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

Frequency of breaks, amount of muscular rest, and sustained muscle activity related to neck pain in a pooled dataset

BACKGROUND

Neck pain remains a persistent challenge in modern society and is frequently encountered across a wide range of occupations, particularly those involving repetitive and monotonous tasks. It might be expected that patterns of trapezius muscle activity at work, characterized by few breaks and prolonged periods of sustained muscle activity, are linked to neck pain. However, previous cross-sectional studies have generally failed to establish a definitive association. While some longitudinal studies have suggested that extended periods of heightened muscle activity could be a risk factor for neck pain, these findings often relied on limited participant numbers or specific professional groups. This study aimed to investigate the relationship between trapezius muscle activity and neck pain by pooling data from seven Scandinavian research institutes encompassing a diverse range of occupational backgrounds.

METHODS

Electromyographic (EMG) data for the upper trapezius muscle, collected during working hours, were coupled with questionnaire responses pertaining to neck pain, individual characteristics, and potential confounding variables for a total of 731 subjects. Additionally, longitudinal data from 258 subjects were available. The various EMG datasets were consolidated into a standardized format, and efforts were made to harmonize inquiries about neck pain. Regression analyses, adjusting for sex and height, were conducted to explore the associations between muscle activity variables and neck pain. An exposure index was devised to quantify the cumulative neck load experienced during working hours and to differentiate between various occupational categories.

RESULTS

The cross-sectional data displayed a distinct pattern characterized by positive associations for brief periods of sustained muscle activity (SUMA) and negative associations for prolonged SUMA-periods and neck pain. The longitudinal data exhibited a contrasting trend, although it was not as pronounced as the cross-sectional findings. When employing the exposure index, notable differences in cumulative muscle load emerged among occupational groups, and positive associations with longitudinal neck pain were identified.

DISCUSSION

The results suggest that individuals with neck pain experience higher cumulative workloads and extended periods of muscle activity over the long term. In the short term, they appear to compensate by taking frequent short breaks, resulting in a lower cumulative workload. Regardless of their occupation, it is crucial to distribute work breaks throughout the workday to ensure that the cumulative load remains manageable.

Identifying Predictors of Neck Disability in Patients with Cervical Pain Using Machine Learning Algorithms: A Cross-Sectional Correlational Study

(1) Background: Neck pain intensity, psychosocial factors, and physical function have been identified as potential predictors of neck disability. Machine learning algorithms have shown promise in classifying patients based on their neck disability status. So, the current study was conducted to identify predictors of neck disability in patients with neck pain based on clinical findings using machine learning algorithms. (2) Methods: Ninety participants with chronic neck pain took part in the study. Demographic characteristics in addition to neck pain intensity, the neck disability index, cervical spine contour, and surface electromyographic characteristics of the axioscapular muscles were measured. Participants were categorised into high disability and low disability groups based on the median value (22.2) of their neck disability index scores. Several regression and classification machine learning models were trained and assessed using a 10-fold cross-validation method; also, MANCOVA was used to compare between the two groups. (3) Results: The multilayer perceptron (MLP) revealed the highest adjusted R2 of 0.768, while linear discriminate analysis showed the highest receiver characteristic operator (ROC) area under the curve of 0.91. Pain intensity was the most important feature in both models with the highest effect size of 0.568 with p < 0.001. (4) Conclusions: The study findings provide valuable insights into pain as the most important predictor of neck disability in patients with cervical pain. Tailoring interventions based on pain can improve patient outcomes and potentially prevent or reduce neck disability.

Instrument Assisted Soft Tissue Mobilization versus Integrated Neuromuscular Inhibition Technique in Nonspecific Chronic Neck Pain: Single-blinding Randomized Trial

Objective

This study aimed to compare the effects of instrument-assisted soft tissue mobilization (IASTM) vs integrated neuromuscular inhibition technique (INIT) on pain intensity, pressure pain threshold, neck disability, and electrophysiological properties in nonspecific chronic neck pain.

Methods

We performed a pre-post prospective randomized controlled trial on 90 participants with nonspecific chronic neck pain. The participants were chosen randomly from physical therapy out-patient clinics in the Giza governorate and allocated randomly by permuted block to the following 3 groups: Group A received INIT on the upper trapezius in addition to supervised traditional therapy (STT) as hot pack, stretching and strengthening exercises, Group B received IASTM on the upper trapezius in addition to STT, and Group C received STT only. Treatment was 3 times per week for 4 weeks. Pain intensity by visual analog scale (VAS), pressure pain threshold (PPT) by commander algometer, neck disability by Arabic Neck Disability Index (ANDI), and electrophysiological properties in the form of muscle amplitude by root mean square (RMS), and fatigue by median frequency (MDF) were measured at baseline and after 4 weeks.

Results

In the within-group analysis, there was a statistically significant decrease in VAS, ANDI, and RMS% values within each group with favor to INIT. In PPT and MDF, there was a significant increase within each group with regard to INIT as P value <.05. In the between-group analysis at posttreatment, the results reported a statistically significant difference between INIT and STT, and also between IASTM and STT in all variables. Between INIT and IASTM, there was no statistically significant difference in VAS and NDI, but there was a statistically significant difference in PPT, RMS%, and MDF. The post hoc test reported improvement in all variables in all groups, with more favor to the INIT group in PPT and electrophysiological properties only.

Conclusion

In this study, we found no statistically significant differences between INIT and IASTM in VAS and ANDI posttreatment, but there were differences between INIT and STT group and IASTM and STT group.

Evaluation of the Diurnal Cycle of Blood Pressure and Sleep in Shift Workers

BACKGROUND

Circadian misalignment of physiological factors in shift workers is poorly studied in the Indian population. In the present study, 24-hour blood pressure measurements were taken on the same subject twice, once during his morning and night shifts. Sleep was also monitored by a self-reported sleep diary, which was confirmed with an activity monitor, and the sleep quality was assessed using sleep questionnaires.

OBJECTIVE

This study aimed to discover the pattern of blood pressure variation, the dipping and non-dipping status, and its correlation with sleep.

METHODOLOGY

This observational study was conducted in the Department of Physiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, from April 2019 to September 2019, among security guards working rotating shifts in the Rishikesh hospital premises. Participants were given an activity sheet with instructions to document their daily activities for a complete 24-hour period on the designated measurement day, including recording the time of waking up and going to sleep. A wrist-worn activity monitor was utilised to assess the self-reported sleep duration provided by each participant on the activity sheet.

RESULTS

The present study showed the mean age of the participants as 27.03 ± 2.71 years, along with a mean body mass index (BMI) of 22.10 ± 1.64. Sleep duration was significantly higher during the morning shift (5.81 ± 1.08 hours) compared to the night shift (4.02 ± 1.70 hours) on the day of ambulatory blood pressure monitoring (ABPM) recording. The mean difference in systolic blood pressure between night shift workers between their awake and sleep periods was 15.91 ± 8.44 mmHg. However, no statistically significant disparity was seen when comparing the systolic blood pressure at the 24-hour mark during wakefulness and sleep between those working morning and night shifts (p >0.05).

CONCLUSION

The current study's findings indicate that participation in shift work, particularly night shift work, could potentially play a role in the emergence of irregular circadian blood pressure patterns and potentially lead to a lack of nocturnal blood pressure decline.

Advances in EMG measurement techniques, analysis procedures, and the impact of muscle mechanics on future requirements for the methodology

Muscular coordination enables locomotion and interaction with the environment. For more than 50 years electromyography (EMG) has provided insights into the central nervous system control of individual muscles or muscle groups, enabling both fine and gross motor functions. This information is available either at individual motor units (Mus) level or on a more global level from the coordination of different muscles or muscle groups. In particular, non-invasive EMG methods such as surface EMG (sEMG) or, more recently, spatial mapping methods (High-Density EMG - HDsEMG) have found their place in research into biomechanics, sport and exercise, ergonomics, rehabilitation, diagnostics, and increasingly for the control of technical devices. With further technical advances and a growing understanding of the relationship between EMG and movement task execution, it is expected that with time, especially non-invasive EMG methods will become increasingly important in movement sciences. However, while the total number of publications per year on non-invasive EMG methods is growing exponentially, the number of publications on this topic in journals with a scope in movement sciences has stagnated in the last decade. This review paper contextualizes non-invasive EMG development over the last 50 years, highlighting methodological progress. Changes in research topics related to non-invasive EMG were identified. Today non-invasive EMG procedures are increasingly used to control technical devices, where muscle mechanics have a minor influence. In movement science, however, the effect of muscle mechanics on the EMG signal cannot be neglected. This explains why non-invasive EMG's relevance in movement sciences has not developed as expected.

Influence of adding strain-counterstrain to standard therapy on axioscapular muscles amplitude and fatigue in mechanical neck pain: a single-blind, randomized trial

BACKGROUND

Strain-counterstrain technique (SCS) or positional release therapy is strongly recommended for patients with mechanical neck pain (MNP) because this method has excellent benefits, but the clinical significance of this method is unclear.

AIM

The aim of this study was to investigate the influence of adding the SCS technique to standard therapy on pain, pressure pain threshold, disability according to Neck Disability Index (NDI), and electrophysiological characteristics (amplitude and fatigue) of the upper part of trapezius in the axioscapular muscles of patients with mechanical neck pain.

DESIGN

Single-blind, randomized clinical trial.

SETTING

Outpatient clinic.

POPULATION

Sixty patients (19-38 years old) with mechanical neck pain participated in this study and were recruited from the outpatient clinic at the faculty of physical therapy after a referral from an orthopedist.

METHODS

Patients were randomly assigned by opaque sealed envelope to two treatment groups: group A received SCS, standard therapy in form of active range of motion, stretching exercises, and postural correction exercises (PCES), whereas group B, received standard therapy only; therapeutic sessions were performed three times/week for 4 weeks. The visual analogue scale, pressure pain threshold, NDI, upper trapezius median frequency, and root mean square were used to evaluate the patients' pretreatment and post-treatment status.

RESULTS

Multiple pairwise comparisons within each group revealed statistically significant differences in all outcome variables with favor to the SCS group.

CONCLUSIONS

The Strain-counterstrain technique combined with traditional standard therapy is an effective method more than traditional standard therapy alone for the management of patients with MNP.

CLINICAL REHABILITATION IMPACT

The present study has implications, especially for clinical decision-making about therapy of choice in MNP to reduce pain, improve function as measured through SCS technique and its impact on normal lifestyle, and to highlight the need for active intervention.

Health-promoting work schedules: protocol for a large-scale cluster randomised controlled trial on the effects of a work schedule without quick returns on sickness absence among healthcare workers

INTRODUCTION

In shift work, quick returns refer to transitions between two shifts with less than 11 hours available rest time. Twenty-three per cent of employees in European countries reported having quick returns. Quick returns are related to short sleep duration, fatigue, sleepiness, work-related accidents and sickness absence. The present study is the first randomised controlled trial (RCT) to investigate the effect of a work schedule without quick returns for 6 months, compared with a work schedule that maintains quick returns during the same time frame.

METHODS AND ANALYSIS

A parallel-group cluster RCT in a target sample of more than 4000 healthcare workers at Haukeland University Hospital in Norway will be conducted. More than 70 hospital units will be assessed for eligibility and randomised to a work schedule without quick returns for 6 months or continue with a schedule that maintains quick returns. The primary outcome is objective records of sickness absence; secondary outcomes are questionnaire data (n≈4000 invited) on sleep and functioning, physical and psychological health, work-related accidents and turnover intention. For a subsample, sleep diaries and objective sleep registrations with radar technology (n≈ 50) will be collected.

ETHICS AND DISSEMINATION

The study protocol was approved by the Regional Committee for Medical and Health Research Ethics in Western Norway (2020/200386). Findings from the trial will be disseminated in peer-reviewed journals and presented at national and international conferences. Exploratory analyses of potential mediators and moderators will be reported. User-friendly outputs will be disseminated to relevant stakeholders, unions and other relevant societal groups.

TRIAL REGISTRATION NUMBER

NCT04693182.

A human factors approach to evaluate predicators of acute care nurse occupational fatigue

Nurses function at the point of care and assume a significant role in intercepting errors. They work in a mentally and physically demanding profession that is comprised of shift-work, subjecting nurses to considerable fatigue. Yet, few studies constructed a comprehensive model that integrates personal and occupational factors to explore their relationship with various types of fatigue (acute, chronic, physical, mental, and total). Here, we examine this type of comprehensive fatigue-model, in a report that represents one aim of a larger, mixed-methods study. The study sample comprised of 1137 registered nurses working in eight hospitals in a Midwestern state. Nurses reported higher levels of acute and total fatigue than chronic and physical fatigue. Staffing and resource adequacy, exercise, and sleep were among the strongest predictors. Since fatigue is a multi-faceted construct, a comprehensive fatigue-management strategy that targets both day and night-shift nurses is the optimal way to manage nurse fatigue.

Ischemic Pressure vs Postisometric Relaxation for Treatment of Rhomboid Latent Myofascial Trigger Points: A Randomized, Blinded Clinical Trial

OBJECTIVE

The purpose of this study was to investigate the effects of ischemic pressure (IP) vs postisometric relaxation (PIR) on rhomboid-muscle latent trigger points (LTrPs).

METHODS

Forty-five participants with rhomboid-muscle LTrPs were randomly assigned into 3 groups and received 3 weeks of treatment-group A: IP and traditional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR and traditional treatment; and group C: traditional treatment. Shoulder pain and disability, neck pain and disability, and pressure pain threshold (PPT) of 3 points on each side were measured before and after treatment.

RESULTS

Multivariate analysis of variance indicated a statistically significant Group × Time interaction (P = .005). The PPT for the right lower point was increased in group A more than in groups B or C. Neck pain was reduced in group B more than in group C. Moreover, shoulder and neck disability were reduced in both groups A and B more than in group C. The PPTs of the left lower and middle points were increased in group B compared with groups A and C. The PPT of the left upper point was increased in group A more than in group C. There were significant changes in all outcomes in the 2 experimental groups (P < .05). No changes were found in the control group except in pain intensity, shoulder disability, and PPT of the left lower point.

CONCLUSION

This study found that IP may be more effective than PIR regarding PPT, but both techniques showed changes in the treatment of rhomboid-muscle LTrPs.

The accumulation of, and associations between, nurses' activity levels within their shift in the emergency department

The aim of this study was to examine emergency nurses' activity levels and associations between hourly activity levels within-shifts. Fifty emergency nurses (45 females, 5 males) wore ActiGraph accelerometers and completed work diaries for up to 4 weeks. A sub-group (n = 42) also wore activPALs. Multilevel analyses examined temporal associations between hourly periods. In any hourly period, increased time spent in moderate- to vigorous-intensity physical activity (MVPA) was associated with less time spent in MVPA in the following hourly period. In any afternoon hourly period, increased time spent in MVPA was associated with more time spent in light-intensity physical activity in the following hourly period. No other associations were significant. Emergency nurses maintain activity levels within-shifts, except when more time spent in MVPA was associated with less time spent in MVPA in the following hour; a potential recovery strategy. Future research should determine how emergency nurses maintain their activity levels within-shifts. Practitioner Summary: Emergency nursing is physically demanding; however, it is unknown how active they are during hourly periods within-shifts. Emergency nurses' activity levels were maintained within hourly periods of a shift. Except for an increase in MVPA in 1 h was associated with a decrease in MVPA in the following hour. Abbreviations: CPR: cardiopulmonary resusitation; LPA: light-intensity physical activity; MPA: moderate-intenisty physical activity; MVPA: moderate- to vigorous-intensity physical activity; SED: sedentary.

Describing objectively measured intensive care nurses' physical work activity behavioural patterns during a 12-hr shift

AIM AND OBJECTIVES

To describe intensive care unit (ICU) nurses' physical work activity behavioural patterns over 12 hr using dual accelerometry, following a job demands-recovery framework.

BACKGROUND

Limited studies utilised accelerometry to objectively analyse nurses' physical workloads. Little is known about intensive care nurses' physical activity patterns during a 12-hr shift.

DESIGN

A cross-sectional study was conducted with intensive care nurses from four units in Auckland, New Zealand.

METHODS

Each participant wore two Axivity AX3 accelerometers to measure physical activity during a 12-hr day or night shift. An online survey captured participants' demographic information. R software (version 3.6.1) and SPSS version 26 were utilised for data analysis. The STROBE was followed.

RESULTS

A total of 102 nurses were included in this study. A high level of light intensity activity behaviours (standing, dynamic standing, walking) was observed throughout the day shifts, with no higher intensity behaviours identified. Activity levels were highest at the beginning of shifts and followed a consistent pattern, with an additional peak around midday for day shifts and at the end of the shift for night shifts. Observable differences were seen between day and night shifts with a greater prevalence of sitting and lying during night shifts. Standing, dynamic standing, sitting, lying and walking were significant factors in the differences of the physical work behaviours between the day shift nurses and the night shift nurses. Significant differences in dynamic standing and lying were found between ICUs.

CONCLUSIONS

Intensive care nurses' physical work activity involved a large amount of standing and dynamic standing during a 12-hr shift. The overall physical workload during a 12-hr day shift was significantly higher than that during a 12-hr night shift.

RELEVANCE TO CLINICAL PRACTICE

Results may help managers attain a better understanding of nurses' physical workloads during a 12-hr shift.

Efficacy of Kinesio Taping and Postural Correction Exercises on Levator Scapula Electromyographic Activities in Mechanical Cervical Dysfunction: A Randomized Blinded Clinical Trial

OBJECTIVE

Mechanical neck dysfunction (MND) is a major health burden. Although postural correction exercises (PCEs) are commonly used for its treatment, efficacy of Kinesio Taping (KT) has received considerable attention. This study was conducted to determine the effect of KT and PCEs on levator scapula (LS) electromyography.

METHODS

Ninety-one patients with MND were randomly assigned into 1 of 3 groups that received 4 weeks' treatment: group A, KT; group B, PCE; and group C, both interventions. Neck pain, LS root mean square (RMS), and median frequency (MDF) were measured pretreatment and post-treatment with the Numerical Pain Rating Scale and surface electromyography, respectively, by an assessor blinded to the patients' allocation.

RESULTS

Multivariate analysis of variance indicates a statistically significant group-by-time interaction (P = .000). Pain intensity was significantly reduced in group C more than in group B (P = .001). Mean values of RMS were significantly reduced in group C compared to both group A (P = .001) and group B (P = .022), whereas MDF was significantly increased in group C compared to either group A (P = .00) or group B (P = .026), and in group B compared to group A (P = 0.26). A paired t test revealed that there was a significant decrease in pain and RMS, and a significant increase in MDF in all groups (P < .01).

CONCLUSION

Application of both KT and PCE combined can significantly reduce neck pain and normalize LS activities in patients with MND more than the application of either intervention.

The association between shift patterns and the quality of hand antisepsis in a neonatal intensive care unit: An observational study

BACKGROUND

Healthcare-associated infections represent a major burden in neonatal intensive care units. Hand antisepsis is the most important tool for prevention, however, compliance among healthcare workers remains low.

OBJECTIVES

To prospectively evaluate the influence of different work shifts (extended working hours, night shifts) on the quality of healthcare workers' hand antisepsis.

DESIGN

Observational study.

SETTINGS

Two equivalent "Level III" neonatal intensive care units at the University Hospital Vienna, Austria.

PARTICIPANTS

Seventy healthcare workers, 46 nurses and 24 physicians.

METHODS

The Semmelweis Scanner, an innovative training device assessing the quality of hand antisepsis with an ultraviolet dye labelled alcohol-based hand rub, was employed to collect data on the hand surface coverage achieved during hand antisepsis of participants. It provides visual feedback of appropriately versus inappropriately disinfected areas of the hand and can also be used for the objective quantification of hand surface coverage with the hand rub. Measurements were performed before and after 12.5 h (h) day and night shifts (nurses), as well as before and after regular 8 h day shifts and extended 25 h shifts (physicians). To avoid any bias caused by residual ultraviolet marker, scans had to be separated by 24 h periods. Primary outcome was the hand surface coverage with the hand rub: Hand scans were categorized as "passed" if an appropriate quality of hand hygiene, defined as a minimum 97% coverage of hand surface, was achieved. A generalized mixed model was used to analyse the data accounting for repeated measurements.

RESULTS

Seventy healthcare workers performed a total of 485 scans. Nineteen scans had to be excluded, resulting in 466 scans for further analyses. A difference in the predicted probability of achieving appropriate hand antisepsis was found between the beginning and end of extended shifts: In physicians, adequate hand antisepsis was remarkably reduced after 25 h shifts (predicted probability 99.4% vs 78.8%), whereas there was no relevant difference between the beginning and end of 8 h day shifts (92.2% vs 97.3%). In nurses, a relevant difference was found between the beginning and end of 12.5 h day shifts (88.6% vs 73.6%). This difference was not found for 12.5 h night shifts. The most frequently missed area on the hands was the right dorsum.

CONCLUSION

The quality of hand antisepsis of healthcare workers in neonatal intensive care units may be associated with long working hours.

Emergency nurses' activity levels across rotating shifts

BACKGROUND

Emergency nurses work consecutive, rotating shift patterns. However, how their occupational physical activity levels are associated between these shifts is unknown. This study aimed to examine the associations between emergency nurses' time spent in different activity levels across one shift and the following day's shift.

METHODS

Fifty emergency nurses (45 female, five male) wore an ActiGraph accelerometer and completed work and sleep diaries across four weeks in 2018. A sub-sample (n = 42) also wore an activPAL inclinometer. Time spent sedentary, physically active, and in postural positions was determined. Multi-level analyses examined associations between one shift and the following day's shift.

RESULTS

Additional time spent sedentary and in light-intensity physical activity during the first shift was associated with more time spent being physically active in the following day's shift for all rotations except back-to-back night shifts. However, additional time spent engaged in moderate- to vigorous-intensity physical activity during the first shift was associated with less time spent physically active in the following day's shift for afternoon-morning and morning-afternoon rotations.

CONCLUSION

These findings demonstrate that shift sequences may impact emergency nurses' physical activity across shifts. Future research should identify the strategies emergency nurses use to maintain activity levels between shifts.

Nurse staffing models in medical-surgical units of acute care settings: A cross-sectional study

BACKGROUND

Nurse staffing models have been developed across different countries to address nursing shortages and improve quality of nursing care. However, there is no published study that describes nurse staffing models in Ethiopian hospitals.

AIMS

To describe the existing staffing models for nursing practice in acute care units of two hospitals (one public and one private) in Ethiopia.

METHODS

A cross-sectional study was conducted from July to December 2018. A self-administered questionnaire was used to collect data such as shift patterns, hours worked, and number of patients cared for per shift. Unit-level data on nurse staffing were collected using a checklist developed specifically for this study.

RESULTS

Fifty-nine percent (59.9%) of participants reported that they worked six or seven days per week. On average, they worked 50 hours per week and 12% working over 60 hours per week. The number of patients they provided care for during their last shift ranged from four to 45 with an average of 13 patients.

CONCLUSION

This study demonstrates that nurses working in acute care settings in Ethiopia are typically working more than 40 hours per week and caring for many patients per shift, which has the potential to impact patient safety.

How many calories do nurses burn at work? A real-time study of nurses' energy expenditure

Background

Nurses have high rates of overweight and obesity, and physical inactivity is one key determinant of weight gain.

Aims

The present study aims to quantify nurses' energy expenditure over a standard 12-hour shift to establish whether activity levels at work are too low to maintain a healthy body weight.

Methods

Ward-based nurses (n = 96, 90 female, mean age = 36 years, mean experience = 10 years, mean body mass index = 26.6) wore heart rate and physical activity monitors for the duration of one full working shift. Heart rate and activity data were used in combination with demographic information to estimate each nurse's energy expenditure over 12 hours.

Results

On average, nurses burned 2.12 kcals per minute while at work, equating to 1521 kcals/6364 kJ (SD = 403 kcals/1686 kJ) per 12-hour shift. Energy expenditure over 12 hours varied markedly between nurses (from 812 kcals/3397 kJ to 3005 kcals/12,573 kJ) but was sufficient in 72% of participants (assuming minimal resting levels of energy expenditure for the 12 hours not at work) to burn off a daily calorie intake of 2000 kcals.

Conclusions

Three-quarters of nurses expend more energy on working days than is required to maintain a healthy body weight if dietary intake does not exceed recommended levels.

Eletromiografia de superfície da região cervical - contribuição para a saúde muscular

Resumo Objetivo: Verificar sintomatologias dolorosas cervicais em um grupo de trabalhadores administrativos e investigar os sinais eletromiográficos do músculo trapézio superior de trabalhadores administrativos em repouso. Métodos: Estudo exploratório, de abordagem intervencionista, realizado com trabalhadores da área portuária. Analisaram-se variáveis pessoais, sintomatológicas, ocupacionais e eletrofisiológicas a partir da eletromiografia da região cervical. Foram aplicados os testes qui quadrado, teste t de Student e Mann Whitney. Resultados: Participaram 43 trabalhadores, que apresentaram média de nota para dor nas regiões do ombro e posterior do pescoço estatisticamente maiores entre mulheres do que entre homens. A formação de ondas positivas ocorreu antes e após o trabalho, afetando dez trabalhadores. A concretização da jornada de trabalho não produziu modificações significativas de atividade eletrofisiológica cervical. Conclusão: O estudo identificou variáveis ergonômicas e a autorreferência de cervicalgia, bem como o recrutamento de ondas positivas em um pequeno grupo de trabalhadores, apresentando que o uso de novos instrumentos de avaliação muscular pela enfermagem pode contribuir para a atuação profissional à saúde do trabalhador. O sexo mostrou-se variável importante na avaliação à dor muscular, especialmente ao sexo feminino, assim como o período pré-jornada, indicando que as ações produzidas anteriormente ao trabalho podem influenciar, positiva ou negativamente, nas condições musculares para o desenvolvimento da jornada de trabalho. Desta forma, delimitou-se um grupo de trabalhadores que demandam promoção a saúde muscular.

Short rest between shift intervals increases the risk of sick leave: a prospective registry study

OBJECTIVES

The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave.

METHODS

A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month.

RESULTS

Exposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave.

CONCLUSIONS

We found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance.

Workplace psychosocial and organizational factors for neck pain in workers in the United States

BACKGROUND

Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain.

METHODS

Data used for this study come from the 2010 National Health Interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations.

RESULTS

This study demonstrated significant associations between neck pain and a set of workplace risk factors, including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs, and long work hours.

CONCLUSION

Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. Am. J. Ind. Med. 59:549-560, 2016. © 2016 Wiley Periodicals, Inc.

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.