Time course of neck-shoulder pain among workers

A longitudinal latent class growth analysis
Objectives: The aims of this study were to (i) identify trajectories of neck-shoulder pain (NSP) over one year in an occupational population and (ii) determine whether these trajectories are predicted by NSP characteristics as well as personal and occupational factors at baseline.
Methods: This longitudinal study was conducted among Danish workers (N=748) from 2012–2014. Text messages were used to collect frequent data on NSP over one year (14 waves in total). Peak NSP intensity in the past month was rated on a 0–10 numeric scale. A baseline questionnaire covered NSP characteristics (pain intensity, duration, comorbidity, pain medication, and pain interference) as well as personal (age, gender, body mass index) and occupational (seniority, work type, physical strain at work) factors. Latent class growth analysis was used to distinguish trajectories of NSP. Multivariate regression models with odds ratios (OR) were constructed to predict trajectories of NSP.
Results: Six distinct trajectories of NSP were identified (asymptomatic 11%, very low NSP 10%, low recovering NSP 18%, moderate recovering NSP 28%, strong fluctuating NSP 24% and severe persistent NSP 9% of the workers). Female gender, age, physical strain at work, NSP intensity and duration, pain medication, and pain interference in daily work at baseline were positively associated with severe persistent NSP and strong fluctuating NSP (all P<0.05). Altogether, personal and occupational factors accounted for 14% of the variance, while NSP characteristics accounted for 54%.
Conclusions: In an occupational sample, six distinct trajectories of NSP were identified. Physical strain at work appears to be a pertinent occupational factor predicting strong fluctuating and severe persistent NSP.

Source: Hallman DM, Rasmussen CDN, Jørgensen MB, Holtermann A. (2017). Scand J Work Environ Health.

Les dispositifs d'assistance physique

Exosquelette, cobot, robot collaboratif… Sous ces dénominatifs parfois un peu barbares, se cache une technologie de plus en plus présente dans le monde du travail : les dispositifs d'assistance physique. Qu'ils soient à contention ou sans, ces systèmes sont destinés à aider physiquement des opérateurs dans l'accomplissement de tâches parfois simples en apparence, mais éprouvantes. Objectif : prévenir l'apparition des troubles musculosquelettiques (TMS) et la pénibilité en limitant la charge physique ou la répétitivité, ou encore prendre en compte le vieillissement au travail ou un handicap et favoriser le maintien dans l'emploi…

Source: (2017). Travail & sécurité.

Work-related physical, psychosocial and individual factors associated with musculoskeletal symptoms among surgeons

Implications for ergonomic interventions
This study evaluated the effect of physical, psychosocial and individual factors on the presence of musculoskeletal symptoms (MSS) among surgeons (n = 312) in Iran. Data were collected using questionnaires and analysed by multivariate logistic regression. The prevalence of MSS, particularly in the knees (48.7%), neck (45.8%), low back (42.3%) and shoulders (40.1%) was relatively high. Work-related factors including time spent on surgeries each week (>25 h/week), number of hours working in standing position per day (>4 h/day), moderate to high levels of work–family conflict, duration of each surgery (>3 h), number of years worked as a surgeon (>10 years) and surgical specialty (particularly cardiothoracic and obstetric/gynecologic surgeries) were independently associated with the presence of MSS in different body regions. Individual factors including gender (being female) and little or no involvement in sport and physical activity were also independently associated with the occurrence of complaints. Implications of the findings for further research and development work for improving the working conditions and consequently reducing MSS among this working group are discussed.

Source: Dianat, I., Bazazan, A., Azad, M. A. S., & Salimi, S. S. (2018). Applied Ergonomics, 67, 115-124.

Return on investment of interventions for the prevention and treatment of musculoskeletal

There were two key objectives for the work:
- To conduct a literature review to identify which interventions are cost-effective in reducing the complications associated with osteoarthritis of the hip or knee, neck pain or back pain;
- To develop an ROI tool that allows the resource and financial consequences of implementing these cost-effective interventions nationally and at local levels.

Source: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/653736/musculoskeletal_conditions_return_on_investment_final_report.pdf

Effectiveness of a participatory physical and psychosocial intervention to balance the demands and resources of industrial workers

A cluster-randomized controlled trial
This study evaluated a participatory intervention aiming to improve the work ability and need for recovery of industrial workers. The intervention was not effective and rather showed tendencies for adverse effects. Companies should consider intervention-related potential adverse effects on workers with already high work demands, and we recommend development of better effect evaluation designs specifically for participatory interventions.

Source: Gupta, N., Wåhlin-Jacobsen, C. D., Abildgaard, J. S., Henriksen, L. N., Nielsen, K., & Holtermann, A. (2017). Scandinavian Journal of Work, Environment & Health.

Saddle Seat Reduces Musculoskeletal Discomfort in Microsurgery Surgeons

Background. Microsurgery is a surgical procedure that requires a high degree of precision and is commonly facilitated through the use of an intraoperative microscope. When operating the microscope system, the long-term posture and stance lead to fatigue and musculoskeletal disorders in surgeons, and seats are commonly employed to diminish these problems. The present study was conducted to evaluate musculoskeletal discomfort during work with a saddle seat especially designed for people using intraoperative microscopes in comparison with conventional seats for microscopic works. Materials and methods. In this study, two types of seats, a saddle and a conventional, were evaluated on 73 microsurgical surgeons in terms of musculoskeletal discomfort. Corlett and Bishop's body part discomfort scale (BPD) was used to assess musculoskeletal discomfort before and after working with the seats. Results. We found that the highest amount of discomfort that microsurgical surgeons acquire in the workplace was focused on their neck, shoulder, arm and back, respectively. During the work with a saddle seat, a significant reduction was found for discomfort values in neck, shoulder, arm, back, elbow and forearm, as well as the whole body (p <0.05). Over 89 percent of the participants said that the use of this seat causes increased comfort during operation. Conclusion. This study showed that the use of saddle seats provides a more appropriate physical posture at work, and can decrease musculoskeletal discomfort in different parts of the body of microsurgical surgeons.

Source: Labbafinejad, Y., Ghasemi, M. S., Bagherzadeh, A., Aazami, H., Eslami-Farsani, M., & Dehghan, N. (2017). International Journal of Occupational Safety and Ergonomics.

Effects of prolonged microscopic work on neck and back strain amongst male ENT clinicians and the benefits of a prototype postural support chair

Musculoskeletal pain is a common occupational hazard experienced by surgeons. Otologists are predisposed to neck and back pain due to regular prolonged microscopic work. We conducted a prospective pilot study to investigate the effects of sustained microscopic work on the neck and back, its correlation to surgical experience and to assess the benefits of a prototype postural support chair (PSC) amongst 10 male ear, nose and throat (ENT) clinicians. We used a subjective measure of time to fatigue and pain for the neck and back as well as objective readings from a surface electromyogram (sEMG). We found that an increase in surgical experience correlated with the time taken to experience fatigue and pain in the neck and back. This was corroborated by our sEMG findings. The PSC significantly delayed the sensations in the neck and also eliminated the difference seen amongst the varying seniority of clinicians.

Source: Vijendren, A., Devereux, G., Kenway, B., Duffield, K., Van Rompaey, V., van de Heyning, P. et Yung, M. (2017). International Journal of Occupational Safety and Ergonomics.

Exercise for the Prevention of Low Back Pain

Systematic Review and Meta-Analysis of Controlled Trials
The aim of this systematic review and meta-analysis was to assess the effect of exercise in population-based interventions to prevent low back pain (LBP) and associated disability. Comprehensive literature searches were conducted in multiple databases including PubMed, Embase, and Cochrane Library from their inception through June 2017. Thirteen randomized controlled trials and three non-randomized controlled trials qualified for meta-analyses. Exercise alone reduced the risk of LBP by 33% (risk ratio = 0.67, 95% CI: 0.53, 0.85, I2 = 23%, 8 randomized controlled trials, n = 1,634) and exercise combined with education by 27% (risk ratio = 0.73, 95% CI: 0.59, 0.91, I2 = 6%, 6 trials, n = 1,381). The severity of LBP and disability from LBP were also lower in exercise than control groups. Moreover, results were not changed by excluding the non-randomized controlled trials, or by adjustment for publication bias. Few trials assessed healthcare consultation or sick leave for LBP, and meta-analyses did not show statistically significant protective effects of exercise on those outcomes. Exercise reduces the risk of LBP and associated disability, and a combination of strengthening with either stretching or aerobic exercises performed 2–3 times/week can reasonably be recommended for prevention of LBP in the general population.

Source: Shiri, R., Coggon, D., & Falah-Hassani, K. (2017). American Journal of Epidemiology.

Is objectively measured sitting at work associated with low back pain?

A cross sectional study in the DPhacto cohort
Objectives: Low-back pain (LBP) is a substantial health challenge due to the risk for long-term sickness absence and early retirement. Several biomechanical exposures at work, including sitting, have been suggested to increase the risk for LBP. The objectives of this study were to determine (i) the extent to which temporal patterns and total amount of objectively measured sitting is associated with LBP intensity and (ii) whether selected modifiers influence these associations.
Methods: This cross sectional study uses baseline data from the Danish PHysical ACTivity cohort with Objective measurements (DPhacto) of physical activities in the cleaning, transport and manufacturing sectors. Peak intensity of LBP was collected by questionnaire on a 0–10 scale and sitting was expressed in terms of total duration and temporal pattern, ie, time spent in brief bursts (≤5 minutes), moderate periods (>5–≤20 minutes), and prolonged periods of sitting (>20 minutes); both during work and whole day (waking hours only). Associations were determined using linear regression in models accounting for moderation and confounding. Factors evaluated as moderators or confounders were assessed by questionnaire.
Results: The population consisted of 704 participants. No significant associations were found between total duration or temporal patterns of sitting and LBP intensity, neither during work nor for the whole day. Body mass index (BMI) significantly moderated the association between sitting and LBP; participants with a high and low BMI showing a negative and positive association, respectively.
Conclusion: Sitting was not independently associated with peak LBP intensity, suggesting other exposures are more powerful risk factors for LBP.

Source: Korshøj, M., Hallman, D., Mathiassen, S. E., Aadahl, M., Holtermann, A., & Birk Jørgensen, M. (2017). Scandinavian Journal of Work, Environment and Health.

A screening tool for the risk of disability retirement due to musculoskeletal disorders

Objective: This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD).
Methods: The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30–60 years (N=3676) and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40–60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up.
Results: The discriminative ability of the model with seven predictors was good (Gönen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of 3 or higher out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15–55) times higher risk of disability retirement due to MSD than those at the bottom 40%.
Conclusion: This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.

Source: Shiri, R., Heliövaara, M., Ahola, K., Kaila-Kangas, L., Haukka, E., Kausto, J., ... et Lallukka, T. (2017). Scandinavian Journal of Work, Environment & Health.

Application des pratiques préventives par les infirmières et infirmiers

La perspective innovante de la capacité d'absorption
L'objectif principal de cette étude est d'identifier et d'analyser les conditions d'application des pratiques préventives des TMS chez le personnel infirmier à partir des théories du transfert de connaissances, notamment celles relatives à la capacité d'absorption des connaissances. Plus précisément, cette étude vise à 1) étudier les étapes du processus de mise en application des pratiques préventives des TMS, 2) faire un examen exhaustif des principales pratiques préventives rapportées dans la littérature, 3) Identifier les facteurs individuels et organisationnels associés aux diverses étapes du processus d'application des pratiques préventives des TMS, 4) fournir des pistes d'amélioration sur la mise en application des pratiques préventives des TMS liés au travail. Pour répondre à ces objectifs, une enquête par sondage en ligne a été réalisée auprès du personnel infirmier (N=399) exerçant dans différents établissements du réseau de la santé et des services sociaux. Ensuite, deux groupes de discussion composés d'infirmières et de gestionnaires (G1=8, G2=6) ont été menés pour valider les résultats et enrichir leur interprétation.

Source: http://www.irsst.qc.ca/publications-et-outils/publication/i/100951/n/pratiques-preventives-infirmieres-infirmiers-capacite-absorption

The Effect of Intelligent Physical Exercise Training on Sickness Presenteeism and Absenteeism Among Office Workers

Objective: The aim of this study was to investigate the effect of individually tailored intelligent physical exercise training (IPET) on presenteeism and absenteeism among office workers.
Methods: In a 1-year randomized controlled trial (RCT), employees were allocated to a training group TG (N = 193) or control group CG (N = 194). TG received 1-hour high-intensity IPET once a week within working hours, and was recommended to perform 30 minutes of moderate-intensity physical activity (PA) 6 days a week during leisure-time.
Results: An intention-to-treat analysis showed no effect on absenteeism, but a significant 4% increase in workability and 9% increase in general health in TG compared with CG. A per-protocol analysis [adherence of ≥70% (N = 89)] in addition showed a significant 6% increase in productivity and a 29% reduction in absenteeism compared with CG.
Conclusion: IPET combined with recommendations of leisure-time PA significantly improved presenteeism and decreased absenteeism if following the protocol.

Source: Justesen, J. B., Søgaard, K., Dalager, T., Christensen, J. R., & Sjøgaard, G. (2017). Journal of occupational and environmental medicine, 59(10), 942-948.

Intégrer la prévention des risques professionnels dès la conception des équipements d'aide à la manutention des personnes

Les risques professionnels encourus par les utilisateurs d'équipements d'aide à la manutention des personnes ne sont pas toujours bien pris en compte lors de leur conception. À travers l'exemple du Milo, un équipement d'aide au transfert de personnes et à la toilette, l'INRS a élaboré des recommandations pour intégrer la prévention de ces risques dès la conception des aides techniques et limiter ainsi les efforts liés à leur utilisation.

Source: Gille, S., Kerangueven, L. (2017). Hygiène et sécurité du travail (248), p. 50-56.

Proceedings of the 5th International Digital Human Modeling Symposium

The proceedings present the the peer-reviewed articles of the 5th International Digital Human Modeling Symposium. The symposium was held from June 26-28, 2017 at the Fraunhofer-Institute for Communication, Information Processing and Ergonomics (FKIE), in cooperation with the unit "Human factors and ergonomics" of the Federal Institute for Occupational Safety and Health (BAuA).

Source: https://www.baua.de/EN/Service/Publications/Report/Gd91.html

Workplace risk management practices to prevent musculoskeletal and mental health disorders: What are the gaps?

Introduction: A large body of evidence demonstrates substantial effects of work-related psychosocial hazards on risks of both musculoskeletal and mental health disorders (MSDs and MHDs), which are two of the most costly occupational health problems in many countries. This study investigated current workplace risk management practices in two industry sectors with high risk of both MSDs and MHDs and evaluated the extent to which risk from psychosocial hazards is being effectively managed.
Method: Nineteen, mostly large, Australian organisations were each asked to provide documentation of their relevant policies and procedures, and semi-structured interviews were conducted with 67 staff who had OHS or management roles within these organisations. Information about current workplace practices was derived from analyses of both the documentation and interview transcripts.
Results: Risk management practices addressing musculoskeletal and mental health risks in these workplaces focused predominately on changing individual behaviours through workplace training, provision of information, individual counselling, and sometimes healthy lifestyle programs. There were formal procedures to control sources of risk for workplace biomechanical hazards affecting musculoskeletal risk, but no corresponding procedures to control risk from work-related psychosocial hazards. Very few risk control actions addressed risk from psychosocial hazards at their workplace sources.
Practical applications: To reduce the risk of both musculoskeletal and mental health disorders, existing practices need considerable expansion to address risk from all potential psychosocial hazards. Risk controls for both biomechanical and psychosocial hazards need to focus more on eliminating or reducing risk at source, in accord with the general risk management hierarchy.

Source: Oakman, J., Macdonald, W., Bartram, T., Keegel, T., & Kinsman, N. (2018). Safety Science, 101, 220-230.

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