Intervention development to reduce musculoskeletal disorders: Is the process on target?

Can biofeedback training in combination with ergonomic information reduce pain among young adult computer users with neck and upper extremity symptoms? - A randomized controlled intervention study

The aim of this randomized controlled study was to explore if an intervention with biofeedback training in combination with ergonomic discussions, could improve working technique and work postures, and reduce pain intensity and perceived exertion in young adult computer users with ongoing neck and upper extremity symptoms. 39 participants were divided into an intervention group and a control group. The intervention consisted of 4 sessions during a three-month period. Working technique, working postures, rated perceived exertion, pain intensity, and duration of computer use were measured at baseline and follow ups after 6 and 12 months. The intervention did not significantly improve working technique and working postures, nor reduce pain intensity and perceived exertion in the intervention group compared to the control group. However, there was a statistically significant reduction in reported pain intensity in the neck/shoulder for the whole group. Also, there was a trend that time spent with computer work without breaks was more reduced in the intervention group than in the control group.

The problem with "ergonomics injuries": What can ergonomists do?

Effects of psychosocial hazards on risk of musculoskeletal disorders (MSDs) are often very substantial, but workplace risk management practices focus largely on biomechanical hazards, as do the risk assessment methods used by ergonomists. Translation of research evidence into more effective workplace practices demands a more holistic risk management framework that encompasses both types of hazard. In this context, we evaluate the validity of different MSD risk assessment methods for different purposes, focusing particularly on requirements for routine workplace risk management. These include choice of fit-for-purpose assessment methods, prioritisation of hazards that are most affecting risk, and control actions as high as possible in the risk control hierarchy. Ergonomists could facilitate more effective workplace risk management by promoting: awareness of the need for change; improvements to guidance from OHS regulators; research on MSD-related workplace management issues; and professional development programs on this topic for ergonomists and other OHS practitioners.

Workplace physical and psychosocial hazards: A systematic review of evidence informed hazard identification tools

Prevention of musculoskeletal disorders (MSDs) requires the identification of physical and psychosocial hazards. This systematic review aimed to identify accessible and validated tools, for the assessment of workplace physical and psychosocial hazards, and consolidate the results into a matrix for use by work health and safety (WHS) professionals. Web of Science, Medline, ProQuest Central, and PsychInfo electronic databases, along with grey literature, were searched (Jan 1990 to July 2020). Studies that included tools with evidence of validity for the identification of physical hazards, psychosocial hazards, or both were included. A total of 83 tools were identified and then reviewed to ensure the tools were accessible. The final matrix included a total of 26 tools (16 physical, 4 psychosocial, and 6 comprehensive [physical and psychosocial]). Evidence on best practice for MSD mitigation supports the need for a comprehensive approach; however, the current review identified limitations in the availability of such tools to support WHS professionals.

Creating safety in care: Student nurses' perspectives

Nursing is often hazardous work. Promoting safety and care requires nurses to apply knowledge, skill and creativity in patient encounters. Nurses' risk exposures are well documented, with research on student nurses' safety more limited. We studied final-year nursing students' risk perceptions using questionnaire-based vignettes involving four patient presentations on patient aggression, manipulating patient and resource risk factors. We found student nurses were most likely to ask for help and wait when managing high-risk patient aggression scenarios. Student nurses placed most importance on their own safety and patient condition in making decisions. Resource risk significantly interacted with gender, with male nurses more likely to seek help when risks were high. There is need to improve student nurse training on managing patient aggression by promoting creative approaches to problem solving and critical thinking using simulation techniques to enhance situation awareness and translate knowledge to practice.

Quantitative analysis of medicinal plants used to treat musculoskeletal ailments by non-institutionally trained siddha practitioners of Virudhunagar district, Tamil Nadu, India

Background

Siddha is one of the traditional medical systems of India; previous ethnobotanical survey in Virudhunagar district indicated a high consensus for treating musculoskeletal ailments.

Objectives

This study was aimed to quantitatively document the medicinal plants used to treat musculoskeletal ailments by non-institutionally trained siddha practitioners of Virudhunagar district, Tamil Nadu, India.

Materials and methods

This work was the outcome of free-list interviews conducted among 45 informants between April 2016 and January 2017. Sampling sufficiency was assessed by plotting Shannon–Wiener's index and cumulative number of UR. Informant consensus was assessed using Informant Consensus Factor (F_ic) and Informant Agreement Ratio (IAR).

Results

This study recorded the data regarding 116 plant species which were used to prepare 129 formulations; analysis of the data yielded 490 UR. Among these, 65.3% of UR dealt with internal applications and 34.6% dealt with external applications. In the case of internally used formulations, pain and general musculoskeletal ailments had high F_ic values. In the case of externally used formulations, headache and pain had high F_ic values.

Conclusion

Important species prescribed by the informants to treat various musculoskeletal ailments were: Azima tetracantha, Ricinus communis, Sesamum indicum, Moringa oleifera, Cardiospermum halicacabum (internal application), Calophyllum inophyllum, Justicia adhatoda, Curcuma longa, Calotropis gigantea, Zingiber officinale, Withania somnifera, Strychnos nux-vomica, Dodonaea viscosa (external application), Azadirachta indica, Clerodendrum phlomidis,Delonix elata, Pergularia daemia and Vitex negundo (internal and external applications). Robust studies on these local claims will help to improve the community healthcare and will yield some novel agents to treat musculoskeletal ailments.

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Siddha is one of major traditional medicinal systems of India.

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Non-institutional training is still major in siddha system of medicine.

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This survey documented the plants used to treat various musculoskeletal ailments.

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Though there were some scientific evidences; many local claims lack rigorous studies.

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Further studies will yield some useful clues for the management of various MSDs.

Barriers to more effective prevention of work-related musculoskeletal and mental health disorders

Work-related psychosocial hazards have substantial effects on risks of both musculoskeletal and mental health disorders (MSDs, MHDs). Recent Australian research on workplace risk management practices in 19 work organisations found that risks from work-related psychosocial hazards were poorly managed. This study identified factors impeding better management of MSD and MHD risks within those organisations. METHOD: Interviews were conducted with staff from residential aged care and logistics/transport organisations in Australia. Transcripts were analysed using a worker-centred systems framework. RESULTS AND CONCLUSIONS: Many barriers to more effective risk management were identified. Most fundamentally, few people knew of the need to manage MSD risk arising from work-related psychosocial hazards, and OHS-related skills of key managers were often reported as inadequate, particularly concerning management of risk from psychosocial hazards. Also, funding and staffing levels were often reported as problematic, and OHS issues were seen as lower priority than accreditation and commercial requirements.

Barriers for implementation of successful change to prevent musculoskeletal disorders and how to systematically address them

This scoping review identified common barriers and facilitators encountered during the implementation of changes to prevent musculoskeletal disorders (MSD) and examined their relationship with those encountered in general Occupational Health and Safety (OHS) efforts. Thematic analysis of the literature identified 11 barriers: (i) Lack of time; (ii) Lack of resources; (iii) Lack of communication; (iv) Lack of management support, commitment, and participation; (v) Lack of knowledge and training; (vi) Resistance to change; (vii) Changing work environment; (viii) Scope of activities; (ix) Lack of trust, fear of job loss, or loss of authority; (x) Process deficiencies; and (xi) Difficulty of implementing controls. Three facilitators identified were: (i) Training, knowledge and ergonomists' support; (ii) Communication, participation and support; and (iii) An effective implementation process. The barriers and facilitators identified were similar to those in general OHS processes. The integration of MSD prevention into a general management system approach may overcome these barriers.

Relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain: a cross-sectional study based on the fourth Korean working conditions survey

Background

It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS).

Method

The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP.

Results

All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46–5.83; aOR 1.98, 95% CI 1.62–2.42; aOR 2.09, 95% CI 1.82–2.40; aOR 1.79, 95% CI 1.60–2.01; aOR 2.04, 95% CI 1.82–2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to ‘fatigue-inducing or painful posture’ aOR 2.17, 95% CI 2.02–2.34; high exposure to both ‘fatigue-inducing or painful posture’ and ‘dragging, pushing, or moving heavy objects’ aOR 2.00, 95% CI 1.82–2.20).

Conclusions

There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.

Optimizing implementation of interventions in agriculture for occupational upper extremity musculoskeletal disorders: Results of an expert panel

BACKGROUND

Upper extremity musculoskeletal disorders (UEMSD) is reported worldwide as the second-largest occupational musculoskeletal disorder in agriculture.

OBJECTIVE

The objective of the study is to identify facilitators and barriers for employers and workers for implementing interventions to reduce work-related risk factors associated with occupational UEMSD in the agricultural sector, according to health and safety consultants.

METHODS

An expert panel was used comprising nine health and safety consultants from the Dutch agricultural sector.

RESULTS

Facilitators and barriers for employers and workers were categorized in the following themes: knowledge, skills, attitude, culture, costs, loss of income, facilitation and employability. There were no differences in facilitators and barriers between UEMSD.

CONCLUSIONS

Facilitators and barriers for implementing preventive interventions in agriculture were on organizational level, like diversity in choice of preventive devices, and personal level such as willingness if there is no work disability.

The stage of change approach for implementing ergonomics advice - Translating research into practice

The Stage of Change (SOC) approach has been proposed as a method to improve the implementation of ergonomics advice. However, despite evidence for its efficacy there is little evidence to suggest it has been adopted by ergonomics consultants. This paper investigates barriers and facilitators to the implementation, monitoring and effectiveness of ergonomics advice and the adoption of the SOC approach in a series of focus groups and a subsequent survey of members of the Human Factors Societies of Australia and New Zealand. A proposed SOC assessment tool developed for use by ergonomics practitioners is presented. Findings from this study suggest the limited application of a SOC based approach to work-related musculoskeletal injury prevention by ergonomics practitioners is due to the absence of a suitable tool in the ergonomists' repertoire, the need for training in this approach, and their limited access to relevant research findings. The final translation of the SOC assessment tool into professional ergonomics practice will require accessible demonstration of its real-world usability to practitioners and the training of ergonomics practitioners in its application.