown between baseline and follow-up. Conclusion: The present rationalisation measures in dentistry do not seem to result in rationalisation at job level, but may potentially be more successful at the overall dental system level. Practitioner summary: In contrast to many previous investigations of the mechanical exposure implications of rationalisation, the present rationalisation measures did not increase the level of risk for dentists. It is highlighted that all occupations involved in the production system should be investigated to assess production system sustainability.

Place, publisher, year, edition, pages
Taylor and Francis: STM, Behavioural Science and Public Health Titles / Taylor and Francis, 2013
Keywords
loss analysis, sustainable production system, inclinometry, video analysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-90206 (URN)10.1080/00140139.2012.760751 (DOI)000315155000013 ()
Available from: 2013-03-21 Created: 2013-03-21 Last updated: 2017-12-06
Rolander, B., Jonker, D., Winkel, J., Sandsjo, L., Balogh, I., Svensson, E. & Ekberg, K. (2013). Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation. Ergonomics, 56(9), 1376-1386
Open this publication in new window or tab >>Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation
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2013 (English)In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 9, p. 1376-1386Article in journal (Refereed) Published
Abstract [en]

In recent decades, comprehensive rationalisations have been implemented in public dentistry in Sweden. How rationalisations affect working conditions, health and production from a long-term perspective has been poorly investigated. This study aims to analyse changes and associations in dentists' working conditions, health and productivity during a 5-year period. In 2003 and 2008, 65 dentists responded to questionnaires measuring work conditions and health. Treatment times for patients and productivity were tracked in electronic registers. Paired t-tests showed that the number of treated adult patients per dentist increased, and perceived physical working conditions improved while perceived work control and leadership deteriorated. Structural equation modelling showed that physical factors were important for health and productivity. When assessing risks in the work environment, there is a need to understand the interaction of effects on working conditions and health due to rationalisations so as to increase the sustainability of production systems.

Practioner Summary: Dentistry in Sweden has undergone considerable change. Questionnaire surveys with dentists, undertaken in 2003 and 2008, found that the present rationalisations resulted in improved perceived physical working conditions. Aspects of the psychosocial working environment had deteriorated, however. This is a concern as health and workability are important for workplace efficiency.

Place, publisher, year, edition, pages
Taylor and Francis: STM, Behavioural Science and Public Health Titles, 2013
Keywords
physical working conditions, production, organisational sustainability, leadership, work control
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100320 (URN)10.1080/00140139.2013.817613 (DOI)000325060600003 ()
Available from: 2013-11-04 Created: 2013-11-04 Last updated: 2017-12-06Bibliographically approved
Jonker, D., Rolander, B., Balogh, I., Sandsjö, L., Ekberg, K. & Winkel, J. (2011). Mechanical exposure among general practice dentists in Sweden and possible implications of rationalization.. Ergonomics, 54(10), 953-560
Open this publication in new window or tab >>Mechanical exposure among general practice dentists in Sweden and possible implications of rationalization.
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2011 (English)In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 54, no 10, p. 953-560Article in journal (Refereed) Published
Abstract [en]

The present study investigates dental work in terms of time distribution and mechanical exposure in value-added and non-value-added tasks. Further rationalization of dental work would typically involve an increase in the proportion of value-added tasks. Information on mechanical exposure within classes of value-added and non-value-added tasks can be used to predict possible implications of rationalization.

Twenty-four dentists were investigated. Using a data logger, postures and movements were continuously recorded for each subject during four hours of work, which included 45 minutes of video recording. Time distribution and mechanical exposure for each work activity were calculated from the video recordings, using a loss analysis technique. Value-added tasks, which comprised 57% of the total working time, generally implied significantly more constrained mechanical exposures as compared with non-value-added tasks.

The results indicate that future rationalization of dental work, involving a reduction of nonvalue-added tasks, may increase the risk of developing musculoskeletal disorders.

Place, publisher, year, edition, pages
Taylor & Francis, 2011
Keywords
Dentistry; Efficiency; Value-added; Workload
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-65419 (URN)10.1080/00140139.2011.606919 (DOI)000299924800007 ()
Available from: 2011-02-07 Created: 2011-02-07 Last updated: 2017-12-11
Rolander, B., Jonker, D., Balogh, I., Sandsjö, L., Winkel, J., Svensson, E. & Ekberg, K. (2010). Impact on working conditions, productivity and health of dentists – a prospective study during rationalizations in public dental care. In: : . Paper presented at 7th International Conference on Prevention of Work-related Musculoskeletal Disorders (PREMUS 2010), 28 August - 3 September 2010, Angers, France.
Open this publication in new window or tab >>Impact on working conditions, productivity and health of dentists – a prospective study during rationalizations in public dental care
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2010 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-73468 (URN)
Conference
7th International Conference on Prevention of Work-related Musculoskeletal Disorders (PREMUS 2010), 28 August - 3 September 2010, Angers, France
Available from: 2012-01-04 Created: 2012-01-04 Last updated: 2013-09-19
Jonker, D., Rolander, B., Balogh, I., Sandsjö, L., Ekberg, K. & Winkel, J. (2010). Rationalization in public dental care and impact on biomechanical exposures for dentists - a prospective study. Oral presentation.. Paper presented at Seventh International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders PREMUS 2010. Angers, France August/September 2010..
Open this publication in new window or tab >>Rationalization in public dental care and impact on biomechanical exposures for dentists - a prospective study. Oral presentation.
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2010 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-73465 (URN)
Conference
Seventh International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders PREMUS 2010. Angers, France August/September 2010.
Available from: 2012-01-04 Created: 2012-01-04 Last updated: 2013-09-03
Jonker, D. (2010). Self-assessed and direct measured physical workload among dentists in public dental clinics in Sweden during a period of rationalizations. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Self-assessed and direct measured physical workload among dentists in public dental clinics in Sweden during a period of rationalizations
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Much research has been done on interventions to reduce work-related musculoskeletal disorders (WMSDs) at the workplace. However, this problem is still a major concern in working life. The economic cost for WMSDs corresponds to between 0.5% and 2% of the gross national product in some European countries, and in 2007, 8.6% of workers in the EU had experienced work-related health problems during the previous 12 months. In Sweden, one in five of all employees have rated occurrence of WMSDs during the previous 12 months.

In spite of comprehensive ergonomic improvements of workplace and tool design in dentistry the prevalence of musculoskeletal disorders in neck, upper arms and back is reported to be between 64% and 93%.

The present thesis investigates if the perceived high exertion during work corresponds to actual physical exposures. Further, it is investigated if risk full physical exposures may be generated due to rationalisations. Specifically, changes in physical exposures are investigated prospectively during a period of rationalisations. Empirical data on production system performance, individual measured physical workload, and self-rated physical workload are provided.

High estimates of self-rated workload were found. These high scores for perceived workload were associated with high measured muscular workload in the upper trapezius muscles. Also, negative correlations were found between low angular velocities in the head, neck and upper extremities on the one hand, and estimates for perceived workload on the other. Both measured muscular workload and mechanical exposure among dentists indicate a higher risk of developing WMSDs than in occupational groups with more varied work content. Value-Adding Work (VAW) comprised about 57% of the total working time and compared to industrial work an increase with about 20 percent units is hypothesised. Furthermore, VAW compared to non-VAW (“waste”) implies more awkward postures and especially low angular velocities interpreted as constrained postures.

Consequently, when increasing the proportion of time spent in VAW due to rationalisations, work intensification is expected. However, at follow up, we did not find such work intensification.

Previous research indicates that rationalisation in working life may be a key factor in the development of WMSD. The present thesis suggests that ergonomics may then be considered proactively as part of the rationalisation process.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. p. 65
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1192
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-65422 (URN)978-91-7393-347-6 (ISBN)
Public defence
2010-10-28, Aulan, Länssjukhuset Ryhov, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-02-07 Created: 2011-02-07 Last updated: 2013-09-03Bibliographically approved
Jonker, D., Rolander, B. & Balogh, I. (2009). Relation between perceived and measured workload obtained by long-term inclinometry among dentists. Applied Ergonomics, 40(3), 309-315
Open this publication in new window or tab >>Relation between perceived and measured workload obtained by long-term inclinometry among dentists
2009 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 40, no 3, p. 309-315Article in journal (Refereed) Published
Abstract [en]

Dentists reported high perceived physical work conditions. Working postures and movements of the head and upper extremities during dental work were registered with inclinometry measurements during four hours. The aim was to clarify the relationship between measured working postures/movements and perceived physical work conditions. Dentists worked with elevated arms and a rather steep forward inclination of the head. Correlations (r = -0.52 to -0.66) between inclination velocity and perceived workload on VAS scales were found, but there were only weak correlations between observed working postures. The different tasks involved in dental work provide limited variation in work movements and postures, measured by inclinometry. By alternating between sitting and standing, it might be possible to achieve variation in physical workload during dental work.

Keywords
Questionnaire, Inclinometry, Dentistry
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17629 (URN)10.1016/j.apergo.2008.12.002 (DOI)
Available from: 2009-04-07 Created: 2009-04-06 Last updated: 2017-12-13
Jonker, D., Rolander, B., Balogh, I., Sandsjö, L., Ekberg, K. & Winkel, J. (2008). Mechanical exposure levels and duration of value-adding versus non-value-adding tasks among general practice dentists in Sweden.. Paper presented at The 40th Nordic Ergonomic Society conference, Reykjavík, Iceland 11-13th August 2008..
Open this publication in new window or tab >>Mechanical exposure levels and duration of value-adding versus non-value-adding tasks among general practice dentists in Sweden.
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2008 (English)Conference paper, Published paper (Refereed)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-73903 (URN)
Conference
The 40th Nordic Ergonomic Society conference, Reykjavík, Iceland 11-13th August 2008.
Available from: 2012-01-16 Created: 2012-01-16 Last updated: 2013-09-03
Rolander, B., Jonker, D., Balogh, I., Sandsjö, L., Winkel, J. & Ekberg, K. (2008). Physical demands and reported illness among dentists - A longitudinal approach.. Paper presented at The 40th Nordic Ergonomic Society conference, Reykjavík, Iceland 11-13th August 2008..
Open this publication in new window or tab >>Physical demands and reported illness among dentists - A longitudinal approach.
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2008 (English)Conference paper, Published paper (Refereed)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-73904 (URN)
Conference
The 40th Nordic Ergonomic Society conference, Reykjavík, Iceland 11-13th August 2008.
Available from: 2012-01-16 Created: 2012-01-16 Last updated: 2013-09-03
Rolander, B., Stenström, U. & Jonker, D. (2008). Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists. Swedish Dental Journal, 32, 197-203
Open this publication in new window or tab >>Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists
2008 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, p. 197-203Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to investigate, in a group of 77 Swedish dentists (36 males, 41 females) working in dental clinics, possible effects of psychosocial work environmental factors, personality traits, and social desirability tendencies on their reporting of their workload and of the physical demands placed on them. Participants were given questionnaires for assessing their workload, the physical and psychosocial demands of their job, their social support at work, and their control over their work situation, using a 10-cm visual analogue scale (V.A.S.). The Eysenck Personality Questionnaire (EPQ) was also given to assess neuroticism and extraversion and the Marlowe-Crown SD-scale to measure tendencies to answer questions in a socially desirable manner. As in two earlier studies of ours, very high assessments were made of workload, physical work demands and social support. Higher assessments of workload and of physical work demands were found in those assessing the psychosocial work demands placed on them to be higher. Those assessing the work load of their job as higher also considered themselves to have less control over their work situation and were less extraverted. Despite these dentists perceiving themselves as being faced with a stressful work situation involving a high workload, strong physical and psychosocial demands being placed on them and their having a low degree of control over their work situation, the high degree of social support they experienced may have made their work situation less stressful.

Place, publisher, year, edition, pages
Stockholm: , 2008
Keywords
Workload, physical demands, psychosocial work factors, personality, dentists
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-67450 (URN)19172921 (PubMedID)
Available from: 2011-04-14 Created: 2011-04-12 Last updated: 2017-12-11Bibliographically approved
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