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

Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis

BACKGROUND

Low back pain (LBP) is one of the most common musculoskeletal conditions. People with LBP often display changes of neuromuscular control and trunk mechanical properties, including trunk stiffness. Although a few individual studies have examined back muscle stiffness in individuals with LBP, a synthesis of the evidence appears to be lacking. Therefore, the aim of this systematic review with meta-analysis was to synthesize and evaluate the available literature investigating back muscle stiffness in association with LBP.

METHODS

We conducted a systematic review of the literature according to the PRISMA guidelines. We searched Pubmed, Scopus, Web of Science and ScienceDirect for studies, that compared back muscle stiffness, measured either by ultrasound-based elastography or myotonometry, between individuals with and without LBP. Pooled data of the included studies were presented descriptively. Additionally, we performed two meta-analyses to calculate the standardized mean difference between the two groups for resting stiffness of the multifidus and erector spinae muscle. For both meta-analyses, the random effect model was used and the weight of individual studies was calculated using the inverse-variance method. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional studies. Furthermore, the certainty of evidence was evaluated using the GRADE approach.

RESULTS

Nine studies were included in our systematic review. Our results suggest that individuals with LBP have higher stiffness of the multifidus (SMD = 0.48, 95% CI: 0.15 - 0.81, p < 0.01; I2 = 48 %, p = 0.11) and erector spinae at rest (SMD = 0.37, 95% CI: 0.11 - 0.62, p < 0.01; I2 = 39 %, p = 0.14) compared to asymptomatic controls. On the other hand, the evidence regarding muscle stiffness during submaximal contractions is somewhat contradictory.

CONCLUSIONS

Based on the findings of this systematic review we conclude that people with LBP may have higher back muscle stiffness compared to asymptomatic controls. Addressing muscle stiffness might represent an important goal of LBP treatment. Nevertheless, our findings should be interpreted with extreme caution due to a limited quality of evidence, small number of included studies and differences in measurement methodology.

Relationship of Healthy Building Determinants With Back and Neck Pain: A Systematic Review

OBJECTIVE

Back pain and neck pain are very common, costly, and disabling. Healthy building determinants within the built environment have not been adequately assessed as contributors to these conditions. The objective of this study was to systematically review the literature on the relationship of healthy building determinants with back and neck pain.

DATA SOURCE

PubMed, CINAHL, EMBASE, Google Scholar, and PEDRo. Study Inclusion and Exclusion Criteria: Studies were included if they met the following criteria: Adults, comparison of healthy building determinants (air quality, ventilation, dust and pests, lighting and views, moisture, noise, safety/security, thermal health, water quality) with back and neck pain, original research, English. Studies were excluded if full text articles were unavailable and if the focus was patient and materials handling or ergonomics.

DATA EXTRACTION

Data extraction and other review procedures were elaborated according to PRISMA guidelines. Data Synthesis: Data were synthesized with an approach adapted from Oxford Centre for Evidence-Based Medicine and American Physical Therapy Association.

RESULTS

37 articles enrolling 46,223 participants were eligible. Most articles were cross-sectional (31/37) and fair quality (28/37). None were interventional. Evidence was found to generally support a relationship indicating that as healthy building determinants worsen, the risk of back and neck pain increases.

CONCLUSION

Although the available evidence precludes interpretations about causality, the study's findings are starting points to guide future research, knowledge creation, and health promotion initiatives about the relationships of the built environment with back and neck pain.

Association between back and neck pain and workplace absenteeism in the USA: the role played by walking, standing, and sitting difficulties

PURPOSE

There is a paucity of literature identifying factors that influence the back and neck pain (BNP)-workplace absenteeism relationship. Therefore, this study aimed to investigate the association between BNP and workplace absenteeism and potential mediating variables in a large sample of the US population.

METHODS

Nationally representative data collected in 2019 from the RAND American Life Panel (ALP) were used for this retrospective study. Workplace absenteeism was defined as the number of days of absence in the past 12 months for health-related reasons (count variable), while BNP corresponded to the presence of back pain due to spinal stenosis, back pain due to other causes, or neck pain (dichotomous variable). Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, obesity, and diabetes. There were eight influential variables (depression, anxiety, sleep disorder, alcohol dependence, opioid dependence, walking difficulty, standing difficulty, and sitting difficulty). The association between BNP and workplace absenteeism was analyzed using a negative binomial regression model.

RESULTS

There were 1,471 adults aged 22-83 years included in this study (52.9% of men; mean [standard deviation] age 44.5 [13.0] years). After adjusting for control variables, BNP was positively and significantly associated with workplace absenteeism (incidence rate ratio = 1.40, 95% confidence interval: 1.07-1.83). Walking, standing, and sitting difficulties individually explained between 24 and 43% of this association.

CONCLUSIONS

Workplace interventions focusing on the management of BNP and overcoming difficulties in walking, standing, and sitting, potentially utilizing exercise, therapy, and ergonomic interventions, may prevent absenteeism.

Predictors of itch and pain in the 12 months following burn injury: results from the Burns Registry of Australia and New Zealand (BRANZ) Long-Term Outcomes Project

Background

Itch and pain are common complaints of patients with burn injuries. This study aimed to describe the prevalence and predictors of itch and moderate to severe pain in the first 12 months following a burn injury, and determine the association between itch, moderate to severe pain, work-related outcomes, and health-related quality of life following a burn injury.

Methods

Burn patients aged 18 years and older were recruited from five Australian specialist burn units. Patients completed the 36-item Short Form Health Survey Version 2 (SF-36 V2), the Sickness Impact Profile (SIP) work scale, and a specially developed questionnaire relating to itch at 1, 6, and 12 months post-injury. Moderate to severe pain was defined as a score less than 40 on the bodily pain domain of the SF-36 V2. Multivariate mixed-effects regression models were used to identify patient and burn injury predictors of itch and moderate to severe pain.

Results

Three hundred and twenty-eight patients were included. The prevalence of itch decreased from 50% at 1 month to 27% at 12 months. Similarly, the prevalence of moderate to severe pain decreased from 23% at 1 month to 13% at 12 months. Compared to patients aged 18-34, the adjusted odds of experiencing any itch were 59% (95% CI: 0.20, 0.82) and 55% (95% CI: 0.22, 0.91) lower for patients aged between 35 and 49 and ≥ 50 years, respectively. Compared to patients aged 18-34, the adjusted odds of experiencing moderate to severe pain were 3.12 (95% CI: 1.35, 7.20) and 3.42 (95% CI: 1.47, 7.93) times higher for patients aged 35-49 and ≥ 50 years, respectively.

Conclusions

Less than 15% of patients reported moderate or severe pain at 12 months, while approximately one-quarter of the patients reported itch at the same period. The presence of moderate to severe pain was associated with a greater negative impact on health-related quality of life and work outcomes compared to itch. Further research is needed to improve our ability to identify patients at higher risk of persistent itch and pain who would benefit from targeted review and intervention studies.

Patterns in the Occurrence and Duration of Musculoskeletal Pain and Interference with Work among Eldercare Workers-A One-Year Longitudinal Study with Measurements Every Four Weeks

The objective of this study was to examine patterns of musculoskeletal pain episodes over time. We conducted a one-year follow-up study among 275 eldercare workers with measurements of musculoskeletal pain (low back pain (LBP) and neck/shoulder pain (NSP)) and pain-related work interference (PWI) reported via text message every four weeks. We found a constant, high four-weekly prevalence of LBP and NSP (between 61% and 72%). The distributions of pain episodes for LBP and NSP were similar with approximately 30% of the episodes being 7 days or less per four weeks. There was also a high recurrence of pain, with 33% reporting LBP or NSP every four weeks. In addition, 24% had pain at every measurement in both the low back and neck/shoulder regions combined throughout the year. On days with LBP or NSP, approximately 59% also reported interference with work, and 18% of the eldercare workers reported that pain interfered with their work all measurements throughout the year. A high proportion of eldercare workers reported pain every four weeks throughout the year and the four-weekly prevalence of pain remained high and constant on a group level. During most days with pain, eldercare workers were hampered in their regular work activities.

How do we assess musicians' musculoskeletal symptoms?: a review of outcomes and tools used

Recent reviews of musicians' musculoskeletal symptoms (MSS) have reported heterogeneity in the outcomes reported and data collection tools used, making it difficult to compare and synthesise findings. The purpose of this present review was to improve the consistency of future research, by documenting the outcomes reported in recent studies of musicians' MSS and the data collection tools used. All English language, peer-reviewed studies, published 2007-2016 that reported musicians' self-reported MSS outcomes were identified. Details of the types of outcomes reported and the tools used were extracted, and synthesised descriptively. A range of MSS outcomes were reported, including MSS with a temporal relationship to activities performed, and the consequences of symptoms. Only 24% of studies used standardised questionnaires, with the Nordic Musculoskeletal Questionnaire (NMQ) being the most commonly used. To improve the homogeneity of outcomes and data collection tools when investigating musicians' MSS, we recommend using the NMQ, where appropriate. Recall periods of 12-months and 7-d are the most appropriate for prevalence, and 7-d recall periods for ratings. Importantly, outcomes and the tools used to collect data should be reported in sufficient detail to ensure that the study can be replicated, critiqued, and accurately interpreted.

Identifying musculoskeletal issues and associated risk factors among clay brick kiln workers

The present study is aimed to investigate the musculoskeletal issues and association of risk-factors with these problems among manual brick kiln workers. A modified Nordic Questionnaire was administered among 376 traditional brick kiln workers to collect data. Logistic regression was used to determine the association between musculoskeletal problems and risk-factors. Majority of workers (76.19%) involved in mould evacuating task reported wrist issues whereas lower back issues were reported by 62.35% of spading task workers. Age was a factor associated with musculoskeletal symptoms in the majority of the body regions. Gender was significantly associated with lower back (OR=3.71, CI: 1.51-9.11) MSDs. Spading task was associated with the wrist (OR=2.42, CI: 51.03-5.66), and lower back (OR=3.97, CI: 1.75-8.98) problems. Mould filling was a contributing factor for the wrist (OR=4.27, CI: 1.81-10.09) and knee (OR=6.88, CI: 2.40-19.70) issues. MSDs in wrist (OR=12.22, CI: 4.82-30.98) and fingers (OR=3.57, CI: 1.23-10.36) were significant in mould evacuating workers. Workers having less than 5 yr of experience were less prone to the neck (OR= 0.03, CI: 0.00-0.72) and upper back (OR=0.08, CI: 0.01-0.76) MSDs. For prevention of problems, ergonomic interventions such as workers' training, use of protecting aids, modification in hand tools and work practices are needed.

Exploring the musculoskeletal problems and associated risk-factors among brick kiln workers

Purpose

Prolonged working in repetitive and awkward postures can result in musculoskeletal disorders among workers involved in labour-intensive jobs like those of brick kiln workers. Unlike other labour-intensive sectors, workers in this particular sector have a lack of awareness about musculoskeletal problems. Therefore, the purpose of this paper is to explore musculoskeletal issues and associated risk-factors among brick kiln workers.

Design/methodology/approach

A questionnaire survey was conducted among 217 male and 111 female workers aged between 17 and 53 years. They were employed in traditional brick kiln units situated in Rajasthan, India. Postures were analysed by Rapid Upper Limb Assessment and Rapid Entire Body Assessment methods. Binary logistic regression was used to find the association between musculoskeletal problems and risk-factors.

Findings

For the mould evacuating task, wrist (76.2 per cent) and lower back (56 per cent) issues were the most frequently reported musculoskeletal problems, while in spading task, lower back (62.4 per cent) and shoulder (57.7 per cent) problems were prominent. Musculoskeletal symptoms in one or more body regions were associated with personal and work-related factors including the type of task and experience.

Research limitations/implications

Kiln workers are exposed to high musculoskeletal and postural risks, particularly in spading and mould filling tasks. To reduce these risks, ergonomic interventions are needed.

Originality/value

It is recognised that the musculoskeletal health of brick kiln workers is a cause for concern. The present study provides the evidence of the prevalence of musculoskeletal symptoms experienced by brick kiln workers and the association of symptoms with various risk-factors, which has not been addressed in previous studies.

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.

Biomechanical evaluation of exoskeleton use on loading of the lumbar spine

The objective of this study was to investigate biomechanical loading to the low back as a result of wearing an exoskeletal intervention designed to assist in occupational work. Twelve subjects simulated the use of two powered hand tools with and without the use of a Steadicam vest with an articulation tool support arm in a laboratory environment. Dependent measures of peak and mean muscle forces in ten trunk muscles and peak and mean spinal loads were examined utilizing a dynamic electromyography-assisted spine model. The exoskeletal device increased both peak and mean muscle forces in the torso extensor muscles (p < 0.001). Peak and mean compressive spinal loads were also increased up to 52.5% and 56.8%, respectively, for the exoskeleton condition relative to the control condition (p < 0.001). The results of this study highlight the need to design exoskeletal interventions while anticipating how mechanical loads might be shifted or transferred with their use.

Electromyographic activity of the erector spinae: The short-effect of one workday for welders with nonspecific chronic low back pain, an observational study

OBJECTIVE

This study aimed to evaluate the effect of one workday on pain and perceived exertion, muscular strength, and electromyographic activity of the erector spinae muscles in welders with and without low back pain. This is an observational cohort study.

PARTICIPANTS

Twenty-two welders, metallurgical shipbuilding, were equally divided into 2 groups: low back pain and no low back pain. Pain and perceived exertion. Muscular strength by maximal voluntary contractions and electromyographic activity of right and left erector spinae muscles during maximal voluntary contractions and in the 3 welding positions for 2 periods of the workday (in the morning and at the end of the workday).

RESULTS

At the end of workday, the pain increased significantly for the low back pain group (t(22) = 2.448; P= 0.023). The perceived exertion also increased significantly for both groups at the end of workday groups (F(1,22) = 8.570, P= 0.000) and periods (F(1,22) = 8.142, P= 0.000). There were no significant differences between groups and workday periods for muscular strength and electromyographic activity during maximal voluntary contractions of the erector spinae. There was no significance difference for electromyographic activity between groups and workday period and in the 3 welding positions.

CONCLUSION

Although the pain and perceived exertion increased at the end of the workday, these results did not interfere in muscular strength and electromyographic activity of right and left erector spinae muscles. Thus, we can conclude that welders with chronic low back pain had a good physical capacity (muscular strength) and that muscle performance was maintained.

Prevalence and Impact of Work-Related Musculoskeletal Disorders on Job Performance of Call Center Operators in Nigeria

Background:

Work-related musculoskeletal disorders (WMSDs) have been documented among various occupational groups in Nigeria. However, there is limited data on the prevalence of WMSDs among call center operators (CCOs).

Objective:

To determine the prevalence of WMSDs among CCOs in Nigeria and to explore the extent to which these discomforts impact the daily work activities of the respondents.

Methods:

374 respondents who were randomly selected from 4 telecommunication companies in Lagos State, Nigeria, participated in this study. They were asked to complete a pretested questionnaire designed to capture the prevalence, impact and associated risk factors of WMSDs among CCOs.

Results:

42% and 65.2% of respondents experienced at least one WMSDs in the past 7 days, and 12 months, respectively. Women and CCOs who received calls with hand-held phones rather than headsets reported more discomforts during both 7 days and 12 months periods. Neck, shoulder, upper back, and lower back were the most affected areas during past 7 days and 12 months. Discomforts in the neck, low back, and knees prevented most of the respondents from performing their daily work.

Conclusion:

WMSDs have a serious impact on the daily job activities of the CCOs in Nigeria.

Trunk kinematics and low back pain during pruning among vineyard workers-A field study at the Chateau Larose-Trintaudon

The prevalence of low back disorders is dramatically high in viticulture. Field measurements that objectively quantify work exposure can provide information on the relationship between the adopted trunk postures and low back pain. The purposes of the present study were three-fold (1) to carry out a kinematics analysis of vineyard-workers’ pruning activity by extracting the duration of bending and rotation of the trunk, (2) to question separately the relationship between the duration of forward bending or trunk rotation with low back pain intensity and pressure pain sensitivity and (3) to question the relationship between the combined duration of forward bending and trunk rotation on low back pain intensity and pressure pain sensitivity. Fifteen vineyard-workers were asked to perform pruning activity for 12 minutes with a wireless triaxial accelerometer placed on their trunk. Kinematic analysis of the trunk showed that vineyard-workers spent more than 50% of the time with the trunk flexed greater than 30° and more than 20% with the trunk rotated greater than 10°. These results show that pruning activity lead to the adoption of forward bended and rotated trunk postures that could significantly increase the risk of work related musculoskeletal disorders in the low back. However, this result was mitigated by the observation of an absence of significant association between the duration of forward bending and trunk rotation with low back pain intensity or pressure pain sensitivity. Even if prospective field measurements and studies assessing the effects of low back pain confounders are needed, this field study provides new genuine information on trunk kinematics during pruning activity.

Occupational back pain among schoolteachers in Jordan: estimated prevalence and factors associated with self-reported pain and work limitations

PURPOSE

To investigate the point prevalence of upper back pain and lower back pain in Jordanian schoolteachers and to estimate the work-related reported disability.

METHOD

A cross-sectional survey was used to assess back pain in a convenience sample of teachers in Jordan. Crude and weighted prevalence estimates of self-reported spinal pain and limited productivity were described. Demographic and occupational factors associated with self-reported pain and limited productivity were identified by multinomial/logistic regression.

RESULTS

Crude rates differed by gender, geographic location, school funding and grade levels of teaching. Weighted estimates for self-reported pain were 46% for females and 36% for males. Pain with limitation was 55% for males and 49% for females. Pain without limitation was associated with female gender (odds ratio [OR] = 5.26). Pain with limitations was associated with female gender (OR = 2.92), teaching in public school (OR = 2.06) and body mass index (OR = 1.1). Among subjects with pain, limitations were associated with male gender (OR = 2.34), teaching in public school (OR = 3.18) and pain in both upper and lower back (OR = 4.64).

CONCLUSIONS

Pain and occupational limitations are highly prevalent in schoolteachers in Jordan.

Economics of Musculoskeletal Ultrasound

Purpose of review

Healthcare costs have exploded in the past 30 years and they are a major concern for governments worldwide. Care management of musculoskeletal disorders and advanced imaging account for a large part of this socioeconomic burden.

Recent findings

Musculoskeletal ultrasound is now performed primarily by nonradiologists. Both musculoskeletal ultrasound and MRI total utilization rates continue to increase. Despite the existence of evidence-based diagnostic recommendations and the potential cost-savings of using musculoskeletal ultrasound instead of MRI in certain clinical situations, ensuring appropriate use of imaging among health professionals remains difficult for various reasons.

Summary

In the context of healthcare budgets restraints, use of imaging must be shown scientifically, to improve patient outcomes and be cost-effective. Current evidence recommends musculoskeletal ultrasound as the primary imaging modality in the investigation of rotator cuff disease. Policies aiming at ensuring the application of imaging guidelines among physicians are needed.

The effect of a knowledge-based ergonomic intervention amongst administrators at Aga Khan University Hospital, Nairobi

BACKGROUND

Low back pain (LBP) and neck pain are part of the common work-related musculoskeletal disorders with a large impact on the affected person. Despite having a multifactorial aetiology, ergonomic factors play a major role thus necessitating workers' education.

OBJECTIVE

To determine the prevalence of ergonomic-related LBP and neck pain, and describe the effect of a knowledge-based ergonomic intervention amongst administrators in Aga Khan University Hospital, Nairobi.

METHODS

This study applied a mixed method design utilizing a survey and two focus group discussions (FGD). A self-administered questionnaire was distributed to 208 participants through systematic sampling. A one hour knowledge-based ergonomic session founded on the survey results was thereafter administered to interested participants, followed by two FGDs a month later with purposive selection of eight participants to explore their experience of the ergonomic intervention. Quantitative data was captured and analyzed using SPSS by means of descriptive and inferential statistics, whereas thematic content analysis was used for qualitative data.

RESULTS

Most participants were knowledgeable about ergonomic-related LBP and neck pain with a twelve month prevalence of 75.5% and 67.8% respectively.

CONCLUSION

Continual ergonomic education is necessary for adherence to health-related behaviours that will preventwork-related LBP and neck pain.

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.

Ergonomics in endourology and laparoscopy: an overview of musculoskeletal problems in urology

PURPOSE

This study aims to provide an overview of type and frequency of musculoskeletal complaints among urologists. In addition, the urologists' knowledge about ergonomic conditions during minimally invasive urology was assessed, and they were asked how they would prefer to gain knowledge about this topic.

MATERIALS AND METHODS

An online and hard copy version questionnaire was administered to urologists from different countries, mainly from Europe, performing endourology and laparoscopy.

RESULTS

Of the 285 respondents, 245 (86.0%) urologists experienced musculoskeletal complaints in the past 12 months and 62.1% were considered to be work related. Most common areas for chronic complaints were neck, back, and shoulders. Almost 50% of the urologists experienced chronic musculoskeletal complaints, for which endourology (odds ratio [OR] 3.06; 95% confidence interval [CI] 1.37-6.80) and laparoscopy (OR 1.70; 95% CI 1.27-2.28) were significant risk factors. One third of the urologists considered their knowledge about ergonomics minimal, and 8% stated that they had no knowledge about these topics. Fifty percent of the respondents preferred to integrate information about ergonomic rules into hands-on training of urologic skills.

CONCLUSION

High prevalence of experienced musculoskeletal complaints was found among urologists predominantly related to endourology and laparoscopy. Urologists indicate that they have a lack of knowledge about ergonomics in the operating room. Hence, we recommend integration of ergonomics in hands-on training programs early in the residency curriculum to gain knowledge and awareness and hopefully to offer possibilities to prevent these complaints in the future.

Prevalence and potential determinants of musculoskeletal disease symptoms among care workers in long-term care facilities in South Korea

AIM

The purpose of this study was to investigate the degree and influencing factors of musculoskeletal disease symptoms among care workers in long-term care facilities in South Korea.

METHODS

Participants in this cross-sectional study were 265 care workers in 15 long-term care facilities. Data were collected between 1 and 27 August 2011, using the Korea Occupational Safety and Health Agency (KOSHA) code H-30-2003 and analyzed using logistic regression with SPSS ver. 18.0.

RESULTS

Of the care workers, 88.7% had pain in at least one of the six body parts. The highest prevalence of musculoskeletal disease symptoms was in the lower back and legs. Among the organizational factors, there were significant differences in neck pain by work shift and patient grade. Neck pain was more severe in the 8 h shift group than 12-24 h shift group. Care workers caring for patients who were classified in the first patient grade of long-term care insurance had 4.73 times more complaints of musculoskeletal symptoms in the neck, 9.54 times (95% confidence interval [CI] = 3.37-27.02) in the hand and wrist, 4.37 times (95% CI = 1.59-12.03) in the lower back, and 2.96 times (95% CI: 1.17-7.51) in the leg and foot.

CONCLUSION

To prevent and manage musculoskeletal disease symptoms, activities and the intensity of work should be arranged systematically and planned, and the improvement of organizational factors such as appropriate assignment by patients' severity is considered.

Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling

The objective of this study was to examine the effect of wearing restrictive trousers on lumbar spine movement, trunk muscle activity and low back discomfort (LBD) in simulations of manual material handling (MMH) tasks. Twenty-eight young adults participated in the study performing box lifting, liquid container handling while squatting, and forward reaching while sitting on a task chair when wearing tight pants (sizes too small for the wearer) vs. fit pants (correct size according to anthropometry). Each task was repeated three times and video recordings were used as a basis for measuring lumbar range of motion (LRoM). The response was normalized in terms on baseline hip mobility. Trunk muscle activity of rectus abdominis (RA) and erector spinae (ES) muscles were also measured in each trial and normalized. At the close of each trial, participants rated LBD using a visual analog scale. Results revealed significant effects of both pants and task types on the normalized LRoM, trunk muscle activity and subjective ratings of LBD. The LRoM was higher and trunk muscle (ES) activity was lower for participants when wearing tight pants, as compared to fit pants. Discomfort ratings were significantly higher for tight pants than fit. These results provide guidance for recommendations on work clothing fit in specific types of MMH activities in order to reduce the potential of low-back pain among younger workers in industrial companies.

Absence from work and return to work in people with back pain: a systematic review and meta-analysis

Background

A considerable proportion of work absence is attributed to back pain, however prospective studies in working populations with back pain are variable in setting and design, and a quantitative summary of current evidence is lacking.

Objective

To investigate the extent to which differences in setting, country, sampling procedures and methods for data collection are responsible for variation in estimates of work absence and return to work.

Methods

Systematic searches of seven bibliographic databases. Inclusion criteria were: adults in paid employment, with back pain, work absence or return to work during follow-up had been reported. Random effects meta-analysis and meta-regression analysis was carried out to provide summary estimates of work absence and return to work rates.

Results

45 studies were identified for inclusion in the review; 34 were included in the meta-analysis. The pooled estimate for the occurrence of work absence in workers with back pain was 15.5% (95% CI 9.8% to 23.6%, n=17 studies, I² 98.1%) in studies with follow-up periods of ≤6 months. The pooled estimate for the proportion of people with back pain returning to work was 68.2% (95% CI 54.8% to 79.1%, n=13, I² 99.2%), 85.6% (95% CI 78.2% to 90.7%, n=13, I² 98.7%) and 93.3% (95% CI 84.0% to 94.7%, n=10, I² 99%), at 1 month, 1–6 months and ≥6 months, respectively. Differences in setting, risk of participation bias and method of assessing work absence explained some of the heterogeneity.

Conclusions

Pooled estimates suggest high return to work rates, with wide variation in estimates of return to work only partly explained by a priori defined study-level variables. The estimated 32% not back at work at 1 month are at a crucial point for intervention to prevent long term work absence.

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.