Les lombalgies liées au travail

Les lombalgies représentent aujourd'hui 20 % des accidents du travail : c'est le chiffre révélé par une étude inédite de l'Assurance Maladie - Risques professionnels. Le nombre des lombalgies d'origine professionnelle ne diminue pas depuis dix ans en dépit de la baisse de la sinistralité. Elles coûtent près d'un milliard d'euros par an, soit l'équivalent du coût des autres troubles musculo-squelettiques (TMS). Certains secteurs d'activité présentent un sur-risque en matière de lombalgie, comme les métiers d'aide et de soins à la personne et les activités logistiques.

Source: http://www.inrs.fr/actualites/lombalgies-travail.html

Effects on musculoskeletal pain from “Take a Stand!”

A cluster-randomized controlled trial reducing sitting time among office workers
The intervention in Take a Stand! was effective in reducing sitting time among office workers, additionally this study shows that pain in neck-shoulders was reduced after the 3-month intervention period. For other pain sites, there were no changes, but for total pain score there was a slight reduction. This is relevant as musculoskeletal pain is very common among office workers.

Source: Danquah, I. H., Kloster, S., Holtermann, A., Aadahl, M., & Tolstrup, J. S. (2017). Scandinavian Journal of Work, Environment & Health.

Évaluer les interventions de prévention des RPS - TMS

Ce guide pratique accompagne étape par étape les intervenants dans leur démarche d'évaluation. Il propose des apports méthodologiques sur l'évaluation, des exemples illustratifs et une grille regroupant les conséquences potentielles des démarches de prévention des risques psychosociaux (RPS) et trouble musculosquelettiques (TMS). Il est accompagné du " Document d'évaluation de mon intervention " que l'intervenant pourra renseigner au fur et à mesure de sa démarche.
La démarche proposée permet de mesurer un large éventail des effets qu'une intervention produit et de les analyser au regard des méthodes mises en oeuvre et de la singularité des contextes rencontrés. Elle permet ainsi de mettre en valeur toute la richesse, la diversité et la complexité des interventions de prévention. 

Source: http://www.inrs.fr/media.html?refINRS=CC%2018

Human Body Mechanics of Pushing and Pulling: Analyzing the Factors of Task-related Strain on the Musculoskeletal System

The purpose of this review is to name and describe the important factors of musculoskeletal strain originating from pushing and pulling tasks such as cart handling that are commonly found in industrial contexts. A literature database search was performed using the research platform Web of Science. For a study to be included in this review differences in measured or calculated strain had to be investigated with regard to: (1) cart weight/ load; (2) handle position and design; (3) exerted forces; (4) handling task (push and pull); or (5) task experience. Thirteen studies met the inclusion criteria and proved to be of adequate methodological quality by the standards of the Alberta Heritage Foundation for Medical Research. External load or cart weight proved to be the most influential factor of strain. The ideal handle positions ranged from hip to shoulder height and were dependent on the strain factor that was focused on as well as the handling task. Furthermore, task experience and subsequently handling technique were also key to reducing strain. Workplace settings that regularly involve pushing and pulling should be checked for potential improvements with regards to lower weight of the loaded handling device, handle design, and good practice guidelines to further reduce musculoskeletal disease prevalence.

Source: Argubi-Wollesen, A., Wollesen, B., Leitner, M., & Mattes, K. (2017). Safety and Health at Work, 8(1), 11-18.

Integration of active pauses and pattern of muscular activity during computer work

Submaximal isometric muscle contractions have been reported to increase variability of muscle activation during computer work; however, other types of active contractions may be more beneficial. Our objective was to determine which type of active pause vs. rest is more efficient in changing muscle activity pattern during a computer task. Asymptomatic regular computer users performed a standardised 20-min computer task four times, integrating a different type of pause: sub-maximal isometric contraction, dynamic contraction, postural exercise and rest. Surface electromyographic (SEMG) activity was recorded bilaterally from five neck/shoulder muscles. Root-mean-square decreased with isometric pauses in the cervical paraspinals, upper trapezius and middle trapezius, whereas it increased with rest. Variability in the pattern of muscular activity was not affected by any type of pause. Overall, no detrimental effects on the level of SEMG during active pauses were found suggesting that they could be implemented without a cost on activation level or variability.

Source: St-Onge, N., Samani, A., & Madeleine, P. (2017). Ergonomics.

Associations of objectively measured sitting and standing with low-back pain intensity

A 6-month follow-up of construction and healthcare workers
This study investigated associations between sitting and standing, respectively, and low-back pain with objectively measured exposures for several days and a prospective design. Sitting at work and during full-day is negatively associated with cross-sectional- and prospective low-back pain intensity. This association was seen for the healthcare sector, but not for the construction sector.

Source: Lunde, L. K., Koch, M., Knardahl, S., & Veiersted, K. B. (2017). Scandinavian Journal of Work, Environment & Health.

Guide aménagement d'un poste d'accueil

Ce guide de prévention vous aidera à concevoir un poste d’accueil sécuritaire et fonctionnel ou à corriger les déficiences d’un poste existant. Il propose une démarche d’aménagement d’un poste d’accueil en quatre étapes : l’analyse des besoins, 
l’élaboration d’un concept, l’élaboration des caractéris­tiques détaillées du poste et, finalement, la validation et le suivi.
À chacune des étapes, l’implication des personnes qui travailleront de près ou de loin au poste d’accueil est essentielle. Ces personnes pourront préciser la nature du travail qui y sera réalisé, exprimer leurs besoins et valider les choix retenus.

Source: http://asstsas.qc.ca/publication/guide-amenagement-dun-poste-daccueil-gp72

Neck posture during lifting and its effect on trunk muscle activation and lumbar spine posture

Neck and head posture have been found to have a significant influence on the posture of the lower spine region during lifting and both an extended/upward gaze and a flexed/downward gaze have been hypothesized to lead to increased pain and/or overuse of the neck musculature. As a result, strength training recommendations have turned to the use of a retracted neck posture as being the safer posture to assume during lifting. This study examined trunk and neck muscle activity and lumbar spine posture in seven participants while performing moderate load lifts using a retracted neck posture (chin drawn in posteriorly; recently gaining popularity among coaches, trainers, and physical therapists to reduce neck pain during lifting, and freestyle neck posture (no instructions given). The retracted neck resulted in less lumbar spine flexion and increased lumbar erector spinae, external oblique, and sternocleidomastoid activity. The retracted posture also resulted in decreased activity in the thoracic erector spinae and dorsal neck musculature. The increased trunk and sternocleidomastoid activity and decreased spine flexion observed in the seven participants of this study when lifting with a retracted neck may have the potential to help lower the risk of spine pain/injury.

Source: Hlavenka, T. M., Christner, V. F., & Gregory, D. E. (2017). Applied Ergonomics, 62, 28-33.

Total Worker Health® Concepts to Reduce the Health Risks from Sedentary Work

U.S. workplaces have become increasingly sedentary, with resulting negative health effects. Through its Total Worker Health® Program, the National Institute for Occupational Safety and Health (NIOSH) recommends an integrated approach to addressing sedentary work environments. An integrated approach is one that protects workers from work-related injury and illness and helps them advance their overall health and well-being, on and off the job. This document describes organizational practices that can reduce the risks associated with sedentary work.

Source: https://www.cdc.gov/niosh/docs/wp-solutions/2017-131/

Qualitative ergonomics/human factors research in health care

Current state and future directions
The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care.

Source: Valdez, R. S., McGuire, K. M., & Rivera, A. J. (2017). Applied Ergonomics, 62, 43-71.

Implementing powered stretcher and load systems was a cost effective intervention to reduce the incidence rates of stretcher related injuries in a paramedic service

Paramedic services are considering moving towards the use of powered stretcher and load systems to reduce stretcher related injuries, but cost is perceived as a barrier. This study compared injury incidence rates, days lost, and compensation costs between Niagara Emergency Medical Service (NEMS) and Hamilton Paramedic Service (HPS) pre- (four years) and post- (one year) implementation of powered stretcher and load systems in NEMS. Prior to the intervention stretcher related musculoskeletal disorder (MSD) incidence rates averaged 20.0 (±6.8) and 17.9 (±6.4) per 100 full time equivalent (FTE), in NEMS and HPS respectively. One-year post intervention rates decreased to 4.3 per 100 FTE in NEMS, a 78% reduction. Rates modestly increased to 24.6 per 100 FTE in HPS in same period. Cost-benefit analysis estimated that the added cost to purchase powered stretcher and load systems would be recovered within their expected 7-year service life due to the reduction in compensation costs.

Source: Armstrong, D. P., Ferron, R., Taylor, C., McLeod, B., Fletcher, S., MacPhee, R. S., & Fischer, S. L. (2017). Applied Ergonomics, 62, 34-42.

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

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