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Experience of musculo-skeletal disorders,intensity of pain, and general conditions in work: The case of employees in non-private dental clinics in a county in southern Sweden.
Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
University College of Health Sciences.
2001 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, Vol. 17, 65-73 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: (1) To identify perceived musculo-skeletal disorders and intensity of pain among the employees in the nonprivate dental clinics; (2) To assess perceived psychosocial and physical work conditions on the localization and intensity of musculo-skeletal disorders and pain. Study design: A questionnaire, comprising four sections (demographic, self-reported psychosocial and physical work conditions, self-reported disorders from the musculo-skeletal system, self-reported intensity of pain on nine different localization on the body) was mailed to 391 employees. Of these, 338 reported musculo-skeletal disorders. In this latter group, 239 reported work as the cause. These employees completed the questionnaire. Results: The greatest amount of pain was reported for the cervico-brachial region. Among all participants, a response pattern was found where the physical work demands were very high, the psychosocial work demands fairly high, the work climate supportive, and the control over work moderate. At an occupational group level, theoretical inconsistencies were identified in terms of a lack of anticipated relationships, especially for the dentist groups. Conclusions: For a scientific and social purpose, more research, which identifies relationships between workrelated musculo-skeletal pain and dos-response [8], effortreward [16], and demand-control [12] aspects of the working conditions, is clearly needed.

Place, publisher, year, edition, pages
2001. Vol. 17, 65-73 p.
Keyword [en]
Physical and psychosocial work conditions, dosresponse model, effort-reward model, demand-control model, musculo-skeletal disorders and pain
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-45095Local ID: 79661OAI: diva2:265957
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-02-07
In thesis
1. Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden: Are dentists working smarter instead of harder?
Open this publication in new window or tab >>Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden: Are dentists working smarter instead of harder?
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: During the last 20 years, Sweden and other countries have been adjusting their models of welfare to a changed economic environment. Rationalization, influenced by New Public Management, has been implemented in public dentistry in order to improve efficiency and to streamline activities. This has involved transferring some of dentists’ tasks to dental hygienists and dental nurses. The goal is to achieve a more efficient mix of skills and more interaction between professional groups, in order to utilize all skills better in a more efficient work organization. Organizational changes may have an effect on the work environment both with regard to physical and to psychosocial work conditions and affect health and well-being. In many cases these changes have a profound negative effect on musculoskeletal and mental health, and corresponding risk factors, by reducing the number of natural breaks and thus reducing the efficacy of targeted ergonomic interventions. Dentists in Jönköping County in Sweden perceive high precision demands and poor working postures in their work. The five studies in this thesis describe organizational changes and analyse the risk of illness among dentists in the public sector in Jönköping County.

Aim: The main aim is to study dentists’ physical and psychosocial work conditions and investigate associations with musculoskeletal disorders, work ability and sick leave during a period of extensive rationalizations; secondly, to assess the risk of illness as a basis for recommending preventive measures.

Methods: The present thesis was designed with four cross-sectional studies (Paper I-IV) and one prospective longitudinal study (Paper V). In Paper I, a questionnaire concerning physical and psychosocial work conditions and health was sent out to all employees working in public dental care in Jönköping County in Sweden. To obtain more information on the difficult physical work situation for dentists (Paper I), an observation study with Portable Ergonomic Observation (Paper II) and an sEMG study (Paper III) was then conducted. Paper IV deals with psychosocial issues (using the same survey as in Paper I) and questions in the Eysenk Personality Questionnaire (EPQ) and the Marlowe-Crown scale SD (MCSD), to analyse their impact on perceived physical load. In Paper V, data about physical and psychosocial conditions and health from a survey, as well as production data (number of adult treatments per year per dentist) from computerized patient records (T4), are analysed with regard to changes and associations during a period of extensive rationalizations (2003 – 2008).

Results: In Paper I, dentists reported the poorest physical work conditions of all occupational groups and high prevalence of musculoskeletal disorders. However, relatively low intensity of pain was reported and only a small proportion thought that work was affected. Paper II and Paper III confirmed that dentists’ work is physically demanding, with sitting postures and head bent forward, as well as prolonged low muscle loading. Paper IV shows that physical load is mainly influenced by psychosocial demands and to some extent by loss of work control. The results in Paper V show that during the period of extensive rationalizations between 2003 and 2008, dentists perceive improved precision demands and fewer uncomfortable work postures, but still a high level of physical load. The number of adults treated per dentist also improved, but there was a slight deterioration in work control and leadership.

Conclusions: The results in this thesis show a consistent picture of high perceived physical load due to high precision demands and uncomfortable work postures, supported by observation of body movements (Portable Ergonomic Observation) and sEMG signs during psychosocially demanding circumstances. The rationalizations implemented in Jönköping County during the period 2003-2008 have not resulted in a deterioration of the physical environment, in spite of the fact that dentists produce more treatments of adult patients than before. This result may indicate that rationalizations do not always lead to increased health risks; it depends how they are implemented. Dentists may have changed the way they work for the better, and due to task delegation and SMS reminders a smoother patient flow has probably resulting in a reduction of workload and perceived stress regarding financial loss.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 78 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1191
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-65428 (URN)978-91-7393-348-3 (ISBN)
Public defence
2010-10-29, Originalet, Qulturumhuset, Länssjukhuset Ryhov, Jönköping, 13:00 (Swedish)
Available from: 2011-02-07 Created: 2011-02-07 Last updated: 2013-09-03Bibliographically approved

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