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. http://dx.doi.org/10.1080/10803548.2016.1275140

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.

Source: https://uwaterloo.ca/centre-of-research-expertise-for-the-prevention-of-musculoskeletal-disorders/resources/position-papers/aging-and-msd-strategies-older-workers

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.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100906/n/exposition-technicien-ambulancier-paramedical-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.

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.

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