Objectives. Standing at work has been associated with discomfort and cardiovascular symptoms. Because standing postures vary in duration, mobility, and constraint, we explored associations between specific postures and pain in the lower extremities. Methods. We used multiple logistic regression to analyze associations between work factors and pain in the lower extremities during the previous 12 months that interfered with usual activities. We used data from among 7757 workers who were interviewed in the 1998 Quebec Health and Social Survey. Results. Among all respondents, 9.4% reported significant ankle or foot pain, and 6.4% had lower-leg or calf pain. Significantly more women than men had pain at both sites. Both leg or calf and ankle or foot pain were strongly associated with standing postures, whole-body vibration, psychological distress, female gender, and being aged 50 years or older. Constrained standing postures were associated with increased ankle or foot pain for both men and women and with leg or calf pain for women, compared with standing with freedom to sit at will. Conclusions. Freedom to sit at work may prevent lower-extremity pain. The effects of specific sitting and standing postures on cartilage, muscle, and the cardiovascular system may help explain discomfort in the lower extremities.
Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980–2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes.
The Yant Award was established in 1964 to honor the contributions of William P. Yant, the first president of the American Industrial Hygiene Association. It is presented annually for outstanding contributions in industrial hygiene or allied fields to an individual residing outside the United States. The 2014 award recipient is Dr. Karen Messing, Professor emeritus, Department of Biological Sciences, Université du Québec à Montréal and Researcher, CINBIOSE Research Centre. Gender (socially determined) differences in occupations, employment, and working conditions, task assignments, and work methods that affect exposure to health risks are increasingly documented. Interactions of (biologically influenced) sex differences with workplace parameters may also influence exposure levels. During field studies, ergonomists learn a lot about gender and sex that can be important when generating and testing hypotheses about the mechanisms that link workplace exposures to health outcomes. Prolonged standing is common in North America; almost half (45%) of Québec workers spend more than three-quarters of their working time on their feet and 40% of these cannot sit at will. This posture has been linked to chronic back pain and musculoskeletal disorders (MSDs) in the lower limbs, but many health professionals suggest workers should stand rather than sit at work. We ask: (1) Given the fact that roughly the same proportion of men and women stand at work, what does a gender-sensitive analysis add to our ability to detect and thus prevent work-related MSDs?; (2) How does ergonomics research inform gender-sensitive analysis of occupational health data?; and (3) What do researchers need to know to orient interventions to improve general working postures? We have sought answers to these questions through collaborative research with specialists in epidemiology, occupational medicine, biomechanics, and physiology, carried out in partnership with public health organisations, community groups, and unions. We conclude that failure to characterize prolonged static standing and to apply gender-sensitive analysis can confuse assessment of musculoskeletal and circulatory effects of working postures. We suggest that prolonged static sitting and standing postures can and should be avoided by changes to workplace organization and environments. Research is needed to define optimal walking speeds and arrive at optimal ratios of sitting, standing, and walking in the workplace.