Work-related hand injuries: type, location, cause, mechanism and severity in a tertiary hospital

Introduction: Work-Related Hand Injuries (WRHIs) may result in disability and diminished productivity and cause economic impacts not only to the individual, worker’s families and industries, but to the local community as well. Objectives: To determine the prevalence of severe Work-Related Hand Injuries (WRHIs) and factors associated at a tertiary hospital. Methods: A pre-tested validated questionnaire was used to obtain data. All patients 18 years and above with WRHIs seen at a tertiary hospital between January 2010 and June 2010 were included in the study. Data was analysed using SPSS version 18. Results: Out of the 297 industrial accidents, 74 (24.9%) were WRHIs. Among those with WRHIs, (47.3%) of them had severe hand injuries. The overall mean age of the respondents was 30.36 (± 9.54 SD) years. Majority (82.5%) of the injuries occurred between Mondays to Friday. Majority (70.1%) of hand injuries were caused by machine and 48.6% of the hand injuries occurred when the hand was caught in the operating part of the machine. Majority (62.1%) of the respondents had fingers’ injuries and 32.4% had open fracture. Bivariate analysis showed that there was significant association between severity of WRHIs and locations of injury, mechanisms of injury, sources of injury and sectors of industry (p < 0.05). Logistic regression analysis showed that WRHIs was significantly associated with source of injury and sector of industry. Respondents with hand injury resulted while operating on mechanical machine was 26 times more likely to report severe WRHIs than those with other sources of their hand injury like (sharp tool, heavy door, and wet floor). Respondents working in metal-machinery industries were eight times more likely to report severe WRHIs than those who working in other sectors of industry like (wood-furniture, constriction, food preparing, service and automotive). Conclusions: WRHIs contributed to 24.9% of all industrial accidents seen at the emergency department and orthopaedic clinic and 47.3% of the respondents with WRHIs had severe hand injuries. Severity of WRHIs was significantly associated with sources of injury and sectors of industry

Neck/shoulder problems and visual disturbances among surgeons: a scoping review

Minimally invasive surgeries are the surgical techniques that lower the size of incisions needed but may increase the physical problems such as neck/shoulder problems and visual disturbances among surgeons. This study aims to determine the prevalence, severity, proposed risk factors, and evidence for a relationship for neck/shoulder problems and visual disturbances (separately and concurrently) among surgeons.A scoping review using the five-stage framework proposed by Arksey and O'Malley was conducted. This included identification of a research question and relevant studies, study selection, charting of data and collating, summarizing, and reporting of the results. Databases searched were PubMed, Embase, CINAHL, Cochrane Library and Web of Science, and Scopus, alongside a hand-search. An Appraisal tool for Cross-Sectional Studies was used to determine methodological quality of studies.Ten articles met the inclusion criteria from 744 identified. Prevalence were reported by all the studies and ranged from 6% to 74% (neck); 7%-35% (right shoulder); 8%-39% (left shoulder); 9%-80% (both shoulders), and 0.4%-63% (visual disturbances). Severity of these concerns was assessed in four studies and was variable. The risk factors for neck/shoulder problems and visual disturbances included workplace physical ergonomic factors, surgery factors, and surgeon-related factors. None of the included studies proposed a relationship between neck/shoulder problems and visual disturbances.There was great variability in the reported prevalence of neck/shoulder problems and visual disturbances among surgeons. Neck/shoulder problems and visual disturbances shared several risk factors, but the link between the two issues has not been fully investigated

Characteristics of headaches among surgeons and associated factors: A cross-sectional study

Background Surgeons performing Minimally Invasive Surgery (MIS) report significant neck/shoulder problems and visual symptoms. Headache is another commonly reported symptom but publications about the characteristics and associated risk factors are limited. Purpose of the study To determine the characteristics of headache among MIS surgeons and the associations of headache with neck/shoulder problems, visual symptoms and other associated factors. Design A cross-sectional study. Methods A comprehensive online survey was sent to MIS surgeons inclusive of 63 questions about individual and workplace physical factors, characteristics of headache, neck/shoulder problems and visual symptoms. Binary logistic regression models were conducted to determine the associations of the prevalence and severity of headache with risk factors. The main findings Headaches in the last 7 days were reported by 36% of surgeons, with 37% of these of moderate to severe intensity. Frequent intense headaches were often preceded by neck pain. Surgeons with headache were eight times more likely to also experience visual symptoms and four times more likely to experience neck/shoulder problems. Several factors (frequently adopting forward head movement, surgical specialty, sex and age) were significantly associated with headaches (p ≤ 0.05). Conclusions This study revealed headaches were present in one-third of MIS surgeons. During surgery, surgeons report adopting non-neutral neck/shoulder/head positions, which may explain headaches, neck/shoulder problems and visual symptoms. Evidence based strategies to assist surgeons better manage these symptoms are warranted

Impact of accommodation, convergence and stereoacuity on perceived symptoms and surgical performance among surgeons

BackgroundMinimally invasive surgery (MIS) is not without impact on surgeons’ neck/shoulder/head and eyes. However, the mechanisms for concurrent symptoms are not clear. This study aims to examine the effect of visual impairments on physical symptoms and surgical performance among surgeons performing simulated surgical tasks using two-dimensional (2D) and three-dimensional (3D) viewing modes.MethodsGynaecologists with experience in laparoscopy performed four simulated surgical tasks in the 2D and 3D viewing modes. Visual parameters (accommodation, convergence and stereoacuity) were measured prior to commencement. Objective performance measures were derived from the laparoscopic tasks, and surgeons also self-reported their mental and physical workload using the NASA-TLX. In addition, perceived symptoms were measured using Visual Analogue Scales, the Simulator Sickness Questionnaire and the Computer Vision Syndrome Questionnaire.ResultsSeventeen healthy gynaecologists participated in this study. There were significant relationships between visual impairments and both the perceived symptoms and surgical performance scores of MIS surgeons. Surgeons with a higher number of accommodation/convergence dysfunctions and/or poorer stereoacuity tended to have poorer objective performance scores on simulated surgical tasks in both viewing modes. NASA-TLX scores indicated that surgeons with poorer stereoacuity also perceived themselves to have been less successful at accomplishing tasks. However, these surgeons also reported less intense physical symptoms and simulator sickness.ConclusionsSurgeons’ performance for the simulated surgical tasks correlated with visual functions, and it also impacted on the symptoms experienced. Regular screening of surgeons’ vision and vision therapy may be required to decrease physical symptoms and improve surgical performance