Factors associated with work-related musculoskeletal disorders in commercial motorcyclists

This study aimed to explore the prevalence of work-related musculoskeletal disorders (WMSDs) and to investigate factors associated with WMSDs in commercial motorcyclists in Indonesia. This cross-sectional study involved commercial motorcyclists operating in Indonesia. Data were collected using an anonymous questionnaire, including the Indonesian Version of the Nordic Musculoskeletal Questionnaire, occupational driving posture questionnaire, and occupational factor-related questions. The questionnaire was distributed at four rest stops located in Central Jakarta, Indonesia. The result showed that 40% of participants (129/322) were having WMSDs. Older age, overweight body mass index (BMI), obese body mass index, nonregular physical activity, driving duration (> 8 h/day), seniority (≥5 years), and poor driving posture were significant risk factors for WMSDs in commercial motorcyclists. Based on the risk factors identified in this study, the development of preventive strategies among commercial motorcyclists is warranted.

CLINICIANS' PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY

Objectives

The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke.

Design

A qualitative focus group study.

Methods

Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed.

Results

Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, "The application of handling in stroke rehabilitation" includes clinical reasoning and real-world handling practices. The second theme, "Physical Effects on Therapists," examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, "Conflicts among health care professionals," investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists.

Conclusion

The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals' perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders.

Prevalence of work-related musculoskeletal disorders and quality of life assessment among garment workers in Tiruppur district, Tamil Nadu

Objectives. The garment industry is a labour-intensive industry, with workers susceptible to musculoskeletal problems, especially those employed in smaller units that lack adequate occupational health provisions. This study aims to determine the prevalence of work-related musculoskeletal disorders (WMSDs) among workers in both large and small garment units and assess their quality of life (QoL). Methods. The study surveyed 746 garment workers, comprising 372 from large units and 374 from small units. Data were collected through the Nordic musculoskeletal questionnaire and the World Health Organization Quality of Life (WHOQOL)-BREF questionnaire, with posture analysis conducted using the rapid upper limb assessment (RULA) and rapid entire body assessment (REBA) scales. Results. The results showed that 32% of workers in large-scale garment units and 43.9% in small-scale garment units reported musculoskeletal symptoms. The occurrence of musculoskeletal disorders (MSDs) was significantly associated with increasing age, smoking, alcohol consumption, job duration, working in shifts and moonlighting. Conclusion. The workers in the garment industry, particularly of small units, are highly susceptible to WMSDs.

Wearables for Monitoring and Postural Feedback in the Work Context: A Scoping Review

Wearables offer a promising solution for simultaneous posture monitoring and/or corrective feedback. The main objective was to identify, synthesise, and characterise the wearables used in the workplace to monitor and postural feedback to workers. The PRISMA-ScR guidelines were followed. Studies were included between 1 January 2000 and 22 March 2023 in Spanish, French, English, and Portuguese without geographical restriction. The databases selected for the research were PubMed®, Web of Science®, Scopus®, and Google Scholar®. Qualitative studies, theses, reviews, and meta-analyses were excluded. Twelve studies were included, involving a total of 304 workers, mostly health professionals (n = 8). The remaining studies covered workers in the industry (n = 2), in the construction (n = 1), and welders (n = 1). For assessment purposes, most studies used one (n = 5) or two sensors (n = 5) characterised as accelerometers (n = 7), sixaxial (n = 2) or nonaxialinertial measurement units (n = 3). The most common source of feedback was the sensor itself (n = 6) or smartphones (n = 4). Haptic feedback was the most prevalent (n = 6), followed by auditory (n = 5) and visual (n = 3). Most studies employed prototype wearables emphasising kinematic variables of human movement. Healthcare professionals were the primary focus of the study along with haptic feedback that proved to be the most common and effective method for correcting posture during work activities.

Compensation Method for Missing and Misidentified Skeletons in Nursing Care Action Assessment by Improving Spatial Temporal Graph Convolutional Networks

With the increasing aging population, nursing care providers have been facing a substantial risk of work-related musculoskeletal disorders (WMSDs). Visual-based pose estimation methods, like OpenPose, are commonly used for ergonomic posture risk assessment. However, these methods face difficulty when identifying overlapping and interactive nursing tasks, resulting in missing and misidentified skeletons. To address this, we propose a skeleton compensation method using improved spatial temporal graph convolutional networks (ST-GCN), which integrates kinematic chain and action features to assess skeleton integrity and compensate for it. The results verified the effectiveness of our approach in optimizing skeletal loss and misidentification in nursing care tasks, leading to improved accuracy in calculating both skeleton joint angles and REBA scores. Moreover, comparative analysis against other skeleton compensation methods demonstrated the superior performance of our approach, achieving an 87.34% REBA accuracy score. Collectively, our method might hold promising potential for optimizing the skeleton loss and misidentification in nursing care tasks.

Online Ergonomic Evaluation in Realistic Manual Material Handling Task: Proof of Concept

Work-related musculoskeletal disorders are globally one of the leading causes of work-related injuries. They significantly impact worker health and business costs. Work task ergonomic risk indices have been developed that use observational assessments to identify potential injuries, and allow safety managers to promptly intervene to mitigate the risks. However, these assessments are very subjective and difficult to perform in real time. This work provides a technique that can digitalize this process by developing an online algorithm to calculate the NIOSH index and provide additional data for ergonomic risk assessment. The method is based on the use of inertial sensors, which are easily found commercially and can be integrated into the industrial environment without any other sensing technology. This preliminary study demonstrates the effectiveness of the first version of the Online Lifting Index (On-LI) algorithm on a common industrial logistic task. The effectiveness is compared to the standard ergonomic assessment method. The results report an average error of 3.6% compared to the NIOSH parameters used to calculate the ergonomic risk and a relative error of the Lifting Index of 2.8% when compared to observational methods.

The association between adverse ergonomic factors and work-related musculoskeletal symptoms among medical staff in China: a cross-sectional study

We investigated the prevalence of work-related musculoskeletal symptoms (WMSs) among medical staff and evaluated the associations of different levels of adverse ergonomic factors with WMSs. A total of 6099 Chinese medical staff were asked to complete a self-reported questionnaire to assess the prevalence and risk factors of WMSs from June 2018 to December 2020. A prevalence rate of 57.5% was observed for WMSs among overall medical staffs, which mainly affected the neck (41.7%) and shoulder (33.5%). 'Keeping sitting for long hours very frequently' (OR = 1.26, 95% CI: 1.04, 1.53) was positively associated with WMSs in doctors, while 'keeping sitting for long hours occasionally' (OR = 0.91, 95% CI: 0.85, 0.97) was identified as a protective factor of WMSs in nurses. The associations of adverse ergonomic factors, organisational factors, and environmental factors with WMSs were different among medical staff in different positions.Practitioner summary: We conducted a multi-city study concerning the risk factors of WMSs by carrying out a face-to-face one-to-multiple questionnaire survey among medical staff in China. As a risk factor of WMSs in medical staff, adverse ergonomic factors should be paid more attention by the standard setting department and policy makers.Abbreviations: WMSDs: work-related musculoskeletal disorders; WMSs: work-related musculoskeletal symptoms; MSDs: musculoskeletal disorders; NMQ: Nordic Musculoskeletal Questionnaires; DMQ: Dutch Musculoskeletal Questionnaires; NIOSH: National Institute for Occupational Safety and Health; ORs: odds ratios.

Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population.

METHODS

Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results.

RESULTS

A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention.

CONCLUSION

The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.

A systematic review of literature on occupational health and safety interventions for older workers

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents 'A future research agenda for older worker health, safety and well-being interventions.' This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design.Practitioner summary: We conducted a systematic literature review of studies focussed on workplace interventions to improve the physical and psychological safety of older workers. Within the existing literature, evidence for effective interventions and guidance for organisations is weak. We present a future research agenda with a systems approach to address these gaps.

A Cross-Sectional Survey of Work-Related Musculoskeletal Disorders in Physiotherapists Using Orebro Musculoskeletal Pain Questionnaire (OMPQ)

Background

Physiotherapists in India are at a high risk of work-related musculoskeletal disorder (WRMSD). Faulty ergonomics and incorrect patient handling techniques are the common causes of WRMSDs. The disabilities caused due to musculoskeletal injuries are the frequent cause of absenteeism from work.

Aim and Method

The aim of this cross-sectional survey is to investigate the occurrence of WRMSDs among physiotherapists in Maharashtra using Orebro Musculoskeletal Pain Questionnaire. Responses were obtained through Google forms and analyzed. Three hundred sixty physiotherapists who fulfilled the inclusion criteria were recruited for the study. All the participants responded to the questionnaire.

Result

The prevalence of WRMSDs was found to be highest in age of 23-30 years (87.22%) and less in age of 41-50 years (2.22%). Most common affected area was neck (43.6%) and lower back (43.1%).

Conclusion

This study highlights the high incidence of WRMSDs among physiotherapists in Maharashtra.

sEMG Spectral Analysis and Machine Learning Algorithms Are Able to Discriminate Biomechanical Risk Classes Associated with Manual Material Liftings

Manual material handling and load lifting are activities that can cause work-related musculoskeletal disorders. For this reason, the National Institute for Occupational Safety and Health proposed an equation depending on the following parameters: intensity, duration, frequency, and geometric characteristics associated with the load lifting. In this paper, we explore the feasibility of several Machine Learning (ML) algorithms, fed with frequency-domain features extracted from electromyographic (EMG) signals of back muscles, to discriminate biomechanical risk classes defined by the Revised NIOSH Lifting Equation. The EMG signals of the multifidus and erector spinae muscles were acquired by means of a wearable device for surface EMG and then segmented to extract several frequency-domain features relating to the Total Power Spectrum of the EMG signal. These features were fed to several ML algorithms to assess their prediction power. The ML algorithms produced interesting results in the classification task, with the Support Vector Machine algorithm outperforming the others with accuracy and Area under the Receiver Operating Characteristic Curve values of up to 0.985. Moreover, a correlation between muscular fatigue and risky lifting activities was found. These results showed the feasibility of the proposed methodology-based on wearable sensors and artificial intelligence-to predict the biomechanical risk associated with load lifting. A future investigation on an enriched study population and additional lifting scenarios could confirm the potential of the proposed methodology and its applicability in the field of occupational ergonomics.

Work-Related Musculoskeletal Disorders Among Farmers in the Southeast Asia Region: A Systematic Review

Background

Southeast Asia has many people who work in the agriculture sector. Not many stakeholders pay special attention to the health of farmers, even though they are exposed to various types of hazards. One of the most common health complaints among farmers is related to work-related musculoskeletal disorders (WMSDs). This study aims to assess the prevalence of WMSDs and factors associated with them among farmers in Southeast Asia.

Methods

A literature search on PubMed, ScienceDirect, Scopus, and EBSCO was conducted. Articles were included if they studied ergonomic problems among farmers from 11 countries in the Southeast Asia region and were published during 2015-2022. The Critical Appraisal Skills Program was used to evaluate the quality of the articles. The search process and retrieval process reflected PRISMA's recommendation.

Result

There were 14 studies found from 3 countries that had published articles in PubMed and ScienceDirect, including Thailand [8], Indonesia [4], and Malaysia [2]. The prevalence of WMSDs in Thailand, Indonesia, and Malaysia was 78,31%, 81,27%, and 88,39%, respectively. Common factors associated with WMSDs include age, sex, smoking habits, drinking alcohol habits, working period (years), type of work, awkward position, non-ergonomic equipment, repetitive movements, and lifting heavy loads.

Conclusion

The prevalence of WMSDs among farmers in Southeast Asia is considerably high. Effective intervention is essential for reducing the prevalence and protecting workers' health and well-being.

Integrating Exosuit Capabilities into Clothing to Make Back Relief Accessible to Workers Unserved by Existing Exoskeletons: Design and Preliminary Evaluation

OCCUPATIONAL APPLICATIONSWe developed a method for integrating back-assist exosuit capabilities into regular clothing to make musculoskeletal relief accessible to more workers. We demonstrated proof-of-concept that this uniform-integrated exosuit can be effective and usable. Existing occupational exosuits are standalone accessories worn on top of a user's clothing and are not suitable for all workers. Our newly developed sub-class of exosuit could be beneficial to workers who alternate between bending, lifting, and sitting tasks, or to those in customer- or patient-facing jobs where it is important for wearable technology to be discreet.

A novel technique in transoral robotic surgery: A case report of rotating and switching technique

BACKGROUND

Transoral robotic surgery (TORS) for tongue base lesions located above the operative field is predominantly an upward procedure, which makes surgery difficult.

METHODS

To illustrate our technique for this procedure, we report the case of an 82-year-old male with a p16-negative oropharyngeal carcinoma of the tongue base who underwent TORS. The field of view was turned upside down, and the operation switched the typical left- and right-arm functions. The daVinci Xi was docked, the 0° endoscope was rotated 180°, and the first arm was switched to the right hand and the third arm to the left hand.

RESULTS

Although the lesion extended from the tongue base to the soft palate and mobile tongue, the planned resection line was followed.

CONCLUSIONS

This technique improves operability by allowing downward manipulation and preventing the left and right arms from crossing. Further validation of the technique's effectiveness and safety is needed.

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.

Influence of load knowledge on lifting biomechanics

Objectives. Findings from previous studies implied that appropriately controlling load knowledge might help improve the biomechanical performance during lifting tasks. However, only load weight knowledge was often discussed in previous studies. The current study aimed to complement the existing studies and provide improved knowledge about the influence of load knowledge on lifting biomechanics. Methods. Twenty-four healthy male participants were recruited and instructed to perform symmetric lifting tasks with different load weights under different load knowledge conditions. Load weights were set at three levels (40, 80 and 120%) of each participant's maximum acceptable lifting capacity. The examined load knowledge conditions included 'no knowledge' condition, 'weight known' condition, 'fragile material known' condition and 'weight and fragile material known' condition. Results. We found that when knowing fragility information about lifting materials, workers tended to be more cautious by adopting a less dynamic motion pattern during the landing phase, as evidenced by decreases of 6-8% in elbow joint acceleration. The 'cautious' lifting pattern when fragility load knowledge was presented could contribute to reduced risk of lower back disorder. Conclusion. This finding could help to develop lower back disorder prevention interventions to improve occupational safety and health.

Ergonomics in Otolaryngology: A Systematic Review and Meta-analysis

OBJECTIVES

To determine the proportion of otolaryngologists with work-related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta-analysis. Random effects meta-analyses were used to estimate the proportion of otolaryngologists reporting WRMD.

RESULTS

The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%-84% of otolaryngologists underwent medical treatment for WRMD. 5%-23% took time off work and 1%-6% stopped operating completely as a result of WRMD. 23%-62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk.

CONCLUSIONS

Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467-475, 2023.

Prevalence and factors associated with low back pain in warehouse workers: A cross-sectional study

BACKGROUND

Low back pain is a highly prevalent musculoskeletal disorder that leads to functional incapacity and absence from work.

OBJECTIVE

To analyze warehouse workers' prevalence and factors associated with low back pain.

METHODS

Cross-sectional study design with 204 male warehouse workers (stocker, separator, checker, and packer) from motor parts companies. Age, body mass, marital status, education, the practice of physical exercise, presence of pain, low back pain intensity, comorbidities, time away from work, handgrip strength, flexibility, and trunk muscle strength were collected and analyzed. Data are presented as mean, standard deviation, absolute and relative frequency. A binary logistic regression was performed, with low back pain (yes or no) as the dependent variable.

RESULTS

24.0% of the workers reported low back pain with an average intensity of 4.7 (± 2.4) points. The participants were young, had completed high school education, were single and married, and had normal body weight. There was a more likely low back pain presence in separator tasks. Greater handgrip strength in the dominant (right) hand and trunk muscle is associated with no low back pain.

CONCLUSION

Low back pain prevalence was 24% among young warehouse workers, more likely in separation tasks. A greater handgrip and trunk strength can be a protective factor to no low back pain.

How Accurately Can Wearable Sensors Assess Low Back Disorder Risks during Material Handling? Exploring the Fundamental Capabilities and Limitations of Different Sensor Signals

Low back disorders (LBDs) are a leading occupational health issue. Wearable sensors, such as inertial measurement units (IMUs) and/or pressure insoles, could automate and enhance the ergonomic assessment of LBD risks during material handling. However, much remains unknown about which sensor signals to use and how accurately sensors can estimate injury risk. The objective of this study was to address two open questions: (1) How accurately can we estimate LBD risk when combining trunk motion and under-the-foot force data (simulating a trunk IMU and pressure insoles used together)? (2) How much greater is this risk assessment accuracy than using only trunk motion (simulating a trunk IMU alone)? We developed a data-driven simulation using randomized lifting tasks, machine learning algorithms, and a validated ergonomic assessment tool. We found that trunk motion-based estimates of LBD risk were not strongly correlated (r range: 0.20-0.56) with ground truth LBD risk, but adding under-the-foot force data yielded strongly correlated LBD risk estimates (r range: 0.93-0.98). These results raise questions about the adequacy of a single IMU for LBD risk assessment during material handling but suggest that combining an IMU on the trunk and pressure insoles with trained algorithms may be able to accurately assess risks.

Vocational Rehabilitation and Length of Stay at Work after Work-Related Musculoskeletal Disorders: A Longitudinal Study in Brazil

Vocational rehabilitation is an intervention to enhance the return to work and improve quality of life. The aim of this study was to evaluate sociodemographic and occupational factors associated with the length of stay at work among workers with work-related musculoskeletal disorders (WRMDs) who had undergone rehabilitation through the Brazilian public social security system. This was a longitudinal study among 680 workers with histories of disability due to WRMDs who returned to the formal job market after vocational rehabilitation between 2014 and 2018. Survival analysis was performed to identify the factors influencing permanence in work. Job dismissal occurred for 29.26% of the workers. The average duration of employment after returning to the formal job position was 56 months. The following factors were associated with shorter length of employment: living in the southeastern region (HR: 2.78; 95% CI 1.12-6.91) or southern region (HR: 2.68; 95% CI 1.04-6.90) of Brazil; working in transportation, storage or postal services (HR: 2.57; 95% CI 1.07-6.17); or working in financial activities, insurance or related services (HR: 2.70; 95% CI 1.05-6.89). These findings may contribute to the discussion about prevention of disability and interventions to ensure health care for workers with WRMD disabilities who undergo rehabilitation.

Clinical Application of Rapid Upper Limb Assessment and Nordic Musculoskeletal Questionnaire in Work-Related Musculoskeletal Disorders: A Bibliometric Study

Assessment of work-related musculoskeletal disorders (WMSDs) using the Rapid Upper Limb Assessment (RULA) and the Nordic Musculoskeletal Questionnaire (NMQ) has become widely accepted and reported in the literature. The objectives of this study are to (1) recognize and describe the topmost 50 cited scientific articles in WMSDs using the RULA and NMQ and (2) explore the factors that contribute to making an article influential. In this bibliometric study, we used the Web of Science and MEDLINE databases to identify the top 50 cited articles published from 1993 to 2022. The data collected were the title of the journal, number of citations, year of publication, type of the study, institution where the work was conducted, level of evidence, contribution of primary authors, and country of origin of the work. Our results showed that the top 50 cited articles were published between 1980 and 2010. The 2000s was the most valuable decade. Regarding journals, the Work journal had the highest number of articles concerning the use of RULA and NMQ in healthcare professionals. The maximum number of citations regarding RULA occurred in the Journal of Robotic Surgery (n = 50) and the maximum for NMQ occurred in the Journal of Safety Research (n = 106). Most articles originated from the United States, followed by England and the Netherlands. Eight authors had two publications published in the top 50 list. The majority of the topmost cited research articles were cross-sectional studies. Most of these studies were level III evidence. The bibliometric analysis from this study provides insights to researchers to choose the most appropriate and influential journal for submitting work on WMSDs.

Upper Limb Disorders in Catering Workers

BACKGROUND

The literature reports that catering workers are exposed to various occupational health hazardsé.

OBJECTIVE

This study aims to assess a cohort of catering workers in relation to upper limb disorders, thus contributing to the quantification of work-related musculoskeletal disorders in this occupational sector.

METHODS

Here, 500 employees, of which 130 were males and 370 were females, with an overall mean age of 50.7 years and an average length of service of 24.8 years, were examined. All subjects completed a standardized questionnaire: the medical history questionnaire of diseases of the upper limbs and spine proposed in "Health surveillance of workers", third edition, EPC.

RESULTS

The obtained data enables the following conclusions to be drawn. Musculoskeletal disorders affect a wide range of catering workers. The most affected anatomical region is the shoulder. These disorders increase with advancing age, specifically shoulder, wrist/hand disorders and daytime and nighttime paresthesias. Employment seniority in the catering sector increases the likelihood of all considered conditions. An increase in weekly workload exclusively affects the shoulder region.

CONCLUSIONS

This study aims to serve as an impetus for further research that seeks to better analyze musculoskeletal problems in the catering sector.

Evaluation of the Efficacy of a Lift-Assist Device Regarding Caregiver Posture and Muscle Load for Transferring Tasks

The aim of this study was to confirm the effect of a lift-assist device when performing a patient-lifting task. Ten working caregivers participated in this experiment, and lifting patients from bed to wheelchair (B2C) and wheelchair to bed (C2B) was performed for manual care (MC) and lift-assist device (robot) care (RC). EMG sensors and IMU motion sensors were attached as indicators of the assistive device's effectiveness. EMG was attached to the right side of eight muscles (UT, MD, TB, BB, ES, RF, VA, and TA), and flexion/extension angles of the neck, shoulder, back, and knee were collected using motion sensors. As a result of the analysis, both B2C and C2B showed higher muscle activities in MC than RC. When using a lift-assist device to lift patients, the RC method showed reductions in muscle activities compared to MC. As a result of the work-posture analysis, both the task type and the task phase exhibited pronounced reductions in shoulder, back, and knee ROM (range of motion) compared to those of MC. Therefore, based on the findings of this study, a lift-assist device is recommended for reducing the physical workloads of caregivers while performing patient-lifting tasks.

Prevalence and determinants of (work-related) musculoskeletal disorders among dentists - A cross sectional evaluative study

Background

Work-related musculoskeletal disorders (WMSDs) are the second most common cause of disability, accounting for 17% of all Years lived with a disability (YLDs) worldwide. Healthcare professionals, especially dentists, are known to be at a higher risk of WMSDs. Therefore, this study aims to determine the point and period prevalence of WMSDs among dentists and to assess the risk factors for WMSDs, including workstation analysis.

Methods

This cross-sectional study was conducted among 120 dentists from three dental colleges in Gujarat (Ahmedabad and Gandhinagar), India. A structured questionnaire was used to collect sociodemographic and occupational history along with pre-validated standardized tools such as the Nordic Musculoskeletal Questionnaire (NMQ), Rapid Entire Body Assessment (REBA) score sheet and Quick Exposure Checklist (QEC). Data analysis was performed using SPSS version 20.

Results

The period prevalence of MSDs and WMSDs were 85% and 75.8% respectively, and the point prevalence was 39.2% and 23.3% respectively. Prosthodontists reported the highest prevalence of WMSDs. The neck (64.7%) was the most commonly affected area. A statistically significant result was obtained between MSDs and BMI (P = 0.02), qualification (P = 0.01) and between WMSDs and duration of work in the sitting posture (P = 0.03).

Conclusions

The prevalence of both MSDs and WMSDs was found to be high. Dentists with higher BMI, higher qualifications, lack of breaks, having poor workstations and higher REBA and QEC scores, whose job tasks involve continuous inspection, frequent bending of elbow joints, frequent repetitive motions, tasks that require them to reach distances greater than 20 inches and tasks that involve twisting of the waist are at a higher risk of developing MSDs.

Hand-arm vibration syndrome among harvesting farmers: A cross-sectional study from Pakistan

BACKGROUND

Constant use of hand-held vibratory tools may cause health issues, including hand dysfunction, among farmers. Thus, exposure to these vibratory instruments may cause hand-arm vibration syndrome (HAVS).

OBJECTIVE

The study aimed to measure the prevalence of HAVS and evaluate neurological and vascular symptoms among farmers.

METHODS

This cross-sectional study included 20 villages in Pakistan and used a three-part questionnaire to collect data from farmers exposed to vibration while farming. The study included demographics, the Health Surveillance Questionnaire, and the Stockholm Workshop Classification Scale. SPSS version 22 was used for the data entry and statistical analysis.

RESULTS

433 (43%) participants had musculoskeletal discomfort and 568 (57%) had hand vibration. Raynaud phenomenon was evident in 430 (43%) participants, whereas carpal tunnel syndrome was found in 218 (22%). Tingling was reported by 255 participants (26%), and numbness was reported by 543 (54%). According to the grading of neurological symptoms, 461 (46%) participants were exposed to vibration but did not experience any symptoms, placing them in stage 0. 185 (18.5%) participants with HAVS with infrequent episodes affecting just the tips of one or more fingers were categorized in stage 01 based on grading of vascular symptoms.

CONCLUSION

HAVS are common among harvesting farmers, with the most noticeable vibrations occurring in the shoulder region. Similarly, most farmers had no vascular symptoms, and most were exposed to vibration but had no neurological symptoms.

Automated and Continuous Fatigue Monitoring in Construction Workers Using Forearm EMG and IMU Wearable Sensors and Recurrent Neural Network

About 40% of the US construction workforce experiences high-level fatigue, which leads to poor judgment, increased risk of injuries, a decrease in productivity, and a lower quality of work. Therefore, it is essential to monitor fatigue to reduce its adverse effects and prevent long-term health problems. However, since fatigue demonstrates itself in several complex processes, there is no single standard measurement method for fatigue detection. This study aims to develop a system for continuous workers' fatigue monitoring by predicting the aerobic fatigue threshold (AFT) using forearm muscle activity and motion data. The proposed system consists of five modules: Data acquisition, activity recognition, oxygen uptake prediction, maximum aerobic capacity (MAC) estimation, and continuous AFT monitoring. The proposed system was evaluated on the participants performing fourteen scaffold-building activities. The results show that the AFT features have achieved a higher accuracy of 92.31% in assessing the workers' fatigue level compared to heart rate (51.28%) and percentage heart rate reserve (50.43%) features. Moreover, the overall performance of the proposed system on unseen data using average two-min AFT features was 76.74%. The study validates the feasibility of using forearm muscle activity and motion data to workers' fatigue levels continuously.

Wearable Sensors and Artificial Intelligence for Physical Ergonomics: A Systematic Review of Literature

Physical ergonomics has established itself as a valid strategy for monitoring potential disorders related, for example, to working activities. Recently, in the field of physical ergonomics, several studies have also shown potential for improvement in experimental methods of ergonomic analysis, through the combined use of artificial intelligence, and wearable sensors. In this regard, this review intends to provide a first account of the investigations carried out using these combined methods, considering the period up to 2021. The method that combines the information obtained on the worker through physical sensors (IMU, accelerometer, gyroscope, etc.) or biopotential sensors (EMG, EEG, EKG/ECG), with the analysis through artificial intelligence systems (machine learning or deep learning), offers interesting perspectives from both diagnostic, prognostic, and preventive points of view. In particular, the signals, obtained from wearable sensors for the recognition and categorization of the postural and biomechanical load of the worker, can be processed to formulate interesting algorithms for applications in the preventive field (especially with respect to musculoskeletal disorders), and with high statistical power. For Ergonomics, but also for Occupational Medicine, these applications improve the knowledge of the limits of the human organism, helping in the definition of sustainability thresholds, and in the ergonomic design of environments, tools, and work organization. The growth prospects for this research area are the refinement of the procedures for the detection and processing of signals; the expansion of the study to assisted working methods (assistive robots, exoskeletons), and to categories of workers suffering from pathologies or disabilities; as well as the development of risk assessment systems that exceed those currently used in ergonomics in precision and agility.

Work-Related Musculoskeletal Disorders among Dentists in the United Arab Emirates: A Cross-Sectional Study

Background and Objectives: A dental environment possesses a serious ergonomic health issue on the dental team members which in turn contributes to the development of work-related musculoskeletal disorders (WMSDs). The present research is aimed at evaluating the frequency of musculoskeletal disorders and their associated sociodemographic and work environment risk factors among dentists in the United Arab Emirates. Material and Methods: In this cross-sectional study, a pretested and validated questionnaire was sent via email as well as on different social media platforms to a total of 497 dentists. A total of 179 dentists completed the study survey, with a total response rate of 36%. A binary logistic regression model was conducted to identify significant risk factors associated with WMSDs. Results: Dentists in the United Arab Emirates experience a high prevalence of work-related musculoskeletal disorders (90.4%) which were associated with high levels of stress in the work environment. Furthermore, dentists in the private sector worked more clinical hours per day (p = 0.000) and had more financial stress (p = 0.007) as compared to those in the governmental sector. Gender (p = 0.007), age (p = 0.01), monthly income (p = 0.073), work experience (p = 0.037), number of patients treated per day (p = 0.049), and the use of an ergonomic dental chair (p = 0.005) were all factors associated with a greater number of affected body regions by WMSDs. Multivariate binary logistic regression for the number of regions affected by WMSDs revealed that not using an ergonomic dental chair (OR 2.70, 95% CI, 1.14-6.36) and high stress in the work environment (OR 1.31, 95% CI 1.02 to1.67) were associated with more body regions being affected by WMSDs. Conclusions: This study highlights the high prevalence rate of WMSDs among dentists in the UAE. Future research should be directed towards reducing stress in the work environment, increasing awareness regarding the importance of an ergonomic dental chair, and reducing gaps between private and governmental practices.

Industrial exoskeletons from bench to field: Human-machine interface and user experience in occupational settings and tasks

Objective

Work-related musculoskeletal disorders (WRMSDs) are considered nowadays the most serious issue in the Occupational Health and Safety field and industrial exoskeletons appear to be a new approach to addressing this medical burden. A systematic review has been carried out to analyze the real-life data of the application of exoskeletons in work settings considering the subjective responses of workers.

Methods

The review was registered on PROSPERO. The literature search and its report have been performed following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus.

Results

Twenty-four original studies were included in the literature review; 42% of the papers retrieved included automobilist industry workers, 17% of the studies evaluated the use of exoskeletons in logistic facilities, and 17% of articles involved healthcare. The remaining six papers recruited farmers, plasterers, wasting collectors, construction workers, and other workmen. All the papers selected tested the use of passive exoskeletons, supporting upper arms or back. Usability, perceived comfort, perceived exertion and fatigue, acceptability and intention to use, occupational safety and health, and job performance and productivity were the main topic analyzed.

Conclusion

Exoskeletons are not a fix-all technology, neither for workers nor for job tasks; they tend to show more of their potential in static activities, while in dynamic tasks, they can obstacle regular job performance. Comfort and easiness of use are the key factors influencing the user's experience. More research is needed to determine the most effective and safe ways to implement exoskeleton use in occupational settings.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275728, identifier CRD42021275728.

Comparisons of Trunk Motions and Low Back Injury Risk between Alternative Hotel Room Cleaning Methods

Hotel room cleaners frequently report job-related pain, with high rates of work-related musculoskeletal disorder injuries established for this group of workers. Surprisingly, there is limited published research documenting the impact of interventions to reduce ergonomic-related injury risks specific to hotel room cleaners' job tasks. In this study focused on hotel bathroom-cleaning and furniture-dusting tasks, twelve experienced hotel room cleaners used their standard method and a risk-reduction method-a tool with a handle that could extend, to perform these tasks. The female study participants' average age was 45.3 (SD 8.7) years with an average of 10 years of work experience as cleaners (range: 0.8-26.0 years). Trunk kinematics and a low back injury risk assessment were measured using the Lumbar Motion Monitor. All study metrics were significantly reduced when cleaning tasks involved use of adjustable, long-handled tools (p < 0.05). This study demonstrated that commonly available cleaning and dusting tools with extendable handles can significantly reduce low back injury risk among hotel room cleaners and potentially reduce injury risk to other body parts known to be the site of musculoskeletal disorders in this workforce. The study findings suggest that cleaning or housekeeping jobs in other industries where these same tasks are performed could benefit from use of extended-handle tools like those investigated here.

Multi-Site Musculoskeletal Symptoms in the Electronics Manufacturing Industry in China: A Cross-Sectional Study

BACKGROUND

With the development of the electronics manufacturing industry, the demand for human resources has increased, which has also led to the frequent occurrence of multi-site work-related musculoskeletal disorders.

METHOD

The participants (n = 7307) were recruited from 30 enterprises in China in 2018. The prevalence of musculoskeletal disorders was estimated using a modified Chinese version of the Musculoskeletal Disorders Questionnaire. The multivariate logistic regression model was applied to evaluate the effects of risk factors on multi-site musculoskeletal symptoms. Additionally, the log-binomial model was established to examine the correlation between the various sites of musculoskeletal symptoms in the body.

RESULTS

The 12-month prevalence of musculoskeletal symptoms among participants was 40.6%. The proportion of musculoskeletal symptoms involving single-site and 2/>2 body sites were 11.6% and 29.0%, respectively. The results of logistic regression showed that female adults who smoked, had >5-year job tenure, and always stood or sat for long period at work had a higher risk in 2/>2 body sites of musculoskeletal symptoms (p < 0.05). However, physical exercise during leisure time and "Squatting or kneeling for long period at work" were more frequently protective factors. Furthermore, the log-binomial model indicated that the neck and shoulder were significantly related to each other (Prevalence Ratio, PR: 5.511 and 7.017).

CONCLUSIONS

Several demographic characteristics and work-related factors were associated with multi-site musculoskeletal symptoms in the electronics manufacturing industry in China. Improving the levels of physical exercise and reducing posture problems and force loads may help to promote the health of workers.

Relationship between Wearing a Lead Apron and Work-related Musculoskeletal Disorders: A Questionnaire Survey of Japanese Radiological Technologists

The purpose of this study was to conduct a self-reported questionnaire survey of work-related musculoskeletal disorders (WMSDs) among Japanese radiological technologists (RTs) and to report on the relationship between wearing a lead apron and WMSDs. Between February and April of 2021, RTs in Okayama Prefecture, Japan, were surveyed by mail and through a website. Information on individual characteristics, physical factors at work, and the presence of WMSDs were collected. All participants were also asked whether they frequently wore lead aprons. A multiple logistic regression analysis was used to assess the relationship between wearing a lead apron and WMSDs. The model was adjusted for age, sex, body mass index (BMI), and working hours. Of the 123 participants, 67 (54.5%) had WMSDs. Multiple logistic regression analysis revealed that WMSDs were significantly associated with wearing a lead apron. Compared to the "Never wear" group, the odds ratios for the "Always/Frequently wear" and "Sometimes/Rarely wear" groups were 7.87 (95% confidence interval [CI]=1.28-48.46; p=0.026) and 7.80 (95% CI=1.43-42.44; p=0.017), respectively. Our analysis suggests that wearing a lead apron is associated with WMSDs, and thus design modifications in lead aprons may improve the occupational health management of RTs.

Automatic Ergonomic Risk Assessment Using a Variational Deep Network Architecture

Ergonomic risk assessment is vital for identifying work-related human postures that can be detrimental to the health of a worker. Traditionally, ergonomic risks are reported by human experts through time-consuming and error-prone procedures; however, automatic algorithmic methods have recently started to emerge. To further facilitate the automatic ergonomic risk assessment, this paper proposes a novel variational deep learning architecture to estimate the ergonomic risk of any work-related task by utilizing the Rapid Entire Body Assessment (REBA) framework. The proposed method relies on the processing of RGB images and the extraction of 3D skeletal information that is then fed to a novel deep network for accurate and robust estimation of REBA scores for both individual body parts and the entire body. Through a variational approach, the proposed method processes the skeletal information to construct a descriptive skeletal latent space that can accurately model human postures. Moreover, the proposed method distills knowledge from ground truth ergonomic risk scores and leverages it to further enhance the discrimination ability of the skeletal latent space, leading to improved accuracy. Experiments on two well-known datasets (i.e., University of Washington Indoor Object Manipulation (UW-IOM) and Technische Universität München (TUM) Kitchen) validate the ability of the proposed method to achieve accurate results, overcoming current state-of-the-art methods.

Manual Therapy Facilitates Homeostatic Adaptation to Bone Microstructural Declines Induced by a Rat Model of Repetitive Forceful Task

The effectiveness of manual therapy in reducing the catabolic effects of performing repetitive intensive force tasks on bones has not been reported. We examined if manual therapy could reduce radial bone microstructural declines in adult female Sprague–Dawley rats performing a 12-week high-repetition and high-force task, with or without simultaneous manual therapy to forelimbs. Additional rats were provided 6 weeks of rest after task cessation, with or without manual therapy. The control rats were untreated or received manual therapy for 12 weeks. The untreated TASK rats showed increased catabolic indices in the radius (decreased trabecular bone volume and numbers, increased osteoclasts in these trabeculae, and mid-diaphyseal cortical bone thinning) and increased serum CTX-1, TNF-α, and muscle macrophages. In contrast, the TASK rats receiving manual therapy showed increased radial bone anabolism (increased trabecular bone volume and osteoblast numbers, decreased osteoclast numbers, and increased mid-diaphyseal total area and periosteal perimeter) and increased serum TNF-α and muscle macrophages. Rest, with or without manual therapy, improved the trabecular thickness and mid-diaphyseal cortical bone attributes but not the mineral density. Thus, preventive manual therapy reduced the net radial bone catabolism by increasing osteogenesis, while rest, with or without manual therapy, was less effective.

Exploratory Field Testing of Passive Exoskeletons in Several Manufacturing Environments: Perceived Usability and User Acceptance

OCCUPATIONAL APPLICATIONSResults of the current exploratory study suggest that use of an exoskeleton (EXO) has the potential to be accepted by workers as an intervention in diverse manufacturing environments. Also evident were that the major factors contributing to EXO-use-intention are perceived comfort, task-technology fit, perceived safety, and perceived usefulness. A user's perception of perceived usability may be established by using an exoskeleton during actual job tasks, yet some aspects of perceived usability likely require multiple exposures to an EXO for an accurate assessment. Many negative comments regarding EXO use were related to physical constraints (e.g., restricted movements, bulkiness), and to the EXO interface (e.g., straps, cuff designs), suggesting a need for further research on EXO design to minimize discomfort. In practice, there is likely value in having workers use and explore candidate EXOs during their actual job, both to accurately assess the usefulness of an EXO and to find the most effective EXO.

Evaluating the Current State of Ergonomics Education Offered to Students in US Medical Students

BACKGROUND

The high rate of work-related musculoskeletal disorders (WMSD) among surgeons is well-documented and found to factor into medical students' interest in surgical specialties. Ergonomic techniques can reduce musculoskeletal pain in surgeons. Access to ergonomics education in residency is minimal and the ergonomics education offered in medical school has not been characterized.

METHODS

An anonymous, online survey was distributed to 210 administrators in medical education and curriculum at all accredited US allopathic medical schools. They were asked about their knowledge of ergonomics, assessment of potential benefits of ergonomics education to their students, and the ergonomics education offered at their institution.

RESULTS

A total of 71 surveys were completed (33.8% response rate). 82% of schools reported familiarity with the study of ergonomics and 81% thought it would be beneficial to the future careers of their students to receive ergonomics education. Respondents estimated 43% of surgeons experience WMSDs and those that did not think ergonomics education would be beneficial to their students' future careers had a statistically significantly lower estimate of WMSD burden amongst practicing surgeons. Only one respondent reported that students at their institution receive greater than three hours of ergonomics education, while 98% reported their students will receive less than three hours. Considering this, 81% of respondents reported that students do have access to other resources that encourage ergonomic practices, such as gym access, yoga classes, and surgical simulation labs.

DISCUSSION

Medical schools should increase access to ergonomics education and integrate it into their curriculum as early as possible.

Evaluation of a New Simplified Inertial Sensor Method against Electrogoniometer for Measuring Wrist Motion in Occupational Studies

Wrist velocity is an important risk factor for work-related musculoskeletal disorders in the elbow/hand, which is also difficult to assess by observation or self-reports. This study aimed to evaluate a new convenient and low-cost inertial measurement unit (IMU)-based method using gyroscope signals against an electrogoniometer for measuring wrist flexion velocity. Twelve participants performed standard wrist movements and simulated work tasks while equipped with both systems. Two computational algorithms for the IMU-based system, i.e., IMU_norm and IMU_flex, were used. For wrist flexion/extension, the mean absolute errors (MAEs) of median wrist flexion velocity compared to the goniometer were <10.1°/s for IMU_norm and <4.1°/s for IMU_flex. During wrist deviation and pronation/supination, all methods showed errors, where the IMU_norm method had the largest overestimations. For simulated work tasks, the IMU_flex method had small bias and better accuracy than the IMU_norm method compared to the goniometer, with the MAEs of median wrist flexion velocity <5.8°/s. The results suggest that the IMU-based method can be considered as a convenient method to assess wrist motion for occupational studies or ergonomic evaluations for the design of workstations and tools by both researchers and practitioners, and the IMU_flex method is preferred. Future studies need to examine algorithms to further improve the accuracy of the IMU-based method in tasks of larger variations, as well as easy calibration procedures.

Work-related Musculoskeletal Disorders and Quality of Life Among Staff Nurses in a Tertiary Care Hospital of Bangalore

BACKGROUND

Work-related musculoskeletal disorder (WMSD) is a collective and descriptive term used for the symptoms caused or aggravated by work. Significant WMSDs can affect the productivity and Quality of Life (QOL) of nurses. This study was undertaken to estimate the prevalence of WMSDs, identify their risk factors, and find the association, if any. This study also assessed the quality of life of nurses and its association with WMSDs.

METHODS

This cross-sectional study was conducted among 207 staff nurses at a tertiary care hospital in Bangalore for a period of 7 months (June-2018 to Dec-2018). The nurses were stratified based on their parent department into three broad categories - Medical, Surgical, and Operation Theatre. Stratified random sampling was followed to obtain the required number of nurses from each stratum. Data was collected using a pre-tested semi-structured questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), clinical examination tests, and WHOQOL-BREF.

RESULTS

The annual prevalence of WMSDs among the study subjects using NMQ was 168 (81.2%). The prevalence of WMSDs based on clinical examination tests was 67 (32.4%). Repetitive movements at work (OR 9.3, 95% CI 3.4-25.7), working in abnormal postures for prolonged periods (OR 4.7, 95% CI 1.7-12.9), and working even when sick (OR 5.3, 95% CI 2.0-14.1) were the risk factors for WMSDs (P < 0.05). No significant association was found between reported WMSDs (according to NMQ) and QOL.

CONCLUSION

Our study found that the prevalence of WMSDs was high among the staff nurses and it did not affect their QOL significantly. Workshops and training sessions on ergonomics should be regularly conducted at the workplace to prevent WMSDs.

A method for the risk assessment of biomechanical overload in hospital physiotherapists

BACKGROUND

In physiotherapists, biomechanical overload risk assessment (RA) is particularly complex due to the tasks' variability. The present study aims to propose a new methodology, named Whole Body RA Biomechanical Overload (WB-RAMBO), to assess the risk in the activities performed by physiotherapists.

METHODS

Each type of intervention was broken down into elementary operations. The risk factors (force, repetitiveness, and incongruous postures) were recorded and evaluated for each of these. For each task, the risk level was obtained by integrating the results of multiple ergonomic methods among those proposed by the international literature. To verify and validate the obtained results, we reviewed the medical records of health surveillance carried out on physiotherapists.

RESULTS

From the ergonomic point of view, RA shows a situation of acceptability. The observed slight dysergonomies are diluted in the work shift and allow an optimal functional recovery of the musculoskeletal system.

CONCLUSIONS

This method proposes a RA for each operation performed. A work plan subjected to such a peculiar RA can be redesigned and adapted to the company's and the hypersusceptible worker's organizational needs.

Evaluation of work ability index and its association with job stress and musculoskeletal disorders among midwives during the Covid-19 pandemic

BACKGROUND

Musculoskeletal disorders (MSDs) and work-related stress are among the factors that can negatively affect work ability. Given the importance of midwives' health, this study aims to evaluate the work ability of midwives and to investigate its association with the prevalence of MSDs and work-related stress in midwifery.

METHODS

Ninety-one midwives participated in this study. Three questionnaires, including Nordic musculoskeletal questionnaire (NMQ) plus body map, Persian version of work ability index (WAI) questionnaire, and Health and Safety Executive (HSE) job stress questionnaire, were used to collect data. Finally, the association of MSDs, work-related stress, and individual characteristics with WAI among midwives was investigated.

RESULTS

The highest rates of pain and discomfort were reported in the lower back and neck. The mean job stress was 116.08 with the highest scores on demand, role, and control subscales. The work ability among midwives was at an acceptable level of 39.07 on average. Inter-variable association analysis showed that the work ability was significantly associated with pain in the past 12 months and the number of coexisting MSDs. Job stress was not associated with work ability.

CONCLUSIONS

Midwives' WAI was at an acceptable level despite high prevalence of MSDs in midwives, the confirmation of the possible correlation between MSDs and work ability, as well as the high job stress in midwifery. Since the present study was conducted during the Covid-19 pandemic, the high stress in midwives may be partly due to the pandemic and may not be permanent. However, this level of stress may reduce the midwives' work ability over a long time.

Manual Therapy With Rest as a Treatment for Established Inflammation and Fibrosis in a Rat Model of Repetitive Strain Injury

Background: Repetitive strain injuries caused by repetitive occupational work are difficult to prevent for multiple reasons. Therefore, we examined the effectiveness of manual therapy (MT) with rest to treat the inflammation and fibrosis that develops through the performance of a repetitive task. We hypothesized that this treatment would reduce task-induced sensorimotor declines and neuromuscular inflammation. Methods: Twenty-nine female Sprague-Dawley rats performed a reaching and lever-pulling task for 14weeks. All ceased performing the task at 14weeks. Ten were euthanized at this timepoint (TASK). Nine received manual therapy to their upper extremities while resting 7weeks (MTR); 10 were assigned to rest alone (REST). Ten additional food restricted rats were included that neither performed the task nor received manual therapy (FRC). Results: Confirming previous experiments, TASK rats showed behavioral changes (forepaw mechanical hypersensitivity, reduced grip strength, lowered forelimb/forepaw agility, and noxious cold temperature sensitivity), reduced median nerve conduction velocity (NCV), and pathological tissue changes (myelin degradation, increased median nerve and muscle inflammation, and collagen production). Manual therapy with rest (MTR) ameliorated cold sensitivity seen in REST rats, enhanced muscle interleukin 10 (IL-10) more than in REST rats, lead to improvement in most other measures, compared to TASK rats. REST rats showed improved grip strength, lowered nerve inflammation and degraded myelin, and lowered muscle tumor necrosis factor alpha (TNFα) and collagen I levels, compared to TASK rats, yet maintained lowered forelimb/forepaw agility and NCV, and increased neural fibrosis. Conclusion: In our model of repetitive motion disorder, manual therapy during rest had modest effects on behavioral, histological, and physiological measures, compared to rest alone. These findings stand in contrast to the robust preventive effects of manual therapy in this same model.

Ergonomics and Work-Related Musculoskeletal Disorders: Characteristics Among Female Interventionists

Interventional radiology is a procedural specialty that performs minimally invasive operations under image guidance. Currently, there are inadequate ergonomic protocols for work-related musculoskeletal disorder (WMSD) prevention in interventional radiology (IR), and there is a paucity of information discerning gender differences in WMSDs. This article reviews current literature that addresses WMSDs in female physicians practicing interventional and fluoroscopic procedures, including interventional radiology, interventional cardiology, electrophysiology, vascular surgery, orthopedic surgery, neurosurgery, and gastroenterology. We searched PubMed and EBSCOhost databases for ergonomic studies that reported female physician WMSDs in the specialties listed above. After a thorough evaluation for inclusion based on eligibility criteria, 11 studies were included. From this search, there was poor female representation, averaging 25.7% of respondents. Several characteristics identified across the studies were that women were generally shorter, wore smaller glove sizes, and were younger than their male colleagues. Seventy-two percent of female proceduralists reported WMSDs versus 46.6% of their male colleagues. Additionally, women may experience more upper extremity pain than lumbar pain, which men commonly reported. Potential contributing factors to WMSDs are the size and design of procedural tools and the possible predisposition of female physicians to experience upper extremity WMSDs while performing the same operations as men. As more women enter medicine and pursue careers in procedural fields like interventional radiology, it is essential to address these discrepancies and develop ergonomically sound solutions for women.

Why Workers Hesitate to Report Their Work-Related Musculoskeletal Symptoms: A Survey at a Korean Semiconductor Company

Underreporting work-related musculoskeletal disorders (WRMSD) has been an issue in South Korea. The purpose of this survey was to figure out how many employees of a semiconductor and liquid crystal display company in South Korea experience WRMSDs and what the possible obstacles in reporting to the company are. A survey was developed with demographic questions, perceived WRMSD symptoms, and reasons for reporting or not reporting WRMSD. The survey was distributed via the company's intranet to all employees (24,380) whose employee identification number ended with an odd number. A total of 2862 employees completed the survey and the response rate was 11.7%. A total of 55.2% of respondents had felt at least one musculoskeletal symptom during the past year. More than 40% of workers who had experienced pain or discomfort during the past year thought their symptoms were more than 50%. work-related. More than one-fourth of respondents answered that they did not report their symptoms to the company more than once. The open-ended answers for not reporting WRMSD were categorized into seven common reasons. The reasons for not reporting WRMSD in previous studies show a combination of personal, organizational, socioeconomical, and cultural factors. To encourage and manage WRMSD effectively, seven recommendations of authors are described.

Work-Related Musculoskeletal Disorders Among Hospital Midwives in Chenzhou, Hunan Province, China and Associations with Job Stress and Working Conditions

Background

Midwives have a high risk of work-related musculoskeletal disorders (WMSDs), which are the leading cause of pain and disability. However, the association between job stress and WMSDs among midwives has not been studied. The aim of this project was to specifically describe relationships between the job stress and WMSDs among a sample of hospital midwives in Chenzhou, Hunan Province, China.

Methods

We conducted a cross-sectional study among a sample of 769 eligible midwives in the city of Chenzhou in Hunan Province, China from May 2018 to January 2019. All participants completed a questionnaire regarding the presence and severity of different pain symptoms and job stress assessed by the Korean occupational stress scale.

Results

A total of 597 participants responded (77.6%), and 491 (82.2%) reported that they had experienced WMSDs at some time over a 12-month period. The most common pain site was low back (72.7%), followed by the neck (52.8%) and shoulders (42.7%). We revealed that various aspects of job stress were associated with WMSDs in the current study, namely “Owing to my workload, I always feel time pressure” (OR, 2.05; 95% CI: 1.28–3.28), “My job has become increasingly overbearing” (OR, 2.34; 95% CI: 1.46–3.77), “My work requires long lasting concentration” (OR, 3.50; 95% CI: 2.13–5.74), “I have to do various jobs simultaneously”, (OR, 3.15; 95% CI: 1.93–5.14)), “My work requires creativity” (OR, 2.15; 95% CI: 1.31–3.54), “My work requires a high level of skill or knowledge” (OR, 2.83; 95% CI: 1.67–4.80), “My supervisor is helpful in getting the job done” (OR, 0.53; 95% CI: 0.33–0.84), “I have someone who understands my difficulties at work” (OR, 0.53; 95% CI: 0.34–0.85), “Undesirable changes (ie, downsizing) will come to my job” (OR, 3.28; 95% CI: 2.01–5.77), “My company provides me with sufficient organizational support” (OR, 0.47; 95% CI: 0.29–0.74), “Departments cooperate each other without conflicts” (OR, 0.50; 95% CI: 0.32–0.80), “I am provided with the opportunity to develop my capacity” (OR, 0.57; 95% CI: 0.36–0.91) and “My company climate is authoritative and hierarchical” (OR: 3.21; 95% CI: 1.97-5.23).

Conclusion

Overall, this study suggests that job stress has an important influence on WMSDs among a sample of hospital midwives in Chenzhou, Hunan Province, China. Given the multifaceted nature of identified risk, a comprehensive approach to reduce this risk is clearly required and a job stress management program will be essential.

Landscaping Work: Work-related Musculoskeletal Problems and Ergonomic Risk Factors

Background

Work-related musculoskeletal disorders (WRMSDs) are considered one of the foremost reason of disability globally with significant economic impact due to loss of productivity. Landscaping work is considered a high-risk industry in the service sector. Landscape workers are susceptible to WRMSDs as they are exposed to high physical demands at work, and exert significant physical effort to complete daily repetitive tasks during long working hours. The aim of this study was to determine the prevalence of WRMSDs and to identify the ergonomic risk factors among landscape workers in a university setting.

Methods

This was a cross-sectional study conducted among landscape workers at a public university in Kota Kinabalu, Sabah. Interviews were conducted due to low literacy of the participants, using structured questionnaires which consist of personal characteristics, work descriptions, ergonomic risk factors, as well as self-reported WRMSD symptoms using NORDIC questionnaire. Ergonomic risk assessment (ERA) using rapid entire body assessment (REBA) was then conducted.

Results

Fifty-five of 60 landscape workers agreed to participate (92% response rate). The overall prevalence of WRMSDs among landscape workers was 85.5%. The highest prevalence involving the shoulder (65.5%), followed by neck (23.6%), wrist/hand (23.6%), and lower back (20.0%) regions based on their self-reported WRMSD symptoms over the past 12 months. Awkward posture was the risk factor identified through ergonomic risk assessment (ERA) conducted by ERA trained personnel. None of the working postures during assessment was noted to be appropriate. Although no significant difference was associated with self-reported WRMSDs, majority of the landscape workers (71%) were classified as medium ergonomic risk group using REBA, with the remaining 29% considered to be high ergonomic risk group.

Conclusion

Improvement in awareness campaigns, modification of working tools, and enhanced administrative approaches are among the control and prevention measures recommended to delay or prevent the occurrence of WRMSDs.

Work-related musculoskeletal disorders and associated risk factors among urban metropolitan hairdressers in India

Objectives

Ergonomic hazards account for a substantial proportion of work‐related diseases and injuries among hairdressers. Awkward posture during work, repetitive movements, prolonged standing, and long working periods to carry out work activities cause mechanical load on the joints and work‐related musculoskeletal disorders (WMSDs). This study investigated the musculoskeletal problems among urban hairdressers and associated risk factors.

Methods

This study investigates the prevalence of WMSDs among 768 study subjects (384 hairdressers and control subjects each) from Ahmedabad and New Delhi metropolis in India. Univariate statistical analysis was carried out along with 95% confidence interval for effect estimates.

Results

Findings reveal that the nearly half of the hairdressers suffered from knee and foot pain (49.5%), followed by lower back pain (39.8%) and upper back pain (38.8%). The neck pain and shoulder pain were reported by more than 25% hairdressers. The odds of developing neck pain (OR = 2.04; 95% CI 1.37‐3.06) and shoulder pain (OR = 1.85; 95% CI 1.25‐2.73) were significantly higher than control. The female hairdressers were more likely to experience work‐related musculoskeletal disorder (OR = 2.63; 95% CI 1.18‐5.86) than male counterparts. Hairdressers within the age of 18‐35 years had significantly higher occurrence of musculoskeletal disorders with longer duration of working hours at the workplace. Longer daily work hours (>12 hours) posed significantly higher risk (OR = 2.47; 95% CI 1.39‐4.38) of experiencing MSD for hairdressers.

Conclusion

A very large proportion of hairdressers suffered with work‐related musculoskeletal disorders. The long daily working hours and gender of the hairdresser are associated with increased risk of developing WMSDs.

A qualitative study of health information-seeking behavior on the Internet among information technology professionals

BACKGROUND

The motivation to seek health information on the Internet for individuals has been varied. The purpose of this paper was to explore the perspectives and experiences about online health information seeking in information technology (IT) professionals.

MATERIALS AND METHODS

A qualitative case study research design was employed to examine the behavior of 15 IT professionals from a state organization in the East Coast of the United States of America. Convenience sampling was used to identify the setting, and purposeful sampling was used to select the participants. A survey questionnaire was used as a recruitment tool, and in-depth individual interviews with standardized semi-structured questions were used to collect data.

RESULTS

Findings illustrated that the Internet was the first source of reference for wellness and prevention information to maintain a healthy lifestyle, and to alleviate and prevent work-related musculoskeletal disorders (WMSDs). The themes that emerged from the study were that the IT professionals searched the Internet for information to self-educate about medical conditions, to maintain fitness, communicate with health-care professionals, decide their treatment options, and to make lifestyle modifications such as ergonomic adjustment of their workstation, postural adjustments, and changing negative health behaviors.

CONCLUSION

The results of this study provide practical implications for organizations and health professionals in providing health education to prevent WMSDs as participants sought health information online to take actions and collaborate with their health-care professionals and actively contributed to their medical health decisions. This underscores a valuable opportunity for health-care providers and public health officials to become more proactive by providing their patients with quality health information outside their office through the Internet by referring them to credible website sources.

Forces: A Motion Capture-Based Ergonomic Method for the Today's World

Approximately three of every five workers are affected by musculoskeletal disorders, especially in production environments. In this regard, workstation ergonomic evaluations are especially beneficial for conducting preventive actions. Nevertheless, today's context demonstrates that traditional ergonomic methods should lead to smart ergonomic methods. This document introduces the Forces ergonomic method, designed considering the possibilities of inertial motion capture technology and its applicability to evaluating actual workstations. This method calculates the joint risks for each posture and provides the total risk for the assessed workstation. In this calculation, Forces uses postural measurement and a kinetic estimation of all forces and torques that the joints support during movement. This paper details the method's fundamentals to achieve structural validity, demonstrating that all parts that compose it are logical and well-founded. This method aims to aid prevention technicians in focusing on what matters: making decisions to improve workers' health. Likewise, it aims to answer the current industry needs and reduce musculoskeletal disorders caused by repetitive tasks and lower the social, economic, and productivity losses that such disorders entail.

Guidelines for Working Heights of the Lower-Limb Exoskeleton (CEX) Based on Ergonomic Evaluations

The aim of this study was to evaluate the muscle activities and subjective discomfort according to the heights of tasks and the lower-limb exoskeleton CEX (Chairless EXoskeleton), which is a chair-type passive exoskeleton. Twenty healthy subjects (thirteen males and seven females) participated in this experiment. The independent variables were wearing of the exoskeleton (w/ CEX, w/o CEX), working height (6 levels: 40, 60, 80, 100, 120, and 140 cm), and muscle type (8 levels: upper trapezius (UT), erector spinae (ES), middle deltoid (MD), triceps brachii (TB), biceps brachii (BB), biceps femoris (BF), rectus femoris (RF), and tibialis anterior (TA)). The dependent variables were EMG activity (% MVC) and subjective discomfort rating. When wearing the CEX, the UT, ES, RF, and TA showed lower muscle activities at low working heights (40-80 cm) than not wearing the CEX, whereas those muscles showed higher muscle activities at high working heights (100-140 cm). Use of the CEX had a positive effect on subjective discomfort rating at lower working heights. Generally, lower discomfort was reported at working heights below 100 cm when using the CEX. At working heights of 100-140 cm, the muscle activity when wearing the CEX tended to be greater than when not wearing it. Thus, considering the results of this study, the use of the lower-limb exoskeleton (CEX) at a working height of 40-100 cm might reduce the muscle activity and discomfort of whole body and decrease the risk of related disorders.

Work-Related Risk Assessment According to the Revised NIOSH Lifting Equation: A Preliminary Study Using a Wearable Inertial Sensor and Machine Learning

Many activities may elicit a biomechanical overload. Among these, lifting loads can cause work-related musculoskeletal disorders. Aspiring to improve risk prevention, the National Institute for Occupational Safety and Health (NIOSH) established a methodology for assessing lifting actions by means of a quantitative method based on intensity, duration, frequency and other geometrical characteristics of lifting. In this paper, we explored the machine learning (ML) feasibility to classify biomechanical risk according to the revised NIOSH lifting equation. Acceleration and angular velocity signals were collected using a wearable sensor during lifting tasks performed by seven subjects and further segmented to extract time-domain features: root mean square, minimum, maximum and standard deviation. The features were fed to several ML algorithms. Interesting results were obtained in terms of evaluation metrics for a binary risk/no-risk classification; specifically, the tree-based algorithms reached accuracies greater than 90% and Area under the Receiver operating curve characteristics curves greater than 0.9. In conclusion, this study indicates the proposed combination of features and algorithms represents a valuable approach to automatically classify work activities in two NIOSH risk groups. These data confirm the potential of this methodology to assess the biomechanical risk to which subjects are exposed during their work activity.