Load on the low back of teachers in nursery schools

In order to evaluate the load on the low back of teachers in nursery schools, basic activity, working posture, child-lifting, and desk-lifting were analyzed for eight nursery teachers using video recording. The trunk inclination angle (TIA) was also measured continuously during full workshifts for 20 nursery teachers using an inclination monitor. The nursery teachers in the 0–1 (year) age class more often adopted low working postures, sitting on the floor and kneeling, while teachers in the 4–5 age class more frequently adopted high working postures, standing and sitting on a chair. The mean of TIA among all subjects was 20°. The time spent at a TIA of more than 20° represented 43% of the workshift. The mean and time distribution of TIA did not differ between the age classes. The frequency of trunk-lifting from severe bending forward (TIA > 45°) was 86 times/hour on average. The frequency of trunk-lifting was highest in the 0–1 age class. The number of times of child-lifting was 46 in the 0–1 age class, while it was 1 in the 4–5 age class.     

造型作业体力负荷接触评估

目的以姿势观察和表面肌电分析相结合,分析造型作业体力负荷暴露特征。方法以OWAS方法观察造型作业姿势5074人次,并分析5个造型作业周期4对躯干肌的表面肌电信号的周期间变异性、躯干肌活动协调性、双侧对称性和典型动作肌电活动。结果姿势观察表明背部非正中姿势占87．7％,其中14．7％为扭腰姿势;13．2％的时间承受10k以上的负荷;手工作业成分如铲、压、搬、推拉和放物合计55．2％。不同造型周期间平均肌电活动变异性很小,而双侧不对称性（约60％）很高;相对其他躯干肌,竖脊肌肌电活动最高,平均超过20％MVC,某些动作时高达50％MVC。结论躯干肌活动不协调、竖脊肌过劳和不对称用力是造型作业躯干肌活动的主要特征,造型作业工作腰背痛高发与其有关。     

A validation study of devices designed to reduce loads in provision of care: whether these assistive devices are used, or not, and whether work posture is appropriate or not.

Our country already faces an aging society, but many care workers suffer from work-related musculoskeletal disorders and assistive devices have not been adopted in care-work sites. In order to evaluate the effectiveness of assistive devices, we conducted a study on care work-load; whether the assistive devices are used or not, and whether work posture is appropriate or not, on five female healthcare workers by measuring surface electromyography (SEMG) of biceps brachii, the trapezius (upper extremity) and lumbar paraspinals between L3 and L4 (low back), and the trunk inclination angle (TIA). Moreover, subjective evaluations both by the caregivers and also the care receivers were verified. The caregivers were asked to rate perceived exertion using the Borg scale and the care receiver was asked to rate dissatisfaction. Work condition 1: Repositioning of a supine patient towards the head of bed. Work condition 2: Transferring a patient from sitting on the bed to sitting in a wheelchair. Under the two work conditions there were five set tasks in which subjects used or did not use the assistive devices and worked with or without the appropriate procedure and posture. The representative value adopted was the 95 percentile value. SEMG: Under both work conditions and at all measurement sites, we observed the statistically significant effectiveness of the appropriate procedure and posture as compared to manual handling. When the assistive devices were used improperly, or in work with low bed height, there was no reduction in workloads on the upper extremities. TIA: In both work conditions we observed statistically significant effectiveness of the appropriate procedure and posture as compared to not only manual handling but also working with improper assistive devices and with low bed heights. Findings of the subjective evaluations: The caregiver's perceived exertion and care receiver's dissatisfaction, showed statistical significance in satisfaction with the appropriate procedure and posture as compared to manual handling. Therefore, to reduce workload, and prevent work-related musculoskeletal disorders of caregivers, it is necessary not only to provide assistive devices but also to supervise the proper procedures and work postures and to improve the work environment.     

某汽车公司铸造厂工人腰背痛的危险因素分析

目的 通过横断面流行病学记查,寻找汽车铸造厂作业工人腰背痛的主要危险因素,为此类疾患的预防提供科学依据.方法 在某汽车公司铸造厂对1340名工人进行腰背痛和劳动负荷问卷调查,利用logistic回归进行危险因素分析.结果 铸造厂工人的腰背痛年患病率为58.9%,其中铸造、物流和造型工种工人腰背痛年患病率较高,分别为64.6%、64.6%和62.5%.以不适体位搬举、大幅度弯腰、弯腰与转身并存及搬运重物这些负荷因素导致患腰背痛危险性最高,其OR值分别为2.085、1.961、1.967和1.956.各个危险因素在不同工种中的分布不同.多元logistic同归分析表明,搬运重物、不适体位搬举、大幅度弯腰、弯腰与转身并存及工龄和性别均被选人模型.结论 手工搬运重物、不良劳动姿势或二者同时存在是导致腰背痛的首要危险因素,应从这方面入手,加强工效学干预研究,减少此类疾患.

Abstract：

Objective To study the main risk factors of low back pain of workers in a foundry factory of the automobile company using cross sectional epidemiological investigation, and to provide scientific base for preventing the disorder. Methods The low back pain and work loads of 1340 workers in a foundry factory of the automobile company were investigated using questionnaire, and logistic regression analysis was used to analyze the risk factors. Results The one-year morbidity of low back pain in workers was 58.9%the morbidities of low back pain in workers engaged in foundry, transportation and modeling were 64.6 %, 64.6 % and 62.5 %, respectively. The lifting with squat postures, bending trunk heavily, bending trunk with twisting and moving the heave objects were found to be the most dominant risk factors for low-back pain, the OR values were 2.085, 1.961, 1.967 and 1.956, respectively. The distributions of risk factors were different among the different jobs. The logistic regression analysis showed that moving the heave objects, lifting with squat postures, bending trunk heavily, bending trunk with twisting existed simultaneously, also the work years and gender were the risk factors. Conclusion The manual moving heave objects, awkward working posture or both were the most important risk factors for low-back pain. The intervene ergonomic study should be performed in future to reduce the morbidity of low-back pain.     

Risk for low back pain from different frequencies, load mass and trunk postures of lifting and carrying among female healthcare workers

Purpose

To investigate the risk of developing non-chronic and chronic low back pain (LBP) from frequency, load mass and trunk postures of occupational lifting and carrying among female healthcare workers.

Methods

A total of 9,847 workers in eldercare answered a questionnaire about occupational lifting and carrying frequency (rarely, occasionally and frequently), load mass (low: 1–7 kg, moderate: 8–30 kg and heavy: >30 kg), trunk posture (upright or forward bent back), and days with LBP in 2005. The odds ratio (OR) for developing non-chronic (1–30 days the last 12 months) and chronic (>30 days the last 12 months) LBP reported in 2006 from these characteristics of occupational lifting and carrying was investigated with multi-adjusted logistic regressions among female healthcare workers without LBP in 2005 (n = 1,612).

Results

Frequently lifting and carrying low load mass with forward bent back doubled the risk for developing chronic LBP (OR: 2.14; 95 % CI: 1.02–4.50). Occasionally and frequently lifting or carrying of any load mass with upright back did not increase the risk for chronic LBP. Lifting and carrying did not increase the risk for non-chronic LBP.

Conclusions

Preventive initiatives for LBP among healthcare workers ought to pay attention to frequent lifting and carrying of low load mass with forward bent back.     

Comparison of methods for the assessment of postural load on the back.

A questionnaire, a self-administered log, and an observational method were simultaneously applied in the workplace of 35 mechanical repair men to assess exposure to strenuous postures and movements of the back. The average duration of time spent in a standing position was considerably underrated by the workers, while the duration of sitting was strongly overrated when compared with the ratings obtained with the observational method. The workers' ratings of duration with a bent or rotated trunk was two to four times lower than the observed duration. The estimate of the average number of lifts performed per hour was more than four times higher in the questionnaire than in the log. The same striking difference was found for the frequency of bending or rotating of the trunk. These results suggest that the reliability of questionnaire methods for the assessment of postural load in epidemiologic studies is probably not very high.     

Association of working postures and some lifestyles with low back pain in a manufactory]

The aim of this study was to determine the relationship between work and low back pain (LBP) by examining both working postures and the workers' everyday lifestyle. Subjects were 118 male workers in a small-to-medium-sized factory having three kinds of workplaces: the slit line, the packing line, and the crane unit. Working posture analysis with OWAS and interviews were carried out. The result of posture analysis showed that the standing posture with both legs straight and back bent appeared most frequently in all three workplaces. Meanwhile, the prevalence of LBP was almost equal among these groups, with 70% of workers having experienced LBP in each group. But the main cause of LBP differed among the three groups. On the slit line, the result of regression analysis and interview suggested that exercises in the past affected the prevalence of LBP, and that aging and work made LBP worse. On the packing line, many workers were transferred to other positions after a few years, and thus might affect the prevalence of LBP in other workplaces. For the crane unit, it appeared that work in previous positions might affect the occurrence of LBP. Moreover, it seemed that activities in the workplace, rather than lifestyles, contribute to the occurrence of LBP in this factory.     

铸造工人腰背痛流行病学特征

[目的 ]描述铸造工人腰背痛流行病学特征 ,探讨职业相关因素。 [方法 ]对 6 17名铸造工人进行背部骨科体检和疼痛测量。 [结果 ]清理和造型工种背部压痛阳性率显著高于后勤组 ,OR值分别达 6 16和 11 90 ,控制性别、年龄和工龄等混杂因素后 ,OR值更为加大 ;曾有腰背痛主诉没有差异 ,但与目前工作有关的调整腰背痛患病率仍以清理和造型高 ,与后勤比OR值在 2倍左右。造型工疼痛诱因以过度用力、重复劳动和不良姿势为主 ,共占 88 4%。腰背疼痛强度多为中等度。 [结论 ]静态弯腰作业和重体力弯腰作业与腰背痛患病率密切相关     

不良工效学因素对缝纫女工的健康效应调查

目的 探讨缝纫女工不良工效学因素与肌肉骨骼效应的关系。方法 采用作业场所工效学分析、劳动姿势评价系统和问卷调查方法对某服装厂缝纫车间进行了不良工效学暴露因素评价和肌肉骨骼症状调查。结果 缝纫女工不良工效学因素包括体力劳动高、工作姿势和动作不良、劳动受限程度大、劳动重复性高、噪声强等。其不良复合姿势达84．2％,有害和非常有害的复合姿势达3．2％;女工肩部、手臂和腰背的疼痛患病率分别是48．0％、30．7％、72．0％,且91．8％的腰背痛发生于工作时间,均明显高于对照组。结论 不良工效学因素与肌肉骨骼疾患高发有一定关系。     

Work-related musculoskeletal problems among women workers in the semiconductor industry in Peninsular Malaysia

A cross-sectional study to identify the prevalence of musculoskeletal problems and work-related risk factors was conducted among 906 women semiconductor workers. Highest prevalences were pain in the lower limbs, neck/shoulders, and upper back, and highest exposures were prolonged (> or = four hours per workshift) hand/wrist movement, standing, and lifting with hands. After logistic regression, lower-limb pain was significantly associated with standing, neck/shoulder pain with sitting and lifting, upper-back pain with climbing steps, low back pain with hand/wrist movement, and hand/wrist pain with lifting. Neck/shoulder pain was significantly higher for workers with shorter working durations, while lower-limb pain was significantly higher for workers with longer working durations. End-of-line assembly workers had significantly higher odds ratios for pain at all sites, while middle-of-line workers had higher odds ratios for pain in neck/shoulders and upper back, and wafer-fabrication workers had higher odds ratios for pain in low back and lower limbs.     

ICU病房护理人员职业相关腰背痛及其危险因素

目的探讨ICU病房护理人员职业相关腰背痛（OLBP）的发生情况及相关的危险因素。方法以某市5家综合性医院ICU病房护士为观察组，普通病房护士为对照组进行横断面调查，发放OLBP问卷调查，并对其中一家医院ICU病房进行现场录像，采用Win OWAS和Bless Pro2．0软件做姿势负荷和生物力学负荷计算。结果ICU病房护士OLBP现患率（87％）、发作频率（每月1次以上者占48％）以及因OLBP误工率（7％）与对照组（分别为60％、32％、2％）比较均明显升高，差异有统计学意义（P〈0．01，P〈0．05）。ICU病房护士典型护理操作危险姿势发生频率依次为观察引流（99％）、在床上搬抬患者（90％）、静脉操作（75％）、吸痰（75％）、调整输液量（6％）；调整输液量、吸痰、静脉操作、观察引流量、在床上搬抬患者的腰椎间盘压力（Fc）比值为100：155：199：301：418。结论ICU病房护士OLBP患病率高，高频率弯腰、扭转姿势和在床上搬抬患者是主要的危险因素。     

Examination of postures and frequency of musculoskeletal disorders among manual workers in Calcutta,India

Background: Manual material handling (MMH) activities require workers to adopt various awkward postures leading to the development of musculoskeletal disorders (MSD).

Objectives: To investigate the postures adopted during heavy load handling and the frequency of MSDs among MMH workers in Calcutta, India.

Methods: We conducted a cross-sectional study with 100 MMH workers. MSD frequency was assessed via the Standardized Nordic Questionnaire. The Ovako Working Posture Assessment System (OWAS) was used to analyze working posture. We used logistic regression to predict MSD risk factors.

Results: Ninety five percent of workers reported a MSD in at least one body part in the past 12 months. According to OWAS results, 83% of the analysed work postures require immediate corrective measures for worker safety. The most harmful posture was carrying a heavy load overhead. Carrying more than 120 kg increased the odds of low back and neck pain by 4.527 and 4.555, respectively.

Conclusions: This sample had a high frequency of reported MSDs, likely attributed to physiologically strenuous occupational activities repeated on average of 30–40 times daily. Ergonomic interventions, such as the use of handcarts, and occupational training are urgently needed.     

Attitudes towards prevention of low back disorders in industry

The attitudes of employees in the metal industry towards possibilitiesfor preventing the occurrence of low back pain were studied.Of 170 clerical employees and 504 manual workers, 86 per cent(n=146) and 63 per cent (n=315), respectively, responded tothe questionnaire. Opinions were positive in both groups, evenamong those who reported experience of recurrent or continuouslow back pain. Measures requiring their own activity, such asdaily training of back and abdominal muscles, straighteningthe back during awkward postures, increasing physical exerciseduring leisure time, and increased information about the structureand loading of the back, were considered effective more oftenthan measures involving changes at work or passive rehabilitation.Attitudes towards possibilities for promoting health in generalby their own behaviour were more positive among the clericalemployees than the manual workers. The attitudes became morenegative with increasing age, as well as with reported experienceof low back pain in both groups. Thus, it is important thatan active approach is taken in occupational health care to motivatesubjects to take action themselves in the prevention of lowback pain at a younger age, and, at the latest, when the firstepisodes of low back pain occur.     

Quantitative measurement of stressful trunk postures in nursing professions

INTRODUCTION: The evaluation of stress to the spinal column in the provision of care has mostly concentrated on the handling of loads. However, awkward body postures alone, without load transfer, can also be stressful for the spinal column. Therefore in this study all the body postures and movements of nurses were quantitatively measured within a working shift. METHODS: The body postures were recorded with the CUELA measurement system (computer-assisted recording and long-term analysis of musculoskeletal loads), coupled to the individual, and this detected all movements of the trunk and the legs. These measurements were supported by video recordings, so that exact allocation of the measured data to the tasks performed was possible. In all, 24 shift measurements were carried out in 8 wards. Extent, frequency and duration of trunk postures were measured in three planes and assessed on the basis of several standards (DIN EN 1005-1, DIN EN 1005-4, ISO 11226). RESULTS: A mean of 1131 (+/-377) trunk inclinations of >20 degrees were performed in each shift. This corresponds to a frequency of 3.5 min(-1). A total of 237 of these inclinations lasted for >4 s. A total of 72 (+/-35) min was spent bending forward with an inclination of >20 degrees . However, the mean time spent in transferring patients (counting only the lifting process) and heavy materials was only 2 min per shift. Postures with trunk inclination of >60 degrees were adopted for a mean of 175 (+/-133) times. The main tasks responsible for this were 'bed making' (21%), 'basic care' (16%) and 'clearing up/cleaning' (16%). CONCLUSIONS: It could be shown that many stressful trunk postures are assumed in nursing work during a shift. Future preventive measures should therefore consider not only load handling but also tasks with awkward postures.     

Overexertion injuries in home health care workers and the need for ergonomics

Home health care workers have high rates of back injuries and other musculoskeletal problems. This article addresses issues surrounding work-related overexertion injuries in home health care workers, including summaries of relevant research on workers in home settings as well as in traditional health care settings such as hospitals and nursing homes. The main work factors associated with these injuries are forceful exertions and awkward postures during patient- care tasks, especially while lifting and moving patients. Ergonomics-the design of work tasks to best accommodate natural human capabilities-is the most promising approach for preventing injuries, and for enhancing the comfort and safety of workers and patients.     

Does leaning posture on the kitchen counter alleviate workload on the low back and legs during dishwashing?

In this study, we evaluated the effects of leaning posture on the kitchen counter, which was observed during dishwashing in a kitchen, on subjective discomfort and muscle activity in the low back and legs. Twelve female volunteers were asked to wash plates for 30 min in each of three working postures: (a) without support (No support), (b) supported by the kitchen counter (Counter), and (c) supported by a standing aid which was a stand equipment to support the shins and the counter (Aid and counter). In the "Aid and counter" posture, the angle of the bent trunk and the muscle activity in the low back were less than that in the "Counter" posture, which was less than that in the "No support" posture. Also, the muscle activities in the legs were greater in the "Counter" and "No support" postures than in the "Aid and counter" posture. We concluded that the effects of leaning posture on the kitchen counter were not enough to decrease the workload on the low back and legs. To improve the comfort of the dishwashing task, new measures, such as the standing aid, are needed.     

Evidence-based care for low back pain in workers eligible for compensation

BACKGROUND: Although guidelines for the management of low back pain have been promoted, few studies have assessed their effectiveness. One previous study did not include patients with workers' compensation claims. AIM: To assess the efficacy of evidence-based care for acute low back pain in patients eligible for workers' compensation. METHODS: In a prospective audit, workers in a health service who presented with acute low back pain were offered the option of usual care from their general practitioner or care provided by a staff specialist who practiced according to evidence-based guidelines. Outcomes were measured in terms of return to normal duties, time off work, recurrence of pain or persistence of pain. RESULTS: Evidence-based care was accepted by 65% of injured workers. Compared with those who elected usual care, these workers had less time off work, spent less time on modified duties and had fewer recurrences. A significantly greater proportion (70%) resumed normal duties immediately, and fewer developed chronic pain, than those managed under usual care. Three types of patients were identified: those who complied readily with evidence-based care, those who initially expressed firm beliefs about how they should be managed and those with occupational psychosocial factors. CONCLUSIONS: Evidence-based care can be successful in retaining patients at work, reducing time off work or on modified duties and reducing recurrences and chronicity. The gains are achieved by conscientiously talking to the patients, and not by any particular or special passive interventions.     

Working hours spent on repeated activities and prevalence of back pain

Background and Aims: Back pain is the most common reason for filing workers' compensation claims in the United States and affects large numbers of workers in many other countries. To evaluate the associations between working hours spent on repeated activities and back pain, data gathered through the 1988 National Health Interview Survey were analysed. The data were also used to identify high risk occupations.

Methods: A total of 30 074 workers participated in the survey. They were asked to provide information on their job, including the time spent on repeated strenuous physical activities (RSPA) and the time spent on repeated bending, twisting, or reaching (RBTR) on a typical job. A case of back pain was defined as a worker who had back pain every day for a week or more during the past 12 months. Each case was asked to report the cause of back pain. Those who attributed their back pain to repeated activities (RA) or a single accident or injury (AI) were asked to recall whether they performed RA or had the AI at work.

Results: Whereas the prevalence of back pain increased as the number of working hours spent on RSPA or RBTR increased, the dose–response relations were not linear for either factor, suggesting the involvement of other unmeasured factors. The estimated overall prevalence of RA back pain was 8.9% among male workers and 5.9% among female workers. "Carpenters" had the highest prevalence (19.2%) and most cases (338 000) among the major occupations of men, and "nursing aides, orderlies, and attendants" had the highest prevalence (15.2%) and most cases (217 000) among the major occupations of women.

Conclusions: The number of hours spent on repeated activities at work was associated with the prevalence of back pain. This study identified high risk occupations for future research and intervention.

     

Bronchial symptoms and respiratory function in workers exposed to methylmethacrylate.

This study aimed to investigate the pulmonary effects of methylmethacrylate (MMA) in a group of occupationally exposed workers. In the exposed group 20% had chronic cough compared with 1% in controls. Spirometric values at the beginning of the workshift were similar in both groups, but a mild airways obstruction appeared during the workshift. The maximum expiratory flow when 50% of the forced vital capacity remained to be exhaled (MEF50) and the ratio of MEF50 to maximal expiratory flow (MEF50/MEF) decreased significantly during the workshift among exposed workers v controls (p = 0.04 and 0.01 respectively). Results remained unaffected after adjustment for smoking. Exposure to MMA seems to be responsible for a mild airways obstruction but further study on a larger population would be useful.     

Severe back pain among farmworker high school students from Starr County, Texas: baseline results

PURPOSE: This cohort study is among the first to estimate the prevalence of and examine potential risk factors for severe back pain (resulting in medical care, 4+ hours of time lost, or pain lasting 1+ weeks) among adolescent farmworkers. These youth often perform tasks requiring bent/stooped postures and heavy lifting. METHODS: Of 2536 students who participated (response rate across the three public high schools, 61.2% to 83.9%), 410 students were farmworkers (largely Hispanic and migrant). Students completed a self-administered Web-based survey including farm work/nonfarm work and back-pain items relating to a 9-month period. RESULTS: The prevalence of severe back pain was 15.7% among farmworkers and 12.4% among nonworkers. The prevalence increased to 19.1% among farm workers (n = 131) who also did nonfarm work. A multiple logistic regression for farmworkers showed that significantly increased adjusted odds ratios for severe back pain were female sex (4.59); prior accident/back injury (9.04); feeling tense, stressed, or anxious sometimes/often (4.11); lifting/carrying heavy objects not at work (2.98); current tobacco use (2.79); 6+ years involved in migrant farm work (5.02); working with/around knives (3.87); and working on corn crops (3.40). CONCLUSIONS: Areas for further research include ergonomic exposure assessments and examining the effects of doing farm work and nonfarm work simultaneously.