Troubles musculo-squelettiques

Occupational lifting and pelvic pain during pregnancy

Maryse Gagnon — Tue, 08 May 2012 17:19:00 GMT

A study within the Danish National Birth Cohort
Objectives : Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim of this study was to examine the association between occupational lifting and pelvic pain during pregnancy.
Methods : The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996–2002. During pregnancy, the women provided information on occupational lifting (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression.
Results : Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg) was associated with an increased risk of pelvic pain during pregnancy as compared to no such lifting. A confounder-adjusted exposure-response relation was observed between self-reported total loads lifted and pelvic pain during pregnancy. Daily lifting of both medium (11–20 kg) and heavy loads (>20 kg) were associated with increased risk, and the highest risk was observed among women who lifted heavy loads independent of exposure to medium loads.
Conclusion : Occupational lifting may increase the risk of pelvic pain during pregnancy.

Source : Larsen P, Strandberg-Larsen K, Juhl M, Svendsen SW, Bonde JP, Nybo Andersen A-M. Scand J Work Environ Health. 2012.
http://dx.doi.org/10.5271/sjweh.3304

Psychosocial precursors and physical consequences of workplace violence towards nurses

Maryse Gagnon — Mon, 07 May 2012 11:51:00 GMT

A longitudinal examination with naturally occurring groups in hospital settings
BACKGROUND: Workplace violence towards nurses is prevalent and consequential, contributing to nurses' reduced health and safety, worsened job attitudes, and compromised productivity. OBJECTIVES: To examine if organizational violence prevention climate as perceived by nurses predicts nurses' physical violence exposure and if physical violence exposure predicts nurses' somatic symptoms and musculoskeletal disorder symptoms. DESIGN: A two-wave longitudinal design with naturally occurring groups, with a 6-month interval. METHODS: Analysis of covariance and logistic regression were applied to test the proposed hypotheses among 176 nurses from two hospitals in the U.S. who participated in both surveys required by this study. All nurses from the two hospitals were recruited to participate voluntarily. The response rate was 30% for the first survey and 36% for the follow-up survey. Among the subjects, only 8 were male. On average, the subjects were about 45 years old, had a job tenure of about 17 years, and worked approximately 37h per week. RESULTS: Violence prevention climate, specifically the dimension of perceived pressure against violence prevention, predicted nurses' chance of being exposed to physical violence over six months (odds ratio 1.69), with no evidence found that violence exposure affected change in climate reports. In addition, results supported that nurses' physical violence exposure had effects on somatic symptoms, and upper body, lower extremity, and low back pain over six months. CONCLUSIONS: Findings of this study suggest that reducing organizational pressure against violence prevention will help decrease the chance of nurses' physical violence exposure and benefit their health and safety.

Source : Yang LQ, Spector PE, Chang CH, Gallant-Roman M, Powell J. Int. J. Nurs. Stud. 2012.
http://dx.doi.org/10.1016/j.ijnurstu.2012.03.006

Individual participant data meta-analysis of mechanical workplace risk factors and low back pain

Maryse Gagnon — Thu, 03 May 2012 16:37:00 GMT

Objectives. We used individual participant data from multiple studies to conduct a comprehensive meta-analysis of mechanical exposures in the workplace and low back pain.
Methods. We conducted a systematic literature search and contacted an author of each study to request their individual participant data. Because outcome definitions and exposure measures were not uniform across studies, we conducted 2 substudies: (1) to identify sets of outcome definitions that could be combined in a meta-analysis and (2) to develop methods to translate mechanical exposure onto a common metric. We used generalized estimating equation regression to analyze the data.
Results. The odds ratios (ORs) for posture exposures ranged from 1.1 to 2.0. Force exposure ORs ranged from 1.4 to 2.1. The magnitudes of the ORs differed according to the definition of low back pain, and heterogeneity was associated with both study-level and individual-level characteristics.
Conclusions. We found small to moderate ORs for the association of mechanical exposures and low back pain, although the relationships were complex. The presence of individual-level OR modifiers in such an area can be best understood by conducting a meta-analysis of individual participant data.

Source : http://www.iwh.on.ca/biblio/individual-participant-data-meta-analysis-of-mechanical-workplace-risk-factors-and-low-back

A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain

Maryse Gagnon — Tue, 01 May 2012 17:11:00 GMT

Background. Back pain is a common problem and a major cause of disability and health care utilization. Purpose. To evaluate the efficacy, harms, and costs of the most common CAM treatments (acupuncture, massage, spinal manipulation, and mobilization) for neck/low-back pain. Data Sources. Records without language restriction from various databases up to February 2010. Data Extraction. The efficacy outcomes of interest were pain intensity and disability. Data Synthesis. Reports of 147 randomized trials and 5 nonrandomized studies were included. CAM treatments were more effective in reducing pain and disability compared to no treatment, physical therapy (exercise and/or electrotherapy) or usual care immediately or at short-term follow-up. Trials that applied sham-acupuncture tended towards statistically nonsignificant results. In several studies, acupuncture caused bleeding on the site of application, and manipulation and massage caused pain episodes of mild and transient nature. Conclusions. CAM treatments were significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment. CAM therapies did not significantly reduce disability compared to sham. None of the CAM treatments was shown systematically as superior to one another. More efforts are needed to improve the conduct and reporting of studies of CAM treatments.

Source : http://www.iwh.on.ca/biblio/a-systematic-review-and-meta-analysis-of-efficacy-cost-effectiveness-and-safety-of-selected

Health-related effects of early part-time sick leave due to musculoskeletal disorders

Maryse Gagnon — Fri, 27 Apr 2012 13:53:00 GMT

A randomized controlled trial
Objective : Previously we reported that early part-time sick leave enhances return to work (RTW) among employees with musculoskeletal disorders (MSD). This paper assesses the health-related effects of this intervention.
Methods : Patients aged 18–60 years who were unable to perform their regular work due to MSD were randomized to part- or full-time sick leave groups. In the former, workload was reduced by halving working time. Using validated questionnaires, we assessed pain intensity and interference with work and sleep, region-specific disability due to MSD, self-rated general health, health-related quality of life (measured via EuroQol), productivity loss, depression, and sleep disturbance at baseline, 1, 3, 8, 12, and 52 weeks. We analyzed the repeated measures data (171–356 observations) with the generalized estimating equation approach.
Results : The intervention (part-time sick leave) and control (full-time sick leave) groups did not differ with regard to pain intensity, pain interference with work and sleep, region-specific disability, productivity loss, depression, or sleep disturbance. The intervention group reported better self-rated general health (adjusted P=0.07) and health-related quality of life (adjusted P=0.02) than the control group. In subgroup analyses, the intervention was more effective among the patients whose current problem began occurring <6 weeks before baseline and those with ≤30% productivity loss at baseline.
Conclusions : Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability, but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD.

Source : Shiri R, Kausto J, Martimo K-P, Kaila-Kangas L, Takala E-P, Viikari-Juntura E. Scand J Work Environ Health. 2012.
http://dx.doi.org/10.5271/sjweh.3301

Long-Term Efficacy of an Ergonomics Program That Includes Patient-Handling Devices on Reducing Musculoskeletal Injuries to Nursing Personnel

Maryse Gagnon — Thu, 19 Apr 2012 16:19:00 GMT

Objective: The aim of this study was to evaluate long-term efficacy of an ergonomics program that included patient-handling devices in six long-term care facilities (LTC) and one chronic care hospital (CCH).
Background: Patient handling is recognized as a major source of musculoskeletal disorders (MSDs) among nursing personnel, and several studies have demonstrated effectiveness of patient-handling devices in reducing those MSDs. However, most studies have been conducted in a single facility, for a short period, and/or without a comprehensive ergonomics program.
Method: Patient-handling devices along with a comprehensive ergonomics program was implemented in six LTC facilities and one CCH. Pre- and post-intervention injury data were collected for 38.9 months (range = 29 to 54 months) and 51.2 months (range = 36 to 60 months), respectively.
Results: Postintervention patient-handling injuries decreased by 59.8% (rate ratio [RR] = 0.36, 95% confidence interval [CI] [0.28, 0.49], p < .001), lost workdays by 86.7% (RR = 0.16, 95% CI [0.13, 0.18], p < .001), modified-duty days by 78.8% (RR = 0.25, 95% CI [0.22, 0.28],p < .001), and workers' compensation costs by 90.6% (RR = 0.12, 95% CI [0.09, 0.15], p < .001). Perceived stresses to low back and shoulders among nursing staff were fairly low. A vast majority of patients found the devices comfortable and safe. Longer transfer times with the use of devices was not an issue.
Conclusion: Implementation of patient-handling devices along with a comprehensive program can be effective in reducing MSDs among nursing personnel. Strategies to expand usage of patient-handling devices in most health care settings should be explored.

Source : GARG, Arun, et Jay M. KAPELLUSCH. Human Factors, March 16, 2012.
http://dx.doi.org/10.1177/0018720812438614

Z1004-12 - Workplace ergonomics - A management and implementation standard

Maryse Gagnon — Mon, 16 Apr 2012 11:37:00 GMT

This is the first edition of CSA Z1004, Workplace ergonomics - A management and implementation Standard. This Standard sets out requirements and provides guidance for the systematic application of ergonomics to the development, design, use, management, and improvement of work systems through the implementation of an Ergonomics Process. The objective of this Standard is to enable an organization to enhance worker health, safety, and well-being and optimize system performance to prevent occupational injuries, illnesses, and fatalities and/or reduce the severity of harm related to occupational activities and work environments.

Source : http://shop.csa.ca/fr/canada/general-workplace-ergonomics/z1004-12/invt/27032732012/?utm_source=ohs-news-apr12&utm_medium=newsletter&utm_term=z1004-12&utm_content=html-txt-link&utm_campaign=health&utm_language=fr

Work-related injury and ill-health among mountain instructors in the UK

Maryse Gagnon — Wed, 11 Apr 2012 12:42:00 GMT

In most industrialised countries, work-related injury and ill-health presents a major burden to society. Musculoskeletal disorders and stress are the most common reported illness types with those working in some industries more at risk than others. This study aimed to understand the occupational health issues of those working as mountain instructors in the outdoor sector within the UK and to identify the cultural norms and behaviours among this unique occupational group which influence health. Semi-structured, telephone interviews were conducted with 20 qualified mountaineers to gain information on work-related injury and ill-health. The majority of interviewees reported a current work-related musculoskeletal problem. Key factors were identified which prevented effective rehabilitation, including; a 'macho' attitude among young instructors, self-imposed extended working hours/days and mismanagement of injuries. Self-employed instructors reported that sick leave after a minor injury or illness was not financially viable. Work-related issues leading to stress were also reported.

Source : McDermott H, Munir F. Safety Sci. 2012; 50(4): 1104-1111.
http://dx.doi.org/10.1016/j.ssci.2011.11.014

Une nouvelle norme pour améliorer les conditions de travail des caissiers et caissières

Maryse Gagnon — Wed, 04 Apr 2012 18:30:00 GMT

Afin d'améliorer les conditions de travail des caissiers et caissières, de réduire les risques, une nouvelle norme AFNOR est désormais disponible pour améliorer l'ergonomie des postes de travail.
Tendinites, douleurs dorsales et cervicales, troubles musculo-squelettiques (TMS), stress… sont quelques-unes des nombreuses pathologies qui frappent les caissiers et caissières. Il devenait urgent de s'intéresser au problème.
Ainsi, la nouvelle norme AFNOR NF X35-701 s'applique à l'ergonomie des postes de travail des caissiers et caissières pour lesquels elle définit depuis le 29 mars, les exigences relatives :
•à la conception,
•aux matériels,
•aux espaces de travail.

Source : http://www.preventica.com/actu-enbref-condition-travail-caissiers-caissieres-3020412.php

The Influence of Ergonomic Devices on Mechanical Load during Patient Handling Activities in Nursing Homes

Maryse Gagnon — Tue, 20 Mar 2012 12:43:00 GMT

Objectives: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities.
Methods: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distinct patient handling activities, defined by transferring a patient, providing personal care, repositioning patients in the bed, and putting on and taking off anti-embolism stockings. During real-time observations over ∼60 h among 186 nurses on 735 separate patient handling activities in 17 nursing homes, it was established whether ergonomic devices were actually used. Mechanical load was assessed through observations of frequency and duration of a flexed or rotated trunk >30° and frequency of pushing, pulling, lifting or carrying requiring forces <100 N, between 100 and 230 N, and >230 N from start to end of each separate patient handling activity. The number of patients and nurses per ward and the ratio of nurses per patient were used as ward characteristics with potential influence on mechanical load. A mixed-effect model for repeated measurements was used to determine the influence of ergonomic devices and ward characteristics on mechanical load.
Results: Use of ergonomic devices was required according to national guidelines in 520 of 735 (71%) separate patient handling activities, and actual use was observed in 357 of 520 (69%) patient handling activities. A favourable ratio of nurses per patient was associated with a decreased duration of time spent in awkward back postures during handling anti-embolism stocking (43%), patient transfers (33%), and personal care of patients (24%) and also frequency of manually lifting patients (33%). Use of lifting devices was associated with a lower frequency of forces exerted (64%), adjustable bed and shower chairs with a shorter duration of awkward back postures (38%), and an anti-embolism stockings slide with a lower frequency of forces exerted (95%).
Conclusions: In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.

Source : KOPPELAAR, Elin, Hanneke J.J, KNIBBE, Harald, S. MIEDEMA, et Alex BURDOFF. Annals of Occupational Hygiene, mars 2012 p. 1-11.
http://dx.doi.org/10.1093/annhyg/mes009

Guide - Ergonomie du bureau

Denise Chicoine — Thu, 15 Mar 2012 18:05:00 GMT

L'aménagement ergonomique des postes informatisés est une condition essentielle, mais insuffisante pour la prévention des TMS. Nous savons maintenant qu'il est malsain de demeurer trop longtemps assis devant un ordinateur. L'organisation des tâches doit prévoir de bouger et de se lever régulièrement de son poste de travail si l'on veut prévenir les TMS.
Ce guide présente un résumé pratique de l'état des connaissances sur l'ergonomie du bureau. Les principes proposés peuvent s'appliquer à d'autres secteurs que celui du bureau.

Éditeur : ASSTSAS ; Auteur : Christine Lamarche, Rose-Ange Proteau, Jocelyn Villeneuve; Parution : Mars 2012 ; Nombre de pages : 124.

Source : http://www.asstsas.qc.ca/publications/publications-specialisees/guides-de-prevention/guide-ergonomie-du-bureau.html

Ache och melancholy

Maryse Gagnon — Thu, 15 Mar 2012 12:17:00 GMT

Co-occurence of musculoskeletal pain and depressive symptoms in Finland
It is important to recognise the connection between musculoskeletal pain and depression in regard to work ability, well-being at work and continuing to work. When present at the same time, they may strengthen each other's negative effect on the quality of life, functional capacity and work ability. The co-occurrence may increase visits to the doctor, sickness absences, work incapacity and early retirement.

Source : http://www.ttl.fi/en/news/Pages/Ache_och_melancholy.aspx

Musculoskeletal injuries among hospital patient care staff before and after implementation of patient lift and transfer equipment

Maryse Gagnon — Fri, 09 Mar 2012 16:38:00 GMT

Objective: Using an observational research design and robust surveillance data, we evaluated rates of musculoskeletal (MS) injuries, days away from work, and restricted work days among patient care staff at a medical center and community hospital in the United States over 13 years, during which time a “minimal manual lift” policy and mechanical lift equipment were implemented.
Methods: Workers’ compensation claims data were linked to human resources data to define outcomes of interest and person-time at risk to calculate rates. Poisson and negative binomial regression with lagging were used to compare outcome rates in different windows of time surrounding the intervention. Patterns of MS injuries associated with patient-handling were contrasted to patterns of other MS injuries that would not be affected by the use of mechanical lift equipment.
Results: At the medical center, no change in the patient-handling MS injury rate followed the intervention. A 44% decrease was observed at the community hospital. At both hospitals, the rate of days away declined immediately – before it was reasonable for the intervention to have been adopted.
Conclusions: Institutional-level changes at the time of the intervention likely influenced observed results with findings only partially consistent with an intervention effect. Observational studies can be useful in assessing effectiveness of safety interventions in complex work environments. Such studies should consider the process of intervention implementation, the time needed for intervention adoption, and the dynamic nature of work environments.

Source : Schoenfisch AL, Lipscomb HJ, Pompeii LA, Myers DJ, Dement JM. Musculoskeletal injuries among hospital patient care staff before and after implementation of patient lift and transfer equipment. Scand J Work Environ Health. 2012.
http://dx.doi.org/10.5271/sjweh.3288

Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

Maryse Gagnon — Fri, 02 Mar 2012 19:24:00 GMT

OBJECTIVES: Epidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In this study, we aimed to relate periods of high peak exposure during computer use with the occurrence of neck-shoulder (NS) and arm-wrist-hand (AWH) symptoms.
METHODS: A prospective cohort study among 1951 office workers was carried out for two years, with periodical questionnaires and continuous measurements of computer input use. To define peak exposure, a distinction was made between peak days and weeks. Peak days were defined as days with a long duration of computer (ie, ≥4 hours) or mouse use (ie, ≥2.5 hours) or days with high frequency of mouse (ie, ≥20 clicks per minute) or keyboard use (ie, ≥160 keystrokes per minute). Weeks containing ≥3 peak days were considered peak weeks. Independent variables were numbers of peak days and peak weeks during a 3-month measurement period; dependent variables were self-reported NS and AWH symptoms during the following 3-month measurement period.
RESULTS: Valid data were available for 2116 measurements of 774 office workers. No relation was found between any of the peak exposure parameters and AWH symptoms or with peak exposure in duration and NS symptoms. Most parameters referring to high frequency-related peak exposure were associated with less NS symptoms, but the effect estimates were very small and the confidence intervals close to the null.
CONCLUSION: In this study, we found no indication that high peaks in computer use were related to the occurrence of NS or AWH symptoms.

Source : Richter JM, van den Heuvel SG, Huysmans MA, van der Beek AJ, Blatter BM. Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms? Scand J Work Environ Health. 2012;38(2):155-162.
http://www.sjweh.fi/show_abstract.php?abstract_id=3196

Risk factors for incidence of rotator cuff syndrome in a large working population

Maryse Gagnon — Tue, 28 Feb 2012 15:53:00 GMT

Objectives: The aim of this study was to assess the effects of personal and work-related factors on the incidence of rotator cuff syndrome (RCS) in a large working population.
Methods: A total of 3710 French workers were included in a cross-sectional study in 2002–2005. All completed a self-administered questionnaire about personal factors and work exposure. Using a standardized physical examination, occupational physicians established a diagnosis of RCS. Between 2007–2010, 1611 workers were re-examined. Associations between RCS and risk factors at baseline were analyzed by logistic regression.
Results: A total of 839 men and 617 women without RCS at baseline were eligible for analysis. RCS was diagnosed in 51 men (6.1%) and 45 women (7.3%). The risk of RCS increased with age for both genders [odds ratio (OR) 4.7 (95% confidence interval [95% CI] 2.2–10.0) for men aged 45–49 years and 5.4 (95% CI 2.3–13.2) for women aged 50–59 years; reference <40 years]. For men, the work-related risk factors were repeated posture with the arms above the shoulder level combined with high perceived physical exertion [OR 3.3 (95% CI 1.3–8.4)] and low supervisor support [OR 2.0 (95% CI 1.1–3.9)]. For women, working with colleagues in temporary employment [OR 2.2 (95% CI 1.2–4.2)] and repeated arm abduction (60–90°) [OR 2.6 (95% CI 1.4–5.0)] were associated with RCS.
Conclusions: Age was the strongest predictor for incident cases of RCS, and arm abduction was the major work-related risk factor for both genders. Lack of social support was a predictor for RCS among men.

Source : Bodin J, Ha C, Petit Le Manac'h A, Sérazin C, Descatha A, Leclerc A, Goldberg M, Roquelaure Y. Scand J Work Environ Health. 2012.
http://dx.doi.org/10.5271/sjweh.3285