Prevalence and ergonomic risk factors of work-related musculoskeletal injuries amongst underground mine workers in Zambia

Work-related musculoskeletal injuries (WMSIs) are common in both developed and third world countries. Most researchers agree that exposure to ergonomic risk factors is a major contributor to these injuries. Objective: The aim of this study was to determine the prevalence of and ergonomic risk factors associated with WMSIs amongst underground mine workers in Kitwe, Zambia. Methods: A cross-sectional quantitative study was conducted using a sample size of 500 workers. A stratified random sampling method according to mining work activity type was used to obtain the sample. Data was collected by means of a structured questionnaire, and the Statistical Package for Social Sciences (SPSS) was used to analyze data using descriptive and inferential statistical methods. Results were significant at 5%. Results: A response rate of 40.4% (202) was obtained. The 12-month prevalence of WMSIs was 42.6%. The mean age of the workers was 40.31 years (SD +/− 8.57 years). Electricians and mechanics reported the highest injury frequencies. The back was the most affected body part. Ergonomic risk factors consistently reported by workers included poor postures and heavy lifting. There were significant (p=0.020) associations between working with the back bent and sustaining a back injury. Significant (p=0.049) associations were also found between injuries of the wrists/hands and grasping an unsupported object(s). Conclusions: This study revealed significant associations between WMSIs and ergonomic risk factors like working with the back bent and grasping object.Web of Scienc

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status