Work-related musculoskeletal complaints and ergonomic risk factors among Egyptian anesthesiologists: a cross-sectional study

BACKGROUND

Anesthesiologists are vulnerable to work-related musculoskeletal disorders (WMSDs) due to sustained repetitive movements and awkward postures. This study aimed to assess the prevalence of WMSDs among anesthesiologists and to evaluate its association with ergonomic risk factors.

METHODS

A convenience sample of 380 Egyptian anesthesiologists were invited to participate in this cross-sectional study through an electronic questionnaire. Data were collected from May to August 2022 and involved questions about participants' demographic, health, and work-related characteristics; the ergonomic risks and perceived hazards; and the musculoskeletal complaints during the past 12 months and 7 days - using Nordic Musculoskeletal Questionnaire (NMQ). Descriptive, bivariate, and multivariate statistical analyses were used to estimate the prevalence of MSD and identify its determinants in the studied sample.

RESULTS

A total of 215 anesthesiologists were included in this study, with a 56.8% response rate, 66% males with an average age of 38 (± 0.7) years. 21% were resident physicians, 47% were specialists, and 32% were consultants. The 12-month prevalence of MSD among anesthesiologists was 71.6% (95% CI: 65.6- 77.7%). Multivariate analysis showed that the main determinants of MSD among the studied sample were age of 45-years and older (OR: 3.22, 95% CI: 1.21-8.52, p = 0.018), regular physical exercise (OR: 0.25, 95% CI: 0.10-0.65, p = 0.005), insufficient rest time between procedures (OR: 2.25, 95% CI: 1.15-4.41, p = 0.018), and three or more awkward postures of the trunk (OR: 3.55, 95% CI: 1.43-8.82, p = 0.006).

CONCLUSIONS

The study highlights a high prevalence of WMSDs among Egyptian anesthesiologists, linked to advancing age, lack of regular exercise, insufficient rest between procedures, and frequent awkward postures. Addressing these ergonomic risk factors through targeted workplace interventions is crucial for promoting the overall well-being of anesthesiologists and ensuring the provision of safe anesthesia services.

Musculoskeletal Injury Concealment in the Reserve Officers' Training Corps: A Survey of Cadets' Reporting Behaviors

BACKGROUND

Among service members, musculoskeletal injuries threaten military readiness and place a substantial burden on medical and financial resources. Emerging research suggests that service members regularly conceal injuries, especially in training environments. The Reserve Officers' Training Corps (ROTC) is a critical training environment for future U.S. military commissioned officers. Training activities expose cadets to a high risk of injury while in the ROTC. The purpose of this study was to explore injury-reporting behaviors in cadets and factors associated with injury concealment.

MATERIALS AND METHODS

We invited Army, Air Force, and Naval cadets from six host universities participating in officer training to complete an online, self-reported survey regarding injury reporting and concealment. Cadets answered questions about pain or injuries experienced during officer training. Survey questions pertained to an injury's anatomic location, onset, severity, functional limitations, and whether or not the injury had been reported. Cadets also selected factors that influenced the decision to report or conceal injuries from predetermined lists in a "choose any" fashion. A series of χ2 tests of independence compared the relationship between injury reporting and other injury characteristics for each individual injury.

RESULTS

One hundred fifty-nine cadets (121 Army, 26 Air Force, and 12 Naval) completed the survey. Eighty-five cadets disclosed a total of 219 injuries. Two-thirds of injuries (144/219) were concealed. Twenty-six percent of participants (22/85) reported all injuries, whereas the remainder (63/85, 74%) had at least one concealed injury. In relation to injury reporting/concealment, there was a weak association with injury onset (χ21 = 4.24, P = .04, V = 0.14), a moderate association with anatomic location (χ212 = 22.64, P = .03, V = 0.32), and relatively strong associations with injury severity (χ23 = 37.79, P < .001, V = 0.42) and functional limitations (χ23 = 42.91, P < .001, V = 0.44).

CONCLUSIONS

Two-thirds of injuries went unreported in this sample of ROTC cadets. Functional limitations, symptom severity, and injury onset may be the largest factors that influence the decision to report or conceal musculoskeletal injuries. This study establishes the foundation for researching injury reporting in cadets and adds to the existing military evidence on the topic.

Effects of sex and age on work-related upper extremity musculoskeletal disorders in Ontario, Canada

BACKGROUND

Effective targeting of workplace upper extremity musculoskeletal disorder (MSD) prevention strategies requires the identification of demographic groups most at risk. Workers' compensation data provides an effective means of surveillance of MSDs at the population level.

OBJECTIVE

The primary purpose of this study was to identify the effects of age and sex on rates of tendon injuries of the wrist and hand, carpal tunnel syndrome (CTS), epicondylitis, and soft tissue shoulder injuries in Ontario, Canada between 2000-2019 using workers' compensation data from the Association of Workers Compensation Boards of Canada (AWCBC).

METHODS

Age and sex specific rates of lost-time injury claims from the four identified injury categories as well as "non-specific" upper extremity MSDs which did not fit into the four categories were calculated by standardizing injury claim totals with "at-risk" population estimates from the Canada Labour Force Survey. A multiple regression analysis was used to analyze the effects of age and sex on rates of specific injury claims.

RESULTS

Statistically significant age and sex effects were identified for rates of claims from tendon injuries of the wrist and hand, CTS, and shoulder injuries, while only age effects were significant for epicondylitis. Between 2000-2019, rates of claims from the four injury categories studied and the magnitude of the age and sex effects declined substantially over time.

CONCLUSION

Detailed surveillance of workplace ergonomic hazards in Ontario workplaces is needed to determine what is causing rates of upper extremity claims to decline.

The potential association of musculoskeletal pain with presenteeism and work engagement among intensive care unit nurses: a cross-sectional study

Aim: Work-related musculoskeletal disorders and associated musculoskeletal pain among intensive care nurses are important, as these factors may be related to presenteeism and work engagement. The aim of this study was to investigate the potential association of musculoskeletal pain with presenteeism and work engagement among intensive care nurses. Material and Method: This descriptive study was carried out with members of the Turkish Society of Critical Care Nurses. All the participants completed a questionnaire, which included questions about general demographic data and occupational musculoskeletal exposures (Occupational Safety and Health Administration [OSHA] Ergonomic Assessment Checklist). To measure pain, work engagement and presenteeism, the following instruments were used: The Brief Pain Inventory Short Form (BPI SF), Utrecht Work Engagement Scale (UWES-17) and Stanford Presenteeism Scale-6 (SPS-6). This study was performed in 2021, and the questionnaire was distributed via email to the database of Turkish Society of Critical Care Nurses. Results: Our study was completed with 153 intensive care unit nurses. Among the study population, 76.5% (n=117) of the nurses had chronic musculoskeletal pain, 80% of whom had exposure to lifting heavy weights. There was a weak negative correlation between pain and work engagement, as shown by the BPI SF pain interference subscale and the vigour subscale of the UWES-17 (p=0.04, r=-.166). There was also a weak negative correlation between pain and presenteeism according to the BPI SF pain interference subscale and SPS-6 (p=0.04, r=-.193). There was no statistically significant association between workplace ergonomic exposures, presenteeism, work engagement and the presence of chronic musculoskeletal pain. Conclusion: Neither chronic musculoskeletal system pain nor pain intensity was significantly correlated with work engagement, occupational musculoskeletal exposures or presenteeism. However, musculoskeletal pain-related effects on daily activities of living had a negative impact on work engagement (vigour) and presenteeism.

Prevalence of and prevention for work-related upper limb disorders among physical therapists: a systematic review

Background

Physical therapists (PTs) are at increased risk for development of work-related upper limb disorders (WRULDs) due to the physically intensive, constant hands-on nature of the profession. The objectives of this systematic review were to examine the literature on WRULDs among PTs, specifically the (1) 1-year prevalence, (2) workplace risk factors, (3) consequences, and (4) coping strategies utilized to mitigate WRULDs.

Methods

A comprehensive search of the literature was performed using PubMed, CINHAL, EMBASE, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for conducting this systematic review. Studies that reported the 1-year prevalence of WRULDs among PTs, workplace risk factors for WRULDs, consequences of WRULDs, and coping strategies utilized by PTs were included.

Results

Twelve studies met the inclusion criteria. The 1-year WRULDs prevalence rates varied widely, with thumb disorders having the highest prevalence (7.6-52.5%), followed by wrist and hand disorders (5-66.2%), shoulder disorders (3.2-45.2%), and elbow disorders (4-16%). Reported risk factors included treating a high volume of patients and frequent performance of manual therapy techniques. Consequences included interference with PTs’ personal and professional activities while coping strategies involved alterations to the work environment, techniques used, and workload.

Conclusions

WRULDs remain a persistent threat to the PT workforce, likely due to the hands-on, physically intensive nature of professional activities. An essential strategy to reduce WRULDs is to improve clinicians’ awareness of WRULDs, workplace risk factors, and subsequent consequences of WRULDs. Effective coping strategies are critical to preserve, protect, and prolong PTs’ use of the upper limbs.

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study

BACKGROUND

Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs.

METHODS

By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure.

RESULTS

Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively.

CONCLUSIONS

Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.

Perceived Stress and Low-Back Pain Among Healthcare Workers: A Multi-Center Prospective Cohort Study

Objective: This study aimed to investigate the association between perceived stress and odds of low-back pain (LBP) in a population of Danish healthcare workers.

Methods: Utilizing a prospective cohort design with 1-year follow-up, a total of 1,944 healthcare workers from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health, and working environment. Using Cohen's Perceived Stress Scale, associations between baseline stress levels and LBP intensity (0–10 scale) at follow-up were modeled using cumulative logistic regression, accounting for clustering at the department level and adjusting for age, sex, baseline intensity of LBP, education, seniority, number of daily patient transfers, psychosocial work environment, and lifestyle factors.

Results: For the entire population, moderate and high stress (reference: low stress) at baseline increased the odds of LBP at 1-year follow-up with odds ratios (ORs) of 1.39 (95% CI 1.13–1.71) and 1.99 (95% CI 1.49–2.66), respectively. Sensitivity analyses among female nurses showed similar results [i.e., OR 1.40 (95% CI 1.08–1.80) and OR 2.08 (95% CI 1.44–3.00) for moderate and high stress, respectively], while only high stress significantly increased the odds among those without LBP at baseline.

Conclusions: Psychological stress increases the odds of LBP among healthcare workers. Identifying and diminishing work-related psychosocial stressors should be included in strategies that aim to prevent musculoskeletal disorders in this population.

Occupational differences in workers' compensation indemnity claims among direct care workers in Minnesota nursing homes, 2005-2016

BACKGROUND

Nursing assistants have one of the highest injury rates in the U.S., but few population-based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes.

METHODS

Indemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling.

RESULTS

Indemnity claim rates were 3.68, 1.38, and 0.69 per 100 full-time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31-2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47-2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement.

CONCLUSIONS

CNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.

Poor Sleep Is a Risk Factor for Low-Back Pain among Healthcare Workers: Prospective Cohort Study

This study aimed to investigate the association between poor sleep and risk of low-back pain (LBP) in healthcare workers. Using a prospective cohort design with 1-year follow-up, a total of 1955 healthcare workers (60% nurses) from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health, and working environment. Associations between sleep scores (0-100) at baseline and LBP intensity (0-10) at follow-up were modelled using cumulative logistic regression accounting for clustering at the department level and adjusted for lifestyle and psychosocial confounders. In the full population of healthcare workers, 43.9% and 24.4% experienced moderate and poor sleep, respectively. In the fully adjusted model with good sleep as reference, moderate, and poor sleep increased the risk of LBP at follow-up, with odds ratios (OR's) of 1.66 (95% confidence interval (CI) 1.35-2.04) and 2.05 (95% CI 1.57-2.69), respectively. Three sensitivity analyses including healthcare workers free from LBP, nurses, and nurses free from LBP at baseline, respectively, yielded similar results. In conclusion, poor sleep constitutes a potent risk factor for LBP among healthcare workers. The presented results provide strong incentives to evaluate and weigh current prevention policies against an updated biopsychosocial framework.

Design and ergonomic assessment of an infusion set connector tool used in nursing work

Nursing is a physically demanding job characterized by a high prevalence of fatigue and musculoskeletal disorders. One of the high-exertion and repetitive nursing tasks is the manual connection of an infusion set to a medical fluid bottle. Such physical work can be eased by the design of new hand tools. Correspondingly, this study designed and ergonomically assessed an infusion set connector tool (ISCT) and compared it with that of manual connection. First, a prototype of ISCT was designed to perform infusion set connecting task in the mechanical form. Subsequently, 12 nurses were asked to connect an infusion set to medical bottle in the form of manual and mechanical tasks and these tasks were evaluated using ergonomic indices including muscular activity level, force, posture, and subjective (Borg scale CR10) measures. Results showed that the activity levels (root mean square) of the extensor digitorum communis, flexor carpi radialis, biceps, triceps, and deltoid muscles remarkably decreased when the nurses used the ISCT. The postures of the wrist, arm, and shoulder regions were corrected from Rapid Upper Limb Assessment action level 3 to 2 when the designed tool was used. Additionally, the subjective perception of exertion was significantly lower with the use of the prototype.

Enhancing the detection of injuries and near-misses among patient care staff in a large pediatric hospital

Objectives Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. Methods Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks. This sample-based active injury surveillance was then integrated into an institutional surveillance system (ISS) centered on passive data collection initiated by employee reports. Results Injuries reported using DVR during two-week intervals from February 2014 to July 2015 were 40.7 times more frequent than what would be expected on the basis of the usual ISS reports. Psychological injuries (eg, stress, conflict) and near-misses were captured at a rate of 16.1 per 1000 days [95% confidence interval (CI) 14.1-18.3] and 35.6 per 1000 days (95% CI 32.7-38.8), respectively. Finally, 68% (95% CI 65-72%) of participants preferred using DVR either as an alternative or complement to the existing ISS. Conclusions This study showed that it is feasible to improve injury surveillance in a healthcare establishment by integrating active data collection based on voice recording within a passive injury surveillance system. Enhanced surveillance provides richer information that can guide the development of effective injury prevention strategies.

The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses

The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers' compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses (n = 1114) from 11 hospitals. Valid responses (n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals' occupational health and safety is necessary.

Underreporting trends of occupational illnesses in Mexico

Objective:

To report trends underreporting levels of occupational illnesses (OI) in Mexico from 2000 to 2015.

Methods:

An ecological study was conducted. Data on OI was obtained from the Statistical Memories of the Mexican Institute of Social Security. We used univariate sensitivity analysis to estimate the average value and range.

Results:

During the 2000-2015 period, the estimated average OI underreporting in the Mexican population was 89.1%; the minimum was 81.8% in 2015 and the maximum 95% in 2007, with an annual decrement rate of 1% (p<0.05) was observed from 2007 to 2015.

Conclusions:

Important changes to improve reporting of OI have taken place since 2007, most likely due to the implementation of new policies in this matter. Even though the OI report in Mexico is higher than what the World Health Organization estimates for Latin America (18% in 2015), activities to address this problem remain insufficient. Furthermore, it is important to evaluate the current process of identification and registration of OI in order to identify those that need reinforcement, to guarantee adherence to regulations, to consolidate training systems, and importantly, to develop the governing capacity of the sanitation and labor authorities to exercise their coordinating and regulatory functions.

Underreporting of Musculoskeletal Injuries in the US Army: Findings From an Infantry Brigade Combat Team Survey Study

Background:

Musculoskeletal injury is a significant threat to readiness in the US Army. Current injury surveillance methods are constrained by accurate injury reporting. Input into electronic medical records or databases therefore may not accurately reflect injury incidence. The purpose of this study was to evaluate injury reporting among active-duty US Army soldiers to explore potential limitations of surveillance approaches.

Hypothesis:

A significant number of injuries go unreported to medical personnel.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Surveys were completed by soldiers assigned to an Army Infantry Brigade Combat Team. Survey questions inquired about injuries sustained in the previous 12 months, injury onset, and whether injuries were reported to a medical provider. Participants were asked to rank reasons for accurately reporting, underreporting, and/or exaggerating injuries. Chi-square analyses were used to compare differences among underreported injuries in terms of injury onset (gradual vs acute) and sex.

Results:

A total of 1388 soldiers reported 3202 injuries that had occurred in the previous 12-month period, including 1636 (51%) that were reported and 1566 (49%) that were identified as not reported to medical personnel. More than 49% of reported injuries were described as acute and 51% were described as chronic. Injury exaggeration was reported by 6% of soldiers. The most common reasons for not reporting injuries were fear that an injury might affect future career opportunities and avoidance of military “profiles” (mandated physical restrictions).

Conclusion:

Approximately half of musculoskeletal injuries in a Brigade Combat Team were not reported.

Clinical Relevance:

Unreported and untreated injuries can lead to reinjury, chronic pain, performance decrements, and increased costs associated with disability benefits. Additionally, unreported injuries can undermine injury surveillance efforts aimed at reducing the musculoskeletal injury problem in the military.

Musculoskeletal Injury Prevention for New Nurses

Nurses continue to sustain musculoskeletal injuries even with increased emphasis on safe patient handling and mobility (SPHM) and organizational cultures of safety to protect health care workers. Analysis of data from 2011-2014 registered nurse graduates explored hospital safety culture, SPHM education/training, and incidence of new-nurse musculoskeletal injury. Results indicated hospitals provided some type of SPHM education and training, but 46% of study participants were not informed or aware of national SPHM standards or guidelines. Merely 13.9% of participants stated a written “no manual lifting policy” had been implemented; only 32.9% indicated staffing was adequate for SPHM tasks; and only 39.4% stated the hospital had all of the equipment needed to perform SPHM safely. Thirty-nine percent of participants had already sustained a musculoskeletal injury with an additional 35% sustaining but not reporting an injury. More actions are needed to ensure a decrease in musculoskeletal injuries for new nurses.

Allied Health Professionals and Work-Related Musculoskeletal Disorders: A Systematic Review

Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.

Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare

Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive. This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses' perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study. Thematic analysis revealed an overarching theme of 'power relations' with a subcategory of '(mis)power' that comprised two subthemes, these being 'how to practice' and 'voicing practice issues'. Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the sociopolitical context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments.

Understanding the hospital sharps injury reporting pathway

BACKGROUND

Patient-care workers are frequently exposed to sharps injuries, which can involve the risk of serious illness. Underreporting of these injuries can compromise prevention efforts.

METHODS

We linked survey responses of 1,572 non-physician patient-care workers with the Occupational Health Services (OHS) database at two academic hospitals. We determined whether survey respondents who said they had sharps injuries indicated that they had reported them and whether reported injuries were recorded in the OHS database.

RESULTS

Respondents said that they reported 62 of 78 sharps injuries occurring over a 12-month period. Only 28 appeared in the OHS data. Safety practices were positively associated with respondents' saying they reported sharps injuries but not with whether reported injuries appeared in the OHS data.

CONCLUSIONS

Administrators should consider creating reporting mechanisms that are simpler and more direct. Administrators and researchers should attempt to understand how incidents might be lost before they are recorded.

Postural biomechanical risks for nursing workersRiscos biomecânicos posturais em trabalhadores de enfermagem

Introduction In the hospital environment, several types of professionals must be involved in continuous working shifts, under working conditions that are often unsatisfactory. Objective The objective of the present study was to analyze the biomechanical risk factors for work-related musculoskeletal disorders (WRMD). Material and methods This was a cross-sectional, exploratory, descriptive and quantitative study and its analysis considered 15 workers, in three shifts. A questionnaire containing personal information and general data regarding the work environment was applied. The REBA protocol was used for posture assessment, once the workers were recorded while performing their activities. The results were presented descriptively. Results In light of the results obtained, the working day was found excessive, particularly considering the weekly frequency and period of time of the working shifts. The REBA protocol showed that the positions adopted presented high risk for the development of WRMD in all nine activities evaluated. Conclusion The nursing activities were characterized as stressful for the workers involved.

Work-Related Injuries in Canadian Occupational Therapy Practice

Background. No studies investigate work-related injuries experienced by Canadian occupational therapists.Purpose. To identify the nature and prevalence of work-related injuries, impact of practice context, cultural and structural factors that influence response to these injuries, and strategies used to manage return-to-work after injury.Methods. Members of the Canadian Association of Occupational Therapists were sent an electronic survey in June 2009.Findings. Over half of the 600 respondents reported at least one injury episode. Patient-handling and equipment-related incidents accounted for the largest proportion of injuries. Almost one-third of respondents reported being threatened at work or experiencing workplace violence.Implications. Injured occupational therapists tended to minimize the extent and impact of their injuries by underreporting incidents and continuing to work after injury. These behaviours may contribute to a failure to recognize the reality of work-related injuries in occupational therapy practice and thereby limit the development of profession-specific, risk-minimization strategies.

It’s not about the hoist: A narrative literature review of manual handling in healthcare

The manual handling of people and objects is integral to the provision of nursing care to patients globally. Despite over 30 years of research intended to guide improvements for nurses’ safety, substantial rates of manual handling injuries persist internationally within the nursing profession. This paper reviews the contemporary international literature regarding manual handling interventions noting the unique context for injury prevention strategies within healthcare. The review includes the recognition of underlying assumptions inherent in the conceptualisation of manual handling and its management, and the preponderance of the post-positivist paradigm in this field.

The complexity of manual handling in healthcare has resulted in a theoretical shift from single factor interventions based on technique training towards an emerging multidimensional approach. However the key elements for sustainable solutions to reduce nurses’ manual handling injuries have not yet been identified and consensus is lacking regarding the implementation and appropriate evaluation of injury prevention programmes. Furthermore, whilst the literature is replete with data derived from surveys or insurance industry records of compensation claims, there is a dearth of literature exploring nurses’ manual handling experiences. The in-depth investigation of nurses’ perspectives on manual handling may uncover new knowledge critical to improvement of the manual handling issues.

Occupational injuries among nurses and aides in a hospital setting

BACKGROUND

Patient care workers in acute care hospitals are at high risk of injury. Recent studies have quantified risks and demonstrated a higher risk for aides than for nurses. However, no detailed studies to date have used OSHA injury definitions to allow for better comparability across studies.

METHODS

We linked records from human resources and occupational health services databases at two large academic hospitals for nurses (n = 5,991) and aides (n = 1,543) in patient care units. Crude rates, rate ratios, and confidence intervals were calculated for injuries involving no days away and those involving at least 1 day away from work.

RESULTS

Aides have substantially higher injury rates per 100 full-time equivalent workers (FTEs) than nurses for both injuries involving days away from work (11.3 vs. 7.2) and those involving no days away (9.9 vs. 5.7). Back injuries were the most common days away (DA) injuries, while sharps injuries were the most common no days away (NDA) injuries. Pediatric/neonatal units and non-inpatient units had the lowest injury rates. Operating rooms and the float pool had high DA injury rates for both occupations, and stepdown units had high rates for nurses. NDA injuries were highest in the operating room for both nurses and aides.

CONCLUSIONS

This study supports the importance of a continuing emphasis on preventing back and sharps injuries and reducing risks faced by aides in the hospital setting. Uniform injury definitions and work time measures can help benchmark safety performance and focus prevention efforts.

Occupational injuries to Oregon workers 24 years and younger: An analysis of workers' compensation claims, 2000-2007

BACKGROUND

Occupational injuries to adolescents and young adults are a known public health problem. We sought to describe and estimate rates of occupational injuries to workers younger than 25 years of age in Oregon during an 8-year period.

METHODS

Oregon workers' compensation disabling claims data (n = 23,325) and one commercial insurance carrier's non-disabling claims data (n = 16,153) were analyzed. Total employment from the Local Employment Dynamics of the U.S. Census Bureau and the Oregon Labor Market Information System was used as a denominator for rates.

RESULTS

Injuries were more frequent among 22-24 year olds and among males, though females accounted for a higher proportion of claims in the youngest age group. The most common injury type was a sprain or strain, but lacerations and burns were more frequently reported in the 14-18 year olds. When non-disabling claims were included, the rate of injury for 14-18 year olds doubled. The overall rate of injury was 122.7/10,000 workers, but was higher in the construction, manufacturing, and transportation sectors, and in the agriculture, forestry, fishing, and hunting sector for older teens and young adults.

CONCLUSIONS

Young workers continue to be at risk for occupational injuries. Our results show that specific interventions may be needed for older teen and young adult workers to reduce their rate of injury.

Nurses' and therapists experiences with occupational musculoskeletal injuries

Occupational musculoskeletal injuries are costly to the health care industry. It is estimated that 12% of nurses leave the profession annually because of back injuries. With the use of grounded theory methodology, 15 nursing personnel and physical therapists were interviewed about their perceptions of occupational musculoskeletal injuries. Analysis of the data identified major themes, including feelings of fear and frustration; chronic issue and part of the job; love of the profession and concerns about continuing in the profession; increased risk of injury; compliant with treatment; negative impact on quality of life; negative feelings about the occupational health department; and educational needs. A theory began to emerge in which health care workers accepted occupational injuries as part of the job and took no action or initiated only minor interventions to prevent work-related injuries. The study indicates a need for education and better communication.

Risks and causes of musculoskeletal injuries among health care workers

BACKGROUND

Musculoskeletal injuries (MSIs) persist as the leading category of occupational injury in health care. Limited evidence exists regarding MSIs for occupations other than direct patient care providers. An evaluation of the risks, causes and activities associated with MSIs that includes non-patient care health care occupations is warranted.

AIMS

To examine the risks and causes of time-loss MSIs for all occupations in health care.

METHODS

Workers employed by a health region in British Columbia were followed from April 2007 to March 2008 using payroll data; injuries were followed using an incidence surveillance database. Frequency and rates were calculated for all occupational injuries and MSIs and relative risks (RRs) were computed using Poisson regression. Causes and occupational activities leading to MSIs were tabulated for direct care occupations and non-patient care occupations.

RESULTS

A total of 944 injuries resulting in time-loss from work were reported by 23 742 workers. Overall, 83% injuries were musculoskeletal. The two occupations showing highest RR of MSIs relative to registered nurses were facility support service workers [RR = 3.16 (2.38-4.18), respectively] and care aides [RR=3.76 (3.09-4.59)]. For direct patient care occupations, the leading causes of MSIs were awkward posture (25%) and force (23%); for non-patient care occupations were force (25%) and slip/fall (24%). Patient handling activities accounted for 60% of all MSIs for direct care occupations. For non-patient care occupations, 55% of MSIs were due to material/equipment handling activities.

CONCLUSIONS

Prevention efforts for MSIs should be directed to non-patient care occupations as well and consider their occupation-specific causes and activities.