Occupational Musculoskeletal Disorders Research Articles

Assessment of occupational musculoskeletal disorders (MSDs) among heavy vehicle drivers.

Professional driving requires long hours of work, uncomfortable seats, negotiating rough terrain and highways, and possibly minor repairs and other auxiliary transportation duties. Heavy vehicle drivers driving vehicles such as trucks, bulldozers, etc. due to such working structures are more prone to various musculoskeletal disorders (MSDs) and pain, which is of great concern. In the present study, it is planned to investigate possible ergonomic risk factors such as age, weight, driving exposure, seat suspension systems, lifting heavy weights causing MSDs in drivers of various heavy vehicles. The results of the study are expected to help drivers reduce the risk of MSDs. For the present study, the Nordic questionnaire on musculoskeletal disorders was modified and standardized and was administered to the 48 heavy vehicle drivers randomly selected to collect the data. The analysis divulged that over the past 12 months, lower back pain (LBP) emerged as the most dominant pain experienced by 56% of drivers, followed by knee pain (KP) (43%) and neck pain (NP) (39%) respectively. The prevalence of shoulder pain (SP) was observed to be much lower than in previous literature. The logistic regression model further revealed that increasing age, poor suspension system and poor body posture were significantly associated with lower back pain. Additionally, a poor suspension system and lifting heavy weights had significant effect on the drivers' knee pain. The results demonstrated the evident necessity for ergonomic consideration in vehicle designing and ergonomic training for heavy vehicle drivers.

Ergonomic benefit using heads-up display compared to conventional surgical microscope in Japanese ophthalmologists.

Occupational musculoskeletal disorders are prevalent in ophthalmic surgeons and can impact surgeons' well-being and productivity. Heads-up displays may reduce ergonomic stress compared to conventional microscopes. This cross-sectional, non-interventional study compared ergonomic experience between heads-up display and conventional ocular microscopes. The study protocol was approved by the independent ethics committee and nonprofit organization MINS Institutional Review Board. An online questionnaire was distributed to a sample of ophthalmic surgeons in Japan with experience operating with heads-up display. The questionnaire captured surgeon-specific variables, the standardized Nordic Musculoskeletal Questionnaire, and custom questions to compare heads-up display and conventional microscope and understand long-term impacts of musculoskeletal disorders. Analysis was conducted on responses from 67 surgeons with a mean 25 years of practice and 2.7 years using heads-up display. Many surgeons agreed or strongly agreed that heads-up display reduced the severity (40%) and frequency (40%) of pain and discomfort, improved posture (61%), and improved overall comfort (61%). Of respondents who experienced asthenopia (n = 59) or pain/discomfort during operation (n = 61), 54% reported improvement in asthenopia and 72% reported feeling less pain/discomfort since using heads-up display. Overall, 69% reported preference for heads-up display. This study provides novel data on musculoskeletal disorders and the long-term impacts of ergonomic strain reported by ophthalmologists building on existing literature demonstrating ergonomic and other advantages of heads-up display. Future studies with objective ergonomic assessment are warranted to validate these findings.

Prevalence and symptomatology of musculoskeletal disorders in dentists with a focus on ergonomics and self-care

Research highlights the growing importance of occupational health, noting that work-related illnesses are becoming increasingly prevalent as global populations age and work longer.The study focuses on occupational musculoskeletal disorders (MSDs) among dental professionals, particularly those who graduated from the Regional Autonomous University of the Andes (UNIANDES). Its aim is to assess the prevalence and contributing factors to MSDs, promoting ergonomic practices to mitigate these issues.The study employed a quantitative, non-experimental, cross-sectional approach, using the Nordic Questionnaire to collect data. Participants were surveyed on demographic and occupational variables, and the results were analyzed using descriptive statistics. It revealed that female dentists and those between 20 and 30 years old are particularly susceptible to these disorders.Many respondents indicated that their symptoms led to changes in their work habits or even job changes. The duration and impact of these symptoms varied, with some reporting chronic problems that affect their ability to work.The research underscores the need to improve ergonomic training and practices in dental education and professional settings. It suggests adopting preventive measures, such as ergonomic workstations, regular breaks, and physical exercises, to reduce the incidence of these conditions

Studying the effect of an educational intervention to prevent occupational musculoskeletal disorders on pain and quality of life of healthcare workers

Studying the effect of an educational intervention to prevent occupational musculoskeletal disorders on pain and quality of life of healthcare workers

Analysis and mapping of the research landscape on occupational musculoskeletal disorders with an emphasis on risk factors and preventive approaches (1993-2022)

<b>Objective: </b>The current study aims to provide a comprehensive overview of the research landscape on the risk factors and preventive approaches to occupational musculoskeletal disorders (MSDs).<br /> <b>Methods: </b>A comprehensive search strategy was developed and used in the Scopus Database for the study period from 1993 to 2022.<br /> <b>Results: </b>A total of 1,132 articles underwent analysis and mapping. Scholars from the United States made the largest contribution, while the Danish institution “<i>National Research Center for the Working Environment</i>” ranked first in the field. The map showed that the nursing profession was the most researched profession with regard to occupational MSDs. The top-100 cited articles included research themes focusing on risk factors, interventions and preventive strategies, and specific body regions affected.<br /> <b>Conclusions: </b>More longitudinal research is needed to identify and confirm the causal relationship between different risk factors and occupational MSDs and more research is needed regarding the effectiveness of various interventional methods on occupational MSDs.

Prevalence and Factors Associated with Occupational Musculoskeletal Disorders among the Nurses of a Tertiary Care Center of Nepal

Introduction: Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system which could lead to temporary or permanent impairments. The nature of nursing jobs makes nurses vulnerable to MSDs. This study aimed to assess the prevalence and potential risk factors associated with MSDs among nurses. Methods: In between March to June 2021, a cross-sectional study was conducted among 165 nurses using self-administered questionnaires. A standardized Nordic Questionnaire was used to measure MSDs. Pearson’s chi-square test and binary logistic regression at a 5% level of significance were performed to identify factors associated with upper extremities and spinal musculoskeletal disorders (UMSD) and lower extremities musculoskeletal disorders (LMSD). Variables associated with UMSD and LMSD in bivariate analysis were subjected to multiple logistic regression. Results: The prevalence of UMSD and LMSD experienced by nurses was 86.1% (95% CI: 79.4%-90.9%) and 66.1% (95% CI: 58.9%-74.3%), respectively. Among several factors, working in same position for long periods (AOR: 4.16, 95% CI: 1.2-13.4), not receiving training in injury prevention programs (AOR: 3.15, 95% CI: 1.0-9.2), not enough rest breaks during the day (AOR: 4.65, 95% CI: 1.3-15.9) and moderate to higher job stress (AOR: 3.62, 95% CI: 1.2-10.8) were found to be significantly associated with UMSD. Not having enough rest breaks during the day (AOR: 2.19, 95% CI: 1.0-4.7) was significantly associated with LMSD. Conclusion: Higher prevalence of MSDs among nurses is a serious concern that threatens individual health as well as the overall healthcare system. Sensitization and capacity enhancement programs on the issue could prevent MSDs among nurses.

Ergonomics and Prevention of Occupational Musculoskeletal Disorders

Background: Occupations have psychological risk factors for musculoskeletal disorders and diseases. Many of them are preventable. Occupational strains are one of the preventive occupational risk factors. Objective: Introduction of musculoskeletal disorders and prevention, kinds, diagnosis and treatment. Materials and Methods: In a review study the author research in related scientific literature, websites and journals about the musculoskeletal disorders. Job musculoskeletal disorders and prevention, kinds, diagnosis and treatment. Results: Musculoskeletal disorders can be classified to neck, upper limbs, spine, lower limbs and rheumatologic disorders. But the prevention is important in the workplaces. Conclusion: Musculoskeletal disorders are important and recognizing the risk factors is important. Prevention is necessary.

Āsana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol.

Extensive literature reports an increase in physical disorders (pain, pathologies, dysfunctions) and mental malaise/uneasiness (stress, burnout) affecting dental professionals in relation to fast and pressing rhythms of work, long working hours, increasingly demanding patients, ever-evolving technologies, etc. This project has been conceived to bring the science of yoga around the world to dental professionals as a preventive (occupational) medicine and to provide knowledge and means for self-care. Yoga is a concentrative self-discipline of the mind, senses, and physical body, that requires regular daily exercise (or meditation), attention, intention, and disciplined action. M&M: The study aimed to design a Yoga protocol specifically devised for dental professionals (dentists, dental hygienists, and dental assistants) including positions (āsana) to be practiced/used in the dental office. The protocol is targeted for the upper body, namely neck, upper back, chest, shoulder girdle, and wrists, being areas greatly affected by work-related musculoskeletal disorders. This paper represents a yoga-based guideline for the self-cure of musculoskeletal disorders among dental professionals. Results: The protocol includes both sitting (Upavistha position) and standing (Utthana or Sama position) āsana, with twisting (Parivrtta), side bending (Parsva), flexion and forward bending (Pashima), and extension and arching (Purva) āsana to mobilize and decompress, and to provide nourishment and oxygen to the musculo-articular system. The paper delivers different concepts and theories developed and deepened by the authors and introduces and spreads yoga as a medical science among dental professionals for the prevention and treatment of work-related musculoskeletal disorders. We articulate notions ranging from stretching out using the vinyāsa method (breath-driven movement) and inward-focused attention to contemplative/concentrative science, interoceptive attention, self-awareness, the mind-body connection, and receptive attitude. The theory of "muscles are bone ties" is coined and delivered with regard to tensegrity musculoskeletal fascial structures connecting, pulling together, and nearing the bone segments where they are anchored. The paper describes over 60 āsana envisaged to be performed on dental stools or using the walls of a dental office or a dental unit chair. A detailed guideline on the work-related disorders that can find relief with the protocol is provided, including the description of breath control for the practice of āsana in vinyāsa. The foundations of the technique reside in the IyengarYoga method and ParināmaYoga method. Conclusions: This paper represents a guideline for self-cure in the prevention or treatment of musculoskeletal disorders affecting dental professionals. Yoga is a powerful concentrative self-discipline able to provide physical and mental well-being, representing great help and support in daily life and business for dental professionals. Yógāsana restores retracted and stiff muscles, giving relief to the strained and tired limbs of dental professionals. Yoga is not intended for flexible or physically performing persons but for people who decide to take care of themselves. The practice of specific āsana represents a powerful tool for the prevention or treatment of MSDs related to poor posture, forward head, chronic neck tension (and related headache), depressed chest, compressive disorders on wrists and shoulders as carpal tunnel, impingement syndromes, outlet syndrome, subacromial pain syndrome and spinal disc pathologies. Yoga, as an integrative science in medicine and public health, represents a powerful tool for the prevention and treatment of occupational musculoskeletal disorders and an extraordinary path for the self-care of dental professionals, sitting job workers, and healthcare providers suffering from occupational biomechanical stresses and awkward postures.

Predictive validity of an indicator of exposure to unfavorable ergonomic working conditions on work-related musculoskeletal disorders

Researchers have long documented a significant association between exposure to unfavorable working conditions and poorer occupational health and safety. However, measures of occupational exposures are often lacking from national and international surveys. Drawing on research on job-exposures matrices (JEMs) and exploiting the Italian O*NET, we construct a new indicator of exposure to ergonomic unfavorable conditions at work (Ergo-Index) and we test its predictive power on the incidence of work-related musculoskeletal disorders. Exploiting 5-years of administrative archives of the Italian National Workers Compensation Institute and running a set of negative binomial regression models, we find a very strong association between the Ergo-Index and the incidence of work-related musculoskeletal disorders (WRMSD). Compared to the least exposed category (Ergo-Index < p25), the risk of WRMSD was 60–70 times higher in the highest exposure group (Ergo-Index > p75) for notified WRMSD, and almost 250 times higher for compensated WRMSD. Hence, the Ergo-Index strongly predicts the occurrence of occupational musculoskeletal disorders and could be used to assign work exposures in studies where occupation is available and for priority setting of ergonomic hazards control.

Impact of Occupational Musculoskeletal Disorders on Dentists

Dentists are particularly vulnerable to ergonomically borne musculoskeletal diseases (MSDs), which decrease efficiency, productivity, and career longevity because to the exact and minute nature of their work. Objective: To determine different consequence of work related disorders among dentist of Lahore, Pakistan. Methods: In this cross-sectional survey 450 dentist of Lahore were approached and a structured proforma based survey was conducted using convenience sampling technique. In the study, dentists between the ages of 24 and 65 were included. Musculoskeletal Disorder has been presented in the form of frequency and percentage whereas age has been shown as mean and standard deviation. Chi square test has been applied to determine the association between musculoskeletal disorder and different study variables. P-value of 0.05 has been deemed significant. Results: In this study out of 450 dentists 236 (52.4%) were male and 214 (47.6%) were females. Mean age of the males were 37.08 ± 9.27 years and females were 33.43 ± 10.42 years. Among the subject’s musculoskeletal disorders were reported by 393(87.3%) dentist. Sick leave was availed by 278 (70.7%) whereas 373 (94.9%) seek medical treatment and 325 (82.7%) prevent daily activity. According to Dentist 388 (98.7%) believes that the disorder is caused by Dental Clinic I.e. Ergonomic issue. Conclusions: With two thirds of dentists taking sick time owing to musculoskeletal disorders, combined with the mental stress, it would appear that dentistry is not an easy profession. This would significantly limit the career of dentists.

The Effect of Physiotherapy Interventions in the Workplace through Active Micro-Break Activities for Employees with Standing and Sedentary Work.

Workers worldwide experience a range of occupational musculoskeletal disorders that affect both the functionality of many parts of their body and their overall performance. Physiotherapists provide counseling and treatment programs during work. Recently, physiotherapy interventions have been introduced during work breaks. This study aimed to investigate the value of different types of workplace-based exercise programs administered during work breaks and compare them with counseling methods. Electronic searches were performed in relevant databases by keywords such as: workplace, musculoskeletal disorders, sedentary, standing, employees, micro-breaks, exercise interventions, and ergonomics. Initially, 706 articles were identified. An article sorting procedure was employed by two independent researchers, based on the inclusion and exclusion criteria set for this study, and after the removal of non-relevant articles (n = 391) or duplicates (n = 300), 15 randomized controlled trials (RCTs) remained for qualitative analysis. The methodological quality of the 13 RCTs was performed using the PEDro scale. No risk of bias evaluation was made. The findings suggested that active micro-breaks that contained various exercise programs including stretching, strengthening, torso stabilization, and ergonomic interventions were more beneficial than passive micro-breaks, reducing pain and the feeling of fatigue and increasing employees’ mood. It is concluded that micro-breaks are beneficial to employees with either orthostatic or sedentary work.

Identifying the risk of opioid misuse in a chronic pain population: the utility of the MMPI-2-RF personality psychopathology five (PSY-5-RF) and higher-order scales.

Prescription-related opioid misuse, especially in chronic pain populations, is an ongoing problem and is related to increased mortality. The purpose of this study was to assess the utility of two restructured scales of the MMPI-2-RF: the Personality Psychopathology Five (PSY-5-RF) and the Higher-Order Scales to determine which of their subscales may be beneficial for identifying the risk of opioid misuse in a chronic pain population. A sample of 136 patients with chronic disabling occupational musculoskeletal disorders completed the MMPI-2-RF and the Current Opioid Misuse Measure (COMM) upon admission to a functional restoration program. The PSY-5-RF and H-O subscales were correlated with the baseline COMM scores. Correlation analyses, ROC curve analyses, and multiple binary logistic regression models were developed to determine which subscales were most associated with elevated COMM scores. The results of the regression analyses suggest that Scale elevations on two of the PSY-5-RF Scales and two Higher-Order Scales of the MMPI-2-RF demonstrated significant associations with elevated COMM scores, thus exhibiting the utility of these subscales in identifying the risk of opioid misuse among chronic pain patients. These findings are clinically meaningful in underscoring the importance of identifying specific personality traits as potential predictors of opioid misuse, and identifying those at risk through careful screening. Clinical implications based on each of the PSY-5-RF and H-O scales significantly associated with elevated COMM scores are discussed.

Musculoskeletal Model for Assessing Firefighters’ Internal Forces and Occupational Musculoskeletal Disorders During Self-Contained Breathing Apparatus Carriage

BackgroundFirefighters are required to carry self-contained breathing apparatus (SCBA), which increases the risk of musculoskeletal disorders. This study assessed the newly recruited firefighters’ internal forces and potential musculoskeletal disorders when carrying SCBA. The effects of SCBA strap lengths were also evaluated. MethodsKinematic parameters of twelve male subjects running in a control condition with no SCBA equipped and three varying-strapped SCBAs were measured using 3D inertial motion capture. Subsequently, motion data and predicted ground reaction force were inputted for subject-specific musculoskeletal modeling to estimate joint and muscle forces. ResultsThe knee was exposed to the highest internal force when carrying SCBA, followed by the rectus femoris and hip, while the shoulder had the lowest force compared to the no-SCBA condition. Our model also revealed that adjusting SCBA straps length was an efficient strategy to influence the force that occurred at the lumbar spine, hip, and knee regions. Grey relation analysis indicated that the deviation of the center of mass, step length, and knee flexion-extension angle could be used as the predictor of musculoskeletal disorders. ConclusionThe finding suggested that the training of the newly recruits focuses on the coordinated movement of muscle and joints in the lower limb. The strap lengths around 98-105 cm were also recommended. The findings are expected to provide injury interventions to enhance the occupational health and safety of the newly recruited firefighters.

The Prevalence, Causes and Prevention of Occupational Musculoskeletal Disorders

Musculoskeletal disorders (MSDs) are collectively referring to an array of conditions affecting the human locomotor system, such as muscles, nerves, joints, tendons and spinal discs. MSDs related to work are called occupational MSDs and are typically caused by physical factors consisting of repetitive tasks, forceful exertions, awkward positions, vibration due to use of vibrational tools and prolonged staying in the same positions. These physical factors are often complicated by psychosocial factors comprising job demand, job control, social support, job satisfaction, job security, work arrangement, etc. which can aggravate the biomechanical loading imposed by physical factors, thus resulting in more severe outcomes. Besides, individual factors such as health conditions, age, education level and medical history could lead to highly variable physiological responses and internal tolerances, hence outcomes. As the physical and psychosocial risk factors vary widely in different workplaces, the prevalence of MSDs tends to vary with sectors, occupations and even regions. Generally, healthcare sector has been reported to have relatively high occupational MSDs cases in multiple nations. To prevent occupational MSDs, priority should be given to elimination of the associated risks through job and workplace designs and management. Where elimination is not practical, the risks could be reduced through modification of workplace layout, work environment, work systems and tools as well as the use of mechanical aids. Provision of information, instruction and training, and other administrative controls such as job rotation which do not target at reducing the risks would have lower priority and should be used together with other control measures of higher priority.

Assessment of serum CK-MM level as a bioindicator for work-related musculoskeletal injuries among Emergency hospital workers.

Musculoskeletal disorders (MSDs) are considered a growing problem among healthcare personnel, especially service workers. The emergency room (ER) service workers are highly exposed to work-related risk factors which predispose them to MSDs. A cross-sectional study was performed on 78 ER workers. Full medical and occupational histories were taken. The Standardized Nordic Questionnaire (SNQ) was used for the assessment of musculoskeletal symptoms. Clinical examination was done with special emphasis on the locomotors system, and serum levels of muscle enzymes, including creatine kinase (CK) and creatine kinase isoenzyme (CK-MM), were measured. The study aims to detect the prevalence of occupational musculoskeletal disorders (MSDs) among ER workers at University hospitals, and assessment of CK-MM as a biomarker used in the early detection of MSDs. We found that 71.8% of the participants were complaining of musculoskeletal disorder in the last 7days before the study, while only 34.6% were complaining of musculoskeletal disorder in the last 12months before the study. The knee joint was the most commonly affected site in the past 7days, by 39.7%. On the other hand, the highest prevalent disorder in the last 12months was for the ankle joint (17.9%) with significantly high levels of serum CK-MM. In conclusion, musculoskeletal injuries are a common complaint among healthcare occupations, especially among ER service workers that need regular health education and ergonomic training programs. Monitoring of serum CK-MM level with cut-off value 90ng\ml could be used as a novel approach for the early detection of work-related musculoskeletal disorders.

Latin Questionnaire: a threshold strategy for anamnestic screening of occupational musculoskeletal disorders through specific reference groups

IntroductionHealth surveillance programs conducted for both individual workers and working populations as a whole are managed by occupational health physicians and focus on disorders and diseases caused by biomechanical overload, primarily for preventive purposes.ObjectivesThe purpose of the paper is to update an anamnestic protocol for studying musculoskeletal disorders after more than 40 years experience of its application. The updated version has been re-named the Latin Questionnaire. The protocol enables preliminary epidemiological evaluation, by comparing results of exposed populations to those from a reference population, thanks to the introduction of a severity threshold, a concept lacking in similar questionnaires.MethodsThe Latin Questionnaire is based on symptoms of discomfort, pain, and paraesthesia. Each symptom is described in terms of location, duration, number of episodes, irradiation, and treatment. The model covers present symptoms during the previous 12 months and is designed to identify positive anamnestic cases (when positive according to the threshold), cases with minor disorders, and negative cases for conditions involving the spine and upper and lower limbs.ResultsThe updated anamnestic model was validated again through the collaborative effort involving 37 physicians from 14 Latin countries. To enable comparisons with exposed populations, an updated reference population (4,000 unexposed workers) is presented, evaluating the percentages of subjects positive according to thresholds for spine and upper and lower limbs and the incidence of acute lower back pain, broken down by gender and age groups. Examples of application of the questionnaire are also presented.ConclusionsThe Latin Questionnaire, which has also been implemented in digital form (free download), allows selection of significant anamnestic cases compared to cases with minor disorders. This strategy is indispensable for correctly conducting preliminary epidemiological studies. Example applications confirm the presence of significant differences between the percentages of subjects with positive thresholds in exposed compared to reference groups, with surpluses proportional to their levels of biomechanical overload.

Effects of two grip force levels and forearm postures on hand‐arm transmitted vibration and physiological responses

AbstractVibration transmitted to the upper limb is the primary source of occupational musculoskeletal disorder. Transmissibility is not just caused by vibration magnitude but is also directly influenced by the applied force and posture. This study investigated the effects of two forearm postures and grip force levels, when using dual‐handle guided equipment, on hand‐arm transmitted vibration and physiological responses. Sixteen young male adults were recruited. Pre‐task and post‐task assessments including grip strength and perceived discomfort were measured. The task was to hold a vibrating handlebar for 5 ‐min under four randomly sequenced conditions: N/PM/H—neutral/pronated forearm and mild/hard grip. Transmissibility and forearm muscle activities were recorded during each task. It was discovered that neutral posture led to higher wrist and elbow transmissibility, whereas hard grip resulted in higher elbow transmissibility, forearm muscle activities, grip strength reduction, and distal arm discomfort. Furthermore, the interaction between the effects of posture and force significantly influenced wrist extensor activity (NH &gt; PH; NM = PM), proximal arm discomfort (NH &lt; PH; NM = PM), and wrist transmissibility (PH &gt; PM; NH = NM). Essentially, with constant vibration and exposure duration, the application of sustained hard grip had more negative physiological effects because of the greater physical workload toward the hands and forearms. Moreover, gripping hard during pronation led to higher discomfort that reached the proximal arm because a greater effort was required. Hence, a neutral forearm posture is recommended when the tasks require forceful movements and either posture is suggested when less powerful movements are involved.

Effectiveness of a multidimensional intervention program in improving occupational musculoskeletal disorders among intensive care unit nurses: a cluster-controlled trial with follow-up at 3 and 6\u2009months

BackgroundIntensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses.MethodsThis study was designed as a two-armed cluster-controlled trial with an intervention group and a control group. The clusters were independent hospital ICUs, and the participants consisted of registered nurses in China. By cluster random sampling, 89 nurses from two ICUs were assigned to the intervention group, and 101 nurses from two other ICUs were assigned to the control group. A multidimensional intervention program based on previous studies was designed. This program combined improving risk perception, health behavior training, and promoting a safe working environment. The multidimensional intervention program was implemented in the intervention group, whereas routine specialist training was implemented in the control group. Baseline and follow-up (3 and 6 months) data were collected using self-reported online questionnaires. The primary outcome was the report rate of WRMDs in the past 7 days. Secondary outcomes were risk perception, application of health behavior, and perception of a safe working environment. The data were statistically analyzed using SPSS 19.0.ResultsA total of 190 nurses provided three recorded outcome measurements (intervention group, N = 89 (94.68%); control group, N = 101 (94.39%)). After 6 months, the intervention group experienced significant improvement relative to the control group in the report rate of WRMDs in the past 7 days (OR = 1.953, p = 0.037), risk perception (OR = 0.517, p < 0.001), application of health behavior (OR = 0.025, p < 0.001), and perception of a safe working environment (OR = 1.637, p = 0.024).ConclusionThe multidimensional intervention program was superior to routine specialist training in preventing the occurrence of WRMDs in ICU nurses. WRMD training should include multifaceted approaches and pay increased attention to specific department functions.

PUI 사용성 개선을 위한 의료기기 손잡이의 인간공학적 평가: 이비인후과 진료장치를 중심으로

Objective: The purpose of this study is to ergonomically evaluate subjective usability according to handle shape, diameter, angle and button position for endoscope, and spray of the Ear, Nose, and Throat (ENT) medical device to suggest optimal design guidelines.<BR>Background: As medical demand increases, the prevalence of occupational diseases among doctors is high such as musculoskeletal and cerebral cardiovascular diseases. Therefore, it is required to design an ergonomic PUI (physical user interface) to minimize human mistakes and errors of a doctor in the medical system.<BR>Method: Forty subjects participated in this study. This study produced a mock-up of an endoscope and spray with various handle types, angles, and diameter. For the pen-type endoscope, the shape of the handle (cylindrical, rectangular) and diameter (32, 35, 38㎜) were considered as independent variables. For the pistol-type endoscope, the shape of the handle (cylindrical, rectangular) and angle (90°, 100°, 110°, 120°, 130°) were considered as independent variables. For the spray, the position of the button (upper-top, middle-front, middle-side, lower-front, lower-side) was considered as the independent variable. As a dependent variable, this study evaluated the subjective usability using by the visual analog scale on a scale of 0 to 100.<BR>Results: The ANOVA result of a pen-type endoscope, there were significant differences in handle shape and diameter. The handle shape of rectangular and 32mm diameter had the significantly highest usability. The ANOVA result of the pistol-type endoscope, the handle angle had the significantly highest usability at 120°. As the angle increased up to 120°, subjective usability also tended to increase, but the angle of 130° decreased the trend. The ANOVA result of spray, the position of push button had the significantly highest subjective usability on bottom-front.<BR>Conclusion: Based on the results of this study, the endoscope and spray should be designed to have a pistol-type cylindrical handle with a diameter of 32 to 35mm and an adjustable angle. If the adjustable design is difficult, it is suggested to design with an angle of about 120°. And also, it is suggested that the spray’s button be positioned in the front, which can be pressed with the thumb.<BR>Application: This study can apply ergonomic handle design guidelines for endoscopy and spray. Furthermore, it could contribute to the prevention of occupational musculoskeletal disorders.

Osteopathic model of the development and prevention of occupational musculoskeletal disorders.

The direct and indirect costs of work-related musculoskeletal disorders are significant. Prevention is the most effective way to control these costs. To do that, we must understand how these disorders develop. To use the five models of osteopathic care to illustrate how cellular processes and neural reflexes interact to create work-related musculoskeletal pathology and to provide evidence-informed musculoskeletal injury and disability prevention recommendations. A literature review of electronic databases (Google Scholar, PubMed, OVID, Cochrane Central Register of Controlled Trials, PEDro, and OSTMED.DR) from inception to October 16, 2019 and hand-search of publication references was performed for systematic reviews, cohort studies, case-control studies, and randomizedcontrolled trials. The search terms reflected topics related to occupational injury and injury prevention, and included supplementary laboratory studies and narrative reviews related to the biological aspects of musculoskeletal injury. The eligible studies contained the following criteria: (1) the population of working age; (2) exposures to known risk factors, musculoskeletal disorders, and psychosocial factors; (3) written in English; (4) full text papers published in peer-reviewed journals; and (5) systematic review, cohort study, case-control study, and randomized controlled trial methodology. Studies were excluded if they included outcomes of productivity andcosts only or outcomes that were assessed through qualitative methods only. The literature search resulted in 1,074 citations; 26 clinical studies and 14 systematic reviews were used in this review. A comprehensive workplace musculoskeletal disorder prevention program should match demands to capacity, correct dysfunctional movement patterns, and limit tissue vulnerability (biomechanical-structural model); restore alpha-gamma balance, tonic-phasic synergistic function, and autonomic balance (neurological model); maximize physiologic reserve (metabolic-energy model) component of a prevention program; optimize respiration and circulation (respiratory-circulatory model); and address cognitive distortions (behavioral-biopsychosocial model). The presented osteopathic model of the development and prevention of work-related musculoskeletal disorders suggests that a combination of preventive interventions will be more effective than any single preventive intervention.