Manual Handling Risks Research Articles

Identification of potential biomechanical risk factors for low back disorders during repetitive rebar lifting

PurposeWork-related low back disorders (LBDs) are prevalent among rebar workers although their causes remain uncertain. The purpose of this study is to examine the self-reported discomfort and spinal biomechanics (muscle activity and spinal kinematics) experienced by rebar workers.Design/methodology/approachIn all, 20 healthy male participants performed simulated repetitive rebar lifting tasks with three different lifting weights, using either a stoop (n = 10) or a squat (n = 10) lifting posture, until subjective fatigue was reached. During these tasks, trunk muscle activity and spinal kinematics were recorded using surface electromyography and motion sensors, respectively.FindingsA mixed-model, repeated measures analysis of variance revealed that an increase in lifting weight significantly increased lower back muscle activity at L3 level but decreased fatigue and time to fatigue (endurance time) (p < 0.05). Lifting postures had no significant effect on spinal biomechanics (p < 0.05). Test results revealed that lifting different weights causes disproportional loading upon muscles, which shortens the time to reach working endurance and increases the risk of developing LBDs among rebar workers.Research limitations/implicationsFuture research is required to: broaden the research scope to include other trades; investigate the effects of using assistive lifting devices to reduce manual handling risks posed; and develop automated human condition-based solutions to monitor trunk muscle activity and spinal kinematics.Originality/valueThis study fulfils an identified need to study laboratory-based simulated task conducted to investigate the risk of developing LBDs among rebar workers primarily caused by repetitive rebar lifting.

Assessing the Risk of Manual Handling of Patients and Its Relationship with the Prevalence of Musculoskeletal Disorders Among Nursing Staff: Performance Evaluation of the MAPO and PTAI Methods

Background: Manual handling of patients without using proper devices built for this purpose is the most important risk factor causing musculoskeletal disorders (MSDs) among nursing staff. Objectives: The aim of the present study was to determine the prevalence of MSDs, assess the risk of manual handling of patients, and identify the risk factors related to the development of such disorders among nursing staff. Methods: This cross-sectional study was conducted in 2015 and included 220 nurses from 24 wards who were working in Baqiyatallah hospital, Tehran, Iran; their duties mainly involved patient handling. The participants were selected based on the random stratified sampling method. In this study, the Nordic musculoskeletal questionnaire, demographic questionnaire, movimentazione and assistenza di pazienti ospedalizzati (MAPO), and patient transfer assessment instrument (PTAI) methods were applied as data collection tools. In addition, Spearman correlation coefficients and binary and multiple logistic regressions were used to determine the possible relationships between the variables. Results: The prevalence of MSDs among the participants over the past 12 months was found to be 79.5%. The results for the risk factors showed that the lower back, neck, shoulders, and upper back were the most affected areas of the body. According to the MAPO and PTAI, 60% and 40% of the wards, respectively, are at risk of MSDs. A significant relationship between MAPO and PTAI was found, with a coefficient correlation of 0.252. Based on the statistical analysis, positively significant relationships were found between body mass index, gender, nurse-to-bed ratio, final PTAI and MAPO indices, and MSDs. Conclusions: The prevalence of MSDs among the nurses was high, and the occurrence of such disorders was found to be related to the scores of MAPO and PTAI indices. Based on the results, these two indices can be used as appropriate tools to assess the risk of MSDs in patient handling by nursing staff. The risk of developing MSDs can be lowered through interventional programs, such as providing and equipping hospitals with the tools required for patient handling and educating staff on how to properly use such devices. In addition, increasing the nurse-to-bed ratio will lower the burden for the nurses in patient handling.

Risks of moving and handling.

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article discussed the use of a structured approach to manual handling risk assessment, which would simplify the process and reduce the risk of injury when undertaking handling tasks.

Combining Passive Sampling with Recombinant Receptor-Reporter Gene Bioassays to Assess the Receptor Activity of Victorian Rivers.

This pilot study was initiated to provide new information on the 'hormonal' activity of Victorian rivers. Chemcatcher™ passive sampler systems containing Empore™ C18FF disks were deployed at eight riverine sites near Melbourne. Little estrogenic activity [<0.4-1.8ng estradiol equivalents (EQ)/disk] and no retinoic acid activity (RAR, all samples <0.8ng trans-retinoic acid EQ/disk) was observed. Almost all sample extracts showed aryl hydrocarbon receptor activity (from <4 to 29ng β-naphthoflavone EQ/disk). Overall, the disk extracts were eminently compatible with the bioassay screening technology, enabling the relative levels of 'hormonal activity' to be observed in the surface waters in and around Melbourne. From a practical perspective, the in situ sampling and pre-concentration provided by passive sampling reduces the manual handling risks associated with sample transport, and the number of laboratory operations required to obtain assay-ready solutions for analysis.

Musculoskeletal injury risks for ambulance workers

The provision of emergency and urgent care has been recognised for many years as exposing ambulance workers to high risks of muskuloskeletal injuries. Sue Hignett explores the common manual handling risks faced by paramedics and considers the role of human factors/ergonomics in occupational health and patient safety.

Evaluation of Ergonomic Risk of Manual Handling of Patients with MAPO Index and its Relationship with Incidence of Low Back Pain among Nurses

Low back pain (LBP) is the most common and most costly musculoskeletal disorder among nursing profession. The ergonomic risk factors are common causes of lumbar injury. This study aims to assess the risk of LBP among nurses in different wards of an Iranian subspecialty hospital by means of MAPO method and to investigate if there is any relationship between calculated index and the self-reported LBP. The study was conducted in 16 sections of an Iranian subspecialty hospital including 174 wards. Exposed nursing staff (N=54) were asked to report LBP experiences in the past year. Our results indicated approximately 90% of examined wards were in the red band while only 9% were in the yellow and 1% in the green bands. Among all nurses who worked in the high risk wards, 25% reported suffering LBP during the past 12 months. However, 16% of those who were in the medium risk wards also experienced LBP in the past year. Chi-square test showed a significant relationship between LBP incidence and the level of MAPO index (p=0.004). This study suggests that the frequency of LBP among nurses is higher than the general population. The most studied wards felt in the red band, indicating the elevated risk for low back in the majority of hospital wards. It is therefore necessary to implement an ergonomic program in order to modify the observed deleterious condition as soon as possible.

Reconceptualising manual handling: Foundations for practice change

Background : Healthcare involves complex manual handling tasks that are unique to the industry. Despite research intended to improve carer safety, substantial rates of manual handling injuries persist within the nursing profession. This paper reviews manual handling issues arising from patient care activities and the strategies deployed in healthcare facilities to reduce musculoskeletal injuries. Discussion : Conventional programs aimed at reducing nurses’ work-related manual handling injuries include assumptions regarding evidence, transferability to the clinical setting and efficacy. Additionally, intervention success is commonly measured by administrative data comprising incident reports and injury rates. However official statistics are contrasted with self-reported injury rates in several studies. The complex nature of the injury mechanism and the obscured visibility of musculoskeletal disorders hinder detection of manual handling injuries and attribution of causality. In turn, this hampers the development of successful injury prevention strategies. Training programs reliant on specific techniques and assistive devices have had limited success. This paper questions the appropriateness of training and compliance strategies to manage manual handling risks in nursing practice and expounds a re-examination of the premises upon which manual handling programs are based. Conclusion: It is argued that the current conceptualisation of manual handling has limited the development of effective injury prevention programs for healthcare. It emphasises the enforcement of guidelines rather than a critique of other influences on practice. Approaching manual handling from a different perspective, inclusive of nurses’ knowledge, is a way forward into the complex environment of manual handling in healthcare contexts. Voicing and validation of nurses’ manual handling knowledge offers critical knowledge necessary to improve manual handling safety for nurses by foregrounding contextual influences that have previously been undervalued.

New tools in Germany: development and appliance of the first two KIM ("lifting, holding and carrying" and "pulling and pushing") and practical use of these methods

The Key Indicator Methods (KIM) assess the risk of manual handling of loads on a screening level. Their purpose is the recognition and removal of job design deficits. The risk assessment is carried out in two stages. The first stage is the ordinal scaled description of workload items. The second stage is the evaluation of the degree of probability of physical overload. The intended user population are both practitioners in enterprises such as safety engineers, industrial engineers, and inspectors. The first two KIM were developed and tested from 1996 to 2001 in connection with the implementation of the EU directives into German national legislation. They consist of two independent, but formally adaptable methods for lifting, holding, and carrying and for pulling, and pushing. The KIM were drafted in the German Federal Institute for Occupational Safety and Health (BAuA) in close collaboration with the German Labour Inspectors. Numerous companies, scientists, statutory accident insurances, institutions, employer associations, and trade unions were involved. Since their first publication in 2000 and 2001, these methods are widely accepted among possible users with a corresponding broad application in Germany. They are recommended by the EU Labour Inspector Conference for application. In 2007 a third KIM for manual handling operating tasks KIM MHO were developed, tested, and validated in the last four years.

Manual handling risks associated with the care, treatment and transportation of bariatric (severely obese) clients in Australia

Carers of bariatric (morbidly obese) clients are exposed to manual handling injury risk throughout the journey that such clients take within the healthcare system. To identify the factors that affect risks associated with bariatric clients and the subsequent adoption of risk control measures focus groups were conducted in two Australian state capitals: a suburban region of Melbourne and a large regional Victorian town. Participants, were recruited from within the primary health care sector, ambulance services, fire services and funeral businesses. It was found that the risks to which nurses, ambulance officers, fire fighters, and funeral industry employees are exposed are significant. The injury risk is influenced by the nature and design of the range of environments within which client movement is undertaken; the limited range of handling equipment available for use with bariatric clients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term ``bariatric'' and the gaps in information flow during the bariatric client journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions.

Manual handling risks associated with the care, treatment and transportation of bariatric patients and clients in Australia

To gain an understanding of the factors that affect the risks and the adoption of risk control measures during the care of bariatric patients, focus groups were conducted in rural and metropolitan locations in Australia. It was found that the manual handling injury risk to carers is influenced by the design of the environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organizational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term 'bariatric' and limitations in the use of weight and body mass index in definitions. There are gaps in information flow during the bariatric patient journey through the health-care system and a lack of knowledge about how to safely manage the unique needs of bariatric patients.

Manual Handling Risks Associated with the Transportation of Bariatric Patients in Australia

Objectives Identify the factors that affect the risks and the adoption of risk control measures during the care of bariatric (morbidly obese) patients by paramedics and fire fighter first responders in Australia. Methods Focus groups were conducted in neutral locations in two Australian state capitals; a suburban region of Melbourne which straddled the rural and metropolitan boundaries; and a large regional Victorian town. Results Carers of bariatric patients are exposed to manual handling injury risk throughout the journey that bariatric patients take within the healthcare and funeral systems. In focussing on paramedics and fire service first responders, as key groups within that journey, it was found that the risks are significant but are not quantifiable. The injury risk is influenced by the nature and design of the range of environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term “bariatric” and gaps in the information flow during the bariatric patient journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions. Conclusion There is a lack of knowledge about how to safely manage the unique needs of bariatric patients. It appears that few streamlined systems have been established for patient management, and many cases are managed as if they are an isolated experience. There is little documentation of systems or case studies and thus very little sharing of the knowledge. Improvements in manual handling risk control for carers requires greater inter and intra-industry collaboration, which in turn requires an agreed definition of “bariatric”.

Risk factors for moving and handling bariatric patients

To identify and explore the manual handling risks for patients and caregivers using bariatric patient pathways in health and social care. A mixed methodological approach, including focus groups and questionnaires, was used in this study. Participants were recruited for the focus groups from the National Back Exchange (NBE) Special Interest Group on Bariatrics and the National Ambulance Risk and Safety Forum (NARSF). The questionnaire was distributed to all members of the NBE and NARSF in 2006. The data sets were analysed thematically (focus groups: n = 25) and descriptively (questionnaires: n = 230). Patient pathways were mapped for medical (acute), community and maternity admissions resulting in five generic themes: patient factors; building and vehicle space and design; equipment and furniture; communication; and organisational and staff issues. A total of 59% (n = 136) of respondents reported that their organisation did not have a bariatric manual handling policy. Of all responding organisations (n = 230), 77% (n = 177) had access to specialist equipment but only 32% (n = 68) of NBE respondents (n = 212) provided specialist bariatric manual handling training for staff. Lack of formal communication systems between and within organisations contributed to manual handling risks at admission and discharge. There is a need to review and design more appropriate buildings, vehicles, furniture and equipment to reduce the manual handling risks to health professionals and bariatric patients. More research is required to examine the implementation of policies, in particular focusing on the use of equipment and the communication between care-providing agencies.

101 Manual Handling Risk Assessment

Introduction: An effective manual handling risk assessment is vital for the safety of nurses and patients admitted to the hospice. An accurate risk assessment and care plan is essential for communicating risks and meeting the individual needs of our patients. Aims: To provide a comprehensive assessment form identifying manual handling risks and a care plan stating handling techniques …

Manual handling risks in the bariatric (obese) patient pathway in acute sector, community and ambulance care and treatment

As part of a larger research project the patient pathway was mapped for an emergency admission to identify the manual handling major risks. Focus group interviews were held with 25 key stakeholders from the acute, community and ambulance healthcare sectors and social services at 3 venues across the United Kingdom (UK). A detailed qualitative iterative analysis used 'cause and effect' or fishbone (Ishikawa) diagrams to identify key issues. Five themes emerged as generic risks throughout the bariatric patient pathway, these were: patient factors including body shape, mobility, pain, co-operation, privacy, comfort and dignity; building (or vehicle) space and design, including space, clearance, floor surface, and safe working load of floor; equipment (manual handling and clinical) and furniture, including fit, maximum weight capacity, availability, suitability, compatibility, size, and effort to move; communication both within and between organisations; and organisational and staff issues, including policies, culture and staff availability and training. It was concluded that buildings, vehicles and equipment need to be designed to 'fit' a range of bariatric shapes and sizes so that bariatric patients could be accommodated in safety and comfort, and with minimal loss of dignity.

Bariatric furniture: Considerations for use

Given the increasing prevalence of obesity throughout the world, it is important that health-care providers are able to meet the needs of this service-user group. One area that is necessary to consider in bariatric care is the suitability of furniture, both in the hospital and in a patient's own home. If these patients have suitable chairs and beds, transfer in to standing or mobility equipment will be facilitated, allowing users to be both more mobile and able to participate in therapy. Prescribing and advising bariatric patients on furniture should take into account all aspects of individual need. Given the amount of time a patient spends in bed and in sitting (both in the hospital and home) a patient's bed or chair will be their most frequently used piece of equipment. By choosing the most appropriate furniture, not only will the quality of life of these patients be improved, but the manual handling risks to both carers and therapists will be reduced. This article will highlight the range of furniture available to this patient group and discuss considerations for use.

Development of a manual handling programme for allied health

In line with current legislation relating to occupational health and safety, a package was developed and implemented to guide patient manual handling for the allied health team. The ‘Allied Health Smart Moves’ (AHSM) package was based on a risk assessment model, incorporating therapists' clinical judgment to minimize manual handling risks, while maximizing the therapeutic benefits for the patient. A working party developed and implemented the package for physiotherapists, occupational therapists and allied health assistants in a large metropolitan Health Network. Eighty eight per cent of all relevant staff completed training in the package and demonstrated improved knowledge of related legislation as well as safe manual handling procedures after training. The number of musculoskeletal disorders reported by the possible 227relevant allied health staff in the 6-month period before implementation of the AHSM package was three, and in the 6-month follow up period was none. The AHSM package was successfully developed and implemented within a large metropolitan health network.

T71 The use of rapid entire body assessment (REBA) for the quantification of manual handling risks

Medical Physics, County Hospital, Lincoln, UK British Nuclear Medicine Society Oral and Poster Abstracts 2007

Manual handling risk management: critical care beds and support systems

This article examines the reduction of manual handling risk to nurses through discussion of the technical and ergonomic features of critical care beds and support systems. It describes the features of different types of manual handling equipment, in particular trolleys, beds and patient platform support surfaces.

Manual handling risk management: critical care beds and support systems

This article examines the reduction of manual handling risk to nurses through discussion of the technical and ergonomic features of critical care beds and support systems. It describes the features of different types of manual handling equipment, in particular trolleys, beds and patient platform support surfaces.

Consultative team to assess manual handling and reduce the risk of occupational injury

OBJECTIVESTo describe the formation of a consultative team to assess the risk of manual handling in the workplace that started in October 1992 within the cleaning services department of a...