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Manual Handling Workload and Musculoskeletal Discomfort in Nursing Personnel

01 Jan 2001-
TL;DR: This paper presents a meta-analysis of the literature on screening for Musculoskeletal Disorders and results show that screening for WMSDs in nurses’ high-risk patient care units results is positive.
Abstract: iv Chapter 1: Introduction 1 Scope and Cost of Back Pain 2 Relationship of Musculoskeletal Pain to Workers’ Compensation Claims 3 Association with Strenuous Tasks 3 Chapter 2: Review of the Literature 6 Causes of Musculoskeletal Disorders 6 Body Parts Affected by WMSDs in Nursing 6 WMSD Risk Factors 6 Patient Handling and Movement Risk Factor Assessment 10 Patient Weight As Risk Factor 12 Assessing Risk 12 Exposure Assessment 16 Nursing Workload Measurement Systems 17 Risk Reduction Factors 19 Characteristics of James A. Haley VAMC High-Risk Patient Care Units 19 Screening for Musculoskeletal Disorders 20 Null Hypotheses 22 Definition of Terms 22 Chapter 3: Methods 27 Study Design 27 Sample and Sampling Procedures 27 Data Collection Procedures 28 Chapter 4: Results 30 Sample Size/Power Analysis 30 Data Analysis 30 Sample 30 Data Coding 32 Independent Variables 32

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Journal ArticleDOI
TL;DR: Measuring the change in current back pain prevalence yields more timely information about the effectiveness of an ergonomic intervention than assessing injury incidence rates, because of the high percent of nursing staff members who work in pain but delay filing workers' compensation claims.
Abstract: 1. The problem of work related musculoskeletal disorders of the low back in nursing personnel has been well documented in the literature by cross sectional studies showing high prevalence rates in licensed nurses and nursing aides. However, it is difficult to compare findings among these studies because of the use of nonstandardized symptom surveys, variations in case definitions, and other methodological inconsistencies. 2. Measuring the change in current back pain prevalence yields more timely information about the effectiveness of an ergonomic intervention than assessing injury incidence rates, because of the high percent of nursing staff members who work in pain but delay filing workers' compensation claims. 3. As employers attempt to reduce manual handling injuries, occupational health nurses may be called upon to survey workers for musculoskeletal symptom prevalence and document the effectiveness of ergonomic interventions. Before using or developing any musculoskeletal disorder symptom survey for workplace surveillance or research, occupational health nurses should determine whether the survey has adequate reliability, validity, responsiveness, and practicality.

76 citations


Cites background from "Manual Handling Workload and Muscul..."

  • ...Forty six studies, including the author's doctoral research (Menzel, 2001), were chosen for further review....

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Journal ArticleDOI
TL;DR: The prevalence of work related musculoskeletal disorders among nurses was high in the study area and working in mal-positions, working in the same positions for long period of time, working with disoriented patients and bending or twisting back during work were identified associated factors.
Abstract: Background: Musculoskeletal disorders represent a significant occupational problem among nurses; however, there is paucity of information on work related musculoskeletal disorder among nurses in Ethiopia. Objective: To assess work related musculoskeletal disorders and associated factors among nurses working in Jimma Zone Public hospitals, South west Ethiopia. Methods: Institutional based cross-sectional study was conducted in Jimma Zone public hospitals from March 12-27, 2015. Systematic random sampling technique was used to select 333 participants. Data were analyzed by using binary logistic regression and Odds ratios with 95% confidence intervals used to examine associations between dependent and independent variables. Results: The prevalence of work related musculoskeletal disorders at any body site was 60.8% and the highest report 124 (67.8%) was seen in the lower back which was followed by the neck 44 (24%) and knees 43 (23.6%). Lifting and transferring dependent patients [AOR 2.1 (1.1-4.3)], giving wound care [AOR 4.2 (1.9-8.9)], working in medical ward [AOR 9.6 (2.4-38.3)] and Intensive care unit [AOR 3.4 (1.2-9.7)], working in mal-positions [AOR 9.7 (2.2-42.6)], working in the same positions for long period of time [AOR, 6.1 (1.3-28.7)], working with disoriented patients [AOR 2.6 ( 1.1-5.7) and bending or twisting back during work [AOR 5.1 (1.1-23.7)] were identified associated factors. Conclusion: The prevalence of work related musculoskeletal disorders among nurses was high in the study area. Lifting and transferring dependent patients, giving wound care, working in medical ward and Intensive care unit, working in mal-positions, working in the same positions for long period of time, working with disoriented patients and bending or twisting back during work were identified associated factors.

6 citations

Journal Article
TL;DR: Age and experience were significantly associated with musculoskeletal symptoms in the different body regions and the results indicated out of every 10 workers, in the last work week, seven reported complaints in the lower legs.
Abstract: Although Musculoskeletal Disorders (MSDs) represents a common occupational problem, few epidemiological studies have investigated MSDs among industrial workers. MSDs are a common industrial health problem throughout the world and a serious cause of disability among the industrial workers.The goal of the study was to investigate the prevalence of musculoskeletal symptoms (ache, pain, or discomfort) among rubber workers in Iran, using the standard Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). The study population consisted of 100 males with mean age 31.73. Out of every 10 workers, in the last work week, seven reported complaints in the lower legs. The results are also indicated age and experience were significantly associated with musculoskeletal symptoms in the different body regions.

4 citations


Cites background from "Manual Handling Workload and Muscul..."

  • ...[21]; Nursing personnel [19]; Information Technology professionals [22]; Production assembly workers [23]; Dental students [24]; notebook computer users [25]....

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References
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Journal ArticleDOI
TL;DR: A combination of "poor" psychosocial work environment and "high" physical work load produced the highest RR for work-related neck and shoulder symptoms among home care workers and municipal employees.
Abstract: This study was based on a questionnaire and included a group of home care workers (HCW) (n = 305) and a reference group of municipal employees (n = 694). The relationship between the work environment and musculoskeletal symptoms was analysed. The HCW were less satisfied with their control over their work and stimulus from their work and had a higher physical work load and prevalence of musculoskeletal symptoms, compared with the reference group. The Rate Ratio (RR) of neck and shoulder symptoms among HCW was 83 and 54 %, respectively, higher among those reporting a “high” psychological work load compared with those reporting a “low” load. The highest RR for a single risk indicator was 2.5, and this concerned low-back symptoms among HCW who often worked with twisted postures. A combination of “poor” psychosocial work environment and “high” physical work load produced the highest RR for work-related neck (RR = 2.57) and shoulder (RR = 2.13) symptoms.

109 citations


"Manual Handling Workload and Muscul..." refers background in this paper

  • ...9 Johansson (1995) studied psychosocial work factors, physical work load, and associated musculoskeletal symptoms among home care workers and concluded that the highest relative risk was for a combination of poor psychosocial work environment and high physical workload....

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Journal ArticleDOI
TL;DR: The results of did not support the hypothesis that nursing work is a risk occupation for seeking care for low-back pain when compared with other occupations, and the combination of physical and psychosocial risk factors was associated with a particularly high risk.
Abstract: Objectives Low-back pain is common among nursing personnel, and its origin is multifactorial. The present study focused on physical and psychosocial work load. The objectives of the study were to estimate the relative risk for nursing personnel, compared with other occupational groups, to seek health care for low-back pain, and to identify risk factors. Methods This study is a part of a population-based case-referent study in the municipality of Norrtalje, situated north of Stockholm. Altogether 333 women served as cases and 733 served as referents. Eighty-one cases and 188 referents were employed in nursing work. The cases had sought health care for low-back pain during the study period, November 1993 to November 1996. The referents were randomly selected from the same population. The subjects filled out 2 questionnaires and participated in interviews about physical exposures and psychosocial factors. Results When the female nursing personnel were compared with other employed women, no increased risk of consultation for low-back pain was found. According to a multivariate logistic regression, nursing personnel exposed to forward-bending working positions, high energetic work load, perceived physical exertion, or insufficient social support had the highest risk estimates. In univariate analyses, the combination of physical and psychosocial risk factors was associated with a particularly high risk. Conclusion In nursing work, physical load seems to be more significant than psychosocial factors when a worker seeks health care for low-back pain. The results of did not support the hypothesis that nursing work is a risk occupation for seeking care for low-back pain when compared with other occupations.

105 citations


Additional excerpts

  • ...Other studies (Fuortes et al, 1994; 6 Josephson & Vingard, 1998; Ryden, Molgaard, Bobbitt, & Conway, 1989; Smedley, Egger, Cooper, & Coggon, 1997; Stubbs et al., 1983; Venning, Walter, & Stitt, 1987) have concluded that job-related (not individual) characteristics were the major predictors of back…...

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Journal ArticleDOI
TL;DR: In this article, the authors present a method by which estimates of exposure from self-report questionnaires, expert observers, work sampling, video analysis and electromyograms can be reported in a common metric, Newtons of force on a tissue, and show, as an example of its application, estimation of spinal compression on auto workers.
Abstract: There are many possible means of determining exposure ranging from self-reports of physical exposure to measures of muscle activations and estimated spinal loads. In epidemiologic studies, issues of validity make instrumented measures preferable, however issues of cost and practicability tend to force investigators to less costly but less valid and less reliable measures of exposure, such as self-report questionnaires. This paper presents a method by which estimates of exposure from self-report questionnaires, expert observers, work sampling, video analysis and electromyograms can be reported in a common metric, Newtons of force on a tissue, and show, as an example of its application, estimation of spinal compression on auto workers. A common metric allows a flexible approach to selection of measurement methods in occupational settings: no matter which instrument is used the results can be combined to provide an overall picture of exposure. This approach to exposure assessment for the low back allows for comparability across studies and settings.

105 citations

Journal ArticleDOI
TL;DR: The need for vigilant ergonomic intervention at job sites and early ergonomic education as an integral part of apprenticeship school training to ensure that carpenters remain fit and healthy throughout their working lifetime is supported.
Abstract: OBJECTIVES: To determine the prevalence and risk factors for work related musculoskeletal disorders among union carpenters. METHODS: A detailed questionnaire on musculoskeletal symptoms and work history was administered to 522 carpenters. The symptom questions assessed if carpenters experienced pain, numbness, or tingling in a particular body region. A subset of this group then received a physical examination of the upper extremities and knees. RESULTS: The study group was primarily white (94.9%) and male (97.8%) with a mean age of 42.3 years. The highest prevalence of work related musculoskeletal disorders cases by carpentry specialty ranged from 20%-24% for those doing drywall or ceiling, finishing or framing, and the building of concrete forms. Generally, as duration of employment increased, the prevalence of symptoms increased. An adjusted logistic regression analysis showed that the group with the longest (> or = 20 years) duration of employment in carpentry was significantly associated with work related musculoskeletal disorders of the shoulders (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.1 to 8.9), hands or wrists (OR 3.1, 95% CI 1.1 to 8.4), and knees (OR 3.5, 95% CI 1.3 to 9.2). Also, analyses showed that carpenters who reported that they had little or no influence over their work schedule had significant increases of work related musculoskeletal disorders of the shoulders, hips, and knees with ORs of 1.9 (95% CI 1.1 to 3.2), 2.9 (95% CI 1.1 to 7.2), and 2.3 (95% CI 1.2 to 4.1), respectively. Feeling exhausted at the end of day was also a significant risk factor for work related musculoskeletal disorders of the knee (OR 1.8, 95% CI 1.1 to 3.1). Upper extremity disorders were the most prevalent work related musculoskeletal disorders reported among all carpenters. Drywall or ceiling activities involve a considerable amount of repetitive motion and awkward postures often with arms raised holding heavy dry walls in place, whereas form work is notable for extensive lumbar flexion and had the two highest rates of work related musculoskeletal disorders. The psychosocial element of job control was associated with both upper and lower extremity disorders. These union carpenters, who were relatively young, already were experiencing considerable work related physical problems. CONCLUSION: This study supports the need for vigilant ergonomic intervention at job sites and early ergonomic education as an integral part of apprenticeship school training to ensure that carpenters remain fit and healthy throughout their working lifetime.

104 citations

Journal ArticleDOI
TL;DR: The data indicate a high overall frequency of occupational back pain, similar to other studies in Europe, and the comparison between the two hospitals suggests factors associated with the disorder: work tasks and particularly nurses/patients ratio are more important factors than age and length of exposure.
Abstract: Nursing staff members of a urban general hospital (GH) and a small oncological department (OD) were surveyed to determine the prevalence of occupational related musculoskeletal disorders (MSDs), the specific disabilities, accidents at work, and working time lost. All subjects had a medical examination to evaluate osteoarthicular disease and selected cases were invited to X-ray examinations. The purpose of this study was to compare MSDs in the two groups of nurses working in two hospitals with different work organization in the same geographical area, Pordenone in Italy. In the previous year 48% GH and 33% OD nurses reported back pain due to work, 29.4 and 16.1% respectively have had X-ray or orthopaedic examinations, 19.2% and 9.1% had been away from work because of back pain. All these differences are statistically significant. The analysis of musculoskeletal pain sites and working tasks in the two hospital workers shows no differences in distribution. Great difference exists when analysing the numbers of patients assisted by a nurse: 0.57 and 1.27 nurse/patients respectively in GH and OD. Our data indicate a high overall frequency of occupational back pain, similar to other studies in Europe. The comparison between the two hospitals suggests factors associated with the disorder: work tasks and particularly nurses/patients ratio are more important factors than age and length of exposure. Different work distribution, shift organization, a better ratio between nurses and patients, an improvement of equipment provision, and specific nurse-training with application of ergonomic methods could improve work efficiency radically and decrease injury rates.

100 citations


"Manual Handling Workload and Muscul..." refers background in this paper

  • ...Larese & Fiorito (1994) found that units with low nurse-to-patient ratios had more back pain and injuries than units with higher ratios....

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