2015-03-01 12:00 - Messages

Les troubles musculosquelettiques du rachis chez les assistantes maternelles

Les assistantes maternelles sont-elles exposées à des contraintes biomécaniques suffisantes pour établir un lien direct avec l'apparition de TMS du rachis ou de hernies discales ?
Pour répondre à cette question, une revue de la littérature a été effectuée et les réseaux de surveillance ont été interrogés. Aucune étude portant spécifiquement sur " assistantes maternelles " et " TMS " ne permet de répondre à la question posée. Cependant, les nuisances documentées dans la littérature, souvent la littérature grise, sont loin d'être négligeables.
Cette étude souligne la nécessité de renforcer, lors de la formation initiale et continue des assistantes maternelles, l'information sur la prévention de leurs risques professionnels et sur les aménagements possibles de leur poste de travail. Elle souligne également la nécessité d'un suivi par un service de santé au travail qui n'est actuellement pas mis en place.

Source: http://www.inrs.fr/media.html?refINRS=TC%20150

Gravitational demand on the neck musculature during tablet computer use

Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head–neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3–5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 < R2 < 0.64, p < 0.001). These findings provide quantitative data about mechanical requirements on the neck musculature during tablet computer use and are important for developing ergonomics guidelines.

Source: Anita N. Vasavada, Derek D. Nevins, Steven M. Monda, Ellis Hughes & David C. Lin. Ergonomics, 2015.
http://dx.doi.org/10.1080/00140139.2015.1005166

Effect of firefighters' personal protective equipment on gait

The biomechanical experiment with eight male and four female firefighters demonstrates that the effect of adding essential equipment: turnout ensemble, self-contained breathing apparatus, and boots (leather and rubber boots), significantly restricts foot pronation. This finding is supported by a decrease in anterior-posterior and medial-lateral excursion of center of plantar pressure (COP) trajectory during walking. The accumulation of this equipment decreases COP velocity and increases foot-ground contact time and stride time, indicating increased gait instability. An increase in the flexing resistance of the boots is the major contributor to restricted foot pronation and gait instability as evidenced by the greater decrease in excursion of COP in leather boots (greater flexing resistance) than in rubber boots (lower resistance). The leather boots also shows the greatest increase in foot contact time and stride time. These negative impacts can increase musculoskeletal injuries in unfavorable fire ground environments.

Source: Park H, Kim S, Morris K, Moukperian M, Moon Y, Stull. J. Appl. Ergon, 2015; 48: 42-48.
http://dx.doi.org/10.1016/j.apergo.2014.11.001

A Tailored Workplace Exercise Program for Women at Risk for Neck and Upper Limb Musculoskeletal Disorders

A Randomized Controlled Trial
Objective: The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain.
Methods: Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention.
Results: The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength.
Conclusions: This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.

Source: Rasotto, Chiara; Bergamin, Marco; Sieverdes, John C.; Gobbo, Stefano; Alberton, Cristine L.; Neunhaeuserer, Daniel; Maso, Stefano; Zaccaria, Marco; Ermolao, Andrea. Journal of Occupational & Environmental Medicine: February 2015, Volume 57, Issue 2, p. 178–183.
http://dx.doi.org/10.1097/JOM.0000000000000329

Association between objectively measured sitting time and neck–shoulder pain among blue-collar workers

OBJECTIVES: Prolonged sitting has been suggested as a risk factor for neck-shoulder pain (NSP). Using a cross-sectional design, we investigated the extent to which objectively measured time sitting is associated with NSP among blue-collar workers. METHODS: Sitting time was measured during multiple working days on male (n = 118) and female (n = 84) blue-collar workers (n = 202) using triaxial accelerometers (Actigraph) placed on the thigh and trunk. Workers were categorized into having, on average, a low, moderate or high sitting time, with mean values (SD between subjects) of 4.9 (1.0), 7.3 (0.5) and 9.6 (1.1) h in total per day. Workers rated their largest NSP intensity during the previous month on a numerical scale (0-9) and were subsequently dichotomized into a low and high NSP intensity group (ratings 0-4 and >4, respectively). Logistic regression analyses adjusted for several individual, and work-related factors were used to investigate the association between average sitting time per day (work, leisure and total) and NSP intensity. RESULTS: For total sitting time, workers in the high sitting category were more likely (adjusted OR 2.97, CI 1.25-7.03) to report high NSP intensity than those who sat moderately (reference category). Low sitting during work was associated with a reduced NSP intensity, but only for males (adjusted OR 0.26 CI 0.07-0.96). No significant association was found between sitting during leisure and NSP intensity. CONCLUSION: These findings suggest an association between sitting time, in total per day and specifically during work, and NSP intensity among blue-collar workers. We encourage studying the structure and explanation of this association further in prospective studies on larger populations.

Source: Hallman DM, Gupta N, Mathiassen SE, et al. Association between objectively measured sitting time and neck-shoulder pain among blue-collar workers. International Archives of Occupational and Environmental Health, 2015.
http://dx.doi.org/10.1007/s00420-015-1031-4

La grande distribution - Dossier

Vaste secteur aux emplois variés, la grande distribution représente l'un des premiers employeurs de France. Marquée par une forte sinistralité, elle a bénéficié d'un plan national d'actions concertées déployé par le réseau Assurance maladie-risques professionnels. Les efforts commencent à payer et un grand nombre d'entreprises restent suivies par les Caisses régionales de santé au travail, afin d'amplifier les actions de prévention en cours.

Source: Travail & Sécurité, no 759, mars 2015.
http://www.travail-et-securite.fr/ts/dossier/.html

Les troubles musculo-squelettiques du membre supérieur en France

Ce document de synthèse porte sur les troubles musculo-squelettiques (TMS) du membre supérieur. Dans ce document, le lecteur trouvera des données sur leur fréquence en termes de prévalence et d'incidence, ainsi que sur la fréquence des expositions aux principaux facteurs de risque connus, selon le sexe, l'âge, les catégories professionnelles et les grands secteurs d'activité. Il trouvera également des informations sur la part des TMS des membres supérieurs attribuable au travail, selon les catégories professionnelles et les grands secteurs d'activité et sur l'ampleur de la sous-déclaration au titre des tableaux de maladies professionnelles indemnisables.
Enfin, un certain nombre de questions permettent de mettre en perspective les résultats présentés.

Source: http://www.invs.sante.fr/Publications-et-outils/Rapports-et-syntheses/Travail-et-sante/2015/Des-indicateurs-en-sante-travail

Revised NIOSH Lifting Equation May generate spine loads exceeding recommended limits

The 1991 NIOSH Lifting Equation (NLE) is widely used to assess the risk of injury to spine by providing estimates of the recommended weight limit (RWL) in hands. The present study uses the predictive equations developed based on a detailed trunk musculoskeletal biomechanical model to verify whether the RWL generates L5-S1 loads within the limits (e.g., 3400 N for compression recommended by NIOSH and 1000 N for shear recommended in some studies). Fifty lifting activities are simulated here to evaluate the RWL by the NLE and the L5-S1 loads by the predictive equations. In lifting activities involving moderate to large forward trunk flexion, the estimated RWL generates L5-S1 spine loads exceeding the recommended limits. The NIOSH vertical multiplier is the likely cause of this inadequacy; a revised multiplier accounting for the trunk flexion angle is hence needed. The use of a fixed 3400 N compression limit is also questioned.

Source: Navid Arjmand, Mohammad Amini, Aboulfazl Shirazi-Adl, André Plamondon, Mohammad Parnianpour. International Journal of Industrial Ergonomics, Volume 47, May 2015, p. 1-8.
http://dx.doi.org/10.1016/j.ergon.2014.09.010

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