2018-09-01 12:00 - Messages

Overall risk index for patient transfers in total assistance mode executed by emergency medical technician-paramedics in real work situations

Few studies have quantified the risk of musculoskeletal disorders during patient transfers in total assistance mode in real-life prehospital emergency care situations. An index to assess the overall risk of patient transfers was created; it makes it possible to quantify risk based on the patient's position and the height of the patient's location. An analysis of 71 transfers executed by paramedics in actual work situations showed that moving a patient from the ground was characterized by acute sagittal flexions and axial rotations, respectively, 42% and 12% of the time. When the patient was lying on a raised surface, the lifting index and perceived exertion were the lowest (2.55; easy). According to the overall risk index, patient transfers from the ground are the riskiest. Paramedics execute many risky lifts even in favorable patient handling contexts.

Source: Larouche, D., Bellemare, M., Prairie, J., Hegg-Deloye, S. et Corbeil, P. (2019). Applied Ergonomics, 74, 177-185.
https://doi.org/10.1016/j.apergo.2018.08.029

A comparison of lumbar spine and muscle loading between male and female workers during box transfers

There is a clear relationship between lumbar spine loading and back musculoskeletal disorders in manual materials handling. The incidence of back disorders is greater in women than men, and for similar work demands females are functioning closer to their physiological limit. It is crucial to study loading on the spine musculoskeletal system with actual handlers, including females, to better understand the risk of back disorders. Extrapolation from biomechanical studies conducted on unexperienced subjects (mainly males) might not be applicable to actual female workers. For male workers, expertise changes the lumbar spine flexion, passive spine resistance, and active/passive muscle forces. However, experienced females select similar postures to those of novices when spine loading is critical. This study proposes that the techniques adopted by male experts, male novices, and females (with considerable experience but not categorized as experts) impact their lumbar spine musculoskeletal systems differently. Spinal loads, muscle forces, and passive resistance (muscle and ligamentous spine) were predicted by a multi-joint EMG-assisted optimization musculoskeletal model of the lumbar spine. Expert males flexed their lumbar spine less (avg. 21.9° vs 30.3-31.7°) and showed decreased passive internal moments (muscle avg. 8.9 % vs 15.9-16.0 %; spine avg. 4.7 % vs 7.1-7.8 %) and increased active internal moments (avg. 72.9 % vs 62.0-63.9 %), thus producing a different impact on their lumbar spine musculoskeletal systems. Experienced females sustained the highest relative spine loads (compression avg. 7.3 N/BW vs 6.2-6.4 N/BW; shear avg. 2.3 N/BW vs 1.7-1.8 N/BW) in addition to passive muscle and ligamentous spine resistance similar to novices. Combined with smaller body size, less strength, and the sequential lifting technique used by females, this could potentially mean greater risk of back injury. Workers should be trained early to limit excessive and repetitive stretching of their lumbar spine passive tissues.

Source: Gagnon, D., Plamondon, A. et Larivière, C. (2018). Journal of Biomechanics.
https://doi.org/10.1016/j.jbiomech.2018.09.017

Two-dimensional biomechanical thumb model for pipetting

Manual pipetting imposes repetitive movements, high force, and awkward postures on the thumb, fingers, and wrist, increasing the risk of musculoskeletal injuries. The purpose of this study is to provide a linear regression model to estimate the optimal pipetting grip height based on the two-dimensional biomechanical static thumb model developed in this study. This biomechanical static thumb model uses hand anatomy and static equilibrium conditions to estimate internal tendon forces against a given external force. Based on the model, we conclude that the optimal grip height is 3 cm in males and 2 cm in females in terms of grip strength and force efficiency. In addition, the model is validated by RMS EMG data from correlation analysis between the predicted internal tendon forces, with RMS EMG values of 0.65 for Flexor Pollicis Longus, 0.57 for Flexor Pollicis Brevis, and 0.61 for Adductor Pollicis.

Source: Kim, E. et Freivalds, A. (2018). International Journal of Industrial Ergonomics, 68, 165-175.
https://doi.org/10.1016/j.ergon.2018.07.008

An ergonomic field study to evaluate the effects of a rotatable handle piece on muscular stress and fatigue as well as subjective ratings of usability, wrist posture and precision during laparoscopic surgery

An explorative pilot study
Purpose: The interface between surgeon and the laparoscopic instrument is an important factor in biomechanical stress that may increase the risk of musculoskeletal complaints in surgeons. This article investigates the effect of a laparoscopic instrument with a rotatable handle piece (rot-HP) on muscular stress and fatigue during routine laparoscopic procedures (LP) as well as usability, wrist posture and working precision.
Methods: 40 LP (subtotal hysterectomies) performed by 11 surgeons were investigated. 20 LP were carried out with the rot-HP and 20 with a fixed (standard) laparoscopic handle piece instrument. Shoulder and arm muscle activity was monitored via surface electromyography (sEMG). The electrical activity (EA) and median power frequency (MPF) were used to determine muscular stress and fatigue. Usability, wrist posture, and working precision between handle piece conditions were assessed by a survey.
Results: Using the rot-HP did not reduce muscular stress. A tendency of muscular fatigue (increasing EA, decreasing MPF) occurred in the upper trapezius, middle deltoid and extensor digitorum muscles; however, no differences were found between handle pieces. Wrist posture was more comfortable using the rot-HP and working precision and usability tended to be preferred using the standard handle piece.
Conclusions: Although wrist posture seemed to be optimized by the rot-HP, no effect on muscular stress and fatigue was observed in routine LP (< 60 min duration). Optimization of wrist posture may provide positive effects in mid- or long-term procedures. However, sufficient familiarization with the new instrument is crucial since working precision and usability could be impaired.

Source: Kraemer, B., Seibt, R., Stoffels, A. K., Rothmund, R., Brucker, S. Y., Rieger, M. A. et Steinhilber, B. (2018). International archives of occupational and environmental health.
https://doi.org/10.1007/s00420-018-1344-1

The influence of external load configuration on trunk biomechanics and spinal loading during sudden loading

Sudden loading is a major risk factor for work-related lower back injuries among occupations involving manual material handling (MMH). The current study explored the effects of external weight configuration on trunk biomechanics and trunk rotational stiffness in the sagittal plane during sudden loading. Fifteen asymptomatic volunteers experienced sudden loadings using the same magnitude of weight (9 kg) with two different configurations (medially- or laterally-distributed) at three levels of height (low, middle and high). Results of this study showed that the medially distributed weight resulted in a significantly higher peak L5/S1 joint compression force (2861 N vs. 2694 N) and trunk rotational stiffness (2413 Nm/rad vs. 1785 Nm/rad) compared to the laterally distributed weight. It was concluded that when experiencing sudden loading, a more laterally distributed weight could increase the load's resistance to physical perturbations and alleviate spinal loading during sudden loading events.

Source: Madinei, S., Motabar, H. et Ning, X. (2018). Ergonomics.
https://doi.org/10.1080/00140139.2018.1489068

What do Workers do to Reduce Their Sitting Time?

The Relationships of Strategy use and Workplace Support with Desk-Based Workers' Behaviour Changes in a Workplace-Delivered Sitting-Reduction and Activity-Promoting Intervention
Objective: To explore workers' sitting-reduction and activity-promoting strategy use following an intervention targeting these changes, and whether strategy use and perceived workplace support impacted on three-month sitting and activity outcomes.
Methods: This secondary analysis in desk-based workers (n = 83) utilised data collected on questionnaire-derived strategy use and workplace support, and activPAL3TM-derived sitting (total; prolonged, ≥30mins) and activity (standing; stepping) at work.
Results: Fourteen strategies were commonly used during the intervention. Increased usage of some strategies were significantly (p < 0.05) associated with beneficial changes in prolonged sitting or stepping only. Workplace support was significantly beneficially associated with changes in sitting, prolonged sitting, and stepping; these associations were largely independent of strategy use changes.
Conclusions: Strategies were highly used, with increased use associated with some behavioural improvements. Workplace support appears essential for improving sitting and activity in the workplace.

Source: Brakenridge, C. L., Healy, G. N., Winkler, E. A. et Fjeldsoe, B. S. (2018). Journal of occupational and environmental medicine.
http://dx.doi.org/10.1097/JOM.0000000000001419

Anthropometry of the Canadian adult population

Developing comprehensive, updated normative-reference standards
Introduction: Applications of structural anthropometric measurements include user-centered design, health risk appraisal and assessment of biological maturity. It is important that anthropometric normative-reference standards are current, comprehensive, and population specific. Previous work by Pheasant (1996) included thirty-six anthropometric measurements to create a comprehensive and comparable list of data. However, Canadian studies have included nineteen or less body dimensions, and relatively small sample sizes. The aims of this investigation were to create current and comprehensive anthropometric normative-reference standards for a young Canadian adult population and to analyze the differences in anthropometric data between subjects in this study and those of a previous study on a similar population.
Methods: Thirty-six structural body dimensions were manually measured on a sample size of 197 male and 204 female Ontario, Canada university-aged subjects. Descriptive statistics were reported based on sex and independent samples t-tests were used to compare the anthropometric dimensions of the current study with that of a similar, previous study on Nova Scotia, Canada university-aged subjects.
Results: Percentiles and standard deviations of the subjects' 36 body dimensions were tabulated and are reported based on sex. For example, male and female 50th percentile values for stature are 1783?mm and 1641?mm, respectively. All differences in body dimensions between both male populations were statistically significant at p?<?0.01. All but four differences in body dimensions between both female populations were statistically significant at p?<?0.01.
Discussion & Conclusions: The current study was able to present anthropometric normative-reference standards of a large Canadian sample that are more comprehensive and current than known to exist. Moreover, as there were many significant differences between the current (Ontario) and previous (Nova Scotia) populations' anthropometric data, it is suggested that a Canada wide study be investigated.

Source: Deneau, J., van Wyk, P. M., Mallender, M. et Duquette, A. (2018). International Journal of Industrial Ergonomics, 68, 199-204.
https://doi.org/10.1016/j.ergon.2018.08.001

Surveillance de la lombalgie en lien avec le travail

Comparaison de quatre sources de données et perspectives pour la prévention
•Quatre sources de données sur les lombalgies en lien avec le travail sont comparées dans les Pays de la Loire : trois issues du réseau multi-volets de surveillance épidémiologique des TMS de Santé publique France et de l’Université d’Angers, et une issue du système de réparation des maladies professionnelles de l’Assurance maladie.
•Pour chaque source, les secteurs d’activité prioritaires pour la prévention ont été identifés à partir des taux de fréquence par secteurs d’activité et de l’indice de prévention, puis les résultats ont été comparés entre sources.
•Chez les hommes, les secteurs de la construction, de l’industrie manufacturière, des transports et communications et de l’agriculture ressortaient pour les 4 sources amenant à les cibler prioritairement pour les actions de prévention alors que chez les femmes, le secteur de l’industrie manufacturière, le secteur de la santé, action sociale, et le secteur du commerce devaient être prioritaires en termes d’actions de prévention des lomboradiculalgies.
•Les résultats sont cohérents et complémentaires, cependant l’utilisation d’une source unique pour la surveillance nationale des lombalgies pour orienter la prévention ne refèterait qu’un aspect du problème.
•Au niveau national, l’utilisation combinée de plusieurs sources de surveillance, chacune avec sa pertinence et ses limites, permet de détecter les secteurs d’activité à cibler de façon prioritaire et mettre en oeuvre des programmes de prévention.
•D’autres indicateurs, et notamment les arrêts de travail prolongés et le coût engendré par ces arrêts, auraient tout leur intérêt pour la surveillance nationale des lombalgies en lien avec le travail utile pour la mise en place de programmes de prévention.

Source: http://invs.santepubliquefrance.fr/Publications-et-outils/Rapports-et-syntheses/Travail-et-sante/2018/Surveillance-de-la-lombalgie-en-lien-avec-le-travail-comparaison-de-quatre-sources-de-donnees-et-perspectives-pour-la-prevention

Overall risk index for patient transfers in total assistance mode executed by emergency medical technician-paramedics in real work situations

Few studies have quantified the risk of musculoskeletal disorders during patient transfers in total assistance mode in real-life prehospital emergency care situations. An index to assess the overall risk of patient transfers was created; it makes it possible to quantify risk based on the patient's position and the height of the patient's location. An analysis of 71 transfers executed by paramedics in actual work situations showed that moving a patient from the ground was characterized by acute sagittal flexions and axial rotations, respectively, 42% and 12% of the time. When the patient was lying on a raised surface, the lifting index and perceived exertion were the lowest (2.55; easy). According to the overall risk index, patient transfers from the ground are the riskiest. Paramedics execute many risky lifts even in favorable patient handling contexts.

Source: Larouche, D., Bellemare, M., Prairie, J., Hegg-Deloye, S. et Corbeil, P. (2019). Applied Ergonomics, 74, 177-185.
https://doi.org/10.1016/j.apergo.2018.08.029

Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers

Evidence was provided for forceful hand-grip work, with and without vibration, as a risk factor for ulnar nerve entrapment (UNE) surgery in a large cohort of Swedish construction  workers. Several individual biomechanical factors comprising such work were associated with increased risk of UNE, including: increased grip force, upper extremity load, frequency of hand-held tool use, and hand arm vibration.

Source: Jackson, J. A., Olsson, D., Punnett, L., Burdorf, A., Järvholm, B. et Wahlström, J. (2018). Scandinavian journal of work, environment & health.
http://dx.doi.org/10.5271/sjweh.3757

The impact of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion interventions on office worker productivity

A cluster-randomized trial
A 12-week workplace combined ergonomics and neck-specific exercise intervention improves sickness presenteeism and monetized health-related productivity loss among a general population of office workers and longer-term sickness absenteeism for those with neck pain, when compared to ergonomics and health promotion education combined. This study provides employers of office workers sought-after evidence of health-related productivity benefit from such workplace interventions.

Source: Pereira, M., Comans, T., Sjøgaard, G., Straker, L., Melloh, M., O'Leary, S., ... et Johnston, V. (2018). Scandinavian journal of work, environment & health.
http://dx.doi.org/10.5271/sjweh.3760

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