Work organization and Low back pain in nursing personnel

Nursing personnel are at a high risk from occupational low back injury. Work organization has been suggested as one factor playing a part in the aetiology of occupational low back pain. Baseline data for a prospective epidemiology study were gathered by means of a questionnaire. One part of the questionnaire elicited characteristics of work organization, perceived autonomy, the relationship with head nurse and satisfaction in the relationship with co-workers. Information on history of musculoskeletal problems, reported frequency of lifting and personal characteristics was also gathered. Of 787 nursing staff at two acute care hospitals, 154 (19-6%) reported troublesome low back pain occurring within the previous 6 months. From univariate analyses, such characteristics of work organization as shift, type of schedule and primary versus functional nursing were not associated with low back pain. The relationship with head nurse and perceived autonomy of the job also were not related to recent back pain. Recent low back pain was significantly associated with younger age, the job category ‘registered nurse’ and greater satisfaction in relationships with co-workers. These associations were confirmed in multivariate analysis. None of the work organization factors examined, with the exception of satisfaction with co-workers, were associated with back pain in this study. Moreover, the positive association of satisfaction with coworkers suggests that interventions to improve working relationships may not be helpful in prevention programmes. To some extent, these results are susceptible to biases resulting from selective attrition from nursing and selective participation in the study.     

Whole-body vibration exposure in sport: four relevant cases

This study investigates the whole-body vibration exposure in kite surfing, alpine skiing, snowboarding and cycling. The vibration exposure was experimentally evaluated following the ISO 2631 guidelines. Results evidenced that the most critical axis is the vertical one. The weighted vibration levels are always larger than 2.5 m/s² and the vibration dose values are larger than 25 m/s^1.75. The exposure limit values of the EU directive are reached after 8–37 min depending on the sport. The vibration magnitude is influenced by the athletes’ speed, by their skill level and sometimes by the equipment. The large vibration values suggest that the practice of sport activities may be a confounding factor in the aetiology of vibration-related diseases.     

The interaction between skill, postures, forces and back pain in wool handling

Wool handling is an important rural occupation where workers process 200 or more fleeces daily, separating them into various quality components. Loads and postures they experience carry substantial risk of low back pain (LBP). Although a formal skill training structure exists, interaction with loads and LBP is unknown. We examined whether skill and LBP influenced trunk postures and loads of 60 wool handlers representing 3 skill levels. LBP prevalence ranged from 20% for junior (lowest skill) to 45% for open class (highest skill) wool handlers. Open class wool handlers demonstrated increased lateral bend and more axially twisted postures, generating greater medio-lateral shear forces and lateral bend and axial twist moments. LBP was associated with open class wool handlers spending more time in severe axially twisted postures. These findings suggest that skill-based training needs to be reviewed to reduce the quantity of axially twisted posture which may help reduce the prevalence of LBP in this workforce.     

Sustaining person-environment fit with a changing workforce

Data on health and lifestyle from the Naval service cohort study of occupational stress form the background to a discussion of employee health and the sustainability of a healthy workforce in relation to secular changes – in particular, the increasing prevalence of obesity. One thousand two hundred and forty-one Naval personnel returned questionnaires in 2007 and 2011 and reported their body mass index (BMI), alcohol consumption and smoking, general health and health conditions such as back pain and high blood pressure on both occasions. Health risk due to high BMI and waist circumference in 2011 was predicted by low participation in exercise in 2007. Those performing physically demanding work in 2007 were more likely to be in the ‘no risk’ category in 2011. High BMI in 2007 was associated with the development of back pain, musculoskeletal conditions and high blood pressure in 2011. The findings are discussed in relation to two aspects of sustainability: the sustainability of current ergonomics practice in relation to health and safety; and the role of ergonomics in sustaining a healthy and productive workforce.

Practitioner Summary: Evidence is presented for the benefits of exercise in sustaining employee health and for an association between a high BMI and a number of common health complaints that have traditionally been tackled through workplace ergonomics. This evidence can be used to support the development of workplace design concepts that promote physical activity.     

Vibration and spinal lengthening in simulated vehicle driving

There is active interest in the relationship between back pain and driving. The availability of a precision stadiometer enabled experiments to be done to explore the effects of simulated driving on the change in spinal length, the hypothesis being that the spinal load would cause a shrinking in the length of the spine. The experiments demonstrated that, when exposed to a combination of vertical and horizontal vibration at 4 Hz the spinal length increased for all eight subjects, whilst under no vibration conditions there was a decrease in the average length. At 6 and 8 Hz there was no statistically significant change in length. The results suggest that there is an unloading of the spine when subjects under simulated driving conditions are exposed to vibrations in two directions at a frequency close to the spine's natural frequency.     

Perception of difficulties for the back related to asssembly work: general findings and impact of back health

The study objective was to describe the perceptions of airplane assemblers on job demand for the back and how back pain modulated these perceptions. One hundred and seventy-six workers answered two questionnaires concerning back pain and the perception of work related difficulties (work activities, work contexts, tools, work positions, efforts). Results show that positions and work contexts are perceived as greater sources of difficulty than efforts or dynamic activities. The duration of a given position is more important than its frequency. Back pain has a significant but complex impact on the perception of difficulty. Assemblers appear to integrate several factors when evaluating their difficulties as opposed to individual aspects, as it is often measured in ergonomic studies. The results have important implications for the measurement of ergonomic factors in the genesis of back pain and illustrates the potential for misclassification and biases in current epidemiologic studies.     

The influence of lift frequency,lift duration and work experience on discomfort reporting

Discomfort surveys are commonly used to assess risk in the workplace and prioritize jobs for interventions before an injury or illness occurs. However, discomfort is a subjective measure and the relationship of discomfort to work-related factors is poorly understood. The objective of this study was to understand how reports of discomfort relate to work-related risk factors for the low back. A total of 12 novice and 12 experienced manual materials handlers performed repetitive, asymmetric lifts at different load levels and at six different lift frequencies throughout an 8-h exposure period. Discomfort was recorded hourly throughout the day. Analyses were performed to determine which experimental factors influenced reporting of discomfort and if discomfort trends matched spine loading trends. Novice lifters reported significantly higher discomfort levels than experienced subjects. They also reported increases in discomfort as moment exposure increased and as the exposure time increased. Novices lifting at 8 Nm load moment level reported increased discomfort from 0.07 to 0.63 by the end of the day, at 36 Nm they reported an increase from 0.04 to 0.40 and at 85 Nm they reported an increase from 0.37 to 3.06. Experienced subjects, on the other hand, reported low levels of discomfort regardless of moment exposure, lift frequency or exposure duration. The reported discomforts were generally unrelated to the biomechanical loading on the spine. Discomfort reporting appears to be more a reflection of experience than of work risk factor exposure. Experienced subjects may have more efficient motor patterns, which reduce spinal load and thus discomfort. Novice subjects seemed to have a lower threshold of discomfort. Caution is needed when using discomfort reporting as a means to identify jobs in need of interventions, in that biomechanical loading may not be accurately represented. Discomfort should only be used as a supplement to objective measures, such as spinal loading, to assess the risk of low back disorders.     

Assumptions necessary and unnecessary to risk homoeostasis

This paper discusses recent criticisms of the theory of risk homoeostasis which has been put forward to explain the spatial, temporal and per capita traffic accident risk in a given jurisdiction, as well as their pattern of interrelation. Four assumptions have recently been proposed in the literature as being necessary for the theory to be valid. These were viewed as wanting and, therefore, presented as a challenge to the theory in question. In the present discussion, these four assumptions are examined on their conceptual pertinence. It is concluded that, without some major and some seemingly minor-yet theoretically crucial—modifications, none of these assumptions appear to be essential to the validity of the theory under debate.     

Neck pain prevalence and associated occupational factors in Portuguese office workers

ObjectiveThis study aimed to assess the prevalence of neck pain and to identify associated occupational factors in Portuguese office workers.BackgroundThere is still necessary to quantify the association of the use of new technologies with neck pain in office workers.MethodsSix hundred-and-one office workers completed online questionnaires with questions related to anthropometric parameters, work-related variables, workstation setup, and musculoskeletal pain from the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire.ResultsThe prevalence of neck pain was 56.1%. An average of 35.6% of the office workers with neck pain reported pain in more than three body segments. The significantly risk factors were “age between 50 and 65” [OR: 1.92 (1.26–2.91) P = 0.002], “working without break for 2 h” [OR: 1.82 (1.00–3.31) P = 0.05], “more than 3 h” [OR: 2.41 (1.35–4.10) P = 0.003], screen localization not centered” [OR: 2.01 (1.01–4.00) P = 0.045], and “use of computer mouse more than 50% of the worktime” [OR: 2.05 (1.14–3.71) P = 0.017].ConclusionThere was a high prevalence of neck pain and a considerable number of painful body segments in office workers. Age, working without break, screen localization and the use of computer mouse where the significant risk factors associated with the development of neck pain.Relevance to industryA high prevalence of neck pain and number of areas with pain in office workers require a detailed pain mechanism assessment. There were associated occupational risk factors for the development of neck pain. Call for concerted actions to explore optimal and efficient management plans.