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Laird I, McIntyre J, Borman B, Adank R, Ashby L. A New Zealand regional work-related sprains and strains surveillance, management and prevention programme: study protocol. BMC Musculoskelet Disord 2022; 23:1143. [PMID: 36585677 PMCID: PMC9803593 DOI: 10.1186/s12891-022-06094-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The impact and costs associated with work-related sprains and strains in New Zealand and globally are substantial and a major occupational and public health burden. In New Zealand around one-third of all sprains and strains workers compensation (ACC) claims (2019) are for back injuries, but shoulder and arm injuries are increasing at a faster rate than other sprain and strain injuries (ACC, 2020). A need exists for a change to current approaches to sprains and strains prevention, to more effectively manage this significant and persistent problem in workplaces. Designing out hazards is one of the most effective means of preventing occupational injuries and illnesses. This paper outlines the study protocol of the surveillance, management and prevention programme and describes the utilisation of prevention through design principles in the prevention of work-related sprains and strains in agriculture/horticulture/food production in the Hawkes Bay region of New Zealand. METHODS This is a prospective mixed methods study incorporating the collection of quantitative data to describe the epidemiology of work related sprains and strains injuries presenting to the regional health centre (Hastings Health Centre) over a period of 24 months and qualitative data from participants presenting at the health centre to identify high risk industry sectors/ occupations/ workplaces and tasks and design, develop and apply prevention through design principles/ solutions/interventions to critical features of the work and work environment and undertake an outcome evaluation during the last 6 months of the project. DISCUSSION The purpose of this project is to establish an epidemiological surveillance programme to assess the incidence and prevalence of work-related sprains and strains according to age, sex, industry sector and occupation to target efforts to prevent work-related sprains and strains, by applying prevention through design (PtD) principles in selected workplaces in agriculture. The collection of more detailed case, occupational and work history data from a sample of patients presenting at the HHC clinic will identify high risk industry sectors/occupations/workplaces and tasks. Assessment techniques will include comprehensive design, design thinking and human factors/ergonomics methodologies through co-design and participatory ergonomics techniques. The PtD solutions/ interventions implemented will be evaluated using a quasi-experimental design consisting of a pre-test/ post-test with-in subjects design with control groups that do not receive the intervention.
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Affiliation(s)
- Ian Laird
- grid.148374.d0000 0001 0696 9806School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | | | - Barry Borman
- grid.148374.d0000 0001 0696 9806Research Centre for Hauora and Health, College of Health, Massey University, Wellington, New Zealand
| | - Rod Adank
- grid.148374.d0000 0001 0696 9806School of Design, College of Creative Arts, Massey University, Wellington, New Zealand
| | - Liz Ashby
- grid.148374.d0000 0001 0696 9806School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
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Bud M, Pricope R, Pop RC, Onaca R, Swerts PJ, Lucaciu O, Delean A. Comparative analysis of preclinical dental students' working postures using dental loupes and dental operating microscope. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:516-523. [PMID: 33180967 DOI: 10.1111/eje.12627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/19/2020] [Accepted: 10/12/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Dentists are susceptible to musculoskeletal disorders due to prolonged static postures during dental treatments. Using a magnification tool like dental operating microscope (DOM) or the dental loupes may correct the operator's posture. Up until now, few studies have focused on preclinical dental students' posture when working with the DOM, while most of them have focused on the loupes. The aim of this study was to comparatively analyse the working posture of preclinical students during a dental restoration procedure, working with two different magnification methods. MATERIALS AND METHODS This study used a randomised cross-over design in which seventeen third year students were randomly divided into three groups. The exclusion criteria were previous contact with magnification systems and previous clinical working experience. Each student prepared 3 Black class 1 cavities on artificial lower molars: first with no magnification, following dental loupes and DOM. They were video-recorded throughout the preparation. Trunk, neck and upper-arm position were evaluated using the Posture Assessment Instrument. Students completed a questionnaire on their subjective perception of the two magnification systems. RESULTS The statistical analysis showed significant improvement of the working posture using magnification systems compared to direct vision. The biggest improvement was obtained through the use of DOM, followed by the dental loupes. Students perceived dental loupes as being the most comfortable and easy to adapt to. They reported being more focused when using DOM. CONCLUSIONS Both magnification systems had a positive impact on the working posture, DOM having the best results. Loupes showed better adaptability while DOM showed better concentration.
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Affiliation(s)
- Marius Bud
- Department of Conservative Odontology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Razvan Pricope
- Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Razvan C Pop
- Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Razvan Onaca
- Faculty of Physical Education and Sport, Babes-Boliay, University of Cluj-Napoca, Cluj-Napoca, Romania
| | | | - Ondine Lucaciu
- Department of Oral Rehabilitation, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Ada Delean
- Department of Conservative Odontology, Faculty of Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
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Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, Hogg-Johnson S, Kristman V, Laberge M, McKenzie D, Newnam S, Palagyi A, Ruseckaite R, Sheppard DM, Shourie S, Steenstra I, Van Eerd D, Amick BC. Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:1-15. [PMID: 28224415 PMCID: PMC5820404 DOI: 10.1007/s10926-016-9690-x] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.
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Affiliation(s)
- K L Cullen
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.
| | - E Irvin
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - A Collie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - F Clay
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - U Gensby
- National Centre for Occupational Rehabilitation, Rauland, Norway
- Team WorkingLife ApS, Copenhagen, Denmark
| | - P A Jennings
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
| | - S Hogg-Johnson
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - V Kristman
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Lakehead University, Thunder Bay, ON, Canada
| | - M Laberge
- University of Montreal and CHU Ste-Justine Research Centre, Montreal, QC, Canada
| | - D McKenzie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - S Newnam
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - A Palagyi
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - R Ruseckaite
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - D M Sheppard
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - S Shourie
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - I Steenstra
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - D Van Eerd
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - B C Amick
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Grayson D, Dale AM, Bohr P, Wolf L, Evanoff B. Ergonomic Evaluation: Part of a Treatment Protocol for Musculoskeletal Injuries. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/216507990505301006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ergonomic analyses and interventions are used as primary prevention methods to reduce physical stressors in the workplace and to prevent work-related musculoskeletal disorders (WMSDs). These methods can also be used for the treatment of injured employees. In this study, 103 employees with WMSDs resulting in more than 5 days away from usual work received an ergonomic evaluation which consisted of observation of usual work tasks, recommendations to minimize identified stressors, and case coordination. The goal of the intervention was to make simple job changes that would assist employees to return safely to usual job duties. The process for implementing this protocol for health care, airline, and university employees is described. The results show that after ergonomic evaluations were performed, the majority of recommendations were fully or partially (89%) implemented. Behavior changes were more likely to occur than administrative and equipment changes (p < .001). Occupational health nurses can use a similar program to enhance treatment plans for clients with WMSDs.
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Affiliation(s)
- Deborah Grayson
- Washington University in St. Louis, General Medical Sciences, St. Louis, MO
| | - Ann Marie Dale
- Washington University in St. Louis, General Medical Sciences, St. Louis, MO
| | - Paula Bohr
- Occupational Therapy Program, Maryville University, St. Louis, MO
| | - Laurie Wolf
- Ergonomic Programs, BJC Corporate Health Services, St. Louis, MO
| | - Bradley Evanoff
- Washington University in St. Louis, General Medical Sciences, St. Louis, MO
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Gaowgzeh RA, Chevidikunnan MF, Al Saif A, El-Gendy S, Karrouf G, Al Senany S. Prevalence of and risk factors for low back pain among dentists. J Phys Ther Sci 2015; 27:2803-6. [PMID: 26504297 PMCID: PMC4616098 DOI: 10.1589/jpts.27.2803] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 06/03/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the prevalence, symptoms of, and risk factors for low back pain among dentists as well as to discover the possible correlation of these factors with working posture and how to reduce their prevalence. [Subjects and Methods] The study was conducted among 60 dentists (28 male and 32 female) with a mean age of 25.7 years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. [Results] The data showed a 70% incidence of back pain among dentists, with low back pain predominating in 47.6% of cases. Most of the subjects (90.5%) had a mild-to-moderate level of severity, and only 9.5% had a severe level of low back pain. The majority of the dentists (57%) treated 1-3 patients per day. Only a few dentists (17%) exercised during their rest period even though 57% of them reported taking a break during their working hours. Although 63% of the dentists were aware of the advantages of assistive tools, only 40% of them used any kind of assistive devices. [Conclusion] Dental professionals demonstrate a high prevalence of low back pain.
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Affiliation(s)
- Riziq Allah Gaowgzeh
- Department of Physical Therapy, Faculty of Applied Medical
Sciences, King Abdulaziz University, Saudi Arabia
| | | | - Amer Al Saif
- Department of Physical Therapy, Faculty of Applied Medical
Sciences, King Abdulaziz University, Saudi Arabia
| | - Salwa El-Gendy
- Department of Physical Therapy, Faculty of Applied Medical
Sciences, King Abdulaziz University, Saudi Arabia
- Kasr Al-Aini Teaching Hospitals, Cairo University,
Egypt
| | - Gamal Karrouf
- King Fahd Medical Research Center, King Abdulaziz
University, Saudi Arabia
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Occupational health and safety surveillance and research using workers' compensation data. J Occup Environ Med 2012; 54:171-6. [PMID: 22237033 DOI: 10.1097/jom.0b013e31823c14cb] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Examine uses of US workers' compensation (WC) data for occupational safety and health purposes. METHODS This article is a summary of the proceedings from an invitational workshop held in September 2009 to discuss the use of WC data for occupational safety and health prevention purposes. RESULTS Workers' compensation data systems, although limited in many ways, contain information such as medical treatments, their costs and outcomes, and disability causes that are unavailable from national occupational surveillance sources. CONCLUSIONS Despite their limitations, WC records are collected in a manner consistent with many occupational health and safety surveillance needs. Reports are available on the use of WC data for surveillance and research purposes such as estimating the frequency, magnitude, severity, and cost of compensated injuries. Inconsistencies in WC data can limit generalization of research results.
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Niu S. Ergonomics and occupational safety and health: an ILO perspective. APPLIED ERGONOMICS 2010; 41:744-753. [PMID: 20347066 DOI: 10.1016/j.apergo.2010.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 03/03/2010] [Indexed: 05/29/2023]
Abstract
The ILO has a mandate to protect workers against sickness, diseases and injuries due to workplace hazards and risks including ergonomic and work organization risk factors. One of the main functions for the ILO is to develop international standards related to labour and work. ILO standards have exerted considerable influence on the laws and regulations of member States. The ILO standards take the form of international Conventions and Recommendations. ILO Conventions and Recommendations relevant to protection of workers against ergonomic risk factors at the workplace include Convention No. 127 and Recommendation No.128 which specify the international requirements concerning the manual transport of a load. To help member States in applying the ILO standards, the ILO produces practical guides and training manuals on ergonomics at work and collects and analyses national practices and laws on ergonomics at the workplace. The ILO also conducts technical cooperation activities in many countries on ergonomics to support and strengthen the capacities of its tripartite constituents in dealing with workplace ergonomic and work organization risks. The ILO's technical cooperation activities give priorities on the promotion of voluntary, participatory and action-oriented actions to improve working conditions and work organizations of the small and medium sized enterprises. This paper reviews ILO's policies and activities on ergonomics in relation to occupational safety and health and prescribes ILO's considerations for its future work on ergonomics.
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Affiliation(s)
- Shengli Niu
- International Labour Organization, Geneva 22, Switzerland.
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Kennedy CA, Amick BC, Dennerlein JT, Brewer S, Catli S, Williams R, Serra C, Gerr F, Irvin E, Mahood Q, Franzblau A, Van Eerd D, Evanoff B, Rempel D. Systematic review of the role of occupational health and safety interventions in the prevention of upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time. JOURNAL OF OCCUPATIONAL REHABILITATION 2010; 20:127-62. [PMID: 19885644 DOI: 10.1007/s10926-009-9211-2] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Little is known about the most effective occupational health and safety (OHS) interventions to reduce upper extremity musculoskeletal disorders (MSDs) and injuries. METHODS A systematic review used a best evidence synthesis approach to address the question: "do occupational health and safety interventions have an effect on upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time?" RESULTS The search identified 36 studies of sufficient methodological quality to be included in data extraction and evidence synthesis. Overall, a mixed level of evidence was found for OHS interventions. Levels of evidence for interventions associated with positive effects were: Moderate evidence for arm supports; and Limited evidence for ergonomics training plus workstation adjustments, new chair and rest breaks. Levels of evidence for interventions associated with "no effect" were: Strong evidence for workstation adjustment alone; Moderate evidence for biofeedback training and job stress management training; and Limited evidence for cognitive behavioral training. No interventions were associated with "negative effects". CONCLUSION It is difficult to make strong evidenced-based recommendations about what practitioners should do to prevent or manage upper extremity MSDs. There is a paucity of high quality OHS interventions evaluating upper extremity MSDs and none focused on traumatic injury outcomes or workplace mandated pre-placement screening exams. We recommend that worksites not engage in OHS activities that include only workstation adjustments. However, when combined with ergonomics training, there is limited evidence that workstation adjustments are beneficial. A practice to consider is using arm supports to reduce upper extremity MSDs.
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Affiliation(s)
- Carol A Kennedy
- The Institute for Work & Health, 481 University Avenue, Toronto, Ontario, Canada.
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Shaw W, Hong QN, Pransky G, Loisel P. A literature review describing the role of return-to-work coordinators in trial programs and interventions designed to prevent workplace disability. JOURNAL OF OCCUPATIONAL REHABILITATION 2008; 18:2-15. [PMID: 18080827 DOI: 10.1007/s10926-007-9115-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 11/26/2007] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Return-to-work (RTW) coordination has been suggested as an effective strategy for preventing workplace disability, but the scope of these services is not well described. The objective of this study was to describe the activities of RTW coordinators in published trials to provide a basis for establishing necessary competencies. METHODS A keyword search of MEDLINE and CINAHL databases was conducted to identify intervention studies with a RTW coordinator providing direct, on-site workplace liaison to reduce work absences associated with physical health ailments. This search yielded 2,383 titles that were inspected by two examiners. Using a stepwise process that allowed for assessment of inter-observer agreement, 90 full articles were selected and reviewed, and 40 articles (22 studies) met criteria for inclusion. RESULTS All but two studies (of traumatic brain injury) focused on musculoskeletal conditions or work injuries. Twenty-nine RTW coordinator activities were identified, but there was variation in the training background, workplace activities, and contextual setting of RTW coordinators. Based on reported RTW coordinator activities, six preliminary competency domains were identified: (1) ergonomic and workplace assessment; (2) clinical interviewing; (3) social problem solving; (4) workplace mediation; (5) knowledge of business and legal aspects; and (6) knowledge of medical conditions. DISCUSSION Principal activities of RTW coordination involve workplace assessment, planning for transitional duty, and facilitating communication and agreement among stakeholders. Successful RTW coordination may depend more on competencies in ergonomic job accommodation, communication, and conflict resolution than on medical training.
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Affiliation(s)
- William Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
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10
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Pillastrini P, Mugnai R, Farneti C, Bertozzi L, Bonfiglioli R, Curti S, Mattioli S, Violante FS. Evaluation of two preventive interventions for reducing musculoskeletal complaints in operators of video display terminals. Phys Ther 2007; 87:536-44. [PMID: 17405805 DOI: 10.2522/ptj.20060092] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to evaluate the efficacy of a preventive ergonomic intervention, which was provided by physical therapists, on spinal and upper-extremity work-related posture and symptom complaints of workers who use video display terminals (VDT). SUBJECTS Two hundred employees who spent at least 20 hours per week at a VDT were randomly divided into 2 groups. Group E received the ergonomic intervention and an informative brochure, and group I received only the brochure. METHODS Both groups were evaluated at the beginning of the study and at a follow-up 5 months later. The following tools were used: a pain drawing and the Rapid Entire Body Assessment (REBA) method to assess spinal and upper-extremity work-related posture. RESULTS Group E had a lower REBA score and reduced lower back, neck, and shoulder symptoms compared with group I. DISCUSSION AND CONCLUSION The results suggest that a personalized preventive ergonomic intervention can improve spinal and upper-extremity work-related posture and musculoskeletal symptoms for workers who use VDTs.
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Affiliation(s)
- Paolo Pillastrini
- Department of Neurological Sciences, School of Physiotherapy, University of Bologna, Bologna, Italy.
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Franche RL, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. JOURNAL OF OCCUPATIONAL REHABILITATION 2005; 15:607-31. [PMID: 16254759 DOI: 10.1007/s10926-005-8038-8] [Citation(s) in RCA: 281] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION A systematic review was conducted to review the effectiveness of workplace-based return-to-work (RTW) interventions. METHOD Seven databases were searched, in English and French, between January 1990 and December 2003 for peer-reviewed studies of RTW interventions provided at the workplace to workers with work disability associated with musculoskeletal or other pain-related conditions. Methodological quality appraisal and data extraction were conducted by pairs of reviewers. RESULTS Of a total of 4124 papers identified by the search, 10 studies were of sufficient quality to be included in the review. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace; and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator. For these five intervention components, there was moderate evidence that they reduce costs associated with work disability duration. Evidence for sustainability of these effects was insufficient or limited. Evidence regarding the impact of supernumerary replacements was insufficient. Evidence levels regarding the impact of the intervention components on quality-of-life was insufficient or mixed. CONCLUSIONS Our systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs, however the evidence regarding their impact on quality-of-life outcomes was much weaker.
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Abstract
American businesses face huge costs for work-related musculoskeletal pain. Work-related musculoskeletal pain is not new or unique to the population of the United States. Many historic manifestations of workplace pain have been related to innovation and technology changes. Incidence rates and severity of symptoms have had an interesting relationship to the public concern and governmental decisions. In 1999, a National Academy of Sciences study found total costs to be more than US dollar 1 trillion per year and concluded that effective prevention of workplace pain through active intervention is not only possible, but results in a significant cost savings for the employer while reducing the disability experienced by the employee. Employers have been reluctant to embrace the benefits of workplace prevention for work-related musculoskeletal pain. The purpose of this review is to examine (1). what is know about prevention of work-related musculoskeletal pain and workplace musculoskeletal disorders, (2). a brief description of several prevention preventing behaviors, (3). an analysis of how these preventing behaviors are maintained, and (4). suggestions on how to reverse these prevention preventing behaviors.
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Affiliation(s)
- J Mark Melhorn
- Department of Surgery, University of Kansas School of Medicine, Wichita, KS, USA.
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14
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Anema JR, Steenstra IA, Urlings IJM, Bongers PM, de Vroome EMM, van Mechelen W. Participatory ergonomics as a return-to-work intervention: a future challenge? Am J Ind Med 2003; 44:273-81. [PMID: 12929147 DOI: 10.1002/ajim.10259] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Participatory ergonomics (PE) are often applied for prevention of low back pain (LBP). In this pilot-study, a PE-program is applied to the disability management of workers sick listed due to LBP. METHODS The process, implementation, satisfaction, and barriers for implementation concerning the PE-program were analyzed quantitatively and qualitatively for 35 workers sick listed 2-6 weeks due to LBP and their ergonomists. RESULTS Two-hundred-and-seventy ergonomic solutions were proposed to the employer. They were targeted more at work design and organization of work (58.9%) than at workplace and equipment design (38.9%). They were planned mostly on a short-term basis (74.8%). Almost half (48.9%) of the solutions for work adjustment were completely or partially implemented within 3 months after the first day of absenteeism. Most workers were satisfied about the PE-program (median score 7.8 on a 10-point scale) and reported a stimulating effect on return-to-work (66.7%). Main obstacles to implementation were technical or organizational difficulties (50.0%) and physical disabilities of the worker (44.8%). CONCLUSIONS This study suggests that compliance, acceptance, and satisfaction related to the PE-program were good for all participants. Almost half of the proposed solutions were implemented.
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Affiliation(s)
- J R Anema
- TNO Work and Employment, PO Box 718, 2130 AS Hoofddorp, The Netherlands.
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Abstract
OBJECTIVE The purpose of this study was to describe the availability of preventive devices and training in relation to neck, shoulder, and back musculoskeletal injuries/disorders (MSD) in registered nurses. SUMMARY BACKGROUND DATA Nurses have one of the highest rates of MSD of any occupation. Studies have shown that mechanical lifting devices and lifting teams can reduce MSD rates and associated costs. METHODS Data from 1163 randomly selected currently working nurses (1+ years on the current job) were collected in anonymous mailed surveys (74% response rate). MSD cases had neck, shoulder, and/or back symptoms for at least 1 week, or at least monthly, and moderate or more pain, in the past year. RESULTS Nurses with mechanical lifting devices available were significantly less likely to have neck or back MSDs. Back injury was less likely when lifting teams were available. However, adjustable beds and transfer sheets were associated with greater odds of back MSD. Training in workstation adjustment was associated with significantly lower MSD prevalence, though postural training was not. CONCLUSIONS Though use of mechanical devices and lifting teams was limited in nursing workplaces, these prevention strategies were related to reduced odds of MSD. Nursing administrators can use these findings to consider workplace changes.
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Affiliation(s)
- Alison M Trinkoff
- Department of Behavioral and Community Health, University of Maryland School of Nursing, Baltimore, 21201, USA.
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Lincoln AE, Feuerstein M, Shaw WS, Miller VI. Impact of case manager training on worksite accommodations in workers' compensation claimants with upper extremity disorders. J Occup Environ Med 2002; 44:237-45. [PMID: 11911025 DOI: 10.1097/00043764-200203000-00011] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Management of the return-to-work process in claimants with work-related upper extremity disorders often poses challenges to the health care provider, claimant, and employer. Modifying workplace ergonomic risk factors as a component of the workplace accommodation process may improve return-to-work outcomes by reducing recurrent pain and discomfort. The present study is a case-control evaluation of the effects of a 2-day training program for nurse case managers that was designed to facilitate the implementation of workplace accommodations within a workers' compensation health care delivery system. After the training, 101 claimants with compensable upper extremity disorders were randomly assigned to case managers with and without training. Overall, 208 accommodations were recommended and 155 of these were implemented (75%). Claimants of trained nurses received 1.5 times as many recommendations for accommodations as claimants managed by nurses not trained in the process, and 1.4 times as many accommodations were implemented, although no differences were found between the two groups in implementation rates. Trained nurses were more likely to recommend accommodations addressing workstation layout, computer-related improvements, furnishings, accessories, and lifting/carrying aids, whereas the untrained nurses were more likely to suggest light duty and lifting restrictions. This study indicates that the training was associated with a change in the practice behavior of case managers regarding the workplace accommodation process. More research is needed to identify barriers to implementation and develop more effective approaches to facilitate worksite accommodations in disabled workers with carpal tunnel syndrome and other persistent upper extremity disorders.
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Affiliation(s)
- Andrew E Lincoln
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, USA
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Abstract
Musculoskeletal misuse syndromes are secondary to misuse of specific tendons, ligaments, or other soft tissues. Despite patient education interventions to prevent acute musculoskeletal injury, these injuries still occur. A well-organized approach to musculoskeletal complaints can reduce the risk of missed diagnoses and ensure appropriate care. This article reviews history and physical examination findings indicative of a misuse etiology and provides clinicians with a discussion of available diagnostic tests and therapies.
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Abstract
More people are employed in the health care sector than in any other industry in the United States. Health care workers are exposed to a wide variety of hazards, including biological, chemical, physical and psychological stressors. Concerns about exposure to contagious diseases such as HIV, Hepatitis B and C, and tuberculosis have influenced the career choices of many health professionals. Physical hazards, especially ergonomic ones, account for the majority of the disability faced by health care workers. Chemical exposure and psychosocial stresses are also present in health care institutions. The exposure encountered in health care facilities is potentially dangerous to health care workers as well as to their family members and unborn children.
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Affiliation(s)
- I G Udasin
- Department of Environmental and Community Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
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Punnett L. Commentary on the scientific basis of the proposed Occupational Safety and Health Administration Ergonomics Program Standard. J Occup Environ Med 2000; 42:970-81. [PMID: 11039161 DOI: 10.1097/00043764-200010000-00003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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