Emerging infectious diseases , Emerging infectious diseases , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی

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Emerging Infectious Diseases

The scientific literature on work-related back disorders was reviewed to identify consistent risk factors and to determine the strength of the association between the two. Thirty-five publications were selected with quantitative information. Lifting or carrying loads, whole-body vibration, and frequent bending and twisting proved to be the physical load risk factors consistently associated with work-related back disorders. Job dissatisfaction and low job decision latitude proved to be important, but the evidence was not consistent across different studies and study designs. The epidemiologic studies illustrated the importance of several confounders, especially age, smoking habits, and education. In this review, gender, height, weight, exercise, and marital status were consistently not associated with back disorders in occupational populations.

Positive and negative evidence of risk factors for back disorders.

This systematic review assessed aspects of physical load during work and leisure time as risk factors for back pain. Several reviews on this topic are available, but this one is based on a strict systematic approach to identify and summarize the evidence, comparable with that applied in the clinical literature on the efficacy of intervention for back pain. A computerized bibliographical search was made of several data bases for studies with a cohort or case-referent design. Cross-sectional studies were excluded. A rating system was used to assess the strength of the evidence, based on the methodological quality of 28 cohort and 3 case-referent studies and the consistency of the findings. Strong evidence exists for manual materials handling, bending and twisting, and whole-body vibration as risk factors for back pain. The evidence was moderate for patient handling and heavy physical work, and no evidence was found for standing or walking, sitting, sports, and total leisure-time physical activity.

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Physical load during work and leisure time as risk factors for back pain

Although patient handlers suffer from low-back injuries at an alarming rate worldwide, there has been limited research quantifying the risk for the specific tasks performed by the patient handlers. The current study used both a comprehensive evaluation system (low-back disorder risk model) and theoretical model (biomechanical spinal loading model) to evaluate risk of LBD of 17 participants (12 experienced and five inexperienced) performing several patient handling tasks. Eight of the participants were female and nine were male. Several patient transfers were evaluated as well as repositioning of the patient in bed; these were performed with one and two people. The patient transfers were between bed and wheelchair (fixed and removable arms) and between commode chair and hospital chair. A 'standard' patient (a 50 kg co-operative female; non-weight bearing but had use of upper body) was used in all patient handling tasks. Overall, patient handling was found to be an extremely hazardous job that had substantial risk of causing a low-back injury whether with one or two patient handlers. The greatest risk was associated with the one-person transferring techniques with the actual task being performed having a limited effect. The repositioning techniques were found to have significant risk of LBD associated with them with the single hook method having the highest LBD risk and spinal loads that exceeded the tolerance limits (worst patient handling job). The two-person draw sheet repositioning technique had the lowest LBD risk and spinal loads but still had relatively high spinal loads and LBD risk. Thus, even the safest of tasks (of the tasks evaluated in this study) had significant risk. Additionally, the current study represented a 'best' case scenario since the patient was relatively light and co-operative. Thus, patient handling in real situations such as in a nursing home, would be expected to be worse. Therefore, to have an impact on LBD, it is necessary to provide mechanical lift assist devices.

A comprehensive analysis of low-back disorder risk and spinal loading during the transferring and repositioning of patients using different techniques

The protection level offered by filtering facepiece particulate respirators and face masks is defined by the percentage of ambient particles penetrating inside the protection device. There are two penetration pathways: (1) through the faceseal leakage, and the (2) filter medium. This study aimed at differentiating the contributions of these two pathways for particles in the size range of 0.03–1 μm under actual breathing conditions. One N95 filtering facepiece respirator and one surgical mask commonly used in health care environments were tested on 25 subjects (matching the latest National Institute for Occupational Safety and Health fit testing panel) as the subjects performed conventional fit test exercises. The respirator and the mask were also tested with breathing manikins that precisely mimicked the prerecorded breathing patterns of the tested subjects. The penetration data obtained in the human subject- and manikin-based tests were compared for different particle sizes and breathing patterns. Overal...

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Performance of an N95 Filtering Facepiece Particulate Respirator and a Surgical Mask During Human Breathing: Two Pathways for Particle Penetration

Biomechanical evaluation of assistive devices for transferring residents

Incidence of low back injuries among nursing personnel as a function of patient lifting frequency

Psychophysical assessment of assistive devices for transferring patients/residents

The purpose of this study was to determine if differences exist in 1) angle-specific torque, 2) torque-velocity relationships, and 3) power-velocity relationships of the quadriceps femoris muscle group when the trunk was and was not stabilized and the starting position was varied. We calculated isokinetic torques from seven adult men while the trunk was and was not stabilized for nine combinations of velocity of movement 0, 30, and 105°/sec) and starting position (40, 60, and 100° of knee flexion). The results suggest that 1) peak angle-specific torques and instantaneous power are greater when the trunk is stabilized, 2) the increase in the trunk-stabilized torque and power was greater at the higher velocity and for the larger ranges of motion, and 3) the testing movement should not begin beyond 30 degrees of the angle of interest.

Effect of Trunk Stabilization on Quadriceps Femoris Muscle Torque

Twenty laborers assumed specific lumbar spine postures and lifted a 157 N crate to three different hand heights to determine if lumbar spine flexion moments or trunk muscle activity were affected by the lifting postures Lumbar flexion moments were lowest when the workers used the lordotic and straight back postures, while the average erector spinae muscle activity tended to be highest in the lordotic and straight back postures The kypohotic posture regularly reduced the activity of the erector spinae to bursts of activity while lifting and caused more discomfort during the lifting tasks than any other posture Therefore, the lumbar lordotic posture is recommended as the posture of choice while lifting, particularly when lifting from the floor level

Terrence J. Stobbe

Papers

Biomechanical evaluation of assistive devices for transferring residents

Incidence of low back injuries among nursing personnel as a function of patient lifting frequency

Psychophysical assessment of assistive devices for transferring patients/residents

Effect of Trunk Stabilization on Quadriceps Femoris Muscle Torque

Effect of lumbar posture on lifting.