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  • 1.
    Bergman, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stomby, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Otten, Julia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lanthén, Ellen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Renklint, Rebecka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Danish Research Center for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Levine, James A.
    Department of Endocrinology, The Mayo Clinic, Rochester, MN, USA; Fondation IPSEN, Paris, France.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial2018In: The Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, article id e523-e535Article in journal (Refereed)
    Abstract [en]

    Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.

    Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.

    Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.

    Interpretation: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.

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  • 2.
    Bergman, Frida
    et al.
    Umeå University.
    Wahlström, Viktoria
    Umeå University.
    Wennberg, Patrik
    Umeå University.
    Boraxbekk, Carl-Johan
    Umeå University.
    Sörlin, Ann
    Umeå University.
    Öhberg, Fredrik
    Umeå University.
    Olsson, Tommy
    Umeå University.
    Increasing Physical Activity In Office Workers - An RCT Of Treadmill Workstations2018In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 50, no 5, p. 47-47Article in journal (Other academic)
    Abstract [en]

    PURPOSE: Our primary hypothesis was that an intervention with treadmill workstations would increase time spent walking. Secondary hypotheses were a decrease in time spent sitting with a concomitant increase in time spent standing and in light intensity physical activity (LPA) leading to positive effects on body measurements and body composition.

    METHODS: The intervention group received a treadmill workstation at their office desk during 13 months. Daily time spent sitting, standing and walking and number of steps was measured with activPAL®. Daily time in LPA and MVPA was measured with Actigraph®. Body weight, BMI and waist circumference were measured according to standardized protocols. Dual X-ray Absorptiometry was used to estimate body composition. Mixed models was used for the statistical analysis, with group, day of week (weekday/ weekend), time point and gender as fixed effects and age as a covariate. p<0.05 was considered significant.

    RESULTS: Eighty participants were included. The intervention group significantly increased their time spent walking at all follow-ups, with a difference at 13 months of 22 minutes (p<0.01) and 1645 steps per day (p<0.05), respectively, versus controls. Concomitantly, they decreased their MVPA with 13 minutes per day (p<0.001) at weekdays at 13 months versus baseline. We also found a decrease in LPA with 19 minutes per day (p<0.05), and of 17 minutes per day for MVPA (p<0.001) at 13 months versus baseline at weekends. The control group increased their time spent sitting with 25 minutes per day (p<0.05) and decreased the time spent standing with 35 minutes per day at weekdays (p<0.001) compared to baseline. There was also a decrease in LPA with 14 minutes per day (p<0.01) and in MVPA with 6 minutes per day (p<0.01) versus baseline during weekdays, with a decrease in sitting time with 36 minutes (p<0.05) at weekends. There were no significant changes in body measurements or body composition.

    CONCLUSION: It is possible to increase daily walking time by introducing treadmill workstations at offices. A decreased MVPA within the intervention group may contribute to lack of effects on body measurements and body composition. It is therefore important that future interventions aim at both reducing sedentary time as well as increasing, or at least remaining, MVPA levels.

  • 3.
    Hallman, David
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning..
    Januario, Leticia
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning..
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning..
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbetshälsovetenskap och psykologi, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning..
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    P09-09 Hybrid work and temporal patterns of sedentary behavior in a 24-hour compositional perspective2022In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 32, no Supplement_2Article in journal (Refereed)
    Abstract [sv]

    Background

    During the COVID-19 pandemic, many white-collar workers were requested to exclusively work from home (WFH), which may have affected their sedentary behavior. In Sweden, having less severe restrictions than many other countries, workers were allowed to alternate between WFH and work at the office (WAO), so called hybrid work. Understanding how hybrid work influences total sedentary behavior and its temporal distribution is an important issue for future health promotion. This study aimed to investigate to what extent office workers changed their temporal pattern of sedentary behavior during days WFH compared to WAO, considering age and gender as potential moderators.

    Methods

    Data were collected from May to December 2020 in office workers (n = 199). Their mean age was 42 (SD 10) years and 55% were women. Physical behaviors were measured using a thigh-worn accelerometer (AxivityAX3) for seven consecutive days. A diary identified working hours, time-in-bed and days WFH or WAO. Time-use was classified as short (0-5 min), moderate (5-30 min) and long bouts (>30 min) of sedentary behavior (SB), non-SB, and time-in-bed during workdays (WAO and WFH) and non-workdays. We used Compositional data analysis to express data as 24-hour compositions and linear mixed models to estimate difference in 24-hour compositions between day types (within worker), including age and gender as covariates and moderators.

    Results

    We found that workdays (WFH and WAO) were associated with proportionally less time-in-bed relative to time awake, more time SB relative to non-SB, and more time in longer relative to shorter sedentary bouts, compared to non-workdays (all p > 0.001). WFH was associated with more time-in-bed relative to awake and more SB relative to non-SB than WAO (p > 0.05), but the differences for sedentary bouts were not significant. Younger workers and women had more SB, and women accumulated more time than men in longer relative to shorter bouts of SB. However, age and gender did not affect differences between day types.

    Conclusions

    Working from home influenced 24-hour time-use in office workers by increasing sedentary behavior in total, while its temporal pattern was unchanged. Results contribute to evidence that can support organizational policies on hybrid work.

  • 4.
    Mehlig, Kirsten
    et al.
    School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Torén, Kjell
    Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Lamontagne, Anthony D.
    Institute for Health Transformation, Deakin University, VIC, Geelong, Australia.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Nyberg, Jenny
    Section for Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
    Waern, Margda
    Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Psychotic Disorders, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
    Åberg, Maria
    General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Regionhälsan, Gothenburg, Sweden.
    Occupation-specific risk estimates for suicide and non-fatal self-harm from a Swedish cohort of male construction workers followed 1987-20182024In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 81, no 3, p. 142-149Article in journal (Refereed)
    Abstract [en]

    Objectives: While suicidal behaviour has become less prevalent in non-manual workers in recent decades, rates have increased in manual workers. We aimed to identify occupations within the construction industry with excess risk of suicide and non-fatal self-harm.

    Methods: This cohort of Swedish construction workers comprises 389 132 individuals examined 1971-1993 and followed 1987-2018 using national hospital and cause of death registers. More than 200 job titles were merged into 22 occupational groups. For 296 891 men alive in 1987 and active in the construction sector, survival was calculated from baseline to first event of non-fatal self-harm or suicide and censored for emigration, long-term unemployment, disability pension, retirement, death from other causes or end of follow-up. HRs with 95% CIs were obtained from multiple Cox proportional hazard regression.

    Results: Overall, 1618 cases of suicide and 4774 events of non-fatal self-harm were registered. Self-harm before baseline was the single largest risk factor for suicide, HR 9.3 (95% CI 7.5 to 11.6). Compared with the overall mean, labourers and rock workers had excess risk for suicide, HR 1.4 (95% CI 1.1 to 1.7) and 1.5 (95% CI 1.0 to 2.3), respectively, while electricians, clerks and foremen had reduced risk. Labourers, concrete workers, sheet metal workers, painters, glaziers and the group € other construction workers' were at increased risk for non-fatal self-harm. Almost all categories of manual workers were at increased risk for suicidal behaviour relative to clerks and foremen.

    Conclusions: Specific occupations within the construction sector were associated with excess risk for suicidal behaviour. Future studies should identify underlying risk factors to inform tailored interventions.

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  • 5.
    Pettersson-Strömbäck, Anita
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bodin Danielsson, Christina
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Öhrn, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Harder, Mette
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slutrapport från AKTIKON-PROJEKTET i Örnsköldsviks kommun: Arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö – en kontrollerad studie i Örnsköldsviks kommun2018Report (Other academic)
    Abstract [sv]

    Projektet Aktivitetsbaserat Kontor (AktiKon) har följt och utvärderat en förändringsprocess i Örnsköldsviks kommun där tjänstemännen i kommunen flyttade från cellkontor till antingen ett aktivitetsbaserat kontor (AB-kontor) eller ett cellkontor. Syftet med forskningsprojektet var att studera effekter på arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö och kunna jämföra med fortsatt arbete i cellkontor. Mätningar med enkäter, fokusgruppsintervjuer, gåturer och observationer utfördes 6 mån före flytt och 6 respektive 18 månader efter flytt. Individuella intervjuer av personer med upplevd funktionsnedsättning utfördes ca 10 månader efter flytt. Rörelsemätningar utfördes vid fem olika tillfällen under flyttprocessen.

    I denna rapport har vi valt att redovisa enkätresultat från anställda som vi har kunnat följa över tid, d.v.s. individer där vi har resultat från enkät besvarad före flytt och från minst ett tillfälle efter flytt. Den ursprungliga studiepopulationen som studerades med denna metod bestod från början av 374 anställda och vid den sista uppföljningen, 18 månader efter flytt, av 152 anställda i AB-kontoret och 63 i cellkontoret. De två grupperna som flyttade till olika kontorsmiljöer var inte helt jämförbara. Exempelvis var det fler män och chefer som flyttade till AB-kontoret och yrkesgrupperna var inte heller lika, men alla som ingick i projektet var tjänstemän inom samma kommun.

    De som flyttade till AB-kontoret upplevde den nya kontorsmiljön som estetiskt tilltalande och luftkvaliteten god. De som flyttade till nya cellkontor hade utifrån kvalitativa intervjuer inte en lika positiv uppfattning vad gäller kontorets design och inredning.

    Arbetsbelastningen och olika typer av krav såg lika ut över tid för respektive grupp. Det var vid 18 månader efter flytt ingen skillnad jämfört med före flytt i hälsofrämjande arbetsfaktorer undersökta med WEMS-instrumentet (Work Experience Measurement Scale) för de som flyttat till AB-kontor. Det var inte heller någon skillnad över tid i jämförelse med de som flyttat till cellkontor. Datorstödet upplevdes mycket positivt av de som flyttade till AB-kontoret och de blev något mer nöjda än de som flyttade till cellkontor. Det fanns i AB-kontoret inte någon säker skillnad i upplevelse av samarbete mellan olika arbetsgrupper eller inom hela organisationen vid 18 månader efter flytt jämfört med utgångsläget och inte heller någon säker skillnad över tid jämfört med cellkontoret. De som flyttade till AB-kontor rapporterade efter flytten en ökad störning av ljud och besvär av bristande avskildhet. Man upplevde i genomsnitt en lägre produktivitet i AB-kontoret efter flytt och det fanns en skillnad mellan de två kontorstyperna över tid.

    Cheferna var generellt nöjda med att arbeta i AB-kontor och de upplevde inte någon minskad produktivitet vid övergång till AB-kontor. I genomsnitt blev det emellertid en minskad nöjdhet med kontorets utformning i gruppen som flyttade till AB-kontor. Nöjdheten med AB-kontoret varierade beroende på yrke och typ av arbetsuppgifter. De som hade mycket enskilt och koncentrationskrävande datorarbete upplevde mindre nöjdhet efter flytt och angav att de helst ville arbeta i cellkontor om de fick välja. De som arbetade mycket i grupp, behövde vara idérika och ofta diskuterade med kollegor föredrog att arbeta i AB-kontor. Bland dem som helst ville arbeta i cellkontor fanns det en ökad förekomst av problem med stress, långvarig utmattning och psykiska besvär.

    Det framkom ökade problem med koncentrationen hos de som flyttade till AB-kontor. Det fanns däremot inga säkra skillnader över tid mellan grupperna vad gäller skattning av allmän hälsa och förekomst av andra typer av besvär.

    Redan före flytten hade båda grupperna tillgång till höj- och sänkbara bord och det var vanligt att arbeta stående under en rätt stor del av arbetsdagen. Efter flytten ökade tiden i gående och antal steg något i AB-kontoret jämfört med cellkontoret. I AB-kontoret fanns tillgång till gå-band, men dessa användes endast av ett fåtal anställda. Den centralt belägna öppna trappan var omtyckt och användes mycket.

    Sammanfattningsvis visar studien att nöjdhet, preferens och produktivitet i AB-kontor varierar mycket beroende på vilka arbetsuppgifter man har. AB-kontoret fungerar särskilt bra för personer med ledningsuppdrag. För att AB-kontoret ska kunna fungera bra även för personer med funktionsnedsättning måste det finnas system för att fånga upp individuella problem och möjliggöra anpassningar vid behov. Detta gäller särskilt vid psykiska besvär och kognitiva svårigheter. Det är angeläget att det i AB-kontoret finns tillgång till stödytor och resurser i tillräcklig omfattning för alla de olika arbetsuppgifter som ska utföras.

    En viktig erfarenhet i projektet är betydelsen av att kunna beskriva den kontext som förändringen sker i. Genom att göra en processutvärdering har det funnits möjlighet att på ett adekvat sätt tolka och förstå de effekter som framkom vid övergång till AB-kontor.

    Framgångsfaktorer vid övergång till AB-kontor är noggrann kartläggning och analys före flytt, samverkan, delaktighet, överenskomna regler och förhållningssätt, och övergripande rutiner som inkluderar hela kontoret för det fortsatta arbetsmiljöarbetet.

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  • 6.
    Stjernbrandt, Albin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Pettersson, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Lewis, Charlotte A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Occupational cold exposure is associated with upper extremity pain2023In: Frontiers in Pain Research, ISSN 2673-561X, Vol. 4, article id 1063599Article in journal (Refereed)
    Abstract [en]

    Background: Occupational cold exposure is common in Sweden but potential impacts on musculoskeletal disorders have not been thoroughly investigated. The primary aim of this study was to determine the associations between occupational contact and ambient cooling in relation to pain in the upper extremity.

    Methods: In this cross-sectional study, a digital survey was conducted on a population-based sample of women and men between 24 and 76 years of age, living in northern Sweden. Occupational cold exposure, heavy manual handling, work with vibrating tools as well as the presence of upper extremity pain at different sites were subjectively reported. Associations between exposure and outcome were evaluated using multiple binary logistic regression.

    Results: The final study sample included 2,089 (54.4%) women and 1,754 men, with a mean age of 56 years. Hand pain was reported by 196 (5.2%), lower arm pain by 144 (3.8%), and upper arm pain by 451 (11.9%). Severe ambient cooling for more than half of the working time was statistically significantly associated with hand pain (OR: 2.30; 95% CI: 1.23–4.29) and upper arm pain (OR: 1.57; 95% CI: 1.00–2.47) but not lower arm pain (OR: 1.87; 95% CI: 0.96–3.65) after adjusting for gender, age, body mass index, current daily smoking, heavy manual handling, and work with vibrating tools.

    Conclusions: Occupational cold exposure was statistically significantly associated with hand pain and upper arm pain. Therefore, occupational cold exposure should be recognized as a potential risk factor for musculoskeletal disorders in the upper extremity.

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  • 7.
    Stjernbrandt, Albin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Vihlborg, Per
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Lewis, Charlotte A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Occupational cold exposure and symptoms of carpal tunnel syndrome: a population-based study2022In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, no 1, article id 596Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).

    METHODS: In this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression.

    RESULTS: The study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62-6.33), as was ambient cooling (OR 2.00; 95% CI 1.03-3.88) and severe ambient cooling (OR 4.02 95% CI 2.09-7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88-13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67.

    CONCLUSIONS: Self-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure-response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment.

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  • 8.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Interventions for increased physical activity among office workers2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The positive association between physical activity (PA) and health is well established. Technical developments in modern life have created major changes in our societies and working life, and a growing body of research has identified sedentary behavior (SB) as an independent risk factor for type 2 diabetes, cardiovascular disease, and cancer as well as for premature mortality. To promote health, it is important to find ways to decrease SB and incorporate PA in office settings, for example, by using new office designs and behavioral interventions.

     

    The aim of this thesis was to evaluate two workplace interventions among office workers to determine if these led to increased PA and reduced SB, and to describe underlying factors behind these results.

     

    The thesis is based on two workplace interventions. The first intervention was the Inphact treadmill study, a 13-month randomized controlled trial where treadmill workstations were installed and participants were instructed to use the treadmill for at least one hour per workday. The second intervention was the Active Office Design (AOD) study. This study included a multicomponent PA promoting program, implemented in parallel with an office relocation to either traditional cell offices or to a flex office with activity-based work (ABW). The two groups in the AOD study were followed from 6 months before relocation to 18 months after. 

     

    Objectively measured data for SB, PA, and body measurements were collected in both studies. In the Inphact treadmill study, body composition, metabolic outcomes, self-reported energy and stress, and depression and anxiety scores were also measured. In the AOD study, measurements of health and lifestyle, musculoskeletal disorders, workload, work tasks, utilization of possibilities to be active at work, and perceptions of the performed PA promoting program were assessed via questionnaires. In addition, interview data were collected via focus groups and individual interviews. Linear mixed models were used for the main statistical analyses of the quantitative data. To explore the factors that influence SB and PA at work we combined factor analysis of mixed data with multiple linear regression.Interview data were analyzed using qualitative content analysis and a deductive approach to a process evaluation model. 

     

    In both study populations, sitting time was low and stand­ing time was high already at baseline, compared to other studies on office workers. In the Inphact treadmill study, the intervention group showed increased walking time during workdays compared to the control group for all follow-up measurements. At the same time, a decrease in moderate-to-vigorous PA (MVPA) was observed in both the intervention and control groups during leisure time. No intervention effects were seen on body measurements, body composition, metabolic outcomes, stress, or anxiety during the treadmill intervention. 

     

    In the AOD study, employees relocated to flex offices increased their walking time and MVPA during work hours to a greater extent than those relocated to cell offices, but neither group changed the amount of time spent sitting at work. Contrary to the Inphact treadmill study, no compensatory effects were seen during leisure time. The exploratory analysis resulted in six employee character-types, where the “harmonic and healthy” and “engaged with high workload” tended to sit more and to stand less, while the character type with “high BMI, creative and collaborative work” tended to sit less and stand more. The process evaluation of the intervention revealed a strong culture to encourage PA within the organization and that the intervention was supported by management. The timing of the program was questioned, and activities to support the relocation to the flex office with ABW were requested. Social acceptance for standing and walking at work increased, although the need for the intervention was debated due to the strong culture of facilitating PA at work already in place prior to the study.

     

    In conclusion, we showed long-term increases in PA were achieved in office workers, but the changes did not lead to improvements in body measurements and metabolic balance during the follow-up period. The two studies showed conflicting results regarding compensatory effects during leisure. Participants in the Inphact treadmill study decreased their MVPA during leisure, while no compensatory effects were seen in the AOD-study. Our results suggest a possible ceiling effect for the amount sitting time can be reducedin office workers, and that SB and PA in offices is influenced by many factors, such as organizational culture, physical environment, work tasks, work load and physical comfort. Together, the studies in this thesis confirm the importance of carefully tailored worksite interventions for decreasing SB and increasing PA at work.

     

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  • 9.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures: a longitudinal study in different office types2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 5, p. 493-504Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office.

    Methods: The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models.

    Results: Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group.

    Conclusions: This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.

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  • 10.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    A longitudinal study of physical activity in different office types2018In: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, no 10, p. S62-S62Article in journal (Other academic)
  • 11.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Harder, Mette
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Implementing a Physical Activity promoting program in a flex-office: A Process Evaluation with a Mixed Methods Design2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 1, article id 23Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate facilitating and hindering factors when implementing a physical activity (PA)-promoting program among office workers moving to a flex office, by conducting a process evaluation. Additionally, we evaluated self-reported and perceived PA behaviors. With a mixed methods design, analyses were based upon data from interviews with 70 employees and repeated questionnaires from 152 employees. The PA-promoting program was fully implemented and supported by management. There was a strong health promoting culture, encouraging PA in the organization already at the start of the study. The lecture and the office design were rated as the most motivating program components. The use of stairs, breaks during meetings and social acceptance for standing and walking at work increased. Employees described a strive for variation, and how managers, the office environment, productivity and ergonomic aspects influenced sedentary behavior (SB) and PA. The need for the PA-promoting program was questioned, and the timing of the program was debated. To conclude, a strong organizational health culture combined with a facilitating physical environment can create sustainable positive PA behaviors in office settings. A thorough understanding of organizational needs and a participatory process are needed to tailor organizational interventions to decrease SB.

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  • 12.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Januario, Leticia Bergamin
    Department of Occupational Health Science and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
    Mathiassen, Svend Erik
    Department of Occupational Health Science and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
    Heiden, Marina
    Department of Occupational Health Science and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
    Hallman, David M.
    Department of Occupational Health Science and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden.
    Hybrid office work in women and men: do directly measured physical behaviors differ between days working from home and days working at the office?2023In: Annals of Work Exposures and Health, ISSN 2398-7308 , E-ISSN 2398-7316 , Vol. 67, no 9, p. 1043-1055Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: We investigated and compared temporal sitting patterns among male and female hybrid office workers when working at the office (WAO), working from home (WFH), and for non-working days (NWD).

    METHODS: We analyzed data collected in 2020 among 165 hybrid office workers, carrying thigh-worn accelerometers for 938 days in total. Day type (WAO, WFH, or NWD) and time in bed were identified using diaries. Time awake was exhaustively classified as non-sitting time and time sitting in short, moderate, and long bouts. Effects of day type and gender on the 24-h compositions of physical behaviors were analyzed using multilevel linear mixed models.

    RESULTS: During workdays (both WAO and WFH), workers spent less time in bed and more time sitting, particularly in moderate and long bouts, than during NWD. Time in bed was longer when working from home than when working at the office, and more of the awake time was spent sitting. Differences between WAO and WFH in ratios between short, moderate, and long bouts of sitting were small and inconsistent. Men spent more time sitting than women, and more time in moderate and long sitting bouts relative to short bouts.

    CONCLUSIONS: When working from home, hybrid office workers sat more during their hours awake compared to when working at the office. Sitting time was larger during working days than during non-working days and was higher in men than in women. These results may contribute to support organizational policies for hybrid work.

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  • 13.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Nygren, Mikael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lewis, Charlotte A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Validity of Three Survey Questions for Self-Assessed Sedentary Time2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 7, article id 4269Article in journal (Refereed)
    Abstract [en]

    Time spent in sedentary behavior (SB) has increased during the last decades. Accurate assessments are of importance when studying health consequences of SB. This study aimed to assess concurrent validity between three different questions for self-reported sitting and thigh worn accelerometer data. In total, 86 participants wore the ActivPAL accelerometer during three separate weeks, assessing sitting time with different questions each week. The questions used were Katzmarzyk, GIH stationary single-item question (SED-GIH), and a modified version of the singleitem from IPAQ short form. In total 64, 57, and 55 participants provided valid accelerometer and questionnaire data at each time-point, respectively, and were included for analysis. Spearman and Pearson correlation was used to assess the validity. The three questions, Katzmarzyk, SED-GIH, and a modified question from IPAQ all showed a weak non-significant correlation to ActivPAL with r-values of 0.26, 0.25, and 0.19 respectively. For Katzmarzyk and SED-GIH, 50% and 37% reported correctly, respectively. For the modified IPAQ, 53% over-reported and 47% under-reported their sitting time. In line with previous research, our study shows poor validity for self-reported sitting-time. For future research, the use of sensor-based data on SB are of high importance.

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  • 14.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Underlying Factors Explaining Physical Behaviors among Office Workers-An Exploratory Analysis2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 24, article id 9158Article in journal (Refereed)
    Abstract [en]

    Studies using technical measurements of physical behavior show wide interindividual variations. This study aimed to explore underlying factors related to sitting, standing and walking among office workers. Cross-sectional data for background characteristics, work-related variables, and device-based measures for sitting, standing and walking were collected among office workers in either a cell office or a flex office with activity-based work. Data were analyzed by Factor Analysis of Mixed Data (FAMD) and multiple robust linear regression. The FAMD resulted in the combination of underlying factors describing six character types. The (1) harmonic and healthy, (2) disabled with poor health, (3) manager that spend a lot of time in meetings and has very high workload, (4) engaged with high workload, (5) employee with creative and computer intense work, with high workload and, (6) employee with high BMI with creative and collaborative work. Regression analysis showed that the character type that was "engaged with high workload" sat more and stood less, while the character type with "high BMI and with creative and collaborative work" sat less. The results suggest that physical behavior among office workers is influenced by a complex combination of factors, which should be taken into account in the evaluation of future studies of larger cohorts.

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  • 15.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Underlying factors explaining sedentary behavior and physical activity among office workers - an exploratory analysisManuscript (preprint) (Other academic)
  • 16.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Öhrn, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Harder, Mette
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Pettersson-Strömbäck, Anita
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Physical work environment in an activity-based flex office: a longitudinal case study2024In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs).

    Methods: The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees.

    Results: Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs.

    Conclusion: Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.

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  • 17.
    Öhlin, Jerry
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Liv, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Andersson, Martin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stjernbrandt, Albin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Occupational physical activity and resting blood pressure in male construction workers2023In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 96, no 9, p. 1283-1289Article in journal (Refereed)
    Abstract [en]

    Objective: This study investigated the association between occupational physical activity (OPA) and resting blood pressure in a cohort of Swedish construction workers.

    Methods: The final sample included 241,176 male construction workers. Occupations with low OPA were foremen and white-collar workers. The most frequent occupations in the medium OPA group were electricians, pipe workers, and machine operators, and in the high OPA group woodworkers, concrete workers, and painters.

    Results: Mixed effects models showed higher systolic and lower diastolic blood pressure with higher OPA, but the associations varied depending on the year of participation and participant age as shown by significant interaction terms (OPA*age, OPA*calendar year, age*calendar year). Age-stratified linear regression analyses showed a pattern of slightly higher systolic (1.49, 95% confidence interval: 1.08-1.90 mmHg) and lower diastolic (0.89, 95% confidence interval: 0.65-1.13 mmHg) blood pressure when comparing low with high OPA, but not among the oldest age groups.

    Conclusion: Despite a rather large contrast in OPA, the differences in systolic and diastolic blood pressure according to OPA were small.

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  • 18.
    Öhrn, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Harder, Mette S.
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Pettersson-Strömbäck, Anita
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bodin Danielsson, Christina
    The Royal Institute of Technology (KTH), School of Architecture and the Built Environment, Stockholm, Sweden.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Andersson, Martin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Productivity, Satisfaction, Work Environment and Health after Relocation to an Activity-Based Flex Office: The Active Office Design Study2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 14, article id 7640Article in journal (Refereed)
    Abstract [en]

    Implementation of activity-based flex offices (AFOs) are becoming increasingly common. The aim of this study was to evaluate the effects of an AFO on perceived productivity, satisfaction, work environment and health. Questionnaire data from the longitudinal, quasi-experimental Active Office Design Study was used. The study evaluates a public organization relocating staff to either an AFO or to cell offices. Measures from baseline, 6 and 18 months after relocation, were analyzed. Employees in the AFO experienced a decreased productivity and satisfaction with the office design. Lack of privacy as well as increased noise disturbance, less satisfaction with sit comfort and work posture were reported. Employees in the AFO with work tasks requiring a high degree of concentration experienced lower productivity while those with a high proportion of teamwork rated productivity to be continually high. No significant group differences were found between the two office types in general health, cognitive stress, salutogenic health indicators or pain in the neck, shoulder or back. The study highlights the importance of taking work characteristics into account in the planning and implementation process of an AFO. Flexible and interactive tasks seem more appropriate in an AFO, whereas individual tasks demanding concentration seem less fit.

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