The influence of a preventive educational programme on trunk flexion in janitors

Physiological responses, trunk posture, and work pace in commercial building cleaning in Washington State: An observational field study

INTRODUCTION

This study aimed to investigate whether work pace is a critical indicator for predicting a janitor's risk of work-related musculoskeletal disorders (WMSDs).

METHOD

Field measurements were obtained from commercial building janitors as well as the determination of work pace. Physiological responses collected were heart rate, energy expenditure (calories), activity level (METs), steps, trunk posture. Data were obtained using direct measurements, along with a time study, which was performed by shadowing 13 janitors in Washington State. The measured values were summarized descriptively, and five of the most common janitorial tasks were compared. The relationships between work pace and the physiological response variables were determined by calculating the Pearson product-moment correlation coefficients.

RESULTS

The highest average percent heart rate reserve (47.4%) was reported during restroom cleaning, while the highest activity and energy expenditure levels (3.6 METs and 217.1 calories/h) were reported for mopping. The top 90% of trunk flexion angles and the highest percentage of time in trunk flexion from 20° to 60° were recorded during restroom cleaning. Restroom cleaning showed the highest correlation between all the physiological response variables and work pace. In most of the tasks, a high work pace may have increased the degree and duration of severe trunk flexion.

CONCLUSION

Overall, when several tasks were considered, the extent of physiological responses, trunk joint angles, and exposure time to awkward postures tended to increase with an increase in work pace.

PRACTICAL APPLICATIONS

This study showed the feasibility of using the work pace measured from time studies as a predictive indicator of WMSDs risks. Using this information, managers may compose a schedule that can minimize WMSDs risks while considering actual work pace deviations that may impact a janitor's ability to complete assigned tasks properly within a shift.

Cleaning in the 21st Century: The musculoskeletal disorders associated with the centuries-old occupation - A literature review

Workers performing cleaning duties experience higher injury rates, especially in the form of musculoskeletal disorders (MSDs), than other industries. It is essential to understand the inherent risks associated with the nature of this occupation. Based on the Balance Theory (Smith & Carayon-Sainfort, 1989), this review surveys the current literature, especially those published since the previous review paper (Kumar & Kumar, 2008), and identifies which elements contributing to MSD risks were examined: task, technology, organization, environment, individual, and their interactions. Thirty-nine research papers published between 2005 and 2021 are identified and summarized. Among these papers, task and individual elements received the most attention, at 42 and 34 occurrences, respectively. The interaction elements of technology-organization, technology-environment, and organization-environment received less than three mentions. The goal of this literature review is to update the knowledge base and identify current trends for the cleaning occupation. Possible interventions for risk reduction and future research directions are suggested.

Muscular Strain during Floor Mopping with Different Cleaning Methods

Mopping is one of the most used cleaning methods. The aim of this study was to quantify and compare local muscular strain during floor mopping with seven different mopping methods with respect to the amount of water ranging from dry to wet. The results showed that the local strain measured with EMG from the trapezius and forearm muscles was higher with the use of wet and damp mopping methods than with the use of dry methods.

Injury risk associated with physical demands and school environment characteristics among a cohort of custodial workers

Few epidemiological studies have investigated the relationship between work exposures and injury risk among custodians. The relationship between injury risk and occupational physical demands (e.g. pushing/pulling, lifting) and school environment characteristics (e.g. school type, season) was investigated among a cohort of 581 school custodians over a 4-year period. In the final Poisson regression models, the risk of injury was associated with time spent in pushing/pulling tasks in a dose-response manner increasing to a five-fold risk among the highest quartile of exposure (risk ratio = 5.15, 95% CI 1.00, 26.5). Injury risk was also associated with working during the school year compared to the summer, working in a school with grass vs. gravel grounds and working in a school with detached classrooms. Results help to target interventions such as alternative methods for floor cleaning to reduce the pushing/pulling demands of custodial work and to support decisions for alternatives to detached classrooms and grass surfaces. Statement of Relevance: This study examines ergonomic factors (physical demand exposures, school environment characteristics) associated with injury risk among custodial school workers. The findings help schools to target interventions to reduce the physical demands associated with injuries and to design school environments to reduce exposures.

Relative effectiveness of worker safety and health training methods

OBJECTIVES

We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries).

METHODS

Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners' participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training).

RESULTS

As training methods became more engaging (i.e., requiring trainees' active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements.

CONCLUSIONS

Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce.

Verbal categories for classification of spinal postures and their respective angular values registered by photographs and electrogoniometry

The perception of posture may allow workers to discern sensations associated with physical overload and potential tissue damage. In an occupational context, the classification of body postures in ranges of amplitude has been useful for researchers and ergonomists interested in evaluating the exposure of workers to uncomfortable and potentially harmful postures. In this paper we describe measurements, using photographs and electrogoniometry of the angle of flexion of the trunk and of the thoracolumbar segment, respectively, adopted according to the verbal categories of mild, moderate, and severe flexion, as requested by the experimenter. The results showed no differences between the groups of subjects, but significant differences occurred in the classification of the movement amplitude per verbal categories.

Back school in a first episode of compensated acute low back pain: a clinical trial to assess efficacy and prevent relapse

OBJECTIVE

To assess the efficacy of a back school program for patients with a first episode of acute work-related low back pain requiring compensation.

DESIGN

A randomized single-blind controlled trial.

SETTING

A private physiatrics outpatient clinic.

PATIENTS

The mean duration of low back pain was 15 days.

INTERVENTION

Eligible patients were randomized to a standard treatment program that included daily physiotherapy (n = 86) or the same program with the addition of back school (n = 82). The back school program consisted of three 90-minute sessions given by a single trained instructor at 0, 1, and 8 weeks.

MAIN OUTCOME MEASURES

The primary outcomes were the time off work for the presenting episode of back pain and the number and duration of recurrences in the year following the study onset. Secondary outcomes included the level of pain, spinal mobility, active straight-leg raising, and functional disability assessed by the Oswestry and Roland-Morris scales.

RESULTS

Those randomized to the back school group gained significantly more knowledge, based on the multiple choice examination (p = .0001) and performed the exercise program significantly better (p = .0001) than the standard care group. There were no differences between the two treatment groups for either of the primary outcomes. The median time to return to work from randomization was 33 days for both the back school and the standard care groups (p = .48). The number of compensated recurrences of low back pain over 1 year was similar (back school = 14, standard care = 10, p = .16), as was the median duration of these episodes (back school = 25 days, standard care = 70 days, p = .21). There were no significant differences favoring the back school group for any of the secondary outcomes at the posttreatment, 6-month, or 12-month assessments.

CONCLUSION

A back school intervention in addition to standard care resulted in no reduction in the time to return to work or the number or duration of recurrences of low back pain requiring compensation over a period of one year.

The gap between back pain patients' prior knowledge and scientific knowledge and its evolution after a back school teaching programme: a quantitative evaluation

This study presents a method for quantitative evaluation of the congruence between patients' representations and teachers' scientific knowledge, which is used as the standard of assessment. First, the patients' knowledge and the teachers' scientific concepts before a back school (BS) programme were compared (T0). Then the evolution of patients' knowledge at 1 month (T1) and 1 year (T2) after the teaching was evaluated. Patients' knowledge was assessed blind by a multidisciplinary panel of nine independent judges. Mean scores were computed for each set of data (T0,T1,T2); these scores were then submitted to an analysis of variance. The results showed an important gap between patients and teachers before BS with an improvement after the teaching. Knowledge referring to know-how and/or attitudes evolved differently when compared to theoretical knowledge.

Back schools in prevention of chronicity

This chapter has reviewed the role of back school and educational programmes for the common and non-specific acute and subacute low back pain patient. The following seems to come out of this review. Education is an important part of patient care. However, several questions arise about the content of the education, the selection of patients, the patient compliance to instruction given, how the information is retained, and which outcome measures should be used. It is also important to realize that the back school is a modality or a tool that may be used as an adjunct, but as a sole treatment it seems to have less impact than in combination with other structured or goal-oriented programmes. When a back school is instituted in a hospital or in industry, it requires administrative and budgetary support and a multidisciplinary staff to successfully carry out the programme. The information given must be adapted to the needs of the participants and all members of the team must give the same information to the patient. A poorly structured back school where patients are dumped because the physician or other health care provider has nothing else to offer is a poor solution for the patient, a poor solution for the health care provider, and can only increase the patient's discomfort and health care costs.

A technique for assessment of torso kinesiology

A technique is described for monitoring and analysis of the angular displacement of the human torso. The technique is based on the use of miniature electromechanical inclinometers and video recording. The system was developed for continuous measurement of the angular displacement of spinal segments in the sagittal plane during all stages of lifting. Angular displacements of the cervical, thoracic and lumbar regions were obtained from a dynamic lifting case study using a digital processing system. The geometrical changes of the torso during five prescribed stages were measured. The system revealed good accuracy with high correlation coefficient scores for a wide range of lifting tasks in a comparative laboratory study. This paper describes the monitoring technique; the system's advantages, disadvantages and measuring accuracy are discussed.