Profiling lower extremity injuries sustained in a state police population: a retrospective cohort study

The Effect of Anthropometric Shoes on Lactic Acid Reduction in Nurses: A Mixed-Methods Study from Indonesia

Background

The mobilization characteristics of nurses' work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses' feet.

Purpose

This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital.

Methods

This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis.

Results

This mixed-method study shows that anthropometric shoes can reduce nurses' lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain.

Conclusion

The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.

Occupational injuries and illnesses among law enforcement officers, 2001-2019: Findings from the Ohio Bureau of Workers' Compensation

BACKGROUND

Occupational injuries are common among law enforcement officers (LEOs) and can impact an agency's ability to serve communities. Workers' compensation (WC) data are an underutilized source for occupational injury surveillance in the law enforcement field.

METHODS

LEOs WC claims from the Ohio Bureau of Workers' Compensation (OHBWC) from 2001 to 2019 were identified based on manual review of the occupation title and injury description. Worker, employer, incident, and injury characteristics were described by claim type-medical-only (MO) and lost-time (8 or more days away from work). Data are presented using injury claim counts.

RESULTS

From 2001 to 2019, 50,793 WC claims were identified among Ohio LEOs. Of these, 68% were MO claims (n = 34,622). WC claims significantly decreased over the 19-year period (p < 0.001). Seventy-five percent of WC claims were from a LEO with more than one claim and of these, 34% were from a LEO with five or more claims during the study period. Male officers and those aged 25-54 years incurred the highest proportion of total claims (87.8% & 91.8%, respectively). Violence (n = 17,247; 34%), falls/slips/trips (n = 9079; 17.9%), and transportation events (n = 7977; 15.7%) were the leading events. Among the 50,793 claims, there were 79,637 unique clinical diagnosis groups. The most common injury diagnoses were sprains (n = 32,796; 41.2%) followed by contusions (n = 13,529; 17%).

CONCLUSIONS

Results can guide the development or improvement of workplace injury prevention strategies for LEOs. Efforts should be focused on better understanding and preventing violent injury events and sprains among LEOs, as well as preventing multiple injury events.

Common law enforcement load carriage systems have limited acute effects on postural stability and muscle activity

Law enforcement officers are inherently at a high risk of injury and the loads they must carry during their occupational duties further increase their injury risk. It is unknown how different methods of carrying a law enforcement officer's load influence factors related to injury risk. This study assessed the effects of common law enforcement load carriage systems on muscular activity and postural stability while standing. Twenty-four participants performed single and dual-task (i.e. concurrent performance of cognitive tasks) standing while wearing a duty belt, tactical vest, and no load. The postural stability and muscle activity were measured and effects of condition and task examined. Dual task standing decreased postural stability and increased muscular activity. The belt and vest (7.2 kg each) increased muscle activity compared to control for the right abdominals, low back, right thigh. The duty belt resulted in less muscle activity in the right abdominals but more muscle activity in the left multifidus compared to the control. The findings indicate that common law enforcement load carriage systems increase muscular activity but do not affect postural stability. However, the lack of differences between the duty belt and tactical vest did not provide clear support for one load carriage system versus the other.

Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers

Mounted police officers are subject to unique occupational tasks which may lead to unique injuries. This study's aim was to describe policing injuries suffered by mounted police officers contextualized through comparison to non-mounted officers. Injury data from 01 July 2014 to 30 June 2020 were provided from a state policing agency's incident reporting database. The data reported the numbers and rates of injuries and classified the injuries by gender, cause, mechanism, nature, and hours worked. Of the 35,406 reported injuries, 35,255 (99.6%) injuries were reported by non-mounted police officers. An annual incidence rate of 338-364 and 626-952 injuries per 1000 personnel were reported in non-mounted and mounted police, respectively. For mounted police, the leading causes of injuries were slips, trips, and falls (23.8%), followed by repetitive tasks and movements (9.9%). Physical assault was the leading cause of injury for non-mounted police officers (21.3%), followed by slips, trips, and falls (16.0%). In mounted police, falls from heights (15.9%) and repetitive tasks and movements (10.6%) comprised the most frequently specified mechanisms of injury, as compared to physical assault (21.0%) and physical exercise (5.2%) in non-mounted police. The most common activities being performed at the time of injury for mounted police were animal handling (64.9%) as opposed to arresting an offender (31.2%) for non-mounted police. Sprains and strains and bruises and swelling were the leading natures of injuries among both mounted (44.4% and 29.1%, respectively) and non-mounted (36.6% and 21.2%, respectively) officers. The leading body sites of injury in mounted officers were the lower back (13.9%) and neck and shoulders (7.3% each), and for non-mounted police, the knee (13.9%), lower back (10.0%), and hand (8.2%) were the most common. Mounted police officers sustained injuries through different activities, causes, and mechanisms and to different body sites at 2-3 times higher incidence rates. Mounted police officers warrant specifically tailored injury mitigation and return-to-work strategies.

The Impact of Footwear on Occupational Task Performance and Musculoskeletal Injury Risk: A Scoping Review to Inform Tactical Footwear

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).

Profiling the injuries of law enforcement recruits during academy training: a retrospective cohort study

Background

Injuries within law enforcement are a significant issue as they increase organisational costs and workforce strain. As one of the biggest risk factors of future injury is previous injury, minimising injuries suffered during academy has multiple beneficial and long-term effects, including a healthier and fitter police force. The purpose of this study was to profile the injuries sustained at a law enforcement academy to inform future injury mitigation strategies.

Methods

Injury data were provided retrospectively (from May 2012 to September 2019) from the official insurance records of a law enforcement academy and included nature, location, and activity performed at time of injury. A total of 4340 (3288 males, 938 females, 114 sex not stated) recruits participated in academy training during this period. Inclusion criteria for the data were (a) injury record related to a recruit, and (b) the recruit was injured during academy training., with injury defined as tissue damage caused by acute or repetitive trauma, inclusive of musculoskeletal, neural, and/or integumentary systems but excluding general medical conditions such as cardiac (e.g. heart attacks) or respiratory (asthma) that was subsequently reported for worker’s compensation. Injury incidence rates and proportions were calculated and a Spearman’s correlation analysis was conducted between injury rates over successive classes.

Results

An injury incidence rate of 368.63 injuries per 1000 recruits per year was calculated in this population, with a moderate correlation coefficient (r_s = 0.60) of increasing injury rates over chronologically occurring classes. Females also had higher injury rates than male recruits, even across various fitness levels. Trauma to joints and ligaments (49.30%) was the most common injury, and the knee the most common location (23.17%) of injury. Physical training (56.10%) was the most common activity being performed at the time of injury.

Conclusions

This research demonstrates a large number of lower limb, musculoskeletal injuries that often occur during physical training. Further research is needed to assess suitable injury mitigation programs.

The Effects Aerobic Fitness has on Heart Rate Responses for a Custody Assistant Recruit Class Performing a Formation Run

This study measured the heart rate (HR) responses to a formation run (group run completed along a set route) performed by higher fitness (HF), moderate fitness (MF), or lower fitness (LF) custody assistant (CA) recruits. Retrospective data from 26 recruits (12 males, 14 females) were analyzed. Prior to academy training, a YMCA step test was administered. Recruits were divided into three groups based on recovery HR: top 25% were HF; bottom 25% were LF; the rest were MF. Recruit HR was measured during a formation run completed at an ~11-minute mile · pace^-1. HR zones were defined as: very light (< 57% of age-predicted maximum heart rate [HR_max]); light (57%-63% HR_max); moderate (64%-76% HR_max); vigorous (77%-95% HR_max); and very vigorous (> 95% HR_max). A one-way ANOVA, with Bonferroni post hoc, calculated between-group differences in time spent and percentage of total time in the HR zones during the run; effect sizes (d) were also calculated. HF recruits spent a significantly longer time and percentage of total time in the very light HR zone compared to the LF group (p ≤ 0.039; d = 1.20-1.35). There were no other significant between-group differences (p = 0.070-0.980). HF CA recruits spent more time in the very light training zone compared to the other groups (d = 0.92-1.35), which may not be optimal for aerobic adaptations. LF recruits spent more time in the vigorous-to-very vigorous HR zones (~45 minutes; 70% of the run). These recruits may potentially be working above their current capacity. Formation runs may not be the most efficient aerobic conditioning method for all CA recruits.