Association of age and physical job demands with musculoskeletal disorders in nurses

Exploring the influence of individual factors on the perception of mental workload and body postures

Studies have revealed that physical and mental demands, psychosocial factors, and individual factors can contribute to the development of WMSDs. Yet, much is still unknown regarding the effects of individual characteristics on WMSDs susceptibility. Previous studies discovered people assumed more awkward body postures to perform an activity when the perception of mental workload is higher. This research study explored if individual characteristics such as age, sex, personality, and anxiety help explain changes or differences in the perception of mental workload and body postures assume when performing activities. The study provided evidence that these individual characteristics have a modifying role on perceived mental workload and body postures. The results suggest that perceived mental workload is influenced to a higher extent by individual characteristics such as anxiety, sex, and personality traits. Women have a higher (18.7%) mental workload perception than men. Likewise, NASA-TLX scores are 22% higher for feelers than thinkers. In general, higher perceptions of mental workload were observed in participants with higher anxiety levels. On the other hand, body postures seem to be influenced by different individual factors depending on the nature of the activity. RULA scores increased on average by 13.1% between baseline and time constraint conditions. Larger differences were observed in certain individuals (e.g. introverts (19.7%) and intuitors (13.8%)) across conditions.

A pilot study on psychosocial factors and perceptions of organizational health among a sample of U.S. waste workers

Solid waste workers encounter a number of occupational hazards that are likely to induce stress. Thus, there are likely to be psychosocial factors that also contribute to their overall perceptions of organizational health. However, attitudes regarding the aforementioned among solid waste workers' have not been assessed. This descriptive, cross-sectional pilot study operationalized the INPUTS Survey to determine workers' perceptions of organizational health and other psychosocial factors of work. Percentage and mean responses to each INPUTS domain are presented in accordance with their survey manual. Pearson's chi-squared tests were run on count data; Fisher's exact tests were run for count data with fewer than five samples. ANOVAs were run on the continuous items. Due to a relatively low sample size (N = 68), two-sided p values < 0.1 were considered statistically significant. Most solid waste worker participants reported high decision authority, that they perceived their management to prioritize workplace health and safety, and had high job satisfaction. However, perceptions of support for health outside of the realm of occupational safety and health was lower. Addressing traditional occupational health hazards continues to take precedence in this industry, with less of a focus on how the social determinants of health may impact workplace health.

Incidence of shoulder disorders in a cohort of healthcare workers from 2009 to 2020

PURPOSE

To estimate the incidence of shoulder disorders in a cohort of Health Care Workers (HCWs).

METHODS

4406 workers employed from 2009 to 2020, were included in the study. Occupational risk factors and jobs were assessed according to working history. Incident cases were defined in case of shoulder pain associated with functional limitations during the medical examination. The Cox regression model was used to calculate the Hazard Ratio (HR) for different work activities, adjusted for age, sex, body mass index, and previous musculoskeletal injuries, using clerks as the reference category.

RESULTS

The incidence rates of shoulder musculoskeletal disorder for men and women were 13.1 for 1000 person-years (CI 95% 10.6-16.3) and 20.1 for 1000 person-years (CI 95% 17.8-22.6) respectively. The adjusted HR was significantly increased with age (1.06, CI 95% 1.05-1.07), outpatient health activities (2.82, CI 95% 1.89-4.219), and wards health activity (2.37, CI 95% 1.68-3.33).

CONCLUSION

HCWs with high biomechanical risk such as nurses and healthcare assistants had a higher incidence of shoulder disorders. Actions are needed for better prevention in health care assistance.

Comparative ergonomic assessment of manual harvesting of un-lodged and lodged paddy crops post-tropical cyclone in India

OBJECTIVE

In recent times, increased rainfall from tropical cyclones due to climate change affects the agricultural sector, mainly the paddy fields. High windspeed with excessive rain causes lodging of paddy crops, which is difficult to harvest. Mechanized harvesting systems are ineffective in this situation due to waterlogging in the fields. Manual harvesting with a traditional sickle is the only way to harvest lodged crops to save food security crises and economic losses. Collecting the lodged paddy stems lying on the ground for harvesting manually is time-consuming and harvesters need to maintain an awkward posture for a prolonged period compared to harvesting un-lodged crops.

METHODS

Seventy-five female harvesters aged 35-75 years were selected for the study from both lodged and un-lodged small-scale farming lands of Kerala, a southwestern coastal state of India. A comparative ergonomic assessment was conducted to measure body pain, perceived exertion, postural risks, and rate of production under both harvesting conditions.

RESULTS

The harvesters reported significant higher rates of body pain, perceived exertion, high postural risks, and low productivity in lodged conditions compared to un-lodged condition.

CONCLUSION

Harvesting lodged crops involves high risks with low productivity and needs immediate ergonomic design intervention for the well-being of the harvesters.

Predicting Challenge and Threat Appraisal of Job Demands among Nurses: The Role of Matching Job Resources

(1) Background: Empirical studies have started to examine employees' subjective appraisals of job demands and their relations to employees' health. However, knowledge of working conditions, which might contribute to how employees appraise specific job demands, is scarce. The present study aimed to examine predictors of nurses' appraisals of job demands (i.e., time pressure, emotional demands, physical demands, and role ambiguity) as challenges and/or threats among corresponding job resources (i.e., autonomy, social support, physical resources, participation in decision-making). It also examined moderating effects of these predictors. (2) Methods: Cross-sectional data were collected via an online survey in a sample of 425 nurses working in Luxembourg. (3) Results: Multiple regression analyses indicated that matching job resources predicted nurses' appraisal of job demands as challenging. Threat appraisal was predicted by three out of four kinds of job resources (i.e., autonomy, physical resources, participation in decision-making). However, the current study did not find any moderating effects between job demands and job resources on challenge/threat appraisals. (4) Conclusions: The present study identified domain-specific job resources that contribute to how employees perceive selected job demands. Accordingly, we encourage scholars and practitioners to align job demands with matching job resources to prevent nurses' threat appraisal of job demands, and to promote their challenge appraisals.

Characteristics of Work-Related Musculoskeletal Disorders in Korea

This study aimed to analyze trends for work-related musculoskeletal disorders (WMSDs) from 1996 to 2020 in Korea and to investigate characteristics of WMSDs, including WMSD approval rates, distribution by WMSD names, and the effects of industry type and size, and workers’ age and gender on WMSD occurrence. The data included those obtained from the official yearbooks for industrial accidents published by the Ministry of Employment and Labor and those obtained personally from the Korea Workers’ Compensation & Welfare Service. The results showed that although the incidence of WMSDs differed by year, approximately 9500 cases of WMSDs occurred in 2019 and 2020, the incidence rate of WMSDs was approximately 5.0 per 10,000 workers, and the proportions of WMSDs among industrial accidents were almost 9%. Low back pain was the leading cause of WMSDs; WMSDs occupied 9.5−71.5% of total occupational diseases by year and occurred most frequently in the manufacturing industry, followed by construction, transportation/warehouse and communication, and mining industries, and nearly 60% of WMSDs occurred in small business with <50 workers. Among chronic WMSDs, rotator cuff syndrome in the shoulder ranked first, intervertebral disc disorders second, and rotator cuff and tendon injuries third. By body parts, the shoulder was most susceptible to chronic WMSDs, followed by the low back, leg, and elbow/lower arm. The chi-square test and logistic regression analysis showed that industry type and size and workers’ gender and age were significantly associated with WMSD approval. It can be concluded that the WMSD preventive efforts should focus on low back pain and rotator cuff syndrome by WMSD name, manufacturing by industry, small business by industry size, men by gender, and aged workers by age.

Prevalence status and associated factors of wrist postural injury in the Chinese occupational population

Objective

This study investigated the prevalence of wrist injuries in 15 industries and different types of work in China. Study on the associated factors of wrist injuries provides a scientific basis for prevention and treatment of wrist diseases in occupational workers.

Methods

A cross-sectional study of musculoskeletal symptoms of related practitioners in 15 industries, including automobile manufacturing, was conducted to retrieve worker demographic information, working wrist posture, and pain conditions. Multivariable binary logistic regression analyses were performed to identify factors associated with work-related musculoskeletal disorders (WMSDs).

Results

The prevalence of wrist injuries among the study population was 13.2%. Toy manufacturing, animal husbandry, automobile manufacturing, shoe manufacturing, and biopharmaceutical manufacturing had the highest wrist injury rates at 29.1, 19.1, 14.9, 14.9, and 14.0%, respectively. Among the types of jobs, enamel workers (63.0%), butchers (43.6%), combers (32.5%), welders (31.3%), and scaffolders (26.5%) had the highest prevalence rates. Based on the final multivariate logistic regression analysis: female [odds ratios (OR) = 1.24; 95% confidence interval (CI), 1.15-1.35], 6-10 years of service (OR = 1.11; 95% CI, 1.03-1.18), >10 years of service (OR = 1.15; 95% CI, 1.06-1.25), frequent upward and downward flexion in wrist posture at work (OR = 1.81; 95% CI, 1.84-2.11), and frequent wrist placement on the edge of angular objects increased the OR of injury (OR = 1.52; 95% CI, 1.44-1.61). Need to squeeze objects tightly while working (OR = 1.72; 95% CI, 1.57-1.89), prolonged wrist flexion (OR = 1.86; 95% CI, 1.75-1.97), and work hand position above the shoulder for prolonged periods (OR = 1.11; 95% CI, 1.04-1.19) also suggested the relationship between these factors and the higher prevalence of wrist injury in the workers. The associated factor was physical activity (OR = 0.86; 95% CI, 0.80-0.94).

Conclusion

This study suggested the relationship between these factors and the higher prevalence of wrist injury in the toy manufacturing, animal husbandry, automobile manufacturing, and shoe-making industries, enamel workers, butchers, and combers. And are work types that require special attention. Females, working age, physical activity, and abnormal posture of the wrist were factors significantly associated with WMSDs.

Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain

OBJECTIVE

This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP).

METHODS

Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis.

RESULTS

Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability.

CONCLUSIONS

Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability.

The Validity and Inter-Rater Reliability of a Video-Based Posture-Matching Tool to Estimate Cumulative Loads on the Lower Back

Background

Low back pain (LBP) is known as one of the most common work-related musculoskeletal disorders. Spinal cumulative loads (CLs) during manual material handling (MMH) tasks are the main risk factors for LBP. However, there is no valid and reliable quantitative lifting analysis tool available for quantifying CLs among Iranian workers performing MMH tasks.

Objective

This study aimed to investigate the validity and inter-rater reliability of a posture-matching load assessment tool (PLAT) for estimating the L5-S1 static cumulative compression (CC) and shear (CS) loads based on predictive regression equations.

Material and Methods

This experimental study was conducted among six participants performing four lifting tasks, each comprised of five trials during which their posture was recorded via a motion capture (Vicon) and simultaneously a three-camera system located at three different angles (0°, 45°, and 90°) to the sagittal plane.

Results

There were no significant differences between the two CLs estimated by PLAT from the three-camera system and the gold-standard Vicon. In addition, ten raters estimated CLs of the tasks using PLAT in three sessions. The calculated intra-class correlation coefficients for the estimated CLs within each task revealed excellent inter-rater reliability (> 0.75), except for CS in the first and third tasks, which were good (0.6 to 0.75).

Conclusion

The proposed posture-matching approach provides a valid and reliable ergonomic assessment tool suitable for assessing spinal CLs during various lifting activities.

What sociodemographic and work characteristics are associated with musculoskeletal complaints in nursing students? A cross-sectional analysis of repeated measurements

Musculoskeletal complaints (MSCs) arise during nursing education. We examined cross-sectional associations between self-reported MSCs and both sociodemographic and workplace characteristics in different clinical placement settings. We included two observations among three cohorts of third-year Dutch nursing students (total N = 711) of the undergraduate nursing program of Rotterdam University of Applied Sciences. Questionnaire data on sociodemographic, physical and psychosocial work characteristics, and MSCs were used. Generalized estimating equation analysis for repeated measurements with backward elimination was used to examine associations with MSCs. In total, 79% of students experienced MSCs. Female sex (OR 0.37, 95% CI 0.22-0.62), lifting and bending (OR 1.01, 95% CI 1.00-1.03), physical job demands (OR 2.33, 95% CI 1.68-3.22) and need for recovery (OR 1.02, 95% CI 1.01-1.03), were statistically significantly associated with overall MSCs. Models for regional complaints are also presented in this article. Nursing school and clinical placement staff should consider these factors when dealing with nursing students with MSCs.

Musculoskeletal Disorders in Nurses in Hospitals

Background Healthcare is a sector with a high risk of musculoskeletal disorders. The work of nurses in a hospital is associated with stress, prolonged work, uncomfortable working postures, bending and twisting of the body and etc. Aim: To identify the risk factors for the frequency and localization of musculoskeletal complaints and diagnosed diseases of the musculoskeletal system in nurses in hospitals. Methods: The study is cross-sectional and comprised 1412 nurses female nurses from 19 hospitals in Sofia having an average age of 50.3±9.9 years. An ergonomic analysis of workplaces in hospitals was made. A survey was conducted in relation to the workplace, the workload, the working posture and movements; Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms were used, BMI. Information on musculoskeletal diseases diagnosed by a doctor was collected with Work ability index (WAI). The statistical analyses were made using SPSS. Results: The frequency of musculoskeletal complaints is high, complaints in the lower back being in the lead with 74.2%, followed by the back, neck and shoulders. A musculoskeletal disorder, diagnosed by a doctor, occurs in 35.6% of the individuals. Widespread is the prolonged work in a standing position, awkward working postures, bending, twisting and stretching. The data from the regression analysis show that the work with bending, twisting and stretching, prolonged work in a standing position and BMI are predictors of musculoskeletal complaints. Conclusion: The results indicate lack of good workplace organisation and equipment. The activity involves prolonged work in a standing position, awkward working postures and work with bending and twisting of the body. High is the incidence of musculoskeletal disorders and the undergone treatment related to them.  Key words: musculoskeletal disorders, workplace, working postures, nurses, hospitals.

Characteristics of Occupational Injuries among Spanish Nursing Workers

Introduction: Nursing professionals face a multitude of daily occupational hazards that can cause occupational accidents. AIM: The objective of this work is to analyze the personal variables included in official accident reports, to evaluate their influence on occupational accidents suffered by nursing and nursing assistant professionals. Methodology: A total of 187,821 occupational accidents recorded in Spain from 2011 to 2019 were analyzed in the sector using contingency tables, chi-square, and corrected standardized residuals. Results: The results showed that the older the professional, the probability that once the accident had occurred, its severity would be more serious. Regarding gender, men are more likely to suffer more serious accidents compared to accidents registered by women. Results about the length of service and nationality did not reach statistical significance in the group of accidents analyzed. Conclusions: The planning of preventive measures must be adapted to the profiles of the workers in the most vulnerable sector.

Being an older nurse or midwife in the healthcare workplace- A qualitative descriptive study

AIM

To explore the experiences of being an older nurse or midwife employed in the healthcare workplace.

DESIGN

A qualitative descriptive study.

METHOD

Semi-structured interviews were conducted with nurses and midwives who self-identified as older workers. All Australian states were represented and given recruitment was undertaken nationally, most interviews were conducted via telephone. Data were collected between November 2018 and October 2019. Audio recordings were transcribed verbatim and then thematically analysed.

RESULTS

A total of 50 nurses and midwives were recruited, aged between 46 and 74 years. Three themes were identified. Ageing body: Being an older worker meant increased fatigue and physical changes affecting their ability to function at full capacity. Youth focus: For many, being an older worker was about being viewed as a poor-quality worker, with limited access to education and promotional opportunities because of their age. Wise worker: For a small number of older nurses and midwives, it was about being valued and respected for their knowledge, experience and skills.

CONCLUSION

Participants self-identifying as older nurses or midwives represented a wide age range. Spanning across the age spectrum, many experienced fatigue, physical changes or loss of value to the workplace which often impacted on their working lives. The findings contributed to an understanding about what it is to be an older nurse or midwife in terms of how their contribution is regarded and valued by others in the workplace.

IMPACT

This study highlighted there is a need for support of older nurses and midwives in managing age-related fatigue and physical changes. It also suggests consideration of a wise-worker model as a means to recognize the important contribution that older workers can offer.

The role of circadian rhythm stability and amplitude in musculoskeletal disorder prevalence and work-family conflict

Aim

This study aimed to investigate the effect of circadian rhythm stability and amplitude on musculoskeletal disorder prevalence and work–family conflict among nurses.

Design

This cross‐sectional study was conducted on 386 nurses working in three hospitals, in Shahroud, Iran.

Method

The data were collected using the Circadian Rhythm Inventory, Nordic Musculoskeletal Disorders, and Carlson Work‐Family Conflict questionnaires.

Results

The highest prevalence of musculoskeletal disorders was reported in the lower back (68.4%), upper back (65.5%) and shoulders (53.6%), respectively. No significant relation was found between circadian rhythm stability and amplitude, and musculoskeletal disorders prevalence. The nurses who could not overcome drowsiness reported more Work Interference with Family (WIF), Family Interference with Work (FIW) (time‐based) and FIW (strain‐based) compared to the nurses who overcame drowsiness. In addition, the appropriate nurses for shift work experienced less WIF, FIW (behavioural‐based) and WIF (strain‐based) compared to the nurses who could not work overtime or at night.

Investigation of psychosocial factors on upper limb musculoskeletal disorders and the prevalence of its musculoskeletal disorders among nurses: a systematic review and meta-analysis

OBJECTIVE

Musculoskeletal disorders are one of the most important occupational problems especially among nurses. The aim of this study was to investigate the prevalence of musculoskeletal disorders in upper limbs and its associated psychosocial factors in the workplace.

METHODS

A systematic review was conducted by searching the Medline/PubMed, EMBASE, Scopus, ISI/web of knowledge and Google Scholar databases. The authors classified studies into categories of psychological work stressors and musculoskeletal problems. The statistical analysis was performed using Stata software.

RESULTS

We found 1742 articles in our initial search. After reviewing the titles, abstracts and full texts, 66 articles were finally analyzed. Psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses were identified which included boring work, inadequate staffing, job demands, insufficient support, time pressure, decision latitude, job dissatisfaction, and job stress. There was a significant relationship between these factors and prevalence of musculoskeletal disorders in the wrists, shoulders, neck and shoulders, and wrists and hands.

CONCLUSION

Collectively, the results of this study provide strong evidence of some psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses. Thus, organizational interventions to minimize these stressors may be promising in reducing one risk factor for the development of nurses' musculoskeletal disorders. These interventions should not only consider the factors of physical ergonomics but also seek to improve the organizational aspects of the workplace.

Prevalence and predictors of work-related musculoskeletal disorders among workers of a gold mine in south Kivu, Democratic Republic of Congo

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) are a major constraint to worker performance and health. However, research on their prevalence and associated factors among workers at gold mines in the Democratic Republic of Congo (DRC) is insufficient. The present study aimed to determine the prevalence and predictors of WRMSDs among workers of a Gold Mine in South Kivu, DRC.

METHODS

Cross sectional data on prevalence of WRMSDs and risk factors was collected using a modified Nordic questionnaire and upper limb Core QX checklist from 196 workers of a gold mine. WRMSDs were defined as pain or injury(ies) or discomfort, numbness or limitation of movement in the musculoskeletal system at any time in the past 12 months which lasted at least 24 h. These had to be either induced or aggravated by work and circumstances of its performance. A generalised linear model of the Poison family with link log and robust error variances was used to generate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the factors associated with WRMSDs. The effect of individual, ergonomic and psychosocial factors on WRMSDs were investigated while controlling for known confounders.

RESULTS

Most workers were males 187 (95.4%) and their age ranged between 23 and 60 years with mean of 36.3 years. Of the 196 workers, 49 (25.0%) reported having at least one WRMSD during the previous 12 months. WRMSDs with highest occurrence rate were the lower back pain (14.8%), followed by thighs/hip pain (9.2%) and shoulder pain (8.2%). Prolonged heavy lifting/shovelling shovelling (PR = 1.69, 95% CI [1.32, 3.24] and longer work shifts (> 9 h) (PR = 3.56, 95% CI [1.76, 16.58]) were predictive for WRMSDs while jobs with low demands were protective against WRMSDs (PR = 0.18, 95% CI [0.08, 0.44]).

CONCLUSION

The prevalence of WRMSDs is high and associated with prolonged heavy lifting/shovelling, longer work shifts and job demands. We recommend lowering workload and job demands and improving work ergonomics to mitigate and prevent the WRMSDs among workers in goldmines.

The influence of age on spinal and lower limb muscle activity during repetitive lifting

This study investigated the effects of age on upper erector spinae (UES), lower erector spinae (LES) and lower body (gluteus maximus; biceps femoris; and vastus lateralis) muscle activity during a repetitive lifting task. Twenty-four participants were assigned to two age groups: 'younger' (n = 12; mean age ± SD = 24.6 ± 3.6 yrs) and 'older' (n = 12; mean age = 46.5 ± 3.0 yrs). Participants lifted and lowered a box (13 kg) repetitively at a frequency of 10 lifts per minute for a maximum of 20 min. EMG signals were collected every minute and normalised to a maximum voluntary isometric contraction. A submaximal endurance test of UES and LES was used to assess fatigue. Older participants showed higher levels of UES and LES muscle activity (approximately 12-13%) throughout the task, but less fatigue compared to the younger group post-task completion. When lifting, lower-limb muscle activity was generally higher in older adults, although temporal changes were similar. While increased paraspinal muscle activity may increase the risk of back injury in older workers when repetitive lifting, younger workers may be more susceptible to fatigue-related effects. Education and training in manual materials handling should consider age-related differences when developing training programmes.

Firefighter Overexertion: A Continuing Problem Found in an Analysis of Non-Fatal Injury Among Career Firefighters

Traditionally, safety-related research on firefighting has focused on fires and fireground smoke as the primary source of non-fatal firefighter injury. However, recent research has found that overexertion and musculoskeletal disorders may be the primary source of firefighter injury. This study aimed to provide an update on injury occurrence among career firefighters. Injury data were collected over a two-year period from two large metropolitan fire departments in the U.S. Injury data were categorized based on the Bureau of Labor Statistics’ Occupational Injury and Illness Classification System. Cross-tabulations and Chi-square tests were used to determine the primary causes of injury, as well as the injury region. Between the two fire departments, there were 914 firefighters included in the analysis. The median age was 40.7 years old with those aged 40–49 as the largest age group for injury cases (38.3%). The most frequently reported cause of injury was ‘overexertion and bodily reaction’ (n = 494; 54.1%). The most reported injury region was in ‘multiple body parts’ (n = 331; 36.3%). To prevent subsequent musculoskeletal disorders that may arise due to overexertion, initiatives that promote enhanced fitness and ergonomics based on an analysis of the physical demands of firefighting are suggested.

Assessment of inhaled dust by workers and suspended dust for pollution control change and ergonomic intervention in metal casting industry: A cross-sectional study

Metal casting industry including is an industry which produce high dust pollution (fly ash). Improvements in the form of ergonomic interventions have been carried out by many companies, but do not guarantee all parameters run well. The total indoor suspended dust (TSP) measurement results are not enough to guarantee healthy working conditions. Additional assessment of workers' inhaled dust is needed to change pollution control and work improvement to ergonomics. The design of this study is Cross Sectional Study. Research subjects numbered 84 people. All samples met the inclusion criteria. Measurement results of Characteristic of research subject, Working Environment Conditions, Exposition of dust inhaled by workers, Total Indoor Suspended Dust of the Company (p > 0.05). Found critical hours of workers exposed to dust (fly ash), starting from 4 h after working (Department of Process Cement, Department of Black Sand) and 2 h after working for the Department of Loam. Critical hours exposed to dust (fly ash) used as the basis for company management and regulators to take new policies in controlling fly ash pollution and ergonomic interventions. Ergonomic interventions can be carried out by activating the dust collector at critical hours, applying active resting hours at critical hours and conditioning workers to breathe fresh air. The impact of this ergonomic intervention is a decrease in musculoskeletal complaints by 25.27%, reduction in boredom 25.01%, and an increase in job satisfaction 38.46%.

The prevention of musculoskeletal complaints: long-term effect of a work-related psychosocial coaching intervention compared to physiotherapy alone-a randomized controlled trial

PURPOSE

Research shows that psychosocial factors play a significant role in the emergence of musculoskeletal complaints (MSC). The aim of this study was to determine the long-term effects on unspecific MSC by a combined physiotherapy and coaching intervention compared to physiotherapy alone. The coaching intervention focussed on enabling better strategies for coping with work stressors.

METHODS

The participants of a previous randomized controlled intervention were invited to participate again in a third follow-up survey 22 months after the end of the intervention. In 2014, 65 nurses completed a 10-week personalised physiotherapy. Additionally, the intervention group (n = 33) passed five individual coaching sessions, plus an opening and closing session. 44 nurses (IG: n = 24; CG: n = 20) passed again a physical examination as well as another questionnaire assessment in 2016. The primary outcome was MSC, secondary outcomes were work ability and work-related well-being. Due to missing data, multiple imputations were conducted using the mice package in R. Data were analysed by ANOVA with two-way repeated measures, t tests for independent samples and Chi-squared tests.

RESULTS

In respect of MSC, stronger improvement of movement in the vertebral column was observed in the IG compared to the CG. No differences between the IG and CG regarding other long-term effects were observed.

CONCLUSIONS

The results suggest that the combined intervention of work-related coaching and physiotherapy had only a marginally stronger long-term effect with respect to MSC than physiotherapy alone.

Prevalence of work-related musculoskeletal disorders in agriculture workers in Korea and preventative interventions

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are estimated to be the most common and frequent of all occupational diseases in agriculture in Korea, but the full extent of the problem has yet to be surveyed.

OBJECTIVE

This paper presents the results of a survey investigating the extent of WMSDs among self-employed farmers in Korea. It also describes ergonomics based preventive interventions initiated by the Korean government.

METHOD

The prevalence of WMSDs was surveyed among 358 farmers using a questionnaire adapted from the Nordic questionnaires, employing three case definitions.

RESULTS

The results showed that the overall prevalence rates of WMSDs by case definition 1 (any symptoms), 2 (symptoms with a pain intensity of moderate or greater), and 3 (symptoms with a pain intensity of high or greater) were 97.2%, 83.2%, and 39.7% respectively and that the shoulder, knee and lower back disorder rates were higher than those of other body parts. Compared to the prevalence rates of WMSDs for workers in other industries in Korea as well as USA farmers, the overall rates for farmers in Korea were much higher. The interventions, which adopted a participatory approach involving government, farmers, ergonomics, technical and industrial hygiene experts, showed benefits in terms of work efficiency, safety and farmer satisfaction.

CONCLUSIONS

The high WMSD symptom prevalence showed that agriculture is one of the most hazardous industries in Korea, and the Korean government's interventions were effective and successful.

Association of musculoskeletal disorders and workload with work schedule and job satisfaction among emergency nurses

BACKGROUND

The emergency department is a highly demanding work environment, considered by high workload and stress. The impact of work-related factors on musculoskeletal disorders (MSDs) in emergency nurses (ENs) are not yet well understood. We investigated the association of MSDs and workload with work schedule (permanent day and night work) and job satisfaction in ENs.

METHOD

Data were collected through a questionnaire including individual and work-related factors, workload (National Aeronautics and Space Administration-Task Load Index [NASA-TLX]) and MSDs (Standardized Nordic Questionnaire) from 380 ENs in five hospitals.

RESULTS

The findings revealed that work schedule and job satisfaction levels were significantly associated with the MSDs in different body regions. Work schedule was significantly related to physical demand, performance, frustration, and overall workload, whereas it was not to the mental and temporal demands and effort. Job satisfaction level was negatively associated with mental demand and frustration. A high prevalence of musculoskeletal problems, particularly in knees, upper back, lower back, neck and shoulders were found.

CONCLUSION

MSDs are highly prevalent among ENs involved in night work and with low job satisfaction levels. The results are discussed in terms of their implications for emergency hospital nurses. The findings can help to better understand the working conditions and emphasize the need for ergonomic interventions in order to reduce MSDs and workload. Also, the study findings highlight the importance of mental aspects of workload in this occupational group.

Work-Related Musculoskeletal Disorders and Their Associated Factors in Nurses: A Cross-Sectional Study in Iran

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) in nursing are regarded as an important factor for creating tension since they may often cause discontent, leave profession, and provide incorrect services to their clients. The present study aimed to determine WMSDs and their related factors among the nursing staff in university hospitals affiliated to Shiraz University of Medical Sciences (SUMS).

METHODS

In the present descriptive cross-sectional study, 300 nurses in SUMS were selected based on systematic random sampling. To this aim, demographic information, and Nordic musculoskeletal disorder questionnaires were used for data collection. The data were analysed by descriptive and analytical tests (mean, standard deviation, independent t-test, and ANOVA) by SPSS/21 software.

RESULTS

Based on the findings of WMSDs, low back disorders (88.33%) were more prevalent. In addition, a significant relationship was observed between WMSDs in different areas of the body with age, sex, and work experience and hours (P < 0.05).

CONCLUSION

Regarding the high prevalence of WMSDs among nurses, it is recommended to adopt interventional program for preventing WMSDs by reducing working hours and physical pressure control.

Sociodemographic and organizational factors associated with musculoskeletal symptoms among intensive care unit professionals

BACKGROUND

The heavy and complex work routine in the intensive care unit (ICU) involves high workload, long working hours, high levels of tension, exposure to extreme situations and to hazards of different nature.

OBJECTIVE

To investigate the influence of sociodemographic and organizational factors on the development of musculoskeletal pain, tension and fatigue among ICU professionals.

METHODS

We interviewed 128 professionals from seven public hospitals in João Pessoa, Paraiba, Brazil.The data were analyzed using a logistic regression model, and differences between professional categories by means of the likelihood ratio, the Wald and χ2 tests, with significance level set to <0.05.

RESULTS

The risk to develop musculoskeletal symptoms differed as a function of the participants' professional category.The odds of nursing technicians to simultaneously develop musculoskeletal pain, fatigue and tension were 4.968 times higher (p=0.023) compared to physicians, nurses and physical therapists.This difference was mediated by factors such as sex, body mass index and number of ICU jobs.Nursing technicians were the most exposed group, and thus they require more attention as concerns workplace health interventions.

CONCLUSIONS

The participants had long working hours, and differed in regard to the most frequent musculoskeletal complaints as a function of the specificities inherent to the activities of each professional category.

Health-promoting Lifestyles of Nurses and Its Association with Musculoskeletal Disorders: A Cross-Sectional Study

Background

Work-related musculoskeletal disorders are a significant concern for public health, leading to temporary and permanent disability. Health care workers, including nurses, are at high risk for these disorders. This study aimed to assess the health-promoting lifestyles of nurses and their association with musculoskeletal disorders and symptoms.

Methods

This study explored health-promoting lifestyles and their association with musculoskeletal symptoms in nurses. In this cross-sectional study, a total of 300 nurses working in the teaching hospitals affiliated with Shiraz University of Medical Sciences (SUMS), were selected using systematic random sampling. Data were collected by two questionnaires, the Health-promoting Lifestyle Profile (HPLP) and the Nordic Musculoskeletal Questionnaire (NMQ).

Results

Study findings showed that 47% of the study participants had a moderate level lifestyle. In terms of musculoskeletal symptoms, the most prevalent were reported in the back (88.33%), knees (83.33%), and thighs (71%). Moreover, Pearson correlation analysis revealed significant negative correlations between eating habits and musculoskeletal symptoms and interpersonal relations, while a significant positive correlation was found between nutrition and stress management with musculoskeletal symptoms.

Conclusion

Lifestyle variables are a good predictor for nurses’ musculoskeletal symptoms. Therefore, knowledge of health-promoting lifestyle behaviors and practice of these behaviors are necessary to reduce musculoskeletal disorders among nurses.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.

Structural equation model of interactions between risk factors and work-related musculoskeletal complaints among Iranian hospital nurses

BACKGROUND

Statistics indicate a high risk of developing work-related musculoskeletal disorders among hospital nurses. The challenge is to understand the associations between musculoskeletal symptoms and various individual and occupational risk factors.

OBJECTIVE

This study examined the direct and indirect interactions of various risk factors with musculoskeletal complaints in hospital nurses.

METHOD

In a cross-sectional design, Iranian hospital nurses from Semnan University of Medical Sciences participated in a questionnaire survey reporting their perceived perceptions of various work-related risk factors and musculoskeletal symptoms. We tested our proposed structural equation model to evaluate the relations between latent and observed concepts and the relative importance and strength of exogenous variables in explaining endogenous musculoskeletal complaints.

RESULTS

Measurement model fits the data relatively acceptable. Our findings showed direct effects of psychological, role-related and work posture stressors on musculoskeletal complaints. Fatigue mediated the adverse indirect relations of psychological, role-related, work posture and individual factors with musculoskeletal complaints.

CONCLUSIONS

Structural equation modeling may provide methodological opportunities in occupational health research with a potential to explain the complexity of interactions among risk factors. Prevention of work-related musculoskeletal disorders among nurses must account for physical and psychosocial conditions.

Anxiety and depression predict musculoskeletal disorders in health care workers

Incidence of musculoskeletal disorders (MSDs) is high among health care workers (HCWs). To determine whether MSDs are associated with preexisting anxiety and/or depression, a case-control study was carried out in female HCWs (56 cases/55 controls). Cases were HCWs with a first-time clinical diagnosis of MSD within the previous 2 years. Occupation, workplace, work shift, direct patient assistance, and anxiety/depression scores (Goldberg scale) were assessed. Increased risk of incident MSDs (multivariate logistic regression) was found in workers with preexisting anxiety/depression compared to those without (OR 5.01; 95% CI 2.20-12.05; p < .01). Other significant risk factors were direct patient assistance (OR 2.59; 95% CI 1.03-6.92; p = .04) and morning work shift (OR 2.47; 95% CI 0.99-6.48; p = .05). Preexisting anxiety/depression was associated with incident MSDs in HCWs, adjusting for occupational exposure risk factors.

Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review

Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.

The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career

AIMS

To identify why some nurses cope well with continuing to work as they age and others struggle.

BACKGROUND

There is a need to understand better the challenges older nurses face and how they manage them.

DESIGN

Secondary analysis of existing data.

METHODS

Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data (n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews (n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies.

RESULTS

Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice.

CONCLUSION

While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers.

Lower extremity musculoskeletal disorders in nurses: A narrative literature review

AIMS

The aim of the narrative review was to describe and analyze lower extremity musculoskeletal disorders (MSDs) in nurses and to identify factors associated with these disorders. The ultimate goal was to promote lower extremity health in nurses by recognizing factors that could improve their well-being at work.

METHODS

A systematic search on the Medline, CINAHL, and PsychInfo databases was conducted, producing altogether 945 citations, of which 35 were selected for this review. The studies were analyzed by content analysis.

RESULTS

Nurses have different MSDs in their lower extremities, with which the knee, foot, and ankle being most commonly affected. These problems are often correlated, and problems in the ankle can first appear as knee problems.

CONCLUSIONS

Musculoskeletal disorders in lower extremities and their resulting disability are common within the nursing workforce worldwide, representing a major cause of sick leave absence and often leading to long-term absence.

Human Factors in the NICU: A Bedside Nurse Perspective

Human factors have been identified as the most frequent cause of and contributory factor to sentinel events. Many human factor errors are preventable, and neonatal nurses are instrumental at the point of care in working with system leaders to identify various problems and potentially safe practices that can be hardwired into daily practice. This article defines human factors that often occur in daily processes of care in many neonatal intensive care units (NICU) and specific evidence-based strategies to implement to reduce preventable human errors. Human factor evidence from other high-risk industries is relevant to healthcare and can be applied to the complex adaptive environment of the NICU. Nurses need to be mindful of their complex environment and to have a basic understanding of the role of human factors principles.

Age-related differences do affect postural kinematics and joint kinetics during repetitive lifting

BACKGROUND

Age is considered a risk factor for manual handling-related injuries and older workers incur higher injury-related costs than younger co-workers. This study investigated the differences between the kinematics and kinetics of repetitive lifting in two groups of handlers of different ages.

METHODS

Fourteen younger (mean 24.4 yr) and 14 older (mean 47.2 yr) males participated in the study. Participants repetitively lifted a box weighing 13 kg at a frequency of 10 lifts/min for a maximum of 20 min. Postural kinematics (joint and lumbosacral angles and angular velocities) and kinetics (joint moments) were measured throughout the lifting task using motion analysis and ground reaction forces. Muscle fatigue of the erector spinae was assessed using electromyography.

FINDINGS

Peak lumbosacral, trunk, hip and knee flexion angles differed significantly between age groups over the duration of the task, as did lumbosacral and trunk angular velocities. The younger group increased peak lumbar flexion by approximately 18% and approached 99% of maximum lumbosacral flexion after 20 min, whereas the older group increased lumbar flexion by 4% and approached 82% maximum flexion. The younger group had a larger increase in peak lumbosacral and trunk angular velocities during extension, which may be related to the increased back muscle fatigue observed among the younger group.

INTERPRETATION

Older participants appeared to control the detrimental effects of fatigue associated with repetitive lifting and limit lumbar spine range of motion. The higher rates of musculoskeletal injury among older workers may stem from a complex interaction of manual handling risk factors.

Work-related risk factors for neck pain in the US working population

STUDY DESIGN

This study uses the Taylor linearized variance estimation method to compute weighted unadjusted and adjusted prevalence of neck pain by occupation, with a cross-section data set from the 2009 to 2012 National Health Interview Survey.

OBJECTIVE

The goal of this study was to explore occupational patterns of neck pain and the relationship between long work hours and neck pain in the working population in the United States.

SUMMARY OF BACKGROUND DATA

The past research has demonstrated that specific occupations have a high prevalence of neck pain. However, occupational patterns of neck pain in the United States have been understudied.

METHODS

Risk of neck pain was estimated using univariate and multivariate logistic regression with odds ratios (ORs) with 95% confidence interval (CI) as measures of association.

RESULTS

After controlling for demographic, socioeconomic status, and behavior-related factors and compared with workers in architecture and engineering occupation group, the top 5 occupational groups with significantly higher relative prevalence of neck pain included: military specific (OR, 2.50; 95% CI, 1.17-5.35); arts, design, entertainment, sports, and media (OR, 1.70; 95% CI, 1.34-2.17); life, physical, and social science (OR, 1.67; 95% CI, 1.33-2.11); health care support (OR, 1.55; 95% CI, 1.23-1.97); and installation, maintenance, and repair (OR, 1.54; 95% CI, 1.21-1.96). Compared with those who worked 40 hours, people who worked 46 to 59 hours (OR, 1.20; 95% CI, 1.10-1.30) and 60 or more hours of work per week (OR, 1.35; 95% CI-1.21, 1.51) were more likely to report neck pain.

CONCLUSION

This study adds to the evidence that an individual's occupation and work hours affect workers' risk for neck pain. This study indicates a need for new research efforts and public policies targeted to workers who are susceptible to neck pain in the United States.

LEVEL OF EVIDENCE

1.

Healthy work environments for the ageing nursing workforce

AIM

The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working.

BACKGROUND

Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care.

EVALUATION

Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated.

KEY ISSUES

Hospital design can help address the physical work challenges that older nurses experience.

CONCLUSIONS

Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse Managers must participate in design efforts and advocate designs that support aging nurses.

Relationship between Psychosocial Risk Factors and Work-Related Musculoskeletal Disorders among Public Hospital Nurses in Malaysia

Objective

This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

Methods

We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model’s psychosocial risk factors.

Results

Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p < 0.05) between nurses with and without WRMSDs. According to univariate logistic regression, all psychosocial risk factors illustrated significant association with the occurrence of WRMSDs in various regions of the body (OR: 1.52–2.14). Multiple logistic regression showed all psychosocial risk factors were significantly associated with WRMSDs across body regions (OR: 1.03–1.19) except for region 1 (neck, shoulders and upper back) and region 4 (hips, knees, ankles, and feet). All demographic variables except for years of employment were statistically and significantly associated with WRMSDs (p < 0.05).

Conclusions

The findings indicated the high prevalence of WRMSDs in many body regions, and the risks of developing WRMSDs according to the various body regions were associated with important psychosocial risk factors based on the job strain model. These findings have implications for the management of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

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.

Effects of age and its interaction with task parameters on lifting biomechanics

This study investigated the age-related differences in lifting biomechanics. Eleven younger and 12 older participants were instructed to perform symmetric lifting tasks defined by different combinations of destination heights and load magnitudes. Lifting biomechanics was assessed. It was found that the trunk flexion in the starting posture was 32% lower and the peak trunk extension velocity was 46% lower in older participants compared with those in younger ones, indicating that older adults tended to use safer lifting strategies than did younger adults. Based on these findings, we recommend that physical exercise programmes may be a more effective ergonomic intervention for reducing the risks of low back pain (LBP) in lifting among older workers, compared with instructions of safe lifting strategies. As for younger workers, instructions of safe lifting strategies would be effective in LBP risk reduction.

Trapezius muscle load, heart rate and time pressure during day and night shift in Swiss and Japanese nurses

The aim of the present study was to analyze the activity of the trapezius muscle, the heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts. The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese nurses. The observed rest time of the trapezius muscle was longer for Swiss than for Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius muscle activity showed a different effect for Swiss than for Japanese nurses. It was higher during the day shift of Swiss nurses and higher during the night shift of Japanese nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of the shifts, time pressure increased for Japanese nurses and slightly decreased for those from Switzerland. Considering trapezius muscle activity and time pressure, the nursing profession was more burdening for the examined Japanese nurses than for Swiss nurses. In particular, the night shift for Japanese nurses was characterized by a high trapezius muscle activity and only few rest times for the trapezius muscle.