Prevalence and risk factors associated with musculoskeletal discomfort in New Zealand veterinarians

Physical stress and musculoskeletal complaints of veterinarians - A narrative review

INTRODUCTION

Veterinarians have high physical workloads. The aim of this narrative review is to evaluate the literature on typical physical workloads, such as lifting/carrying and forced position (during surgery) and predictors of injuries. The health complaints of veterinarians were also examined.

METHODS

Diverse databases were used. Prevalence rates of total workloads (also including surgery), health complaints, musculoskeletal discomfort, and predictors of injury, musculoskeletal disorders, and precaution awareness were examined.

RESULTS

Thirteen studies were included. The most prevalent injury was animal attacks (9%-84%). Working in large and mixed practice types were predictors of injuries or musculoskeletal disorders (e.g., shoulder, lower back, head/neck) compared to other types of practice.

CONCLUSION

The study findings presented here clearly show a high need for intervention to minimize and prevent occupational risks. Ergonomic working conditions and occupational safety training can reduce the risk of musculoskeletal disorders.

Worker and work-related factors influence on musculoskeletal symptoms among veterinary surgeons

Worker and work-related musculoskeletal symptoms are prevalent among surgeons operating on human patients. Despite incidence rates for accidents among veterinarians and their staff being 2.9 times higher than that of general practitioners of human medicine, little is known about musculoskeletal symptoms among veterinary surgeons. In this study, 212 board-certified members of the American College of Veterinary Surgeons responded to a survey regarding various work-related activities and their experience with musculoskeletal symptoms in 10 different body regions. Across all body regions, reported pain increased from before to after a typical day of surgery (p <.01). Gender, weight, age, and years performing surgery were worker factors that were related to pain (p <.05), while number of procedures, practice focus, and proportion of minimally invasive surgery were work factors related to pain (p <.05). Our findings suggest that musculoskeletal symptoms are prevalent among veterinary surgeons and may help provide evidence for guidelines for minimising musculoskeletal injuries in veterinary surgery.Practitioner summary: Little is known about the risk factors for musculoskeletal symptoms (MSS) among veterinary surgeons. This cross-sectional survey of veterinary surgeons investigates worker and work factors related to MSS. We show that MSS are prevalent and identify key factors providing evidence that MSS are a concern in veterinary surgery.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Family planning unmet need among women attending primary healthcare clinics in Western Region, Saudi Arabia

Background

The gap between some women's reproductive intention and their contraceptive behavior clearly poses a challenge to the ongoing family planning program. Unmet need has generated much interest, both among academics and policymakers over the years. This study aims to estimate the prevalence, subgroups, and reasons of unmet need for family planning among married Saudi women in Military Hospitals in Taif city.

Methods

A cross-sectional study was adopted in Taif city, Saudi Arabia. It included a random representative sample of married women in the childbearing age (18-49 years) who attended the Family Medicine center in Prince Mansour military hospital (n = 8 clinics), Family medicine clinics at Al-Hada Armed Forces hospital (n = 3 clinics), and Al-Razi center in Prince Sultan hospital throughout the study period (March-June, 2022), provided that they had at least one child. A self-created validated questionnaire in the Arabic language was used to collect data regarding socio-demographic variables, reproductive history, and contraceptive practice including reasons of either using or never using contraceptive methods.

Results

Four hundred women participated in the study out of a targeted 431 with a response rate of 92.8%. The age of the participating women varied from 20 to 50 years (34.2 ± 7.5 years). Slightly less than half of the participant married women (48.5%) were contraceptive users. Spacing between children was mentioned by majority of those used/using contraceptives (82%), whereas limiting the number of children was mentioned by 9% of them. The commonest reported method of contraception used by women was oral contraceptive pills (58.3%), followed by intrauterine device (IUD) (41.6%). History of unintended pregnancy was reported by more than one-third of the participants (37%). Regarding contraceptive method used during unintended pregnancy, oral contraceptives (39.2%), safety period (21.6%), and condom (21.6) were the most frequent methods. Unmet contraceptive need prevalence was 49.9%. Unmet contraceptive need was significantly associated with husband's educational level (P = 0.008), husband's job (P = 0.011), family income (P = 0.001), age of marriage (<0.001), age of pregnancy (<0.001), number of pregnancy (<0.001), and parity (<0.001).

Conclusion

The prevalence of unmet need of contraception use among women in Taif city is high. Husband-related factors were significantly associated with unmet contraception use.

Health Promotion for Students of Veterinary Medicine: A Preliminary Study on Active Microbreaks and Ergonomics Education

Occupational hazards, such as psychosocial stressors, physical injuries from human-animal interactions, and physically demanding work tasks, are common in the veterinary profession, and musculoskeletal discomfort and pain (MDP) may already be present in veterinary undergraduates. This preliminary study investigates the effects of very short, active interventions, called microbreaks, in 36 veterinary students. At the start, participants had a high prevalence of MDP, especially in the neck and lower back. Within a 12-week observational period, 6 weeks of active intervention comprised teaching microbreaks (nine strengthening, stretching, and relaxation exercises; 30-90 s each) and a weekly veterinary-specific ergonomics education and discussion. After the intervention, participants reported fewer painful body regions and an increase in their self-efficacy in potentially painful, risky, or dangerous human-animal interactions. After the 12-week observational period, participants had increased self-efficacy in the maintenance of physical health and self-protection but decreased self-efficacy in healing injuries after veterinary human-animal interactions. Participants felt to have increased and decreased control over dangerous situations with dogs and horses, respectively, although self-efficacy in handling horses increased. Participants integrated microbreaks well into their undergraduate activities and rated the topic relevant to their (later) profession. This should encourage the inclusion of similar programs in undergraduate curricula.

Prevalence of Work-Related Musculoskeletal Symptoms in Veterinary Surgeons - A Cross-Sectional Survey

OBJECTIVES

 The aim of this study was to determine the prevalence of work-related musculoskeletal symptoms (MSS) in veterinary surgeons using an online survey.

METHODS

 An online survey was distributed to 1,031 diplomates of American College of Veterinary Surgeons. Responses were collected with data regarding surgical activities, experience with various types of MSS in 10 different body sites and attempts to reduce MSS.

RESULTS

 Two hundred and twelve respondents (21% response rate) completed the distributed survey in 2021. Ninety-three per cent of respondents had experienced MSS associated with surgery in at least one body part, with the neck, lower back and upper back frequently affected. Musculoskeletal discomfort and pain worsened with prolonged surgical hours. Forty-two per cent of them suffered from chronic pain persisting longer than 24 hours after surgeries. Musculoskeletal discomfort was common regardless of practice emphasis and procedure types. Forty-nine per cent of respondents with musculoskeletal pain had taken medication, 34% sought physical therapy for MSS and 38% ignored the symptoms. Over 85% of respondents showed more than some concern regarding career longevity due to musculoskeletal pain.

CLINICAL SIGNIFICANCE

 Work-related MSS are common in veterinary surgeons, and the results of this study warrant longitudinal clinical studies to determine risk factors and attention to workplace ergonomics in veterinary surgery.

Characterizing exposure to physical risk factors during veterinary surgery with wearable sensors: a pilot study

Occupational ApplicationsVeterinarians provide comprehensive health services for animals, but despite exposure to similar occupational and safety hazards as medical physicians, physical risk factors for these doctors and healthcare teams have not been characterized. In this pilot study, we used wearable sensor technology and showed that veterinary surgeons commonly experience static and demanding postures while performing soft tissue and orthopedic surgeries. Observations showed that muscle activation was highest in the right trapezius. Job factors such as surgical role (attending vs. assisting) and surgical specialty (soft tissue vs. orthopedics) appeared to influence exposure to physical risk factors. These findings suggest a need to consider the unique demands of surgical specialties in order to address the key risk factors impacting injury risks among veterinarians. For example, static postures may be a priority for soft tissue surgeons, while tools that reduce force requirements are more pressing for orthopedic surgeons.Technical AbstractBackground: Although musculoskeletal fatigue, pain, and injuries are commonly reported among surgeons in veterinary medicine, few studies have objectively characterized the exposure to physical risk factors among veterinary surgeons.Purpose: This study aimed to characterize muscle activation and postures of the neck and shoulders during live veterinary surgeries in the soft tissue and orthopedic specialties.Methods: Forty-four ergonomic exposure assessments (exposures) were collected during 26 surgical procedures across five surgeons. Exposures were collected from both soft tissue (n = 23) and orthopedic (n = 21) specialties. Physical risk factors were characterized by: 1) directly measuring muscle activation and posture of the neck and shoulders, using surface electromyography and inertial measurement units, respectively; and 2) collecting self-reported workload, pain, and stiffness.Results: Across the 44 exposures, neck and back symptoms respectively worsened after the surgery in 27% and 14% of the exposures. Veterinary surgeons exhibited neck postures involving a mean of 17° flexion during the surgical procedures. Static postures were common, occurring during 53-80% of the procedures. Compared to soft tissue procedures (e.g., 13.2% MVC in the right trapezius), higher muscle activity was observed during orthopaedic procedures (e.g., 27.6% MVC in the right trapezius).Conclusions: This pilot study showed that physical risk factors (i.e., muscle activity and posture of the neck/shoulder) can be measured using wearable sensors during live veterinary surgeries. The observed risk factors were similar to those documented for medical physicians. Further studies are needed to bring awareness to opportunities for improving workplace ergonomics in veterinary medicine and surgery.

Musculoskeletal discomfort in veterinary healthcare professions

BACKGROUND

Veterinarians appear to be at risk for work-related musculoskeletal discomfort (MSD), based on surveys conducted outside the US.

OBJECTIVE

This study provides new information about MSD prevalence in veterinarians and veterinary technicians in the US.

METHODS

Cross-sectional survey and observation.

RESULTS

A survey of 56 veterinarians and 38 veterinary technicians in Ohio found 12-month prevalence of MSD exceeded 60% in the neck, low back, and legs/feet. More than 85% of participants reported that work activities exacerbated discomfort in at least one region. Less than one-third of participants reported symptom-related lost work time. Personal and work-related burnout scores were higher for veterinary technicians, compared with veterinarians. Nine percent of observed work activities performed by veterinarians and 43% performed by veterinary technicians were rated high or very high risk.

CONCLUSIONS

High prevalence of MSD and low lost work time suggest many individuals are working in pain. Increased adoption of existing ergonomics solutions (equipment and process changes), in addition to further investigation of unmet needs, could improve working conditions and reduce musculoskeletal stress in veterinary health professions.

Electromyographic Analysis of Muscle Activation Patterns During Bovine Transrectal Palpation and the Development of the Bovine Pregnancy Diagnosis Improvement Exercise Program

The unusual and tiring physical activity of bovine transrectal palpation (TRP) requires a novel approach to improve students' TRP and pregnancy diagnosis (PD) skills. It has been shown that students who participated in an exercise program and students who had a grip strength (GS) of more than 30 kilograms performed better in bovine PDs. Participation in the exercise program increased students' sensitivity (ability to identify pregnant cows) but did not increase total arm muscle strength. To identify which muscles are used during TRPs and to improve the exercise program, an electromyographic (EMG) analysis was used to identify muscle activation patterns and muscle activity levels during bovine TRPs. Eight subject matter experts (SMEs) each palpated two live cows and one Breed'n Betsy^® rectal examination simulator while an EMG Triggered Stimulator recorded muscle activity. Muscle activation was higher for forearm muscles compared with all other examined muscle groups (p < .001); was higher during retraction of the uterus and palpation of left and right uterine horn, compared with palpation of cervix, uterine body, left ovary, and right ovary (p < .001); and showed an endurance pattern. Findings have been used to modify the previously developed exercise program in effort to improve students' TRP and PD skills. The Bovine PD Improvement Exercise Program is available to students through an online application (http://icarus.up.ac.za/vetmlp/) and aims to not only improve GS and TRP accuracy but also stamina and well-being while adding fun to busy study schedules.

The Relationship of Grip and Pinch Strength to Musculoskeletal Disorders in Female Carpet Weavers in Southeastern Iran, 2019

Background:

The repetitive and prolonged exertion of grip and pinch strength are current among carpet weaver tasks. The three objectives of this study were (1) to investigate the relationship between symptoms of musculoskeletal disorders and grip and pinch strength of carpet weavers in carpet weaving workshops in Kerman province, (2) to compare the grip and pinch strength of carpet weavers with normal values, and (3) to identify the relationship between hand postures of carpet weavers during work and force exertion.

Methods:

In this cross-sectional study, grip strength and key, tip and palmar pinch strengths of 101 female carpet weavers aged 20 to 71 years were measured in Kerman province, in 2018. Nordic Musculoskeletal Questionnaire (Extended version) was also used to evaluate musculoskeletal disorders.

Results:

Bivariate and multivariate linear regression analyses showed that participants who suffered from musculoskeletal disorders had lower grip and pinch strength than others and this decrease was statistically significant in upper back, wrists/hands, and knees. Moreover, there was a significant difference between grip and three types of pinch strength of carpet weavers and normal values. Furthermore, for both hands, the grip strength in the position recommended by American Society of Hand Therapists was significantly greater than that in the normal position carpet weavers usually adopt.

Conclusion:

Based on the results, the high prevalence of musculoskeletal disorders has led to a significant decrease in the grip and pinch strength of carpet weavers. Therefore, it is necessary to undertake ergonomic interventions in designing the carpet weaving workstation.

Ergonomic assessment of veterinarians during performance of bovine reproductive examinations

OBJECTIVE

To identify and quantify potential ergonomic hazards associated with routine reproductive examinations of cattle.

SAMPLE

7 bovine veterinarians.

PROCEDURES

Each veterinarian was observed and videotaped during 2 bovine reproductive examination appointments. During each appointment, a force-matching protocol was used to estimate the entry force used by the veterinarian to insert an arm into a cow's rectum. Veterinarian posture and repetitive movements and the work environment were assessed and quantified during review of the video recordings. Descriptive data were generated.

RESULTS

Of the 14 appointments observed, 9 and 5 involved examination of beef and dairy cows, respectively. For all veterinarians, an arm inclination ≥ 60° was observed during most reproductive examinations. The number of examinations performed per hour ranged from 19.1 to 116.8. The estimated entry force ranged from 121 to 349 N. During all 9 appointments involving beef cows, the veterinarian participated in other tasks (eg, operating overhead levers, opening gates, or assisting with cattle handling) that represented ergonomic hazards.

CONCLUSIONS AND CLINICAL RELEVANCE

Results confirmed that reproductive examination of cattle exposes veterinarians to various ergonomic hazards involving awkward positions and repetitive and forceful exertions that can contribute to musculoskeletal discomfort and injury, particularly of the upper extremities (neck, shoulders, upper back, arms, elbows, wrists, and hands). Veterinarians frequently participated in other tasks during reproductive examination appointments that exposed them to additional ergonomic hazards. Risk mitigation strategies should prioritize minimizing exposure of veterinarians to tasks not directly associated with the reproductive examination procedure to decrease their overall ergonomic hazard burden.

Risk factors associated with work-preventing musculoskeletal discomfort in the upper extremities of bovine practitioners

OBJECTIVE

To identify risk factors associated with work-preventing musculoskeletal discomfort (MSKD) in the upper extremities (defined as neck, shoulders, upper back, arms, elbows, wrists, and hands) of bovine practitioners.

SAMPLE

116 members of the Western Canadian Association of Bovine Practitioners.

PROCEDURES

Data from a previously described cross-sectional survey of western Canadian bovine practitioners underwent further analysis. The survey, developed to glean information about MSKD in bovine practitioners, was a modified standardized Nordic questionnaire that included questions regarding personal and work characteristics and incidence and location of MSKD during the preceding 12 months along with perceptions about most physically demanding tasks. Logistic regression was used to identify factors associated with work-preventing upper extremity MSKD.

RESULTS

18 of 116 (15.5%) respondents indicated they had experienced work-preventing upper extremity MSKD during the preceding 12 months. The final multivariable regression model indicated that practice type (mixed animal vs primarily [> 50%] bovine; OR, 3.20; 95% CI, 0.96 to 10.67), practitioner height (OR, 0.93; 95% CI, 0.87 to 0.99), and number of veterinarians in the practice (OR, 1.32; 95% CI, 1.05 to 1.66) were significantly associated with the odds of work-preventing upper extremity MSKD.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that reproductive examination of cattle was not a significant risk factor for upper extremity MSKD in bovine practitioners. Further research into the effects of biomechanical, organizational, and psychosocial workplace factors on the development of MSKD in bovine practitioners is necessary to help inform prevention strategies to foster career longevity in this increasingly diverse practitioner group.

Kinematic and perceptual responses in heavy lifting and pulling: Are there differences between males and females?

This study investigated kinematic and perceptual differences between the sexes in a heavy lifting and pulling task. A 20 kg box was lifted from floor to chest height, and a 70 kg mannequin pulled across 20m. The effect of height, mass and average grip strength on kinematics and perceived workload was examined in 42 (19 females, 23 males) healthy individuals. A univariate linear regression analysis found females lifted with greater lumbar extension compared to males (p < 0.001), and adopted more hip (p = 0.006) and knee flexion (p = 0.036) in the pulling task. Females reported a greater perceived workload in both tasks (p < 0.001). After the multivariable analysis, only grip strength remained significant for perceived workload in the lift (p = 0.04), and height for knee flexion in the pull (p = 0.009). This highlights that height and strength are important factors driving kinematics and perceived workload. Clinicians may consider these factors in heavy manual tasks, more so than sex.

Dawal SZ, Yusoff N. Maximum acceptable frequency of lift for combined manual material handling task in Malaysia

BACKGROUND

Extensive studies have been carried out over the years to determine the maximum acceptable weight that a worker is capable of lifting in a given situation among Occidental populations across Europe and US. Nonetheless, studies that place emphasis on using lifting frequency as the quantifying task parameter, especially in developing countries such as Malaysia, appear to be in scarcity. Hence, this study determined the maximum acceptable frequency of lift (MAFL) for combined manual material handling (MMH) tasks amongst Malaysian males.

METHOD

Two lifting loads were considered in this study: 1 kg and 5 kg. Each subject adjusted his frequency of lifting using a psychophysical approach. The subjects were instructed to perform combined MMH task as fast as they could over a period of 45 minutes without exhausting themselves or becoming overheated. The physiological response energy expenditure was recorded during the experimental sessions. The ratings of perceived exertion (RPE) for four body parts (forearms, upper arm, lower back and entire body) were recorded after the subjects had completed the instructed task.

RESULTS

The mean frequencies of the MMH task had been 6.8 and 5.5 cycles/minute for lifting load of 1 and 5 kg, respectively, while the mean energy expenditure values were 4.16 and 5.62 kcal/min for 1 and 5 kg load, respectively. These displayed a significant difference in the Maximum Acceptable Frequency of Lift (MAFL) between the two loads, energy expenditure and RPE (p < 0.05) whereby the subjects appeared to work harder physiologically for heavier load.

CONCLUSION

It can be concluded that it is significant to assess physiological response and RPE in determining the maximum acceptable lifting frequency at varied levels of load weight. The findings retrieved in this study can aid in designing tasks that do not exceed the capacity of workers in order to minimise the risk of WRMSDs.

Assessment of Musculoskeletal Injuries Associated with Palpation, Infection Control Practices, and Zoonotic Disease Risks among Utah Clinical Veterinarians

OBJECTIVES

Practicing veterinarians are exposed to unique occupational hazards and zoonotic diseases. National studies have highlighted an increase risk to injuries and a lack of veterinary awareness for these hazards. In Utah (and likely other states), reports of acquired zoonoses are sporadic, and underlying risk factors poorly understood. To better clarify occupational risk factors, the knowledge, attitudes, and behaviors of Utah veterinarians were examined.

METHODS

A total sample of 809 Utah veterinarians were identified from the 2017 licensure listing provided by the Utah Division of Professional Licensing. These individuals were invited to participate in an internet-based survey to self-report musculoskeletal injuries associated with large animal palpation practices. The relationships between some variables and Precaution awareness (PA) score rankings were examined using logistic regression and odds ratios.

RESULTS

Of 809 veterinarians, 223 (28%) responded, with 209 self-identifying as clinical veterinarians. Frequent palpation of large animals (equine or bovine) was performed by 43 (22%) of 197 responding veterinarians. Joint pain or injury was experienced by 29 (67%) of 43 responding veterinarians who frequently palpated large animals (equine or bovine). Animal bites, needle-sticks, and cuts were the most frequently reported injuries within the past year. There were 44 (22%) of 197 respondents who reported having contracted a zoonotic disease. Most of the respondents failed to use appropriate PPE when examining an ill animal or when handling potentially infectious specimens. Clinical veterinarians who have less than 10 years of experience and work in a practice providing clinic-based services were 2.3 and 3.8 times more likely to have low PA rankings, respectively.

CONCLUSION

Our work underscores the importance for continued clinical veterinarian education on occupational risks associated with musculoskeletal injuries, animal bites, needle-sticks, and cuts. The fact that survey veterinarians reported a high level of zoonotic disease infection illustrates the need for education and training on proper PPE use. Further work is needed to understand why precaution awareness scores were low among this sample of participants in this study. Additional follow-up with veterinarians is recommended to assess availability of large animal handling facilities and safety practices to prevent musculoskeletal injuries.

The examination of work-related musculoskeletal discomforts and risk factors in veterinarians

This study aimed to determine the frequency of work-related musculoskeletal discomforts (WMSDs) observed in veterinarians and the risk factors that may bring about these. Two hundred and seven veterinarians working in three provinces in south west Turkey were included in the study. The demographic and occupational information on the participants was recorded. The Modified Nordic Musculoskeletal Questionnaire was used to evaluate the musculoskeletal problems of different body parts, which cause difficulties at work and result in staying away from work. 49.8 % of veterinarians mostly have problems with lower back, 41.1 % with back, and 39.1 % with neck. The frequency of WMSDs tends to increase with the progress of professional experience. Three work-related activities during which veterinarians experience most difficulties while at work are obstetric procedures (28 %), vaccination (25.6 %), and driving (23.2 %). It is statistically significant that arm problems are observed more in veterinarians working with large animal types (p<0.05). The high level of job related stress and low job satisfaction statistically significantly affect the formation of WMSDs (p<0.05). The study showed that a large number of veterinarians experienced work-related musculoskeletal pain and discomforts that could be caused by some physical and psychosocial risk factors. Therefore, it is recommended for veterinarians to receive education on ergonomics and exercise from the beginning of their professional lives to prevent WMSDs.

Work environment and occupational risk assessment for small animal Portuguese veterinary activities

The professional work of small animal veterinary staff encompasses a wide diversity of demanding tasks. This has prompted a number of studies covering physical, chemical, biological, ergonomic, or psychological hazards, as well as their health effects upon veterinary workers. However, such results were obtained from self-reported surveys (via paper or online). This study reports the identification of potential hazards and provides a risk assessment of 15 veterinary clinics based on data from walk-through surveys, interviews with workers, and quantification of indoor air quality parameters including concentration of volatile organic compounds (total, isoflurane, and glutaraldehyde). The risk arising from X-ray exposure was unacceptable in seven clinics; X-ray examination should be discontinued in the absence of isolated radiation rooms, poor safety practices, and lack of personal protective equipment. Ergonomic-related hazards and work practices should be revised as soon as possible, considering that improper postures, as well as moving and lifting heavy animals are major causes of musculoskeletal disorders. The risk levels were, in general, small or medium (acceptable) with regard to exposure to physical hazards (such as bites, scratches, cuts, and burns) and biological hazards. It was observed that the indoor air quality parameters including temperature, respirable particulate matter and total volatile organic compounds do not indicate a comfortable workplace environment, requiring clinics' attention to keep the safe environment. The veterinarians and nurses were exposed to isoflurane (above 2 ppm) during surgery if an extractor system for waste gas was used instead of a scavenging system. Finally, veterinary workers did not possess any type of training on occupational safety and health issues, even though they recognized its importance.

Trapezius muscle activity and body movement at the beginning and the end of a workday and during the lunch period in female office employees

The aim of this study was to analyze the activity of the trapezius muscle and the arm acceleration during the course of a workday in office employees. It was examined if there are significant changes in trapezius muscle activity in the afternoon compared to the morning work period and relationships to the level of arm acceleration during lunchtime. Nineteen female office employees were recruited. A one hour period of the work in the morning, afternoon, and lunchtime were compared. The measures of the trapezius muscle activity and muscle rest time (TR) did not significantly differ between working in the morning (TR: median 10%; range 1%-49) or working in the afternoon (TR: median 18%; range 2%-34%). The 90^th percentile of arm acceleration during lunch time significantly correlated with less trapezius muscle activity in the afternoon compared to the morning values (RT: Spearman R=0.80; p<0.01). Differences in the duration and level of trapezius muscle activity were bigger between the subjects than between different work periods or between lunchtime and work. Furthermore it seems that higher arm accelerations during lunch may be beneficial in reducing trapezius activity in the afternoon compared to the morning values.

The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs

As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

Muscle activity and hand motion in veterinarians performing laparoscopic training tasks with a box trainer

OBJECTIVE

To evaluate muscle activity and hand motion in veterinarians performing a standard set of laparoscopic training tasks.

SAMPLE

12 veterinarians with experience performing laparoscopic procedures.

PROCEDURES

Participants were asked to perform peg transfer, coordination, precision cutting, and suturing tasks in a laparoscopic box trainer. Activity of the right biceps brachii, triceps brachii, forearm flexor, forearm extensor, and trapezius muscles was analyzed by means of surface electromyography. Right hand movements and wrist angle data were registered through the use of a data glove, and risk levels for the wrist joint were determined by use of a modified rapid upper limb assessment (RULA) method. One-way repeated-measures ANOVA with a Bonferroni post hoc test was performed to compare values between tasks.

RESULTS

Activity in the biceps muscle did not differ significantly among the 4 tasks. Activity in the triceps, forearm flexor, and forearm extensor muscles was significantly higher during precision cutting than during the coordination task. Activity in the trapezius muscle was highest during the suturing task and did not differ significantly among the other 3 tasks. The RULA score was unacceptable (score, 3) for the coordination, peg transfer, and precision cutting tasks but was acceptable (score, 2) for the suturing task.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that the ergonomics of laparoscopic training depended on the tasks performed and the design of the instruments used. Precision cutting and suturing tasks were associated with the highest muscle activity. Acceptable wrist position, as determined with the RULA method, was found with the suturing task, which was performed with an axial-handled instrument.

Survey of occupational hazards in Minnesota veterinary practices in 2012

OBJECTIVE

To identify the scope of occupational hazards encountered by veterinary personnel and compare hazard exposures between veterinarians and technicians working in small and large animal practices.

DESIGN

Cross-sectional survey.

POPULATION

Licensed veterinarians and veterinary staff in Minnesota.

PROCEDURES

A survey of Minnesota veterinary personnel was conducted between February 1 and December 1, 2012. Adult veterinary personnel working in clinical practice for > 12 months were eligible to participate. Information was collected on various workplace hazards as well as on workplace safety culture.

RESULTS

831 eligible people responded, representing approximately 10% of Minnesota veterinary personnel. A greater proportion of veterinarians (93%; 368/394) reported having received preexposure rabies vaccinations than did veterinary technicians (54%; 198/365). During their career, 226 (27%) respondents had acquired at least 1 zoonotic infection and 636 (77%) had been injured by a needle or other sharps. Recapping of needles was reported by 87% of respondents; the most common reason reported by veterinarians (41%; 142/345) and veterinary technicians (71%; 238/333) was being trained to do so at school or work. Recent feelings of depression were reported by 204 (25%) respondents. A greater proportion of technicians (42%; 155/365) than veterinarians (21%; 81/394) indicated working in an environment in which employees experienced some form of workplace abuse.

CONCLUSIONS AND CLINICAL RELEVANCE

Veterinary personnel in Minnesota were exposed to several work-related hazards. Practice staff should assess workplace hazards, implement controls, and incorporate instruction on occupational health into employee training.

Work-related injuries to animal care workers, Washington 2007-2011

BACKGROUND

For workers engaged in animal care, workplace hazards are common and may outnumber those experienced by human healthcare workers.

METHODS

We used accepted Washington State workers' compensation claims for the period from January 1, 2007 and December 31, 2011 to compare injury rates and types of injuries across animal care occupations.

RESULTS

Work-related injuries frequently affect veterinary support staff and those working in pet stores, shelters, grooming facilities and kennels. Animal-related injuries were the most commonly reported injury type experienced by all groups, though the animal source of injury appears to differ by work setting.

CONCLUSIONS

Workplace related injuries among animal care workers are common and most often caused by physical insults resulting from worker-animal interaction.

Interaction between physical and psychosocial risk factors on the presence of neck/shoulder symptoms and its consequences

This study aimed to quantify the interaction between physical and psychosocial factors on the presence of neck/shoulder symptoms (NSS) and its consequences (reduced activities and absenteeism) among 1294 coal mining workers in Indonesia. A self-administered questionnaire was used to obtain information on current workplace exposure and NSS and its consequences. Participants were grouped into one of four combination exposure groups: low physical and low psychosocial (as the reference group); low physical and high psychosocial; high physical and low psychosocial, and high physical and high psychosocial (HPhyHPsy). The attributable proportion (AP) due to interaction between both factors was examined. Individuals in the HPhyHPsy group were most likely to report NSS [odds ratio (OR) 4.83, 95% confidence interval (CI) 2.43-9.58], reduced activities (OR 3.90, 95% CI 2.36-6.43), and absenteeism (OR 3.91, 95% CI 2.11-7.25). This study has shown an interaction between physical and psychosocial factors that increases the OR of NSS (AP 0.49, 95% CI 0.08-0.89). Practitioner Summary: Although physical and psychosocial factors are known to be predictors for NSS, little is known about their interaction. Self-reported questionnaire was used to obtain information about physical and psychosocial factors at work. This study found an interaction between the physical and psychosocial risk factors that increases the odds ratio of NSS.

Interaction between physical and psychosocial work risk factors for low back symptoms and its consequences amongst Indonesian coal mining workers

This study assessed the interaction between physical and psychosocial factors for low back symptoms (LBS) and its consequences (reduced activities and absenteeism) in a developing country. A sample of 1294 Indonesian coal mining workers reported occupational exposures, LBS and its consequences using a self-administered questionnaire. Respondents were placed into one of four combination exposure groups: high physical and high psychosocial (HPhyHPsy); high physical and low psychosocial (HPhyLPsy); low physical and high psychosocial (LPhyHPsy), and; low physical and low psychosocial (LPhyLPsy). The attributable proportion due to interaction between physical and psychosocial factors was examined. Individuals in the HPhyHPsy group were most likely to report LBS (OR 5.42, 95% CI 3.30-8.89), reduced activities (OR 4.89, 95% CI 3.09-7.74), and absenteeism (OR 4.96, 95% CI 3.05-8.06). Interactions between physical and psychosocial factors were present for LBS, reduced activities, and absenteeism; although for LBS and absenteeism the interactions were not significant. Current smokers were more likely to report LBS consequences. Permanent employment and night shift work increased the odds of LBS and its consequences. We conclude that interventions aimed at reducing LBS and its consequences should address both physical and psychosocial factors, with a focus on smokers, permanent employment and night shift work.

The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences

This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression. Combined exposure to physical and psychosocial/organisational and/or environmental factors increased the odds of MSS in the neck/shoulder (OR 3.14, 95% CI 1.79-5.52), arms/elbow regions (OR 4.14, 95% CI 2.21-7.76) and low back (OR 1.74, 95% CI 1.28-2.37) and its consequences, i.e. reduced activities due to neck/shoulder symptoms (OR 5.45, 95% CI 2.28-13.00), absenteeism due to neck/shoulder symptoms (OR 5.19, 95% CI 2.24-12.01) and absenteeism due to low back symptoms (OR 4.37, 95% CI 2.92-6.53). In contrast, favourable psychosocial/organisational work conditions reduced the odds of wrist symptoms due to poor physical work conditions (OR 2.19, 95% CI 1.44-3.34). We conclude that to reduce MSS and its consequences, employers need to adopt a multifaceted approach: concentrate on improving physical conditions as well as the psychosocial/organisational and environmental aspects of the working environment.

Physical workload, trapezius muscle activity, and neck pain in nurses' night and day shifts: a physiological evaluation

The purpose of this study was to compare physical workload, electromyography (EMG) of the trapezius muscle, neck pain and mental well-being at work between night and day shifts in twenty Swiss nurses. Work pulse (average increase of heart rate over resting heart rate) was lower during night (27 bpm) compared to day shifts (34 bpm; p < 0.01). Relative arm acceleration also indicated less physical activity during night (82% of average) compared to day shifts (110%; p < 0.01). Rest periods were significantly longer during night shifts. Trapezius muscle rest time was longer during night (13% of shift duration) than day shifts (7%; p < 0.01) and the 50th percentile of EMG activity was smaller (p = 0.02), indicating more opportunities for muscle relaxation during night shifts. Neck pain and mental well-being at work were similar between shifts. Subjective perception of burden was similar between shifts despite less physical burden at night, suggesting there are other contributing factors.

Self-reported musculoskeletal disorders of the distal upper extremities and the neck in German veterinarians: a cross-sectional study

Background

Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD), the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed.

Methods

In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4%) veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities.

Results

MSD in the neck (66.6%) and shoulder (60.5%) were more prevalent than in the hand (34.5%) or elbow (24.5%). Normal activities were affected in 28.7% (neck), 29.5% (shoulder), 19.4% (hand) and 14% (elbow) of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3%) or in the shoulder (10.8%). The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%). For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout.

Conclusion

From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work.

Personal consequences of work-related physical discomfort: an exploratory study

BACKGROUND

Work-related physical discomfort has been reported in Australian optometrists. The purpose of this paper is to explore the personal consequences of work-related discomfort.

METHODS

Forty-seven optometrists with self-reported work-related discomfort participated in a 30-minute telephone or face-to-face interview related to ergonomics and physical comfort. Self-employed, employee, locum and retired optometrists participated. Four avenues were investigated; namely, description of discomfort, non-work contributing factors, whether the participant has ever stopped work due to discomfort, and the treatments accessed to alleviate discomfort. These data were subject to qualitative and quantitative analyses.

RESULTS

Reported discomfort ranged from mild to severe. Eight participants (17 per cent) ascribed their discomfort entirely to work and seven (15 per cent) cited non-work factors as the cause. Many participants (32, 68 per cent) reported that non-work factors, for example, sport and driving, aggravated existing work-related discomfort and for some, their discomfort impacted on home and leisure activities. There were 15 participants (32 per cent), who have stopped work because of discomfort, including two who have ceased working as an optometrist and two who now work reduced hours. The majority (32) continue to work despite discomfort. Many participants (31, 66 per cent) seek treatment to alleviate discomfort, with seven participants (15 per cent) reporting that they receive multiple therapies per week. Work-related discomfort was generally viewed as a personal issue, with most participants accessing treatment in their own time (27, 57 per cent) and funding it personally or with private health insurance. Only four participants have received funding through workers' compensation or income protection insurance.

CONCLUSIONS

Work-related discomfort has significant financial and personal costs for some Australian optometrists. These qualitative data can be used to develop quantitative tools for assessing the impact of discomfort on quality of life for optometrists and their families. The results also highlight the need for preventative action to reduce work-related discomfort within the optometric profession.

Prevalence of low back symptoms and its consequences in relation to occupational group

BACKGROUND

The purpose of this study was to examine: (1) the prevalence of low back symptoms (LBS) and its consequences (reduced activities and absenteeism); (2) the association between occupational group and LBS; and (3) the association between LBS and its consequences.

METHODS

A self-administered questionnaire was used to determine the prevalence of LBS in 1,294 Indonesian coal mining workers. A Cox proportional hazards model was developed to quantify the 12-monthly hazard of LBS. Logistic regression models were developed to identify risk factors for reduced activity and absenteeism from the workplace.

RESULTS

The 12-month period prevalence for LBS, reduced activities, and absenteeism were 75%, 16%, and 13%, respectively. The 12-monthly hazard of LBS for blue-collar workers was 1.85 (95% CI: 1.06-3.25) times that of white-collar workers. LBS and smoking increased the risk of reduced activity and absenteeism.

CONCLUSIONS

Indonesian coal mining workers have a high prevalence of LBS. The findings imply that efforts to reduce LBS and in the workplace should focus on blue-collar workers. For smokers who report reduced activities and/or absenteeism, there should be a focus on rehabilitation and/or return-to-work programs.

Prevalence and Risk Factors Associated with Musculoskeletal Discomfort in Spay and Neuter Veterinarians

Simple Summary

This study examined musculoskeletal pain and discomfort in spay and neuter veterinarians using an internet-based questionnaire. Hand pain was most common in the right thumb and wrist, and body pain was most common in the lower back, shoulders, and neck. Several work-related risk factors for discomfort were discovered, including long career in spay and neuter, increasing weekly hours in surgery, and decreasing job satisfaction. Although most respondents felt posture during surgery was important, few spay and neuter veterinarians have received any instruction in posture or ergonomics in surgery.

Abstract

A cross-sectional study to investigate musculoskeletal discomfort (MSD) surveyed 219 veterinarians who currently or previously perform spays and neuters at least 4 hours per week. Participants were asked about the presence and severity of hand and body MSD during the previous month, whether MSD interfered with work or daily activities, whether they attributed their MSD to their spay/neuter work, and whether MSD had ever necessitated absence from work. The period prevalence of MSD was 99.1%, with 76.7% experiencing hand or wrist pain and 98.2% experiencing body pain. Hand discomfort was most commonly reported in the right thumb and/or thumb base (49.8%) and the right wrist (37.9%). Body discomfort was most commonly reported in the lower back (76.7%), shoulders (72.6%), and neck (71.7%). Increasing career length, increasing weekly hours in surgery and decreasing job satisfaction were the work-related factors with the greatest relative contribution accounting for variation in hand pain severity and total pain. Although 94.4% of respondents felt that posture during surgery is important, only 30.6% had received any instruction in posture and positioning for surgery. Future interventions should aim to optimize surgical efficiency, surgeon work schedules, and working environment. Analysis and intervention studies are required to determine further causes of MSD in these veterinarians and develop interventions to prevent MSD.

Work-related musculoskeletal disorders among Irish farm operators

BACKGROUND

To establish prevalence, risk factors, and impact of work-related musculoskeletal disorders (WMSDs) among farmers in Ireland.

METHODS

In summer 2009, a questionnaire was appended to the Teagasc (Irish Agricultural and Food Development Authority) National Farm Survey (n = 1,110) to obtain data on the prevalence, risk factors and impact of WMSDs amongst farm operators in Ireland. Data were collected by trained recorders and analyzed using chi-square tests, t-tests, Mann-Whitney's U-tests and logistic regression models.

RESULTS

The prevalence of WMSDs in the previous year was 9.4% (n = 103), with the most commonly affected body region being the low back 31% (n = 32). Nearly 60% (n = 57) of farmers reported missing at least a full day's work as a consequence of their WMSD. Personal factors evaluated using binary regression analysis, were found not to influence whether or not a farmer experienced a WMSD. However, work-related factors such as larger European Size Units (ESUs, OR: 1.007, CI: 1.002-1.012), greater number of hectares farmed (OR: 2.501, CI: 1.208-4.920), higher income (OR: 1.859, CI: 1.088-3.177), dairy enterprise (OR: 1.734, CI: 1.081-2.781), and working on a full-time farm (OR: 2.156, CI: 1.399-3.321) increased the likelihood of experiencing a WMSD. Working on a full-time farm was the only factor found to independently predict WMSDs in the multiple regression analyses.

CONCLUSIONS

This study suggests that the prevalence of WMSDs can be reduced by the application of improved farm management practices. A more detailed examination of the risk factors associated with WMSDs is required to establish causality and develop effective interventions.

Serious injuries to Australian veterinarians working with cattle

OBJECTIVE

To describe the factors associated with serious injuries sustained during cattle-associated activities by veterinarians responding to the Health Risks of Australian Veterinarians (HRAV) survey.

METHODS

Responses from the HRAV survey were reviewed and the factors associated with serious injuries reported by veterinarians while working with cattle were analysed. All veterinarians who had graduated from Australian veterinary schools between 1960 and 2000 were eligible for inclusion in the survey.

RESULTS

The survey identified 474 serious injuries sustained while undertaking cattle-associated activities. Most cattle-associated injuries (82%) were sustained in stock or handling yards and 57% of reported injuries were sustained while undertaking pregnancy testing or undertaking examinations. Nearly 80% of all cattle-associated injuries were sustained as a result of the veterinarian being kicked or struck (49%) or pushed against or stepped on (30%). The part of the body most commonly injured was the upper limbs. Fractures were the most common type of serious injury sustained. The use of safety precautions at the time of the injury was reported by 62% of those veterinarians reporting injury.

CONCLUSIONS

This study describes factors associated with serious injuries while working with cattle, as reported by veterinarians responding to the HRAV survey. Findings from this study will facilitate discussions aimed at addressing injury prevention for cattle veterinarians, including improving the awareness of safe handling practices and safety precautions.

An evaluation of low back pain among farmers in Ireland

BACKGROUND

Low back pain (LBP) is the most commonly reported musculoskeletal disorder among farmers. There is limited research regarding LBP among farmers in Ireland.

AIMS

To explore attributed causes of LBP, investigate the relationship between LBP and personal and work-related factors and measure the impact of LBP.

METHODS

A questionnaire survey of Irish farmers was conducted on farmers from each of the main farm enterprise systems in Ireland. Data were analysed using chi-square tests, t-tests, Mann-Whitney tests and logistic regression models.

RESULTS

There were 600 farmers included in the survey with 100 from each of the six main farm systems. Lifting/pulling/pushing was identified as the most commonly attributed cause of LBP. In the multiple regression analysis the variables found to be associated with LBP included farm size and self-rated health. The odds ratios (OR) of LBP were greater among operators of medium and large farms [(OR = 1.52; 95% confidence interval (CI): 1.04-2.22 and OR = 1.86; 95% CI: 1.16-3.98, respectively] compared with smaller farms (P < 0.05). Those who perceived health as 'good' (OR = 1.63; 95% CI: 1.14-2.33) by comparison with a rating of 'very good' had greater odds of LBP (P < 0.01). Some farmers changed work habits, sought help and needed time off work due to LBP.

CONCLUSIONS

Lifting was identified as the main attributed cause for LBP. LBP leads to work disability that necessitated farmers changing work habits, getting help and needing time off work. In order to reduce LBP-related disability among farmers in the future, work practices involving lifting need to be further investigated.

Cumulative trauma disorders among California veterinarians

BACKGROUND

The prevalence of cumulative trauma disorders (CTDs) in veterinarians has not been adequately studied.

METHODS

A questionnaire was sent to 2,000 California veterinarians in 1997; the return rate was 73% (n = 1,415).

RESULTS

Ninety-six percent (1,353) of the respondents were professionally active and were included in the analyses. Sixty-four percent were male and 90% were working full-time. One-fourth of the respondents reported a CTD during their career that required treatment or restricted usual activities. Two-thirds of those reporting CTDs reported chronic or residual problems. In a multivariate regression analysis female sex, working full-time, rectal palpations, and large animal practice were significant risk factors for CTDs.

CONCLUSIONS

Being in large animal practice increased the CTD risk for both women and men whether they worked full or part-time. CTD risk was highest in women working full-time and doing 80% rectal palpations. Preventive methods to attenuate the risk of CTDs especially in large animal practice should be investigated.

Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms

Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e. self-reported reduced activities and absenteeism). The 12-month period prevalence of reduced activities and absenteeism were 18% and 9%, respectively. Lifting (OR 1.79 95% CI 1.16-2.77) increased the risk of reduced activities. Working in awkward/tiring positions (OR 2.11 95% CI 1.20-3.70) and in a cold/damp environment (OR 2.18 95% CI 1.11-4.28) increased the risk of absenteeism. Among those with LBS, reduced activities increased with working in a hot/warm environment (OR 2.14 95% CI 1.22-3.76) and absenteeism was increased with work in awkward/tiring positions (OR 2.06 95% CI 1.13-3.77), tight deadlines (OR 1.89 95% CI 1.02-3.50), and a hot/warm environment (OR 3.35 95% CI 1.68-6.68). Interventions to reduce the consequences of LBS should aim to reduce awkward/tiring positions, lifting and work in a cold/damp environment. For individuals with LBS, additional focus should be to reduce tight deadlines, and work in hot/warm environments.

How do Australian optometrists manage work-related physical discomfort?

BACKGROUND

Work-related physical discomfort exists within the optometric profession. It is not well understood how optometrists manage this issue in their workplaces.

METHOD

An online questionnaire was sent by e-mail to approximately 1,700 Australian optometrists. Participants were asked if they experienced work-related discomfort in any of eight nominated body regions. If so, they were asked to describe specific work tasks, which contribute to their work-related discomfort, and strategies they have adopted to minimise their discomfort. These data were subject to qualitative and quantitative analyses.

RESULTS

There was a 25 per cent response rate and 416 optometrists participated in the questionnaire. Work-related physical discomfort was reported by 339 respondents (81 per cent), most commonly with the use of the phoropter (n = 144, 35 per cent) and slitlamp (n = 94, 23 per cent). Males were more likely to report lower back discomfort with phoropter use (Chi-squared, p < 0.01) and ophthalmoscopy (Chi-squared, p < 0.01). To minimise discomfort, optometrists 41 years and older were more likely to report that they adjust their posture (Chi-squared, p < 0.03) and females were more likely to report that they alter their work schedule (Chi-squared, p < 0.05). A recurrent theme expressed by participants was an inability to make changes to improve their comfort due to room and equipment design, poorly maintained equipment, non-supply of suitable equipment or furniture and inherent difficulties within optometric tasks.

CONCLUSION

There is a need for all optometrists to have skills to evaluate their own personal risk of discomfort in the consultation room. Owners and managers of optometric practices also need greater awareness of the importance of room and equipment design and maintenance on work-related discomfort. This has implications for the well-being of optometrists, for their productivity and for compliance with health and safety legislation.

Prevalence of musculoskeletal disorders among farmers: A systematic review

OBJECTIVE

To determine the prevalence of musculoskeletal disorders (MSDs) among farmers and to establish the most common regional MSDs reported.

METHODS

Comprehensive electronic searches of Pubmed, Web of Science, CINAHL, SCOPUS, EMBASE, Agris Database, and Cochrane Library were carried out using keywords for MSDs and farmers. Pooled estimates of prevalence with 95% confidence intervals were calculated for overall MSD prevalence and the most common regional MSDs reported.

RESULTS

Twenty-four studies fulfilled the inclusion criteria and were incorporated into this review. From these studies, life-time prevalence of any form of MSD among farmers was 90.6% while 1-year MSD prevalence was 76.9% (95% CI 69.8-82.7). The majority of studies focused on spinal MSDs with low back pain (LBP) the most frequently investigated. Life-time LBP prevalence was 75% (95% CI 67-81.5) while 1-year LBP prevalence was 47.8% (95% CI 40.2-55.5). The next most common regional MSDs reported were upper (range 3.6-71.4%) and lower extremities (range 10.4-41%).

CONCLUSIONS

The systematic review identified the prevalence of MSDs by body region in farmers and established that LBP was the most common MSD, followed by upper and then lower extremity MSDs. Reported trends suggest that the prevalence of MSDs in farmers is greater than in non-farmer populations. Case-definition uniformity among MSD researchers is warranted. More studies are needed regarding upper and lower extremity MSDs, gender, workplace, and task context of MSDs.

Gender differences in work-related risk factors associated with low back symptoms

The prevalence of low back symptoms (LBS) in many working populations is high and differences in prevalence between genders are inconsistent. However, gender-specific risk factors for LBS have seldom been examined. Hence, the aim of the present study was to indicate gender-specific LBS risk factors. A sample of 3003 people was interviewed by telephone to get information about current workplace exposure and LBS. The risk of LBS for the whole population increased with work in awkward/tiring positions (OR 1.37, 95% CI 1.12-1.68) and very/extremely stressful jobs (OR 1.46, 95% CI 1.05-2.03). None of the explanatory variables were significantly associated with LBS for males but working in awkward/tiring positions (OR 1.51, 95% CI 1.04-2.20), dissatisfaction with contact and cooperation with management (OR 1.68, 95% CI 1.02-2.78) and finding their job to be very/extremely stressful (OR 2.27, 95% CI 1.46-3.52) were significantly associated with LBS for females. Interventions to reduce LBS in workplaces should focus on reducing working in awkward/tiring positions, improving contact and cooperation with management, and reducing stressful jobs, especially amongst females.

PRACTITIONER SUMMARY

Strategies to prevent or reduce LBS should focus on reducing exposure to awkward or tiring positions at work, improving contact and cooperation with management, and reducing stressful jobs, especially for females.

The prevalence and characteristics of back pain among school children in New Zealand

A cross-sectional survey among 245 children was conducted to establish the prevalence and characteristics of back pain in school children aged 11-14 years. A self-complete questionnaire was used to ascertain demographic details, pain prevalence, psychosocial parameters, school and leisure activities and family characteristics. In the last month, 58% of children had experienced spinal pain. In total, 31% of children reported that pain occurred in one part of the back, while 28% stated that pain presented in more than one spinal region. Pain in the last month was found to be equally prevalent in the low back (35%) and neck (36%) regions. Low back pain was associated with the most severe pain and pain lasting for the longest duration when compared with the upper back and neck regions. Further research should be directed towards investigating pain in the neck region and understanding the characteristics of symptom co-occurrence. STATEMENT OF RELEVANCE: A survey was conducted to establish the prevalence and characteristics of back pain in school children. The results provide additional evidence that back pain is a serious problem in children aged 11-14 years, whilst also indicating widespread co-occurrence of pain in the neck, upper back and lower back spinal regions.