新疆护理人员职业性肌肉骨骼疾患所致缺勤的现状调查

目的了解新疆二、三级医院护理人员职业性肌肉骨骼疾患(WMSDs)的患病现状,分析WMSDs引起缺勤的状况,为职业卫生行政管理部门以及医疗卫生管理部门的管理提供依据。方法采用整群抽样的方法,抽取新疆70家医院的10 665名护理人员,采用WMSDs调查问卷调查WMSDs患病率以及WMSDs引起的缺勤状况。结果护理人员三个时间层面WMSDs患病率为67.92%(曾患病率)、61.20%(年患病率)、28.98%(周患病率);近1年因WMSDs请假的缺勤率为6.81%,因腰部WMSDs缺勤率占比最高(5.32%);不同年龄、工龄、婚姻及生育状况、工作科室的护士近1年因WMSDs所致缺勤率差异有统计学意义(均P0.01)。结论新疆护理人员职业性肌肉骨骼疾患患病率较高,因WMSDs缺勤率低于一般职业人群,可能与重视程度不高、数据上报保守等有关。建议管理者及护理人员提高对WMSDs的重视程度,做好职业防护。     

Prevalence, characteristics, and impacts of work-related musculoskeletal disorders: a survey among physical therapists in the State of Kuwait

Background  

Physical therapists working in the State of Kuwait are at risk of work-related musculoskeletal disorders (WMSDs). However, prevalence rates and risk factors are not well documented. The objective of this study was to determine the prevalence, characteristics, and impacts of WMSDs among physical therapists in the State of Kuwait.     

Prediction of chronic disability in work-related musculoskeletal disorders: a prospective,population-based study

Background  

Disability associated with work-related musculoskeletal disorders is an increasingly serious societal problem. Although most injured workers return quickly to work, a substantial number do not. The costs of chronic disability to the injured worker, his or her family, employers, and society are enormous. A means of accurate early identification of injured workers at risk for chronic disability could enable these individuals to be targeted for early intervention to promote return to work and normal functioning. The purpose of this study is to develop statistical models that accurately predict chronic work disability from data obtained from administrative databases and worker interviews soon after a work injury. Based on these models, we will develop a brief instrument that could be administered in medical or workers' compensation settings to screen injured workers for chronic disability risk.     

An upper body musculoskeletal assessment instrument for patients with work-related musculoskeletal disorders: a pilot study.

OBJECTIVES: To examine the reliability and validity of a new outcome measure, the Upper Body Musculoskeletal Assessment (UBMA). DESIGN: Twenty subjects physician-diagnosed as having work-related musculoskeletal disorders (WRMD) and ten healthy subjects were assessed using the UBMA on three separate occasions. All subjects with WRMD attributed their injury to equipment use on their job. RESULTS: The WRMD group had significantly higher UBMA scores on the side of equipment use than on the other side (p <0.01), whereas the healthy group had similar scores on both sides (p> 0.05). UBMA scores for the WRMD group were significantly greater on both sides of the body than scores for the healthy group (p<0.01). Only one test occasion was required to produce excellent reliability coefficients (ICCs>0.88). Although group reliability was excellent, changes of 24% for patients with WRMD and 44% for healthy subjects would be required for confidence that UBMA scores for individual patients on the side of equipment use had changed from baseline. CONCLUSIONS: Although testing on one occasion produced reliable UBMA scores, healthy subjects could be distinguished from patients with WRMD, and the side of equipment use could be distinguished from the other side in patients with WRMD, prediction of individual UBMA scores was poor. In its present form, the UBMA is useful for making decisions about groups but not about individual patients. Modifications of the current UBMA are required to reduce measurement error.     

Prescription ergonomics: adding prevention to the diagnosis and treatment of work-related musculoskeletal disorders

The physician treating patients who have work-related musculoskeletal disorders (WMSDs) must educate the patient and employer about the nature of the problem and what to do about it. To do this effectively, diagnostic findings must be linked to prevention efforts in a way that is understandable for the physician, the patient, and the company's safety professional. Three skills are required. First, the physician must be able to recognize how the injury presentation reflects acute or chronic biomechanical stress patterns. Second, the physician must be able to recognize the work relationships and other elements that influence biomechanical stress. Third, the physician must have access to a mnemonic that enables him or her to analyze the work method and explain significant findings to the patient and employer.     

Incidence and risk factors for musculoskeletal disorders of the elbow in baseball pitchers: a systematic review of the literature

ObjectiveTo determine the incidence and risk factors of musculoskeletal disorders of the elbow in baseball pitchers.DesignSystematic review.Data SourcesMedline, CINAHL, Cochrane, PubMed and SportDiscus from onset to July 7, 2018.Eligibility CriteriaEligible studies included randomized controlled trials, cohort studies and case-control studies. Independent pairs of reviewers screened titles and abstracts for eligibility. Relevant articles were critically appraised for internal validity using the SIGN criteria. We included low risk of bias studies in our best evidence synthesis.ResultsWe retrieved 4502 articles, 39 were critically appraised and nine had a low risk of bias. These were included in the evidence synthesis. The incidence of musculoskeletal disorders of the elbow ranges from 2.3% in adolescent pitchers to 40.6% in youth pitchers. Evidence suggests that pitch characteristics, inadequate rest, biomechanical and anthropometric factors may be risk factors of UCL tears.Summary/ConclusionBaseball pitchers develop musculoskeletal disorders of the elbow. There is little high-quality evidence to understand the etiology. Preliminary evidence suggests the risk factors are multifactorial.PROSPERO Trial Registration Number: CRD42018092081     

Absence of back disorders in adults and work-related predictive factors in a 5-year perspective

Factors important for avoiding back disorders in different age-groups have seldom been compared and studied over time. We therefore set out to study age-related differences in socio-economic and work-related factors associated with the absence of back disorders in a 5-year comparative cohort study using a mailed questionnaire. Two subgroups (aged 25-34 and 54-59 years) derived from a representative sample of the Swedish population were followed at baseline, 1 year and 5 years. Questions were asked about the duration of back pain episodes, relapses, work changes and work satisfaction. A work adaptability, partnership, growth, affection, resolve (APGAR) score was included in the final questionnaire. Multivariate logistic regression was used to identify factors predicting the absence of back disorders. Absence of physically heavy work predicted an absence of back disorders [odds ratio (OR), 2.86; 95% confidence interval (CI), 1.3-6.3] in the older group. In the younger age-group, the absence of stressful work predicted absence of back disorders (OR, 2.0; 95% CI, 1.1-3.6). Thirty-seven per cent of the younger age-group and 43% of the older age-group did not experience any back pain episodes during the study period. The exploratory work APGAR scores indicated that back disorders were only associated with lower work satisfaction in the older group. The analyses point out the importance of avoiding perceived psychological stress in the young and avoiding perceived physically heavy work in the older age-group for avoiding back disorders. The results suggest a need for different programmes at workplaces to avoid back disorders depending on the age of the employees concerned.     

Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination

Background  

In epidemiological studies on neck-shoulder disorders, physical examination by health professionals, although more expensive, is usually considered a better method of data collection than self-administered questionnaires on symptoms. However, little is known on the comparison of these two methods of data collection. The agreement between self-administered questionnaires and the physical examination on the presence of neck-shoulders disorders was assessed in the present study.     

Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France

OBJECTIVES: The goals of this study were to document the prevalence of varicose veins, skin trophic changes, and venous symptoms in a sample of the general population of France, to document their main risk factors, and to assess relationships between them. METHODS: This cross-sectional epidemiologic study was carried out in the general population of 4 locations in France: Tarentaise, Grenoble, Nyons, and Toulon. Random samples of 2000 subjects per location were interviewed by telephone, and a sub-sample of subjects completed medical interviews and underwent physical examination, and the presence of varicose veins, trophic changes, and venous symptoms was recorded. RESULTS: Prevalence of varicose veins, skin trophic changes, and venous symptoms was not statistically different in the 4 locations. In contrast, sex-related differences were found: varicose veins were found in 50.5% of women versus 30.1% of men ( P < .001); trophic skin changes were found in 2.8% of women versus 5.4% of men ( P = NS), and venous symptoms were found in 51.3% of women 51.3% versus 20.4% of men ( P < .001). Main risk factors for varicose veins were age and family history in both sexes, and pregnancy in women. Female sex was a significant factor only for non-saphenous varicose veins. Varicose veins, age, and pitting edema were the most significant risk factors for trophic skin changes. The risk factors for venous symptoms were female sex, varicose veins, and prolonged sitting or standing. A negative relationship with age was found in women. CONCLUSION: Our results show a high prevalence of chronic venous disorders of the lower limbs in the general population of France, with no significant geographic variations. They also provide interesting insights regarding the association of varicose veins, skin trophic changes, and venous symptoms.     

Median nerve trauma in a rat model of work-related musculoskeletal disorder

Anatomical and physiological changes were evaluated in the median nerves of rats trained to perform repetitive reaching. Motor degradation was evident after 4 weeks. ED1-immunoreactive macrophages were seen in the transcarpal region of the median nerve of both forelimbs by 5-6 weeks. Fibrosis, characterized by increased immunoexpression of collagen type I by 8 weeks and connective tissue growth factor by 12 weeks, was evident. The conduction velocity (NCV) within the carpal tunnel showed a modest but significant decline after 9-12 weeks. The lowest NCV values were found in animals that refused to participate in the task for the full time available. Thus, both anatomical and physiological signs of progressive tissue damage were present in this model. These results, together with other recent findings indicate that work-related carpal tunnel syndrome develops through mechanisms that include injury, inflammation, fibrosis and subsequent nerve compression.     

Aging enhances serum cytokine response but not task-induced grip strength declines in a rat model of work-related musculoskeletal disorders

Background  

We previously reported early tissue injury, increased serum and tissue inflammatory cytokines and decreased grip in young rats performing a moderate demand repetitive task. The tissue cytokine response was transient, the serum response and decreased grip were still evident by 8 weeks. Thus, here, we examined their levels at 12 weeks in young rats. Since aging is known to enhance serum cytokine levels, we also examined aged rats.     

Work-related musculoskeletal disorders : A survey of physical therapists in Izmir-Turkey

Background  

This study was planned to collect data about causes, prevalence and responses to work-related musculoskeletal disorders reported by physiotherapists employed in Izmir, Turkey.     

Development and trial use of multistep diagnosis of musculoskeletal disorders during a routine physical examination at the workplace

Musculoskeletal disorders represent the main cause for absenteeism. To determine the disorders exactly, a multistep inventory of examinations was developed. The method of diagnostics may be an indicator of the quality of occupational medical management. It may improve the availability of health data related to working conditions and may increase the chances of goal-oriented prevention in the field of working conditions as well as in the field of behavior. In addition, the standardized recording of data provides an opportunity for evaluation in epidemiological studies, which may be organized as longitudinal studies to look for the development of musculoskeletal disorders over time.     

Work related musculoskeletal disorders amongst therapists in physically demanding roles: qualitative analysis of risk factors and strategies for prevention

Background  

Physiotherapy and occupational therapy are two professions at high risk of work related musculoskeletal disorders (WRMD). This investigation aimed to identify risk factors for WRMD as perceived by the health professionals working in these roles (Aim 1), as well as current and future strategies they perceive will allow them to continue to work in physically demanding clinical roles (Aim 2).     

Magnitude of impact and healthcare use for musculoskeletal disorders in the paediaric: a population-based study

Background

The gluteus medius muscle is essential for gait and hip stability. Changes that occur in the gluteus medius muscles in patients with developmental dysplasia of the hip (DDH) are not well understood. A better understanding of DDH related changes will have positive repercussions toward hip soft tissue reconstruction.

Methods

19 adult patients with unilateral DDH scheduled for total hip arthroplasty were assessed for: cross-sectional area (CSA), radiological density (RD) and the length of gluteus medius using computed tomograhpy(CT) (scanned before THA). Hip abductor moment arm and gluteus medius activation angle were also measured via hip anteroposterior radiographs.

Results

Both CSA and RD of gluteus medius muscle were significantly reduced (p?<?0.05) in the affected hip compared to the control. In the affected hip, the length of the gluteus medius muscle was reduced by 8-11?% (p?<?0.05) while the gluteus medius activation angle was significantly increased (p?<?0.05) and the hip abductor moment arm was decreased (p?<?0.05).

Conclusions

The gluteus medius showed substantial loss of CSA, RD as well as decreased length in patients with DDH in the affected hip. These changes should be considered in both hip reconstruction and postoperative rehabilitation training in patients with DDH.     

Sick leave among home-care personnel: a longitudinal study of risk factors

Background  

Sick leave due to neck, shoulder and back disorders (NSBD) is higher among health-care workers, especially nursing aides/assistant nurses, compared with employees in other occupations. More information is needed about predictors of sick leave among health care workers. The aim of the study was to assess whether self-reported factors related to health, work and leisure time could predict: 1) future certified sick leave due to any cause, in nursing aides/assistant nurses (Study group I) and 2) future self-reported sick leave due to NSBD in nursing aides/assistant nurses (Study group II).     

Work-life conflict and musculoskeletal disorders: a cross-sectional study of an unexplored association

Background  

The health consequences of work-family or rather work-life conflict (WLC) have been studied by numerous researchers. The work-related causes of musculoskeletal disorders (MSD) are also well explored. And stress (at work) has been found to be a consequence of WLC as well as a cause of MSD. But very little is known about a potential association between WLC and MSD and the possible mediating role of stress in this relationship.     

Infertility among couples in a population-based study in Iran: prevalence and associated risk factors

To explore the prevalence and risk factors of infertility in Iran, a total of 12 285 ever-married women aged 15-50 years old and their husbands (if available) were interviewed by 82 female general practitioners and answered a self-administered questionnaire on several aspects of infertility. They were identified from the national population in 30 counties, and invited to a confidential interview. Data were obtained about their age, education, marital status, toxic habits, medical history, disabilities and illnesses, help-seeking, economy, ethnicity, geographic location, contraceptive use and age at which they had first intercourse. This study used the definition of childlessness proposed by World Health Organization: 'the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 2 years'. The overall prevalence of infertility was 8% (95% CI: 3.2-15.0). The weighted national estimate of primary infertility was 4.6% (95% CI: 3.6-5.2). There was a pronounced regional pattern in the levels of primary infertility. The primary infertility increased significantly from 2.6 to 4.3 to 5.5% for the 1985-1989, 1990-1994 and 1995-2000 marriage cohorts. The prevalence of secondary infertility was 3.4% (95% CI: 2.4-5.1). Overall the prevalence of infertility falls within a relatively wide range being high in the Southern counties, and low in the Northern counties. The probability of first pregnancy at the end of 2 years of marriage was 0.78 for all ever-married women. The prevalence of infertility increased with age (linear chi-square 198.012, 1 d.f., p = 0.01). The age pattern of infertility also varies quite markedly across the counties analysed. No effect of race was detected; neither the intercept (analysis of covariance p = 0.36) nor the slope of the age relationship was influenced by race (analysis of covariance p = 0.41). Infertility were observed as significantly higher in the presence of history of tubo-ovarian surgery [odds ratio (OR): 1.43; 95% CI: 1.28-2.23; p = 0.01], salpingitis (OR: 2.34; 95% CI: 1.31-4.3; p = 0.016), ectopic pregnancy (OR: 2.45; 95% CI: 1.90-3.44; p = 0.04), varicocele (OR: 2.85; 95% CI: 1.61-5.20; p = 0.01) and cryptorchidism (OR: 3.81; 95% CI: 2.51-4.28; p = 0.031). This study provides a quantitative estimate of the prevalence and main risk factors for infertility in Iranian couples. Yet, further studies on the cause of primary and secondary infertility and geographical variations in the incidence and prevalence of infertility in Iran are needed.