Objective There has not been a theoretical test run in Germany that compares different navigation systems with an industry solution (MapTrip112). The aim of this study was to compare navigation systems to elucidate whether the emergency response time (ERT) was reduced and, consequently, whether the adherence to the travel time improved.Design Prospective, simulation study, cross-sectional study.Setting Offices of the Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt (60 590 Frankfurt am Main, Germany). The situation-adaptable industry navigation solution MapTrip112 was tested in its ‘Lights and Siren(s) (L&S)’ mode in comparison to the TomTom and Google Maps navigation systems. MapTrip112 was set to calculate a route that takes special emergency rights of way into account.Outcome measures All three navigation systems simultaneously calculated the distances and durations of fictitious routes. Three scenarios were tested: the University Hospital Frankfurt (60 596 Frankfurt am Main, Germany) and the Central Fire Station 1 (60435 Frankfurt am Main, Germany) served as the starting points for the urban routes, while the Odenwald Health Centre (64 711 Erbach, Germany) served as the starting point for rural routes. The routes’ endpoints were arbitrarily chosen locations inside the customary operational radius. The routes were selected for short and long distances as well as for different periods, including weekdays, weekends and evening rush hour (4–7 pm), in the German cities of Frankfurt am Main and Odenwaldkreis (Southern Hesse).Results The time and distance were calculated for a total of 4650 trips. When comparing travel times and distances between rural and urban areas as well as between weekdays and weekends, statistically significant results were obtained (p<0.001). With time advantages ranging from 23.5 s to 300.5 s (4.75% to 50% of the travel time) on weekdays and weekends, MapTrip112 consistently outperformed both TomTom and Google Maps. For city missions, MapTrip112 achieved time gains of up to 50% over its competitors, with significant advantages during the rush hours and around specific locations such as the University Hospital Frankfurt and Fire Station 1.Conclusion MapTrip112 always achieved the fastest routes although these were not always accompanied by a shortened distance. These findings underscore MapTrip112’s superiority in providing efficient routing solutions across various scenarios. For this reason, the use of this software should be considered in practice and investigated in real-world conditions in further studies.

Background For the prevention of musculoskeletal diseases (MSD) stretch training is a measure of the workplace health promotion (WHP) for office workers. This can lead to an increase in mobility and relaxation on a psychological level. The aim of the study was to examine a standardized and individualized stretch training on a device, the so-called five Business, for MSD, quality of life and mobility. This is a summary of internationally published results. Material and methods A total of 252 subjects were included in this study, 156 in the intervention group (IG) and 96 in the control group (KG). In 12 weeks the IG completed a total of 22-24 training sessions on the five Business device preferably twice a week. Data were collected in the form of a pre-post study using range of motion (ROM) tests, the Nordic questionnaire (NQ) and the SF-36. Results After the intervention, in the NQ significantly fewer IG subjects reported complaints in the upper back (p < 0.001) compared to the KG. No significant differences were found for complaints in the neck, shoulders, hips and the lower back. The general health status and health-related quality of life assessed with the SF-36 (according to subjective data) improved significantly (sum score IG: p = 0.005). The cumulative score of SF-36 showed significantly better values in the IG (p = 0.005). In the ROM tests, IG subjects showed significantly greater pre-post differences in the sagittal plane (fingertip to floor test and retroflexion of the trunk, p < 0.001) and in the modified shoulder test of Janda on the left side (p = 0.003). Conclusion Despite the relatively low training effort in terms of duration and frequency, relevant improvements were achieved on both the physical and psychological levels. Thus, the five Business stretch training can be recommended as a WHP measure.

Objectives For the prevention of musculoskeletal diseases (MSDs), stretch training can be a measure of the workplace health promotion (WHP) for office workers. This can lead to an increase in mobility and, ultimately, reduce or prevent MSD. The aim of the study was to examine a standardised and individualised stretch training on a device, specifically ‘five Business’, for the prevalence of MSD. Design This study is a non-randomised control study. Setting WHP programme with clerical employees of a German car manufacturer. Participants 252 (110 women; 142 men) subjects (median age of 44 ( X∼ 21 years) finished the study successfully. Inclusion criteria included a full-time employment in the office workplace and subjective health. Intervention The intervention group completed 22–24 training units of 10 min each on the ‘five-Business’ device two times a week for 12 weeks. Primary and secondary outcome measures Data were collected in the form of a pre–post study Nordic Questionnaire. Results After the intervention, significantly fewer subjects reported pain in the area of the neck (−17.79), shoulder (−11.28%), upper back (−14.7%), lower back (−12.78%) and feet (−8.51%). The gender analysis revealed that women are, in general, more often affected by musculoskeletal complaints than men, especially in the neck (+29.5%) and feet (+15.03%). Both sexes had significant reductions of MSD in the most commonly affected regions. Thus, 27.12% less women reported having neck pain, while 13.14% less men reported having low back pain. Conclusions The results suggest that a stretching programme performed for 3 months can reduce musculoskeletal complaints in the most commonly affected areas in office workers. Both men and women benefited from the stretch training to a similar extent, suggesting that this would be a promising measure for therapy and prevention as part of WHP.

Zusammenfassung Hintergrund Dehntrainings sind eine Maßnahme der betrieblichen Gesundheitsförderung (BGF) für Büroangestellte zur Prävention von muskuloskeletalen Erkrankungen (MSE). Sie können zu Beweglichkeitszuwächsen führen und auf psychischer Ebene entspannen. Ziel der Studie war es, ein standardisiertes und individualisiertes Dehntraining am Gerät, das „five-Business“, auf MSE, Lebensqualität und Beweglichkeit zu untersuchen. Dies ist eine Zusammenfassung der international publizierten Ergebnisse. Methodik In diese Untersuchung wurden 252 Proband(innen) eingeschlossen, 156 in die Interventionsgruppe (IG), 96 in die Kontrollgruppe (KG). Die IG absolvierte für 12 Wochen 22–24 Trainingseinheiten am „five-Business“, möglichst zweimal wöchentlich. Die Datenerhebung erfolgte mittels sportmotorischer bzw. Range-of-motion(ROM)-Tests, dem Nordic Questionnaire (NQ) und dem SF-36-Fragebogen in Form einer Prä-Post-Untersuchung. Ergebnisse Nach der Intervention gaben im NQ signifikant weniger Proband(innen) der IG Beschwerden im oberen Rücken ( p < 0,001) im Vergleich zur KG an; keine signifikanten Unterschiede wurden bei Beschwerden im Nacken, Schultern, Hüfte und dem unteren Rücken gefunden. Der mit dem SF-36 erhobene allgemeine Gesundheitszustand und die gesundheitsbezogene Lebensqualität haben sich (nach subjektiven Angaben) signifikant verbessert (Summenscore IG: p = 0,005). In den ROM-Tests waren die Prä-Post-Differenzen bei IG-Proband(innen) in der Sagittalebene (Finger-Boden-Abstand und Retroflexion; p < 0,001) und im modifizierten Schultertest nach Janda auf der linken Seite ( p = 0,003) signifikant größer. Diskussion Trotz des in Zeitdauer und Häufigkeit relativ geringen Trainingsaufwandes wurden sowohl auf körperlicher als auch auf psychischer Ebene relevante Verbesserungen erzielt, so dass das „five-Business“-Dehntraining als BGF-Maßnahme empfohlen werden kann.

Background In clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM). Methods Two raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements. Findings Intra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886–0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71–0.87) and the IMC methods (ICCs 0.61–0.993) and (almost) perfect in the TM methods (ICCs 0.923–0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9–3.3° for the DI methods and 0.5–1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5–1.3cm for the TM methods and 0.6–2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41–0.81). Interpretation Measurement repetitions of either one or multiple trained raters can be considered reliable in all three devices.

In the context of workplace health promotion, physical activity programs have been shown to reduce musculoskeletal diseases and stress, and to improve the quality of life. The aim of this study was to examine the effects of using the “five-Business” stretch training device for office workers on their quality of life. A total of 313 office workers (173m/137f) participated voluntarily in this intervention–control study with an average age of 43.37 ± 11.24 (SD) years, 175.37 ± 9.35 cm in height and 75.76 ± 15.23 kg in weight, with an average BMI of 24.5 ± 3.81 kg/m2. The participants completed the stretch training twice a week for approximately 10 min for a duration of 12 weeks. The SF-36 questionnaire was used to evaluate the effectiveness of the intervention at baseline and after 12 weeks. Significantly improved outcomes in mental sum score (p = 0.008), physical functioning (p < 0.001), bodily pain (p = 0.01), vitality (p = 0.025), role limitations due to physical problems (p = 0.018) and mental health (p = 0.012) were shown after the stretching training. The results suggest that a 12-week stretching program for office desk workers is suitable to improve significantly their health-related quality of life.

Background Musculoskeletal disorders (MSD) are a common health problem in office workers. In Germany, MSD (mainly back pain related) are the main cause of workdays lost to incapacity. This is not only bothersome for the employees, but also causes higher costs for the health system and employers. Workplace health promotion programmes (WHPP) can help to reduce this as they reach large target groups and are easily accessible. In this context, stretch training exercises have already proven to be effective. In the present study, a new approach focusing on trunk extension is to be investigated. Methods To evaluate the training device “five-Business”, 250 office workers will train two times a week for 3 months. The control group will consist of 100 office employees. The device “five-Business” enables five different full body exercises. The intervention will be evaluated before week one and after week twelve via three assessments: a) the Short Form-36 (SF-36) to record the general health status and health-related quality of life, taking into account physical, psychological and social factors, b) the Nordic Questionnaire to evaluate complaints of the musculoskeletal system, c) Range of Motion (ROM) measurements using a digital inclinometer and a measuring tape respectively. Conclusion The “five-Business” combines elements of yoga and the McKenzie fundamentals, taking into account the Myers myofascial pathways in a highly torso-oriented, standardized stretching program. Due to the given exercise execution on the device and the individual adjustment possibilities of the stretching position (body size and range of motion) by the abutment, all exercises are individualized and standardized at the same time. In comparison to existing stretching interventions, this is a new approach in the framework of reducing musculoskeletal disorders and improving the quality of life in workplace health promotion.

Ökonomische Umstrukturierungen nehmen in Deutschland einen immer größeren Stellenwert ein und ziehen strukturelle Veränderungen für das gesamte soziale und medizinische Versorgungssystem und die Schichtarbeit nach sich. Ziel dieser Arbeit ist eine szientometrische Analyse des Forschungsaufkommens zum Thema Schicht- und Nachtarbeit. Insgesamt konnten 3092 Treffer identifiziert werden. Die Anzahl der Publikationen befand sich seit 1977 in ständigem Wachstum, wobei eine deutliche Zunahme nach 1990 zu verzeichnen war. Mit 884 Veröffentlichungen war den USA etwa ein Drittel des Forschungsaufkommens zuzuordnen. Neben den Vereinigten Staaten publizierten das Vereinigte Königreich Großbritannien 365 und Frankreich 244 Arbeiten zum Thema Schicht- und Nachtarbeit. Die meistpublizierenden Zeitschriften waren Sleep, Ergonomics und Chronobiology International. Der schwedische Wissenschaftler Torbjörn Akerstedt ist als derzeit renommiertester Forscher anzusehen. Er war mit 105 themenbezogenen Arbeiten nicht nur der publikationsstärkste, sondern wies mit 30 auch den höchsten Hirsch-Index auf. Selbstzitierungen und Co-Autorenschaften beeinflussen Parameter wie Impact Faktor und Hirsch-Index massiv und sollten deshalb kritisch hinterfragt werden.

Introduction: Functional tests of the locomotor system are an important diagnostic method and also helpful in occupational prevention activities according to the spine. To perform such tests, the physician has to be experienced and needs time for the examination, too. So far, it's questionable whether functional tests can be verified by using technical devices for muscular strength and if these technical devices can also be used as an adequate diagnostic method.Methods: 72 healthy trainees from the metal-industry, which were employed not longer than 2 years, have been tested with the M-3 diagnos+-system (Fa. Schnell) for measurements of the maximum power and the strength endurance of the flexor and extensor muscles of the trunk. The data were compared intraindividually with results of functional tests of the locomotor system from the medical check before employment. Data from these tests were available for the spine function and mobility, maximum muscular power and strength endurance and coordination (Farwer et al. 2000). In detail, an association between functional tests of the power endurance of the abdomen and back muscles and the corresponding technical measurements has been of specific interest.Results: Only 1 out of 11 correlation tests could be identified for a possible but not significant association between technical measurements of the isometric maximum power of the back muscles and corresponding functional test results of these muscles. Nor the considering for results of abdomen muscle testing neither for back muscle testing was able to establish an association between isometric or dynamic M-3 diagnos+datas and individual strength endurance. No technical test showed any association with the functional tests for the coordination.Summary: A technical measurement system can't be used to verify or objectivize functional tests of the locomotor system. The technical tests have advantages for the determination of the individual muscular efficiency, but not for a testing of coordinative patterns. Functional test results are helpful in estimating an individual risk for low back pain in contrast to tests with technical devices which can be helpful under rehabilitation aspects.

Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"-exposure in relation to non-"traffic zone"-exposure.Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including NO2, SO2, nanoparticles and ozone.

AIM:Sleep disturbances induce proinflammatory immune responses, which might increase cardiovascular disease risk. So far the effects of acute sleep deprivation and chronic sleep illnesses on the immune system have been investigated. The particular impact of shift work induced chronic circadian disruption on specific immune responses has not been addressed so far.METHODS:Pittsburgh-Sleep-Quality-Index (PSQI) questionnaire and blood sampling was performed by 225 shift workers and 137 daytime workers. As possible markers the proinflammatory cytokines IL-6 and TNF-alpha and lymphocyte cell count were investigated. A medical examination was performed and biometrical data including age, gender, height, weight, waist and hip circumference and smoking habits were collected by a structured interview.RESULTS:Shift workers had a significantly higher mean PSQI score than day workers (6.73 vs. 4.66; p < 0.001). Day workers and shift workers had similar serum levels of IL-6 (2.30 vs. 2.67 resp.; p = 0.276), TNF-alpha (5.58 vs. 5.68, resp.; p = 0.841) or lymphocytes count (33.68 vs. 32.99, resp.; p = 0.404). Furthermore there were no differences in cytokine levels (IL-6 p = 0.761; TNF-alpha p = 0.759) or lymphocyte count (p = 0.593) comparing the sleep quality within the cohorts. When this calculation of sleep quality was stratified by shift and day workers irrespective of their sleep quality day workers and shift workers had similar serum levels of IL-6, TNF-alpha or lymphocytes count. Multiple linear regression analysis showed a significant correlation of lymphocytes count and smoking habits.CONCLUSION:Shift work induces chronic sleep debt. Our data reveals that chronic sleep debt might not always lead to an activation of the immune system, as we did not observe differences in lymphocyte count or level of IL-6 or TNF-alpha serum concentration between shift workers and day workers. Therefore chronic sleep restriction might be eased by a long-term compensating immune regulation which (in healthy) protects against an overstimulation of proinflammatory immune mechanisms and moderates metabolic changes, as they are known from short-term sleep deprivation or sleep related breathing disorders.

Klinisch-funktionelle Prüfungen des Bewegungsapparates stellen ein wesentliches Diagnostikverfahren für eine zielgerichtete arbeitsmedizinische Vorsorge bei Wirbelsäulenbelastungen dar. Da manuelle Funktionsprüfungen sowohl ärztliche Erfahrung als auch eine gewisse Untersuchungszeit benötigen, ist die Frage von Interesse, ob auch gerätegestützte Messungen der Muskelfunktionen und -kraft als adäquate Diagnostik eingesetzt werden können.

Background: Musculoskeletal disorders (MSDs) due to repetitive work are common in manufacturing industries, such as the automotive industry. However, it's still unclear which MSDs of the upper limb are to be expected in the automotive industry in a first aid unit as well as in occupational precaution examinations. It is also unclear which examination method could be performed effectively for practical reasons and under rehabilitation aspects. Additionally, it was to discuss whether the conception of unspecific description for MSDs has advantages or disadvantages in contrast to a precise medical diagnosis.Methods: We investigated the health status of two study populations working at two automotive plants in Germany. The first part included 67 consecutive patients who were seen for acute or chronic MSDs at the forearm over a 4-month period at the plants' medical services. Information about patients' working conditions and musculoskeletal symptoms was obtained during a standardized interview, which was followed by a standardized orthopedic-chiropractic physical examination. In the second part, 209 workers with daily exposure to video display terminals (VDT) completed a standardized questionnaire and were examined with function-oriented muscular tests on the occasion of their routine occupational precaution medical check-up.Results: The majority of the 67 patients seen by the company's medical services were blue-collar works from the assembly lines and trainees rather than white-collar workers from offices. Rates of musculoskeletal complaints were disproportionately higher among experienced people performing new tasks and younger trainees. The most common MSD in this group were disorders of flexor tendons of the forearm. By contrast, among the 209 employees working at VDT disorders of the neck and shoulders were more common than discomfort in the forearm. A positive tendency between restricted rotation of the cervical vertebrae and years worked at VDT was observed. In addition, only less than 8% of unspecific disorders of the upper limb (esp. wrist and forearm) were found.Conclusions: Functional tests for the upper limb seemed to be very helpful to give precise medical advice to the employees to prevent individual complaints. The results are also helpful for developing specific training programs before beginning new tasks as well as for rehabilitation reasons. There's no need to use uncertain terminology (such as RSI) as it may not be representative of the actual underlying disorders as diagnosed by more thorough physical examinations.

Porcine influenza is a viral disease. Along with other viral diseases such as avian influenza or SARS it may lead to serious consequences for the population. The disease occurs after infection with the influenza virus A/H1N1. Reassortment of RNA genome sequences of porcine and human influenza viruses can lead to new antigenic variants (antigen shift) with human pathogenic features. The present articles supplies recent information with relevance for occupational health.

Aim There is an ongoing discussion whether work under shift work conditions enhances the ulcerogenic potential of Helicobacter pylori infections. This may be induced by a disruption of the circadian rhythm. The present study assessed whether there is an association between H. pylori infection and an increased risk of gastrointestinal complaints or frequency of gastritis or peptic ulcer in H. pylori -infected shift workers. Methods We analyzed 615 workers divided in shift and daytime. Upper gastrointestinal diseases, medication or operation, unspecific gastrointestinal complaints, smoking habits, subjective job strain and private stress factors were monitored. The H. pylori status was analyzed using IgA and IgG antibody concentration in blood and qualitative ELISA for feces. Results It was observed that 27.6% of all workers, 34.6% of the shift workers and 16% of daytime workers were Hp positive ( P = 0.004). Shift workers reported reflux or pyrosis less frequently than daytime workers. No increased lifetime prevalence for gastritis, ulcus or eradication therapy was found for shift workers. Analysis revealed a weak regression between age and Hp-positive gastritis or upper gastrointestinal complaints, smoking habits were a major confounding factor for ulcus disease. Clinical manifestation of gastritis or ulcus disease did not correlate with shift work or especially shift work including night work. Conclusions As a result of the present study, it cannot be confirmed that there is a causal connection between shift work and upper or unspecific gastrointestinal complaints or gastritis or peptic ulcer in dependency of a H. pylori colonization.

In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists.

Working in shift work system may result in varied influences on the general health. A working hour system colliding with circadian and social rhythm causes adverse effects if no actions were taken regarding the occupational level, the working hour organisation as well as the individual life-style of shift workers. Most often shift workers complain of sleep disorders and sleep-related disturbances of the general health, gastrointestinal and unspecific discomfort. But social effects may be severe, too. Most scientific attention is given to metabolic alterations due to shift work which were already observed within the scope of sleep apnea syndrome and with acute sleeping deprivation under the idea that a chronic deficit of sleep can originate from shy of sleeping hygiene and unfavourable sequence of work shifts. In the following the current state of knowledge about sleeping disturbances and working in shift work is summarised, possible effects are shown.