We conducted this experimental study to estimate a risk of a high-risk group of low back pain (LBP) membership in workers who perform the manual material handling (MMH) tasks in an actual workplace setting.
The subjects include healthy workers who were engaged in 12 MMH tasks at 6 manufacturing companies. We assessed the dynamic motion of trunk or lumbar spine using an industrial lumbar motion monitor (BioDynamics Laboratory of Ohio State University). The subjects were evaluated for the age, gender, years of working and anthropometric measurements (e.g., height, weight, shoulder height, elbow height, iliac height, leg length, trunk length, trunk circumference, iliac width, iliac depth, xiphoid width and xiphoid depth). Moreover, they were also evaluated for a risk of a high-risk group of LBP membership based on lift frequency, average twisting velocity, maximum moment, maximum sagittal flexion and maximum lateral velocity.
The subjects who were engaged in a packaging at a detergent manufacturing company are at the greatest risk of LBP (63.76%). This was followed by packaging at a leather product manufacturing company (57.06%), packaging at a non-metallic casting material manufacturing company (57.03%), manual injection at a non-metallic casting material manufacturing company (52.00%), toggling at a leather product manufacturing company (46.09%), non-metallic casting material manufacturing company (42.88%), rolling at a non-metallic mineral product manufacturing company (42.12%), shooting at a non-metallic casting material manufacturing company (40.99%), vacuum processes at a leather product manufacturing company (35.00%), looping at a general industrial machinery manufacturing company (33.93%), setting at a leather product manufacturing company (30.22%) and packaging at a general metal product manufacturing company (22.02%).
Our approach indicates that there is a risk of a high-risk group of LBP membership in workers who perform the MMH tasks.
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Job rotation was introduced in various industries as a strategic form of work for improving workers' job skills and health management. This study aims to examine the relationship between job rotation and work-related low back pain (LBP), one of the typical work-related musculoskeletal symptoms of Korean workers.
We conducted this study using the data of the 5th Korean Working Conditions Survey (KWCS). As the subject of this study, 27,163 wage workers were selected, and classified into three groups according to occupational type (white-collar, service and sales, and blue-collar). In this study, job rotation means to change the work-related activities with other colleagues periodically and work-related LBP was defined as whether there was work-related LBP in the last 12 months. Chi-square test and logistic regression were used to analyze the relationship between job rotation and work-related LBP.
Out of 27,163 workers, 2,421 (8.9%) answered that they had job rotation and 2,281 (8.4%) answered that they experienced work-related LBP. According to the results from logistic regression, job rotation was significantly associated with low prevalence of work-related LBP among blue-collar workers (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58–0.88), whereas no significant relationship was observed among white-collar, service and sales groups. In addition, the negative association between job rotation and work-related LBP among blue-collar workers was more pronounced when exposed to ergonomic risk factors (uncomfortable posture OR: 0.79, 95% CI: 0.64–0.98; heavy work OR: 0.74, 95% CI: 0.57–0.96; repetitive work OR: 0.74, 95% CI: 0.60–0.92).
Job rotation was associated with low prevalence of work-related LBP among workers in the blue-collar occupational group in Korea. It is necessary to evaluate the effect of job rotation by occupational type and introduce an appropriate method of job rotation to reduce workers' work-related musculoskeletal symptoms.
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It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS).
The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP.
All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46–5.83; aOR 1.98, 95% CI 1.62–2.42; aOR 2.09, 95% CI 1.82–2.40; aOR 1.79, 95% CI 1.60–2.01; aOR 2.04, 95% CI 1.82–2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to ‘fatigue-inducing or painful posture’ aOR 2.17, 95% CI 2.02–2.34; high exposure to both ‘fatigue-inducing or painful posture’ and ‘dragging, pushing, or moving heavy objects’ aOR 2.00, 95% CI 1.82–2.20).
There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.
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There are few published studies on the relationship between occupational lumbar load and facet joint degeneration (FJD). This cross-sectional study was conducted to evaluate the effect of physical lumbar load on FJD by comparing magnetic resonance imaging (MRI) findings of firefighters (FFs) and hospital office workers (HOWs).
We randomly sampled 341 male FFs and 80 male HOWs by age stratification. A questionnaire and clinical examination, including MRI of the lumbar spine (T12-S1), were conducted. FJD was diagnosed and graded by using the classification of Pathria et al., and reclassified into two groups as follows: no FJD (grade 0) and FJD (grades 1, 2, and 3). The prevalence of FJD was analyzed according to occupational group.
The prevalence of FJD ranged from 31% (L1–L2) to 75% (L4–L5) in the FFs, and from 18% (L1–L2) to 69% (L4–L5) in the HOWs. After adjustment for age, body mass index, and frequency of physical exercise, the adjusted odds ratios (OR) for FJD in the FFs were significantly higher than those in the HOWs at all lumbar spinal levels, except for L3–L4 (L1–L2: OR, 2.644; 95% confidence interval [CI], 1.317–5.310; L2–L3: OR, 2.285; 95% CI, 1.304–4.006; L4–L5: OR, 1.918; 95% CI, 1.037–3.544; L5–S1: OR, 1.811; 95% CI, 1.031–3.181).
This study shows that FFs exhibit a greater likelihood of having FJD than HOWs after controlling for other risk factors of FJD. This suggests that the physical occupational demands of FFs affect their risk of developing FJD.
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Low Back Pain (LBP) is the commonest musculoskeletal disorder and an important occupational hazard among healthcare workers (HCWs) that peaks among Operating Room (OR) staff. This cross-sectional study aimed to assess the prevalence, characteristics, and risk factors of low back pain among operating room (OR) staff in a tertiary healthcare center in Makkah, Saudi Arabia.
A 39-item self-administered questionnaire was distributed to all available OR staff. Data about personal, sociodemographic, general risk factors OR specific risky activities, and LBP characteristics were obtained. Descriptive, crosstabs, and univariate and multivariate logistic regression tests were employed.
Out of the 143 distributed questionnaires, 84 % were received. LBP prevalence was 74.2 %. No statistically significant associations were detected between LBP and any of the general risk factors (
LBP is a common health issue among KAMC OR staff. OR risky activities were found to contribute to this problem. We suggest designing educational interventional programs to teach OR staff the best way to prevent this problem.
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A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel
Low Back Pain Among Nurses Working at Public Hospitals in Eastern Ethiopia
Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), moderate (B), limited (C) or based on expert consensus (D) according to their level of evidence. It is recommended to deliver reassuring and consistent information concerning LBP prognosis (Level B); to perform a clinical examination looking for medical signs of severity related to LBP (Level A), encourage continuation or resumption of physical activity (Level A), identify any changes in working conditions and evaluate the occupational impact of LBP (Level D). In case of persistent/recurrent LBP, assess prognostic factors likely to influence progression to chronic LBP, prolonged disability and delayed return to work (Level A). In case of prolonged/repeated sick leave, evaluate the pain, functional disability and their impact and main risk factors for prolonged work disability (Level A), promote return to work measures and inter professional coordination (Level D). These good practice guidelines are primarily intended for professionals of occupational health but also for treating physicians and paramedical personnel participating in the management of LBP, workers and employers.
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The objective of this study was to identify the musculoskeletal co-morbidities of neck pain of myofascial origin among IT professionals.
A retrospective report analysis of 5357 IT professionals from various IT companies in India was conducted. Demographic details, type and intensity of the musculoskeletal problems, employee feedbacks on status of musculoskeletal health and physician’s diagnosis were analysed. Descriptive statistics were used to describe the age, gender, body area affected and nature of work. Chi square test was used to find the association between musculoskeletal co-morbidities and myofascial neck pain (MNP).
The study participants were predominantly males (71%). 41% of the population used laptops, 35% desktops and 24% both. Neck pain was the commonest reported symptom, followed by low back, shoulder and arm pain respectively. Statistical analysis also revealed that low back pain and shoulder pain, had a significant association with neck pain. Further analysis revealed that there was a significant association between the presence of MNP and thoracic outlet syndrome (p < 0.001) and fibromyalgia syndrome (p < 0.001). Other than the listed co-morbidities, eye strain was also found to be associated with MNP.
Low back pain and shoulder pain was found to be co morbid symptoms noted among IT professionals with MNP. Thoracic outlet syndrome and fibromyalgia were found to be the most commonly associated disorders with MNP among IT professionals.
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We developed an evidence-based practice guideline to support occupational safety and health (OSH) professionals in assessing the risk due to lifting and in selecting effective preventive measures for low back pain (LBP) in the Netherlands. The guideline was developed at the request of the Dutch government by a project team of experts and OSH professionals in lifting and work-related LBP. The recommendations for risk assessment were based on the quality of instruments to assess the risk on LBP due to lifting. Recommendations for interventions were based on a systematic review of the effects of worker- and work directed interventions to reduce back load due to lifting. The quality of the evidence was rated as strong (A), moderate (B), limited (C) or based on consensus (D). Finally, eight experts and twenty-four OSH professionals commented on and evaluated the content and the feasibility of the preliminary guideline. For risk assessment we recommend loads heavier than 25 kg always to be considered a risk for LBP while loads less than 3 kg do not pose a risk. For loads between 3–25 kg, risk assessment shall be performed using the Manual handling Assessment Charts (MAC)-Tool or National Institute for Occupational Safety and Health (NIOSH) lifting equation. Effective work oriented interventions are patient lifting devices (Level A) and lifting devices for goods (Level C), optimizing working height (Level A) and reducing load mass (Level C). Ineffective work oriented preventive measures are regulations to ban lifting without proper alternatives (Level D). We do not recommend worker-oriented interventions but consider personal lift assist devices as promising (Level C). Ineffective worker-oriented preventive measures are training in lifting technique (Level A), use of back-belts (Level A) and pre-employment medical examinations (Level A). This multidisciplinary evidence-based practice guideline gives clear criteria whether an employee is at risk for LBP while lifting and provides an easy-reference for (in)effective risk reduction measures based on scientific evidence, experience, and consensus among OSH experts and practitioners.
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Existing methods for practically evaluating musculoskeletal exposures such as posture and repetition in workplace settings have limitations. We aimed to automate the estimation of parameters in the revised United States National Institute for Occupational Safety and Health (NIOSH) lifting equation, a standard manual observational tool used to evaluate back injury risk related to lifting in workplace settings, using depth camera (Microsoft Kinect) and skeleton algorithm technology.
A large dataset (approximately 22,000 frames, derived from six subjects) of simultaneous lifting and other motions recorded in a laboratory setting using the Kinect (Microsoft Corporation, Redmond, Washington, United States) and a standard optical motion capture system (Qualysis, Qualysis Motion Capture Systems, Qualysis AB, Sweden) was assembled. Error-correction regression models were developed to improve the accuracy of NIOSH lifting equation parameters estimated from the Kinect skeleton. Kinect-Qualysis errors were modelled using gradient boosted regression trees with a Huber loss function. Models were trained on data from all but one subject and tested on the excluded subject. Finally, models were tested on three lifting trials performed by subjects not involved in the generation of the model-building dataset.
Error-correction appears to produce estimates for NIOSH lifting equation parameters that are more accurate than those derived from the Microsoft Kinect algorithm alone. Our error-correction models substantially decreased the variance of parameter errors. In general, the Kinect underestimated parameters, and modelling reduced this bias, particularly for more biased estimates. Use of the raw Kinect skeleton model tended to result in falsely high safe recommended weight limits of loads, whereas error-corrected models gave more conservative, protective estimates.
Our results suggest that it may be possible to produce reasonable estimates of posture and temporal elements of tasks such as task frequency in an automated fashion, although these findings should be confirmed in a larger study. Further work is needed to incorporate force assessments and address workplace feasibility challenges. We anticipate that this approach could ultimately be used to perform large-scale musculoskeletal exposure assessment not only for research but also to provide real-time feedback to workers and employers during work method improvement activities and employee training.
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