Evaluating repeated patient handling injuries following the implementation of a multi-factor ergonomic intervention program among health care workers

Objective

The objective of this study was to evaluate repeated patient handling injuries following a multi-factor ergonomic intervention program among health care workers.

Methods

This was a quasi-experimental study which had an intervention group and a non-randomized control group. Data were collected from six hospitals in Saskatchewan, Canada from September 1, 2001 to December 1, 2006.

Results

A total of 1,480 individuals who had a previous injury were eligible for the study. Medium and small size hospitals in the intervention group had significantly fewer repeated injuries than in the control group. Multivariate analysis showed that the intervention group had 38.1% lower odds of having repeated injury compared to the control group, after adjusting for hospital size.

Conclusions

The work-related repeated injury after a multi-factor intervention program was reduced. The synergistic relationships between components of multi-factor intervention and applicability of injury prevention programs to different settings need to be further explored.

Impact on Industry

Implementing a multi-factor program with the right equipment and training can lower the risk of injury among health care workers.     

Validating an evidence-based, self-rated fall risk questionnaire (FRQ) for older adults

Background

Falls are a common, serious, and often unrecognized problem facing older adults. The objective of this study was to provide an initial clinical and statistical validation for a public health strategy of fall risk self-assessment by older adults using a Fall Risk Questionnaire (FRQ).

Methods

Adults age 65 + (n = 40) were recruited at a Los Angeles Veterans Affairs (VA) medical facility and at a local assisted living facility. Participants completed the FRQ self-assessment and results were compared to a “gold standard” of a clinical evaluation of risks using the American/British Geriatrics Society guidelines to assess independent predictors of falls: history of previous falls, fear of falling, gait/balance, muscle weakness, incontinence, sensation and proprioception, depression, vision, and medications. For the comparison, we used an iterative statistical approach, weighing items based on relative risk.

Results

There was strong agreement between the FRQ and clinical evaluation (kappa = .875, p < .0001). Individual item kappa values ranged from .305-.832. After dropping one FRQ item (vision risk) because of inadequate agreement with the clinical evaluation (kappa = .139, p = .321), the final FRQ had good concurrent validity.

Conclusions

The FRQ goes beyond existing screening tools in that it is based on both evidence and clinical acceptability and has been initially validated with clinical examination data. A larger validation with longitudinal follow-up should determine the actual strength of the FRQ in predicting future falls.     

INFLUENCES OF WATERSHED,RIPARIAN‐CORRIDOR,AND REACH‐SCALE CHARACTERISTICS ON AQUATIC BIOTA IN AGRICULTURAL WATERSHEDS1

ABSTRACT: Multivariate analyses and correlations revealed strong relations between watershed and riparian‐corridor land cover, and reach‐scale habitat versus fish and macroinvertebrate assemblages in 38 warmwater streams in eastern Wisconsin. Watersheds were dominated by agricultural use, and ranged in size from 9 to 71 km² Watershed land cover was summarized from satellite‐derived data for the area outside a 30‐m buffer. Riparian land cover was interpreted from digital orthophotos within 10‐, 10‐to 20‐, and 20‐to 30‐m buffers. Reach‐scale habitat, fish, and macroinvertebrates were collected in 1998 and biotic indices calculated. Correlations between land cover, habitat, and stream‐quality indicators revealed significant relations at the watershed, riparian‐corridor, and reach scales. At the watershed scale, fish diversity, intolerant fish and EPT species increased, and Hilsenhoff biotic index (HBI) decreased as percent forest increased. At the riparian‐corridor scale, EPT species decreased and HBI increased as riparian vegetation became more fragmented. For the reach, EPT species decreased with embeddedness. Multivariate analyses further indicated that riparian (percent agriculture, grassland, urban and forest, and fragmentation of vegetation), watershed (percent forest) and reach‐scale characteristics (embeddedness) were the most important variables influencing fish (IBI, density, diversity, number, and percent tolerant and insectivorous species) and macroinvertebrate (HBI and EPT) communities.     

The injury problem among older adults: mortality, morbidity and costs

The Journal of Safety Research has partnered with the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the seventh in a series of CDC articles.     

Effects of Bioengineered Streambank Stabilization on Bank Habitat and Macroinvertebrates in Urban Streams

Non-structural streambank stabilization, or bioengineering, is a common stream restoration practice used to slow streambank erosion, but its ecological effects have rarely been assessed. We surveyed bank habitat and sampled bank macroinvertebrates at four bioengineered sites, an unrestored site, and a comparatively less-impacted reference site in the urban Peachtree-Nancy Creek catchment in Atlanta, GA, USA. The amount of organic bank habitat (wood and roots) was much higher at the reference site and three of the bioengineered sites than at the unrestored site or the other bioengineered site, where a very different bioengineering technique was used (“joint planting”). At all sites, we saw a high abundance of pollution-tolerant taxa, especially chironomids and oligochaetes, and a low richness and diversity of the bank macroinvertebrate community. Total biomass, insect biomass, and non-chironomid insect biomass were highest at the reference site and two of the bioengineered sites (p < 0.05). Higher biomass and abundance were found on organic habitats (wood and roots) versus inorganic habitats (mud, sand, and rock) across all sites. Percent organic bank habitat at each site proved to be strongly positively correlated with many factors, including taxon richness, total biomass, and shredder biomass. These results suggest that bioengineered bank stabilization can have positive effects on bank habitat and macroinvertebrate communities in urban streams, but it cannot completely mitigate the impacts of urbanization.     

Dioxin-like compounds in Australian sewage sludge--review and national survey

An Australian survey of dioxin-like compounds in sewage sludge was conducted in two parts (a) a national survey, and (b) a time-study. All sewage sludge samples analysed as part of these studies had low overall concentrations of dioxin-like compounds. Out of 37 samples, all except one, were within the reported concentration range of soil within the Australian environment. The mean concentration of dioxin-like compounds in the Australian sewage sludge survey of 2006 was found to be 5.6 (s.d. 4.5) ng WHO(05) TEQkg(-1) (n=14) and were within the range of 1.2-15.3 ng WHO(05) TEQ kg(-1). All the Australian sewage sludge samples cited in these studies were below the Victorian EPA "investigation limit" of 50 ng WHO(98) TEQ kg(-1), and well below the European proposed guidelines of 100 ng I-TEQ kg(-1). The burden of dioxin-like compounds in Australian sewage sludge is low and its land application as biosolids is not likely to pose a problem. A general positive relationship was found between population of the town producing the waste and both dioxin-like PCDD/Fs and dioxin-like PCBs. The one exception to this trend was sludge from a town that had a history of smelting and had a relatively high burden of dioxin-like compounds. Sludge from one rural WWTP also had a higher burden of dioxin-like compounds. The treatment plant services a geographically isolated town with a low population and no known emitters of dioxin-like compounds. However, this sample also had a relatively high burden of dioxin-like PCBs, which could be the source of the dioxin-like PCDD/Fs found in this sludge. The time study analyzing sludges from three WWTP from the same city between the years 2002 and 2006 found no apparent difference between WWTPs, but a statistically significant decline of 1.49 ng WHO(05) TEQ kg(-1) per year. Also, a comprehensive review of the scientific literature, presents typical levels and sources of dioxin-like compounds in international sewage sludges.