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Work-related Musculoskeletal Disorders, a tri-sector exploration
High rates of WRMSD-related sick leave put pressure on employers and businesses, hitting their bottom lines and potentially leading to understaffing, reduced productivity and lower staff morale. Directly affected workers not only suffer pain but also consequences that can be felt across their working, home and social lives. The construction, healthcare and transportation and storage industries were selected as the focus of this research because they have significantly higher rates of WRMSDs compared with the average rate for all industry. Qualitative research was commissioned to: - Explore what...
Participatory organizational intervention for improved use of assistive devices in patient transfer
A single-blinded cluster randomized controlled trial Objectives: This randomized controlled trial (RCT) evaluated the effect of a participatory organizational intervention for improved use of assistive devices (AD) in patient transfer. Methods: We randomly allocated 27 departments from five hospitals in Denmark to a participatory intervention (14 clusters, 316 healthcare workers) or a control group (13 clusters, 309 healthcare workers). The intervention consisted of 2×2 hour workshops with managers, the hospital's health and safety staff, and 2–5 healthcare workers from each department...
Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence
Background: Symptoms of depression and musculoskeletal pain have both been found to be associated with increased risk of long term sickness absence (LTSA). The comorbidity between depression and pain i.e. simultaneous presence of both symptoms, is well established in the literature. The aim for the current investigation was to investigate whether the presence of comorbid pain influences the associations between depressive symptoms and LTSA or if the presence of comorbid depressive symptoms influences associations between musculoskeletal pain and LTSA. Methods: A sample of 6572 Danish female health...
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...
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...
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...
Hand forces exerted by long-term care staff when pushing wheelchairs on compliant and non-compliant flooring
Purpose-designed compliant flooring and carpeting have been promoted as a means for reducing fall-related injuries in high-risk environments, such as long-term care. However, it is not known whether these surfaces influence the forces that long-term care staff exert when pushing residents in wheelchairs. We studied 14 direct-care staff who pushed a loaded wheelchair instrumented with a triaxial load cell to test the effects on hand force of flooring overlay (vinyl versus carpet) and flooring subfloor (concrete versus compliant rubber [brand: SmartCells]). During straight-line pushing, carpet overlay...
Aide et soin à la personne - Dossier
En France, plus de 3,5 millions de professionnels travaillent dans l'aide et le soin à la personne. Ce secteur, qui emploie majoritairement du personnel féminin, est toujours en pleine croissance et marqué par une grande diversité d'acteurs. Certains exercent en établissement, d'autres au domicile d'un bénéficiaire avec, d'un lieu à l'autre, des conditions d'intervention et des moyens extrêmement variables. Source: (2018). Travail & sécurité (794). http://www.travail-et-securite.fr/ts/dossier...
Impact of a Safe Resident Handling Program in Nursing Homes on Return-to-Work and Re-injury Outcomes Following Work Injury
Purpose: This study examined the impact of a Safe Resident Handling Program (SRHP) on length of disability and re-injury, following work-related injuries of nursing home workers. Resident handling-related injuries and back injuries were of particular interest. Methods: A large national nursing home corporation introduced a SRHP followed by three years of training for 136 centers. Lost-time workers' compensation claims (3 years pre-SRHP and 6 years post-SRHP) were evaluated. For each claim, length of first episode of disability and recurrence of disabling injury were evaluated over time. Differences...
Manual handling risks to midwives associated with birthing pools literature review and incident analysis
This report describes research into the manual handling related risks to midwives associated with providing care to women choosing to use a birthing pool for labour and/or birth at home and in hospital. The research comprised: a review of incidents reported to the Health and Safety Executive, a literature review and familiarisation visits to include discussions with midwives to identify current practices and procedures. The manual handling risks are likely to result from the position of the mother in the pool, as well as from the position of the midwife whilst undertaking tasks at the birthing...
Ergonomic study on wrist posture when using laparoscopic tools in four different techniques regarding minimally invasive surgery
Purpose: With reference to four different minimally invasive surgery (MIS) cholecystectomy the aims were: to recognize the factors influencing dominant wrist postures manifested by the surgeon; to detect risk factors involved in maintaining deviated wrist postures; to compare the wrist postures of surgeons while using laparoscopic tools. Materials and methods: Video films were recorded during live surgeries. The films were synchronized with wrist joint angles obtained from wireless electrogoniometers placed on the surgeon's hand. The analysis was conducted for five different laparoscopic tools...
Differences in postural loading between primary and assistant surgeons during vaginal surgery
While increasing attention has been given to the prevalence of work-related musculoskeletal disorders (WMDs) among surgeons in various medical specialties, there is no quantitative information about the potential work-related risk factors that contribute to WMDs among vaginal surgeons in the operating room (OR). This study aimed to quantify the frequency and duration of awkward postures, as well as musculoskeletal discomfort experienced by primary and assistant vaginal surgeons during surgery in order to provide a first step of informing ergonomics interventions that reduce postural loading during...
Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses
A systematic review Background: Musculoskeletal injuries and musculoskeletal pain are prevalent among nurses compared to many other occupational groups. Objective: To identify interventions that may be effective at reducing the prevalence and impact of musculoskeletal injuries and pain in registered nurses. Results: Twenty studies met criteria for inclusion in the review. Types of interventions reported included: patient lift systems (N?=?8), patient handling training (N?=?3), multi-component interventions (N?=?7), cognitive behavioural therapy (N?=?1), and unstable shoes (N?=?1). Only two studies...
Barriers to the Use of Assistive Devices in Patient Handling
Work-related musculoskeletal disorders (WMSD) are a major safety concern in today’s health care environment due to the manual lifting of patients with higher acuity levels and obesity. Nurses move patients multiple times each day, incurring cumulative stress and trauma resulting in chronic pain and potential injury. The purpose of this study was to assess barriers to the use of assistive devices in safe patient handling and mobility (SPHM) that contribute to WMSD in health care workers. Interpersonal, situational, organizational, and environmental influences have both direct and indirect...
The efficacy of interventions for low back pain in nurses
A systematic review OBJECTIVES: To investigate the efficacy of interventions for the prevention and treatment of low back pain in nurses. DESIGN: Systematic review. DATA SOURCES: The review was registered on the PROSPERO database (CRD42015026941) and followed the PRISMA statement guidelines. A two phase approach was used. In phase one, all randomised controlled trials included in the systematic review of Dawson et al. (2007) which reviewed interventions for low back pain in nurses until 2004 were selected. In phase two, relevant randomised controlled trials and cluster randomised controlled trials...
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...
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...
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...
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...
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...
Identifying the critical physical demanding tasks of paramedic work
Towards the development of a physical employment standard Public safety related occupations including police, fire and military commonly apply physical employment standard (PES) to facilitate job matching, an approach to evaluate if candidates demonstrate acceptable physical capabilities as required to perform the job safely and effectively. In Canada, paramedics remain as one of the few public safety occupations without an evidence-based, validated PES. The purpose of this study was to document and describe the physical demands of paramedic work and to identify the most physically demanding tasks...
Paramedics' working strategies while loading a stretcher into an ambulance
For paramedics, loading a stretcher into an ambulance is an activity with a high risk of back injury and accidents. The objective of this study was to document strategies paramedics use at work while loading a powered stretcher into an ambulance. A total of 249 stretcher loading operations performed by 58 paramedics, and 51 semistructured post-intervention interviews were analyzed. Almost three quarters of loading operations required additional actions (e.g., raising the shoulders and additional lifting) to insert the stretcher into the cot fastener system in the ambulance. Some strategies that...
Méthode d'analyse de la charge physique de travail - Secteur sanitaire et social
La méthode d'analyse de la charge physique de travail dans le secteur sanitaire et social a été conçue pour être utilisée dans les établissements spécialisés (hôpitaux, cliniques, hébergements pour personnes âgées, handicapés, enfants) et les services d'aide et de soins à domicile. Elle permet de repérer et d'analyser les facteurs de risques pour l'appareil locomoteur en tenant compte de la globalité des composantes de l'activité. Elle propose une conduite...
A Study of the Prevalence of Musculoskeletal Disorders in Surgeons Performing Minimally Invasive Surgery
Introduction: Minimally invasive surgery (MIS) has shown significant benefits for patients and healthcare systems. However, due to the poor ergonomic adaptation of operating rooms and surgical instruments, most surgeons suffer from pain caused by musculoskeletal disorders (MSDs). Methods: A descriptive survey on MIS surgeons working on different surgical specialties has been carried out in Hospital Valdecilla (Spain). The aim is to determine the prevalence of MSDs by using a personal interview and the standardized Nordic questionnaire (SNQ). The study determines the prevalence of MSDs in different...
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 . http://dx.doi.org...
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