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.
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.
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.
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.
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).
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.
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.
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.
Étude sur dix pays européens
EUROGIP publie les résultats d'une étude sur la reconnaissance des troubles musculosquelettiques (TMS) en maladies professionnelles en Allemagne, Autriche, Belgique, Danemark, Espagne, Finlande, France, Italie, Suède et Suisse.
L'étude s'articule autour :
d'un panorama exhaustif des TMS susceptibles d'être reconnus en MP et des facteurs qui entrent en ligne de compte dans cette reconnaissance,
de 4 cas pratiques représentatifs de TMS fréquents chez les travailleurs - le syndrome du canal carpien, la tendinopathie de la coiffe des rotateurs, la lombalgie et l'épicondylite - qui permettent d'illustrer les pratiques en vigueur,
de statistiques comparées de sinistralité pour apprécier le volume de TMS pris en charge par chacun des pays et leur évolution entre 2007 et 2014.
Upper extremity musculoskeletal disorders (MSDs) include painful conditions and injuries of the muscles, tendons, joints and nerves that affect the neck, shoulders, elbows, wrists and hands. In Canada, upper extremity MSDs and low-back pain are the leading causes of disabling work-related injuries.
While there is general agreement that work hazards (such as repetitive, awkward and static postures, heavy loads, vibration, low job control and poor social support) can contribute to the development of upper extremity MSDs, there is less agreement on the most appropriate ways to reduce or eliminate these hazards. This systematic review, an update of another conducted about 10 years ago, sets out to find occupational health and safety (OHS) interventions that effectively prevent and manage upper extremity MSDs.
Health and safety in hand-intensive healthcare occupations Preventing work-related upper limb disorders
The main focus of previous research on musculoskeletal injuries in healthcare workers has been on back injuries, in particular to nurses. Less attention has been given to work-related upper limb disorders (WRULDs) specifically for those who are performing hand-intensive tasks as part of their work; that include precision hand and wrist movements, repetitive hand motions and sustained awkward postures. Professional healthcare workers such as physiotherapists, physical therapists, sports therapists and manual/manipulative therapists are exposed to risk factors for upper limb disorders on a daily basis, despite the irony that they treat patients and clients with musculoskeletal disorders, and also have specialist knowledge of body mechanics and injury prevention strategies. However physiotherapists and physical therapists are just typical occupations from a range of other health care occupations with hand-intensive work characteristics such as podiatrists, sonographers, dentists and many more.
A qualitative study with Australian office workers
Office workers spend a large proportion of their working hours sitting. This may contribute to an increased risk of chronic disease and premature mortality. While there is growing interest in workplace interventions targeting prolonged sitting, few qualitative studies have explored workers' perceptions of reducing occupational sitting outside of an intervention context. This study explored barriers to reducing office workplace sitting, and the feasibility and acceptability of strategies targeting prolonged sitting in this context.
Source: Hadgraft, N. T., Brakenridge, C. L., LaMontagne, A. D., Fjeldsoe, B. S., Lynch, B. M., Dunstan, D. W., ... & Lawler, S. P. (2016). BMC Public Health, 16(1), 933.
BACKGROUND: Harmful health effects associated with sedentary behaviour may be attenuated by breaking up long periods of sitting by standing or walking. However, studies assess interruptions in sitting time differently, making comparisons between studies difficult. It has not previously been described how the definition of minimum break duration affects sitting outcomes. Therefore, the aim was to address how definitions of break length affect total sitting time, number of sit-to-stand transitions, prolonged sitting periods and time accumulated in prolonged sitting periods among office workers. METHODS: Data were collected from 317 office workers. Thigh position was assessed with an ActiGraph GT3x+ fixed on the right thigh. Data were exported with varying bout length of breaks. Afterwards, sitting outcomes were calculated for the respective break lengths. RESULTS: Absolute numbers of sit-to-stand transitions decreased, and number of prolonged sitting periods and total time accumulated in prolonged sitting periods increased, with increasing minimum break length. Total sitting time was not influenced by varying break length. CONCLUSIONS: The definition of minimum break length influenced the sitting outcomes with the exception of total sitting time. A standard definition of break length is needed for comparison and interpretation of studies in the evolving research field of sedentary behaviour.
Source: Kloster S, Danquah IH, Holtermann A, et al. (2016). Journal of Physical Activity & Health.
Comprendre pour agir en prévention
Le départ précoce de la plupart des pâtissiers salariés de l'artisanat, survenant bien avant l'âge légal de la retraite, constitue à la fois un paradoxe et un défi de prévention en santé au travail. Le présent article fondé sur une analyse pluridisciplinaire décrit l'activité et les altérations de santé caractéristiques de ce métier, ses contraintes et la tension entre deux configurations différentes d'exercice. Des marges de progrès et des actions possibles de prévention à adapter aux particularités de l'entreprise sont décrites.
Source: PICHENE-HOUARD A., LAPOIRE-CHASSET M., MARTEL L., GAUDART C., VOLKOFF S., CLAUDON L. Références en santé au travail, septembre 2016, no 147, p. 51-68.
A randomized controlled trial
This paper notes that a careful case definition of workers with previous history of low-back pain (LBP) is needed to better characterize sub-groups based on their recurrences profile. Workers with highly recurrent LBP may require a stepped secondary prevention in order to prevent recurrences and sick leave. The value of a workplace component reducing physical and psychosocial risks in secondary prevention of LBP must be explored.
Source: Chaléat-Valayer E, Denis A, Abelin-Genevois K, Zelmar A, Siani-Trebern F, Touzet S, Bergeret A, Colin C, Fassier J-B. Scand J Work Environ Health, 2016.
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