Guide aménagement d'un poste d'accueil

Ce guide de prévention vous aidera à concevoir un poste d’accueil sécuritaire et fonctionnel ou à corriger les déficiences d’un poste existant. Il propose une démarche d’aménagement d’un poste d’accueil en quatre étapes : l’analyse des besoins, 
l’élaboration d’un concept, l’élaboration des caractéris­tiques détaillées du poste et, finalement, la validation et le suivi.
À chacune des étapes, l’implication des personnes qui travailleront de près ou de loin au poste d’accueil est essentielle. Ces personnes pourront préciser la nature du travail qui y sera réalisé, exprimer leurs besoins et valider les choix retenus.


Neck posture during lifting and its effect on trunk muscle activation and lumbar spine posture

Neck and head posture have been found to have a significant influence on the posture of the lower spine region during lifting and both an extended/upward gaze and a flexed/downward gaze have been hypothesized to lead to increased pain and/or overuse of the neck musculature. As a result, strength training recommendations have turned to the use of a retracted neck posture as being the safer posture to assume during lifting. This study examined trunk and neck muscle activity and lumbar spine posture in seven participants while performing moderate load lifts using a retracted neck posture (chin drawn in posteriorly; recently gaining popularity among coaches, trainers, and physical therapists to reduce neck pain during lifting, and freestyle neck posture (no instructions given). The retracted neck resulted in less lumbar spine flexion and increased lumbar erector spinae, external oblique, and sternocleidomastoid activity. The retracted posture also resulted in decreased activity in the thoracic erector spinae and dorsal neck musculature. The increased trunk and sternocleidomastoid activity and decreased spine flexion observed in the seven participants of this study when lifting with a retracted neck may have the potential to help lower the risk of spine pain/injury.

Source: Hlavenka, T. M., Christner, V. F., & Gregory, D. E. (2017). Applied Ergonomics, 62, 28-33.

Total Worker Health® Concepts to Reduce the Health Risks from Sedentary Work

U.S. workplaces have become increasingly sedentary, with resulting negative health effects. Through its Total Worker Health® Program, the National Institute for Occupational Safety and Health (NIOSH) recommends an integrated approach to addressing sedentary work environments. An integrated approach is one that protects workers from work-related injury and illness and helps them advance their overall health and well-being, on and off the job. This document describes organizational practices that can reduce the risks associated with sedentary work.


Qualitative ergonomics/human factors research in health care

Current state and future directions
The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care.

Source: Valdez, R. S., McGuire, K. M., & Rivera, A. J. (2017). Applied Ergonomics, 62, 43-71.

Implementing powered stretcher and load systems was a cost effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service

Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs.

Source: Armstrong, D. P., Ferron, R., Taylor, C., McLeod, B., Fletcher, S., MacPhee, R. S., & Fischer, S. L. (2017). Applied Ergonomics, 62, 34-42.

A qualitative review of existing national and international occupational safety and health policies relating to occupational sedentary behaviour

Prolonged sedentary time is now recognised as an emergent ergonomics issue. We aimed to review current occupational safety and health policies relevant to occupational sedentary behaviour.
An electronic search for documents was conducted on websites of ergonomics and occupational safety and health organisations from 10 countries and six international/pan-European agencies. Additionally, 43 informants (nine countries) were contacted and an international conference workshop held. 119 documents (e.g. legislation, guidelines, codes of practice) were identified. Using a qualitative synthesis, it was observed that many jurisdictions had legal frameworks establishing a duty of care for employers, designers/manufacturers/suppliers and employees. While no occupational authority policies focusing specifically on sedentary behaviour were found, relevant aspects of existing policies were identified.
We highlight implications for ergonomics research and practice and recommend the development of policy to specifically address occupational sedentary behaviour and support workplace initiatives to assess and control the risks of this emergent hazard.

Source: Coenen, Pieter, Gilson, Nicholas, Healy, Genevieve N., Dunstan, David W., & Straker, Leon M. (2017). Applied Ergonomics, 320-333.

Electromyographic analysis of relevant muscle groups during completion of computer tasks using different computer mouse positions

Background: We analyzed muscular activity for different computer mouse positions during the completion of a timed computer task and determined whether the different mouse positions could affect muscular activity, productivity and perceived fatigue. Methods: The subjects were nine healthy young men. Two mouse positions were studied: the distal position (DP), with the forearm rested on the desk; the proximal position (PP), with only the wrist rested on the desk. The subjects performed a 16-min task in each position. Surface electromyography data were recorded for the upper back and shoulder muscles. Work productivity and muscular activity were measured for each mouse position. A visual analog scale was used to assess subjective fatigue. Results: Muscular activity was higher in muscle (m.) deltoideus (posterior) for the DP, while it was significantly higher in m. inferior infraspinatus for the PP. The visual analog scale score was significantly higher and work productivity was lower in the PP. Conclusions: We found that using a mouse in the DP rather than the PP leads to less activity of the external rotators, less perceived fatigue and more productivity. This suggests that the DP is preferable to the PP for computer work involving a mouse.

Source: Sako, Shunji, Sugiura, Hiromichi, Tanoue, Hironori, Kojima, Makoto, Kono, Mitsunobu, & Inaba, Ryoichi. (2016). JOSE : International Journal of Occupational Safety and Ergonomics.

A work systems analysis approach to understanding fatigue in hospital nurses

Occupational fatigue is an important challenge in improving health and safety in health care systems. A secondary analysis of cross-sectional data from a survey sample comprised 340 hospital nurses was conducted to explore the relationships between components of the nursing work system (person, tasks, tools and technology, environment, organisation) and nurse fatigue and recovery levels. All components of the work system were significantly associated with changes in fatigue and recovery. Results of a tree-based classification method indicated significant interactions between multiple work system components and fatigue and recovery. For example, the relationship between a task variable of ‘excessive work' and acute fatigue varied based on an organisation variable related to ‘time to communicate with managers/supervisors'. A work systems analysis contributes to increased understanding of fatigue, allowing for a more accurate representation of the complexity in health care systems to guide future research and practice to achieve increased nurse health and safety.

Source: Steege, Linsey M., Pasupathy, Kalyan S., & Drake, Diane A. (2017). Ergonomics

Aging and MSD: Strategies for Older Workers

The global population is aging with a projection that one in five people will be over the age of 60 by 2050. The Canadian population aged 65 and over is expected to double over the next 25 years. The Canadian workforce is also aging with a large proportion of workers (42.4%) in the 45 to 64 age group in 2011 and the average age of labor market participant predicted to continue to rise until 20314. However, it appears that very few Canadian companies have addressed the impact of an aging workforce on occupational health.
Musculoskeletal disorders (MSD) are a burden to all industrial sectors. They present with pain and symptoms such as numbness and tingling. These symptoms may be warning signs of current or impending MSD, such as peripheral nerve entrapments, peripheral enthesopathies, and many other non-specific musculoskeletal pain disorders such as low back pain. There are concerns that MSD maybe more prevalent and costly among older workers, although the evidence supporting these concerns is not consistent. However, it would seem prudent for workplaces to consider strategies for healthy aging to address an aging workforce regardless.
The World Health Organization (WHO) recently released their World Report on Ageing and Health which defines healthy aging as “the process of developing and maintaining the functional ability that enables well-being in older age”6. The WHO report provides a framework for healthy aging. As part of the framework there are proposed strategies for creating age friendly environments that we propose can be adapted and applied to workplaces. The strategies include: i) combating ageism; ii) enabling autonomy, and iii) supporting healthy aging in policy. We suggest that these strategies are valuable for workplaces and by extension MSD and show some supporting research for each of them below.
As part of a scoping review of the literature we present some recent research addressing the WHO strategies and how they may apply to workplaces. We also drew on recent searches for larger ongoing systematic reviews carried out by a team of Institute for Work & Health researchers as part of the prevention review program, including: aging and return to work, return to work and upper extremity MSD prevention. Overall, we note that there is a lack of literature evaluating interventions or strategies related to older workers and MSD.


Designing, prototype making and evaluating a mechanical aid device for patient transfer between bed and stretcher

Introduction: The present study aimed at designing, prototype making and evaluating a new assistive device to improve patient transfer conditions. Methods: A new aid device for patient transfer was designed and its prototype was made. Comfort and perceived physical exertion of users and stability and applicability of the device were examined. The test subjects included 37 healthcare workers from a hospital with patient transfer experience. The data collection tools consisted of visual analog scales (VAS) and Borg's rating physical effort scale. The rapid entire body assessment (REBA) method was applied to evaluate working posture. Results: The results showed that in 70% of the wards, patient transfer was performed manually more than five times per shift. While using the newly designed device, the mean (SD) of the users' comfort, and the clients' comfort and safety, was measured as 8.59 (0.87), 8.46 (0.92) and 8.67 (0.71), respectively, as reported by VAS. The results revealed a significant reduction in the users' rating of perceived exertion (p < 0.001). Additionally, the REBA score was lower in mechanical transfer. Conclusion:. The new assistive device increased the users' and the clients' comfort, reduced the users' physical exertion and improved working postures.

Source: Salmani Nodooshan, H., Choobineh, A., Razeghi, M., & Shahnazar, T. (2016). International Journal of Occupational Safety and Ergonomics, 1-28.

9e Conférence scientifique internationale sur la prévention des troubles musculosquelettiques (PREMUS) - 2016

Réunissant près de 400 participants, 360 communications orales et 60 posters, PREMUS, la 9e Conférence scientifique internationale sur la prévention des troubles musculosquelettiques (TMS) a permis d'échanger sur les recherches actuelles et les pratiques d'interventions sur ce sujet. Plusieurs thèmes ont notamment été abordés : travail sédentaire, travail en posture debout, biomécanique des membres supérieurs lors de l'utilisation des nouvelles technologies de communication, prise en compte du sexe/genre, variabilité motrice, exercices physiques au travail et capteurs inertiels.

Source: Claudon, L., Cuny-Guerrier, A., Desbrosses, K., Gilles, M.A., & Savescu, A. (2016). Références en santé au travail, 148, 91-98.

Mesure de l'exposition du technicien ambulancier paramédical aux facteurs de risque de troubles musculosquelettiques

Le technicien ambulancier paramédical (TAP) a comme fonction principale de prodiguer les soins préhospitaliers d'urgence tout en assurant, de façon sécuritaire, le transport du bénéficiaire vers un centre hospitalier. Fondamentalement, son objectif est de réduire au minimum la mortalité et la morbidité des bénéficiaires en minimisant le temps de réponse. De nombreuses études à travers le monde, incluant le Québec, montrent que les TAP ont un taux plus élevé de lésions professionnelles et prennent leur retraite plus tôt que les autres travailleurs de la population y compris ceux du système de santé. Plusieurs TAP quittent leur emploi pour un autre dont les tâches sont moins exigeantes à mesure qu'ils vieillissent. Très peu d'attention a été dirigée sur ce qui se passe réellement sur le terrain lors de situations de travail et les mesures actuelles d'exposition aux facteurs de risque s'avèrent souvent insuffisantes. Ce projet avait donc pour objectif de décrire le contexte de travail des TAP et de quantifier leur exposition aux facteurs de risque de troubles musculosquelettiques.


Evaluation of a Training Program to Reduce Stressful Trunk Postures in the Nursing Professions

A Pilot Study
Objectives: The aim of this pilot study was to evaluate metrologically the effectiveness of a training program on the reduction of stressful trunk postures in geriatric nursing professions.
Methods: A training program, consisting of instruction on body postures in nursing, practical ergonomic work methods at the bedside or in the bathroom, reorganization of work equipment, and physical exercises, was conducted in 12 wards of 6 nursing homes in Germany. The Computer-Assisted Recording and Long-Term Analysis of Musculoskeletal Loads (CUELA) measurement system was used to evaluate all movements and trunk postures adopted during work before and 6 months after the training program. In total, 23 shifts were measured. All measurements were supported by video recordings. A specific software program (WIDAAN 2.75) was used to synchronize the measurement data and video footage.
Results: The median proportion of time spent in sagittal inclinations at an angle of >20° was significantly reduced (by 29%) 6 months after the intervention [from 35.4% interquartile range (27.6–43.1) to 25.3% (20.7–34.1); P < 0.001]. Very pronounced inclinations exceeding 60° [2.5% (1.1–4.6) to 1.0% (0.8–1.7); P = 0.002] and static inclinations of over 20° for >4 s [4.4% (3.0–6.7) to 3.6% (2.5–4.5); P < 0.001] were significantly reduced, by 60% and 22%, respectively. Video analysis showed that in 49% of care situations, ergonomic measures were implemented properly, either at the bedside or in the bathroom.
Conclusions: Stressful trunk postures could be significantly reduced by raising awareness of the physical strains that frequently occur during a shift, by changes in work practices and by redesigning the work environment. Workplace interventions aimed at preventing or reducing low back pain in nursing personnel would probably benefit from sensitizing employees to their postures during work.

Source: Kozak, Agnessa, Freitag, Sonja, & Nienhaus, Albert. (2017). Annals of Work Exposures and Health, 61(1), 22-32.

Reversible median nerve impairment after three weeks of repetitive work

Little is known about the time relation between entry into a job with high mechanical exposures and median nerve affection. We found that 22 days of seasonal repetitive work led to impaired sensory and motor nerve conduction with recovery within 3-6 weeks post-season. If related to newly increased exposures, median nerve affection is most likely reversible if exposures are reduced.

Source: Tabatabaeifar, S., Svendsen, S. W., Johnsen, B., Hansson, G. Å., Fuglsang-Frederiksen, A., & Frost, P. (2017). Scandinavian Journal of Work, Environment & Health.

Initial Results of an Evidence-Based Safe Patient Handling and Mobility Program to Decrease Hospital Worker Injuries

The rate for musculoskeletal injuries among health care workers is one of the highest for all industrial sectors in the United States; these injuries often occur during manual handling (i.e., lifting, moving, transferring, and repositioning) of patients. The following article describes the process used to complete a comprehensive assessment, as well as the planning, implementation, and initial evaluation of a quality improvement program to reduce work-related musculoskeletal disorders (WMSD) among health care workers employed by a rural Midwest hospital. Key elements for WMSD injury reduction were identified and compared across literature sources, national standards, and current state and federal legislative requirements for hospitals. The program used a multi-factor design that included evidence-based interventions (i.e., those supported by emerging evidence) to create a comprehensive Safe Patient Handling and Mobility (SPHM) program intended to address the unique needs of the organization. Initial program results are reviewed as well as significant considerations and challenges for SPHM programs.

Source: Przybysz, L., & Levin, P. F. (2016). Workplace health & safety.

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