Healthy Workers Research Articles

Occurrence of Antibiotic-Resistant Staphylococcus spp. in Orange Orchards in Thailand.

Background: The widespread indiscriminate application of antibiotics to food crops to control plant disease represents a potential human health risk. In this study, the presence of antibiotic-resistant staphylococci associated with workers and orange orchard environments was determined. A total of 20 orchards (orange and other fruits) were enrolled in the study. Trees in the orange orchards were treated with ampicillin on a pre-determined schedule. Environmental samples (n = 60) included soil, water, and oranges; 152 hand and nasal samples were collected from 76 healthy workers. Antibiotic susceptibility profiles were determined for all staphylococcal isolates. Results: This investigation revealed that of the total Staphylococcus spp. recovered from the orange orchard, 30% (3/10) were resistant to erythromycin, 20% (2/10) were resistant to ampicillin, and 20% (2/10) resistant to both erythromycin and ampicillin. Conclusion: The application of antibiotics to orange trees in open production environments to halt the spread of bacterial disease presents risks to the environment and creates health concerns for Thai farmers using those agents. ARB on crops such as oranges may enter the global food supply and adversely affect public health.

High Carriage Rate of the Multiple Resistant Plasmids Harboring Quinolone Resistance Genes in Enterobacter spp. Isolated from Healthy Individuals.

Antimicrobial-resistant bacteria causing intractable and even fatal infections are a major health concern. Resistant bacteria residing in the intestinal tract of healthy individuals present a silent threat because of frequent transmission via conjugation and transposition. Plasmids harboring quinolone resistance genes are increasingly detected in clinical isolates worldwide. Here, we investigated the molecular epidemiology of plasmid-mediated quinolone resistance (PMQR) in Gram-negative bacteria from healthy service trade workers. From 157 rectal swab samples, 125 ciprofloxacin-resistant strains, including 112 Escherichia coli, 10 Klebsiella pneumoniae, two Proteus mirabilis, and one Citrobacter braakii, were isolated. Multiplex PCR screening identified 39 strains harboring the PMQR genes (including 17 qnr,19 aac(6′)-Ib-cr, and 22 oqxA/oqxB). The genome and plasmid sequences of 39 and 31 strains, respectively, were obtained by short- and long-read sequencing. PMQR genes mainly resided in the IncFIB, IncFII, and IncR plasmids, and coexisted with 3–11 other resistance genes. The high PMQR gene carriage rate among Gram-negative bacteria isolated from healthy individuals suggests the high-frequency transmission of these genes via plasmids, along with other resistance genes. Thus, healthy individuals may spread antibiotic-resistant bacterial, highlighting the need for improved monitoring and control of the spread of antibiotic-resistant bacteria and genes in healthy individuals.

PROGRAM GERAKAN MASYARAKAT HIDUP SEHAT (GERMAS) TERHADAP PENINGKATAN MOTIVASI KERJA PADA KARYAWAN PT. MARUKI INTERNASIONAL INDONESIA MAKASSAR

The Healthy Living Community Movement (Germas) is an effort to increase awareness, willingness and ability for everyone to live a healthy life in order to improve the health status of the community as high as possible. The purpose of this study was to conduct an analysis that influenced the Germas program to increase employee motivation at PT. Maruki international Indonesia Makassar. The research method is an analytic survey with a cross sectional study approach. The total population in this study were 241 employees and the sample size was 71 respondents. Collecting quantitative data using questionnaires and checklists, analyzed by univariate, bivariate and multivariate. The results showed that the Physical Activity variable had a significant effect (p=0.012<a=0.05) on the increase in work motivation, the Nutrition Improvement Variable had a significant effect (0,=0.048 <0,=0.05) on the increase in work motivation, the detection variable Early childhood has a significant effect (p=0.008<a=0.05) on increasing work motivation It is recommended with the results of this study that the relevant government and company management can provide socialization in the application of the Healthy Living Community Movement (GERMAS) program, especially in the workplace, so that healthy workers' productivity increases

The real deal: the ant species, Pheidole sauberi (Hymenoptera: Formicidae), first description of the queen and first record of a mermithergate in the Philippines

The occurrence of mermithism in ants is reported for the first time in the Philippines. The mermithergate worker and previously undescribed dealate queen of Pheidole sauberi are described. The mermithergate worker is intermediate in size between the major and minor workers and pale yellow in color, in contrast to the brown healthy workers, and has a much larger gaster than either uninfected subcaste. Colony demographics and nest ecology are also reported. This find offers an opportunity for interdisciplinary research on ant parasitism.

Development of the Prevent for Work Questionnaire (P4Wq) for the assessment of musculoskeletal risk factors in the workplace: part 2—pilot study for questionnaire development and validation

ObjectiveThe aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders...

Analysis of the Effect of Wearing Extensible and Non-Extensible Lumbar Belts on Biomechanical Factors of the Sit-to-Stand Movement and Pain-Related Psychological Factors Affecting Office Workers with Low Back Pain.

This study aimed to investigate the effects of wearing extensible and non-extensible lumbar belt (LB) on biomechanical factors of the sit-to-stand (STD) movement and pain-related psychological factors affecting office workers with low back pain. Among 30 office workers, 15 with low back pain (LBP) were assigned to the experimental group and 15 healthy adults were assigned to the control group. The participants performed STD movement in random order of three different conditions: without LB (Condition 1), with extensible LB (Condition 2), and with non-extensible LB (Condition 3). Biomechanical variables of STD movement in each condition were measured using a three-dimensional motion analysis system and force plate. Pain-related psychological factors were measured only in the experimental group. Among the biomechanical factors of STD movement, an interaction effect was found in the maximum anterior pelvic tilt angle and total-phase range of motion of the trunk (p < 0.05). Pain intensity, pain-related anxiety, and pain catastrophizing were decreased in the conditions with lumbar belts (Conditions 2 and 3) compared to the condition without LB (Condition 1) (p < 0.05). Extensible and non-extensible lumbar belts engender biomechanically beneficial effects during STD movement in both office workers with LBP and healthy office workers. Further, pain intensity, pain-related anxiety, and pain catastrophizing were decreased in office workers with LBP. Therefore, both types of extensible lumbar belts may be helpful in the daily life of patients with LBP and office workers.

Prevalence of non-communicable diseases among healthy male decontamination workers after the Fukushima nuclear disaster in Japan: an observational study

The health status of healthy decontamination workers employed after the Fukushima nuclear disaster remains unclear. This study aimed to evaluate the prevalence of non-communicable diseases among such workers. In this observational study, questionnaires on lifestyle and social factors were administered as part of a health promotion program for decontamination workers in 2016 in Minamisoma City, Fukushima. The questionnaires and health check-up results were compared with those of the 2016 National Health and Nutrition Examination Survey (NHANES) in Japan. Overall, 123 male decontamination workers were enrolled; 93 (75.6%) were drinkers, and 84 (68.3%) were current smokers. The age-adjusted prevalence (95% confidence interval) of hypertension, dyslipidemia, diabetes mellitus, and obesity were 27.2% (20.1–34.4%), 30.4% (22.6–38.2%), 11.3% (5.5–17.1%), and 49.0% (39.0–58.9%), respectively. The age-adjusted prevalence in the NHANES were 32.8% (31.1–34.5%), 16.1% (14.5–17.6%), 7.0% (6.2–7.7%), and 31.2% (29.9–32.5%), respectively. The prevalence of obesity, dyslipidemia, binge drinking, and smoking were higher in healthy male decontamination workers than in the general population. Decontamination workers in disaster-struck areas may have higher risks of developing non-communicable diseases, possibly due to their original health status. Continuous monitoring of their health status and proper interventions are warranted.

Evaluation of antibody response to BNT162b2 mRNA COVID-19 vaccine in patients affected by immune-mediated inflammatory diseases up to 5 months after vaccination

SARS-CoV-2 vaccination with mRNA product BNT162b2 elicited high immunogenicity in healthy subjects in trials. This study aims to better understand the factors that influence the humoral immune response to vaccination against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). We enrolled patients and healthy healthcare workers control group (HCW) that underwent mRNA BNT162b2 vaccination and measured the serum IgG anti-S-RBD response at booster dose (T1), one month after booster dose (T2) and up to 5 months (T3). Demographic, disease-specific and vaccination data were recorded. Vaccination response of 551 participants naïve to SARS-CoV-2 infection were included in HCW and 102 in the IMID group, analyzing separately those on anti-CD20. At T2 all naïve HCW developed anti-S-RBD-IgG, while 94% of IMID responded (p < 0.001). IMID patients had a significantly different level of IgG than HCW at both T1 (p = 0.031), T2 (p < 0.001), while there was no significant difference at T3. There were no statistically significant differences according to the IMID type or to ongoing treatment with immunosuppressants, corticosteroids or biological drugs other than anti-CD20. The proportion and magnitude of response was significantly lower in IMID treated with anti-CD20 drugs. There was a correlation with age at T1 and at T2 but not at T3, stronger in patients than in HCW. Immune response close after BNT162b2 vaccination is reduced in patients with IMID, but there is no significant difference at 5 months. The measured reduction is related to age and the disease itself rather than treatments, with the exception of anti-CD20 drugs.

Community Healthy Workers Fill in the Gaps for Participants Who Became Lost to Follow-up in a Healthy Start Program.

The purpose of this mixed methods study was to solicit information from Community Health Workers (CHWs) in order to further understand reasons for Healthy Start participants becoming lost to follow-up after delivery. Four CHWs from a local Healthy Start Program completed questionnaires for participants in their caseloads who had become lost to follow-up from the program (n = 146) between Sep 2018 and Jan 2020. The questionnaire included open ended items about ease of contact before and after delivery, changes in contact information, compliance with prenatal care visits, other life challenges (such as housing, legal, transportation, and family support), family size, living arrangements, working/student status, and substance use. Participants were categorized by ease of contact throughout participation into Easy (28.8%), Easy then Difficult (11%) and Difficult (60.3%). Responses to questions were reviewed and coded to identify common themes. Groups differed on: having a change in contact information, having challenges with transportation, having lots of help, having other children between 6 and 10years old, compliance with prenatal care, and race being non-Black. Areas where groups differed may indicate possible reasons for participants becoming lost to follow up after delivery. The descriptive results from this study can help CHWs address these issues with participants during prenatal care, when they are easier to contact, to develop contingency plans for remaining in contact after delivery.

Epidemiological and economic impact of COVID-19 in the US

This research measures the epidemiological and economic impact of COVID-19 spread in the US under different mitigation scenarios, comprising of non-pharmaceutical interventions. A detailed disease model of COVID-19 is combined with a model of the US economy to estimate the direct impact of labor supply shock to each sector arising from morbidity, mortality, and lockdown, as well as the indirect impact caused by the interdependencies between sectors. During a lockdown, estimates of jobs that are workable from home in each sector are used to modify the shock to labor supply. Results show trade-offs between economic losses, and lives saved and infections averted are non-linear in compliance to social distancing and the duration of the lockdown. Sectors that are worst hit are not the labor-intensive sectors such as the Agriculture sector and the Construction sector, but the ones with high valued jobs such as the Professional Services, even after the teleworkability of jobs is accounted for. Additionally, the findings show that a low compliance to interventions can be overcome by a longer shutdown period and vice versa to arrive at similar epidemiological impact but their net effect on economic loss depends on the interplay between the marginal gains from averting infections and deaths, versus the marginal loss from having healthy workers stay at home during the shutdown.

Daytime fatigue as a predictor for subsequent retirement among older New Zealand workers

ObjectivesThere is limited information on the role of fatigue on retirement, either independently or in association with poor sleep. The aim of this study was to examine the prospective association between daytime fatigue, measured as feeling tired or feeling worn out, independently and in relation to dissatisfaction with sleep, and subsequent retirement among 960 older workers in New Zealand. MethodsData from 2 consecutive surveys (2008 and 2010) of the New Zealand Health, Work, and Retirement Longitudinal Study were used. Poisson regression was used to investigate whether feeling tired and feeling worn out in 2008, along with dissatisfaction with sleep, were associated with self-reported retirement either due to health reasons or other reasons by 2010. ResultsThe risk for retirement due to health reasons during a 2-year follow-up was 1.80-fold (95% confidence interval [CI] 1.16-2.45) among those who felt tired and 1.99-fold (95% CI 1.34-2.64) among those who felt worn out when compared to those not tired or not feeling worn out after adjusting for several sociodemographic, work characteristics and self-rated health. The risk for retirement due to health reasons was even higher when participant experienced both tiredness and feeling worn out. Dissatisfaction with sleep did not predict retirement due to health or other reasons. ConclusionsOur results highlight that workers at risk of subsequent retirement due to health reasons may be identified with rather simple questions on tiredness and feeling worn out even among generally healthy older workers.

Metabolome-wide association study of occupational exposure to benzene.

Benzene is a recognized hematotoxin and leukemogen; however, its mechanism of action in humans remain unclear. To provide insight into the processes underlying benzene hematotoxicity, we performed high-resolution metabolomic profiling of plasma collected from a cross-sectional study of 33 healthy workers exposed to benzene (median 8-h time-weighted average exposure; 20 ppma), and 25 unexposed controls in Shanghai, China. Metabolic features associated with benzene were identified using a metabolome-wide association study (MWAS) that tested for the relationship between feature intensity and benzene exposure. MWAS identified 478 mass spectral features associated with benzene exposure at false discovery rate < 20%. Comparison to a list of 13 known benzene metabolites and metabolites predicted using a multi-component biotransformation algorithm showed five metabolites were detected, which included the known metabolites phenol and benzene diolepoxide. Metabolic pathway enrichment identified 41 pathways associated with benzene exposure, with altered pathways including carnitine shuttle, fatty acid metabolism, sulfur amino acid metabolism, glycolysis, gluconeogenesis and branched chain amino acid metabolism. These results suggest disruption to fatty acid uptake, energy metabolism and increased oxidative stress, and point towards pathways related to mitochondrial dysfunction, which has previously been linked to benzene exposure in animal models and human studies. Taken together, these results suggest benzene exposure is associated with disruption of mitochondrial pathways, and provide promising, systems biology biomarkers for risk assessment of benzene-induced hematotoxicity in humans.

Mitigating the externality of diseases of poverty through health aid.

Externality exists in healthcare when an individual benefits from others being healthy as it reduces the probability of getting sick from illness. Healthy workers are considered to be the more productive labourers leading to a country’s positive economic growth over time. Several research studies have modelled disease transmission and its economic impact on a single country in isolation. We developed a two-country disease-economy model that explores disease transmission and cross-border infection of disease for its impacts. The model includes aspects of a worsening and rapid transmission of disease juxtaposed by positive impacts to the economy from tourism. We found that high friction affects the gross domestic product (GDP) of the lower-income country more than the higher-income country. Health aid from one country to another can substantially help grow the GDP of both countries due to the positive externality of disease reduction. Disease has less impact to both economies if the relative cost of treatment over an alternative (e.g. vaccination) is lower than the baseline value. Providing medical supplies to another country, adopting moderate friction between the countries, and finding treatments with lower costs result in the best scenario to preserve the GDP of both countries.

LUNG TRANSPLANTATION AMONG UNDOCUMENTED IMMIGRANTS

TOPIC: Transplantation TYPE: Original Investigations PURPOSE: Legal status in the United States is an important social determinant of health. Undocumented immigrants face several obstacles in obtaining equivalent healthcare to United States citizens or resident aliens. Despite these obstacles, undocumented individuals are eligible to be listed for and receive organ transplant for advanced disease. We hypothesize that this population represents healthy workers, and has significantly different social and clinical needs pre-transplantation than the population of listed US Citizens or resident aliens. We sought to describe this population of undocumented patients, listed for lung transplantation, for the first time, to identify potential disparities in care and develop strategies to address the needs of this unique patient population. METHODS: Using the de-identified United Network for Organ Sharing (UNOS) Thoracic dataset we identified 64,585 individuals who had been listed for lung transplant between 1985 and 2020. We identified 232 undocumented individuals; non-resident aliens who did not travel to the US for the purpose of transplant evaluation or have their care paid for by a foreign healthcare system. We evaluated demographic, disease characteristic, and payer differences between documented and undocumented individuals using bivariate tests of difference. We report Cohen’s d statistics, when possible, to characterize the degree of difference between the two populations. RESULTS: The mean age of undocumented individuals listed for transplant was 41.1 years, which was significantly lower than that of documented individuals (p < 0.00001). The proportion of individuals with the listing diagnoses of idiopathic pulmonary fibrosis (IPF), pulmonary arterial hypertension (PAH), and bronchiectasis was significantly higher in the undocumented cohort of patients (p- values of 0.002, < 0.001, and <0.001 respectively). However, the proportion of undocumented individuals with a listing diagnosis of chronic obstructive pulmonary disease (COPD) was significantly lower (p < 0.001). Patients within the undocumented cohort also had a higher initial Lung Allocation Score (LAS) than documented individuals with an average score of 43.1 indicating more severe disease (p = 0.046). Undocumented individuals were less likely to have a history of tobacco use (p < 0.001). The majority of undocumented individuals were self-pay and there were no significant differences in Medicaid users between both cohorts. CONCLUSIONS: Undocumented patients listed for lung transplant represent a younger population of non-smokers who likely have very different medical and social needs than US citizens or resident aliens. Further evaluation of the specific needs of this population is warranted, particularly in areas with high populations of undocumented individuals. CLINICAL IMPLICATIONS: These patients are not more likely than US citizens or resident aliens to rely on public insurance programs (e.g. Medicare and Medicaid) indicating that the current practice of listing these individuals does not place an excessive burden on public health programs. DISCLOSURES: No relevant relationships by Lilia Cervantes, source=Web Response No relevant relationships by Daniel Colon Hidalgo, source=Web Response No relevant relationships by Matthew Griffith, source=Web Response No relevant relationships by Guillermo Jimenez, source=Web Response No relevant relationships by Matthew Rockstrom, source=Web Response

Effectiveness of an Internet-Based Machine-Guided Stress Management Program Based on Cognitive Behavioral Therapy for Improving Depression Among Workers: Protocol for a Randomized Controlled Trial.

BackgroundThe effect of an unguided internet-based cognitive behavioral therapy (iCBT) stress management program on depression may be enhanced by applying artificial intelligence (AI) technologies to guide participants adopting the program.ObjectiveThe aim of this study is to describe a research protocol to investigate the effect of a newly developed iCBT stress management program adopting AI technologies on improving depression among healthy workers during the COVID-19 pandemic.MethodsThis study is a two-arm, parallel, randomized controlled trial. Participants (N=1400) will be recruited, and those who meet the inclusion criteria will be randomly allocated to the intervention or control (treatment as usual) group. A 6-week, six-module, internet-based stress management program, SMART-CBT, has been developed that includes machine-guided exercises to help participants acquire CBT skills, and it applies machine learning and deep learning technologies. The intervention group will participate in the program for 10 weeks. The primary outcome, depression, will be measured using the Beck Depression Inventory II at baseline and 3- and 6-month follow-ups. A mixed model repeated measures analysis will be used to test the intervention effect (group × time interactions) in the total sample (universal prevention) on an intention-to-treat basis.ResultsThe study was at the stage of recruitment of participants at the time of submission. The data analysis related to the primary outcome will start in January 2022, and the results might be published in 2022 or 2023.ConclusionsThis is the first study to investigate the effectiveness of a fully automated machine-guided iCBT program for improving subthreshold depression among workers using a randomized controlled trial design. The study will explore the potential of a machine-guided stress management program that can be disseminated online to a large number of workers with minimal cost in the post–COVID-19 era.Trial RegistrationUMIN Clinical Trials Registry（UMIN-CTR) UMIN000043897; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050125International Registered Report Identifier (IRRID)PRR1-10.2196/30305

Rate of Chicken Eggs Consumption Does not Affect Blood Pressure and Serum Lipogram, Glucose, Proteins, IGF-1 or Total Bile Acids Levels in Healthy Young Male Adult Farm Workers : A Cross-Sectional Study

Rate of Chicken Eggs Consumption Does not Affect Blood Pressure and Serum Lipogram, Glucose, Proteins, IGF-1 or Total Bile Acids Levels in Healthy Young Male Adult Farm Workers : A Cross-Sectional Study

Occupational Health Risks from Combined Exposure to Welding Fumes and Cold Environment for Welders

Introduction: Intensification of economic activities in the northern regions of Russia requires a better understanding of the combined health effect of cold environment and occupational risk factors. Objective: To assess the risk of developing health disorders in gas and electric welders exposed to low and normal workplace temperatures. Materials and methods: We conducted a comparative analysis of working conditions and health status of welders at two enterprises. The main cohort included 310 workers exposed to welding fumes and cold microclimate in an underground mine. The control cohort included 282 employees of a railcar manufacturing facility performing their functional duties in workshops with acceptable microclimate parameters. Results: According to the results of periodic medical examinations, 499 chronic diseases were diagnosed in welders of the main cohort against 230 among the controls. Compared to the reference cohort, underground welders were at higher risk of developing diseases of the digestive system (RR = 2.63; CI: 1.47–4.70; p = 0.0006), genitourinary (RR = 6.55; CI: 1.51–28.4; p = 0.004), musculoskeletal (RR = 1.50; CI: 1.14–1.97; p = 0.003), and nervous systems (RR = 5.29; CI 1.19–23.4; p = 0.014), skin (RR = 3.85; CI: 1.61–9.18; p = 0.001), respiratory organs (RR = 3.23; CI: 1.84–5.69; p &lt; 0.001), as well as infectious and parasitic diseases (RR = 8.61; CI: 2.03–36.5; p = 0.0004). Thus, the number of healthy workers was smaller while the number of workers suffering from two or more chronic diseases was bigger in this cohort (p &lt; 0.001). Conclusions: The welders working in cold environment were significantly less healthy than those working in normal workplace temperatures. The results necessitate the development of additional measures of disease prevention for this category of employees.

Evaluating a Self-Determination Model of Physical Activity and Exercise in People With Chronic Musculoskeletal Pain

BackgroundResearch evidence supports the assertion that healthy employees are happier and more productive. Employers prefer to hire healthy workers to reduce absenteeism. Rehabilitation counselors have started to explore health promotion interventions to help individuals with chronic health conditions and disability improve their physical and mental health as a strategy to increase their employment opportunities.PurposeThe present study evaluated a self-determination theory (SDT) model of physical activity and exercise in a sample of 218 individuals with chronic musculoskeletal pain using structural equation modeling.ResultsThe SDT model fit the data well, accounting for 54% of the variance in physical activity and exercise. Relatedness was significantly associated with autonomous motivation for physical activity and exercise. Autonomous motivation was associated with competency. Competency was associated with physical activity and exercise. Autonomous motivation and competency mediated relatedness and physical activity and exercise.ImplicationsThis study contributes to an emerging body of theory-informed health promotion literature and identifies the specific pathways that will increase the motivation to engage in physical activity and exercise. Findings can be used to design and validate theory-driven health promotion interventions as an employment strategy for people with chronic musculoskeletal pain receiving vocational rehabilitation services.

BNT162b2 SARS-CoV-2 Vaccination Elicits High Titers of Neutralizing Antibodies to Both B.1 and P.1 Variants in Previously Infected and Uninfected Subjects

We aimed to investigate neutralizing antibody titers (NtAbT) to the P.1 and B.1 SARS-CoV-2 variants in a cohort of healthy health care workers (HCW), including 20 previously infected individuals tested at baseline (BLinf, after a median of 298 days from diagnosis) and 21 days after receiving one vaccine dose (D1inf) and 15 uninfected subjects tested 21 days after the second-dose vaccination (D2uninf). All the subjects received BNT162b2 vaccination. D1inf NtAbT increased significantly with respect to BLinf against both B.1 and P.1 variants, with a fold-change significantly higher for P.1. D1inf NtAbT were significantly higher than D2uninf NtAbT, against B.1 and P.1. NtAbT against the two strains were highly correlated. P.1 NtAbT were significantly higher than B.1 NtAbT. This difference was significant for post-vaccination sera in infected and uninfected subjects. A single-dose BNT162b2 vaccination substantially boosted the NtAb response to both variants in the previously infected subjects. NtAb titers to B.1 and P.1 lineages were highly correlated, suggesting substantial cross-neutralization. Higher titers to the P.1 than to the B.1 strain were driven by the post-vaccination titers, highlighting that cross-neutralization can be enhanced by vaccination.

The effects of active break and postural shift interventions on recovery from and recurrence of neck and low back pain in office workers: A 3-arm cluster-randomized controlled trial

ObjectivesTo investigate the efficacy of active break and postural shift interventions aimed to reduce sitting discomfort on recovery duration and recurrence of neck and low back pain among high-risk office workers. MethodsA 3-arm cluster-randomized controlled trial with 12-month follow-up was conducted in 193 healthy but high-risk office workers. Participants in the intervention groups received custom-designed apparatus to facilitate either active breaks or postural shifts to reduce sitting discomfort at work. Participants in a control group received a placebo seat pad. Incidence of neck and low back pain with pain intensity and disability level was recorded monthly. Main outcome measures were recovery time and recurrent rate of neck and low back pain. Analyses were performed using log rank test and Cox proportional hazard models. ResultsMedian time to recovery in those receiving active break and postural shift interventions (1 month) was significantly shorter than those in the control group (2 months). Neck and low back pain recurrent rates for the active break, postural shift, and control groups were 21%, 18%, and 44%, respectively. Hazard rate (HR) ratios after adjusting for biopsychosocial factors indicated a protective effect of active break and postural shift interventions for neck and low back pain recurrence (HRadj 0.22, 95% CI 0.06–0.83 for active breaks and HRadj 0.35, 95% CI 0.16–0.77 for postural shift). ConclusionActive break and postural shift interventions shortened recovery time and reduced recurrence of neck and low back pain among high-risk office workers.