The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.     

The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.     

Effectiveness of participatory ergonomic interventions on health outcomes: a systematic review

The objective of this study was to conduct a systematic review of the literature on the effectiveness of participatory ergonomic (PE) interventions for improving workers' health. The search strategy targeted six electronic databases and identified 442 potential articles. Each article was examined by pairs of reviewers for relevance (assessed a participative ergonomic workplace intervention, with at least one health outcome, published in English in peer reviewed literature). Twenty-three articles met relevance criteria and were then appraised for methodological strength. Using a best evidence synthesis approach, 12 studies that were rated as 'medium' or higher provided partial to moderate evidence that PE interventions have a positive impact on: musculoskeletal symptoms, reducing injuries and workers' compensation claims, and a reduction in lost days from work or sickness absence. However, the magnitude of the effect requires more precise definition.     

A model for solving work related musculoskeletal problems in a profitable way

Interventions against occupational musculoskeletal disorders are usually performed by ergonomists. An overview of the literature shows that ergonomists often are unsuccessful; musculoskeletal disorders may be prevalent at workplaces where large ergonomic resources have been put in, thus illustrating the significance of other factors in addition to those against which the intervention is applied. It is claimed that some modern rationalization strategies may offer a potential for 'good' ergonomics. Thus, prevailing management approaches often now focus on team building, flat organizations, training of multiple skills and so on. The main scope of the present issue of Applied Ergonomics is to throw light on this possibility of 'achieving ergonomics impact through management intervention'. This present paper presents a historical overview of occupational physical work load as a function of ergonomics, as well as rationalizations and concludes with a more elaborate discussion of the present intervention concept for solving work related musculoskeletal problems in a profitable way. Rationalization and guidelines for physical work load are the basic parameters in the present intervention concept. Due to this the present special issue also presents historical overviews of the development of these parameters (Westgaard and Winkel; Bjorkman). 'Achieving ergonomics impact through management intervention' is illustrated through two case studies (Kadefors et al and Bao et al). They demonstrate an obvious ergonomic potential offered by the presented intervention concept. However, the two case studies also describe several practical obstacles which need to be further investigated in future intervention research.     

Effect of Physical Ergonomics on VDT Workers' Health: A Longitudinal Intervention Field Study in a Service Organization

This article examines the effect of physical ergonomic work conditions on occupational health in video display terminal (VDT)-intensive work settings. A longitudinal intervention field study was conducted in a catalog retail service organization in the Midwest to explore the impact of ergonomic interventions. There were 3 levels of ergonomic interventions, each adding incrementally to the previous one. The 1st level was ergonomic training for all VDT users accompanied by workstation ergonomic analysis leading to specific customized adjustments (Group C). The 2nd level added specific workstation accessories supplied by Details, Inc. if the analysis indicated a need for them (Group B). The 3rd level added a Steelcase Criterion(tm) 453 Series chair (Group A). Health data were gathered from 80 volunteer participants by administering a survey before (baseline), 6 months after, and 12 months after interventions were put in place. The findings show that neck, back, and shoulders as well as wrists stand out in terms of self-reported musculoskeletal pain in VDT-intensive work. Reductions in self-reported musculoskeletal discomfort were found for all 3 levels of incremental ergonomic interventions. The number of cases showing improvement in health over time was significant for intervention Groups A and B, but not C.     

Effectiveness of ergonomic training to reduce physical demands and musculoskeletal symptoms - An overview of systematic reviews

Work-related musculoskeletal disorders are associated with awkward postures, excessive force, manual material handling and repetitive movements. This risk factors can be minimized through interventions such as ergonomic training. The literature covers several studies involving the use of this type of intervention, but there is no consensus about the effectiveness of ergonomic training. The aim of this study was to identify the available evidence about the effectiveness of ergonomic training to reduce physical work demand and musculoskeletal symptoms through an overview of systematic reviews. The searches were carried out in Pubmed/Medline, Web of Science, CINAHL, Embase and Cochrane Library. The START (State of the Art through Systematic Review, v.1.06.2) platform aided the selection and evaluation of studies. The studies were evaluated for methodological quality through the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) criteria and the implications for practice. This overview identified a large number of studies with a low to moderate level of evidence, indicating the ineffectiveness of ergonomic training alone or associated with another type of intervention in reducing physical demand and musculoskeletal symptoms in workers. The findings may have occurred due to four main factors: superficial identification of the ergonomic risk factors; lack of scientific evidence about the appropriate configurations of the types of ergonomic training; ambiguous results in the application of ergonomic training; and the difficulty in the effectiveness of the intervention. The study identified an inconsistency in the level of evidence of ergonomic training to reduce physical demand and musculoskeletal symptoms among workers.     

Associations of ergonomic and psychosocial work hazards with musculoskeletal disorders of specific body parts: A study of general employees in Taiwan

Background and aimsMusculoskeletal disorders (MSDs) are major occupational health concerns. This study examined the associations of ergonomic and psychosocial work hazards with the risks of MSDs of specific body parts and their distribution across a wide range of occupational groups.MethodsStudy participants comprised 8,937 male and 7,052 female employees aged 20–65 years from a nationwide survey in 2016. A self-report questionnaire was administered to obtain information regarding demographic characteristics, work conditions, ergonomic and psychosocial work hazards, and MSDs of different body parts in 12 months. Multivariate logistic regression models were used to estimate prevalence ratios of MSDs in relation to ergonomic and psychosocial work hazards.ResultsIn professionals and skilled workers, MSDs of the neck and shoulders were more prevalent, whereas in manual workers, MSDs of the hands, wrists, and lower back were more prevalent. Psychosocial work hazards, including high psychological demand and low workplace justice, were major work-related risk factors for shoulder and neck disorders, whereas ergonomic hazards were major work-related risk factors for lower back and wrist or hand disorders.ConclusionDifferent workplace hazards contribute to the risks of different MSDs. To prevent the development of MSDs, occupational health professionals should evaluate both ergonomic and psychosocial work hazards and develop health prevention programs tailored to the risk profiles of working populations.     

Assessing exposure to risk factors for work-related musculoskeletal disorders using Quick Exposure Check (QEC) in taxi drivers

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world. This study aimed to examine the risk factors that are involved in the development of WMSDs in taxi drivers. In total 382 taxi drivers were observed using Quick Exposure Check (QEC) observational tool, which allows practitioners and workers to assess four key areas of the body. Results of the QEC scores were found to be very high for the shoulder/arm, wrist/hand and neck, whereas the scores for the back were found to be high for static use and moderate for moving. The results also showed that the occupational risk factors for WMSDs were associated with restricted postures, repetitive movements, vibration, work related stress. Essential ergonomic interventions are needed to eliminate risk of exposures to WMSDs in taxi drivers.Relevance to industryThe study results have relevance for ergonomists, health and safety practitioners as well as the drivers themselves, and helpful for estimating the main physical risk factors for WMDSs before choosing a method prior to an ergonomic intervention in industry.     

Cross-sectional study of risk factors for symptoms in the neck and shoulder area

Abstract

This study was performed in order to evaluate how individual characteristics, as well as ergonomic, organizational and psychosocial factors in the work situation are associated with early symptoms in the neck and shoulder area. Nine hundred randomly drawn subjects of the working population in a semi-rural community in Sweden were mailed a questionnaire comprising the Nordic questionnaire on musculoskeletal symptoms, questions on ergonomic, organizational and psychosocial work conditions, life style factors, and background factors. The total response rate was 73% ( n = 637). Questions on ergonomic work conditions and on organizational and psychosocial work conditions provided the measures of exposure. Prevalence ratios (PR) were calculated for symptoms in the neck and shoulder area as reported by 303 subjects. Significant determinants for early symptoms were being a female and being an immigrant, as were repetitive movements demanding precision. High work pace, low work content and work role ambiguity were significant organizational risk factors while life style characteristics did not appear as risk factors. The results suggest that symptoms are signals not only of ergonomic deficiencies in the work situation, but in particular of work organizational conditions. Special attention should be given to the work conditions of women and immigrants in preventive interventions.     

Can we simulate the biomechanical effects of exoskeletons prior to workstation implementation? Application of the Forces ergonomic method

Increasingly, exoskeletons are becoming a valuable tool for prevention technicians to promote occupational health and reduce the risk of musculoskeletal disorders in industry. However, the effective implementation of industrial exoskeletons is a complex challenge. Deciding whether these devices are the optimal solution to the detected ergonomic risks at a specific workstation is not straightforward. This study presents the modelling of three commercial passive exoskeletons, one for lumbar and two for shoulder risk reduction, to be considered in the musculoskeletal risk assessment of industrial workstations. The presented modelling considers the forces and moments applied by exoskeletons to the body using the Forces ergonomic method, providing the musculoskeletal risk for each joint based on inertial motion capture data registered at each workstation. This approach is exemplified on simulated and actual production workstations. The results reveal that the modelling application allows an objective understanding of the biomechanical effects of exoskeletons. Modelling establishes a predictive tool to assess and make decisions regarding the suitability of the exoskeleton prior to implementation at a workstation.     

Ergonomic intervention research for improved musculoskeletal health: A critical review

This literature review of ergonomic intervention studies aims to identify effective ergonomic interventions for improved musculoskeletal health in the workplace and to make recommendations for quality criteria in ergonomic intervention research. To avoid ambiguity in terminology a list of definitions of the ergonomic terms used in this paper is provided in an appendix. Models were developed for use in the classification of ergonomic intervention research and to illustrate the problems in interpreting ergonomic intervention data. The relevant literature was identified by a two-step process. First the relevant literature was identified by inclusion criteria, then, quality criteria were applied to identify studies of good quality for effective intervention. These appear to be firstly “organizational culture” and secondly modifier interventions, the former using multiple interventions with high stakeholder commitment to reduce identified risk factors, and the latter especially focusing workers at risk and using measures which actively involve the individual. A list of recommendations is provided.     

Ergonomic interventions among waste collection workers: A systematic review

Waste collection workers are frequently exposed to significant occupational hazards. Even though ergonomic interventions can mitigate these occupational hazards, only a few studies have attempted to study the importance of the interventions. The current review identifies the gaps in ergonomic interventions among waste collection workers. A systematic review and a bibliometric analysis of the literature on the assessment of occupational hazards and ergonomic interventions in different countries were performed to identify the scope of the interventions. A literature search was carried out in Web of Science, PubMed and Scopus for articles published until December 2018. The search yielded seventy articles on the assessment of occupational health and ten articles on ergonomic interventions among waste collection workers. Based on the review, this paper proposes a hierarchical framework for the implementation of ergonomic interventions in waste associated occupations. The problems faced by formal and informal waste collectors are critical, particularly in developing countries and there is a growing need for low-cost interventions. It is suggested that the potential interventions have to be implemented based on the nature of occupational hazard considering social, cultural and economic factors.     

Musculoskeletal pain among teleworkers: Frequency and associated factors

Teleworking, also known as remote working, has become the new norm for many workers since the coronavirus disease 2019 (COVID-19) pandemic. Studies show that during this time, the incidence of musculoskeletal pain is increasing among these workers. Despite this, few studies have addressed the possible correlates of musculoskeletal paśin in teleworkers, with several potential predictors receiving little or no attention in published studies. With this in mind, an online survey was conducted among organizations in the IT and communications sectors in Malta. Information was collected from 459 teleworkers on the frequency of telework, frequency of work during nonworking hours, exercise frequency, burnout, and ergonomic arrangements. Demographic data were also collected. Results revealed that 55.8% reported one or more musculoskeletal pain. Back pain was the most common, followed by neck and shoulder pain. The presence of pain, the number of painful body areas, and the presence of back, neck, and shoulder pain were each individually associated with work during nonworking hours, lower levels of exercise, and higher levels of burnout. It is argued that musculoskeletal pain appears to be common among teleworkers and may negatively impact the quality of life and organizational performance. Companies and occupational health practitioners should strive to identify the prevalence of these problems among their teleworkers, develop appropriate preventive measures, and support workers to obtain multidisciplinary care when needed.     

Evaluation of musculoskeletal health outcomes in the context of job rotation and multifunctional jobs

Higher physical demands at work are associated with health outcomes such as discomfort, disorders and sick leave. Variations in work exposure patterns, introduced by multifunctional jobs and ergonomic interventions, bring confounders into the complex relation between occupational risks and musculoskeletal disorders. This study compared whole-body rating of perceived exertion (RPE), discomfort, ergonomic workplace analysis (EWA) and sick leave due to musculoskeletal disorders, among workers exposed to diversified work. The results showed that EWA performed by the observer differed from workers' ratings. There were no differences between groups of workers taking or not taking sick leave regarding RPE and discomfort at their current workstations. Workers significantly discriminated between progressive workload levels, and RPE scores for specific tasks were nonlinear during shifts. These differences might be associated with exposure variability. Thus, in the context of diversified work, the RPE scale seems more appropriate for evaluating acute effects of work variability.     

Prevention of musculoskeletal disorders at work: Validation and reliability in a multicenter intervention study

During the years 1986–1989 The Finnish Work Environment Fund initiated a multicenter, intervention study (programme) to prevent musculoskeletal disorders at work. The programme consisted of four different projects comprising methodological, epidemiological, and interventive themes. The main results were as follows: (1) More than half of the occupational physiotherapists and physicians involved in the project felt that they did not have adequate training for testing the performance capacity of the musculoskeletal system. Several of the most commonly used musculoskeletal tests had either poor validity in predicting future musculoskeletal troubles or had poor reliability. (2) A controlled intervention study showed that active training of neck-shoulder muscles can prevent musculoskeletal troubles, even more than ergonomic actions. (3) It is possible to reduce sick-leave due to low-back disorders by intervention measures directed toward both the work (environment, tools) and the workers (working methods, positive attitude to work, preparedness to keep fit). (4) The identification of ergonomic hazards with the help of teamwork proved to be feasible. The practical improvements, however, were difficult to implement in the prevailing conditions. Some of the improvements increased the work load and the stress of the workers. This aspect needs further consideration.     

Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms

Standardised questionnaires for the analysis of musculoskeletal symptoms in an ergonomic or occupational health context are presented. The questions are forced choice variants and may be either self-administered or used in interviews. They concentrate on symptoms most often encountered in an occupational setting. The reliability of the questionnaires has been shown to be acceptable. Specific characteristics of work strain are reflected in the frequency of responses to the questionnaires.     

Occupational stress factors in visual display terminal (VDT) operation: a review of empirical research

A review of the literature involving empirical research (experimental and field investigations) on stressful aspects of visual display terminal (VDT) operation is presented. Studies reviewed included assessment of visual fatigue and/or performance, musculoskeletal symptoms and operator attitudes towards job demands and quality of working life. In addition, some investigation included discussions and evaluations of the physical attributes of VDT workplaces; including ergonomic factors (task lighting, glare conditions, anthropometric configuration of VDT and accompanying furniture), environmental factors (temperature, humidity, radiation) and psychosocial factors (job demand, work content, work-rest schedules).

The literature reveals that levels of visual and musculoskeletal complaints among VDT operators are high. Moreover, ergonomic field assessment of VDT workplaces indicate that the majority of those examined were suboptimal with respect to existing recommendations regarding lighting, glare control and anthropometric dimensions of screen, keyboard, desk and chair. Nevertheless, evidence of causal linkages between specific ergonomic attributes of the workplace and specific patterns of symptomatology are lacking.

Finally, work demand and task structure attributes to the VDT operation were demonstrated to have strong effects on incidences of reports of visual and postural symptoms as well as on psychosocial attitudinal indicators. Hence, it is argued that approaches toward stress reduction must include job content as well as ergonomic factors.     

Musculoskeletal pain in operating room nurses: Associations with quality of work life,working posture,socio-demographic and job characteristics

This cross-sectional study evaluated the association of socio-demographic and job characteristics as well as quality of work life (QWL) and working posture with the presence of musculoskeletal pain (MSP) among 144 operating room (OR) nurses in Iran. A questionnaire (including the Nordic Musculoskeletal Questionnaire [NMQ] and the QWL questionnaire) and direct observations of working postures using the Rapid Entire Body Assessment (REBA) method were used. A high prevalence of MSP, particularly in the low back (61.9%), knees (60.5%), ankles/feet (55.8%) and neck (44.9%) were found. The overall mean REBA score of 7.7 suggested that most OR nurses (with posture assessed at action levels 3 and 4) needed an immediate investigation and changes in their working habits and workstations to reduce the risk level. Work-related factors including type of operating room, work shifts (rotating), feeling pressure due to work, total QWL and its dimensions (particularly health and safety, knowledge and esteem needs) and working postures were associated with the presence of MSP in different body regions. Socio-demographic factors including gender (being female) and little or no involvement in sport/physical activity were also independently associated with the occurrence of complaints. The findings emphasise the need for multiple component ergonomic interventions involving the socio-demographic and work-related physical and psychosocial factors for prevention of MSP in this occupational group.