Assessing the effects of an educational program for the prevention of work-related musculoskeletal disorders among school teachers

Musculoskeletal disorders among teachers: a systematic review and meta-analysis

Introduction

As a result of the demands of their profession, teachers encounter a range of ergonomic risk factors and are highly susceptible to developing musculoskeletal disorders (MSDs). Accordingly, this systematic review and meta-analysis was carried out to examine the frequency of MSDs among teachers.

Materials and methods

The present research followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and its protocol was registered in international prospective register of systematic review (PROSPERO) under the code CRD42024509263. To conduct the searches, various databases such as PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar were utilized, and the search period was until February 7th, 2024 without time restriction. A random effects model was employed for meta-analysis, and I2 index was utilized to assess heterogeneity among the studies. Data analysis was carried out using STATA (version 14).

Results

After an initial search across the mentioned databases, a total of 2,047 articles were identified. Following screening, study selection, and quality evaluation, 44 studies were ultimately chosen for meta-analysis, involving 15,972 teachers. The results of the meta-analysis revealed that the overall prevalence of MSDs among teachers is 68% (95% CI: 61-75, I2 = 99.2%, p < 0.001). Furthermore, the prevalence rates of MSDs in different body regions, such as the neck (47%), lower back (47%), shoulder (44%), upper back (37%), knee (35%), ankle (30%), wrist (27%), hip (22%), and elbow (13%), were reported.

Conclusion

The overall prevalence of MSDs among teachers is relatively high. Neck and lower back pain are more common among them compared to other body regions. It is recommended that periodic occupational medicine examinations, training, and the implementation of ergonomic interventions for this occupational group focus on assessing the risk factors for MSDs, especially in the neck and lower back regions.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=509263, identifier CRD42024509263.

Investigating the Effectiveness of a Workplace Musculoskeletal Disorders Management Program

Musculoskeletal disorders (MSDs) present a major occupational health challenge, especially among office workers. Objective: To evaluate the effectiveness of a workplace intervention program for managing MSDs and measure its impact on presenteeism/absenteeism and health status. Methods: This semi-experimental study was conducted between May 2019 and October 2022 in Greece and involved 247 office workers randomly assigned to early and late intervention groups. The intervention included a seminar on ergonomics and proper workstation practices with a demonstration of exercises. Data were collected by the SF-36, the Standardised Nordic, and the Work Productivity and Activity Impairment Questionnaires. Results: In the early intervention group (n = 143), presenteeism significantly decreased (p = 0.045), from a mean value of 0.11 to 0.07, but not absenteeism. Significant improvements were observed in physical (p = 0.007) and mental health (p = 0.012). Reductions in pain were recorded for the neck (p = 0.032), shoulders (p = 0.015), wrists (p = 0.014), upper back, lower back, hips, and knees (p = 0.044 for each). In the late intervention group (n=104), there were no significant changes in absenteeism or presenteeism. Mental health improved significantly (p = 0.008), and reductions in pain were noted for the neck (p = 0.001), wrist (p = 0.0005), and upper back (p = 0.001). Conclusions: This workplace intervention program proved effective both in reducing pain in various body areas and reducing presenteeism, and improved physical and mental health were observed in the intervention groups while absenteeism remained unchanged.

Predictors of musculoskeletal disorders among special education teachers in Sabah, Malaysia

Special education teachers encounter considerable occupational challenges, yet there is limited information concerning musculoskeletal disorders (MSD) within this group. Therefore, this study aimed to address this gap by determining the prevalence of MSD, investigating associated factors of MSD, and identifying predictors of MSD among special education teachers. A cross-sectional study was conducted among special education teachers in Kota Kinabalu and Penampang, Sabah. Data were collected through self-administered questionnaires and musculoskeletal fitness assessments. Chi-square tests and independent t-tests were utilized to determine factors associated with MSD, while multiple logistic regression was performed to develop a comprehensive predictive model for MSD, which was then validated and tested for model fitness. A total of 122 individuals participated in the study, yielding a response rate of 95 %. The findings revealed a high prevalence of MSD (77.9 %) among special education teachers, with the lower back, shoulder, neck, knee, upper back, and foot being the most affected regions. The multivariable regression model identified several predictors of MSD, including marital status (adjusted odds ratio [aOR] = 4.78, 95 % confidence interval [CI] = 1.49-15.40), body fat percentage (aOR = 1.06, 95 % CI = 1.00-1.12), teaching in prolonged standing for few days a week (aOR = 3.20, 95 % CI = 0.99-10.29) or every day (aOR = 6.20, 95 % CI = 1.44-26.70), mindfulness (aOR = 0.47, 95 % CI = 0.22-0.98), and back extensor strength (aOR = 5.86, 95 % CI = 1.92-17.92). This study highlights the necessity of implementing interventions focusing on the ergonomic, psychological, and musculoskeletal fitness components to mitigate the prevalence of MSD and improve the overall well-being of special education teachers.

A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: a scoping review

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are a key topic in occupational health. In the primary prevention of these disorders, interventions to minimize exposure to work-related physical risk factors are widely advocated. Besides interventions aimed at the work organisation and the workplace, interventions are also aimed at the behaviour of workers, the so-called individual working practice (IWP). At the moment, no conceptual framework for interventions for IWP exists. This study is a first step towards such a framework.

METHODS

A scoping review was carried out starting with a systematic search in Ovid Medline, Ovid Embase, Ovid APA PsycInfo, and Web of Science. Intervention studies aimed at reducing exposure to physical ergonomic risk factors involving the worker were included. The content of these interventions for IWP was extracted and coded in order to arrive at distinguishing and overarching categories of these interventions for IWP.

RESULTS

More than 12.000 papers were found and 110 intervention studies were included, describing 810 topics for IWP. Eventually eight overarching categories of interventions for IWP were distinguished: (1) Workplace adjustment, (2) Variation, (3) Exercising, (4) Use of aids, (5) Professional skills, (6) Professional manners, (7) Task content & task organisation and (8) Motoric skills.

CONCLUSION

Eight categories of interventions for IWP are described in the literature. These categories are a starting point for developing and evaluating effective interventions performed by workers to prevent WMSDs. In order to reach consensus on these categories, an international expert consultation is a necessary next step.

Prevalence, risk factors and quality of life impact of work-related musculoskeletal disorders among school teachers in Cairo, Egypt

BACKGROUND

School teachers constitute an occupational group which reported a high prevalence of work-related musculoskeletal disorders (WRMSDs). Different individual, occupational and psychosocial factors have been identified to influence the complex process of WRMSDs. WRMSDs represent an important and costly occupational health problem being responsible for a poor quality of life (QOL) of teachers. This study aimed to determine the prevalence, the risk factors, and the impact of WRMSDs on the QOL of teachers.

METHODS

310 full-time teachers from 15 public schools were surveyed using an interview questionnaire about their sociodemographic and occupational characteristics, the Nordic Musculoskeletal Questionnaire and the SF-36 Health Survey (SF-36).

RESULTS

Self-reported prevalence of WRMSDs at any body part over the past 12 months among teachers was 66.77%. Neck pain (56.1%) was the most prevalent WRMSD followed by shoulders (53.2%), low back (53.2%) and knees (50.6%) pain. Female gender, body mass index, the number of students per classroom, the number of classes per week, different adapted awkward postures and the lack of enough supervisor's psychological support at work were among the risk factors positively associated with WRMSDs. WRMSDs had a negative impact on the physical and mental QOL of teachers with WRMSDs as reflected by their lower scores on all scales of the SF-36 compared to their counterparts without WRMSDs (p ˂ 0.05).

CONCLUSION

WRMSDs were a highly prevalent problem among teachers in Cairo, Egypt and negatively influencing their physical and mental QOL. Different individual, occupational and psychosocial factors had been shown to be significant predictors for the occurrence of WRMSDs reflecting their complex nature and multifactorial etiology.

Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran

Background

Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers.

Methods

The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS.

Results

The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P <  0.05).

Conclusion

Designing and implementing an educational intervention based on HBM could affect in adopting neck health-promoting behaviors among teachers.

Trial registration

IRCT20210301050542N1, 16/03/2021 first registration has been approved in Iranian Registry of Clinical Trials at (16/03/2021).

Educational intervention for the prevention of occupational neck pain: protocol of randomized trial

Background

Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). It has important social and economic consequences such as reduced productivity due to absenteeism, leave, and early retirement and financial losses due to medical expenses for the workforce especially teachers. This study aims to evaluate whether a model-based social media intervention could change the high-risk behaviors that cause work-related neck pain among teachers.

Methods

This is a randomized controlled trial that will be done in three steps. The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire, and the third stage is designing and implementation of model-based educational intervention in social media context. The study population is teachers who working in junior high school in the 19th district of education minister in Tehran, Iran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media, and the control group does not receive any training. The educational intervention tries to improve the knowledge, attitude, skills, and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can promote preventive neck pain behavior among teachers.

Discussion

Work-related neck pain can have a negative impact on teachers’ health. This study is an attempt to investigate the impact of developed interventions in promoting preventive behavior regarding work-related neck pain through social media context.

Trial registration

Iranian registry of Clinical Trial (IRCT) IRCT20210301050542N1. Registered on 16 March 2021

Ethics code: IR.MODARES.REC.1399.163

Modeling and Validation of Fatigue and Recovery of Muscles for Manual Demolition Tasks

Manual demolition tasks are heavy, physically demanding tasks that could cause muscle fatigue accumulation and lead to work-related musculoskeletal disorders (WMSDs). Fatigue and recovery models of muscles are essential in understanding the accumulation and the reduction in muscle fatigue for forceful exertion tasks. This study aims to explore the onset of muscle fatigue under different work/rest arrangements during manual demolition tasks and the offset of fatigue over time after the tasks were performed. An experiment, including a muscle fatigue test and a muscle fatigue recovery test, was performed. Seventeen male adults without experience in demolition hammer operation were recruited as human participants. Two demolition hammers (large and small) were adopted. The push force was either 20 or 40 N. The posture mimicked that of a demolition task on a wall. In the muscle fatigue test, the muscle strength (MS) before and after the demolition task, maximum endurance time (MET), and the Borg category-ratio-10 (CR-10) ratings of perceived exertion after the demolition task were measured. In the muscle fatigue recovery test, MS and CR-10 at times 1, 2, 3, 4, 5, and 6 min were recorded. Statistical analyses were performed to explore the influence of push force and the weight of the tool on MS, MET, and CR-10. Both muscle fatigue models and muscle fatigue recovery models were established and validated. The results showed that push force affected MET significantly (p < 0.05). The weight of the tool was significant (p < 0.05) only on the CR-10 rating after the first pull. During the muscle fatigue recovery test, the MS increase and the CR-10 decrease were both significant (p < 0.05) after one or more breaks. Models of MET and MS prediction were established to assess muscle fatigue recovery, respectively. The absolute (AD) and relative (RD) deviations of the MET model were 1.83 (±1.94) min and 34.80 (±31.48)%, respectively. The AD and RD of the MS model were 1.39 (±0.81) N and 1.9 (±1.2)%, respectively. These models are capable of predicting the progress and recovery of muscle fatigue, respectively, and may be adopted in work/rest arrangements for novice workers performing demolition tasks.

Job Demands and Resources Experienced by the Early Childhood Education Workforce Serving High-Need Populations

The early childhood education (ECE) workforce plays a key role in promoting early childhood development by their interactions with young children during formative years. However, the inherent demands of the profession and the work conditions within ECE settings affect job satisfaction and overall health and well-being. This study applied the Job Demands-Resources Model (JD-R) and administered a cross-sectional survey (n = 137) to examine disparities in personal and external demands and resources that may impact job satisfaction and turnover rates among ECE staff who provide care for preschool children (3-5 years of age). ECE staff reported higher levels of personal demands, including depression and perceived stress, and external demands, including workload and staffing concerns, compared to the national workforce (all p < .01). The data also illustrated disparities related to resource access; ECE staff reported lower levels of personal resources, including mindfulness, and less access to external resources including safety climate, resource adequacy, role clarity, respect, and management relationships (all p < .01). Only 34% of ECE staff reported being very satisfied with their work compared to 49% of the national workforce (p < .01). External resources were significantly and positively associated with job satisfaction (B = .09, p < .01). These findings suggest that ECE staff experience significantly higher demands and have access to significantly fewer resources in the workplace, and that bolstering job-related resources may translate to increased job satisfaction.

Assessing the association between breastfeeding, type of childbirth and family structure with childhood obesity: results from an observational study among 10-12 years old children

This study examined the association between breastfeeding, type of childbirth, and family structure with childhood obesity. During 2014-2016, 1728 Greek students attending primary schools and their parents were enrolled. Children's weight status was measured and classified according to the International Obesity Task Force criteria. A self-administered questionnaire assessing the type of childbirth, the family structure, and several perinatal and demographic characteristics was used. Factors associated with higher breastfeeding rates were the type of childbirth, high maternal educational level, and nuclear family structure. No association was found between childhood obesity and type of childbirth (p = 0.64) and family structure (p = 0.26). Although the short-term beneficial effects of breastfeeding on childhood obesity are undeniable and it is of great importance to all health professionals to promote breastfeeding, no significant long-term effects on obesity in adolescence were observed. More studies are needed in order to elucidate the role of breastfeeding in obesity status in adolescence.

Work-related musculoskeletal disorders among schoolteachers

Introduction:

Teachers belong to a risk group for the onset of musculoskeletal disorders, which may be justified by some work-related factors, with a direct impact on their lives.

Objectives:

To evaluate the occurrence of musculoskeletal disorders among elementary school teachers in Jequié, state of Bahia, Brazil, and to investigate the association of these disorders with sociodemographic, occupational, organizational and health variables.

Methods:

A cross-sectional epidemiological study with a sample of 304 elementary school teachers in Jequié. A standardized collection instrument was applied and the instrument data were analyzed using descriptive statistics procedures, with prevalence ratios and 95% confidence interval.

Results:

The prevalence of musculoskeletal disorders was 24.3% for any of the body segments, 15.5% for the back, 16.1% for the upper limbs and 12.5% for the lower limbs. There was a statistically significant association between musculoskeletal disorders and female sex, older age, black, brown and red skin, time working as a teacher of more than 14 years, presence of comorbidities, irregular sleeping pattern, consumption of alcohol and tobacco, and a regular lifestyle.

Conclusions:

Teachers presented a high prevalence of musculoskeletal disorders in upper limbs, back, and lower limbs. In addition, associations with the investigated factors demonstrate that inadequate teaching conditions contribute negatively to teachers’ health.

Testing a holistic conceptual framework for early childhood teacher well-being

Using a holistic conceptualization of teacher well-being in concert with the Job Demands and Resources (JD-R) framework, our interdisciplinary study examined associations among various job demands and resources and whole teacher well-being (i.e., professional, psychological, and physical well-being) in early care and education settings. First, we investigated direct associations of job demands and resources with teachers' professional well-being. Second, we tested two models of potential mediation for the relationship of job demands and resources to well-being using structural equation modeling techniques: (a) that psychological and physical well-being mediate the relationship between demands, resources, and professional well-being; and (b) that professional well-being mediates the relationship between demands, resources, and psychological and physical well-being. Although our sample of early childhood teachers (n = 262) reported high levels of professional well-being (i.e., work commitment, self-efficacy), a substantial number of them experienced challenges in both psychological (e.g., perceived stress, depressive symptoms) and physical (e.g., ergonomic pain) well-being. As expected, teachers' work-related stressors and work resources (positive work climate, quality of the physical environment) were directly associated with teachers' professional well-being. Contrary to our expectations, however, instrumental resources (i.e, wages, health insurance) did not predict any aspects of teachers' professional well-being. Our data only supported the first of the two tested mediation hypotheses (i.e., that psychological and physical well-being mediated the associations between working conditions and professional well-being), but with one caveat: physical well-being preceded psychological well-being in mediating the associations. These results advance our understanding of the challenges present in the early childhood workforce and have implications for policies and programs to improve teacher working conditions and well-being.

Study of the interrelationships between musculoskeletal disorders and psychosocial risk factors in occupational health and safety technicians

Objectives. The aim of this work is to examine the presence of musculoskeletal disorders (MSDs) and the exposure to psychosocial risk in a sample of 399 occupational health and safety technicians (OHSTs), deepening the associations between both aspects. Methods. The standardized Nordic questionnaire and the Decore questionnaire were used. Different descriptive and correlational analyses and a multivariate analysis model were carried out. Results. In total, 77.17% of the participants affirmed having suffered some muscle ailments. The most critical psychosocial risk factors are those related to the rewards that the worker obtains for their work, with 54.7% of the technicians in a situation of alert or emergency. It is highlighted that the fact of not feeling professionally valued, working outside working hours, having musculoskeletal discomfort and perceiving a state of poor or fair health increase the global risk index (GRI) score. Conclusions. The study highlights the high exposure of OHSTs to both physical and psychosocial risk factors as well as the significant relationship between these variables. Furthermore, the predictive model shows the variables that best predict the probability of MSDs: gender, training in emerging risks, perceived health and exposure to psychosocial risk.

Prevalence of musculoskeletal disorders amongst flower farm workers in Kenya

Background

Work-related musculoskeletal disorders (WMSDs) are a global public concern for health and social-care systems, as well as individuals. They are the second-most prevalent cause of disability globally.

Objectives

The primary objective was to determine the prevalence of WMSDs amongst flower farm workers. The secondary objective was to determine the association between the socio-demographic characteristics and the presence of WMSDs in the previous 12-month period.

Method

A cross-sectional descriptive study was conducted. A sample of 270 participants was drawn from 897 farm workers. Quantitative data related to musculoskeletal disorders were collected using the Nordic Musculoskeletal Questionnaire (NMQ). Descriptive statistics were undertaken using frequencies and percentages. Inferential statistics were analysed using a chi-squared test (X²) based on an alpha level of p < 0.05.

Results

A total of 184 (68.1%) respondents reported musculoskeletal discomfort. Amongst the 184 respondents, 178 were performing general farm work. Most 103 (38.1%) of the WMSDs were reported in the lower back. There was a strong association between job designation as a general worker (p = 0.016), an older age (p = 0.027) and having worked for a long time as a farm worker (p = 0.041) and WMSDs.

Conclusion

Flower farm workers in Kenya were found to be heavily burdened by WMSDs. Furthermore, the job designation, older age, as well as having worked for a long time, predisposes workers to the risk of developing WMSDs.

Clinical implications

The high prevalence of WMSDs necessitates policy reform in the flower farm industry.

Does tutors' support contribute to a telehealth program that aims to promote the quality of life of office workers? A cluster randomized controlled trial

The quality of life in the workplace can be achieved by creating a place more humanized and strategies that provide wellness to workers. The aim of this study was to investigate the effectiveness of telehealth education program to promote quality of life of office workers.This is a cluster randomized controlled trial (RCT). The participants were office workers computer users (n = 326). All received 9 audiovisual content (grouped into topics: musculoskeletal health, healthy diet, and mental health) that addresses the real needs identified by them in the focus groups. The intervention group (n = 178) was instructed to seek the tutor support about topics addressed by the audiovisual content. The primary outcome measure was quality of life by WHOQOL-BREF. The secondary outcome measure was level of physical activity of the participants. Data analysis was performed by General Linear Mixed Model. After six months of telehealth education program a general improvement in health and environmental domain, was observed in the intervention group. During that period, a within-group analysis showed that there was a significant improvement in the intervention group, with respect to quality of life in general health (p < 0.05) and in the environmental domain (p < 0.01).In the baseline to the eighth month, there were statistically significant changes within-group for the general health (p < 0.05) and for the physical domain (p < 0.01) in both groups (p < 0.01). Telehealth education program promoted an improvement in the participants' quality of life. There was no benefit in favor of the telehealth education program, with tutor support in relation to the conventional program.

TRIAL REGISTRATION

The trial was prospectively registered at ClinicalTrial.gov (NCT02980237). The date of registration was August 23, 2016.

The musculoskeletal problems and psychosocial status of teachers giving online education during the COVID-19 pandemic and preventive telerehabilitation for musculoskeletal problems

BACKGROUND

Musculoskeletal and psychosocial problems have tended to increase during the COVID-19 pandemic.

OBJECTIVE

To evaluate the changes in musculoskeletal problems and psychosocial status of teachers during the COVID-19 pandemic due to online education and to investigate the effects of preventive telerehabilitation applications for musculoskeletal problems.

METHODS

Forty teachers who conducted online education during the pandemic volunteered to participate in the study. All assessments were performed via online methods. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), ProFitMap-Neck questionnaire, Oswestry Disability Index (ODI), and Upper Extremity Functional Index (UEFI) were used to evaluate musculoskeletal problems; the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to evaluate anxiety and depression, respectively; and the Work-Life Balance Scale (WLBS) was used to evaluate how well individuals achieve this balance. Information about before online education, during online education, and after training was obtained with the assessments. After the first assessment, telerehabilitation, which involved presentations and brochures, was applied to 18 participants willing to participate in the training.

RESULTS

The ProFitMap, UEFI, and WLBS scores during the online education decreased significantly, while the scores of the CMDQ, ODI, BDI, and BAI during the online education increased significantly compared to the pre-online education scores (p < 0.05). In addition, the total CMDQ, ProFitMap, and ODI scores improved significantly after the training (p < 0.05).

CONCLUSION

Musculoskeletal and psychosocial problems increased in teachers during online education. Preventive telerehabilitation methods will be beneficial for individuals who do not have access to face-to-face physiotherapy.

The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units

Working at intensive care units (ICUs) is considered a risk factor for developing musculoskeletal complaints (MSC). This study was conducted between January 2017 and June 2019 in two ICUs of a university hospital. It was designed as a pre- and post-assessment of the intervention group (IG) (N = 27) compared with a control group (CG) (N = 23) to determine the effects of a multifaceted ergonomics intervention program in reducing MSC. The IG (N: 35) received a multifaceted ergonomic intervention program, which was implemented by an ERGO team over an 18 month period. Four ergonomic interventions were planned as follows: individual level interventions such as training; stretching exercises and motivation meetings; administrative intervention such as a daily 10 min stretching exercises break; engineering interventions such as lifting and usage of auxiliary devices. The CG (N:29) did not receive any intervention. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to assess MSC in both groups. At the start of the intervention, both groups were similar concerning the number of visits to doctors due to MSC, the number of sick leave days, and total CMDQ scores (p > 0.05 for all). Two factor repeated ANOVA measures were performed for between-groups and within-group analyses. The mean of the initial CMSDQ total scores in both groups increased significantly in the 18th month (p < 0.001). However, the interaction effect of group and time (between and within factors) was not significant (p = 0.992). Work-related MSC is a common occupational health problem among nurses. This study showed that individual-level interventions are not likely to succeed in eliminating manual patient lifting by nurses. Our results suggested that interventions without administrative measures might have limited success

Preventive factors against work-related musculoskeletal disorders: narrative review

Musculoskeletal disorders (MSDs) are major causes of morbidity among workers. They comprise several signs and symptoms, as e.g. pain, paresthesia, fatigue and limited range of motion, which can be related to work tasks. Workplace-related factors include physical, psychological, social and biomechanical hazards. The main kinetic factors associated with MSDs include repetitive movements, exerting excessive force, awkward postures, compression and mechanical vibration. Accurate knowledge of epidemiological aspects, evaluation of ergonomic hazards and musculoskeletal symptoms, and workplace exercise may help reduce the occurrence of MSDs. The aim of the present review is to analyze the applicability of preventive strategies against MSDs among workers. We performed a narrative review based on a survey of databases PubMed and BIREME and included studies published in English, Spanish or Portuguese. We found that workplace exercise is beneficial for both employers and workers. Risk analysis of MSDs is essential for early identification of occupational hazards and to prevent health consequences and costs associated with absenteeism.

Safety and Health Innovation in Preschools: A Total Worker Health Pilot Project

OBJECTIVE

The primary objective of this study was to evaluate quality of work life in early childhood education (ECE) centers and implement a total worker health (TWH) pilot project with a small sample of ECE teachers.

METHODS

An evidence-based strategic planning process to make policy, system, and environmental (PSE) changes related to TWH was implemented with six ECE centers. A pre-post design with mixed-methods was used to evaluate the impact.

RESULTS

Baseline findings suggest that there are significant disparities related to quality of work life among ECE teachers compared with the national population. After implementation of the pilot project, ECE centers averaged 4.7 PSE changes. Qualitative data informed facilitators and barriers to implementation of TWH-related changes.

CONCLUSIONS

This pilot project reflects an evidence-based participatory approach to assessing and improving the well-being of ECE teachers.

The Current State of Surgical Ergonomics Education in U.S. Surgical Training: A Survey Study

OBJECTIVE

The aim of this study was to characterize the current state of surgical ergonomics education in the United States.

BACKGROUND

The burden of work-related musculoskeletal disorders (MSDs) in surgeons is high and no overarching strategy for redress exists. Twelve distinct specialties describe an unmet need for surgical ergonomics education (SEE). This study aimed to define the current state of SEE in U.S. surgical training programs.

METHODS

We performed a descriptive analysis of a 20-item questionnaire of ACGME-certified program directors from 14 surgical and interventional medical specialties. Formal SEE was defined as any organized education module that reviewed the occupation-specific burden of common work-related MSDs and described a framework for prevention via occupation-specific applied ergonomics. Program directors were queried regarding SEE provision, characteristics, and perceived trainee attitude toward the education.

RESULTS

Questionnaires were received from 130 of 441 (29.5%) program directors. Two (1.5%) provided formal SEE and 33 (25.4%) provided informal SEE, which consisted of unstructured intraoperative directives and isolated lectures. Two programs previously provided SEE but discontinued the effort due to lack of an evidence-based framework and instructors. Trainees appeared to think that learning surgical ergonomics skills was a worthwhile time investment in 100% and 76.7% of current formal and informal SEE, respectively.

CONCLUSION

SEE is rarely provided in any capacity (25.4%), let alone in a consistent or evaluable fashion (1.5%). Impediments to sustainable SEE include lack of an evidence-based framework for education and instructors. An evidence-based, reproducible, and accreditation council-compliant SEE module would be a valuable resource for the surgical and interventional medical communities.

Deciphering programs for optimal self-management of persistent musculoskeletal-related pain and disability - Clinical implications for PTs

The prolonged disability associated with musculoskeletal (MSK) pain represents an enormous health burden, for individuals as well as society. Promoting pain and disability management for patients with persistent MSK-related conditions can be very challenging for rehabilitation professionals. These often-complex conditions require the adoption of a biopsychosocial perspective in order to assess and address a vast array of potential factors affecting the patient. Fortunately, a self-management (SM) approach has been deemed effective in enhancing patients' control over their symptoms and disabilities. However, given the many different existing SM approaches, rehabilitation professionals would benefit from a clearer definition of SM and a better understanding of the basics of a SM program in order to facilitate their patients' development of SM skills, as this can lead to better outcomes. This narrative review explores the various components of an intervention program intended to facilitate patients' SM of their symptoms and disabilities resulting from a persistent MSK condition. It does so by drawing on a body of published work on pain and disability management, conceptual frameworks underlying SM programs, essential skills associated with optimal SM, and examples from the persistent low back pain (LBP) literature.

Burden of shoulder and/neck pain among school teachers in Ethiopia

BACKGROUND

Shoulder and neck pain are reported as the most common occupational-related health problem and cause of morbidity, absenteeism from work among school teachers worldwide. School teachers represent an occupational group, who are exposed and appears to have prevalent shoulder and/or neck pain due to their daily work tasks and the nature of work. There is a scant epidemiological study regarding shoulder and neck pain among school teachers in Ethiopia. Therefore, this study was set out to assess the prevalence and associated factors of shoulder and/or neck pain among school teachers of Gondar town in North West Ethiopia.

METHOD

An institutional based cross-sectional study was conducted from December 2016 to January 2017, a structured questionnaire adapted from the Nordic musculoskeletal questionnaire was distributed to 848 primary and secondary school teachers in Gondar town, Northwest Ethiopia. To assess the burden of shoulder and/neck pain, data were collected using a self-administered questionnaire and physical measures like height and weight were also measured during data collection. Independent variables which had significant association were identified using logistic regression model.

RESULT

A total of 754 teachers participated, with a mean age of 42 ± 9.73 years (88.9% response rate). Previous 12 months self-reported prevalence of shoulder and/ neck pain among school teachers was 57.3% with 95%CI (53.4-61.0%). Regular physical exercise (OR = 0.18, 95% CI: 0.08-0.42), teaching experience (OR = 2.85, 95% CI: 1.09-7.42), static head down posture (OR = 2.26, 95% CI: 1.55-3.33), elevated arm over shoulder (OR = 2.71, 95% CI: 1.86-3.95), prolonged sitting (OR = 1.50,95% CI: 1.02-2.23) and hypertension (OR = 2.18, 95% CI: 1.24-3.82) were factors found to be significantly associated with shoulder and/neck pain.

CONCLUSION AND RECOMMENDATION

More than half of the study participants self-reported to have suffered shoulder and neck pain in the previous 12 months. Teaching experience, static head down posture, elevated arm over shoulder, and hypertension are likely to be significantly associated with shoulder and/ neck pain among school teachers in Ethiopia. Engaging in regular physical exercise has a protective effect against the shoulder and/or neck pain. Therefore, school authorities are recommended to provide facilities to enhance physical activity among school teachers and also provide adjustable board and classroom materials.

Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis

Importance

Physicians in procedural specialties are at high risk for work-related musculoskeletal disorders (MSDs). This has been called "an impending epidemic" in the context of the looming workforce shortage; however, prevalence estimates vary by study.

Objectives

To estimate the prevalence of work-related MSDs among at-risk physicians and to evaluate the scope of preventive efforts.

Data Sources and Study Selection

Systematic search in MEDLINE (Ovid), Embase (Elsevier), Web of Science, PubMed (National Center for Biotechnology Information), and 2 clinical trial registries, without language restriction, for studies reporting on the prevalence and prevention of work-related MSDs among at-risk physicians published until December 2016. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for meta-analyses and systematic reviews of observational studies were used. At-risk physicians were defined as surgeons and medical interventionalists. Studies reporting on specific disorders or pain assessed with validated instruments were included.

Data Extraction and Synthesis

Study characteristics; disease prevalence for the neck, shoulder, back, and upper extremity; and measures of resulting disability were recorded. Study estimates were pooled using random-effects meta-analytic models.

Main Outcomes and Measures

Career prevalence of injuries and 12-month prevalence of pain.

Results

Among 21 articles (5828 physicians [mean age, 46.0 years; 78.5% male; 12.8 years in practice; 14.4 hours performing procedures per week]) included in this systematic review and meta-analysis, pooled crude prevalence estimates of the most common work-related MSDs were degenerative cervical spine disease in 17% (457 of 2406 physicians) (95% CI, 12%-25%), rotator cuff pathology in 18% (300 of 1513 physicians) (95% CI, 13%-25%), degenerative lumbar spine disease in 19% (544 of 2449 physicians) (95% CI, 5%-16%), and carpal tunnel syndrome in 9% (256 of 2449 physicians) (95% CI, 5%-16%). From 1997 to 2015, the prevalence of degenerative cervical spine disease and degenerative lumbar spine disease increased by 18.3% and 27%, respectively. Pooled prevalence estimates for pain ranged from 35% to 60% and differed by assessment instrument. Of those with a work-related MSD, 12% (277 of 2319 physicians) (95% CI, 7%-18%) required a leave of absence, practice restriction or modification, or early retirement. Heterogeneity was considerable for all crude analyses (mean I2 = 93.5%) but was lower for sensitivity analyses (mean I2 = 72.3%). Interventions focused on products and behaviors. Twelve at-risk specialties described a gross lack of awareness and an unmet need for ergonomics education.

Conclusions and Relevance

Prevalence estimates of work-related MSDs among at-risk physicians appear to be high. Further research is needed to develop and validate an evidence-based applied ergonomics program aimed at preventing these disorders in this population.

Sintomas osteomusculares e estresse não alteram a qualidade de vida de professores da educação básica

RESUMO Este estudo avaliou a prevalência de sintomas osteomusculares, nível de estresse e qualidade de vida de professores do ensino básico. A amostra foi composta de 298 professores (265 mulheres e 33 homens) da educação infantil e fundamental do município de Caçador, Santa Catarina. Foram avaliados sintomas osteomusculares (Questionário Nórdico de Sintomas Osteomusculares), nível de estresse (Questionário dos Sintomas de Estresse de Lipp) e a qualidade de vida (Questionário WHOQOL-bref). Apresentaram sintomas osteomusculares 48% dos professores e 65% se afastaram das atividades diárias. Manifestaram algum nível de estresse 42% dos professores, principalmente na fase de resistência (73%) e quase-exaustão (19%). Os sintomas psicológicos predominaram sobre os físicos (p<0,05). Os escores médios dos domínios Físico (57,1) e Meio Ambiente (58,2) foram significativamente menores (p<0,001) que os domínios Psicológico (63,8) e Relações Sociais (71,2). O escore da qualidade de vida geral de 62,6 pontos classificou os professores como satisfeitos com a sua qualidade de vida. Em conclusão, a alta prevalência de sintomas osteomusculares e de estresse não altera a qualidade de vida de professores do ensino básico.

Evaluation of the efficacy of a short-course, personalized self-management and intensive spa therapy intervention as active prevention of musculoskeletal disorders of the upper extremities (Muska): a research protocol for a randomized controlled trial

Background

Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies. The disease needs to be prevented, not only for medical and economic reasons, but also for legal reasons, owing to the requirement of assessing occupational risks. The strategy envisaged may thus revolve around active, multimodal prevention that has employees fully involved at the heart of their care. Although physical exercise is widely recommended, few studies with a good level of evidence have enabled us to base a complete, well-constructed intervention on exercise that can be offered as secondary prevention in these disorders.

Methods

A prospective, multicenter, comparative (intervention arm vs. control arm), randomized (immediate vs. later treatment) study using Zelen’s design. This study falls under active prevention of MSDs of the upper extremities (UE-MSDs). Participants are workers aged between 18 and 65 years with latent or symptomatic MSDS, with any type of job or workstation, with or without an history of sick leave. The primary aim is to show the superiority at 3 months of a combination of spa therapy, exercise, and self-management workshops for 6 days over usual care in the management of MSDs in terms of employee functional capacity in personal and professional daily life. Secondary aims are to assess the benefit of the intervention in terms of pain, quality of life, and accumulated duration of sick leave.

Discussion

This randomized controlled trial is the first that will aim to evaluate multidisciplinary management of UE-MSDs using nonpharmacological treatment combining exercise, self-management, and spa therapy. The originality of this intervention lies, in its short, intensive format, which is compatible with remaining in work; and in its multidisciplinary approach. This trial has the potential to demonstrate, with a good level of evidence, the benefits of a short course of spa therapy combined with a personalized self-management program on the functional capacity, pain, and quality of life of employees in their daily life.

Trial registration

Clinical trial.gov NCT02702466 retrospectively registered.

Protocol: Version 4 of 9/10/2015.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-016-1353-8) contains supplementary material, which is available to authorized users.

Imbalances in the German public health system - numbers of state-certified occupational physicians and relation to socioeconomic data

Background

State-certified occupational physicians who work as civil servants in the Federal Republic of Germany are key players in the German Public Health system. They control i.e. the legal compliance in occupational health and participate in the occupational disease procedures. Despite the role model function of the German Public health system for many developing countries, this area of Public health is debated to have been hampered in the past years by a disregard concerning structural developments.

Methods

Different databases were screened for occupational health benchmarks. Obtained data were compared to socioeconomic data and indices were calculated.

Results

The overall numbers of State-certified occupational physicians decreased in Germany between 1992 and 2012 from 136 to 86 (63 %). On the single state level, the ratios of State-certified occupational physicians per 1 Mio. working population ranged from 8 for the state of Saarland to 0.8 for the state of North Rhine Westphalia. A general difference was found for old versus new German states. Also, large differences were present for the ratios of State-certified occupational physicians per 10⁶ employees towards public debt per capita (€) and the ratios of State-certified occupational physicians per Gross Domestic Product (GDP) in the 16 German states in 2012.

Conclusions

In striking contrast to the WHO document on the Occupational safety and health (OSH) system that states in its executive summary that the human and institutional capacities of the German occupational health system are very strong in both quantity and quality, we here show extreme imbalances present at the single state levels that developed over the past 20 years. With a regard to the increasing complexity of the economic system a reversal of this trend should be demanded.

Ergonomic Risk Factors and Their Association With Lower Back and Neck Pain Among Pharmaceutical Employees in Iran

The aim of this cross-sectional study was to explore the ergonomic risk factors for low back pain (LBP) and neck pain in an industry in which only light tasks are performed. These common disorders can be significant work-related musculoskeletal disorders. This study included 396 employees who worked in packaging units of pharmaceutical companies. The Nordic Musculoskeletal Questionnaire and the rapid upper limb assessment (RULA) were used to generate data. This study showed an association between LBP, RULA scores, and workers' education. For neck pain, an association was found with age, gender, and subjective questions about working posture (mostly sitting/standing or alternating between the two). Absence from work more than 3 days, which could have been associated with pain, was significantly associated with both disorders.

Change in Musculoskeletal Pain in Patients With Work-Related Musculoskeletal Disorder After Tailored Rehabilitation Education: A One-Year Follow-Up Survey

OBJECTIVE

To apply tailored rehabilitation education to video display terminal (VDT) workers with musculoskeletal pain and to assess changes in musculoskeletal pain after rehabilitation education.

METHODS

A total of 8,828 VDT workers were screened for musculoskeletal disorders using a self-report questionnaire. Six hundred twenty-six VDT workers selected based on their questionnaires were enrolled in musculoskeletal rehabilitation education, which consisted of education on VDT syndrome and confirmed diseases, exercise therapy including self-stretching and strengthening, and posture correction. One year later, a follow-up screening survey was performed on 316 VDT workers, and the results were compared with the previous data.

RESULTS

Compared with the initial survey, pain intensity was significantly decreased in the neck area; pain duration and frequency were significantly decreased in the low back area; and pain duration, intensity, and frequency were significantly decreased in the shoulder and wrist after tailored rehabilitation education. In addition, pain duration, intensity, and frequency showed a greater significant decrease after tailored rehabilitation education in the mild pain group than in the severe pain group.

CONCLUSIONS

This study found that work-related musculoskeletal pain was reduced after tailored rehabilitation education, especially in the shoulder, wrist, and low back.