The natural history and risk factors of musculoskeletal conditions resulting in disability among US Army personnel

We describe the natural history of 13 musculoskeletal conditions requiring hospitalization and identify demographic, behavioral, psychosocial, occupational, and clinical characteristics most strongly associated with disability discharge from the Army. Subjects included 15,268 active-duty personnel hospitalized for a common musculoskeletal condition between the years 1989-1996 who were retrospectively followed through 1997. Back conditions had the greatest 5-year cumulative risk of disability (21%, 19%, and 17% for intervertebral disc displacement, intervertebral disc degeneration, and nonspecific low back pain, respectively). Cox proportional hazards models identified the following risk factors for disability among males: lower pay grade, musculoskeletal diagnosis, shorter length of service, older age, occupational category, lower job satisfaction, recurrent musculoskeletal hospitalizations, more cigarette smoking, greater work stress, and heavier physical demands. Among females, fewer covariates reached statistical significance, although lower education level was significant in more than one model. Modifiable risk factors related to work (job satisfaction, work stress, physical demands, occupation) and health behaviors (smoking) suggest possible targets for intervention.     

Injury prevention in physiotherapists--a scientific review

This review targeted all research previously conducted on the topic of musculoskeletal disorders and injury among physiotherapists, with a particular focus on studies that had examined individual, physical and psychosocial risk factors and provided suggestions or recommendations to prevent such injuries. Scientific literature published in English languages was searched using electronic way. A total of 17 appropriate studies were located and examined, most of which had focused on the prevalence of musculoskeletal disorders/pan or any other injury. From the review, it was shown that major risk factors among the physiotherapist were manual therapy, repetitive movement, awkward and static posture, physical load, lifting and transferring, treating large number of patients treating in a single day, working while injured, years of experience. The preventive measures that described in these literatures were awareness of reporting of injury, use of less manual therapy, proper exercise, formulation of new devices, intervention at the level of workplace, work schedule allocation, proper training, ongoing risk assessment and control.     

Posttraumatic stress disorder and occupational performance: building resilience and fostering occupational adaptation

Resilience and vulnerability refer to an individual's capacity to persevere in the face of adversity. Resiliency and vulnerability are distinctive personal characteristics influenced by environmental factors such as socio-cultural and institutional contexts. Resiliency and vulnerability are not absolute; they are psychosocial constructs of a phenomenological continuum. Hence, a resilient individual is not invincible to all life events but has the capacity to endure in most circumstances. Clients who sustain traumatic injuries or witness traumatic events have a greater vulnerability to stress disorders like posttraumatic stress disorder (PTSD). Occupational therapy practitioners should be cognizant of a client's resilient and adaptive capacities when providing services to a client who has endured a traumatic event. This paper explores resilience theory and its application to occupational therapy practice.     

Implementation of an ergonomics program for the welding department inside a car assembly company

The premise for this project is to implement an ergonomics program for the welding department of a car assembly company, considering that this area represents the highest occupational risk in relation to musculoskeletal injuries. The project also allows the demonstration of the different implementation processes of an ergonomics program; it also permits the determination of individual risks faced by workers of the welding department, and finally gives a chance of improving common injuries using the sentinel system. The main challenge is to reduce musculoskeletal injuries and absenteeism among welders through actions implemented by the ergonomics program.     

Migrant women farm workers in the occupational health literature

Little attention has been given to the vulnerable populations of migrant women agricultural workers. A systemic review in PubMed was carried out (1990-2008) using terms related to migrant agricultural workers, with specific focus on women. Case studies from Lebanon and California are presented to highlight key physical, psychosocial, and cultural risk factors among these working populations. The review revealed a host of potential problems that span from pesticide exposure and musculoskeletal disorders to socio-cultural barriers. Comprehensive exposure-outcome and intervention studies focusing specifically on migrant women in agriculture are lacking. In depth studies focusing on the work environment of migrant women workers in the agricultural sector are needed. Personal and environmental factors that influence health should be considered in any effective intervention aiming to influence policy making and have a positive impact on these vulnerable working populations.     

It's no picnic: personal and family safety for rural social workers

This paper reports the key research findings related to personal and family safety of rural welfare and social workers, from a study conducted in rural Victoria, Australia. Significant findings included concerns about personal and family safety, frequency of episodes of work related violence and harassment, and the resultant impact on personal and family activities. A range of useful strategies was identified to combat and cope with both the risk and experience of violence and harassment for the worker, and for their families. Workplaces, professional associations and educators need to recognise the impact of this occupational hazard and respond with sensitivity to these issues, which have particular relevance for rural practitioners where anonymity and privacy are frequently compromised.     

Preventing workplace aggression and violence--a role for occupational therapy

Workplace aggression and violence is the fastest growing societal concerns in USA. The review of literature indicates that violence is a substantial contributor to occupational injuries and death. Preventative strategies for minimizing the risk of workplace violence include, cash-handling policies, physical separation of workers from customers, environmental modifications; good lighting, security devices, escort services, and employee training. Studies also suggest that as a preventive measure, employers will attract and retain the best workers if high-risk behaviors are discouraged and appropriate behaviors are supported. Proactive strategies reduce stress, increase productivity, and enhance creativity. A role for occupational therapy practitioners in the prevention of workplace violence is proposed.     

Interactions between task repetition and psychosocial factors

Psychosocial factors, individual factors, workplace requirements, and workplace organizational factors have all been reported as being associated with the risk of musculoskeletal disorders [11]. Huang, Feuerstein, and Sauter [5] described the various concepts and models proposed to link occupational stress and work-related upper extremity disorders, as well as the difficulty in verifying the suggested linkages. Huang et al. [5] suggested that decomposing a complex model would be an appropriate method to begin the investigations of the proposed models. Task repetition is a workplace requirement that is considered a potential risk factor for cumulative trauma and its relationship to psychosocial factors was investigated. The study found only weak to no statistically significant relationship between task repetition and reported psychosocial factors of job stress in workers in Taiwan.     

Safe patient handling curriculum in occupational therapy and occupational therapy assistant programs: A descriptive study of school curriculum within the United States of America

The purpose of this study was to identify safe patient handling (SPH) curricular content in accredited occupational therapy and occupational therapy assistant programs in the United States of America. A survey was emailed to 155 accredited occupational therapy and 137 accredited occupational therapy assistant programs. With a 39% response rate, most programs addressed SPH curricula by including lectures and lab-based experiences with gait belts, slide boards, and manual transfers while stressing ‘safe’ body mechanics. There were limited responses regarding curricular-based hands-on experience, evaluation of sit-to-stand lifts, how to safely transfer bariatric persons, and information on “no-lift” policies. While occupational therapists have a central role in teaching SPH to caregivers, it is important to enhance SPH curricula to reduce exposure to musculoskeletal risk, thereby, increasing the health and safety of the occupational therapy workforce as well those whom the profession serves.     

Psychosocial interventions used to treat children with ADHD: safety and efficacy

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.     

Musculoskeletal symptom survey among cement and concrete workers

Work in construction is associated with a high risk for musculoskeletal disorders and injuries. The symptom survey was conducted to determine the magnitude and musculoskeletal injury characteristics among the cement and concrete workers and identify the most problematic work-related activities and job factors that might have contributed to the occurrence of these disorders. Findings revealed that a large proportion of the laborers (77%) experienced at least one musculoskeletal disorder in the last year. Low back pain was reported as the most frequently experienced symptom (66%). 'Working while in pain' the concrete workers perceived as the major problem in the trade. Other problematic work-related activities included 'bending or twisting the back', 'work in hot, cold or wet conditions', and 'handling heavy objects'. Most of the laborers (82%) requested on-the-job safety training. Survey results combined with the outcomes of focus groups discussions and work site observations were used in the design of a training program aimed at the prevention of musculoskeletal morbidity in the trade. The program incorporated ergonomics principles, hazard recognition, safe work practices, problem solving and personal protection in the training curriculum for membership of the trade.     

Musculoskeletal injuries associated with selected university staff and faculty in an office environment

A research team with backgrounds in occupational therapy, rehabilitation, policy and rulemaking, and prevention programs affecting occupational health and safety designed, validated, and analyzed an ergonomics survey of university staff and faculty. The purpose of the study was to validate identified risk factors from the literature contributing to work-related musculoskeletal disorders (WRMDs) in an office setting within a university setting. The study was also designed to determine differences between faculty and staff in the university setting and their exposure to physical risk factors to WRMDs. The results suggest faculty have their keyboard in awkward positions more frequently than staff, and staff had more experience with mechanical stress than faculty. The researchers recommend parameters for the design of a university ergonomics program based on employee and education, management commitment, medical case management, problem job identification, and development of solutions.     

Health risks associated with prolonged standing

Seventeen studies, which included information regarding the adverse health risks associated with prolonged standing, were selected for review. Prolonged standing was defined as standing for over 8 hours [7,8,9]. Studies were divided into three categories relating to the particular health risk associated with prolonged standing. Review of the literature indicated that chronic venous insufficiency [7,16], musculoskeletal pain of the lower back and feet [11,13], preterm birth, and spontaneous abortions [4,6,12,14] were health risks associated with working conditions that required prolonged standing. The use of support hose was associated with positive outcomes in the treatment of chronic venous insufficiency in several studies [1,2,3,9,17].     

Physical and psychosocial indicators among office workers from public sector with and without musculoskeletal symptoms

Work-related musculoskeletal disorders (WRMD) are the result of the combination of different risk factors. They are very common among computer workers, mainly when neck and upper limbs are considered. Forty-two office workers from a public university participated in this study. They were divided into two groups: Symptomatic Subjects (SS, n=20) and Asymptomatic Subjects (AS, n=22), according to the Nordic Musculoskeletal Questionnaire (NMQ). Psychosocial indicators were assessed using the Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES). Workplaces were evaluated according to the Ergonomic Workplace Analysis (EWA), proposed by the Finnish Institute of Occupational Health. The NMQ showed higher weekly prevalence of complaints on neck, shoulders and wrist/hands (p=0.00) among SS. The annual prevalence of symptoms on wrist/hands was also higher among SS (p=0.02). The JCQ did not show any difference between groups (p>0.05). Higher proportion of servers with 'high level' of engagement, dedication and absorption, according to UWES, was identified among SS (p<0.01). EWA showed worse scores for 'Work Site', 'Job Content' and 'Repetitiveness of the Work' among SS (p<0.05). Servers are exposed to physical and psychosocial risk factors that can contribute to the development of WRMD. Work conditions need to be change in order to improve musculoskeletal health.     

Health professional students' occupational exposures to blood-borne pathogens: primary and secondary prevention strategies

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

Increased of Brazilian productivity in the slaughterhouse sector: a review

Due to Brazil is a tropical country has activities in occupational exposure to cold restricted to few sectors especially the meatpacking industry. Taking into account that the country in 2010, was again the largest exporter of poultry meat in the world and consequently employing a large number of workers for their slaughter and processing. The search for greater productivity can result in an increase in work rate, as indicated in this sector as monotonous, repetitive and uncomfortable. According the Programa de Frigorífico it was found that within six years, about 20% of the six thousand workers in a slaughterhouse in southern Brazil, received welfare benefits due to musculoskeletal diseases. Adding to this, the lack of parameters for the Brazilian standardization concerning occupational activities carried out in cold. Although several epidemiological studies point to the cold as a risk factor for occurrence or aggravation of musculoskeletal disorders, research in this field is still limited and often contradictory conclusions. This article aims to review developments concerning the poultry industry and the fridge in Brazil, as well as raising the question about the increased productivity of the slaughterhouse, since it has already shown a high prevalence of musculoskeletal disorders related to work.     

Effect of ergonomic and workstyle risk factors on work related musculoskeletal disorders among IT professionals in India

'Workstyle' can be described as a mechanism by which ergonomic and psychosocial risk factors interact to affect the development, exacerbation and/or maintenance of upper limb pain and functional limitations. Workstyle is associated with the increase in the work demand. In today's life use of computer in the workplace is very common and it causes to increase the work demand among the workers who are working with computer. As work demand increase, according to the characteristic of workstyle, risk of the development of musculoskeletal disorders also increased. This study aimed at to findout the association between ergonomics risk factors, workstyle and WRMSD. Two hundred IT professionals participated in this study. Result revealed that most prevalenet body regions were lower back (20%), Upper back (16%) and shoulder (14%). Study result says that there is a positive association between workstyle score with musculoskeletal pain (r=0.85). Also it revealed that posture and regional pain is associated (r=0.62), per day use of computer and musculoskeletal pain (r=0.46), micro breaks and pain (r=0.87) and productivity and the pain (r=0.95). This study further validates these observations and extends support for the assessment of working postures and workstyle behaviors during the design of WMSD treatment.     

Patients' Evaluations of the Mental Health Service at a Health Sciences Campus

Abstract

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk and effectiveness of exercise interventions

Chronic musculoskeletal conditions in the lower extremities, particularly arthritis, and the chronic pain associated with them, are independent risk factors for falls, with approximately 50% of people with arthritis reporting one or more falls. Despite this, few studies have specifically addressed balance dysfunction, falls risk and falls incidence in people with arthritis. This review aimed to identify potential factors contributing to the increased risk of falls in people with lower limb osteoarthritis or rheumatoid arthritis and to summarise the evidence base for effective exercise interventions targeted to reduce their risk of falls. A systematic search of the literature was conducted in February 2010 and included the following databases: MEDLINE (Ovid), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Cochrane Library and PsycINFO. Only three studies that investigated exercise programmes for people with lower limb arthritis met all inclusion criteria, but none used falls as an outcome measure. To broaden the review, systematic reviews that assessed the effectiveness of exercise interventions for fall prevention in older people were also included. The presence of any form of lower limb arthritis and the associated consequences including pain, balance impairment, reduced muscle strength and reduced function are all associated with increased risk of falling. Due to the link between musculoskeletal pain and the increased risk of falls, further research needs to investigate which type of exercise programme will be effective in reducing the risk of falls in populations with arthritis in the lower limbs.