Interventions to prevent needle stick injuries among health care workers

Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster three-armed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a 'safety device plus workshop', to a group that was subjected to a 'workshop only' or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI's.     

Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands

Despite worldwide attention, musculoskeletal disorders (MSDs) remain a substantial concern at work. To support ergonomists to assess the work-related risk factors for MSDs, several instruments are available. Unfortunately, many of these instruments are not supported by evidence-based exposure criteria for particular MSDs. For effective prevention of MSDs, it is important to know to what extent work-related risk factors are present in the work situation. The Netherlands Center for Occupational Diseases (NCOD) develops evidence-based criteria documents for the assessment of work-related MSDs. The exposure criteria of these documents can be used on a group level to support ergonomists in their assessment of the physical job demands that are associated with work-related MSDs. At the moment the NCOD has exposure criteria for the assessment of 22 work-related MSDs, for instance on the work-relatedness of upper extremity disorders, non-specific low back pain or patellar tendinopathy. The use of these exposure criteria enables ergonomist to better assess the work-related risks of MSDs as a starting point for effective prevention.     

Does team lifting increase the variability in peak lumbar compression in ironworkers?

Ironworkers frequently perform heavy lifting tasks in teams of two or four workers. Team lifting could potentially lead to a higher variation in peak lumbar compression forces than lifts performed by one worker, resulting in higher maximal peak lumbar compression forces. This study compared single-worker lifts (25-kg, iron bar) to two-worker lifts (50-kg, two iron bars) and to four-worker lifts (100-kg, iron lattice). Inverse dynamics was used to calculate peak lumbar compression forces. To assess the variability in peak lumbar loading, all three lifting tasks were performed six times. Results showed that the variability in peak lumbar loading was somewhat higher in the team lifts compared to the single-worker lifts. However, despite this increased variability, team lifts did not result in larger maximum peak lumbar compression forces. Therefore, it was concluded that, from a biomechanical point of view, team lifting does not result in an additional risk for low back complaints in ironworkers.     

The evaluation of team lifting on physical work demands and workload in ironworkers

Lifting and carrying heavy loads occur frequently among ironworkers and result in high prevalence and incidence rates of low back complaints, injuries and work-disability. From a health perspective, little information is available on the effect of team lifting on work demands and workload. Therefore, the objective of this study was to compare the effects of team lifting of maximally 50 kg by two ironworkers (T50) with team lifting of maximally 100 kg by four ironworkers (T100). This study combined a field and laboratory study with the following outcome measures: duration and frequency of tasks and activities, energetic workload, perceived discomfort and maximal compression forces (Fc peak) on the low back. The physical work demands and workload of an individual iron worker during manual handling of rebar materials of 100 kg with four workers did not differ from the manual handling of rebar materials of 50 kg with two workers, with the exception of low back discomfort and Fc peak. The biomechanical workload of the low back exceeded for both T50 and T100 the NIOSH threshold limit of 3400N. Therefore, mechanical transport or other effective design solutions should be considered to reduce the biomechanical workload of the low back and the accompanying health risks among iron workers.     

A case study in venture management

This paper examines the venture concept as a means of stimulating new product development within large companies. The literature reveals a significant difference between the venture idea as originally conceived in North America and as applied in European companies. A case study of a UK venture experiment is then presented which clearly demonstrates the resistance to substantive change which may characterise large organisations.