Work-related musculoskeletal disorders significantly impact the job performance and quality of life of nursing personnel in China, necessitating an understanding of their prevalence and risk factors ...to enhance occupational health and improve medical safety.
To systematically evaluate the prevalence and risk factors of work-related musculoskeletal disorders among clinical nurses in China.
Systematic literature review and meta-analysis.
A computerized search was conducted on databases, including the China Knowledge Resource Integrated Database, Wanfang Database, China Biomedical Literature Database, Weipu Database, Embase, PubMed, Web of Science, the Cochrane Library, and CINAHL, covering studies from inception to February 28, 2024, addressing the risk factors for work-related musculoskeletal disorders among clinical nursing professionals in China. The meta-analysis was performed using Review Manager 5.4 and Stata 14 software.
The analysis included 23 articles, involving a total of 21,042 cases, and revealed a prevalence rate of 79 % (95 % CI: 73 %–84 %) for work-related musculoskeletal disorders among clinical nursing staff in China. Subgroup analysis revealed that the prevalence of work-related musculoskeletal disorders was highest among those with length of service >15 years, at 87 %; the 31–40 age group had a higher prevalence than other age groups, at 85 %; female nurses exhibited a prevalence rate of 80 %, surpassing male nurses at 77 %, while surgical nurses had a higher prevalence rate (83 %) than those in other departments. The most affected body parts were the neck (58 %), waist (57 %), shoulders (49 %), and back (35 %). Identified risk factors for work-related musculoskeletal disorders among clinical nurses in China included age >35 years (OR = 1.69, 95 % CI: 1.16–2.45), length of service ≥10 years (OR = 3.30, 95 % CI: 1.84–5.92), marital status (married) (OR = 2.19, 95 % CI: 1.91–2.50), heavy workload (OR = 2.46, 95 % CI: 1.25–4.83), weekly work hours >40 h (OR = 1.50, 95 % CI: 1.34–1.67), daily work hours >8 h (OR = 1.71, 95 % CI: 1.32–2.21), strong sense of work fatigue (OR = 1.47, 95 % CI: 1.22–1.76), and high night shift frequency (OR = 1.81, 95 % CI: 1.62–2.02). Regular physical exercise was found to be a protective factor (OR = 0.68, 95 % CI: 0.56–0.82).
The overall prevalence of work-related musculoskeletal disorders among clinical nursing staff in China was 79 %. Age >35 years, length of service ≥10 years, marital status (married), heavy workload, weekly work hours >40 h, daily work hours >8 h, strong sense of work fatigue, and night shift frequency were identified as risk factors. Nursing administrators and staff can take proactive measures against the aforementioned factors to reduce the risk of illness and ensure the safety of medical care.
PROSPERO: CRD42023479433.
•Musculoskeletal symptoms and injuries negatively affect surgical team members and their performance in the operating room (OR).•The study aimed to assess the impact of a commercial passive ...arm-support exoskeleton on OR team members during live surgeries.•Using the exoskeleton significantly decreased time in demanding postures for the right shoulder and decreased peak muscle activation levels of the left trapezius, right deltoid, and right lumbar erector spinae muscles. No significant differences were found in perceived effort or overall usability scores.•Arm-support exoskeletons have the potential to reduce musculoskeletal pain and fatigue indicators in the OR.
Background: Musculoskeletal symptoms and injuries adversely impact the health of surgical team members and their performance in the operating room (OR). Though ergonomic risks in surgery are well-recognized, mitigating these risks is especially difficult. In this study, we aimed to assess the impacts of an exoskeleton when used by OR team members during live surgeries. Methods: A commercial passive arm-support exoskeleton was used. One surgical nurse, one attending surgeon, and five surgical trainees participated. Twenty-seven surgeries were completed, 12 with and 15 without the exoskeleton. Upper-body postures and muscle activation levels were measured during the surgeries using inertial measurement units and electromyography sensors, respectively. Postures, muscle activation levels, and self-report metrics were compared between the baseline and exoskeleton conditions using non-parametric tests. Results: Using the exoskeleton significantly decreased the percentage of time in demanding postures (>45° shoulder elevation) for the right shoulder by 7% and decreased peak muscle activation of the left trapezius, right deltoid, and right lumbar erector spinae muscles, by 7%, 8%, and 12%, respectively. No differences were found in perceived effort, and overall scores on usability ranged from “OK” to “excellent.” Conclusions: Arm-support exoskeletons have the potential to assist OR team members in reducing musculoskeletal pain and fatigue indicators. To further increase usability in the OR, however, better methods are needed to identify the surgical tasks for which an exoskeleton is effective.
Objectives
To determine the proportion of otolaryngologists with work‐related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.
Study Design
Systematic ...review and meta‐analysis.
Methods
A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta‐analysis. Random effects meta‐analyses were used to estimate the proportion of otolaryngologists reporting WRMD.
Results
The overall proportion (95% confidence intervals CI) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR 95% confidence interval 0.53 0.22, 1.25). 23%–84% of otolaryngologists underwent medical treatment for WRMD. 5%–23% took time off work and 1%–6% stopped operating completely as a result of WRMD. 23%–62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk.
Conclusions
Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467–475, 2023
Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. The overall proportion (95% confidence intervals CI) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms.
Tissue fibrosis is a hallmark of overuse musculoskeletal injuries and contributes to functional declines. We tested whether inhibition of CCN2 (cellular communication network factor 2, previously ...known as connective tissue growth factor, CTGF) using a specific antibody (termed FG‐3019 or pamrevlumab) reduces established overuse‐induced muscle fibrosis in a clinically relevant rodent model of upper extremity overuse injury. Young adult rats performed a high repetition high force (HRHF) reaching and lever‐pulling task for 18 weeks, after first being shaped for 6 weeks to learn this operant task. Rats were then euthanized (HRHF‐Untreated), or rested and treated for 6 weeks with FG‐3019 (HRHF‐Rest/FG‐3019) or a human IgG as a vehicle control (HRHF‐Rest/IgG). HRHF‐Untreated and HRHF‐Rest/IgG rats had higher muscle levels of several fibrosis‐related proteins (TGFβ1, CCN2, collagen types I and III, and FGF2), and higher muscle numbers of alpha SMA and pERK immunopositive cells, compared to control rats. Each of these fibrogenic changes was restored to control levels by the blocking of CCN2 signaling in HRHF‐Rest/FG‐3019 rats, as were HRHF task‐induced increases in serum CCN2 and pro‐collagen I intact N‐terminal protein. Levels of cleaved CCN3, an antifibrotic protein, were lowered in HRHF‐Untreated and HRHF‐Rest/IgG rats, compared to control rats, yet elevated back to control levels in HRHF‐Rest/FG‐3019 rats. Significant grip strength declines observed in HRHF‐Untreated and HRHF‐Rest/IgG rats, were restored to control levels in HRHF‐Rest/FG‐3019 rats. These results are highly encouraging for use of FG‐3019 for therapeutic treatment of persistent skeletal muscle fibrosis, such as those induced with chronic overuse.
The construction industry is labor-intensive and physically demanding even with continuous development of advanced tools and machines. Workers are heavily involved in manual procedures, which ...constantly expose them to a great risk of injury. Recently, exoskeletons and their potential to protect workers from injury have received wide attention. Significant advances have been made in both of their industrial developments and scholarly assessment. This paper reviewed existing exoskeleton technologies and analyzed their potential for manual handling tasks in construction. It first retrieved 85 relevant research articles and categorized them based on exoskeleton types, functions, and assessment procedures. Then, the potential of the exoskeleton use in construction at trade level was analyzed. A map was generated to suggest the potential exoskeleton type for each trade with evaluation of benefits and challenges. The map is expected to provide construction professionals with insights and guidelines when integrating exoskeletons into their current routine construction practices.
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•85 industrial exoskeleton relevant journal articles from 2006 to 2020 were reviewed.•Wearing exoskeletons may reduce physical fatigue and muscle activity in workplace.•A map was developed to suggest potential exoskeleton types for different trades.•Risk and safety concerns exist on wearing exoskeletons in workplace.•More assessments are required to evaluate exoskeleton's efficacy in field practice.
Risks of work-related musculoskeletal injuries can be reduced by adequately training construction workers on performing work in safe postures. Traditional training approaches provide limited support ...for performing work tasks and receiving real-time feedback. This paper describes a cyber-physical postural training environment where workers can practice to perform work with reduced ergonomic risks. The proposed system uses wearable sensors, Vive trackers, machine learning and virtual reality to track body kinematics, and engagement with physical construction resources, and provides feedback via an interactive user interface. The postural training system was developed for training workers engaged in wood frame construction. User study of the effectiveness of the feedback and user interface was conducted. Findings showed that the user interface was perceived as convenient with limited interference with the workspace. The feedback was understandable in learning risks associated with participant's postures. Further research will involve conducting formative workload evaluation of the user interface and developing a reinforcement learning model for adapting the feedback based on the state of learning.
•This paper delineates a cyber-physical system for training workers on safe work postures.•Development of the postural training system for wood frame construction is presented.•Real-time postural feedback is provided via an interactive user interface augmented on the field of view.•Usability study of the effectiveness of the user interface and the feedback is presented.•Contribution of this study is in demonstrating the efficacy of the user interface in providing feedback on safe work performance.
Aims
To identify the prevalence of work‐related musculoskeletal disorders, levels of chronic occupational fatigue, and how they vary with individual and work organization factors.
Design
A ...multi‐hospital cross‐sectional survey.
Methods
Nurses from 39 hospitals completed self‐reported questionnaires from June to September 2015. Descriptive statistics were used to summarize hospitals and nurses’ characteristics, fatigue levels and prevalence, and type of musculoskeletal disorders. Linear and logistic regression analyses were used to identify correlational factors.
Results
The results revealed that 71.3% of participants reported a work‐related musculoskeletal disorder in the previous 12 months, mainly back pain. The reported musculoskeletal disorders were significantly correlated with years of experience, nurse to patient ratios, and chronic occupational fatigue. Higher chronic occupational fatigue levels were associated with education, age, years of experience, nurse to patient ratio, and model of care.
Conclusion
Preventive work organization strategies are needed to ensure healthier occupational environment for nurses.
目的
确定与工作相关的肌肉骨骼疾患患病率、慢性职业疲劳水平,以及它们如何随个体因素和工作组织架构因素而变化。
设计
一项多医院横断面调查法。
方法
2015年6月至9月,39所医院的护士完成了自我报告式问卷。描述性统计用于总结医院和护士的特征、疲劳程度和患病率以及肌肉骨骼疾患的类型。采用了线性回归分析法和逻辑回归分析法来识别相关因素。
结果
结果显示,71.3%的参与者报告,在过去的12个月中出现了与工作相关的肌肉骨骼疾患,主要是背部疼痛。报告的肌肉骨骼疾患与多年经验、护士与病人比例和慢性职业疲劳显著相关。较高的慢性职业疲劳水平与 教育状况、年龄、多年经验、护士与病人比例和护理模式有关。
结论
预防性工作组织架构策略是保证更加健康型护士职业环境的必要手段。
Encapsulation of median nerves is a hallmark of overuse‐induced median mononeuropathy and contributes to functional declines. We tested if an antibody against CTGF/CCN2 (termed FG‐3019 or ...Pamrevlumab) reduces established neural fibrosis and sensorimotor declines in a clinically relevant rodent model of overuse in which median mononeuropathy develops. Young adult female rats performed a high repetition high force (HRHF) lever‐pulling task for 18 weeks. Rats were then euthanised at 18 weeks (HRHF untreated), or rested and systemically treated for 6 weeks with either an anti‐CCN2 monoclonal antibody (HRHF‐Rest/FG‐3019) or IgG (HRHF‐Rest/IgG), with results compared with nontask control rats. Neuropathology was evident in HRHF‐untreated and HRHF‐Rest/IgG rats as increased perineural collagen deposition and degraded myelin basic protein (dMBP) in median nerves, and increased substance P in lower cervical dorsal root ganglia (DRG), compared with controls. Both groups showed functional declines, specifically, decreased sensory conduction velocity in median nerves, noxious cold temperature hypersensitivity, and grip strength declines, compared with controls. There were also increases of ATF3‐immunopositive nuclei in ventral horn neurons in HRHF‐untreated rats, compared with controls (which showed none). FG‐3019‐treated rats showed no increase above control levels of perineural collagen or dMBP in median nerves, Substance P in lower cervical DRGs, or ATF3‐immunopositive nuclei in ventral horns, and similar median nerve conduction velocities and thermal sensitivity, compared with controls. We hypothesize that neural fibrotic processes underpin the sensorimotor declines by compressing or impeding median nerves during movement, and that inhibiting fibrosis using an anti‐CCN2 treatment reverses these effects.
We develop a novel method that performs accurate ergonomic risk assessment, automatically computing Rapid Upper Limb Assessment (RULA) scores from snapshots or digital video using computer vision and ...machine learning techniques. Our method overcomes the limitations in recent developments based on computer vision or in wearable measurement sensors, being able to perform unsupervised assessment handling multiple workers simultaneously, even under sub-optimal viewing conditions (e.g., poor illumination, occlusions, and unstable camera views). The processing workflow uses open-source neural networks to detect the workers’ skeletons, after which their body-joint positions and angles are inferred, with which RULA scores are computed. The method was tested with computer-generated, controlled real-world image datasets, and with freely available videos taken in outdoor working scenarios. The computed RULA scores were in close agreement with the assessments of seven specialists in the field, achieving a Cohen’s κ over 0.6 in most real-world experiments.
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•Full-body method to perform Rapid Upper Limb Assessment (RULA) evaluations.•Employs Computer vision open-source technologies and Industry 4.0 standard.•Collectively measure various workers in real-world operational environments.•The method can operate even when the camera takes are sub-optimal conditions.•The system performance has been compared to experts assessment scores.
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