Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers

Work-Related Musculoskeletal Disorder Prevalence by Body Area Among Nurses in Europe: Systematic Review and Meta-Analysis

Background/Objectives: Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Global prevalence exceeds 80%, and several body areas are equally at risk. Numerous studies have assessed the exposure in many countries, but few have provided an overview by continent. The aim of this study was to propose a literature review and meta-analysis to investigate the overall and body area prevalence of WMSDs among nurses in Europe. Methods: A systematic review and a meta-analysis were conducted between September and November 2024. Five databases were scanned without a date limit: ScienceDirect, PubMed/Medline, Google Scholar, Science.gov, and Mendeley. The article selection, review, critical appraisal, and data extraction were performed by two authors independently. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results. Results: Among the 15,751 unique identified records, 12 studies met the inclusion criteria and were included for data extraction. The studies reported a total of 5153 nurses in Europe. High heterogeneity (Cochran's Q test and I2 statistic) was observed between studies. The results of the meta-analysis based on the random-effects model showed an overall prevalence of 87.8% (95% CI: 83.3-92.2%). The highest prevalence was found for lower back 61.4% (95% CI: 55.1-67.7%), neck 49.9% (95% CI: 42.9-56.8%), and upper back 46.3% (95% CI: 42.4-50.2%). Conclusions: Nurses are highly exposed to WMSDs, with a prevalence of over 30% for three-quarters of body areas. Due to the multitude of risk factors associated with nurses' work, the development of recommendations is a complex multifactorial issue, requiring the exploration of different strategies to reduce the prevalence of MSDs in nurses.

Framework Using Multicriteria Analysis for Evaluating the Risk of Musculoskeletal Disorders

This study includes musculoskeletal disorder (MSD) risk evaluation based on the IMU sensor data gathered from patient-lifting movement performed by healthcare specialists. This is a continuation of previous research focusing on a novel multicriteria statistical model integrating experimental and large-scale statistical datasets. The proposed model estimates MSD probabilities over 5, 10, and 15 years for the neck (0.537 ± 0.156), shoulder (0.449 ± 0.084), and elbows (0.277 ± 0.221). The model enables individual risk profiling, influenced by dynamic parameters that can reduce the long-term risk by up to 70.49%. The model is in its early development stages, i.e., it is the proof of concept that offers a new approach to assessing MSD risk at work using motion tracking data in combination with statistics. Further studies with larger sample sizes and validated criterion weights are needed to refine and validate this approach.

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

INTRODUCTION

The job of sonographers exposes them to numerous ergonomic risk factors, making the sonography profession one of the high-risk job groups vulnerable to musculoskeletal disorders (MSDs). The present systematic review and meta-analysis specifically examined the prevalence of MSDs among sonographers.

MATERIALS AND METHODS

The present review study was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The protocol of the study was registered in the international prospective register of systematic review (PROSPERO) with the code CRD42024507972. Searches were conducted in databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, without imposing a time limit until February 7th, 2024. The random-effects model was employed for meta-analysis, and the I2 index was used to assess heterogeneity among studies. Finally, data analysis was performed using STATA (version 14).

RESULTS

Based on the search in different databases, a total of 4367 articles were identified. Finally, after screening, selecting, and quality evaluation of the studies, 30 studies were considered for meta-analysis in which 13,916 sonographers were examined. According to the results of the meta-analysis, the overall prevalence of MSDs among sonographers was reported as 75.80% (95% CI: 65.37-86.23, I2 = 99.7%, P < 0.001). Additionally, the prevalence rates of these disorders in the neck (63.73%), shoulder (60.13%), upper back (53.69%), lower back (49.84%), wrist (44.41%), elbow (27.46), hip (24.93%), knee (19.59), and ankle (16.92%) were determined.

CONCLUSION

Given the relatively high prevalence of MSDs among sonographers and the importance of reducing specific risk factors associated with their duties, it is recommended to consider solutions such as carrying out ergonomic assessments and interventions, as well as providing training programs and appropriate corrective exercises to mitigate MSDs among sonographers.

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.

Evaluation of ergonomic risks for work-related musculoskeletal disorders of nursing tasks in Korea

Among all industrial accident-induced diseases, musculoskeletal disorders (MSDs) are most prominently observed among nurses. The physical load of everyday tasks involved in nursing work was assessed in this study using a developed risk index, whereby the physical burden was evaluated using the exposure duration and work intensity levels. This survey targeted nine small, medium and large-sized hospitals in South Korea and categorized representative nursing tasks into six groups. The subtasks within these six categories (evaluated as high risk) included changing a patient's posture and assisting with walkers or wheelchairs, transporting/handling drug carts, bathing patients, replacing bedding, traction therapy, cardiopulmonary resuscitation and artificial manual breathing unit, and computer work. The risk index ratio was significantly different by task type for each task. We demonstrated that the risk index developed in this study can be used to evaluate MSDs in hospitals.

High workload is related to lower quality of life in public school teachers: A cross-sectional study

BACKGROUND

People with long work hours, as evidenced by teachers, were more likely to present health problems that impact their quality of life (QoL). The reduced physical activity (PA) level or higher sedentary behavior in public school teachers was related to obesity. Although PA seems to improve the QoL in other professions, assessing whether the PA level could influence the relationship between workload and QoL in public school teachers is necessary.

OBJECTIVE

To analyze whether the high workload was related to worse QoL in teachers considered less active and more active.

METHODS

Two hundred forty-three teachers from public schools participated in this study. The domains of QoL and PA levels were assessed by SF-36 and Baecke questionnaires, respectively. Workload perception was assessed by a Likert scale. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the PA level in a model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition).

RESULTS

Heavy workload was associated with less chances of having better physical limitation domain of both less and more physically active teachers. Less active teachers with heavy workloads were 53%, 61%, and 56% less likely to have better vitality, social functioning, and mental health, respectively. No such associations were observed in the more physically active teachers.

CONCLUSION

Less active teachers with a heavy workload demonstrate lower QoL. Although the PA practice eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in physical limitation domain.

University professors’ quality of life and posture during the COVID-19 pandemic

Abstract Introduction The COVID-19 pandemic led to adaptations in educational settings, such as replacing in-person with online classes. Hence, teachers increased their screen time, posing a greater risk to their mental health, quality of life, and body posture. Objective To assess and correlate the quality of life and body posture of higher education faculty during the COVID-19 pandemic. Methods This exploratory research initially contacted participants via digital invitations during the pandemic. Volunteers answered an online questionnaire with data on eligibility criteria and were later assessed regarding their quality of life (SF-36) and postural biomechanics (SAPO software). The variables in question were correlated regarding sex and age ranges with Spearman's correlation, setting the significance level at 5%. Results The sample had 21 professors of both sexes, aged 26 to 62 years (mean age of 38.47 years; SD = 8.53). The females’ mean age was 40.27 years (SD = 8.47) and that of males was 33.83 years (SD = 7.38). Males had a greater correlation between cervical spine issues and mental and physical domains, while females had body posture changes and a moderate correlation mainly with physical quality-of-life domains. Conclusion There was a correlation between body posture and quality of life in higher education faculty during the COVID-19 pandemic.

The Effects of Frequent Coffee Drinking on Female-Dominated Healthcare Workers Experiencing Musculoskeletal Pain and a Lack of Sleep

Previous research has demonstrated that chronic diseases can occur due to musculoskeletal (MS) pain and poor sleep. It is also worth noting that the caffeine in coffee can reduce overall sleep duration, efficiency, and quality. Thus, the present study examines the effects of frequent coffee drinking (two cups per day) on individuals experiencing MS pain and a lack of sleep during the COVID-19 period. This observational and cross-sectional study recruited 1615 individuals who completed the self-reported (Nordic musculoskeletal) questionnaire. Long-term, frequent coffee drinking and a sleep duration of less than 6 h per day were significantly associated with neck and shoulder pain among healthy individuals. The mediation model demonstrated that the shorter sleep duration and drinking multiple cups of coffee per day had a two-way relationship that worsened such pain over the long term. Specifically, individuals who experienced such pain frequently drank multiple cups of coffee per day, which, in turn, shortened their sleep durations. In summary, long-term coffee drinking creates a vicious cycle between MS pain and sleep duration. Therefore, the amount of coffee should be fewer than two cups per day for individuals who sleep less than 6 h per day or suffer from MS pain, especially neck and shoulder pain.

Prevalence and risk factors analysis for low back pain among occupational groups in key industries of China

BACKGROUND

With the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP.

METHODS

We adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors.

RESULTS

LBP annual incidence among workers in China's key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors.

CONCLUSION

LBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers' health.

Musculoskeletal disorders among sonographers in secondary care hospitals in the city of Al-Ahsa, Saudi Arabia

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) among sonographers have raised significant concerns in recent years. OBJECTIVES: This study aimed to estimate the prevalence of WMSDs and identify risk factors for WMSDs among sonographers. To date, there is little research on WMSDs among sonographers in Saudi Arabia. Therefore, this study aimed to contribute to the Saudi literature by filling this gap. METHODS: A cross-sectional study was conducted among sonographers (n = 98) working in four major governmental hospitals in the city of Al-Ahsa, Saudi Arabia. The participants completed a validated, self-administered questionnaire that focused on the analysis of musculoskeletal symptoms among sonographers. RESULTS: The mean age of the respondents was 35.5±9 years. The majority of the participants were female (71.4%), non-Saudi (51%), and working as technicians (49%). The prevalence rates of shoulder and neck disorders among the participants were 65.3% and 57.1%, respectively. Gender (female), job title (sonography technicians), and years of experience (seasoned sonographers) were identified as risk factors for WMSDs. CONCLUSIONS: Among the studied sonographers, WMSDs were a significant, common problem. Being female, being a sonography technician, and being a seasoned sonographer were identified as risk factors for these disorders. Preventive measures should be implemented to reduce the risk of WMSDs in this occupational setting.

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

A framework for participatory work environment interventions in home care - success factors and some challenges

Background

Home care is beset with work environment issues and high staff turnover, while research concerned with interventions to improve the work environment is sparse. Few of the existing interventions apply a participative approach, despite this being associated with more positive outcomes and sustainable change. This paper presents a framework, rooted in action research and action learning, for participatory work environment interventions in home care, and demonstrates how this framework has been implemented in four Swedish home care organizations.

Methods

The framework has three phases (pre-intervention, intervention planning and intervention implementation) and consists of cycles of action and reflection in three constellations: a group of researchers, a reference group with labour market organization representatives and home care managers, and intervention work groups in the home care organizations. The work was documented and analysed with focus on the realization of the framework and challenges that were met on the way. The interventions were evaluated using a pre-/post-test questionnaire design.

Results

Parts of the framework were successfully implemented. The pre-intervention phase and the intervention planning phase, with intervention work groups, worked well. All four groups identified one intervention relevant to their own context. However, only two of the proposed interventions were fully implemented and evaluated. The high staff and management turnover, and the high rate of organizational changes made it impossible to evaluate the interventions statistically. Yet, data from open-ended questions in the post questionnaire showed that the two implemented interventions were perceived as successful.

Conclusions

The participatory framework, presented in this paper, seems promising for work environment interventions in home care. The framework was designed to reduce the risk of known disturbances affecting the process in unstable organizations. Despite this, it proved challenging to execute the framework, and especially the interventions, due to changes happening at high speed. In the two cases where organizational changes were not dominating, the interventions were implemented successfully. While the prerequisites for participation and successful implementation could be improved somewhat, the main issue, the instability of the organizational context, is hard for researchers or the individual home care units to tackle alone.

Toward Ergonomic Design in Ultrasound Scanning: Strategies to Mitigate Injurious Forces

ABSTRACT

Sonographers experience stress-related musculoskeletal injuries at alarming rates. The magnitude of the problem has resulted in substantial economic and human costs. Early efforts, such as the transposition of office ergonomic models to the ultrasound suite, have been only marginally successful because of the vast difference between clerical and sonography work demands. In addition, although the issue has attracted the attention of professional sonographer societies, equipment manufacturers, and governmental agencies, such as the OSHA (Occupational Safety and Health), the causative mechanisms by which sonographers are injured remain inadequately addressed. A definitive ergonomic solution has been elusive.With the help of occupational therapists and biomechanical engineers, we have developed a number of possible ergonomic modifications of ultrasound equipment. We explain the rationale behind these approaches to transducer design and assess the strengths and deficiencies of each.

Musculoskeletal Disorders and Caring Behaviors among Nursing Staff in Greek Hospitals: a Prospective Multicenter Study

Introduction:Care delivery from nursing staff to patients in hospital environment may involve the exertion of considerable muscular force and, as a result, there is a consequent risk of developing musculoskeletal disorders (MSDs). The aim of this prospective study was to investigate the relationship between reported MSDs and perceived caring behaviors among nursing staff. Methods: A total of 250 questionnaires were completed in three Greek hospitals during February and March 2019. The Nordic Musculoskeletal Questionnaire for the evaluation of MSDs and the Caring Behaviors Inventory-24 (CBI-24) for the assessment of caring behaviors were used. Results:A total of 185 participants (74%) were found to have at least one MSD. Back (64.3%), neck (63.2%) and shoulder (58.4%) pain were the most commonly reported MSDs. The mean score on the CBI-24 scale was 5.06 (SD=0.51) and the mean "Connectedness" dimension was 4.59 (SD=0.74). Elbow MSDs were significantly associated with the lowest score in the "Knowledge and skills" dimension (p=0.024) and the lowest overall nursing score (p=0.048). Linear regression analysis showed that the lowest nursing care score was associated with left-handed nurses (p=0.008) of low hierarchical position (p=0.013), suffering from elbow MSDs (p=0.002), for which they did not seek treatment (p=0.023). Participants who continued to work on a regular basis despite MSDs showed a lower score on the dimensions of "Respectful" (p=0.05) and "Connectedness" (p=0.01). Conclusion:The nursing staff showed high percentage of MSDs that negatively affected their perceived dimensions of caring behaviors. These findings could be used to prevent and deal with work-related MSDs, reduce occupational hazards and improve hospital patient care.

Action Levels for the Prevention of Work-Related Musculoskeletal Disorders in the Neck and Upper Extremities: A Proposal

There are several well-known risk factors for work-related musculoskeletal disorders (MSDs). Despite this knowledge, too many people still work in harmful conditions. The absence of occupational exposure limits (OELs) for physical workload impedes both supervision and preventive work. To prevent myalgia, tendon disorders, and nerve entrapments in the upper musculoskeletal system, we propose action levels concerning work postures, movement velocities and muscular loads recorded by wearable equipment. As an example, we propose that wrist velocity should not exceed 20°/s as a median over a working day. This has the potential to reduce the prevalence of carpal tunnel syndrome (CTS) in highly exposed male occupational groups by 93%. By reducing upper arm velocity in highly exposed female groups to the suggested action level 60°/s, the prevalence of pronounced neck/shoulder myalgia with clinical findings (tension neck syndrome) could be reduced by 22%. Furthermore, we propose several other action levels for the physical workload. Our ambition is to start a discussion concerning limits for physical workload, with the long-term goal that OELs shall be introduced in legislation. Obviously, the specific values of the proposed action levels can, and should, be discussed. We hope that quantitative measurements, combined with action levels, will become an integral part of systematic occupational health efforts, enabling reduction and prevention of work-related MSDs.

Predictors of work-related musculoskeletal symptoms in shoulders among nursing assistants working in nursing homes

Nursing assistants (NAs) working in nursing homes (NHs) are at higher risk for work-related musculoskeletal symptoms (WRMSs) than their counterparts working in other health care settings. Worldwide, NAs have ranked shoulders in the top three body parts at risk of WRMSs. However, factors associated with their shoulder WRMSs are currently unknown. The aim of this study was to identify these associated risk factors among NAs working in NHs. 440 NAs from 47 nursing homes (with 60-90% response rate from each nursing home), recruited by convenience sampling, participated in this cross-sectional study in 2014-2015. A validated and reliable questionnaire was used for data collection. Information on demographic, job content questionnaire (JCQ), perceived physical exertion (PE), workstyle, ergonomic and manual handling knowledge and other work-related factors was collected using a self-administered questionnaire. 53% of the participants reported experiencing with WRMSs in their shoulders. Nine associated factors of shoulder WRMSs were identified using bivariate analysis. With the adjustment of age and gender using multivariable logistic regression, body mass index (OR = .931, 95% CI [.874-.991]), job title of health workers (OR = 2.72, 95% CI [1.18-6.25]) and workstyle-working through pain (OR = 1.06, 95% CI [1.01-1.11]) remained as predictors. Effort should be directed at integrating "workstyle intervention" into lifestyle physical activity training for NAs.

Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and META-analysis

BACKGROUND

To evaluate the prevalence of work-related musculoskeletal disorders (WRMSDs) in perioperative nurses and to explore their association with personal characteristics.

METHODS

Medline, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library and Joanna Briggs Institute Database were systematically searched. A meta-analysis calculating event rates, and relative 95% Confidence Intervals (CI) was performed for each musculoskeletal body region. The contribution of perioperative nurses' sex, age, and BMI was assessed through a meta-regression.

RESULTS

Twenty-two studies, considering 3590 perioperative nurses, were included in the systematic review. The highest prevalence of WRMSDs was found for the lower-back (62%; 95% CI 0.54-0.70), followed by knee (47%; 95% CI 0.36-0.59), shoulder (44%; 95% CI 0.37-0.51), waist (42%; 95% CI 0.31-0.53), neck (39%; 95% CI 0.29-0.51), ankle-feet (35%; 95% CI 0.22-0.51), upper-back (34%; 95% CI 0.25-0.44), hand-wrist (29%; 95% CI 0.20-0.40), and elbow (18%; 95% CI 0.12-0.26). Meta-regression showed that sex, age, and BMI were not significant predictors of low-back disorders (p = 0.69; R² = 0).

CONCLUSIONS

WRMSDs represent a high prevalence issue among perioperative nurses. Perioperative nurses, in general, are steadily exposed to both physical and temporal risk factors. Further studies should be addressed to identify specific interventions aimed at reducing the burden of WRMSDs including ergonomic education and physical rehabilitation. Our data could be used in future studies as a reference to assess the risk of WRMSDs in other health-care professionals' population.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Ankle and Foot Pain and Associated Factors Among Nurses at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia: Cross-Sectional Study

Background

Ankle–foot pain is a significant public health problem in nurse professionals and has great burdens to the individuals, healthcare systems, and community at large. However, there is limited evidence on the prevalence of ankle–foot pain and its associated factors among nurses in Ethiopia. Thus, the finding of this study will help to address health problems resulting from ankle–foot pain among nurses.

Purpose

The aim of this study was to determine the prevalence and associated factors of ankle–s–foot pain among nurse working in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia.

Patients and Methods

An institutional-based cross-sectional study was conducted on a total of 366 nurses, and a simple random sampling technique was used to recruit study participants. Data were collected by using a self-administered adapted standardized Nordic questionnaire. Descriptive statistics and a bivariate logistic regression model were done to identify factors associated with ankle–foot pain. Those variables with a P-value less than 0.05 with 95% CI in multivariate model were taken as statistically significant. Finally, AOR with 95% confidence interval at a P-value of <0.05 was reported.

Results

The prevalence of self-reported ankle–foot pain among nurses was 43.7% (95% CI=38.5–49.1). Older age (AOR=7.669, 95% CI=2.316−25.390), low shoe comfort (AOR=4.215, 95% CI=2.031–8.745), multiple foot conditions (AOR=6.102 95% CI=1.959–19.008), working night shifts (AOR=2.047, 95% CI=1.098−3.816), high physical demand (AOR=3.487, 95% CI=1.988–6.116), and nurses working in the intensive care unit (AOR=2.402, 95% CI=1.219–4.732) showed a statistically significant association with ankle–foot pain.

Conclusion

This study indicated that the prevalence of ankle–foot pain is commonly reported among nurses working in Ayder Comprehensive Specialized Hospital. Therefore, awareness and prevention of ankle and foot pain in nurses should be prioritized to reducing risk factors. Nurses should give attention to comfortable footwear, and further longitudinal research is recommended.

Evaluation of the occurrence of work-related musculoskeletal pain among anesthesiology, intensive care, and surgical nurses: An observational and descriptive study

Clinical nurses can encounter musculoskeletal pain episodes stemming from regular exposure to workplace risk factors that contribute to overloads. This study aimed to evaluate the occurrence and location of work-related musculoskeletal pain among Polish nurses. An observational and descriptive survey study was conducted among 136 nurses working in the anesthesiology, intensive care, and surgery units. An extended version of the Nordic Musculoskeletal Questionnaire was used to investigate musculoskeletal pain. Only 8% of the participating nurses experienced no musculoskeletal pain, while 85% suffered from pain in more than one location. The lower back (67%), upper back (59%), and neck (66%) were the most common pain locations. In summary, nurses experienced multiple musculoskeletal pain episodes, occurring most frequently in the spinal region (lower and upper back and neck). It is crucial to determine the real causes of musculoskeletal pain and to take appropriate preventive measures to improve workplace ergonomics.

Following the Principles of Ergonomics and Musculoskeletal Disorders in Ultrasonographers

Background/Aim. It has been noticed that doctors who regularly perform ultrasound examinations have different clinical manifestations of musculoskeletal disorders. The aim of this research is to examine the level of knowledge of ultrasonographers regarding preventative measures and health consequences of the forced body positions during work.

Subjects and methods. The total of 75 doctors of both genders, aged 31-50 years, who use ultrasound diagnostics participated in the research. The research was conducted throughout 2016, as a cross-sectional study, with the aid of a structured questionaire.

Results. The total of 60% subjects either rarely use the break during working hours or do not have a break at all. The participants most commonly use the movable monitor and the ability to wrap the cable around their arm (73,3%). This percentage is similar in all age groups. The respondents most often stated that they walk daily (41,3%), with no differences among age groups. 25% of the respondents negate any spine related pains, while over a half said that they experience pain in one segment of the spinal column (cervical, thoracic or lumbar), regardless of the age group. 52% said that they serch for information on their own accord, while 36% stated that they are not at all informed. Only in less than 10% of cases is information provided by the authorities in the institution where the participants are employed, and during regular health examinations, information is given by the designated doctor in 2,7% of cases.

Conclusion. The respondents implement the recommendations regarding safe work and other preventative measures to a very small extent, regardless of gender and age. Most of the respondents experience pain in the spine and joints, which can be related to the work in ultrasound diagnostics. Additionally, doctors are not well-informed regarding the preventative measures.

The prevalence of foot pain and its associated factors among Saudi school teachers in Abha sector, Saudi Arabia

Background:

The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg. Foot pain is not rare finding in the general population, particularly in older adults. The prevalence in adults ages ≥18 year's ranges from 17 to 24%. Heel pain is a general term used to describe pain and discomfort felt anywhere in or around the rear of the foot. This study aimed to estimate the prevalence of heel and foot pain and their determinants among teachers in Abha sector.

Methodology:

A deceptive cross-sectional approach was applied for the current research. All accessible teachers working in governmental and private schools in Abha sector. To be included, teachers should be teaching but not in administrative positions, free of musculoskeletal disorders due to causes other than teaching. Teachers with foot congenital anomalies, newly employed teachers. A self-administered questionnaire was personally distributed to included school teachers in Abha sector. Questionnaires were distributed and collected on second day after being filled by teachers. Posterior HP health Survey questionnaire was used to assess foot and foot pain.

Results:

The study included 1,439 teachers from different districts of Abha sector with their ages ranged from 24 to 60 years old with mean age of 41 ± 9 years. Female teachers constituted 72.8% of the sample and teachers’ weight ranged from 45 to 185 kg with mean weight of 76.6 ± 18.2 kg. Exact of 85.5% of the teachers had foot pain during the last 12 months. Foot pain was mild among 17.3% of the teachers with foot pain and severe among 25.5% of them. Low back pain was recorded among 81% of the teachers followed with knee pain (62%), neck pain (58%), shoulder pain (55%), and wrist pain (28%).

Conclusions and Recommendations:

In conclusion, the study revealed that majority of teachers complained of foot pain. The pain was moderate especially after long standing. The pain was more among old aged teachers with high load of teaching sessions. The pain altered the traditional daily activities among majority of teachers but very few number who asked for medical consultation.

The impact of occupational and personal factors on musculoskeletal pain - a cohort study of female nurses, sonographers and teachers

Background

Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. The aim of this study was to explore the relative importance of physical, psychosocial and personal factors, in number of pain sites and in five specific pain sites, among women in common professions with a broad variety of occupational exposures.

Methods

A cohort of 1115 women responded to a questionnaire on ergonomic, psychosocial, personal and life-style factors, and the outcome measure of musculoskeletal pain (based on frequency and intensity of complaints at nine anatomical sites), at baseline and at follow-up. Sum scores of ergonomic and psychosocial factors were created. The importance of exposure at baseline for the number of pain sites at follow-up were estimated using ordinal regression. The importance of exposure at baseline for pain in the neck, shoulders, hands, lower back and feet at follow-up were estimated using multi-exposure Poisson regression models.

Results

High sum scores for ergonomic and psychosocial factors were of importance for a high number of pain sites, although the strongest risk factor was a high number of pain sites already at baseline. On the individual level, there was a large fluctuation in number of pain sites between the two time points. Eighteen percent reported persistent (or recurrent) ≥ four pain sites, while only 11 % did not report any pain at baseline or at follow-up. Among the specific pain sites, a high sum score of ergonomic factors was associated with pain in the neck, hands and feet. A high sum score of psychosocial factors was associated with neck and shoulder pain. The strongest risk factor was, however, pain at that specific anatomical site at baseline. Only a few of the personal and life-style factors were associated with pain.

Conclusions

An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic and psychosocial factors were predictive of a high number of pain sites and of specific pain sites. These findings indicate the need for preventive measures on the individual, organizational and societal level.

Risk Factors for Work-Related Musculoskeletal Disorders Among Intensive Care Unit Nurses in China: A Structural Equation Model Approach

PURPOSE

This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs).

METHODS

A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors.

RESULTS

Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p < .05). In the structural equation model, the occurrence of WRMDs was directly affected by the following: physical factors, risk perception, and job stress. Physical factors and a safe environment indirectly affected WRMDs through risk perception and job stress. The strongest correlations with WRMDs were physical factors.

CONCLUSION

The model provided a new perspective for understanding the associations among physical factors, workplace safety environment, risk perception, job stress, and WRMDs. To improve the practice setting of the ICU, efforts should be made to help prevent WRMDs from physical, psychosocial, and environmental factors.

Predictors of musculoskeletal symptoms in radiology technologists in Austria, Europe

BACKGROUND

Musculoskeletal symptoms (MSS) are a major health problem in health professionals. However, there is very little evidence about predictors of MSS in the group of radiology technologists.

OBJECTIVES

The aim of this study was to identify prevalence and predictors of MSS in radiology technologists working in Austrian Hospitals.

METHODS

272 radiology technologists completed a self-report questionnaire including MSS, work demands, work strain and well-being (WHO-5 questionnaire).

RESULTS

Lower back pain and upper back pain are the most frequent MSS in radiology technologists. A high proportion of participants experience these symptoms every day (20.1% and 19.8%, respectively). Work strain, age and well-being were the best predictors for MSS in a regression model.

CONCLUSIONS

MSS is a major health issue for radiology technologist working in hospitals. Our results provide evidence for the assumption that psychological factors play an important role in development of MSS. Thus, beside physical health promotion programs (e.g. safe patient handling), psychological intervention may have positive effects on MSS.

Neck and upper extremity pain in sonographers - a longitudinal study

Background

Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/hand pain at follow-up.

Methods

A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up.

Results

Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50–2.76], for neck/shoulders and (PR 3.45; CI 2.29–5.22) for elbows/hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05–1.49), a high mechanical exposure index (PR 1.66; CI 1.09–2.52), and adverse visual conditions (PR 1.24; CI 1.00–1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01–3.12), and a high mechanical exposure index (PR 2.0; CI 0.98–4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08–2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53–7.31).

Conclusion

Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.

Upper Limb Work-Related Musculoskeletal Disorders in Operating Room Nurses: A Multicenter Cross-Sectional Study

This study aimed to evaluate the association between personal and job characteristics and the risk of upper limb work-related musculoskeletal disorders (WMSDs) among operating room nurses (ORNs). To this end, we collected data from 148 ORNs working at 8 Italian hospitals and measured any upper limb disabilities experienced in the previous year using the Italian version of the disabilities of the arm, shoulder and hand (DASH) questionnaire. The associations between personal and job characteristics and risk of upper limb WMSDs were estimated by unconditional logistic regression models. The prevalence of upper limb WMSDs was 45.9%. Multivariate analysis showed the "female gender" and "monthly hours spent working as a scrub nurse" to be directly associated with a higher DASH score (adjusted OR for gender = 5.37, 95% CI: 1.65-17.51, p < 0.01; adjusted OR for monthly hours as scrub nurse = 3.09, 95% CI: 1.33-7.19, p < 0.01). Overall, our findings indicate that a full-time job (>120 h/month) as a scrub nurse significantly increases the risk of developing upper limb WMSDs among female ORNs. Thus, to reduce such risk in this particularly sensitive population, we recommend urgent implementation of ergonomic interventions on surgical equipment alongside job rotation and medical surveillance programs.

Longitudinal Associations between Anatomical Regions of Pain and Work Conditions: A Study from The SwePain Cohort

We investigated the time-based associations between workload (physical and mechanical), psychosocial work stressors (demands, control, and support), and the number of anatomical regions with pain (ARP). This population-based study with a two-year follow-up included 11,386 responders (5125 men, 6261 women; mean age: 48.8 years; SD: 18.5) living in south-eastern Sweden. Predictive associations were assessed through generalised linear models, and changes over time were examined using a generalised estimating equation. The results of both models were reported as parameter estimates (B) with 95% confidence interval (CIs). Mean changes in the number of ARP, workload, and psychosocial work stressors were stable over time. High mechanical workload and job demands were likely associated with the number of ARP at the two-year follow-up. In the reverse prospective model, we found that the number of ARP was also associated with high physical and mechanical workload and low job control and support. In the two time-based models of changes, we found a reciprocal association between number of ARP and mechanical workload. Our results add epidemiological evidence to the associations between work conditions and the extent of pain on the body. Components of work conditions, including job demands and mechanical strain, must be considered when organisations and health policy makers plan and employ ergonomic evaluations to minimise workplace hazards in the general population.

Stability of Three Different Sanitary Shoes on Healthcare Workers: A Cross-Sectional Study

Background: The main purpose of this research was to determine the stability of three different sanitary shoes on nurses with eyes open and closed with respect to barefoot condition. In addition, the secondary aim was to determine the reliability of stability measurements under these different conditions. Methods: A crossover quasi-experimental study (NCT03764332) was performed. Twenty-six nurses who wore different sanitary shoes (Eva Plus Ultralight^®, Gym Step^® and Milan-SCL Liso^®) were evaluated with respect to barefoot condition for stability measures on the Podoprint^® podobarometric and stabilometry tool and with eyes open and closed. Furthermore, the reliability of stability measurements was determined by the intraclass correlation coefficient (ICC) under these different conditions. Results: Between-groups comparisons of the static and stabilometry podobarometric data with eyes open showed statistically significant differences (p < 0.05). Milan-SCL Liso^® sanitary shoes improved podobarometric data of forefoot force and distribution with respect to barefoot condition. Eva Plus Ultralight^® and Gym Step^® sanitary shoes increased the stroke length mean, stroke surface mean, and anterior speed mean as well as reduced y axis displacement mean with respect to barefoot condition. Similar findings were determined for measurements with eyes closed. ICCs ranged from poor to excellent reliability (ICC = 0.010–0.995). Conclusions: Sanitary shoes improved podobarometric and stabilometry stability with respect to barefoot condition.

Burnout among school teachers: quantitative and qualitative results from a follow-up study in southern Sweden

Background

Teachers are at high risk of stress-related disorders. This longitudinal study aimed to (a) identify which occupational, sociodemographic and life-style factors and self-efficacy at baseline that were of importance for burnout, (b) explore associations between changes in the studied factors versus changes in burnout, and (c) by interviews increase the understanding of perceived job demands among teachers.

Methods

A cohort of 310 Swedish teachers in school-years 4–9 responded to a questionnaire of occupational, sociodemographic and life-style factors, self-efficacy and burnout, at baseline and at follow-up (mean 30 months later). A combined measure with four levels of burnout was crafted, based on exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey). Quantitative data were analysed with multiple ordinal regression, and qualitative data were analysed with content analysis of interview responses from a subgroup of the teachers (n = 81).

Results

The occurrence of high burnout (level 2 and 3 combined) were similar at baseline and follow-up (14% vs. 15%). However, many teachers fluctuated between the levels of burnout (28% increased and 24% decreased). Burnout at baseline was of importance for change of work or being off duty at follow up. In the multi-exposure model, low self-efficacy [OR 0.42; CI 0.26–0.68] and high job demands [OR 1.97; CI 1.02–3.8] were the strongest explanatory variables. Low self-efficacy remained as the strongest explanatory factor after adjustment for burnout at baseline. Increased job demands during follow-up was associated with an increased level of burnout [OR 3.41; CI 1.73–6.69], whereas increased decision latitude was associated with a decreased level of burnout [OR 0.51; CI 0.30–0.87]. Two major categories of demands emerged in the qualitative analysis; i.e. too high workload and a sense of inadequacy.

Conclusions

A substantial proportion of teachers showed signs of burnout at both occasions. Low self-efficacy and high job demands was of importance for burnout, and changes in burnout was further associated with changes in decision latitude. The results points to the need of actions on individual, organizational and a societal levels.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6972-1) contains supplementary material, which is available to authorized users.

Work-related neck and upper limb disorders - quantitative exposure-response relationships adjusted for personal characteristics and psychosocial conditions

BACKGROUND

We have previously reported quantitative exposure-response relationships between physical exposures recorded by technical methods, and complaints and diagnoses in the neck/shoulders, and the elbows/hands, based on group data. In the present study the number of workers was doubled, and information on individual factors, and psychosocial working conditions was used. Relationships between various kinds of exposure and response have been analysed in this larger and more detailed sample.

METHODS

The prevalence of complaints (Nordic Questionnaire) and diagnoses (clinical examination) were recorded in a number of occupational groups within which the participants had similar work tasks, 34 groups of female employees (N = 4733 women) and 17 groups of male employees (N = 1107 men). Age and other individual characteristics were recorded, as well as psychosocial work environment factors (job-content questionnaire) for most participants. Postures and velocities (inclinometry) of the head (N = 505) and right upper arm (N = 510), right wrist postures and velocities (electrogoniometry; N = 685), and muscular activity (electromyography; EMG) in the right trapezius muscle (N = 647) and forearm extensors (N = 396) were recorded in representative sub-groups. Exposure-response relationships between physical exposure and musculoskeletal disorders, adjusted for individual factors with Poisson regression were then calculated. The effect of introducing psychosocial conditions into the models was also assessed.

RESULTS

Associations were found between head velocity, trapezius activity, upper arm velocity, forearm extensor activity and wrist posture and velocity, and most neck/shoulder and elbow/hand complaints and diagnoses. Adjustment for age, other individual characteristics and psychosocial work conditions had only a limited effect on these associations. For example, the attributable fraction for tension neck syndrome among female workers with the highest quintile of trapezius activity was 58%, for carpal tunnel syndrome versus wrist velocity it was 92% in men in the highest exposure quintile.

CONCLUSIONS

Based on the findings, we propose threshold limit values for upper arm and wrist velocity.

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.

The importance of obstetric and gynaecologic sonographer health and safety

In the field of obstetrics and gynaecology, sonographers are often exposed to health and safety risks that may have significant consequences: it has been reported that up to 90% of sonographers experience work-related musculoskeletal disorders. These have the potential to be career-ending. This topic warrants routine evaluation, which is the aim of this editorial. We intend to achieve this by presenting a summary of risks, their outcomes, and strategies to optimise health and wellness in the workplace of sonographers in obstetrics and gynaecology. We believe this discussion is of utmost importance to sonographers, their employers, and regulatory bodies.

Assessments of Physical Workload in Sonography Tasks Using Inclinometry, Goniometry, and Electromyography

Background

Echocardiography involves strenuous postures of the upper limbs. This study explored the physical workload in the neck and upper limbs in sonographers performing echocardiography, and the extent to which the workload differs from than in other work tasks (other sonographic examinations, and nonsonographic tasks).

Methods

The physical load was assessed by inclinometry, goniometry, and electromyography methods in 33 female sonographers during authentic work using three different echocardiography techniques and other work tasks.

Results

Echocardiography was characterized by low velocities of the head, arms, and wrists, and a low proportion of muscular resting time in the forearms, in the transducer limb, and the computer limb. The transducer limb was more elevated in one of the techniques, but this technique also involved a higher proportion of muscular resting time of the trapezius muscle. We also found a high proportion of awkward wrist postures in the transducer wrist in all three techniques; in one due to prolonged flexion, and in the others due to prolonged extension. Other work tasks were less static, and were performed with higher upper arm and wrist velocities.

Conclusion

None of the three echocardiography techniques was optimal concerning physical workload. Thus, to achieve more variation in physical load we recommend that the equipment be arranged so that the sonographer can alternate between two different techniques during the workday. We also propose alternation between echocardiography and nonsonographic tasks, in order to introduce variation in the physical workload. Clinical expertise should be used to achieve further improvements.

Prevalence and associated factors of foot and ankle pain among nurses at a university hospital in Japan: A cross-sectional study

OBJECTIVES

The purposes of this study were to clarify 1) the prevalence of foot and ankle pain and 2) the factors associated with foot and ankle pain among nurses.

METHODS

Nurses working at a university hospital in Japan were recruited to participate in this cross-sectional, questionnaire-based study. The occurrence of foot and ankle pain in the previous month was assessed by using the Standardized Nordic Questionnaire and the Manchester Foot Pain and Disability Index. Subjects also answered questions on footwear-related factors, including using the visual analog scale for shoe comfort. In addition, information on personal factors and psychosocial factors was collected using the Job Content Questionnaire. The relationships between the presence of foot and ankle pain and the associated factors were examined using multiple logistic regression analysis.

RESULTS

Responses of 636 nurses (response rate, 67%) were included for analysis. The prevalence of foot and ankle pain was 23% and 51% when using the Standardized Nordic Questionnaire and the Manchester Foot Pain and Disability Index, respectively. The prevalence of pain that prevented the nurses from performing activities of daily living and work was 4% and 17%, respectively. A low level of shoe comfort, personal factors (age and body mass index), and psychosocial factors (low job control and high job strain) was independently associated with the presence of foot and ankle pain.

CONCLUSIONS

Foot and ankle pain occurred frequently in nurses. Shoe comfort, personal factors, and psychosocial factors were associated with foot and ankle pain.

Work-Related Biomechanical Exposure and Job Strain as Separate and Joint Predictors of Musculoskeletal Diseases: A 28-Year Prospective Follow-up Study

We investigated how work-related biomechanical exposure and job strain in midlife separately and jointly predicted back and degenerative musculoskeletal diseases (MSDs). A total of 6,257 employees participated in the Finnish Longitudinal Study on Aging Municipal Employees (FLAME) in 1981 and were followed up for 28 years. Risk ratios and the relative excessive risk due to interaction and 95% confidence intervals were modeled for separate and joint prediction estimates, respectively. After adjustment for confounders, job strain predicted degenerative MSDs among women after 4 and 11 years of follow-up. After 11 years, both exposures predicted both types of MSDs among men. Joint exposure predicted both types of MSDs after 4 years among women (for back MSDs, risk ratio (RR) = 1.58, 95% confidence interval (CI): 1.15, 2.18; for degenerative MSDs, RR = 1.59, 95% CI: 1.21, 2.07) and men (for back MSDs, RR = 1.50, 95% CI: 1.05, 2.15; for degenerative MSDs, RR = 1.61, 95% CI: 1.16, 2.22) and both types of MSDs after 11 years (for back MSDs, RR = 1.72, 95% CI: 1.21, 2.43; for degenerative MSDs, RR = 1.68, 95% CI: 1.25, 2.46) among men only, but the relative excessive risk due to interaction was not significant throughout. However, after 28 years, the separate and joint exposures did not predict MSDs. Workplace interventions should be focused on reducing job strain along with biomechanical exposure for possible prevention of MSDs in working life and around the time of retirement, but there may be other pathways of onset of MSDs in old age.

Evaluation of body posture in nursing students

OBJECTIVE

To investigate the body posture of nursing students before and after clinical practice.

METHOD

The study was developed in two stages. Initially the body posture of students of the 2nd, 4th, 6th, and 8th periods were assessed through photogrammetry. All images were analyzed in a random and masked manner with CorporisPro® 3.1.3 software. Three evaluations were performed for each angle and then the mean value was calculated. Two years later, when the 4th period students had developed their clinical internships, their body posture was again evaluated.

RESULTS

The total sample consisted of 112 students. Comparison of their posture with the normality pattern showed that all the angles presented significant differences (p< 0.00), except for the angle of the Thales triangle. Reassessment of these students evidenced significant differences in the angles of the acromioclavicular joint (p=0.03), knee flexion (p< 0.00) and in the tibiotarsal angle (p< 0.00).

CONCLUSION

All the students presented alterations when compared to the normality values. The segments that presented significant differences between before and after practice were the acromioclavicular angle, knee flexion, and tibiotarsal angle; the latter two were in the rolling position.

OBJETIVO

Investigar a postura dos estudantes de enfermagem antes e após a prática clínica.

MÉTODO

O estudo foi desenvolvido em duas etapas, inicialmente com estudantes (2º, 4°, 6° e 8º períodos) tiveram sua postural corporal avaliada por meio da fotogrametria. Todas as imagens foram analisadas, de maneira aleatória e mascarada, por meio do software CorporisPro® 3.1.3. Foram realizadas três avaliações para cada ângulo e calculada a média. Dois anos depois, quando os estudantes do 4º período desenvolveram os estágios clínicos, foram novamente avaliados quanto à postura corporal.

RESULTADOS

A amostra total foi composta por 112 estudantes. Comparando-se os estudantes com o padrão de normalidade, todos os ângulos apresentaram diferença significativa (p< 0,00), com exceção do ângulo triângulo de Tales. Reavaliando os mesmos estudantes, houve diferença significativa nos ângulos da articulação acromioclavicular (p=0,03), da flexão de joelhos (p< 0,00) e no ângulo tibiotársico (p< 0,00).

CONCLUSÃO

Todos os estudantes apresentaram alterações, comparadas aos valores de normalidade. Os segmentos com diferença significativa, comparando-se antes e após a prática, foram o ângulo acromioclavicular, flexo de joelho e ângulo tibiotársico, sendo os dois últimos na posição de rolamento.

Neck and upper extremity pain in sonographers - Associations with occupational factors

Sonographers have a high risk of musculoskeletal disorders. This study explores the associations between working conditions and musculoskeletal pain based on the frequency and intensity of pain in the neck and upper extremities. A questionnaire was answered by 291 female sonographers. High prevalence of neck/shoulder pain was associated with eye complaints and headache related to work on the computer, dissatisfaction with the computer workstation, high mechanical exposure index (MEI) and high demands. The possibility to adjust the keyboard and chair, and adequately corrected eyesight were positive factors. High prevalence of elbow/hand pain was associated with performing echocardiography, computer-related eye complaints, high MEI and high job and sensory demands. In echocardiography, working with a straight wrist and holding the transducer with a two-handed grip or alternating hands was associated with a low prevalence of elbow/hand pain. Thus, further improvements in the working conditions are possible and are recommended.

Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement

BACKGROUND

Sonographers' perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers' perceptions of ergonomic problems at work, and their suggestions for improvement strategies.

METHODS

Twenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied.

RESULTS

The sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient's physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills.

CONCLUSION

Sonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable.

Burnout among Swedish school teachers - a cross-sectional analysis

Background

Teachers are at high risk of stress-related disorders. This study aimed to examine the occurrence of burnout in a sample of Swedish school-teachers, to test a combined measure of three burnout dimensions on the individual level, to characterize associations between burnout and factors encountered during work and leisure time, and to explore any differences between the genders.

Methods

A questionnaire of occupational, sociodemographic and life-style factors was answered by 490 teachers in school years 4–9. Outcome measures were (a) the single burnout dimensions of exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey), and (b) a combined measure based on high or low values in the three dimensions. The combined measure was used to stratify the study population into four levels (0–3) of burnout. Multivariable Poisson regression was applied on level 2 + 3 vs. level 0 + 1, for variables that we considered as relevant risk factors for burn out.

Results

Half of the teachers reported low values in all three dimensions (level 0), whereas 15 were classified as having high burnout in at least two out of the three dimensions (level 2 + 3), and 4 % in all three dimensions (level 3). Almost all psychosocial factors were incrementally more unfavourably reported through the rising levels of burnout, and so were dissatisfaction with the computer workstation, pain, sleep problems and lack of personal recovery. There was no association between gender and rising levels of overall burnout (p > 0.30). Low self-efficacy, poor leadership, high job demands and teaching in higher grades were the variables most clearly associated with burnout in multivariable Poisson regression.

Conclusions

Even if circa 50 % of the teachers appear do well with respect to burnout, the results points to the need of implementing multifaceted countermeasures that may serve to reduce burnout.

Opting to wear prismatic spectacles was associated with reduced neck pain in dental personnel: a longitudinal cohort study

Background

The aim of this study was to investigate effects on perceived exertion, work ability self-reported neck pain and clinically diagnosed conditions in the neck, of an intervention with prismatic spectacles among dental personnel.

Methods

In this cohort study a baseline questionnaire including questions about frequency of neck pain, perceived exertion during work and background information was distributed to dental personnel in municipal dental care units. In connection, personnel from 78 out of 110 dental care units underwent a clinical neck examination and rated their perceived work ability with the single-item question from the Work Ability Index. The study population consisted of 564 participants; 366 in the questionnaire group, 321 in the examination group, whereof 123 participated in both assessments. In total 371 belonged to the intervention group and received individually adjusted prismatic spectacles after the baseline assessments (inclusion based on self-selection) and 193 belonged to the reference group. At the 12-month follow-up the clinical examination was repeated and the same questionnaire with additional questions was completed. Fisher’s exact test or the Mann–Whitney U test was used to assess differences between the intervention group and the reference group at baseline. Differences at follow up between the two groups were assessed by means of Linear-by Linear association test for trends.

Results

A significant decrease in neck pain (p = 0.047), clinical diagnoses in the neck (p = 0.025), and perceived exertion (p = 0.003) was observed at follow up for the intervention group compared to the reference group. Moreover, for the intervention group a significantly improved self-rated work ability (p = 0.040) was reported. Finally, opting to wear prismatic spectacles during dental work appeared to have a preventive effect on neck pain.

Conclusions

Dental personnel opting to wear prismatic spectacles reduced their neck pain significantly more at follow up compared with the reference group. These results are worthwhile testing in a randomised design. The practical implication of this study is that recommendations regarding ergonomics for dental professionals may include the use of prismatic glasses, both as primary and secondary prevention of work-related neck pain. Such glasses should also be tested in other working situations where the work tasks include high visual demands in sustained awkward neck postures.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-016-1145-1) contains supplementary material, which is available to authorized users.