Work activities and musculoskeletal complaints among preschool workers

Relationship Between Chronic Health Conditions and Occupational Burnout in the Early Care and Education Workforce

OBJECTIVE

The early care and education (ECE) workforce experiences high rates of poor mental and physical health outcomes, which impact staff well-being and burnout. This study aimed to assess the relationship between chronic health conditions and occupational burnout in ECE Head Start staff working in low-resourced locations.

METHODS

This study administered an 89-item cross-sectional survey to 332 ECE staff employed in 42 Head Start centers in the United States. Staff self-reported on the following 10 chronic health conditions: arthritis, asthma, cancer, depression, diabetes, heart disease, high blood pressure, insomnia, lung disease, and musculoskeletal disorders.

RESULTS

We found that multimorbidity of chronic conditions significantly predicted overall burnout ( B = 2.39, P < 0.01), particularly related to emotional exhaustion ( B = 2.04, P < 0.01).

CONCLUSIONS

Workplace interventions targeting emotional exhaustion related to chronic health conditions are recommended to effectively address occupational burnout among ECE staff.

Physical and psychological strain in upper Austrian elementary school teachers - an observational study

Musculoskeletal disorders (MSDs) are the main cause of pain leading to high economic burden and psychosocial disadvantages. In addition, psychological stress impacts the overall health as well as the quality of life. Elementary school teachers clearly are a cohort with a high risk of MSDs and stress. The 'BelaPrim' study was conducted to determine the physical and psychological conditions of elementary school teachers in Upper Austria and to investigate the influence of physical and psychological parameters on MSDs. Physical and mental strain was determined with the Nordic Musculoskeletal Questionnaire (NMQ) and the 11-item short version of a German work-related behaviour and experience assessment (AVEM), respectively. Despite a high prevalence of MSDs, high scores were found on personality dimensions. Furthermore, qualitative results indicated the need of administrative/pedagogical support. A linear regression model showed that body height (+), work engagement (+), and emotions (-) are predictors for the occurrence of back pain.Practitioner summary: Despite a high proportion of physical complaints, Upper Austrian elementary school teachers show good mental health. Body height, a high work engagement, and low level of emotions are predictors for the occurrence of back pain. Health initiatives for elementary schools should have a multifactorial view to improve teachers' health.Abbreviations: BA: professional ambition; BE: willingness to spend; VB: striving for perfection PE: ability to distance; DF: tendency to resign in case of failure; RT: offensive problem-solving: OP; inner calm and balance; IR: experiencing success at work; EE: life satisfaction; LZ and SU: experiencing social support.

Quantifying high flexion postures in occupational childcare as they relate to the potential for increased risk of knee osteoarthritis

High knee flexion postures, despite their association with increased incidences of osteoarthritis, are frequently adopted in occupational childcare. This study sought to define and quantify high flexion postures typically adopted in childcare to evaluate any increased likelihood of knee osteoarthritis development. Through video analysis of eighteen childcare workers caring for infant, toddler, and preschool-aged children, eight high knee flexion postures were identified and quantified by duration and frequency. An analysis of postural adoption by task was subsequently performed to determine which might pose the greatest risk for cumulative joint trauma. Childcare workers caring for children of all ages were found to adopt kneeling and seated postures for extended durations and at elevated frequencies, exceeding proposed thresholds for incidences of knee osteoarthritis development. Structured activities, playing, and feeding tasks demanded the greatest adoption of high flexion postures and should be evaluated to minimise the potential childcare-related risks of osteoarthritis. Practitioner summary: High knee flexion postures (kneeling, squatting, etc.) have been associated with increased incidences of knee injury yet are commonly adopted in childcare. Childcare workers' postures were examined through video analysis revealing that proposed adoption thresholds for knee health are commonly exceeded when caring for children of all ages. Abbreviations: OA: osteoarthritis; WSIB: workplace safety insurance board; CAD: Canadian Dollar; DK: dorsiflexed kneeling; PK: plantarflexed kneeling; SAK: single arm supported kneeling; DAK: double arm supported kneeling; FS: flatfoot squatting; HS: heels up squatting; FLRS: floor sitting; SS: side sitting or leaning; STLS: stool sitting; BR: bending and reaching.

Classification of high knee flexion postures using EMG signals

BACKGROUND

High knee flexion postures are often adopted in occupational settings and may lead to increased risk of knee osteoarthritis. Pattern recognition algorithms using wireless electromyographic (EMG) signals may be capable of detecting and quantifying occupational exposures throughout a working day.

OBJECTIVE

To develop a k-Nearest Neighbor (kNN) algorithm for the classification of eight high knee flexion activities frequently observed in childcare.

METHODS

EMG signals from eight lower limb muscles were recorded for 30 participants, signals were decomposed into time- and frequency-domain features, and used to develop a kNN classification algorithm. Features were reduced to a combination of ten time-domain features from 8 muscles using neighborhood component analysis, in order to most effectively identify the postures of interest.

RESULTS

The final classifier was capable of accurately identifying 80.1%of high knee flexion postures based on novel data from participants included in the training dataset, yet only achieved 18.4%accuracy when predicting postures based on novel subject data.

CONCLUSIONS

EMG based classification of high flexion postures may be possible within occupational settings when the model is first trained on sample data from a given individual. The developed algorithm may provide quantitative measures leading to a greater understanding of occupation specific postural requirements.

The prevalence of foot pain and its associated factors among Saudi school teachers in Abha sector, Saudi Arabia

Background:

The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg. Foot pain is not rare finding in the general population, particularly in older adults. The prevalence in adults ages ≥18 year's ranges from 17 to 24%. Heel pain is a general term used to describe pain and discomfort felt anywhere in or around the rear of the foot. This study aimed to estimate the prevalence of heel and foot pain and their determinants among teachers in Abha sector.

Methodology:

A deceptive cross-sectional approach was applied for the current research. All accessible teachers working in governmental and private schools in Abha sector. To be included, teachers should be teaching but not in administrative positions, free of musculoskeletal disorders due to causes other than teaching. Teachers with foot congenital anomalies, newly employed teachers. A self-administered questionnaire was personally distributed to included school teachers in Abha sector. Questionnaires were distributed and collected on second day after being filled by teachers. Posterior HP health Survey questionnaire was used to assess foot and foot pain.

Results:

The study included 1,439 teachers from different districts of Abha sector with their ages ranged from 24 to 60 years old with mean age of 41 ± 9 years. Female teachers constituted 72.8% of the sample and teachers’ weight ranged from 45 to 185 kg with mean weight of 76.6 ± 18.2 kg. Exact of 85.5% of the teachers had foot pain during the last 12 months. Foot pain was mild among 17.3% of the teachers with foot pain and severe among 25.5% of them. Low back pain was recorded among 81% of the teachers followed with knee pain (62%), neck pain (58%), shoulder pain (55%), and wrist pain (28%).

Conclusions and Recommendations:

In conclusion, the study revealed that majority of teachers complained of foot pain. The pain was moderate especially after long standing. The pain was more among old aged teachers with high load of teaching sessions. The pain altered the traditional daily activities among majority of teachers but very few number who asked for medical consultation.

Factors associated with preschool workers' willingness to continue working

In industrialized countries, the turnover rate of preschool workers is extremely high and now represents a social problem. Consequently, it has become important to promote stable early care and educational environments for this population. Several factors related to working environments are known to affect turnover intention; however, the specific factors related to turnover intention among preschool workers have not yet been identified. Considering this, the objective of the present study was to determine factors associated with preschool workers' willingness to continue working.The participants of this study were 1137 preschool workers based in Nagasaki Prefecture, Japan. Multivariate logistic regression analysis was used to analyze the participants' data, with willingness to continue working for 5 years or more set as the dependent variable.Analysis of the results for all subjects clearly showed that male sex, older age, good mental health, high number of social supports, and good work engagement have a positive effect on willingness to continue working. Further, stratifying the participants in terms of age revealed that for preschool workers under 39 years, male sex, good mental health, high number of social supports, and good work engagement act positively in regard to willingness to continue working. Meanwhile, for those over 40 years, it was found that permanent employment and good work engagement act positively in this regard. Thus, work engagement was the only common factor between preschool workers under 39 and over 40.The findings of this cross-sectional study demonstrate that the factors associated with willingness to continue working among preschool workers differ between younger and older professionals. These findings underline the importance of considering age categories when attempting to maximize such professionals' willingness to continue working.

We cannot be "forever young," but our children are: A multilevel intervention to sustain nursery school teachers' resources and well-being during their long work life cycle

INTRODUCTION

The aging of workers generally implies an increased number of workers with health problems or psychological diseases because of the growing distance between personal resources and job demands; the first may decrease, while the second are stable. In the preschool setting, the demands remain constant because children are always aged 0-3 years, while the preschool teacher's personal resources decrease with age. It is, therefore, necessary to propose multilevel interventions aimed at supporting work sustainability and workers' resources.

METHOD

This study involved twenty-seven preschools (324 teachers with an average age of 48.7 years): the control group included seventeen schools (190 teachers with an average age of 48.5 years), five schools were assigned to experimental group one (69 teachers with an average age of 48.8), and five schools were assigned to experimental group two (65 teachers with an average age of 49.1). In this context, we proposed two protocols of multilevel intervention comprising three solutions; two of these were common to both experimental groups: psychological counseling and psychosocial intervention. The third solution differed between groups: environmental redefinition (for group one); gymnastic and vocal hygiene (for group two). We hypothesized that the interventions improve teachers' work abilities, increase well-being, and decrease stress and burnout. Furthermore we hypothesized that there would be an improvement in the organizational climate of trust and in social job resources.

RESULTS

Data analysis showed that the interventions were effective. In particular, the experimental groups reported significant decreases in psychological exhaustion (EG2: ß = -1.48; p = .00), indolence (EG1: ß = -1.36; p = .00), and stress (EG2: ß = -0.94; p = .00). Furthermore, the experimental groups significantly increased their enthusiasm towards work (EG2: ß = 1.21; p = .01), vertical trust (EG1: ß = 0.54; p = .01), and the perception of coworker social support (EG2: ß = 0.54; p = .01). The protocol that involved the GC2 was particularly effective.

CONCLUSIONS

These results demonstrate the effectiveness of the intervention in a particular job setting (preschool classroom), emphasizing the need for implementing solutions aimed at supporting workers' well-being, especially in light of an aging workforce.

Musculoskeletal disorders among preschool teachers: analyzing the relationships among relational demands, work meaning, and intention to leave the job

Background

Based on the conservation of resource (COR) theory by Hobfoll, the aim of the present study was to test whether the relationships among relational demands, work meaning, and intention to leave vary as a function of the presence of musculoskeletal disorders (MSDs).

Method

The study was cross-sectional and non-randomized. Analyses were carried out on a dataset consisting of 429 preschool teachers, who filled out a self-report questionnaire. Of them, 238 reported a MSD diagnosis and 191 were free form MSDs.

Results

As expected, among those who reported MSDs, relational demands were significantly associated to intention to leave, and this relationship was mediated by work meaning; moreover, among those free from MSDs, no significant paths among the three variables were found.

Conclusion

In general, results showed that suffering from MSDs impairs workers’ ability to face to relational demands, thus activating a spiral that encompasses diminished work meaning and intention to leave. Practical implications of results will be discussed in the paper.

The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study

Background

The prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis.

Methods

In 2014 childcare workers (N = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later (N = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression.

Results

At baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points (p = 0.034).

Conclusions

ERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.

Electronic supplementary material

The online version of this article (doi:10.1186/s12995-017-0163-8) contains supplementary material, which is available to authorized users.

Are there any job resources capable of moderating the effect of physical demands on work ability? A study among kindergarten teachers

BACKGROUND

It is recognized that teaching in a preschool context is physically demanding. Despite this, the consequences of physical demands on psychophysical health (including work ability) are significantly understudied among kindergarten teachers.

OBJECTIVES

The aim of the present study is to examine (a) the association between physical demands and work ability and (b) whether psychosocial job resources buffer the negative impact of physical demands among kindergarten teachers.

METHOD

A total of 426 kindergarten teachers employed in the municipal educational services of a city in northwest Italy filled out a self-reported questionnaire.

RESULTS

High association was found between physical demand and work ability. Moderated hierarchical regressions showed that decision authority, skill discretion, reward and meaning of work buffer the hampering effect of physical demands and work ability. No buffering effects were observed for support from superiors and colleagues.

CONCLUSION

The present study has relevant, practical implications, highlighting the importance of investing in interventions encompassing a holistic perspective (e.g., psychosocial and ergonomic) in order to effectively combat the hampering effect of physical demands on work ability.

Identifying Health and Safety Risks for Childcare Workers

Childcare workers are exposed to several health and safety risks in their work environment, the most common being infectious diseases, musculoskeletal injuries, accidents, and occupational stress. Pregnant childcare workers have an additional risk of potential harm to the fetus. Occupational health nurses can work collaboratively with childcare workers to reduce these risks and provide workplace health promotion programs. This article explores the occupational health and safety issues for childcare workers and suggests health promotion strategies that could be implemented by occupational health nurses working in this arena.

Evaluation of the Impact of the Revised National Institute for Occupational Safety and Health Lifting Equation

OBJECTIVE

The objective of this article is to evaluate the impact of the Revised National Institute for Occupational Safety and Health Lifting Equation (RNLE).

BACKGROUND

The RNLE has been used extensively as a risk assessment method for prevention of low back pain (LBP). However, the impact of the RNLE has not been documented.

METHODS

A systematic review of the literature on the RNLE was conducted. The review consisted of three parts: characterization of the RNLE publications, assessment of the impact of the RNLE, and evaluation of the influences of the RNLE on ergonomic standards. The literature for assessing the impact was categorized into four research areas: methodology, laboratory, field, and risk assessment studies using the Lifting Index (LI) or Composite LI (CLI), both of which are the products of the RNLE.

RESULTS

The impact of the RNLE has been both widespread and influential. We found 24 studies that examined the criteria used to define lifting capacity used by the RNLE, 28 studies that compared risk assessment methods for identifying LBP, 23 studies that found the RNLE useful in identifying the risk of LBP with different work populations, and 13 studies on the relationship between LI/CLI and LBP outcomes. We also found evidence on the adoption of the RNLE as an ergonomic standard for use by various local, state, and international entities.

CONCLUSION

The review found 13 studies that link LI/CLI to adverse LBP outcomes. These studies showed a positive relationship between LI/CLI metrics and the severity of LBP outcomes.

Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers - A Cross-Sectional Study

Objectives

German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers.

Methods and Findings

Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS.

Conclusion

Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities.

Low back pain among school teachers in Botswana, prevalence and risk factors

BACKGROUND

Although low back pain (LBP) represents a common occupational problem, few epidemiological studies have investigated the prevalence and risk factors for LBP among school teachers, particularly in Africa. School teachers are known to represent an occupational group among which there appears to be a high prevalence of LBP. The objective of this study was, therefore, to conduct one of the first epidemiological investigations of LBP among teachers in Botswana.

METHODS

A cross-sectional study was conducted among teachers in Botswana using self-administered questionnaires which were distributed to 3100 randomly selected school teachers and collected over a five-month period between July and November 2012. The questionnaire included low back pain information, demographic data, lifestyle, work-related characteristics and psychosocial factors. Data were analysed using Chi-squared and logistic regression models. The 12 month prevalence and LBP disability and associated risk factors were also analysed.

RESULTS

A total of 1747 teachers returned completed questionnaires, yielding a response rate of 56.3%. The 12-month prevalence of LBP was 55.7%, with 67.1% of them reporting minimal disability. The results of logistic regression analysis revealed that female gender [OR: 1.51, 95% CI: 1.14-2.00] and previous back injury [OR: 9.67, 95% CI: 4.94-18.93] were positively correlated to LBP. Awkward arm position [OR: 1.81, 95% CI: 1.24-2.62] and high psychological job demands [OR: 1.40, 95% CI: 1.02-1.93] were also significantly associated with LBP. Regular physical exercise was negatively associated with LBP [OR: 0.63, 95% CI: 0.43-0.93]. Female gender [OR: 2.67, 95% CI: 1.52-3.99] and previous back injury [OR: 3.01, 95% CI: 1.92-4.74] were also positively associated with LBP disability.

CONCLUSION

The prevalence of LBP appears to be high among school teachers in Botswana. A wide variety of LBP risk factors were identified in this study. Female gender and previous injury were both associated with LBP presence and disability. The complex nature of LBP risk factors found in this study suggests than no single specific preventative or intervention strategy will help in reducing these conditions. As such, to help reduce the prevalence, progression and burden of LBP among Botswana teachers, a greater emphasis should now be placed on ergonomics education, regular physical exercise and occupational stress.

Occupational low back pain in primary and high school teachers: prevalence and associated factors

OBJECTIVE

The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP.

METHODS

In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires.

RESULTS

Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P < .05 in all instances). Prolonged sitting and standing, working hours with computer, and correcting examination papers were the most aggravating factors, respectively. Rest and participation in physical activity were found to be the most relieving factors.

CONCLUSION

The prevalence of LBP in teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population.

Condições de trabalho e saúde de professores pré-escolares da rede pública de ensino de Pelotas, RS, Brasil

O presente estudo descreve as condições de trabalho e saúde de professores pré-escolares da rede pública de ensino da cidade de Pelotas, RS. Foi realizado um estudo descritivo do tipo censo nas escolas do município e estado que ofereciam a pré-escola. Foi aplicado um questionário incluindo questões sociodemográficas, econômicas, comportamentais, nutricionais, de saúde e trabalho. Todos os professores estudados eram do sexo feminino, mais de 55% foram classificadas com sobrepeso, 12,6% fumavam atualmente e 73,0% eram insuficientemente ativos no tempo de lazer. Quanto às condições de trabalho, 66,7% relataram trabalhar em posição incômoda, 40,5% consideraram o mobiliário de trabalho inadequado e 50,5% responderam que as pausas realizadas durante o trabalho são insuficientes para o descanso. A prevalência de dor nas regiões lombar, torácica, pescoço e ombros foi elevada e 17,8% das entrevistadas apresentou positividade para transtornos psiquiátricos menores. As prevalências encontradas para as exposições ocupacionais e as más condições de saúde dos professores pré-escolares são importantes e podem interferir na qualidade de vida e de trabalho desses indivíduos.

Work-related musculoskeletal disorders and ergonomic risk factors in early intervention educators

BACKGROUND

Early intervention educators who serve children with special needs often suffer from physical strains. The objectives of this study were to investigate the prevalence of work-related musculoskeletal disorders in this population, and to evaluate the relationship between work-related musculoskeletal disorders and personal/ergonomic risk factors.

METHODS

A self-designed questionnaire consisting three domains (demographics/prevalence of work-related musculoskeletal disorders/ergonomic risk factors) was delivered to educators who work in early intervention institutions.

RESULTS

Ninety-four percent of early intervention educators suffered from musculoskeletal disorders. Logistic regression revealed that some work-related ergonomic factors were highly associated with symptoms on lower back, shoulder and neck, with odds ratios ranging from 0.321 to 4.256.

CONCLUSION

High prevalence of work-related musculoskeletal disorders impacts this occupation negatively. Further regulations to the institutions regarding workplace health promotion and environment modification, as well as training to the employees for body mechanics, should be implemented to prevent injury occurrence.

Factors that might give rise to musculoskeletal disorders when mothers lift children in the home

OBJECTIVE

The objective of this research was to identify the risk factors for musculoskeletal disorders present when mothers lift normally developing children weighing between 20 and 31 lbs (9-14 kg) in the home.

METHOD

Twenty five mothers aged 28-40 years completed Sanders and Morse's (2005) self-report survey of pain and high-risk practices. In addition, the OMLITH, a structured checklist for observing mothers lifting children in the home, was developed. Criteria to rate variables relating to the load (child), environment, person (mother) and task as low, moderate or high risk were developed, on the basis of published manual handling assessments. The mothers were observed performing 87 lifts, and risk factors were rated.

RESULTS

The majority of participants reported low back pain (64%). They self-rated bending while carrying a child as most stressful, and various other tasks involving carrying; prolonged bending, squatting or stooping; and lifting a child as physically stressful. At least one risk factor related to the load was recorded in all 87 observations, with moderate to high risk most frequently related to the child's weight (73.6%) or the mother's grip on the child (93.1%). Common environmental factors presenting a moderate to high risk related to space constraints (59.7% of tasks) and equipment (58.6%). Factors related to the mothers' strength and fitness (57.5% of tasks) commonly posed moderate to high risk, as did horizontal reach distances (82.8%), vertical lift distances (78.2%) and reaches above shoulder height or below mid thigh level (88.5%). Trunk rotation greater than 45° or combining rotation and side bending while lifting resulted in a moderate to high risk rating in 72.4% of tasks. The developmental age of the child interacted with weight to increase or decrease the requirement for lifting.

CONCLUSION

Risk factors for musculoskeletal disorders are present to a significant degree, and further research in this area is warranted.

A systematic review of musculoskeletal disorders among school teachers

BACKGROUND

Musculoskeletal disorders (MSD) represent one of the most common and most expensive occupational health problems in both developed and developing countries. School teachers represent an occupational group among which there appears to be a high prevalence of MSD. Given that causes of MSD have been described as multi-factorial and prevalence rates vary between body sites and location of study, the objective of this systematic review was to investigate the prevalence and risk factors for MSD among teaching staff.

METHODS

The study involved an extensive search of MEDLINE and EMBASE databases in 2011. All studies which reported on the prevalence and/or risk factors for MSD in the teaching profession were initially selected for inclusion. Reference lists of articles identified in the original search were then examined for additional publications. Of the 80 articles initially located, a final group of 33 met the inclusion criteria and were examined in detail.

RESULTS

This review suggests that the prevalence of self-reported MSD among school teachers ranges between 39% and 95%. The most prevalent body sites appear to be the back, neck and upper limbs. Nursery school teachers appear to be more likely to report suffering from low back pain. Factors such as gender, age, length of employment and awkward posture have been associated with higher MSD prevalence rates.

CONCLUSION

Overall, this study suggests that school teachers are at a high risk of MSD. Further research, preferably longitudinal, is required to more thoroughly investigate the issue of MSD among teachers, with a greater emphasis on the possible wider use of ergonomic principles. This would represent a major step forward in the prevention of MSD among teachers, especially if easy to implement control measures could be recommended.

Hard work at home: musculoskeletal pain among female homemakers

This study explores the relationship between housework and musculoskeletal symptoms among homemakers, adjusting for social, demographic and economic factors. A cross-sectional survey was carried out on 435 women from Nabaa, a low-income community in Lebanon. In total, 77% of women reported having musculoskeletal pain in the previous 12 months. Both psychosocial and physical factors showed significant associations with musculoskeletal symptoms. Related psychosocial factors included feelings of stress associated with homemaking and homemakers' number of children and self-rated health. The physical factors associated with musculoskeletal pain were feeling fatigued at the end of a housework day, working long hours and working in awkward postures or frequently engaging in repetitive hand movements. Ergonomic stressors were also associated with pain in the back and upper and lower extremities. Women from this community engage in a large number of hours of housework that, alongside other factors, were associated with high prevalence of musculoskeletal pain.

PRACTITIONER SUMMARY

This study contributes to the literature by studying women's housework activities in association with musculoskeletal pain. The role of women in homemaking activities is explored together with physical exposures leading to reported symptoms. This study adds a perspective of a Middle Eastern context to the literature of women's musculoskeletal health.

Effectiveness of an at-work exercise program in the prevention and management of neck and low back complaints in nursery school teachers

The aim of the study was to determine the effectiveness of an extension-oriented exercise program in the prevention and management of low back/neck pain in nursery school teachers. A Cluster Randomized Controlled Trial was utilized. Seventy-one nursery school teachers working in nine school buildings were randomly divided into two groups, with each school as a unit of randomization. All the teachers in both groups received an ergonomic brochure; teachers in the experimental group also received an extension-oriented exercise program, conducted by a physical therapist. Data were collected at baseline and at a two-month follow-up. The primary outcome measure recorded was the level of disability (Roland Morris Disability Questionnaire and Oswestry Disability Index), while secondary outcome measure included the evaluation of cervical and lumbar physical discomfort (Visual Analogue Scale). At follow-up, a significant improvement was registered in the experimental group as compared to the control group for all the outcomes evaluated. In conclusion an extension-oriented exercise program may be a useful strategy to prevent low back and neck complaints and to reduce consequent LBP functional disability among nursery school teachers.

The association between back pain and trunk posture of workers in a special school for the severe handicaps

Background

The present study aims to determine the time spent in different static trunk postures during a typical working day of workers in a special school for the severe handicaps.

Methods

Eighteen workers with low back pain (LBP) and fifteen asymptomatic workers were recruited. A cross-sectional design was employed to study the time spent in different static trunk postures which was recorded by a biaxial accelerometer attached to the T₁₂ level of the back of the subjects.

Results

The results of ANCOVA revealed that subjects with LBP spent significantly longer percentage of time in static trunk posture when compared to normal (p < 0.05). It was also shown that they spent significantly longer time in trunk flexion for more than 10° (p < 0.0125).

Conclusion

An innovative method has been developed for continuous tracking of spinal posture, and this has potential for widespread applications in the workplace. The findings of the present investigation suggest that teachers in special schools are at increased risk of getting LBP. In order to minimise such risk, frequent postural change and awareness of work posture are recommended.

Development and Psychometric Properties of the Self-Efficacy Scale for Transfers for Caregivers of Children Requiring Transfer Assistance

OBJECTIVE

To test the psychometric properties of a newly developed measure of caregiver self-efficacy, the Caregiver Self-Efficacy Scale for Transfers (CSEST), a 14-item questionnaire that measures the perceived self-efficacy of adult caregivers of dependent children and focuses on their perceived abilities and the challenges of assisting a child with restricted transfer ability.

DESIGN

Reliability and validity study using survey data.

SETTING

Community-based survey study.

PARTICIPANTS

Adult caregivers (eg, mother, father, grandparent) of dependent minors who require transfer assistance.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Using the Rasch measurement model, the CSEST was tested for reliability and separation, validity (hierarchical and content), and factor structure.

RESULTS

The CSEST yields data with sufficient reliability (reliability indices of .96 and .94 for respondents and items, respectively) as well as sufficient separation of levels of self-efficacy (item separation index, 4.13; person separation index, 5.23). The CSEST has a stable hierarchical structure with adequate content validity (standardized chi2 fit statistics <2.0) and point biserial correlations greater than .67. Factor analysis confirmed 2 insubstantial subscales; the 14-item CSEST accounted for greater than 85% of the total variance.

CONCLUSIONS

The CSEST yields reliable data and valid inferences of self-efficacy from adult caregivers of children requiring transfer assistance. The CSEST may identify areas of need and/or difficulty with transfers for parents caring for dependent children.

Musculoskeletal pain in ragpickers in a southern city in Brazil

BACKGROUND

Ragpickers are informal workers who collect recyclable materials to earn a small wage. Their life and working conditions are extremely precarious. The ergonomic hazards and musculoskeletal pain in a sample of ragpickers in Pelotas, a city in southern Brazil are examined.

METHODS

Two comparison groups were available: a matched sample of non-ragpickers from the same poor neighborhoods, and a random sample of the general population of the city. The cross-sectional study gathered data by interview on 990 individuals in 2004. Musculoskeletal pain was assessed using the Standardized Nordic Questionnaire.

RESULTS

Ragpickers reported higher prevalences for most awkward postures and ergonomic exposures compared to neighbors with other demanding manual jobs. The prevalence within the last 12 months of low back pain (LBP), lower extremity pain (LEP), and upper extremity pain (UEP) among ragpickers were 49.2%, 45.1%, and 34.9%, respectively; levels similar to those reported by neighborhood controls. Both ragpickers and non-ragpickers reported considerably higher ergonomic exposures, and more prevalent LBP, than the general population.

CONCLUSIONS

Ragpickers experience many occupational hazards and ergonomic stressors. Their overall prevalence of musculoskeletal pain was similar to a comparison group with other physically demanding manual jobs. For LBP, this prevalence was substantially higher (49% vs. 35%) than in the general population.