Presence Of Musculoskeletal Disorders Research Articles

Musculoskeletal Disorders Among the United Arab Emirates Healthcare Professionals: Ergonomics Knowledge and Practice Study

Background: Healthcare professionals are particularly vulnerable to musculoskeletal disorders (MSDs) due to job demands such as prolonged standing, patient handling, and awkward postures. Objectives: This study aimed to assess the prevalence of MSDs among healthcare professionals, examine the association between ergonomic knowledge and practices with MSDs, and identify predictors of ergonomic knowledge. Methods: A cross-sectional study was conducted among healthcare professionals, including doctors and nurses, working in the United Arab Emirates (UAE). The prevalence of MSDs was determined using the Nordic Questionnaire. Ergonomic knowledge and practice were assessed through a validated questionnaire covering sociodemographic and work-related factors, ten knowledge items, and fifteen practice items. A scoring system was used, where correct answers received a score of one, and incorrect answers received a score of zero. Ergonomic knowledge and practices were considered inadequate when participant scores fell below the median values of six for knowledge and eight for practice. The calculated sample size was 398, with a response rate of 96%, resulting in 380 participants. The chi-square test, binary, and multivariable logistic regression analyses were performed. Results: The twelve-month prevalence of MSDs was 90.4%, with the highest percentage reported in the lower back (56%), followed by the upper back (43.4%), neck (39.2%), shoulder (38.9%), and elbow (21.3%). Inadequate ergonomic knowledge and incorrect ergonomic practices were found in 61.8% and 36.3% of healthcare professionals, respectively. A significant association was observed between inadequate ergonomic knowledge (P < 0.001) and practice (P = 0.035) and the presence of MSDs. Significant predictors of inadequate ergonomic knowledge included the number of years worked (OR: 1.9; 95%CI: 1.00 - 3.5, P = 0.049), the provision of ergonomics training and awareness at the workplace (OR: 3.7; 95%CI: 1.9 - 7.2, P < 0.001), and inadequate ergonomic practices (OR: 1.9; 95%CI: 1.1 - 3.0, P = 0.014). Conclusions: A very high prevalence of MSDs was found among healthcare professionals, with the lower back being the most commonly affected site. Significant predictors of inadequate ergonomic knowledge included the number of years worked, the availability of ergonomics training at the workplace, and inadequate ergonomic practices. This study underscores the need for ergonomic training programs and ergonomically friendly workplaces to equip healthcare professionals with the knowledge and practices necessary to prevent musculoskeletal disorders.

Association between internet addiction and musculoskeletal disorders in Iranian medical sciences students

BackgroundThe utilization of the Internet can lead to adverse outcomes in students’ lives. Prolonged Internet usage may result in academic failure, an elevated risk of musculoskeletal problems, and the emergence of issues impacting the lives of students and their peers. This study aimed to explore the relationship between Internet addiction and musculoskeletal disorders (MSDs) among students in the field of medical sciences.MethodsIn this cross-sectional study, 314 medical sciences students in Semnan, Iran, were assessed using the census sampling method. The participants’ Internet addiction status and the presence of MSDs were determined through Young’s Internet Addiction questionnaire and the Nordic self-report questionnaire, respectively. Data underwent analysis employing logistic regression test to ascertain the relationship between Internet addiction and MSDs.ResultsAmong the 314 participating students in this research, about 21% and 1.6% of the participants were lay open to and suffered from Internet addiction, respectively. Internet addiction was associated with the presence of pain, discomfort, burning, or numbness in the neck, wrist, upper back, hips, and thighs. For each unit increase in the Internet addiction score, the chance of neck and wrist pain rises by 3% compared to a 2% increase in upper back and hip/thigh pain.ConclusionThe findings of this study indicate that excessive Internet use is linked to a heightened risk of MSDs in medical sciences students. Consequently, it is imperative to raise awareness about these complications and promote the adoption of proper posture when using the Internet. Further research is also warranted among diverse student populations to investigate the impact of Internet addiction.

Factors associated with the use of cannabis for self-medication by adults: data from the French TEMPO cohort study.

Medical cannabis, legalized in many countries, remains illegal in France. Despite an experiment in the medical use of cannabis that began in March 2021 in France, little is known about the factors associated with the use of cannabis for self-medication among adults. Data came from the French TEMPO cohort and were collected between December 2020 and May 2021. Overall, 345 participants aged 27-47 were included. Cannabis for self-medication was defined using the following questions: 'Why do you use cannabis?' and 'In what form do you use cannabis?'. The penalized regression method "Elastic net" was used to determine factors associated with the use of cannabis for self-medication, with the hypothesis that it is mainly used for pain in individuals who have already used cannabis. More than half of the participants reported having ever used cannabis (58%). Only 10% used it for self-declared medical reasons (n = 36). All self-medication cannabis users, except one, were also using cannabis for recreational purposes. The main factors associated with cannabis use for self-medication vs. other reasons included cannabis use trajectories, the presence of musculoskeletal disorders, tobacco smoking, and parental divorce. Engaging in cannabis use during adolescence or early adulthood may increase the likelihood of resorting to self-medication in adulthood. Due to the propensity of individuals with cannabis use during adolescence to resort to uncontrolled products for self-medication, this population should be more systematically targeted and screened for symptoms and comorbidities that may be associated with cannabis use.

Influence of Pelvic Floor Disorders on Sleep Quality in Women.

Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. An observational study was conducted among women in Spain during 2021 and 2022. A self-developed questionnaire was used to collect sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems. A validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), was used to assess the quality of sleep. The presence and impact of pelvic floor problems was assessed with the Pelvic Floor Distress Inventory (PFDI-20). Odds ratios (OR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals were calculated using logistic regression. A total of 1396 women participated in the study. The total PSQI indicated that 75.36% (1052) of women have altered general sleep quality. Women with pelvic floor disorders have a higher probability of developing sleep alterations (aOR: 1.32; 95% CI: 1.22-1.42; for every 20 points). A high BMI (aOR: 1.04; 95% CI: 1.01-1.07; for each point) and the presence of musculoskeletal disorders (aOR: 3.14; 95% CI: 1.20-8.27) are also associated with sleep quality in women. Women with pelvic floor disorders are more likely to develop sleep disorders, probably due to all the discomfort they entail.

Identification of prevalence of musculoskeletal disorders and various risk factors in dentists

PurposeThe awkward and repetitive movements lead to tissue straining, potentially leading to painful musculoskeletal disorders (MSDs). MSDs in dentists result in work inefficiency and a reduction in work hours. A survey was conducted to assess the prevalence of MSDs amongst the dental population of interest. MethodsCustomized individual detail questionnaires, Standard Nordic Musculoskeletal questionnaires, and Level of Pain estimation using the Likert Scale were used to deduce the various responsible risk factors for the occurrence of MSDs in dentists. Inferential statistical analysis was done to identify the prevalence and severity of the MSDs. The Chi-Square test (95 % confidence interval) was used to identify and compare the association of risk factors involved in MSDs with the occurrence of the Effect of MSDs, the presence of MSDs, and the severity of the MSDs. ResultsThe results of the study deduced that the dentists followed the sedentary work practices. The dentists experienced maximum discomfort in the neck region, which was accompanied by the discomfort experienced in the lower back, hands and wrists, making the upper extremity being more susceptible to the MSDs. Gender risk factors the, the prevalence of MSDs in the dentist's upper back, and the severity of pain in the upper back region showed a significant association level. ConclusionThe wrist posture, the prevalence of MSDs and the severity of pain in the dentists' neck, shoulder and upper back showed a significant association level.

A Feasibility Study on the Conversion from Manual to Semi-Automatic Material Handling in an Oil and Gas Service Company

In manufacturing companies, manual material handling (MMH) involves lifting, pushing, pulling, carrying, moving, and lowering objects, which can lead to musculoskeletal disorders (MSDs) among workers, resulting in high labor costs due to excessive overtime incurred for manual product preparation. The aim of this study was to show how ergonomic measures were used to reduce the risk of MSDs and to reduce operating costs in the warehouse department of an oil and gas service company. A preliminary study using the Nordic Body Map survey showed that the workers experienced pain in various parts of the body, indicating the presence of MSDs. The researchers then used methods such as the Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and National Institute for Occupational Safety and Health (NIOSH) assessments to verify whether the MMH activities had an acceptable level of risk. The results revealed that certain manual material handling (MMH) activities were assessed as low–very high risk, with RULA scores ranging from 3 to 7 and REBA scores ranging from 4 to 11. An immediate solution was to replace the manual process with a semi-automatic process using a vacuum lifter. A feasibility study was conducted using the net present value (NPV), internal rate of return (IRR), and payback period to justify the economic viability of the solution. The analysis indicated that implementing the vacuum lifter not only mitigated the risk of MSDs but also reduced the operating costs, demonstrating its viability and profitability. Overall, this study suggests that implementing a vacuum lifter as an assistive device in the warehouse would be a beneficial investment for both the workers and the company, improving both well-being and finances.

Musculoskeletal disorders in university professors who telework due to COVID-19 pandemic

Introduction: Teaching virtually can cause symptoms related to muscle pain due to bad postures when working with computers. Objective: To determine the presence of musculoskeletal disorders in university professors who telework during the COVID-19 pandemic. Materials and methods: Analytical cross-sectional study in professors from health programs at a northeastern Colombian university. The validated Spanish version of the Nordic Kuorinka questionnaire was used (Cronbach’s alpha 0.8-0.9). Using non-probabilistic sampling and an instrument applied virtually, 68 professors were included in the study. The dependent variable was presence of musculoskeletal disorder, whereas the independent ones were the sociodemographic conditions related to telework. The Fisher or were used for qualitative variables. Comparison of means were carried out through Student’s t test. p<0.05 values were interpreted as statistical association. Results: 67.7% of participants reported musculoskeletal disorder in at least one anatomical site, being the neck the one mostly affected. Female gender and seniority in teaching practice showed an association with the disorder (p<0.05). Conclusion: Working conditions triggered by teleworking during the pandemic are associated with the presence of musculoskeletal disorders in professors.

Musculoskeletal Disorders among Dentists from Constanta, Romania after COVID-19 Pandemic

Musculoskeletal disorders (MSD) are a category of work-related diseases affecting the dentists. The aim of this work is to investigate among dentists from Constanta the prevalence and characteristics of MSD, their posture during working and the adoption of ergonomic standards. Methods: A sample of 280 dentists working in private practice in Constanta were invited to participate to this study. The response rate was 65% (n=182). The participants filled a 35-items questionnaire including personal data, working position, MSD characteristics and treatment. The level of significance was set at p<0.05. Results: 67% of the dentists reported the presence of MSD and 71% consider that symptoms are related to the dental activity. MSD were located mostly in cervical area and neck (41%), followed by lower back (24%). No statistical correlation was found between presence of MSD and body weight (p=0,7). A sitting position was always used by 27% of subjects, 46% are using both sitting and standing working postures. No statistical significant correlation was found among the presence of MSD pathology and the activity of the dentists during Covid-19 pandemic (p=0,8). Conclusion: A high percentage of dentists reported MSDs. The main location is the spine, the cervical and lower back area. It is concluded postural problems leading to neck and back reported from the dentists in Constanta are comparable to those from other countries. Adoption of correct posture, sport and stretching exercises could prevent or minimize the effect of static dental activity.

Frequency and risk factors of musculoskeletal disorders in high risk occupation workers in Urban, Karachi

Objective: To determine the frequency and risk factors of musculoskeletal disorders in high-risk occupation workers in an urban setting. Method: The analytical cross-sectional study was conducted in Karachi from July to December 2020, and comprised office workers, operation theatre technicians and coolies. The presence of musculoskeletal disorders was assessed using the Nordic Musculoskeletal Questionnaire to determine factors associated with moderate to severe condition. Data was analysed using SPSS 20. Results: Of the 300 male subjects, 100(33.3%) each were office workers, operation theatre technicians and coolies. The overall mean age was 33.25±6.8 years (range: 18-50 years). The overall prevalence of musculoskeletal disorders was 179(59.7%). Besides, 117(65.4%) patients with musculoskeletal disorders had intermediate stage of the disease. The lower back and neck were the most common site of trouble involved in preceding 12 months 111(43.6%) each. Conclusion: Prevalence of musculoskeletal disorders was found to be a common problem affecting high-risk occupational workers. Key Words: High-risk occupations, Musculoskeletal disorders.

State of the art on the predictors of reduced capacity for work in Brazilian workers

Work Capacity (WC) is a dynamic process that involves an interrelationship between human resources and work and is influenced by various factors, especially the work environment and working conditions, as well as the worker's lifestyle. Thus, a close and complex relationship between health and work is observed, and health is negatively affected when work activities are performed in inappropriate environments, which can precipitate or aggravate the reduction of WC, which represents a measure of functional aging and an indicator of worker health. This study aimed to evaluate the state of the art on the predictors of reduced work capacity in Brazilian workers. This is a narrative literature review study in which articles were searched in the BVS, Scielo, LILACS, PubMed, and Medline databases from July to December 2020, using the descriptors/keywords: work capacity evaluation, working conditions, and work capacity index. A total of 119 studies were identified, and 29 full articles were selected for reading in full and analysis. The factors associated with reduced WC were older age, female gender, high demand at work, long working hours, more than one employment relationship, presence of musculoskeletal disorders, absence of physical activity, tobacco use, and obesity. The identification and adequate management of the factors associated with the reduction of WC are fundamental for the prevention of functional aging in the working class, allowing the execution of prevention and health promotion actions that favor an active and healthy aging, avoiding the reduction or early loss of WC.

Prevalence of musculoskeletal disorders (MSD) and smartphone addictions among university students in Malaysia

University students in Malaysia were identified as a high-risked population for smartphone addiction. It was proved that repetitive movements when using a smartphone will eventually lead to musculoskeletal disorders (MSD). The main objectives of this study were to assess the level of smartphone addictions and the presence of MSD among university students in Malaysia. Moreover, this study tried to explore the association between the two objectives above. Two hundred and twenty-six (n=226) university students in Malaysia aged 17-35 years old participated in this study through convenience sampling. Participants were asked to complete a set of self-reported questionnaires via online. The data were analysed by using descriptive analysis and inferential analysis (Spearman correlation test). About 82.3% (n=186) of participants reported the presence of MSD symptoms in at least one body part and neck has the highest prevalence of MSD, 65.9% (n=149). Moreover, the study also found that 73.5% (n=166) of participants were at risk of having smartphone addiction. After analysis, the presence of MSD in 17 body parts showed significant positive association (p<0.05) with smartphone addiction. However, all of them had a low correlation score (r<0.18). The high prevalence of smartphone addiction among university students is alarmed in the study.

Exploring the Effort-Reward Structure of University Work Focusing on Perceived Overall Stress, Self-Reported Health, and Musculoskeletal Disorders

Background: The effort-reward imbalance (ERI) model by Siegrist encouraged numerous scientific investigations that reported particular ties between psychosocial risks and poor self-reported health (SRH), while psychosocial work-related stress has also been linked to musculoskeletal disorders (MSDs). The aim of this study was to examine the health status and the perceived levels of occupational stress of university employees and to analyse the findings according to the employees’ effort and reward structure of work, perceived overall stress, SRH and the presence of MSDs.Design and methods: 398 employees – including healthcare professionals, academic personnel and workers with administrative or other jobs – employed at the University of Szeged, Faculty of Medicine were investigated with a self-administered questionnaire including the Effort-Reward Imbalance Questionnaire (ERIQ) and Perceived Stress Scale 4 (PSS-4).Results: More than half of the investigated subjects (54.8%) reported some forms of MSDs. Low self-reported health (P<0.001) and presence of MSDs (P=0.015) were significantly associated with the level of perceived stress and effort-reward imbalance (ERI), moreover increased level of perceived stress was independently associated with the likelihood of MSDs (AOR=1.13) and low self-reported health (AOR=1.30). ERI well predicted low self-reported health (AOR=2.05) as well. Increased level of perceived stress positively correlated with high workrelated effort (r=0.247, P<0.001) and over-commitment (r=0.387, P<0.001) while with work-related reward (r=−0.181, P=0.011) perceived stress showed a negative connection.Conclusion: Our results suggest that addressing the burden of effort-reward imbalance and MSDs would likely lessen employees’ perceived level of overall stress and affect their self-reported overall state of health. Significance for public health In a university hospital setting, numerous areas of academic and healthcare work are strongly interlaced. For that reason, healthcare workers, academics, and employees with various other job roles all share the work-related psychosocial and health risks that originate from the same organizational setting. As workrelated stress, poor self-reported health, and musculoskeletal disorders (MSDs) are all closely linked to effort-reward imbalance (ERI), exploring the effort and reward structure of university work could provide valuable insight in the possible role of the ERI model to guide interventions in this particular setting. Our results suggest that addressing university employees’ ERI, their burden of MSD, or possibly both, would likely affect employees’ perceived level of overall stress and self-reported overall state of health.

Musculoskeletal disorders and work ability of workers at a university campus in southern Brazil.

When performed in unfavorable conditions, work can lead to the development of musculoskeletal disorders and decrease in work ability. To identify the differences between three groups of workers (professors, technicians and outsourced workers) as for the sociodemographic profile, work ability, prevalence of musculoskeletal disorders, activity restrictions, and the correlation between the presence of musculoskeletal disorders and activity restrictions with each domain of the Work Ability Index. The sample consisted of 67 university workers assessed by a Sociodemographic Data Questionnaire, the Nordic Musculoskeletal Symptoms Questionnaire and the Work Ability Index. Descriptive statistics and Kendall's Tau correlation coefficient were used. Professors presented more favorable sociodemographic and lifestyle aspects and higher work ability, while outsourced workers had less favorable sociodemographic and lifestyle aspects and lower work ability. The correlation between activity restrictions and work ability was found in only one domain of Work Ability Index among professors. Among outsourced workers were found correlations on presence of musculoskeletal disorders and activity restrictions with six domains of Work Ability Index. Technicians did not show significant correlation. Outsourced workers presented worse work ability and less favorable sociodemographic and lifestyle aspects among the workers in the study, requiring the maintenance and improvement of work ability in this population.

Work ability in aging office workers with musculoskeletal disorders and non-communicable diseases and its associated factors: a cross-sectional study

Objectives. The prevalence of musculoskeletal disorders (MSDs) and non-communicable diseases (NCDs) increases with age. This study examined the impact of MSDs and NCDs on work ability, using the work ability index (WAI), among aging office workers (between 45 and 60 years old) and determined factors associated with WAI scores. Methods. A cross-sectional study was conducted in office workers from 27 government offices in Bangkok and nearby provinces using an online questionnaire. Analyses were conducted using the Mann–Whitney U test and a multivariable logistic regression model. Results. Of 689 workers (452 females and 237 males), 34, 13, 12 and 41% reported MSDs, NCDs, MSDs + NCDs and no MSDs/NCDs, respectively, in the past year. Median scores (interquartile range) of WAI were 37.0 (6) for MSDs, 37.0 (4) for NCDs, 34.5 (6) for MSDs + NCDs and 40.0 (4) for no MSDs/NCDs. Significant difference in WAI scores was found between the MSDs and MSDs + NCDs groups (p = 0.005); and between the NCDs and MSDs + NCDs groups (p < 0.001). Female, high work experience and low job control were significantly associated with reduced WAI scores (WAI ≤ 36). Conclusion. The presence of MSDs or NCDs reduced work ability among aging office workers compared to their healthy counterparts. Having MSDs + NCDs further reduced work ability.

Impact of musculoskeletal conditions on the perioperative period in patients with stable coronary artery disease

Abstract Background The aging of the population increases the number of elderly patients undergoing cardiac surgery. Despite the proven effectiveness of coronary bypass graft (CABG) surgery, it can lead to postoperative complications, similar to any other medical intervention. The early postoperative complications are associated directly with the clinical status of the patient. Most recent studies have focused on the effect of patient's musculoskeletal conditions on quality of life, disability and mortality. However, there are few studies devoted to assessment of the impact of musculoskeletal conditions on the course of the postoperative period in patients treated with CABG. Aim To evaluate the impact of musculoskeletal conditions on the early postoperative period in CABG patients with stable coronary artery disease (CAD). Materials and methods 387 patients aged 65 (59; 69) years with stable CAD, scheduled for CABG were enrolled in the study. Before enrollment all patients signed an informed consent form. For the assessment of the musculoskeletal function, sarcopenia was defined in accordance with the European Working Group on Sarcopenia in Older People (EWGSOP, 2019) and osteopenic syndrome (osteopenia/osteoporosis) was defined in accordance with the World Health Organization (WHO,2008). Osteosarcopenia was diagnosed in cases of co-existent sarcopenia and osteopenia/osteoporosis. The patients were divided into two groups according to the presence of musculoskeletal disorders. The 1st group included 105 (27.1%) patients: 52 (49.5%) with sarcopenia; 28 (26.7%) with osteopenic syndrome (osteopenia/osteoporosis) and 25 (23.8%) with osteosarcopenia. The 2nd group included 282 (72.9%) patients without musculoskeletal conditions. The analyzed groups were comparable in age, gender and comorbidities. CABG was performed via a midline sternotomy incision with the cardiopulmonary bypass. In the postoperative period, the total number of developed complications (cardiovascular, surgical, pulmonary) in patients with CAD was taken into account. Statistical analysis was performed using the Statistica software. Results In the early postoperative period, the total number of complications was statistically higher among patients who initially had musculoskeletal disorder. The prevalence of complications was higher in the 1st group of patients - 80 out of 105 (76.2%), while patients without musculoskeletal conditions demonstrated a 1.17 times lower prevalence - 183 out of 282 (64.99%), p=0.034. The incidence and the strength of association was estimated by the odds ratio (OR) and 95% confidence interval (CI). The presence of the initial musculoskeletal disorder was found associated with the 1.7 times increased risk of complications after CABG (OR =1.73, 95% CI: 1.03–2.89, p=0.035). Conclusions The presence of the musculoskeletal condition in CABG patients with CAD is a predictor of early adverse effects in the postoperative period. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The study was supported by Federal State Budgetary Institution of Higher Education “Kemerovo State University” (Contract No. 1327/2020/223, under the Agreement No. 075-15-2020-766 made as of 14th of December, 2020, entitled “Patient-centered care for patients with coronary artery disease and osteosarcopenia who underwent coronary artery bypass graft surgery”).

Musculoskeletal Disorders in Portuguese Welders: Effects on Bodily Pain and Health-Related Quality of Life.

Background: Musculoskeletal disorders in welders may influence their health-related quality of life. However, few studies have addressed this issue and their results were inconclusive. This study investigates whether there are musculoskeletal disorders with a higher incidence in welders compared to non-welders, and whether these disorders lead to an increase in bodily pain which in turn decreases their health-related quality of life.Methods: A priori analyses of statistical power were conducted to determine the sample size needed to find medium to large statistical effects, for a 0.05 alpha, and critical sampling, combined with snowball sampling, was carried out. The study was cross-sectional, and participants were asked to respond to a survey using validated instruments (Nwelders = 40, Nnon−welders = 42).Results: As expected, a higher incidence of symptoms of musculoskeletal disorders in the cervical, dorsal, lumbar, and wrists and hands was found in welders in comparison to non-welders. Furthermore, the presence of musculoskeletal disorders, particularly in the lumbar area, was related to an increased bodily pain and decreased health-related quality of life.Conclusion: Welders are exposed to a higher incidence of musculoskeletal disorders that decrease their quality of life. It is essential to increase the awareness of welders, organizations, and regulatory institutions toward this issue in order to motivate the development and implementation of prevention strategies. The need for primary and secondary prevention-type strategies, which have already proven their effectiveness in the context of welding, is highlighted.

Study of the interrelationships between musculoskeletal disorders and psychosocial risk factors in occupational health and safety technicians

ABSTRACT Objectives. The aim of this work is to examine the presence of musculoskeletal disorders (MSDs) and the exposure to psychosocial risk in a sample of 399 occupational health and safety technicians (OHSTs), deepening the associations between both aspects. Methods. The standardized Nordic questionnaire and the Decore questionnaire were used. Different descriptive and correlational analyses and a multivariate analysis model were carried out. Results. In total, 77.17% of the participants affirmed having suffered some muscle ailments. The most critical psychosocial risk factors are those related to the rewards that the worker obtains for their work, with 54.7% of the technicians in a situation of alert or emergency. It is highlighted that the fact of not feeling professionally valued, working outside working hours, having musculoskeletal discomfort and perceiving a state of poor or fair health increase the global risk index (GRI) score. Conclusions. The study highlights the high exposure of OHSTs to both physical and psychosocial risk factors as well as the significant relationship between these variables. Furthermore, the predictive model shows the variables that best predict the probability of MSDs: gender, training in emerging risks, perceived health and exposure to psychosocial risk.

The European campaign to fight musculoskeletal disorders - the need for eHealth

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018. Background The focus of the European Health and Safety Agency's 2020-2022 campaign is on the prevention of work-related musculoskeletal disorders (MSD). In the employment of medical professionals, they are common. The introduction of eHealth in Bulgaria supports the processes of information, monitoring and prevention. Methods An adapted Neck Injury Index (NII) questionnaire was developed by: Vernon, H. &amp; Mior, S. (1991) to determine specific injuries in the cervical spine, administered to 251 healthcare professionals from a large medical establishment. Results A study of the relationship between gender and the answers given in the ten sections of the questionnaire revealed a statistically significant difference in the answers for 'headache', 'driving' and 'sleeping' with p = 0.005, p &amp;lt; 0.001 and p = 0.020 respectively. 74.6% of men and 63.7% of women gave negative answers for headache, no driving pain, with men leading by 92.3% and a lower proportion of women than 56.1%, and without any sleep disturbances. 94.9% of men and 68.9% of women surveyed. The relationship between the profession and the medical profession indicating symptoms of neck damage, statistical significance was confirmed except in the above sections and also in 'lifting weights' (p = 0.009) and 'reading' with p = 0.002. As 65.3% of physicians, 51.9% of healthcare professionals and 56.5% of paramedics have no complaints of additional neck pain when lifting weights. A significant correlation was also found between mild injury rate (10 to 28%) and work experience over 10 years in 53.5% of those working in the hospital (p = 0.031). Conclusions The multifactorial influence of gender, position, and special length of service in the surveyed health care professionals did not cause symptoms indicating specific changes in the neck. Key messages It is important to establish a database through the introduction of eHealth with an information system. Identification changes in health and the presence of MSD in working nurses.

Association of salivary inflammatory biomarkers with primary Sjögren's syndrome.

Primary Sjogren's syndrome (pSS) is an autoimmune disease that leads to salivary and lacrimal gland dysfunction. The adaptive immune response associated with T helper-2 lymphocytes appears to be altered in these patients. Therefore, the objective of this study was to determine the salivary levels of interleukin (IL)-6, IL-5, and IL-4 in patients with pSS when compared to a healthy control (HC) group. The secondary objectives were to study whether ILs levels in pSS patients were associated with salivary flow, patient-reported outcomes (PROMs) for xerostomia and oral health quality of life (Oral Health Impact Profile-14 [OHIP-14]), pSS classification criteria and presence of extraglandular manifestations. A case-control study was conducted in 36 patients with pSS and 35 HCs. Cytokine levels were measured using high-sensitivity multiplex map human immunoassays. Unstimulated and stimulated whole saliva were collected and patients filled out questionnaires. The Mann-Whitney U test, chi-squared test, and Spearman correlation test were used. Interleukin-6 was significantly higher in pSS patients than in HCs (P=.0001). IL-6 was significantly higher in pSS patients with a positive salivary gland biopsy (P=.04), whole stimulated saliva hyposalivation (P=.02), and presence of musculoskeletal disorders (P=.03). There was a non-significant positive correlation between IL-6 levels and PROMs for xerostomia (r=.31; P=.06) and OHIP-14 (r=.07; P=.68) in pSS patients. Levels of IL-4 and IL-5 were not detected in both pSS and HCs patients. Salivary IL-6 levels are significantly associated with pSS patients, and therefore, it is hypothesized that this biomarker may be useful in the diagnosis and follow-up of this disease.

Antidepressant and gabapentinoid prescription rates in patients with osteoarthritis: a population based cohort study

Purpose: There are indications that antidepressants and anticonvulsants (gabapentinoids) are more often prescribed in OA patients, despite limited evidence. To examine incidence, prevalence, and time-trends of antidepressant and gabapentinoid prescription rates in patients with osteoarthritis. In addition, to assess the percentage of long-term prescription, and patients characteristics associated with antidepressant or gabapentinoid prescription. Methods: A population based cohort study was conducted in the Integrated Primary Care Information database. Incident and prevalent prescription rates for antidepressants (amitriptyline, nortriptyline and duloxetine) and anticonvulsants (gabapentinoids) were calculated for the period 2008-2017. Logistic regression was used to assess which patient characteristics were associated with prescriptions. Results: In total, 175.279 patients were included, of these patients 62.173 patients had incident OA. Two third of the patients were female and mean age was 66.6 years (SD ± 12.4) (Table 1). Most patients were diagnosed with knee OA (27.4%) and almost a quarter had a diagnosis in two or more joint groups. The occurrence of other musculoskeletal disorders during the cohort time was common (63.5%). The incident and prevalent prescription rates of amitriptyline, nortriptyline, gabapentin and pregabalin increased over time (Figure 1). The increase of the prescription rates for gabapentinoids was more pronounced. The incident prescription rate for gabapentin increased from 3.7 per 1000 person years in 2008 to 5.6 per 1000 person years in 2017 and for pregabalin from 7.1 to 13.8 per 1000 person years. Amitriptyline was most prescribed (15.1 incident prescriptions per 1000 person years in 2017). The prescription rates of duloxetine remained stable around 2.0 incident prescription per 1000 person years. All medication were prescribed for long-term (≥ 3 months) in ≤1% of the total population. The medications were more frequently prescribed with increasing age, to females and to patients with OA in ≥2 joints, spinal OA, and with presence of musculoskeletal disorders. Conclusions: Prescription rates of amitriptyline, nortriptyline and the gabapentinoids increased over time. Since there is little evidence to support prescription in OA caution is necessary when prescribing.