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.

An observational method for Postural Ergonomic Risk Assessment (PERA)

Monotonous, repetitive work characterizes production lines. Repetitive movements and awkward postures are the most prominent physical risk factors in the workplace. Various legislations have been enacted along with technical standards for ergonomic risk evaluation to ensure the safety of the operators.
There are numerous methods to assess the ergonomic risk at work. However, most methods are not meant to be used for assessing cyclic work. This paper proposes a method, Postural Ergonomic Risk Assessment (PERA), which is suitable to evaluate the postural ergonomic risk of short cyclic assembly work. Its key features are simplicity and compliance with standards. The added value of the method is that it provides an analysis of every work task in the work cycle, which facilitates the identification of sources of high risk to the operator.
The method has been verified on nine work cycles, constituted by 88 work tasks, and it demonstrates accordance with the European Assembly Worksheet (EAWS), which has been developed to comply with the relevant standards and is one of the most comprehensive tools for ergonomic risk assessment.

Source: Chander, D. S., & Cavatorta, M. P. (2017). International Journal of Industrial Ergonomics, 57, 32-41.

Difference between male and female workers lifting the same relative load when palletizing boxes

A few biomechanical studies have contrasted the work techniques of female and male workers during manual material handling (MMH). A recent study showed that female workers differed from males mostly in the strategy they used to lift 15-kg boxes from the ground, especially regarding task duration, knee and back postures and interjoint coordination. However, the lifting technique difference observed in females compared to males was perhaps due to a strength differences. The objective of this study was to test whether female workers would repeat the same lifting technique with a load adjusted to their overall strength (females: 10 kg; males: 15 kg), which can be considered a “relative load” since the overall back strength of females is 2/3 that of males. The task for the participants consisted in transferring boxes from one pallet to another. A dynamic 3D linked segment model was used to estimate the net moments at L5/S1, and different kinematic variables were considered. The results showed that the biomechanics of the lifting techniques used by males and females were similar in terms of task duration and cumulative loading, but different in terms of interjoint coordination pattern. The sequential interjoint coordination pattern previously seen in females with an absolute load (15 kg) was still present with the relative load, suggesting the influence of factors more intrinsically linked to sex. Considering that the female coordination pattern likely stretched posterior passive tissues when lifting boxes from the ground, potentially leading to higher risk of injury, the reason for this sex effect must be identified so that preventive interventions can be proposed.

Source: Plamondon, A., Larivière, C., Denis, D., Mecheri, H., Nastasia, I., & IRSST MMH research group. (2017). Applied Ergonomics, 60, 93-102.

Work-Related Psychosocial Factors and Mental Health Problems Associated with Musculoskeletal Pain in Nurses

A Cross-Sectional Study
Background. Musculoskeletal pain is the most common cause of incapacity among nurses. This study aimed to report the prevalence of musculoskeletal pain among hospital nurses and to explore the associations of work-related psychosocial factors and mental health problems with musculoskeletal pain. Methods. A cross-sectional survey was carried out among registered nurses at Tartu University Hospital during April and May 2011. Binary logistic regression was used to assess the associations between dependent and independent variables. Results. Analysis was based on 404 nurses (45% of the hospital's nursing population). The overall prevalence of MSP was 70% in the past year and 64% in the past month. Lower back (57%) and neck (56%) were the body areas most commonly painful in the past year. Higher quantitative and emotional demands, work pace, low justice and respect in the workplace, influence on work organisation, and role conflicts were significantly associated with musculoskeletal pain among nurses. All mental health problems and most strongly somatic stress symptoms were associated with musculoskeletal pain. Conclusions. Work-related psychosocial risk factors and mental health problems, especially somatic stress symptoms, have an important impact on the occurrence of musculoskeletal pain among university hospital nurses.

Source: Freimann, T., Pääsuke, M., & Merisalu, E. (2016). Pain Research and Management.

Pushing and pulling: An assessment tool for OHS practitioners

A tool has been developed for supporting practitioners when assessing manual pushing and pulling operations based on an initiative by two global companies in the manufacturing industry. The aim of the tool is to support occupational health and safety practitioners in risk assessment and risk management of pushing and pulling operations in the manufacturing and logistics industries. It is based on a nine-multiplier equation that includes a wide range of factors affecting an operator's health risk and capacity in pushing and pulling. These multipliers are based on psychophysical, physiological, and biomechanical studies in combination with judgments from an expert group consisting of senior researchers and ergonomists. In order to consider usability, more than fifty occupational health and safety practitioners (e.g. ergonomists, managers, safety representatives, and production personnel) participated in the development of the tool. An evaluation by 22 ergonomists supports that the push/pull tool is user friendly in general.

Source: Lind, C. M. (2016). International Journal of Occupational Safety and Ergonomics, 1-40.

A multi-component patient-handling intervention improves attitudes and behaviors for safe patient handling and reduces aggression experienced by nursing staff

A controlled before-after study
This study evaluated an intervention for patient-handling equipment aimed to improve nursing staffs' use of patient handling equipment and improve their general health, reduce musculoskeletal problems, aggressive episodes, days of absence and work-related accidents. As a controlled before-after study, questionnaire data were collected at baseline and 12-month follow-up among nursing staff at intervention and control wards at two hospitals. At 12-month follow-up, the intervention group had more positive attitudes towards patient-handling equipment and increased use of specific patient-handling equipment. In addition, a lower proportion of nursing staff in the intervention group had experienced physically aggressive episodes. No significant change was observed in general health status, musculoskeletal problems, days of absence or work-related accidents. The intervention resulted in more positive attitudes and behaviours for safe patient-handling and less physically aggressive episodes. However, this did not translate into improved health of the staff during the 12-month study period.

Source: Risør, B. W., Casper, S. D., Andersen, L. L., & Sørensen, J. (2017). Applied Ergonomics, 60, 74-82.

Allied Health Professionals and Work-Related Musculoskeletal Disorders

A Systematic Review
Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.

Source: Anderson, S. P., & Oakman, J. (2016). Safety and Health at Work.

Injury rates before and after the implementation of a safe resident handling program in the long-term care sector

Manual resident handling (RH) tasks increase risk of musculoskeletal disorders (MSDs) for clinical staff in nursing homes. To reduce the incidence and cost of MSDs, a large healthcare corporation instituted a Safe Resident Handling Program (SRHP) comprising purchase of mechanical lifting equipment, worker training, and detailed usage/maintenance protocols. The program was initially administered by a third-party company; after three years, program responsibility shifted to individual centers.
Workers' compensation claim rates were compared before and after SRHP implementation. Claims and FTEs were classified as “pre-SRHP,” “first post period” (up to 3 years post-SRHP), or “second post period” (4–6 years post-SRHP), based on claim date relative to implementation date for each center.
Complete data were available for 136 nursing homes with average annual employment of 18,571 full-time equivalents. Over the 8-year period, 22,445 claims were recorded. At each time period, the majority of RH claims affected the back (36% low, 15% other) and upper extremity (26%). Workers' compensation claims were reduced by 11% during the first post period and 14% during the second post period. RH-related claims were reduced by 32% and 38%, respectively. After six years, the rate for all claims had decreased in 72% of centers, and RH claim rates decreased in 82%. Relative risk for post-/pre-SRHP injury rates increased for centers with less developed wellness programs, unionized centers, and centers with higher LPN turnover pre-SRHP. Injury reduction among these nursing home workers is plausibly attributable to the introduction of mechanical lifting equipment within the context of this multi-faceted SRHP.

Source: Kurowski, A., Gore, R., Roberts, Y., Kincaid, K. R., & Punnett, L. (2017). Safety Science, 92, 217-224.

Low back pain patterns over one year among 842 workers in the DPhacto study and predictors for chronicity based on repetitive measurements

BACKGROUND: Low back pain (LBP) occurrence and intensity are considered to fluctuate over time, requiring frequent repetitive assessments to capture its true time pattern. Text messages makes frequent reporting of LBP feasible, which enables investigation of 1) the time pattern of LBP, and 2) predictors for having a continued high (chronic) level of LBP over longer periods of time. However, this has not previously been investigated in a larger working population. The aim of this study was to examine these two aspects in a working population of 842 workers with repetitive measurements of LBP over one year. METHODS: There were 842 workers from 15 companies in the DPhacto study participating in this study. Demographic, work- and health-related factors, and back endurance were measured at baseline, while 14 monthly repeated text message assessments of LBP intensity were prospectively collected. A factor analysis was used to cluster different time-patterns of LBP, and defining the group of participants with chronic LBP. A multi-adjusted logistic regression analysis was performed to investigate baseline predictors for chronic LBP. RESULTS: The factor analysis revealed two dimensions of the time pattern of LBP, defined as the LBP intensity and LBP variation, respectively. A Visual Pain Mapping was formed based on the combination of the two pain dimensions, classifying the time-patterns of LBP into four categories: (1) low intensity and low variation, (2) low intensity and high variation, (3) high intensity and high variation, (4) high intensity and low variation (defined as chronic LBP). Significant baseline predictors for chronic LBP in the fully adjusted model were high baseline LBP (p < 0.01), low workability (p < 0.01), low BMI (p < 0.05), and being a blue-collar worker (vs. white-collar worker) (p < 0.05). CONCLUSION: This study presents a novel classification of the course of LBP based on repetitive measurements over a year, and revealed the predicting factors for chronic LBP based on repetitive measurements in a working population.

Source: Lagersted-Olsen, J., Bay, H., Jørgensen, M. B., Holtermann, A., & Søgaard, K. (2016). BMC Musculoskeletal Disorders, 17(1), 453.

Influence of Manual Labor at Work on Muscular Fitness and Its Relationship With Work Performance

Objective: The present study examined the influence of workplace manual labor on measures of muscular fitness, with a secondary aim to investigate the relationship between muscular fitness and work performance in blue-collar (BC) workers.
Methods: Leg extension isokinetic strength at slow and fast velocities, hamstring and hip-flexor flexibility, and low back muscular endurance were examined in young and older BC workers and white-collar (WC) controls, while work performance was examined in the BC cohort.
Results: There were no differences in muscular fitness variables between BC and WC groups; however, the older men had lower low back muscular endurance (−43.0%) and strength at slow (−9.4%) and fast (−12.7%) velocities. Work performance was associated with strength at fast velocities (r=0.633) in the older BC workers.
Conclusions: Leg strength may influence work performance, with higher velocities becoming more important in older workers.

Source: Ryan, E. D., Thompson, B. J., & Sobolewski, E. J. (2016). Journal of Occupational and Environmental Medicine, 58(10), 1034-1039.

L’ergonomie du genre: quelles influences sur l’intervention et la formation ?

Le numéro spécial proposé sur ergonomie et genre vise à comprendre dans une approche pluridisciplinaire les façons différentes pour les femmes et les hommes de réaliser leur activité de travail et hors travail. L'objectif est d'interroger nos méthodes d'intervention ergonomique sur les relations entre travail et santé du point de vue du sexe/genre et d'en tirer des leçons pour la formation et la recherche. Une dizaine d'articles dans des secteurs variés apportent des connaissances sur la nécessité d'analyser de manière différenciée les expositions aux risques, les difficultés de santé selon le sexe/genre. Les stéréotypes apparaissent dans la répartition des emplois, la division du travail, l'attribution de rôle selon les horaires de travail. Porter le regard sur l'activité, plus exactement sur les modalités de régulations dans le travail en fonction des formes d'organisation du travail selon le sexe/genre, amène aux différentes étapes de l'intervention ergonomique à questionner les processus de transformation du travail qui peuvent tenir davantage l'égalité professionnelle. La première étape de la démarche est d'analyser des données préliminaires à partir d'une demande d'intervention pour construire le problème à traiter du point de vue du sexe/genre. La deuxième étape consiste à faire une analyse du travail en mettant en évidence les stratégies différenciées mises en œuvre par les hommes et les femmes dans l'activité et leurs effets sur la préservation de la santé et les processus de construction. La troisième étape traite d'une réflexion plus générale sur la transformation des représentations et des situations selon l'approche sexe/genre à partir des contextes spécifiques du travail ou des situations de formation et des demandes d'intervention émanant du terrain. Ce numéro spécial est porté par un groupe de chercheurs et praticiens pluridisciplinaires en Europe et au Canada qui participent de façon active à plusieurs congrès nationaux et internationaux pour promouvoir une approche du sexe/genre du point de vue de l'activité de travail.

Source: (2016). Pistes, 18(2).

Effects of natural posture imbalance on posture deviation caused by load carriage

The purpose of this study was to explore posture deviation variability caused by load carriages depending on natural posture imbalance to provide information about a carrying habit exaggerating an individual's posture imbalance. All people exhibit some imbalance from the standard anatomical pose which assumes alignment with the frontal and median planes. In this study natural posture imbalance is the starting point for determining posture deviation which is posture imbalance resulting from an activity, carrying an item.

Source: Lyu, S., & LaBat, K. L. (2016). International Journal of Industrial Ergonomics, 56, 115-123.

Sickness absence and permanent work disability in relation to upper- and lower-body pain and occupational mechanical and psychosocial exposures

Musculoskeletal pain in multiple sites has been associated with sickness absence and permanent work disability. We found that high occupational mechanical exposures were associated with sickness absence, particularly in case of combined pain in the upper and lower body. We also found that combined pain and low social support at work were associated with permanent work disability.

Source: Sommer, T. G., Svendsen, S. W., & Frost, P. (2016). Scandinavian Journal of Work, Environment & Health.

Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care

A systematic review
For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for the implementation of non-specific low back and/or neck pain guidelines in health care.

Source: Suman, A., Dikkers, M. F., Schaafsma, F. G., van Tulder, M. W., & Anema, J. R. (2016). Implementation Science, 11(1), 126.

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