Occupational Therapy Practitioners with Occupational Musculoskeletal Injuries

Prevalence and Risk Factors
Purpose: The purpose of this study was to examine the prevalence and risk factors of occupational musculoskeletal injuries (OMIs) among occupational therapy practitioners over a 12-month period. Method: A self-administered questionnaire mailed to 500 randomly selected practicing occupational therapists (OTs) and occupational therapy assistants (OTAs) living in the state of Texas. Results: A response rate of 38 % was attained with 192 questionnaires returned. In a 12-months working period, 23 % of occupational therapy practitioners experienced musculoskeletal injuries. Muscle strain (52 %) was most reported injury and lower back (32 %) was most injured body part. Years of practicing experience (t = 2.83, p = 0.01), and age x2(2, N = 192) = 8.28, p = 0.02 were found as significant factors associated with injuries among OTAs. No factors were significantly associated with injuries among OTs. Conclusion: Patient handling was the primary factor associated with injuries. Also, minimal experience and older age were concluded as risk factors that might contribute to OMIs.

Source: Alnaser MZ. J. Occup. Rehabil. June 2015.

La prévention des troubles musculo-squelettiques dans le secteur de l'agriculture

Dans cette brochure, les propriétaires d’exploitations agricoles et les travailleurs trouveront une description générale des troubles musculo-squelettiques (TMS) et de leurs stades de développement. On y propose également des moyens de prévention à appliquer pour prévenir les TMS et une méthode d’évaluation des risques. Finalement, on y trace un portrait des TMS dans le secteur de l’agriculture et on y décrit des situations de travail propres au secteur de même que les risques de TMS que ces dernières comportent.

Source: http://www.csst.qc.ca/publications/300/Pages/DC_300_1002.aspx

Temporal changes in occupational sitting time in the Danish workforce and associations with all-cause mortality

Results from the Danish work environment cohort study
BACKGROUND: Prolonged sitting has been negatively associated with a range of non-communicably diseases. However, the role of occupational sitting is less clear, and little is known on the changes of occupational sitting in a working population over time. The present study aimed to determine 1) temporal changes in occupational sitting time between 1990 and 2010 in the Danish workforce; 2) the association and possible dose-response relationship between occupational sitting time and all-cause mortality. METHODS: This study analysed data from the Danish Work Environment Cohort Study (DWECS), which is a cohort study of the Danish working population conducted in five yearly intervals between 1990 and 2010. Occupational sitting time is self-reported in the DWECS. To determine the association with all-cause mortality, the DWECS was linked to the Danish Register of Causes of Death via the Central Person Register. RESULTS: Between 1990 and 2010 the proportion of the Danish workforce who sat for at least three quarters of their work time gradually increased from 33.1 to 39.1 %. All-cause mortality analyses were performed with 149,773 person-years of observation and an average follow-up of 12.61 years, during which 533 deaths were registered. None of the presented analyses found a statistically significant association between occupational sitting time and all-cause mortality. The hazard ratio for all-cause mortality was 0.97 (95 % CI: 0.79; 1.18) when >/=24 hr/wk occupational sitting time was compared to <24 hr/wk for the 1990-2005 waves. CONCLUSIONS: Occupational sitting time increased by 18 % in the Danish workforce, which seemed to be limited to people with high socio-economic status. If this increase is accompanied by increases in total sitting time, this development has serious public health implications, given the detrimental associations between total sitting time and mortality. The current study was inconclusive on the specific role that occupational sitting might play in the increased all-cause mortality risk associated with the total volume of sitting.

Source: van der Ploeg HP, Møller SV, Hannerz H, et al. International Journal of Behavioral Nutrition and Physical Activity, 2015; 12 (1): 71.

Occupational exposures and sick leave during pregnancy

Results from a Danish cohort study
Objective: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10–29 completed pregnancy weeks in a large cohort of Danish pregnant women.
Methods: Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996–2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome.
Results: We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HRrange 1.55–2.79), cumulative lifting HRtrend 1.29, 95% CI 1.26–1.31, shift work (HRevening 1.90, 95% CI 1.73–2.09, HRnight 1.52, 95% CI 1.15–2.01), monthly night shifts HRtrend 1.12, 95% CI 1.11–1.14, increasing weekly work hours HRtrend 0.93, 95% CI 0.91–0.95 and high job strain HR 1.52, 95% CI 1.42–1.63. Some exposures influenced HR in either a positive or negative time-dependent way.
Conclusion: Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

Source: Hansen ML, Thulstrup AM, Juhl M, Kristensen JK, Ramlau-Hansen CH. Scand J Work Environ Health, 2015. 

Portrait des pratiques de prévention primaire et secondaire en bureautique au Québec chez les intervenants et dans les milieux de travail

Dans la perspective de stimuler la prévention des troubles musculo-squelettiques (TMS) dans le domaine de la bureautique au Québec, et de préparer un guide de bonnes pratiques, une première étape nous est apparue incontournable : documenter les pratiques de praticiens et celles mises en œuvre dans les milieux de travail au Québec. Il s'agissait de décrire ce qui se fait au Québec, de déterminer les approches les plus prometteuses, de décrire les difficultés rencontrées et, inversement, les conditions de succès.

Source: http://www.irsst.qc.ca/-publication-irsst-pratiques-prevention-bureautique-intervenants-r-874.html

Is musculoskeletal pain a consequence or a cause of occupational stress?

A longitudinal study
Objectives: Longitudinal studies have linked stress at work with a higher incidence of musculoskeletal pain. We aimed to explore the extent to which musculoskeletal pain is a cause as opposed to a consequence of perceived occupational stress.
Methods: As part of the international cultural and psychosocial influences on disability study, we collected information from 305 Italian nurses, at baseline and again after 12 months, about pain during the past month in the low-back and neck/shoulder, and about effort–reward imbalance (ERI) (assessed by Siegrist's ERI questionnaire). Poisson regression was used to assess the RR of ERI >1 at follow-up according to the report of pain and of ERI >1 at baseline.
Results: Among nurses with ERI ≤1 at baseline, ERI >1 at follow-up was associated with baseline report of pain in the low-back (RR 2.7, 95 % CI 1.4–5.0) and neck/shoulder (RR 2.6, 95 % CI 1.3–5.1). However, there was no corresponding association with persistence of ERI in nurses who already had ERI >1 at baseline. Associations of ERI at baseline with pain at follow-up were weak.
Conclusion: Our results suggest that the well-documented association between job stress and musculoskeletal pain is not explained entirely by an effect of stress on reporting of pain. It appears also that workers who report musculoskeletal pain are more likely to develop subsequent perceptions of stress. This may be because pain renders people less tolerant of the psychological demands of work. Another possibility is that reports of pain and stress are both manifestations of a general tendency to be aware of and complain about symptoms and difficulties.

Source: Bonzini, Matteo, Bertu, Lorenza, Veronesi, Giovanni, Conti, Marco, Coggon, David, & Ferrario, Marco M. (2015). International Archives of Occupational and Environmental Health, 88(5), 607-612.

Height-adjustable workstations to reduce sedentary behaviour in office-based workers

Systematic review
Background: Time spent sitting in the workplace is an important contributor to overall sedentary risk. Installation of height-adjustable workstations has been proposed as a feasible approach for reducing occupational sitting time in office workers.
Aims: To provide an accurate overview of the controlled trials that have evaluated the effects of height-adjustable workstation interventions on workplace sitting time in office-based workers.
Methods: A comprehensive search was conducted up until March 2014 in the following databases: Medline, PsychINFO, CENTRAL, EMBASE and PEDro. To identify unpublished studies and grey literature, the reference lists of relevant official or scientific web pages were also checked. Studies assessing the effectiveness of height-adjustable workstations using a randomized or non-randomized controlled design were included.
Results: The initial search yielded a total of 8497 citations. After a thorough selection process, five studies were included with 172 participants. A formal quality assessment indicated that risk of bias was high in all studies and heterogeneity in interventions and outcomes prevented meta-analysis. Nevertheless, all studies reported that height-adjustable workstation interventions reduced occupational sitting time in office workers. There was insufficient evidence to determine effects on other relevant health outcomes (e.g. body composition, musculoskeletal symptoms, mental health).
Conclusions: There is insufficient evidence to make firm conclusions regarding the effects of installing height-adjustable workstations on sedentary behaviour and associated health outcomes in office workers. Larger and longer term controlled studies are needed, which include more representative populations.

Source: Tew, G.A., Posso, M.C., Arundel, C.E., & McDaid, C.M. (2015). Occupational Medicine.

A multi-faceted workplace intervention for low back pain in nurses' aides

A pragmatic stepped wedge cluster randomised controlled trial
The present study established the effectiveness of a workplace multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training for low back pain. Between November 2012 and May 2014, we conducted a pragmatic stepped-wedge cluster-randomized controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomized to four successive time periods, three months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training (12 sessions), cognitive behavioural training (2 sessions) and participatory ergonomics (5 sessions)). Low back pain was the outcome and was measured as days, intensity (worst pain on a 0-10 numeric rank scale) and bothersomeness (days) by monthly text messages. Linear mixed models were used to estimate the intervention effect. Analyses were performed according to intention to treat, including all eligible randomized participants and were adjusted for baseline values of the outcome. The linear mixed models yielded significant effects on low back pain days of -0.8 (95% confidence interval -1.19 to -0.38), low back pain intensity of -0.4 (95% confidence interval -0.60 to -0.26) and bothersomeness days of -0.5 (95% confidence interval -0.85 to -0.13) after the intervention compared to the control group. This study shows that a multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training can reduce low back pain among workers in eldercare. Thus, multi-faceted interventions may be relevant for improving low back pain in a working population.This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivatives 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially  

Source: Rasmussen CDN, Holtermann A, Bay H, et al. Pain, 2015.

Similarities between work related musculoskeletal disorders and slips, trips and falls

Most occupational risks manifest themselves through movements performed at work, for example musculoskeletal disorders, slips, trips and falls. Research focusing on such risks often differentiates diseases from accidents. All these risks prove to be diffuse, widespread, emergent and devoid of an external harmful hazard, when analysed through their common vector, i.e. through the movements manifesting them. These characteristics have a strong impact on risk perception and on approaches necessary to ensure sustainable prevention. A participative search for local solutions to preventing these risks, integrating shared risk representation and several analysis levels, would seem helpful. A balance between defended and resilience-based conceptions of health and safety should be established. Research should also be extended to enhance in-depth understanding of controls impacting worker movements when performing a task, while safeguarding health and safety.

Source: Leclercq S, Cuny-Guerrier A, Gaudez C, Aublet-Cuvelier A. Ergonomics, 2015.

Anthropometric Study of U.S. Truck Drivers

Methods, Summary Statistics, and Multivariate Accommodation Models
Since up-to-date anthropometric data, which plays an important role in improving ergonomic design of truck cabs, has not been collected for decades, NIOSH launched the first-ever federal anthropometric study of U.S. truck drivers. This document summarizes the results of the study that, we hope, will be used by truck manufacturers, parts suppliers, transportation researchers, fleet managers, and other interested parties for decades to come.

Source: http://www.cdc.gov/niosh/docs/2015-116/

Influences on the use of observational methods by practitioners when identifying risk factors in physical work

Most observational methods for musculoskeletal disorder risk assessment have been developed by researchers to be applied in specific situations, and practitioners could find difficulties in their use in real-work conditions. The main objective of this study was to identify the factors which have an influence on how useful the observational techniques are perceived to be by practitioners and to what extent these factors influence their perception. A survey was conducted on practitioners regarding the problems normally encountered when implementing these methods, as well as the perceived overall utility of these techniques. The results show that practitioners place particular importance on the support the methods provide in making decisions regarding changes in work systems and how applicable they are to different types of jobs. The results of this study can serve as guide to researchers for the development of new assessment techniques that are more useful and applicable in real-work situations.

Source: Diego-Mas JA, Poveda-Bautista R, Garzon-Leal DC. Ergonomics, 2015.

Observatoire des troubles musculo-squelettiques des actifs agricoles

Bilan national 2008-2012
Toute démarche de prévention devant nécessairement s'appuyer sur un état des lieux, ce bilan national permet de connaître plus précisément les caractéristiques en France des Troubles Musculo-Squelettiques (TMS) dans le secteur agricole. Les principaux objectifs de cette étude sont de : 

  • suivre, sur les 5 dernières années, l'évolution annuelle d'indicateurs spécifiques pour les TMS des actifs agricoles dont les données ou caractéristiques sont connues et consolidées,
  • regrouper ces indicateurs dans des tableaux de bord,
  • établir un bilan national sur des grandes tendances, à partir de quelques indicateurs de référence couramment utilisés (nombre de maladies avec et sans arrêt de travail, nombre de maladies graves, indice et taux de fréquence des maladies avec et sans arrêt de travail, coût des maladies, …),
  • répondre à l'accord cadre des partenaires sociaux européens en agriculture en centralisant les données relatives aux TMS en agriculture.

    Source: http://ssa.msa.fr/lfr/documents/21447876/0/11635_Observatoire+des+TMS+2008-2012.pdf

    High Prevalence of Carpal Tunnel Syndrome among Poultry Workers

    Musculoskeletal disorders (MSD) of the upper extremities among poultry processing employees are well documented (Lipscomb et al. 2008; Cartwright et al. 2012). The combination of highly repetitive tasks, forceful movements and working in cold temperatures can increase risk for MSDs such as carpal tunnel syndrome, a disabling medical condition affecting the hands and wrists. In 2014, the National Institute for Occupational Safety and Health (NIOSH) was asked to perform a Health Hazard Evaluation at a poultry processing plant in Maryland.

    Source: http://blogs.cdc.gov/niosh-science-blog/2015/04/06/poultry-workers-cts/

    Troubles musculosquelettiques et santé psychologique

    Démarche de soutien aux activités de prise et de répartition des appels d'urgence 9-1-1
    La présente étude constitue un prolongement des recherches antérieures ayant pour objectif de réduire les risques psychosociaux associés aux troubles musculosquelettiques et de santé psychologique chez les préposés des centres d'urgence 9-1-1. Elle se fonde plus précisément sur la précédente recherche (Toulouse et coll., 2011) dont les résultats suggéraient la nécessité de mieux soutenir les préposés aux prises avec des situations d'appels difficiles. En effet, les résultats montraient que les situations, qui génèrent une charge de travail ou une charge cognitive plus élevée sont corrélées à l'augmentation de l'intensité des douleurs au cou et aux épaules, alors que les douleurs au bas du dos s'accroissent avec l'accentuation des émotions négatives. L'élévation de la charge de travail, de la charge cognitive ou émotionnelle est occasionnée par les difficultés de traitement de certains appels. Celles-ci proviennent des problèmes de communication qui complexifient l'application des procédures déterminant l'envoi des intervenants sur les lieux de l'évènement. Ces problèmes de communication sont inhérents aux exigences du travail des préposés aux appels d'urgence. Ils requièrent la mise en place de moyens de soutien pour aider les préposés à développer et à maintenir des compétences leur permettant de réaliser un travail efficace tout en préservant leur santé. Dans cette perspective, il devenait essentiel de connaître l'état des pratiques existantes, afin de proposer une démarche visant à les améliorer. Pour ce faire, des entrevues ont été réalisées dans dix centres d'appels d'urgence avec les gestionnaires, les formateurs et des préposés. Ces entrevues ont porté sur le soutien existant et les améliorations souhaitées concernant différentes situations difficiles telles que : appels de citoyens arrogants, en crise, aux prises avec des problèmes de santé mentale ou avec des tendances suicidaires, les appels pour lesquels le degré d'urgence est incertain, le fait de servir d'intermédiaire entre le citoyen et la police dans un évènement criminel, les situations d'urgence dramatique, la répartition d'urgence majeure.

    Source: http://www.irsst.qc.ca/-publication-irsst-troubles-musculosquelettiques-sante-psychologique-r-868.html

    Prévalence des symptômes musculo-squelettiques du membre supérieur chez les travailleurs de l'agriculture en France en 2010

    Introduction: La phase pilote du programme Coset-MSA a permis d'évaluer la prévalence des symptômes musculo-squelettiques du membre supérieur parmi les travailleurs de l'agriculture et, notamment, parmi les agriculteurs exploitants et les ouvriers agricoles couverts par la Mutualité sociale agricole (MSA).
    Méthode: Les travailleurs ont été recrutés, dans cinq départements, par tirage au sort dans les bases de données de la MSA et invités à remplir un auto-questionnaire. L'échantillon d'analyse était constitué de 1 130 travailleurs, âgés de 18 à 65 ans, exerçant dans le secteur Agriculture, sylviculture et pêche, et en activité au moment
    de l'enquête.
    Résultats: La prévalence de symptômes déclarés du membre supérieur au cours des 12 derniers mois était de 54% chez les hommes et 67% chez les femmes (p<10-3) et, respectivement, 20% et 34% ont eu des symptômes pendant plus de 30 jours. La prévalence la plus élevée, au cours des 12 derniers mois, concernait l'épaule pour
    les hommes (37%) et la zone main/poignet pour les femmes (49%). Ces dernières présentaient des taux de prévalence significativement plus élevés que les hommes, sauf pour le coude/avant-bras, zone pour laquelle il n'y avait pas de différence. Les prévalences de symptômes ne différaient pas significativement entre les agriculteurs
    exploitants et les ouvriers agricoles, chez les hommes comme chez les femmes.
    Discussion-conclusion: Cette étude montre une forte prévalence des symptômes musculo-squelettiques du membre supérieur chez les travailleurs de l'agriculture qui constituent une population à surveiller en particulier, et à cibler en termes d'actions de prévention.

    Source: Cercier, Elodie; Fouquet, Natacha; Bodin, Julie; et al. Bulletin épidémiologique hebdomadaire, 10/03/2015, pp. 1-8.

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