Occupational injuries in California's health care and social assistance industry, 2009 to 2018

Underreporting of work-related low back pain among registered nurses: A mixed method study

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.

Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials

Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines.

An Empirical and Subjective Model of Upper Extremity Fatigue Under Hypogravity

In the context of extra-terrestrial missions, the effects of hypogravity (0 < G < 1) on the human body can reduce the well-being of the crew, cause musculoskeletal problems and affect their ability to perform tasks, especially during long-term missions. To date, studies of the effects of hypogravity on human movement are limited to experiments on the lower limbs. Here, we extend the knowledge base to the upper limbs, by conducting experiments to evaluate the effect of hypogravity on upper limb physical fatigue and mental workload in participants. Our hypothesis was that hypogravity would both increase participant productivity, by reducing overall physical fatigue expressed in Endurance Time, and reduce mental workload. Task Intensity-Endurance time curves are developed especially in seated positions, while performing static, dynamic, repetitive tasks. This experiment involved 32 healthy participants without chronic problems of the musculoskeletal system aged 33.59 ± 8.16 years. Using the collected data, fatigue models were constructed for tasks of varying Intensity. In addition, all participants completed the NASA – Task Load Index subjective mental workload assessment, which revealed the level of subjective workload when executing different tasks. We found two trends in the empirical fatigue models associated with the difference between the strength capabilities of males and females. The first is a significant positive (p = 0.002) relation between Endurance time and gravity level (⅙ G Moon, ⅓ G Mars, 1G) with negative coefficient for males and females for a static task. And there is marginal relation (p < 0.1) between overall mental workload and gravity level with a positive coefficient for males and females for the same task. The same trend was observed for dynamic and repetitive tasks. We concluded that the Task Intensity-Endurance Time model, adapted to hypogravity in combination with subjective mental assessment, is useful to human fatigue investigation. The combination of these methods used for ergonomic analysis and digital human modeling, could improve worker productivity. Finally, this study may help prepare astronauts for long-term missions on the Moon and Mars and improve our understanding of how we can prevent musculoskeletal disorders caused by hazardous manual handling under such extreme environments.