Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A Prospective Cohort Study

Purpose Much research has been performed on physical exposures during work (e.g. lifting, trunk flexion or body vibrations) as risk factors for low back pain (LBP), however results are inconsistent. Information on the effect of doses (e.g. spinal force or low back moments) on LBP may be more reliable but is lacking yet. The aim of the present study was to investigate the prospective relationship of cumulative low back loads (CLBL) with LBP and to compare the association of this mechanical load measure to exposure measures used previously. Methods The current study was part of the Study on Musculoskeletal disorders, Absenteeism and Health (SMASH) study in which 1,745 workers completed questionnaires. Physical load at the workplace was assessed by video-observations and force measurements. These measures were used to calculate CLBL. Furthermore, a 3-year follow-up was conducted to assess the occurrence of LBP. Logistic regressions were performed to assess associations of CLBL and physical risk factors established earlier (i.e. lifting and working in a flexed posture) with LBP. Furthermore, CLBL and the risk factors combined were assessed as predictors in logistic regression analyses to assess the association with LBP. Results Results showed that CLBL is a significant risk factor for LBP (OR: 2.06 (1.32-3.20)). Furthermore, CLBL had a more consistent association with LBP than two of the three risk factors reported earlier. Conclusions From these results it can be concluded that CLBL is a risk factor for the occurrence of LBP, having a more consistent association with LBP compared to most risk factors reported earlier. © 2012 The Author(s)

A comparison of ISO 2631-5:2004 and ISO 2631-5:2018 standards for whole-body vibrations exposure: A case study

Agricultural tractor drivers are exposed to high level of vibrations during different activities. Continued exposure to Whole Body Vibration (WBV) may cause musculoskeletal disorders and degenerative changes in lumbar spine. This study analyses the WBV transmitted to drivers associated to a typical operation with agricultural tractor. This measurement was based on the models defined in ISO 2631-5:2004 and ISO 2631-5:2018. The study had been carried out in order to make a comparison between the Standards. The R factor (defined in the ISO 2631-5:2004 to estimate the lumbar spine response acceleration), and Ra factor (defined in the ISO 2631-5:2018 to estimate internal spinal forces, ISO 2631-5:2018) were calculated to predict adverse effects in the lumbar spine. In this case study both standards provide similar assessment, low probability of an adverse health effect. © Springer Nature Switzerland AG 2019

Use of a H∞ controller on a half semi-trailer truck model to reduce vibrations and its implications on human factor

© Springer Nature Switzerland AG 2019.Comfort of a large goods vehicle driver has a crucial factor on fatigue one of which being physical (muscular) fatigue, which has common indicators of pain in the back and legs caused by prolonged voluntary and involuntary muscle activities as an attempt by the body to counteract the vibrations induced via the seat. Therefore, drivers working under uncomfortable driving conditions, encounter ergonomic problems, increased fatigue and require additional rest time. Consequently, these rests increase both in time and numbers resulting with lost logistics time and reduced efficiency. Additionally, these drivers suffer from medical issues both physically and mentally. It is shown that muscular health complaints is mostly accompanied by mental health complaints (e.g.: stress, burnout etc.). These muscular and mental health complaints increase drivers need for recovery, however drivers undergo problems to recover from this work-related fatigue at the end of work day. Though it may be seen as an acute issue, in long term, the accumulation of restlessness may induce the development of psychosomatic health problems. Hence, drop in medical status and efficiency of drivers burden the organizations with major financial costs, via sickness absence of worker, compensations of absenteeism, errors or mistakes occurred at work caused by sudden pain, stress, and etc. Therefore an uncomfortable driving experience becomes not only a health issue for the drivers but also an economical inconvenience to the company. To increase comfort and prevent these issues a H∞ controller with a dynamic output feedback was proposed in this study. This controller was designed and modeled with linear matrix inequality (LMI) method, and implemented on a model of a half semi-trailer truck augmented with a human-seat couple model. Both uncontrolled and controlled cases were simulated and compared in terms of the comfort level of the driver with respect to ISO 2631 standard. As a result, controller decreased the root mean square (RMS) acceleration on the human-seat couple and increased the comfort. Originating from these results, a discussion was made in the perspective of human factor such that, reducing the vibration is not only meant to increasing comfort of driver, but also eliminating the negative effects of discomfort on safe driving and reducing fatigue

Psychosocial and behavioural determinants of the implementation of Pharmaceutical Care in Spain

Objective We aimed to gain greater understanding of the implementation of the Pharmaceutical Care (PhC) initiative in Spain. Our investigation was underpinned by Prochaska and Di Clemente’s stages of change model. We also used the A.S.E. (Attitude, Social influence and self-Efficacy) Model to identify the psychosocial determinants of this professional behaviour. Setting Spanish community pharmacists. Method A validated questionnaire was sent to all community pharmacists registered on a national database and 1,977 (10.3%) responded. The questionnaire assessed stage of change regarding the implementation of PhC and the psychosocial determinants of this professional behaviour. Data were analyzed using descriptive statistics. Kruskal–Wallis and Mann–Whitney U tests were used to compare psychosocial determinants according to stage of change. The profile of community pharmacists who had implemented PhC was identified through logistic regression analysis. Main outcome measures: attitude, social influence, self-efficacy, motivations, needs and stages of change to perform PhC. Results Some respondents (n = 228; 11.8%) had adopted PhC, and were, thus, in the action or maintenance stage. The mean A.S.E. determinants scores increased significantly by stage i.e. from “precontemplation” to “action”: attitude (0.28 vs. 0.99), social influence of people (2.61 vs. 3.07), and self-efficacy (2.74 vs. 3.61). Conversely, most needs were highlighted by precontemplators (3.66 vs. 347.). Variables significantly associated with the probability of implementing PhC were: having undertaken appropriate training (OR: 13.92; CI 95%: 5.37–36.08); self-efficacy (OR: 3.19; CI 95%: 2.38–4.28), having assistant pharmacists (OR: 1.70; CI 95%: 1.02–2.80) and positive attitude (OR: 1.03; CI 95%: 1.01–1.04). The A.S.E. determinants were the best predictors of PhC implementation according to the regression model. Conclusion The implementation of PhC among Spanish community pharmacists appears to be relatively low. Strategies to move pharmacists should be adapted to stage: focussed on emphasizing advantages at initial stages and facilitating training courses, guidelines and communication to professionals at intermediate and advanced stages

Whole-body vibration and occupational physical performance: a review

© 2015 Springer-Verlag Berlin Heidelberg Introduction: In the occupational environment, there are a considerable number of stressors that can affect physical performance in job tasks. Whole-body vibration (WBV), which arises from vehicle transit, is one such stressor that has been demonstrated to alter human function in several ways. This study identifies the known physical changes to human function which result from WBV, to comment on changes which may translate to performance in physically demanding occupational tasks. Methods: A systematic review is performed on the literature relating to changes in the neuromuscular, physiological and biomechanical properties of the human body, when exposed to WBV. Selection criteria are constructed to synthesise articles which strictly relate to in-vehicle WBV and physical responses. Results: In total, 29 articles were identified which satisfied the criteria for inclusion. A range of physical responses produced from WBV are presented; however, little consistency exists in study design and the responses reported. Discussion: Given the inconsistency in the reported responses, the precise changes to human function remain unknown. However, there is sufficient evidence to warrant the design of studies which investigate occupationally relevant physical performance changes following WBV