Take a Stand!

Amulti-component intervention aimed at reducing sitting time among office workers - A cluster randomized trial
BACKGROUND: Prolonged sitting time has been associated with adverse health outcomes. Interventions at work may contribute to reduced sitting. The objective was to test if a multicomponent work-based intervention can reduce sitting time and the number of prolonged sitting periods (> 30 min), increase the number of sit-to-stand transitions and decrease waist circumference and body fat percentage among office workers. Primary outcomes were: change in sitting time, prolonged sitting periods and sit-to-stand transitions at follow-up 1 month later. METHODS: At four workplaces, 19 offices (317 workers in total) were cluster randomized for intervention or control. The intervention included the appointment of local ambassadors, management support, environmental changes, a lecture and a workshop. Sitting time was measured using an ActiGraph GT3X+ fixed on the thigh. Data were processed using Acti4 software providing data on time spent sitting, standing and doing other activities. Control participants were instructed to behave as usual. Follow-up measurements were obtained after 1 and 3 months. RESULTS: At 1 and 3 months, total sitting time was 71 (P< 0.001) and 48 min (P< 0.001) lower per 8-h workday in the intervention group compared with the control group. At 1 month, the number of prolonged sitting periods was lower (-0.79/8-h workday,P< 0.001) and sit-to-stand transitions were higher (+14%/sitting hour,P= 0.001) in the intervention compared with the control group. After 3 months, trends persisted. The body fat percentage was lower by 0.61 percentage points (P= 0.011) in the intervention group compared with the control group after 3 months. CONCLUSIONS: The multicomponent workplace-based intervention was effective in reducing sitting time, prolonged sitting periods and body fat percentage, and in increasing the number of sit-to-stand transitions.

Source: Danquah IH, Kloster S, Holtermann A, et al. Int J Epidemiol, 2016.

Carpal tunnel syndrome and manual work

The OCTOPUS cohort, results of a ten-year longitudinal study
This large longitudinal cohort study provides a prospective validation of the ACGIH TLV® method for the assessment of biomechanical exposures at work. It confirmed that “forceful hand exertions” more than “any exertion” significantly increase the risk of CTS. This study suggests that the current limits (AL and TLV) might not be sufficiently protective for some workers.

Source: Violante FS, Farioli A, Graziosi F, Marinelli F, Curti S, Armstrong TJ, Mattioli S, Bonfiglioli R. Scand J Work Environ Health, 2016.  

Tarification à l’expérience, incidence des troubles musculo-squelettiques et arrêts de travail

L'assurance des risques professionnels des travailleurs salariés du Régime général est financée par les entreprises sur la base de cotisations modulées selon leur sinistralité passée. En théorie, ce mode de tarification devrait contribuer à inciter les employeurs à développer des démarches de prévention des risques professionnels et à minimiser ainsi le coût des mauvaises conditions de travail. À partir d'une expérience naturelle observée en région Nord – Pas-de-Calais – Picardie en 2007, cette étude mesure l'influence d'une augmentation de la contribution des entreprises au coût des troubles musculo-squelettiques (TMS) sur l'incidence de ces maladies et les arrêts de travail associés. Cette étude s'appuie sur les données administratives de tarification des risques professionnels. La méthode repose sur une estimation en différence de différences. Les résultats indiquent que l'augmentation de la contribution des entreprises au coût des TMS a eu pour effet de limiter l'incidence de ces maladies. Cela s'est traduit par une baisse significative du nombre de jours d'arrêts de travail liés à ces pathologies.

Source: http://www.irdes.fr/recherche/questions-d-economie-de-la-sante/215-tarification-a-l-experience-incidence-des-troubles-musculo-squelettiques-et-arrets-de-travail.pdf

Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer

Objective: To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees. Methods: This study is a randomized controlled intervention study. It comprised 116 office workers using computers. Those in the intervention group were taught office ergonomics and the risk assessment method. Cox proportional hazards model and generalized estimating equations (GEEs) were used. Results: In the 10-month postintervention follow-up, the possibility of developing symptoms was 50.9%. According to multivariate analysis results, the possibility of developing symptoms on the right side of the neck and in the right wrist and hand was significantly less in the intervention group than in the control group (p < 0.05). Neck disability/symptom scores over time were significantly lower in the intervention group compared with the control group (p < 0.05). Conclusion: The participatory ergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers.

Source: Baydur, Hakan, Ergör, Alp, Demiral, Yücef, & Akalin, Elif. (2016). Journal of Occupational Health.

Collaborating with mammographers to address their work-related musculoskeletal discomfort

Mammographers are an understudied group of health care workers, yet the prevalence of musculoskeletal (MSK) symptoms in mammographers appears to be elevated, similar to many occupations in health care. In this study, we used a participatory approach to identify needs and opportunities for developing interventions to reduce mammographers' exposures to risk factors that lead to the development of MSK symptoms. In this paper, we present a number of those needs and several intervention concepts along with evaluations of those concepts from experienced mammographers. We include findings from a preliminary field test of a novel intervention concept to reduce the need to adopt awkward postures while positioning patients for a screening or diagnostic mammogram.

Source: Sommerich, Carolyn M., Lavender, Steven A., Evans, kevin D., Sanders, Elizabeth, Joines, Sharon, Lamar, Sabrina,... Park, SangHyun. (2016). Ergonomics. http://dx.doi.org/10.1080/00140139.2016.1140815

A Psychophysical Protocol to Develop Ergonomic Recommendations for Sitting and Standing Workstations

Objective: The aim of this study was to determine user self-selected setup for both sitting and standing computer workstations and identify major differences.
Background: No current ergonomic setup guideline for standing computer workstations is available.
Methods: Twenty adult participants completed four 45-min sessions of simulated office computer work with an adjustable sit-stand computer workstation. Placement and relative position of all workstation components, including a cordless mouse, a cordless keyboard, a height-adjustable desk, and a 22-inch monitor mounted on a mechanical-assisted arm were recorded during the four sessions, which alternated between sitting and standing for each session. Participants were interrupted four times within each session, and the workstation was “reset” to extreme locations. Participants were instructed to adjust the location to achieve the most comfortable arrangement and to make as many adjustments during the session to achieve this goal.
Results: Overall, users placed the keyboard closer to their body (sternum), set desk height lower than their elbow, and set the monitor lower relative to their eyes with a greater upward tilt while standing compared to sitting. During the 45-min sessions, the number of adjustments participants made became smaller and over the four sessions was consistent, suggesting the psychophysical protocol was effective and consistent.
Conclusion: Users preferred different workstation setups for sitting and standing computer workstations. Therefore, future setup guidelines and principles for standing computer workstations may not be simply translated from those for sitting.
Application: These results can serve as the first step toward making recommendations to establish ergonomic guidelines for standing computer workstation arrangement.

Source: Lin, Michael Y., Catalano, Paul, & Dennerlein, Jack T. (2016). Human Factors.

Safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings

A systematic review
Objectives: To explore the safety risks associated with physical interactions between patients and caregivers during treatment and care delivery in Home Care settings.
Design: Seven-stage framework from the PRISMA statement for research question, eligibility (definition), search, identification of relevant papers from title and abstract, selection and retrieval of papers, appraisal and synthesis.
Review methods: The included references (n = 42) were critically appraised using a modified version of Downs and Black checklist and the Mixed Methods Appraisal Tool.
Results: The risk factors are reported using the modified model of human factors of health care in the home to represent the roles of both patients and caregivers in the system. The results are grouped as environment (health policy, physical and social), artefacts (equipment and technology), tasks (procedures and work schedules) and care recipient/provider. These include permanent and temporary building design and access, communication and lone working, provision of equipment and consumables, and clinical tasks. The topics with strong evidence from at least 2 papers relate to risks associated with awkward working positions, social environment issues (additional tasks and distractions), abuse and violence, inadequate team (peer) support, problems with workload planning, needle stick injuries and physical workload (moving and handling patients).
Conclusions: As home care increases, there is a need to ensure the safety of both patients and caregivers with an understanding of the physical interactions and tasks to manage safety risks and plan safer care delivery systems.

Source: Hignett, Sue, Otter, Mary Edmunds, Keen, Christine. (2016). International Journal of Nursing Studies, 59, 1-14.

The biomechanical demands of manual scaling on the shoulders & neck of dental hygienists

The purpose of this study was to evaluate the postural and muscular demands placed on the shoulders and neck of dental hygienists when performing a simulated manual scaling task. Nineteen healthy female dental hygienists performed 30-min of simulated manual scaling on a manikin head in a laboratory setting. Surface electromyography was used to monitor muscle activity from several neck and shoulder muscles, and neck and arm elevation kinematics were evaluated using motion capture. The simulated scaling task resulted in a large range of neck and arm elevation angles and excessive low-level muscular demands in the neck extensor and scapular stabilising muscles. The physical demands varied depending on the working position of the hygienists relative to the manikin head. These findings are valuable in guiding future ergonomics interventions aimed at reducing the physical exposures of dental hygiene work.

Source: La Delfa, Nicholas J., Grondin, Diane E., Cox, Jocelyn, Potvin, Jim R., & Howarth, Samuel J. (2016). Ergonomics.

Temporal patterns of sitting at work are associated with neck–shoulder pain in blue-collar workers

A cross-sectional analysis of accelerometer data in the DPHACTO study
BACKGROUND: Our aim was to examine the extent to which temporal patterns of sitting during occupational work and during leisure-time, assessed using accelerometry, are associated with intense neck-shoulder pain (NSP) in blue-collar workers. METHODS: The population consisted of 659 Danish blue-collar workers. Accelerometers were attached to the thigh, hip, trunk and upper dominant arm to measure sitting time and physical activity across four consecutive days. Temporal sitting patterns were expressed separately for work and leisure by the proportion of total time spent sitting in brief bursts (0-5 min), moderate (>5-20 min) and prolonged (>20 min) periods. The peak NSP intensity during the previous 3 months was assessed using a numerical rating scale (range 0-10) and dichotomized into a lower (4) NSP score. Logistic regression analyses with multiple adjustments for individual and occupational factors were performed to determine the association between brief, moderate and prolonged sitting periods, and NSP intensity. RESULTS: Time in brief bursts of occupational sitting was negatively associated with NSP intensity (adjusted OR 0.68, 95 % CI 0.48-0.98), while time in moderate periods of occupational sitting showed a positive association with NSP (adjusted OR 1.32, 95 % CI 1.04-1.69). Time in prolonged periods of occupational sitting was not associated with NSP (adjusted OR 0.78, 95 % CI 0.78-1.09). We found no significant association between brief, moderate or prolonged sitting periods during leisure, and NSP. CONCLUSION: Our findings indicate that the association between occupational sitting time and intense NSP among blue-collar workers is sensitive to the temporal pattern of sitting.

Source: Hallman DM, Mathiassen SE, Heiden M, et al. International Archieves of Occupational and Environmental Health, 2016.

Impact of a Sit-Stand Workstation on Chronic Low Back Pain

Results of a Randomized Trial
Objective: The aim of the study was to determine whether chronic low back pain (LBP) might be attenuated through the introduction of a sit-stand workstation (SSW) in office employees.
Methods: Participants were randomized to receive a SSW at the beginning or at the end of a 3-month study period. Participants responded to a short survey at the end of each workday and a comprehensive survey at weeks 1, 6, and 12. Surveys consisted of a modified brief pain inventory and the Roland Morris Disability Questionnaire.
Results: Forty-six university employees with self-reported chronic LBP were enrolled. Participants who were given access to a SSW reported a significant reduction in current (P?=?0.02) and worst (P?=?0.04) LBP over time.
Conclusions: Our findings support the hypothesis that chronic LBP might be improved by the introduction of a SSW in an office environment.

Source: Ognibene, Grant T.; Torres, Wilson; von Eyben, Rie; Horst, Kathleen C. Journal of Occupational & Environmental Medicine: March 2016, Volume 58, Issue 3, p. 287-293.

Une intervention ergonomique dans une entreprise utilisant des nanomatériaux

Cet article présente une intervention ergonomique dans une entreprise du secteur industriel amenée à fabriquer du papier contenant des nanoparticules. Les salariés du laboratoire de recherche et développement de l'entreprise, chargés d'étudier les caractéristiques du produit, ont refusé de le manipuler. À la demande du CHSCT de l'entreprise, l'INRS est intervenu afin de mieux comprendre les pratiques réelles de travail et d'aider à mettre en oeuvre, au cas par cas, une démarche de prévention adaptée au risque potentiel.

Source: L'Allain, C., Caroly, S., Drais, E., Caroly, S., Caroly, S., Landry, A., ... & Casse, C. (2016). Hygiène et Sécurité du Travail, 242, 58-62.

Association of objectively measured occupational walking and standing still with low back pain

A cross-sectional study
Objectives: This cross-sectional study investigated the association of objectively measured walking and standing still time at work with low back pain (LBP) intensity among blue-collar workers. Design: A cross-sectional study. Methods: 187 workers attached two accelerometers for diurnal standing still and walking measurements, which were categorised using tertiles. Workers' self-reported LBP intensity (scale 0–9) was categorised into low (0–5) and high pain (6–9). Results: Of the 187 workers, 17% reported a high level of LBP. Results of the multi-adjusted logistic regression analysis demonstrated a negative association between walking and high LBP intensity (OR 0.24 CL 95% 0.07 to 0.79). The results between standing still and high LBP intensity were mixed and non-significant. Conclusion: Blue-collar workers who walk more at work tend to have low LBP. These results should be verified using objective measures in a prospective design.

Source: Nielsen CM, Gupta N, Knudsen LE, et al. Ergonomics, 2016.

Associations between biopsychosocial factors and chronic upper limb pain among slaughterhouse workers

Cross sectional study
BACKGROUND: Knowledge of factors associated with chronic pain is necessary for preventive strategies. The present study investigates biopsychosocial differences, with specific focus on rate of force development (RFD) and work ability, between workers with and without chronic upper limb pain. METHODS: Eighty-two male slaughterhouse workers, 49 with chronic upper limb pain and 33 pain-free controls participated in the study. Maximal muscle strength, RFD, and muscle activity was determined from fast and forceful maximal voluntary contractions for the shoulder and hand. Participants filled out a questionnaire on work ability (work ability index), work disability (Work module of DASH questionnaire), fear avoidance, and self-rated health. Additionally, pressure pain threshold (PPT) was measured in muscles of the arm, shoulder and lower leg. RESULTS: Muscle strength and RFD (determined within time intervals of 30, 50, 100, and 200 ms relative to onset of contraction) was 28 % and 58-78 % lower, respectively, in workers with chronic pain compared with pain-free controls, and paralleled by reduced muscle activity (all p < 0.001). Workers with chronic pain had lower PPT of the arm, shoulder and lower leg (p < 0.01), and reported impaired work ability index score and general health along with higher work disability and fear avoidance compared with controls (all p < 0.0001). No differences were observed between the groups in regard to age, BMI, physical activity level, job position and duration of slaughterhouse work (all p > 0.4). CONCLUSIONS: Chronic upper limb pain was paralleled by reduced neuromuscular function of the shoulder and hand along with impaired work ability, work disability and general health. Future studies on chronic pain management at the workplace should carefully consider the biopsychosocial nature of pain when designing and implementing preventive stratégies.

Source: Sundstrup E, Jakobsen MD, Brandt M, et al. BMC Musculoskeletal Disorders, 2016;17(1):104.

La démarche TMS pros

Les troubles musculosquelettiques représentent la première cause de maladies professionnelles reconnues en France. Face à ce constat, l'Assurance maladie-risques professionnels a lancé auprès d'environ 8 000 entreprises une démarche de prévention structurée en quatre étapes, nommée TMS Pros.

Source: Travail et Sécurité, avril 2016, Numéro 771.

Solutions visant l’amélioration des conditions de santé et de sécurité des poseurs de revêtements de sol

La pose de revêtement de sol se divise en différentes spécialités : céramique, bois et revêtement souple. C'est ce dernier secteur qui nous intéresse, soit la pose de tapis (accrochés ou collés; en rouleau, en tuiles) ou de matériaux résilients (linoléum, vinyle, caoutchouc, gazon synthétique, etc.). Le métier de poseur de revêtement de sol est exigeant sur le plan physique (manutention de rouleaux très lourds, travail à genou prolongé, épandage de colle sur de grandes surfaces), mais aussi en matière de savoir-faire à développer. La pose exige de la précision, entre autres, pour ajuster les motifs et effectuer les raccords. Avec les matériaux résilients, le moindre petit défaut se voit. Présentement, un jeune qui complète son diplôme d'étude professionnelle de poseur débutera comme apprenti; il pourra obtenir le plein statut de compagnon après avoir accompli trois périodes de 2 000 heures dûment déclarées (depuis 2014). Les conditions de travail peuvent aussi être difficiles : chaleur, aires de circulations déficientes, contraintes de temps de fin de chantier, etc. Le milieu éprouve actuellement de la difficulté à recruter de la main-d'oeuvre et il s'inquiète du maintien en activité de ses poseurs vieillissants. Présentement, il y aurait 1 200 à 1 600 travailleurs dont la pose est l'activité principale. Ils travaillent essentiellement au sein de très petites entreprises. Intervenir dans un tel contexte représente un grand défi en SST, car les outils et approches sont le plus souvent développés dans le cadre de grandes et moyennes entreprises. On parle donc d'un milieu dispersé qui dispose de peu de ressources, au sein duquel une multitude d'interlocuteurs-organisations s'entrecroisent (fabricants, détaillants, responsables de chantiers, représentants de la Commission de la construction du Québec, enseignants et intervenants des commissions scolaires, etc.), dont le travail est varié, se transforme rapidement et où les risques de développer des problèmes musculosquelettiques aux genoux, au dos, aux épaules, aux mains, aux poignets et aux chevilles sont réputés élevés. Par contre, le milieu peut compter sur des éléments fédérateurs, comme la Fédération québécoise des revêtements de sol (FQRS) et le GROUPE Agr, mutuelle de prévention.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100858/n/amelioration-sante-securite-poseurs-revetements-sol

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