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Kwon S, Lee SJ. Underreporting of work-related low back pain among registered nurses: A mixed method study. Am J Ind Med 2023; 66:952-964. [PMID: 37635360 DOI: 10.1002/ajim.23530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Identifying and addressing work-related health problems early is crucial, but workers often perceive barriers in reporting these to management. This study aimed to investigate the factors associated with nurses' reporting of work-related low back pain to their managers and explored the reasons why nurses with patient handling injuries did not report them. METHODS This study is a concurrent mixed-method analysis of data from two statewide cross-sectional surveys of California registered nurses conducted in 2013 and 2016. The reporting of work-related low back pain to management (n = 288) was examined for associations with individual, occupational, and organizational factors. For qualitative analysis, the reasons for not reporting patient handling injuries were explored using open-ended responses (n = 42). RESULTS Reporting was associated with BIPOC (Black, Indigenous, and People of Color) men (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) compared to non-Hispanic White women; being a non-US educated nurse (AOR: 0.90, 95% CI: 0.80-1.01); experiencing greater low back pain (AOR: 1.07, 95% CI: 1.02-1.12); missing work (AOR: 1.38, 95% CI: 1.21-2.62); perceiving high physical workload (AOR: 0.89, 95% CI: 0.81-0.98); perceiving high people-oriented culture (AOR: 1.14, 95% CI: 1.04-1.25); and perceiving high ergonomic practices (AOR: 0.89, 95% CI: 0.81-0.98). Identified themes on the reasons for not reporting injuries included organizational-culture attitudes toward work-related injuries and injury characteristics of musculoskeletal disorders. CONCLUSIONS The findings indicate a need for management to remove structural barriers and improve organizational practices, and for a culture that promotes trust and open communication between workers and management.
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Affiliation(s)
- Suyoung Kwon
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Soo Jeong Lee
- School of Nursing, University of California San Francisco, San Francisco, California, USA
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Poor Health Conditions among Brazilian Healthcare Workers: The Study Design and Baseline Characteristics of the HEROES Cohort. Healthcare (Basel) 2022; 10:healthcare10102096. [PMID: 36292544 PMCID: PMC9602115 DOI: 10.3390/healthcare10102096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
This study was conducted to describe the health conditions (the psychosocial aspects, sleep quality, and musculoskeletal symptoms) among Brazilian healthcare workers in the context of the pandemic. Workers answered an online questionnaire, including the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II), the Pittsburgh Sleep Quality Index (PSQI), the Nordic Musculoskeletal Questionnaire (NMQ), and the Beck Depression Inventory (BDI). The most unfavourable psychosocial factors were work pace (61%; 95% CI: 52–69%), emotional work demands (75%; 95% CI: 67–82%), predictability (47%; 95% CI: 39–56%), work-family conflict (55%; 95% CI: 46–64%), burnout (86%; 95% CI: 78–91%), and stress (81%; 95% CI: 73–87%). Most workers (74%; 95% CI: 66–81%) were classified as poor sleepers. Musculoskeletal symptoms were frequent in the neck (64%; 95% CI: 55–72%), shoulders (62%; 95% CI: 54–70%), upper back (58%; 95% CI: 50–67%), and lower back (61%; 95% CI: 52–69%). Depressive symptoms were also highly prevalent (mild: 22%; 95% CI: 15–30%, moderate: 16%; 95% CI: 11–23%, severe: 8%; 95% CI: 4–14%). Most healthcare workers experience unfavourable psychosocial factors, poor sleep quality, as well as musculoskeletal and depressive symptoms. These findings underscore the urgent need to acknowledge and address psychological and physical distress to improve the personal and professional well-being of this population.
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Macaluso F, Macaluso M, Daraiseh NM. The psychosocial work environment, musculoskeletal disorders and their functional consequences among pediatric healthcare providers. Ann Epidemiol 2021; 58:76-82. [PMID: 33689845 DOI: 10.1016/j.annepidem.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/31/2020] [Accepted: 02/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of this study was to examine the association between aspects of the psychosocial work environment and prevalence of musculoskeletal disorders (MSDs) and associated functional consequences among pediatric healthcare providers. BACKGROUND The psychosocial work demands make pediatric care providers susceptible to MSDs and subsequent functional consequences, but research on this at-risk group is lacking. METHODS Randomly selected pediatric registered nurses, behavioral health specialists, and patient care assistants (N = 569) completed a survey assessing psychosocial factors, MSDs, and functional consequences (e.g., missing work). Logistic regression was used to assess associations between psychosocial factors and outcomes. RESULTS The analysis yielded moderate-to-strong, significant associations between psychosocial environment factors and MSDs and their functional consequences. The odds of MSDs increased nearly three-fold in the highest quartile of the psychosocial summary score vs. the lowest (OR: 2.7, 95% CI: 1.6-4.5). The highest quartiles of the psychosocial environment measures were significantly associated with functional consequences of MSDs. CONCLUSION Results confirm knowledge about the association between the psychosocial environment and MSDs and demonstrates the association also exists among pediatric providers. Our study highlights the importance of studying the functional consequences of MSDs, which characterize the impact of MSD burden at work and elsewhere.
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Affiliation(s)
| | - Maurizio Macaluso
- Cincinnati Children's Hospital, Cincinnati, OH; University of Cincinnati, College of Medicine, Cincinnati, OH
| | - Nancy M Daraiseh
- Cincinnati Children's Hospital, Cincinnati, OH; University of Cincinnati, College of Medicine, Cincinnati, OH.
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López Gómez MA, Williams JAR, Boden L, Sorensen G, Hopcia K, Hashimoto D, Sabbath E. The relationship of occupational injury and use of mental health care. JOURNAL OF SAFETY RESEARCH 2020; 74:227-232. [PMID: 32951787 PMCID: PMC10868658 DOI: 10.1016/j.jsr.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/09/2019] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Symptoms of depression and anxiety are a common consequence of occupational injury regardless of its cause and type. Nevertheless, mental health care is rarely covered by workers' compensation systems. The aim of this study was to assess the use of mental health care post-injury. METHODS We used a subsample of patient-care workers from the Boston Hospital Workers Health Study (BHWHS). We matched one injured worker with three uninjured workers during the period of 2012-2014 based on age and job title (nurse or patient-care associate) and looked at their mental health care use pre- and post-injury using medical claims data from the employer sponsored health plan. We used logistic regression analysis to assess the likelihood of mental health care use three and six months post-injury controlling for any pre-injury visits. Analyses were repeated separately by job title. RESULTS There were 556 injured workers between 2012 and 2014 that were matched with three uninjured workers at the time of injury (n = 1,649). Injured workers had a higher likelihood of seeking mental health care services than their uninjured counterparts during the six months after injury (OR = 1.646, 95% CI: 1.23-2.20), but not three months post-injury (OR = 0.825, 95% CI: 0.57-1.19). Patient-care associates had a higher likelihood to seek mental health care post-injury, than nurses (OR: 2.133 vs OR: 1.556) during the six months period. CONCLUSIONS Injured workers have a higher likelihood to experience symptoms of depression and anxiety based on their use of mental health care post-injury and use is more predominant among patient-care associates; however, our sample has a small number of patient-care associates. Practical Applications: Treating depression and anxiety as part of the workers' compensation system has the potential of preventing further physical ailment and improving the return to work process regardless of nature of injury.
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Affiliation(s)
| | - Jessica A R Williams
- Harvard T.H. Chan School of Public Health, United States; University of Kansas School of Medicine, University of Kansas Medical Center, Department of Health Policy and Management, United States; Dana-Farber Cancer Institute Center for Community-Based Research, United States.
| | - Leslie Boden
- Boston University School of Public Health, United States.
| | - Glorian Sorensen
- Harvard T.H. Chan School of Public Health, United States; Dana-Farber Cancer Institute Center for Community-Based Research, United States.
| | - Karen Hopcia
- Workplace Health and Wellbeing, Partners HealthCare System, United States.
| | - Dean Hashimoto
- Partners HealthCare, Inc., Boston, MA, United States; Boston College Law School, United States.
| | - Erika Sabbath
- Boston College, School of Social Work, United States.
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Literature Review of Policy Implications From Findings of the Center for Work, Health, and Well-being. J Occup Environ Med 2019; 61:868-876. [PMID: 31453894 DOI: 10.1097/jom.0000000000001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review the publications of a Total Worker Health Center of Excellence, the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being, in order to identify research findings relevant to either organizational or public policies. METHODS Two researchers independently reviewed 57 publications from 2011 to 2019 to identify cross-cutting themes that focus on working conditions or related health outcomes and their organizational and public policy implications. RESULTS Twelve cross-cutting themes were identified with their respective organizational and public policy implications. Several policy implications cut across work-related themes. CONCLUSIONS Policy implications of TWH research will aid in setting priorities to translate this from research into practice in future studies and help identify gaps that we and others can use to plan future TWH research.
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Sabbath EL, Hashimoto D, Boden LI, Dennerlein JT, Williams JAR, Hopcia K, Orechia T, Tripodis Y, Stoddard A, Sorensen G. Cohort profile: The Boston Hospital Workers Health Study (BHWHS). Int J Epidemiol 2019; 47:1739-1740g. [PMID: 30107500 DOI: 10.1093/ije/dyy164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Erika L Sabbath
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Dean Hashimoto
- Partners HealthCare, Boston, MA, USA.,School of Law, Boston College, Newton, MA, USA
| | - Leslie I Boden
- School of Public Health, Boston University, Boston, MA, USA
| | - Jack T Dennerlein
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | | | | | | | | | - Anne Stoddard
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Glorian Sorensen
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Sabbath EL, Yang J, Dennerlein JT, Boden LI, Hashimoto D, Sorensen G. Paradoxical Impact of a Patient-Handling Intervention on Injury Rate Disparity Among Hospital Workers. Am J Public Health 2019; 109:618-625. [PMID: 30789763 DOI: 10.2105/ajph.2018.304929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To test whether a comprehensive safe patient-handling intervention, which successfully reduced overall injury rates among hospital workers in a prior study, was differentially effective for higher-wage workers (nurses) versus low-wage workers (patient care associates [PCAs]). METHODS Data were from a cohort of nurses and PCAs at 2 large hospitals in Boston, Massachusetts. One hospital received the intervention in 2013; the other did not. Using longitudinal survey data from 2012 and 2014 plus longitudinal administrative injury and payroll data, we tested for socioeconomic differences in changes in self-reported safe patient-handling practices, and for socioeconomic differences in changes in injury rates using administrative data. RESULTS After the intervention, improvements in self-reported patient-handling practices were equivalent for PCAs and for nurses. However, in administrative data, lifting and exertion injuries decreased among nurses (rate ratio [RR] = 0.64; 95% confidence interval [CI] = 0.41, 1.00) but not PCAs (RR = 1.10; 95% CI = 0.74,1.63; P for occupation × intervention interaction = 0.02). CONCLUSIONS Although the population-level injury rate decreased after the intervention, most improvements were among higher-wage workers, widening the socioeconomic gap in injury and exemplifying the inequality paradox. Results have implications for public health intervention development, implementation, and analysis.
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Affiliation(s)
- Erika L Sabbath
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jie Yang
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jack T Dennerlein
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Leslie I Boden
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Dean Hashimoto
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Glorian Sorensen
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
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Macaluso M, Summerville LA, Tabangin ME, Daraiseh NM. Enhancing the detection of injuries and near-misses among patient care staff in a large pediatric hospital. Scand J Work Environ Health 2018; 44:377-384. [PMID: 29777614 DOI: 10.5271/sjweh.3739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. Methods Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks. This sample-based active injury surveillance was then integrated into an institutional surveillance system (ISS) centered on passive data collection initiated by employee reports. Results Injuries reported using DVR during two-week intervals from February 2014 to July 2015 were 40.7 times more frequent than what would be expected on the basis of the usual ISS reports. Psychological injuries (eg, stress, conflict) and near-misses were captured at a rate of 16.1 per 1000 days [95% confidence interval (CI) 14.1-18.3] and 35.6 per 1000 days (95% CI 32.7-38.8), respectively. Finally, 68% (95% CI 65-72%) of participants preferred using DVR either as an alternative or complement to the existing ISS. Conclusions This study showed that it is feasible to improve injury surveillance in a healthcare establishment by integrating active data collection based on voice recording within a passive injury surveillance system. Enhanced surveillance provides richer information that can guide the development of effective injury prevention strategies.
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Affiliation(s)
- Maurizio Macaluso
- Research in Patient Services; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. Cincinnati, OH 45229, USA. MLC 7014.
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Hegewald J, Berge W, Heinrich P, Staudte R, Freiberg A, Scharfe J, Girbig M, Nienhaus A, Seidler A. Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?-A Systematic Review of Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E476. [PMID: 29522440 PMCID: PMC5877021 DOI: 10.3390/ijerph15030476] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 01/25/2023]
Abstract
The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear. A systematic review of controlled intervention studies was conducted to examine if the risk of musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE®/PubMed®, EMBASE®, Allied and Complementary Medicine Database (AMED), and Cumulative Index of Nursing and Allied Health Literature (CINAHL®) were searched using terms for nursing, caregiving, technical aids, musculoskeletal injuries, and complaints. Randomized controlled trials and controlled before-after studies of interventions including technical patient handling equipment were included. The titles and abstracts of 9554 publications and 97 full-texts were screened by two reviewers. The qualitative synthesis included one randomized controlled trial (RCT) and ten controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio for musculoskeletal injury claims (post-intervention) of 0.78 (95% confidence interval 0.68-0.90). Overall, the methodological quality of the studies was poor and the results often based on administrative injury claim data, introducing potential selection bias. Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the certainty of the evidence according to GRADE approach ranged from low to very low.
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Affiliation(s)
- Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Wera Berge
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Philipp Heinrich
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Ronny Staudte
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Julia Scharfe
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Maria Girbig
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Albert Nienhaus
- Institute for Health Service Research in Dermatology and Nursing, University Clinics Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Service, Pappelallee 33-37, 22089 Hamburg, Germany.
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
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Williams JAR, Sorensen G, Hashimoto D, Hopcia K, Wagner GR, Boden LI. Impact of Occupational Injuries on Nonworkers' Compensation Medical Costs of Patient-Care Workers. J Occup Environ Med 2017; 59:e119-e124. [PMID: 28598939 PMCID: PMC5488856 DOI: 10.1097/jom.0000000000001047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the extent to which work-related injuries contribute to medical expenditures paid for by group health insurance. METHODS Administrative data on OSHA recordable injuries spanning 2010 to 2013 were obtained for female patient care workers (n = 2495). Expenditures were aggregated group health insurance claims for 3 and 6-month periods before/after injury. Group health insurance plan type, age group, and job category were control variables. RESULTS Being injured is associated with the odds of having expenditures at both 3 months, odds ratio (OR) 2.17 [95% confidence interval (95% CI) 1.61 to 2.92], and 6 months, 2.95 (95% CI 1.96 to 4.45). Injury was associated with $275 of additional expenditures (95% CI $38 to $549) over 3 months and $587 of additional expenditures (95% CI $167 to $1140) over 6 months. CONCLUSIONS Injury was associated with increased odds of positive expenditures and increased expenditures paid for by group health insurance.
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Affiliation(s)
- Jessica A R Williams
- University of Kansas School of Medicine, Kansas City, Kansas (Dr Williams); Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts (Dr Sorensen); Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Dr Sorensen); Partners HealthCare, Boston, Massachusetts (Drs Hashimoto, Hopcia); Boston College Law School, Newton, Massachusetts (Dr Hashimoto); Harvard Medical School, Boston, Massachusetts (Dr Hashimoto); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Dr Wagner); and Boston University School of Public Health, Boston, Massachusetts (Dr Boden)
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Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050544. [PMID: 28534859 PMCID: PMC5451994 DOI: 10.3390/ijerph14050544] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/08/2017] [Accepted: 05/16/2017] [Indexed: 11/16/2022]
Abstract
Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.
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Arias OE, Umukoroa PE, Stoffel SD, Hopcia K, Sorensen G, Dennerlein JT. Associations between trunk flexion and physical activity of patient care workers for a single shift: A pilot study. Work 2017; 56:247-255. [PMID: 28211832 PMCID: PMC7641201 DOI: 10.3233/wor-172481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Trunk flexion and occupational physical activity are parameters that have been used to assess and characterize jobs with high physical demands. OBJECTIVE Characterize the physical load of trunk flexion and physical activity of patient care unit (PCU) workers during a single work shift. METHODS Participants wore an accelerometer to measure physical activity and an inclinometer to assess trunk flexion during a single work shift, which was compared using correlation and linear regression analyses. RESULTS Participants spent 74% of their work time upright between - 10° to 20° and 19% of their time flexed between 20° to 45°. On average workers spent 3% and 5% of their time, in the extreme postures of less than - 10° and greater than 45°, respectively. Participants spent 99% of their shift below moderate and vigorous activity. The largest correlation found was between the number of forward trunk flexions to 20° degrees per shift and minutes in lifestyle activity (r = 0.6, p < 0.001). No correlations between minutes of moderate or vigorous physical activity and trunk flexion were observed. CONCLUSIONS This study suggests that the physical demands of patient care unit workers as measured through trunk flexion are associated with lifestyle and light levels of physical activity.
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Affiliation(s)
- Oscar E. Arias
- Harvard School of Public Health Center for Work, Health and Wellbeing, Boston, MA, USA
- Department of Environmental Health Sciences, University of California, Los Angeles (UCLA), CA, USA
| | - Peter E. Umukoroa
- Harvard School of Public Health Center for Work, Health and Wellbeing, Boston, MA, USA
| | - Sonja D. Stoffel
- Centre for Sport and Exercise Education, Camosun College, Victoria, BC, Canada
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Karen Hopcia
- Department of Occupational Health, Partners HealthCare, Inc., Boston, MA, USA
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Glorian Sorensen
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
- Center for Community Based Research, Dana Faber Cancer Institute, Boston, MA, USA
| | - Jack T. Dennerlein
- Harvard School of Public Health Center for Work, Health and Wellbeing, Boston, MA, USA
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
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Jakobsen MD, Sundstrup E, Brandt M, Andersen LL. Factors affecting pain relief in response to physical exercise interventions among healthcare workers. Scand J Med Sci Sports 2016; 27:1854-1863. [PMID: 28028866 DOI: 10.1111/sms.12802] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 12/19/2022]
Abstract
The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain.
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Affiliation(s)
- M D Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - E Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - M Brandt
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Aalborg, Denmark
| | - L L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Aalborg, Denmark
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Dennerlein JT, O'Day ET, Mulloy DF, Somerville J, Stoddard AM, Kenwood C, Teeple E, Boden LI, Sorensen G, Hashimoto D. Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme. Occup Environ Med 2016; 74:336-343. [PMID: 27919058 DOI: 10.1136/oemed-2015-103507] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 09/15/2016] [Accepted: 10/03/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. METHODS Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. RESULTS Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. CONCLUSIONS Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.
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Affiliation(s)
- Jack T Dennerlein
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Department of Environmental Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Tucker O'Day
- Department of Occupational Health Services, Partners HealthCare System, Boston, Massachusetts, USA
| | - Deborah F Mulloy
- Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jackie Somerville
- Patient Care Services Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anne M Stoddard
- Center of Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Erin Teeple
- Department of Environmental Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Glorian Sorensen
- Center of Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Dean Hashimoto
- Department of Occupational Health Services, Partners HealthCare System, Boston, Massachusetts, USA.,Boston College Law School, Newton Centre, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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15
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Sorensen G, McLellan DL, Sabbath EL, Dennerlein JT, Nagler EM, Hurtado DA, Pronk NP, Wagner GR. Integrating worksite health protection and health promotion: A conceptual model for intervention and research. Prev Med 2016; 91:188-196. [PMID: 27527576 PMCID: PMC5050152 DOI: 10.1016/j.ypmed.2016.08.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/28/2016] [Accepted: 08/01/2016] [Indexed: 01/03/2023]
Abstract
There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009-2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting's conditions of work.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Deborah L McLellan
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Erika L Sabbath
- Boston College, School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Jack T Dennerlein
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Northeastern University, Bouvé College of Health Sciences, 360 Huntington Ave, Boston, MA, USA
| | - Eve M Nagler
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - David A Hurtado
- Oregon Institute of Occupational Health Science, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L606, Portland, OR 97239, USA
| | - Nicolaas P Pronk
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; HealthPartners, Inc., 8170 33rd Ave S, Bloomington, MN 55425, USA
| | - Gregory R Wagner
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; National Institute for Occupational Safety and Health, 395 E Street, SW, Washington, DC 20201, USA
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16
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Sorensen G, Nagler EM, Hashimoto D, Dennerlein JT, Theron J, Stoddard AM, Buxton OM, Wallace L, Kenwood C, Nelson CC, Tamers SL, Grant MP, Wagner G. Implementing an Integrated Health Protection/Health Promotion Intervention in the Hospital Setting: Lessons Learned From the Be Well, Work Well Study. J Occup Environ Med 2016; 58:185-94. [PMID: 26849263 PMCID: PMC4746007 DOI: 10.1097/jom.0000000000000592] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study reports findings from a proof-of-concept trial designed to examine the feasibility and estimates the efficacy of the "Be Well, Work Well" workplace intervention. METHODS The intervention included consultation for nurse managers to implement changes on patient-care units and educational programming for patient-care staff to facilitate improvements in safety and health behaviors. We used a mixed-methods approach to evaluate feasibility and efficacy. RESULTS Using findings from process tracking and qualitative research, we observed challenges to implementing the intervention due to the physical demands, time constraints, and psychological strains of patient care. Using survey data, we found no significant intervention effects. CONCLUSIONS Beyond educating individual workers, systemwide initiatives that respond to conditions of work might be needed to transform the workplace culture and broader milieu in support of worker health and safety.
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Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eve M. Nagler
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Dean Hashimoto
- Partners HealthCare System, Boston, MA
- Boston College Law School, Newton Centre, MA
- Harvard Medical School, Boston, MA
| | - Jack T. Dennerlein
- Harvard T.H. Chan School of Public Health, Boston, MA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA
| | - Julie Theron
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
| | | | - Orfeu M. Buxton
- Harvard Medical School, Boston, MA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Lorraine Wallace
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Sara L. Tamers
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington DC*
| | | | - Gregory Wagner
- Harvard T.H. Chan School of Public Health, Boston, MA
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington DC*
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17
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Impact of organizational policies and practices on workplace injuries in a hospital setting. J Occup Environ Med 2015; 56:802-8. [PMID: 25099405 DOI: 10.1097/jom.0000000000000189] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units. METHODS A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases. RESULTS Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes. CONCLUSIONS Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.
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18
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Boden LI, Petrofsky YV, Hopcia K, Wagner GR, Hashimoto D. Understanding the hospital sharps injury reporting pathway. Am J Ind Med 2015; 58:282-9. [PMID: 25308763 PMCID: PMC5077298 DOI: 10.1002/ajim.22392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patient-care workers are frequently exposed to sharps injuries, which can involve the risk of serious illness. Underreporting of these injuries can compromise prevention efforts. METHODS We linked survey responses of 1,572 non-physician patient-care workers with the Occupational Health Services (OHS) database at two academic hospitals. We determined whether survey respondents who said they had sharps injuries indicated that they had reported them and whether reported injuries were recorded in the OHS database. RESULTS Respondents said that they reported 62 of 78 sharps injuries occurring over a 12-month period. Only 28 appeared in the OHS data. Safety practices were positively associated with respondents' saying they reported sharps injuries but not with whether reported injuries appeared in the OHS data. CONCLUSIONS Administrators should consider creating reporting mechanisms that are simpler and more direct. Administrators and researchers should attempt to understand how incidents might be lost before they are recorded.
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Affiliation(s)
- Leslie I. Boden
- Boston University School of Public Health, Boston, Massachusetts
| | | | - Karen Hopcia
- University of Illinois at Chicago College of Nursing, Chicago, Illinois
| | - Gregory R. Wagner
- National Institute for Occupational Safety and Health, Washington, DC and Harvard School of Public Health, Boston, Massachusetts
| | - Dean Hashimoto
- Partners HealthCare System, Occupational Health Services, Boston, Massachusetts and Boston College Law School, Newton, Massachusetts
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19
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Williams JAR, Rosenstock L. Squeezing blood from a stone: how income inequality affects the health of the American workforce. Am J Public Health 2015; 105:616-21. [PMID: 25713936 DOI: 10.2105/ajph.2014.302424] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Income inequality is very topical-in both political and economic circles-but although income and socioeconomic status are known determinants of health status, income inequality has garnered scant attention with respect to the health of US workers. By several measures, income inequality in the United States has risen since 1960. In addition to pressures from an increasingly competitive labor market, with cash wages losing out to benefits, workers face pressures from changes in work organization. We explored these factors and the mounting evidence of income inequality as a contributing factor to poorer health for the workforce. Although political differences may divide the policy approaches undertaken, addressing income inequality is likely to improve the overall social and health conditions for those affected.
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Affiliation(s)
- Jessica Allia R Williams
- Jessica Allia R. Williams is with the Harvard Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA. Linda Rosenstock is with the Departments of Health Policy and Management and Environmental Health Sciences, University of California, Los Angeles (UCLA) Fielding School of Public Health and Department of Medicine, UCLA Geffen School of Medicine
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20
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Jordan G, Nowrouzi-Kia B, Gohar B, Nowrouzi B. Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review. Saf Health Work 2015; 6:1-8. [PMID: 25830063 PMCID: PMC4372183 DOI: 10.1016/j.shaw.2014.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/19/2014] [Accepted: 12/18/2014] [Indexed: 12/01/2022] Open
Abstract
Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs) was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.
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Affiliation(s)
- Gillian Jordan
- School of Occupational and Public Health and Safety, Ryerson University, Toronto, Ontario, Canada
| | - Behnam Nowrouzi-Kia
- Michael G. Degroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Basem Gohar
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Ontario, Canada
| | - Behdin Nowrouzi
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Ontario, Canada
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21
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Reme SE, Shaw WS, Boden LI, Tveito TH, O'Day ET, Dennerlein JT, Sorensen G. Worker assessments of organizational practices and psychosocial work environment are associated with musculoskeletal injuries in hospital patient care workers. Am J Ind Med 2014; 57:810-8. [PMID: 24737462 DOI: 10.1002/ajim.22319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hospital patient care (PC) workers have high rates of workplace injuries, particularly musculoskeletal injuries. Despite a wide spectrum of documented health hazards, little is known about the association between psychosocial factors at work and OSHA-recordable musculoskeletal injuries. METHODS PC-workers (n = 1,572, 79%) completed surveys assessing a number of organizational, psychosocial and psychological variables. Associations between the survey responses and injury records were tested using bivariate and multivariate analyses. RESULTS A 5% of the PC-workers had at least one OSHA-recordable musculoskeletal injury over the year, and the injuries were significantly associated with: organizational factors (lower people-oriented culture), psychosocial factors (lower supervisor support), and structural factors (job title: being a patient care assistant). CONCLUSIONS The results show support for a multifactorial understanding of musculoskeletal injuries in hospital PC-workers. An increased focus on the various dimensions associated with injury reports, particularly the organizational and psychosocial factors, could contribute to more efficient interventions and programs.
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Affiliation(s)
- Silje Endresen Reme
- Harvard School of Public Health; Boston Massachusetts
- Uni Health; Uni Research AS; Bergen Norway
| | - William S. Shaw
- Liberty Mutual Research Institute for Safety; Hopkinton Massachusetts
| | | | | | | | - Jack T. Dennerlein
- Harvard School of Public Health; Boston Massachusetts
- Northeastern University; Boston Massachusetts
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22
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Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study. J Occup Environ Med 2014; 55:973-7. [PMID: 23887704 DOI: 10.1097/jom.0b013e318297325b] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma. METHODS The level of severity/control in nurses with prevalent doctor-diagnosed asthma in 1998/2000 was compared, using nominal logistic regression, in OR nursing (n = 69) and administrative nursing (n = 546) from the US Nurses' Health Study for whom detailed information on asthma and nursing employment status was available. RESULTS We observed a significant association between OR nursing, compared with administrative nursing, and severe persistent asthma (adjusted odds ratio, 2.48; 95% confidence interval, 1.06 to 5.77). CONCLUSIONS Our findings suggest that nurses working in the OR are at a higher risk of severe persistent asthma. Further studies with detailed estimates of occupational exposures, especially to disinfectant/cleaning agents, are warranted.
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23
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Physical Activity at Work Contributes Little to Patient Care Workers' Weekly Totals. J Occup Environ Med 2013; 55:S63-8. [DOI: 10.1097/jom.0000000000000046] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Caspi CE, Dennerlein JT, Kenwood C, Stoddard AM, Hopcia K, Hashimoto D, Sorensen G. Results of a pilot intervention to improve health and safety for health care workers. J Occup Environ Med 2013; 55:1449-55. [PMID: 24270297 PMCID: PMC3858503 DOI: 10.1097/jom.0b013e3182a7e65a] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the feasibility of a multicomponent pilot intervention to improve worker safety and wellness in two Boston hospitals. METHODS A 3-month intervention was conducted on seven hospital units. Pre- (374 workers) and postsurveys (303 workers) assessed changes in safety/ergonomic behaviors and practices, and social support. Wellness outcomes included self-reported pain/aching in specific body areas (musculoskeletal disorders or MSDs) and physical activity (PA). RESULTS Pain was reported frequently (81%), and PA averaged 4 hours per week. There was a postintervention increase in safe patient handling (P < 0.0001), safety practices (P = 0.0004), ergonomics (P = 0.009), and supervisor support (P = 0.01), but no changes in MSDs or PA. CONCLUSIONS Safe patient handling, ergonomics, and safety practices are good targets for worker safety and wellness interventions; longer intervention periods may reduce the risk of MSDs.
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Affiliation(s)
- Caitlin Eicher Caspi
- From the Department of Family Medicine and Community Health (Dr Caspi), University of Minnesota, Minneapolis, Minn; Department of Physical Therapy (Dr Dennerlein), Northeastern University, Boston, Mass; New England Research Institutes (Mr Kenwood and Dr Stoddard), Watertown, Mass; College of Nursing (Dr Hopcia), University of Illinois at Chicago, Chicago, Ill; Department of Occupational Heath (Dr Hashimoto), Partner's HealthCare, Inc, Boston, Mass; Department of Society, Human Development and Health (Dr Sorensen), Harvard School of Public Health, Boston, Mass; and Center for Community-Based Research (Dr Sorensen), Dana-Farber Cancer Institute, Boston, Mass
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25
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Sorensen G, McLellan D, Dennerlein JT, Pronk NP, Allen JD, Boden LI, Okechukwu CA, Hashimoto D, Stoddard A, Wagner GR. Integration of health protection and health promotion: rationale, indicators, and metrics. J Occup Environ Med 2013; 55:S12-8. [PMID: 24284762 PMCID: PMC4184212 DOI: 10.1097/jom.0000000000000032] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To offer a definition of an "integrated" approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. METHODS Guided by the question-How will we know it when we see it?-we reviewed relevant literature to identify available definitions and metrics, and used a modified Delphi process to review and refine indicators and measures of integrated approaches. RESULTS A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers, and workers. CONCLUSIONS A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, Boston, MA
- Harvard School of Public Health, Boston, MA
| | | | | | - Nicolaas P. Pronk
- Harvard School of Public Health, Boston, MA
- HealthPartners, Inc., Minneapolis, MN
| | | | | | | | - Dean Hashimoto
- Partners HealthCare, Inc., Boston, MA
- Boston College Law School, Newton Centre, MA
| | | | - Gregory R Wagner
- Harvard School of Public Health, Boston, MA
- National Institute for Occupational Safety and Health, Washington, DC
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26
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Yassi A, Lockhart K. Work-relatedness of low back pain in nursing personnel: a systematic review. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 19:223-44. [PMID: 23885775 DOI: 10.1179/2049396713y.0000000027] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Although non-specific low back pain (LBP) is known to be multifactorial, studies from across the globe have documented their higher prevalence in nurses. This systematic review was conducted to ascertain whether this much-documented association constitutes a causal relationship, and whether there is a discernible threshold of exposures associated with this elevated risk. METHODS PRISMA guidelines were followed and standard critical appraisal tools were applied. The outcome of interest was non-specific LBP or back injury; exposure was "performing nursing duties." Applicable studies, published in English during 1980-2012, were identified through database searches, screened against preset inclusion/exclusion criteria. Ergonomic assessments of nursing tasks were included along with epidemiological studies. Bradford Hill considerations for causation were utilized as a framework for discussing findings. FINDINGS Of 987 studies identified, 89 qualified for inclusion, comprising 21 longitudinal, 36 cross-sectional analytic, 23 descriptive biomechanical/ergonomic, and 9 review studies. Overall studies showed that nursing activities conferred increased risk for, and were associated with back disorders regardless of nursing technique, personal characteristics, and non-work-related factors. Patient handling appears to confer the highest risk, but other nursing duties are also associated with elevated risk, and confound dose-response assessments related to patient handling alone. Associations were strong, consistent, temporally possible, plausible, coherent, and analogous to other exposure-outcomes, with risk estimates ranging from 1·2 to 5·5 depending on definitions. A threshold of nursing activities below which the risk of back disorders is not elevated has not been established. INTERPRETATION Notwithstanding the bio-psycho-social nature of LBP, and complexities of studying this area, sufficient evidence exists of a causal relationship between nursing tasks and back disorders to warrant new policies.
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Affiliation(s)
- Annalee Yassi
- The University of British Columbia, Vancouver, BC, Canada
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27
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Sembajwe G, Tveito TH, Hopcia K, Kenwood C, O'Day ET, Stoddard AM, Dennerlein JT, Hashimoto D, Sorensen G. Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers. Workplace Health Saf 2013; 61:117-25. [PMID: 23452130 DOI: 10.1177/216507991306100304] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 10/15/2012] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations.
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Affiliation(s)
- Grace Sembajwe
- City University New York School of Public Health at Hunter College, New York, NY 10035, USA.
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Sembajwe G, Tveito TH, Hopcia K, Kenwood C, O’Day ET, Stoddard AM, Dennerlein JT, Hashimoto D, Sorensen G. Psychosocial Stress and Multi-site Musculoskeletal Pain: A Cross-sectional Survey of Patient Care Workers. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130226-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dennerlein JT, Hopcia K, Sembajwe G, Kenwood C, Stoddard AM, Tveito TH, Hashimoto DM, Sorensen G. Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations. Am J Ind Med 2012; 55:107-16. [PMID: 22113975 DOI: 10.1002/ajim.21036] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND With the high prevalence of musculoskeletal disorders (MSDs) for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related MSDs. METHODS We completed a cross-sectional survey of patient care workers (n = 1,572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations. RESULTS Prevalence of self-reported musculoskeletal symptoms in the past 3 months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3 months, interference with work caused by this pain, symptom severity, and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions. CONCLUSIONS Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings.
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Affiliation(s)
- Jack T Dennerlein
- Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
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