Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers

A. Technical measurements of the physical workload. (DOCX 18 kb

Ergonomic factors and musculoskeletal pain in sonographers

Background: Sonographers have a high risk of musculoskeletal disorders. Sonography involves strenuous postures in the neck and upper limbs, and is visually demanding. Echocardiography is especially challenging, with static postures and monotonous movements. Aim: The overall aim of this thesis was to identify ergonomic risk factors for pain in sonographers, and to propose actions for sustainable work conditions. Method: At baseline a questionnaire on occupational factors and perceived pain was distributed to all female sonographers in Sweden (N=291). A qualitative interview was performed in a subgroup (N=22). The physical workload was assessed by technical measurements of postures, movements and muscular load in another subgroup (N=33), comparing different tasks and different techniques for echocardiography. A follow up questionnaire concerning pain was distributed about 2.5 years after baseline. Results: At baseline neck/shoulder as well as elbow/hand pain were associated with computer related eye complaints, high mechanical exposure index (MEI) and high job demands. To perform echocardiography was associated with elbow/hand pain while transducer handling with a two-handed/alternating grip and straight wrist was associated with a low prevalence of elbow/hand pain. The patient´s comfort was often prioritised to the disadvantage of working posture. Suggested improvements included reducing the manual handling of the transducer and to alternate hands. Echocardiography was static with awkward wrist postures and a lack of forearm muscular rest. In comparison, none of the techniques explored was optimal. The prevalence of neck/shoulder pain increased during the follow up period. Computer related eye problems, high MEI, high job demands and pain at baseline predicted neck/shoulder pain at follow up in both regions. Full time work and high job demands were associated with a high incidence of pain during the follow up period, whereas full time work was associated with a low recovery of neck/shoulder pain. For elbows hands, high sensory demands and pain at baseline were predictors for pain at follow/up and high sensory demands were associated with a high incidence of pain during the follow up period. Conclusions: We recommend improved visual ergonomics and optimal adjustability of the equipment. For echocardiography, we recommend that the equipment should be arranged so that a variation in work postures is enabled, as none of the techniques was optimal

Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement

Background: Sonographers' perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers' perceptions of ergonomic problems at work, and their suggestions for improvement strategies. Methods: Twenty-two female sonographers were individually interviewed regarding different aspects of their physical working environment. Content analysis was applied. Results: The sonographers perceived different ergonomic problems in their working environment, but to offer patient comfort and to obtain the best possible images were often prioritized over working posture. Echocardiography was considered demanding as the examination is performed with little variation in posture. Ergonomic improvements included reducing the manual handling of the transducer, optimizing the adjustability of equipment, and taking the patient's physique and health into account. As some examinations were perceived to be more ergonomically demanding, variation between examinations was suggested, however, this requires broader skills. Conclusion: Sonography, especially echocardiography is ergonomically demanding but the improvement strategies suggested were perceived useful and applicable

Betydelsen av fysiska och psykosociala riskfaktorer för sjukdom/besvär i muskler och leder - en prospektiv studie av kvinnor inom vård och skola: Uppföljning

Primary outcome variables: pain neck / shoulder and elbow / hand. Primary exposures: Physical exertion (ergonomic factors) and psychosocial work environment (demand-control, fatigue, etc.). Monitoring will take place 2 ½ years after baseline. Purpose: To elucidate the importance of physical and psychosocial work factors for disorders of the muscles and joints and to develop intervention of ergonomic conditions that reduce risk.Primära utfallsvariabler: Smärta nacke/axlar respektive armbåge/hand. Primära exponeringar: Fysisk arbetsbelastning (ergonomiska faktorer) och psykosocial arbetsmiljö (krav- kontroll, utmattning mm). Uppföljning kommer att ske 2 ½ år efter baseline. Syfte: Att klarlägga betydelsen av fysiska och psykosociala arbetsmiljöfaktorer för besvär i muskler och leder och att utarbeta intervention av ergonomiska förhållanden som ger minskad risk

Betydelsen av fysiska och psykosociala riskfaktorer för sjukdom/besvär i muskler och leder - en prospektiv studie av kvinnor inom vård och skola: Baseline

Primary outcome variables: pain neck / shoulder and elbow / hand. Primary exposures: Physical exertion (ergonomic factors) and psychosocial work environment (demand-control, fatigue, etc.). Monitoring will take place 2 ½ years after baseline. Purpose: To elucidate the importance of physical and psychosocial work factors for disorders of the muscles and joints and to develop intervention of ergonomic conditions that reduce risk.Primära utfallsvariabler: Smärta nacke/axlar respektive armbåge/hand. Primära exponeringar: Fysisk arbetsbelastning (ergonomiska faktorer) och psykosocial arbetsmiljö (krav- kontroll, utmattning mm). Uppföljning kommer att ske 2 ½ år efter baseline. Syfte: Att klarlägga betydelsen av fysiska och psykosociala arbetsmiljöfaktorer för besvär i muskler och leder och att utarbeta intervention av ergonomiska förhållanden som ger minskad risk

Ergonomics in the operating room

Surgical staff is considered to have several ergonomic risk factors, but their physical workload and musculoskeletal health have seldom been evaluated. Clinical examinations of neck and upper extremities were performed in 99 theatre nurses and 93 assisting nurses, all females. Their physical workload was assessed by questionnaire, and by technical measurements of postures, movements and muscular load in subgroups of both categories. The prevalences of diagnoses in neck/shoulders were not remarkably high in the nurses, compared to other occupational groups. In elbows/hands though, the prevalence was rather high among assistant nurses, 13 vs. 5% in theatre nurses; POR 3.0 (CI 95% 1.0-8.9). Theatre nurses experienced prolonged static postures in the questionnaire, whilst assistant nurses reported high physical load. Accordingly, the technical measurements showed more strenuous working postures in the theatre nurses, but lower wrist angular velocities. The time proportion of muscular rest in m. trapezius was rather high in both groups. Although both groups had some stressful loads they had relatively low prevalence of diagnoses in neck/shoulders. The high proportion of muscular rest may be protective. The elevated risk of elbows/hands diagnoses among assistant nurses may be explained by strenuous work tasks of short duration