Patient handling and musculoskeletal disorders among hospital workers: Analysis of 7 years of institutional workers' compensation claims data

Abstract

Musculoskeletal disorders (MSDs) are the most common occupational injuries and illnesses among hospital workers in the United States. To date, there is little in the literature examining the principal effect of patient handling on MSDs. The primary objective of this study was to investigate and confirm the principal effect of patient handling on hospital worker MSDs. Workers' Compensation (WC) claims related to MSDs filed during 2003-2009 by employees in a large US healthcare system were classified using ICD-9. Patient handling, demographic, work, and injury characteristics were obtained. Two multivariable Poisson regression models were compared to evaluate association between risk factors and MSDs. One model contained all risk factors, excluding patient handling; the other model included patient handling. Among 3,452 claims from 24,824 FTEs, 76% were MSDs. About half of the MSDs involved patient handling. In the regression model without patient handling, EMS workers, women, 50-59 years of age, union members, evening shift workers, and fulltime workers showed associations with MSDs. However, all the observed associations disappeared when patient handling was included in the second regression model; patient handling was the only factor showing an association with MSDs, although the effect was not strong (RR = 1.2, 95% CI = 1.2-1.3). All the observed associations of risk factors disappeared and were further away from patient handling on the causal pathway to MSDs. Patient handling involves numerous work elements and dynamic physical activities. Understanding the work elements of patient handling and conducting interventions based on specific patient handling tasks can substantially reduce MSDs among hospital workers.