Manual Handling Injuries in Health Care Workers

Nursing aides are particularly susceptible to manual handling injuries because they have the primary responsibility for heavy lifting. The aim of this study was to determine why a specific group of nursing aides have the highest manual handling injury rate in their hospital. The study investigated the adequacy of the manual handling training program, knowledge of manual handling, mechanical aid availability, and use of mechanical aids. Results indicated that the nursing aides’ manual handling knowledge was adequate but that they rarely used mechanical aids. This lack of use of aids was in part due to an over-reliance on their own strength and abilities. This may have been due to a lack of suitable mechanical aids on the wards or a lack of familiarity with the available aids. This study suggests that neither training alone nor the purchase of equipment alone is likely to resolve manual handling problems.     

Back injuries among nursing personnel — identification of work conditions with cluster analysis

The aim of the present study was to identify work conditions that are typical for nursing personnel and relevant for the risk of back injuries, and to analyse how individual characteristics contribute to the risk of injuries in these situations. Six well-defined clusters were identified by cluster analysis. Two clusters had an over-representation of injuries and they were characterised by a combination of full-time work, work on a rolling schedule, regular patient transfers and a high proportion of assistant nurses. In the three clusters with a lower proportion of injuries the nurses worked part-time. In the cluster with the lowest rate of injuries no one performed regular patient transfers. Working part-time seemed to be a preventive factor for back injury, even when regular patient transfers were performed. The decreased risk of injury among the general registered nurses may thus be a joint effect of fewer working hours, fixed working schedule and less patient handling. The advantages of cluster analysis for detecting the pattern of interacting risk indicators and modifiers are discussed.     

A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses

INTRODUCTION: Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan. METHOD: We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions. RESULTS: A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07). IMPACT ON INDUSTRY: The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.     

Harmful postures and musculoskeletal symptoms among sanitation workers of a fish processing factory in ghana: a preliminary investigation.

This study investigated musculoskeletal symptoms among sanitation workers of a fish-processing factory. The methods used included administration of a questionnaire, walk through observation, interview, task analysis and future workshop. All 27 male participants answered and submitted their questionnaires. Of the 11 operations identified, all except one was considered safe. Bent back, bent legs, and heavy manual handling were observed to impose intolerable health risk on participants. This corresponds with questionnaire results in which musculoskeletal symptoms were mostly prevalent in the neck, the shoulder, the low back, the wrists/hands and the upper back regions. Poor psychosocial complaints were also made on the job. There was no significant correlation (p < .05) between musculoskeletal symptoms and age, working hours and length of service. Neither was any significant correlation observed (p < .05) between psychosocial work factors and musculoskeletal symptoms. Recommendations such as task redesign to eliminate high-risk elements in operations, workplace changes and worker training were suggested.     

Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah

A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s^?2 and at vector sum was 0.29 (0.07) m·s^?2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.     

Lifting technique and abdominal belt usage: a biomechanical, physiological and subjective investigation

Some 10 male subjects carried out a repetitive lifting task for 15 min under four conditions on separate days. Subjects used either a squat lifting or a stoop lifting technique with or without an abdominal belt on each day. Measurements of spinal shrinkage, heart rate, perceived exertion and regional body pain were made under each condition. Although there was a significant difference in spinal shrinkage under all lifting conditions compared with shrinkage during 15 min of quiet standing (4.36 ± 2.24 vs. 1.13 ± 1.18 mm), there were no significant differences in shrinkage between the conditions. The subjects' heart rates were higher during the squat lift than the stoop lift (123 vs. 97 beats/min; p < 0.001). While the squat lift was perceived to be the safest lift by 90% of the subjects, 60% regarded this lift as the least preferred method (with or without the belt). Although all 10 subjects perceived the safest lifting method to involve the use of the belt, 50% rated the belt as their least preferred lifting condition. The findings cast doubt on the efficacy and acceptability of both abdominal belts and the practice of training workers in ‘safe’ lifting techniques and indicate that individual characteristics and preferences need to be considered when attempting to improve the safety of manual handling operations in industry.     

Epidemiological and biomechanical evaluation of airline baggage handling

Objectives. Musculoskeletal disorders (MSDs) are prevalent among airline baggage handlers due to manual materials handling. In this study, the Nordic musculoskeletal questionnaire (NMQ), the revised National Institute for Occupational Safety and Health (NIOSH) lifting equation, and the University of Michigan 3D Static Strength Prediction Program? (3DSSPP) were used to analyze MSDs among baggage handlers. Methods. The NMQ was filled out by 209 baggage handlers and 46 arbitrarily selected baggage handlers were evaluated using the NIOSH method and 3DSSPP. Results. The obtained results showed that the most common MSDs occurred in the lower back region. The next risky regions included knees, neck, and upper back, respectively. The NIOSH results confirmed that the subjects lifted loads heavier than the permitted limit and their lifting postures were inappropriate. The results of the 3DSSPP also indicated that compression forces exceeded the NIOSH limit in these awkward postures. Conclusions. Relying on this study, holding compulsory ergonomic lifting training courses could be proposed for workers and regulations adjusting an upper limit for maximum baggage weight must be also enacted in order to improve occupational health and prevent the prevalence of increasing MSDs.     

Epidemiology of musculoskeletal symptoms among Korean hospital nurses.

We investigated the epidemiology of musculoskeletal symptoms (MSS) among a complete cross-section of 330 nurses from a large Korean hospital, by means of a questionnaire survey (response rate: 97.9%). The prevalence of MSS at any body site was 93.6%, with symptoms most commonly reported at the shoulder (74.5%), lower back (72.4%), neck (62.7%), lower legs (52.1%) and hand/wrist (46.7%). Logistic regression indicated that nurses who undertook manual handling of patients were 7.2 times as likely to report MSS (OR 7.2, 95%CI 1.2-42.3, P = .0275), while nurses suffering from periodic depression experienced a 3.3-fold MSS risk (OR 3.3, 95%CI 1.3-8.3, P = .0104). Overall, our study suggests that Korean nurses incur a very high MSS burden when compared internationally. A greater commitment is needed to improve physical conditions, occupational tasks and psychosocial work issues among nurses in this country.     

Ergonomics Intervention in an Iranian Tire Manufacturing Industry

The aim of an ergonomics intervention conducted in the tire manufacturing industry was to improve working conditions. Before the start, a senior manager supported the intervention. Participants were divided into teams and trained. After observing the overall performance of the teams, over 100 improvements were successfully implemented. After the improvements, there were statistically significant differences in annual and weekly prevalence of, and annual disability reported for, the upper back, the lower back, knees and wrists between before and after intervention. The annual prevalence of upper back, lower back, knee and wrist complaints decreased from, respectively, 60.3%, 50.2%, 28.9%, 25.8% before the intervention to 31.3%, 35.9%, 17.1%, 20.7% after the intervention. Significant factors were training and supportive environment based on full commitment of the top management.     

Investigation into effects of work-related quality of life and some related factors on cognitive failures among nurses

Objective. Cognitive failure is one of the factors which can be influenced by personal and professional characteristics. This research was carried out to study the effect of work-related quality of life (WRQoL) and some related factors on cognitive failures (CF) among nurses. Methods. This cross-sectional study was conducted among nurses working in intensive care units, critical care units and emergency units in 2014. Results. In total, 750 nurses participated in the study. The mean?±?SD for the total CF and WRQoL was 40.5?±?12.7 and 75.8?±?13.7 respectively. The results show that CF have a statistically significant difference among the age groups, experience groups and working units. Multiple regression tests show that age, income and WRQoL have a significant effect on CF. Based on the results, for a unit increase in WRQoL we expect a 0.26 unit decrease in CF. Analysis of variance results show that the emergency ward had changed the overall effect of WRQoL on CF, after the effect of WRQoL was controlled. Conclusions. Overall results from the present research indicated that, despite the high level of WRQoL among the studied nurses, the rate of CF was not at an appropriate level. Development of supportive and interventional strategies is highly recommended.     

Work–family conflict and neck and back pain in surgical nurses

Objective. Surgical nurses’ work is physically and mentally demanding, possibly leading to work–family conflict (WFC). The current study tests WFC to be a risk factor for neck and lower back pain (LBP). Job influence and social support are tested as resources that could buffer the detrimental impact of WFC. Methods. Forty-eight surgical nurses from two university hospitals in Germany and Switzerland were recruited. WFC was assessed with the Work–Family Conflict Scale. Job influence and social support were assessed with the Copenhagen Psychosocial Questionnaire, and back pain was assessed with the North American Spine Society Instrument. Results. Multiple linear regression analyses confirmed WFC as a significant predictor of cervical pain (β?=?0.45, p?β?=?0.33, p?=?0.012). Job influence and social support did not turn out to be significant predictors and were not found to buffer the impact of WFC in moderator analyses. Conclusion. WFC is likely to affect neck and back pain in surgery nurses. Work–life interventions may have the potential to reduce WFC in surgery nurses.     

Expert opinions, fuzzy probabilities, and warnings: toward a mathematical method for evaluating warning “read and heed” effectiveness

In many situations, and particularly in legal matters, decisions may be based on whether some possibility is judged to be “more probable than not”, as for example, whether a warning, had it been present, would “more probably than not” have prevented an injury. The probability of a warning accomplishing its purpose of preventing injury can, in principle, be computed based on probability calculus. However, this paper proposes that: (1) such computations must use “fuzzy” probability statements which as a result produce a range of weighted possibilities for the final outcome and, moreover; (2) the critical statistic for determining whether the outcome is “more probable than not” is the median rather than the mean of the possible outcomes. This paper briefly outlines the mathematics for such computations and provides several examples. The paper basically treats fuzzy probabilities as standard “random variables” restricted to the range of [0,1].For brevity, this paper only treats the multiplication of two or more fuzzy probabilities. However, this is adequate for evaluation of a two stage “read and heed”, or of longer multiple step linear sequences and is indicative of the general approach. Treatment of the additive and general case will be found in later publications.     

Effect of a nurse back injury prevention intervention on the rate of injury compensation claims

Problem

This study evaluated the effect of introducing a No Lifting policy on back injuries to nurses, across an entire health care system.

Methods

Methods included: analysis of the data for all public health agencies in the Australian state of Victoria; compensation data from the Victorian Workcover Authority; data about workforce and program implementation from a retrospective survey of agencies; longitudinal analysis of standardized workers compensation claim rates for back injuries before, during and after the intervention.

Results

A statistically significant decline in back injury claim rates during implementation contrasted with no statistically significant trends within the periods before and after the intervention. A statistically significant reduction occurred in mean quarterly standard back injury claim incidence rates per 1,000 equivalent fulltime nursing staff (EFTNS), representing a 24% reduction in standard back injury claims/1000 EFTNS.

Discussion

Ergonomics principles encourage changing the work environment to suit the worker. This approach delivered a significant improvement in the immediate term.

Impact of industry

The substantial decline in back injury rates signifies a major improvement in the safety of a critical aspect of the work environment for nurses.     

位移反分析的PSA-ANFIS方法研究

地下工程中,通常采用位移反分析方法来确定围岩的力学参数,而现有的位移反分析方法均存在诸多不足之处,为此,采用模式搜索算法、自适应神经模糊推理系统以及正交试验设计方法,建立了位移反分析的PSA-ANFIS方法;同时还对一标准弹塑性问题进行了解析计算,得到了相应的训练数据对、检测数据对和预测数据对;最后采用此方法对该弹塑性问题的力学参数进行了反演。反演结果表明,所建立的位移反分析的PSA-ANFIS方法除了能够充分发挥ANFIS的各种优点外,还能有效地减少模型建立和参数调节过程中的人为干预,因此是一种优异的位移反分析方法。     

Shiftwork and department-type related to job stress,work attitudes and behavioral intentions: A study of nurses

The present study examined the relationship of shiftwork and department-type with employees' job stress, stressors, work attitudes and behavioral intention. Data were collected by means of a structured questionnaire from nurses (N = 1148) working in eight hospitals in a large, metropolitan city in eastern Canada. One-way ANOVA, MANOVA and two-way ANOVA were used to analyze data. Results generally support the prediction that nurses working on fixed shifts were better off than nurses working on rotating shifts in terms of the dependent variables of the present study. The prediction that nurses working in non-intensive care departments were better off than nurses working in intensive care departments received mixed support at best. A few interaction effects of shiftwork × department-type on dependent variables were also noted. The impact of socio-demographic variables — age, marital status, cultural background (English- versus French-speaking) — on the above relationships were also analyzed. Results are discussed in light of the previous empirical evidence on shiftwork and department-type.     

Predictive Models of Lumbar Loadings When Handling Boxes

Back problems resulting from the compression forces on the intervertebral disks during manual material-handling tasks are an important problem affecting workers in various industries. The quantification of these forces using intradiscal pressure or biomechanical modeling is complex, time consuming, and costly, and these methods cannot be readily used in the workplace to estimate loadings on the lower back. The objective of this study was to develop a predictive model that would allow the estimation of lumbar loadings for lifting and lowering boxes using easily measured anthropometric variables and variables related to the task. A dynamic and planar segmental model and a model of internal forces at L5/S1 were used to determine the compression forces on the lower back. Two predictive models, a field model and a laboratory model, were developed to estimate the compression forces when lifting or lowering 3.3 kg to 22.0 kg boxes between heights of 15 cm and 185 cm. Both models were validated by an examination of the residuals. Their predictive performance was also compared, with the laboratory model offering a slightly better prediction than the field model. Thus, these equations represent a practical tool for a better planning of handling tasks in the working environment with the purpose of reducing the back injuries of workers.     

Handling Techniques: The Influence of Weight and Height for Experts and Novices

The purpose of this study was to evaluate the influence of the weight of the load (12 kg, 22 kg) and of the height of the grasp (high: 126 cm; middle: 64 cm and 95 cm; low: 33 cm) on the handling techniques adopted by six experienced handlers and six novices having only limited handling experience during a free box-handling task. Each subject had to transfer two sets of 16 boxes from a platform to a four-wheel cart. The observations dealt with the position of the subject at the beginning of transfer and at deposit (position of the back, knees and feet, pelvic orientation, position of the hands), his way of moving during the transfer (position of the feet), and his way of positioning and moving the box during handling (tilt of the box, impulse given to the box, grip change). The results show that the weight and the height of grasp/deposit had an influence on the techniques adopted by expert handlers and novices. Some of these variations are common to both groups but many of them are not, such as the position of the knees, the grips and the position of the box. This study suggests that there is not one method that is suitable for all situations, and that expert handlers may have learned how to adjust their methods to the working environment. A better understanding of the experts’ techniques could help in redesigning efficient training programs.     

Violence breeds violence: burnout as a mediator between patient violence and nurse violence

The present study examines whether patient-perpetrated violence triggers anger, hatred and other negative emotions that, under certain circumstances, might motivate nurses to behave violently with patients. In doing so, this study considers burnout as a mediator in the patient violence–nurse violence relationship. To test the causal paths, data were collected from 182 nurses working in two government-sector teaching hospitals of Pakistan's Punjab province. Results confirm that patient violence toward nurses leads to nurse violence toward patients through the mediating effect of burnout. The study advises hospitals to provide wellness and stress management programs to nurses who regularly experience events involving patient violence. Hospitals may consider allowing nurses to take short breaks after an encounter with violently behaving patients. In addition, hospitals should conduct empathy-promoting training, emotional intelligence training and ‘lens of the patient’ training programs to sensitize their nursing staff.     

The impact of a peer-led participatory health and safety training program for Latino day laborers in construction

Background

Immigrant Latino day laborers working in residential construction are at particularly high risk of fatal and non-fatal traumatic injury and benefit from targeted training.

Objective

To understand the impact of a participatory, peer-facilitated health and safety awareness training customized to the needs of Latino day laborers.

Methods

Baseline surveys exploring exposures, PPE use, attitudes, work practices and work-related injuries were collected from more than 300 New Jersey Latino day laborers in construction prior to their participation in a one day (minimum of six hour) Spanish language health and safety training class. The classes, led by trained worker trainers, engaged participants in a series of tasks requiring teamwork and active problem solving focused on applying safe practices to situations they encounter at their worksites. Follow-up surveys were difficult to obtain among mobile day laborers, and were collected from 70 men (22% response rate) 2-6 months following training. Chi-square analysis was used to compare pre- and post-intervention PPE use, self protective actions, and self-reported injury rates. Focus groups and in-depth interviews addressing similar issues provided a context for discussing the survey findings.

Results

At baseline, the majority of day laborers who participated in this study reported great concern about the hazards of their work and were receptive to learning about health and safety despite limited influence over employers. Changes from baseline to follow-up revealed statistically significant differences in the use of certain types of PPE (hard hats, work boots with steel toes, safety harnesses, and visible safety vests), and in the frequency of self-protective work practices (e.g., trying to find out more about job hazards on your own). There was also a suggestive decrease in self-reported injuries (receiving an injury at work serious enough that you had to stop working for the rest of the day) post-training based on small numbers. Sixty-six percent of workers surveyed post-training reported sharing information from their safety workbook with friends and co-workers. Focus groups and interview results generally confirmed the quantitative findings.

Conclusions

Participatory, peer led training tailored to the needs of construction day laborers may have a positive effect on Latino immigrant workers’ attitudes, work practices, and self reported injury rates, but major changes would require employer engagement.

Impact on Industry

Health and safety researchers have identified reducing the number of traumatic injuries among the immigrant construction workforce as an increasingly important priority. This project provides one model for collaboration between university-based researchers, a union, and a community-based organization. The specific elements of this project—participatory curriculum customized to the needs of day laborers in residential construction, training day laborers to facilitate training classes, and involving peer leaders in outreach and research—could be adapted by other organizations. The findings of this study suggest that the Latino day laborers have a strong interest in and some ability to act on health and safety information. Widespread implementation of this type of training, especially if supported with cooperation from residential contractors, could lead to reduced rates of traumatic injury in the residential construction industry.     

Infrared thermography reveals effect of working posture on skin temperature in office workers

Introduction. Musculoskeletal symptoms related to using traditional computer workstations are common. Quantitative methods for measuring muscle stress and strain are needed to improve ergonomics of workstations. We hypothesize that infrared thermography (IRT) is suited for this purpose. Methods. This hypothesis was evaluated by estimating muscle activity in upright and traditional working postures with IRT and surface electromyography (sEMG). IRT and sEMG measurements were conducted in 14 female participants with both working postures. First, measurements with the traditional posture were performed. Later, participants had 1?month to adjust to the upright working posture before repeating the measurements. IRT images were acquired before and after a full working day, with sEMG recordings being conducted throughout the measurement days. Participants evaluated their neck pain severity using neck disability index (NDI) questionnaires before the first and after the second measurement day. Results. Spatial variation in upper back temperature was higher (p?=?0.008) when working in traditional posture and the upright working posture reduced (p?p?=?0.003) after working in the upright posture. Conclusion. IRT was found suitable for evaluating muscle activity and upright working posture to reduce the NDI and muscle activity in the upper back.