Paramètres biomécaniques et sensorimoteurs affectant la réponse biodynamique du système main-bras
L'exposition aux vibrations est une préoccupation importante au regard de la prévention des troubles musculo-squelettiques aux membres supérieurs. Les vibrations main-bras sont spécifiquement reconnues pour être la cause du syndrome des vibrations, une maladie atteignant les doigts et la main en matière vasculaire, musculo-squelettique et neurosensoriel. De longues durées et de fortes intensités de vibration peuvent accélérer l'apparition des symptômes.
Cette étude, qui comporte deux volets, a servi à explorer différentes variables pouvant influencer la transmission de la vibration aux membres supérieurs tout comme le recrutement musculaire. Douze participants regroupés selon deux somatotypes (six ectomorphes et six mésomorphes) ont participé à chacun de ces volets. L'utilisation d'un pot vibrant a permis de contrôler certaines variables afin d'exposer les sujets à diverses combinaisons d'amplitude (2,5 m/s2, 5 m/s2 et 10 m/s2) et de fréquence (20, 40 et 65 Hz) de vibration pour les deux volets. La tâche des sujets consistait à maintenir la poignée instrumentée du pot vibrant pendant une période de dix secondes.
Objective: To identify work ability trajectories among Finnish firefighters during a 13-year follow-up. We examined whether baseline musculoskeletal pain and depressive symptoms (DPS) predicted membership of the trajectories.
Methods: We studied 411 male firefighters who responded to a questionnaire at both baseline and at least one of two follow-ups. The outcome variable was perceived work ability (0 to 10). The predictors were musculoskeletal and depressive symptoms. Covariates included age, diseases, lifestyle habits, and work-related factors.
Results: One fourth of the firefighters belonged to the Diminished work ability trajectory. Musculoskeletal and depressive symptoms, lifestyle risks and diseases, and, in separate analyses, low back pain, were strong predictors of this.
Conclusions: When planning preventive actions and workplace health promotion among firefighters, even one site musculoskeletal pain and mild signs of depression should be taken into account. Prevention of adverse lifestyle habits is also essential.
Source: Punakallio, Anne PhD; Lusa, Sirpa PhD; Luukkonen, Ritva PhD; Airila, Auli MSc; Leino-Arjas, Päivi MD. Journal of Occupational & Environmental Medicine: April 2014 - Volume 56 - Issue 4 - p 367–375.
The National Institute for Occupational Safety and Health (NIOSH) has issued the final report from its Health Hazard Evaluation at a South Carolina poultry processing plant. The plant requested the Health Hazard Evaluation.
The final report makes recommendations to improve work conditions and minimize exposures to factors that increase the risk for musculoskeletal disorders and traumatic injuries. The recommendations address changes for reducing the amount of hand activity and force, changing work schedule and rotation patterns and policies, and improving work practices related to tool and equipment use. These recommendations are aimed at what is an alarming prevalence of carpal tunnel syndrome in poultry processing workers noted in this evaluation.
Approximately 100 of the illustrations accompanying the checkpoints were improved and revised in this second edition of the manual. The first edition was published in 2012 and it was well received by the ergonomic and occupational safety and health (OSH) practitioners and professional bodies around the world. Certain users recommended improving the illustrations so that they reflect the best available ergonomic techniques and practice globally, rather than in a few project countries. ILO specialists and external experts reviewed and commented on the illustrations.
Conçue par des prescripteurs de prévention, cette brochure propose une méthode d'analyse des risques liés à la charge physique de travail. Elle permet de repérer et d'analyser les facteurs de risques pour l'appareil locomoteur en tenant compte de la globalité des composantes de l'activité. Elle permet également d'établir des priorités, d'orienter vers des pistes pertinentes de prévention et d'en évaluer l'efficacité.
Objectives It has been suggested that the handling of heavy loads during pregnancy is associated with impaired fetal growth. We examined the association between quantity and frequency of maternal occupational lifting and the child's size at birth, measured by weight, length, ponderal index, small-for-gestational-age (SGA), abdominal circumference, head circumference, and placental weight.
Methods We analyzed birth size from the Danish Medical Birth Registry of 66 693 live-born children in the Danish National Birth Cohort according to the mother's self-reported information on occupational lifting from telephone interviews around gestational week 16. Data were collected in the period 1996–2002. We used linear and logistic regression models and adjusted for confounders.
Results In the fully adjusted models, most of the mean differences in birth size measures had values indicating a smaller size of offspring among women with occupational lifting versus women with no lifting, but the differences were very small, and there was a statistically significant trend only for placental weight showing lighter weight with increasing number of kilos lifted per day. In jobs likely to include person-lifting, we found increased odds of SGA among children of women who lifted 501–1000 kilos per day [odds ratio (OR) 1.34, 95% confidence interval (95% CI) 0.98–1.83] and >1000 kilos per day (OR 1.51, 95% CI 0.83–2.76) compared to no lifting. In jobs with no person-lifting, occupational lifting was not associated with SGA.
Conclusions Overall, we observed no strong support for an association between maternal occupational lifting and impaired size at birth. Our data indicated a potential association between lifting and SGA among offspring of women in occupations that are likely to include person-lifting. These results should, however, be interpreted with caution due to limited statistical power, and we suggest that future studies include detailed, individual information on job functions and ergonomic routines of lifting procedures.
Source: Juhl M, Larsen PS, Andersen PK, Svendsen SW, Bonde JP, Nybo Andersen A-M, Strandberg-Larsen K. Scand J Work Environ Health. 2014.
Les problèmes chroniques de douleur et de perte de fonction de l'épaule touchent jusqu'à 20 % des adultes (Pope, Croft et coll., 1997). La proportion serait encore plus élevée chez les adultes âgés de plus de 50 ans. Au Québec, la Commission de la santé et de la sécurité au travail du Québec (CSST) rapporte que, pour les années 2003 à 2006, les lésions à l'épaule représentaient 39% des 32 549 lésions inflammatoires dues à un travail répétitif ou à un traumatisme. Les lésions à l'épaule ont requis en moyenne 75,4 jours d'absence du travail et 4 533 $ en indemnités de remplacement du revenu (IRR) par travailleur. En comparaison, les lésions au membre inférieur représentaient moins de 10 % des lésions rapportées et ont requis en moyenne 39,5 jours d'absence et des IRR de 2 439 $ par travailleur (CSST, 2007). Ces chiffres montrent non seulement l'importance du problème, mais aussi que les lésions à l'épaule nécessitent proportionnellement plus de temps pour retrouver une fonction adéquate et permettre un retour durable au travail. Ceci témoigne de l'importance d'identifier rapidement les personnes à risque de développer des problèmes de fonction à l'épaule afin de les orienter vers des programmes de réadaptation efficaces et adaptés.
A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. Results Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. Conclusions At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
Source: Varatharajan S, Côté P, Shearer HM, Loisel P, Wong JJ, Southerst D, Yu H, Randhawa K, Sutton D, van der Velde G, Mior S, Carroll LJ, Jacobs C, Taylor-Vaisey A. J. Occup. Rehabil. 2014.
A Review and Meta-Analysis
Objective: A meta-analysis on epidemiological studies was undertaken to assess association between carpal tunnel syndrome (CTS) and computer work.
Methods: Four databases (PubMed, Embase, Web of Science, and Base de Donnees de Sante Publique) were searched with cross-references from published reviews. We included recent studies, original epidemiological studies for which the association was assessed with blind reviewing with control group. Relevant associations were extracted, and a metarisk was calculated using the generic variance approach (meta–odds ratio [meta-OR]).
Results: Six studies met the criteria for inclusion. Results are contradictory because of heterogeneous work exposure. The meta-OR for computer use was 1.67 (95% confidence interval [CI], 0.79 to 3.55). The meta-OR for keyboarding was 1.11 (95% CI, 0.62 to 1.98) and for mouse 1.94 (95% CI, 0.90 to 4.21).
Conclusion: It was not possible to show an association between computer use and CTS, although some particular work circumstances may be associated with CTS.
Source: Mediouni, Zakia MD; de Roquemaurel, Alexis MD; Dumontier, Christian MD; Becour, Bertrand MD; Garrabe, Hélène; Roquelaure, Yves MD, PhD; Descatha, Alexis MD, PhD. Journal of Occupational & Environmental Medicine: February 2014, Volume, Issue 2, p. 204–208.
Manual handling solutions for the food and drink industries
This book is aimed at employers and dutyholders within the food and drink industry. It discusses manual handling risks and solutions.
Specifically, it covers:
- the main causes of injuries
- handling raw materials
- packing into containers
- stacking and moving containers
- handling equipment
- off-site delivery
The introduction in this new edition has been revised but the case studies remain unchanged.
BACKGROUND: This analysis examines the associations of work organization attributes among Latino women in manual occupations with musculoskeletal and neurological injuries. METHODS: Participants included 234 women in western North Carolina. Outcome measures included epicondylitis, rotator cuff syndrome, back pain, and carpal tunnel syndrome. Independent measures included indicators of job demand, job control, and job support, as well as personal characteristics. RESULTS: Latina workers commonly experienced epicondylitis, rotator cuff syndrome, back pain, and CTS. Awkward posture and decision latitude were associated with epicondylitis. Rotator cuff syndrome was associated with awkward posture and psychological demand. Awkward posture and psychological demand, and decreased skill variety and job control were related to CTS. CONCLUSIONS: Work organization factors are potentially important for musculoskeletal and neurological injury among vulnerable workers. Research is required to understand the associations of work and health outcomes of these women. Policy initiatives need to consider how work organization affects health.
Source : Arcury TA, Cartwright MS, Chen H, Rosenbaum DA, Walker FO, Mora DC, Quandt SA. Am. J. Ind. Med. 2014.
Objectives : This study compared the cost efficiency of observation and inclinometer assessment of trunk and upper-arm inclination in a population of flight baggage handlers, as an illustration of a general procedure for addressing the trade-off between resource consumption and statistical performance in occupational epidemiology.
Methods : Trunk and upper-arm inclination with respect to the line of gravity were assessed for three days on each of 27 airport baggage handlers using simultaneous inclinometer and video recordings. Labor and equipment costs associated with data collection and processing were tracked throughout. Statistical performance was computed from the variance components within and between workers and bias (with inclinometer assumed to produce “correct” inclination angles). The behavior of the trade-off between cost and efficiency with changed sample size, as well as with changed logistics for data collection and processing, was investigated using simulations.
Results : At similar total costs, time spent at trunk and arm inclination angles >60 ° as well as 90th percentile arm inclination were estimated at higher precision using inclinometers, while median inclination and 90th percentile trunk inclination was determined more precisely using observation. This hierarchy remained when the study was reproduced in another population, while inclinometry was more cost-efficient than observation for all three posture variables in a scenario where data were already collected and only needed to be processed.
Conclusions : When statistical performance was measured only in terms of precision, inclinometers were more cost-efficient than observation for two out of three posture metrics investigated. Since observations were biased, inclinometers consistently outperformed observation when both bias and precision were included in statistical performance. This general model for assessing cost efficiency may be used for designing exposure assessment strategies with considerations not only of statistical but also cost criteria. The empirical data provide a specific basis for planning assessments of working postures in occupational groups.
Source : Trask C, Mathiassen SE, Wahlström J, Forsman M. Scand J Work Environ Health. 2014.
A two-year follow-up study of workers in municipal kitchens
Objective : We studied predictors of sickness absences (SA) due to musculoskeletal pain over two years among 386 municipal female kitchen workers.
Methods : Pain and SA periods (no/yes) due to pain in seven sites during the past three months were assessed at 3-month intervals over two years by questionnaire. Age, musculoskeletal pain, multisite pain (pain in ≥3 sites), musculoskeletal and other somatic diseases, depressive symptoms, physical and psychosocial workload, body mass index, smoking, and leisure-time physical activity (LTPA) at baseline were considered as predictors. Trajectory analysis and multinomial logistic regression were used.
Results : Three trajectories of SA emerged, labelled as “none” (41% of the subjects), “intermediate” (48%), and “high” (11%). With the “none” trajectory (no SA) as reference, pain in all musculoskeletal sites excepting the low back predicted belonging to the “intermediate” [odds ratio (OR) 1.82–2.48] or “high” (OR 2.56–3.74) trajectory adjusted for age; multisite pain predicted membership of the “intermediate” [OR 2.15, 95% confidence interval (95% CI) 1.38–3.34] or “high” (OR 4.66, 95% CI 2.10–10.3) trajectories. In a mutually adjusted final model, smoking (OR 2.12, 95% CI 1.22–3.69), multisite pain (OR 1.87, 95% CI 1.15–3.02), and overweight/obesity (OR 1.71, 95% CI 1.08–2.72) predicted belonging to the “intermediate” trajectory, while depressive symptoms (OR 3.57, 95% CI 1.57–8.10), musculoskeletal diseases (OR 3.18, 95% CI 1.37–7.37), and multisite pain (OR 2.72, 95% CI 1.15–6.40) were associated with the “high” trajectory.
Conclusion : Along with the number of pain sites and musculoskeletal diseases, attention to depressive symptoms, smoking, and overweight/obesity is needed to tackle SA related to musculoskeletal pain.
Source : Haukka E, Kaila-Kangas L, Luukkonen R, Takala E-P, Viikari-Juntura E, Leino-Arjas P. Scand J Work Environ Health. 2014.
Prospective cohort study on the risk for occupational back injury among healthcare workers
Objectives : This prospective cohort study investigates work-related risk factors for occupational back injury among healthcare workers.
Methods : The study comprised 5017 female healthcare workers in eldercare from 36 municipalities in Denmark who responded to a baseline and follow-up questionnaire in 2005 and 2006, respectively. Using logistic regression, the odds for occupational back injury (ie, sudden onset episodes) in 2006 from patient transfers in 2005 was modeled.
Results : In the total study population, 3.9% experienced back injury during follow-up, of which 0.5% were recurrent events. When adjusting for lifestyle (body mass index, leisure-time physical activity, smoking), work-related characteristics (seniority and perceived influence at work), and history of back pain and injury, daily patient transfers increased the risk for back injury (trend, P=0.03): odds ratio (OR) 1.75 [95% confidence interval (95% CI) 1.05–2.93] for 1–2 transfers per day, OR 1.81 (95% CI 1.14–2.85) for 3–10 transfers per day, and OR 1.56 (95% CI 0.96–2.54) for >10 transfers per day, referencing those with <1 patient transfer on average per day. The population attributable fraction of daily patient transfer for back injury was estimated to be 36%. Among those with daily patient transfer (N=3820), using an assistive device decreased the risk for back injury for “often” and “very often” use [OR 0.59 (95% CI 0.36–0.98) and OR 0.62 (95% CI 0.38–1.00), respectively] referencing those who “seldom” use assistive devices.
Conclusion : Daily patient transfer was associated with increased risk for back injury among healthcare workers. Persistent use of an assistive device was associated with reduced risk for back injury among healthcare workers with daily patient transfers.
Source : Andersen LL, Burdorf A, Fallentin N, Persson R, Jakobsen MD, Mortensen OS, Clausen T, Holtermann A. Scand J Work Environ Health. 2014; 40 (1): 74-81.
Work-related upper limb disorder (WRULD), repetitive strain injury (RSI), occupational overuse syndrome (OOS) and work-related complaints of the arm, neck or shoulder (CANS) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements, awkward postures and impact of external forces such as those associated with operating vibrating tools. Work-related CANS, which is the term we use in this review, severely hampers the working population.
Source : http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008742.pub2/abstract
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