Susan E. Kotowski

Characteristics of job rotation in the Midwest US manufacturing sector

Job rotation has been advocated as a suitable intervention to control work-related musculoskeletal disorders. However, little is known regarding the prevalence of job rotation, methods used to identify jobs for rotation or the benefits or limitations of job rotation. A web-based questionnaire was developed to survey job rotation practices from Midwest US manufacturing companies. Results indicated that 42.7% of the companies contacted used job rotation, where the median time for which they had used job rotation was 5 years. Job rotation was used mainly to reduce exposure to risk factors for work-related injuries and to reduce work related injuries, whereas supervisor decisions and ergonomic analyses were used to select jobs for the rotation scheme. Major limitations to successful implementation of job rotation included rotation of individuals with medical restrictions, decreased product quality and lack of jobs to rotate to. These findings suggest that further study is needed to determine if exposure to risk factors is reduced through current efforts.

Prevalence of Musculoskeletal Disorders for Nurses in Hospitals, Long-Term Care Facilities, and Home Health Care A Comprehensive Review

Objective The aim of this study was to determine the prevalence of musculoskeletal pain and reported injuries for nurses and nursing aides. Background Nurses and nursing aides suffer from work-related pain and musculoskeletal disorders (MSDs). Although there have been a plethora of studies on MSDs, an overall understanding of the prevalence of MSDs and pain can lead to better prioritization of research needs with respect to the health care industry. Method A total of 132 articles on prevalence of MSD pain and injuries were included in the review. All articles were published in peer-reviewed English-speaking journals and subjected to a quality review. Results Reported prevalence of MSD pain for nurses and nursing aides was highest in the low back, followed by shoulders and neck. However, the majority of the studies have been concentrated on 12-month pain in the low back and predominantly in hospitals. Few researchers have investigated pain in the upper and lower extremities (less than 27% of the studies). Even fewer researchers have evaluated reported injuries or even subjective lost-time injuries (less than 15% of the studies). Conclusion MSD pain in the nursing profession has been widely investigated worldwide, with a major focus on low-back pain. Given new directions in health care, such as patients who live longer with more chronic diseases, bariatric patients, early mobility requirements, and those who want to be at home during sickness, higher prevalence levels may shift to different populations—home health care workers, long-term care workers, and physical therapists—as well as shift to different body regions, such as shoulders and upper extremities.

Postural Variability: An Effective Way to Reduce Musculoskeletal Discomfort in Office Work

Objective: This article investigates whether different interventions aimed at promoting postural change could increase body movement throughout the shift and reduce musculoskeletal discomfort. Background: Many researchers have reported high levels of discomfort for workers that have relatively low-level demands but whose jobs are sedentary in nature. To date, few interventions have been found to be effective in reducing worker discomfort. Methods: Thirty-seven call center operators were evaluated in four different workstation conditions: conventional workstation, sit-stand workstation, conventional workstation with reminder software, and sit-stand workstation with break reminder software–prompt to remind workers to take break. The primary outcome variables consisted of productivity, measured by custom software; posture changes, measured by continuous video recording; and discomfort, measured by simple survey. Each condition was evaluated over a 2-week period. Results: Significant reductions in short-term discomfort were reported in the shoulders, upper back, and lower back when utilizing reminder software, independent of workstation type. Although not significant, many productivity indices were found to increase by about 10%. Conclusions: Posture-altering workstation interventions, specifically sit-stand tables or reminder software with traditional tables, were effective in introducing posture variability. Further, postural variability appears to be linked to decreased short-term discomfort at the end of the day without a negative impact on productivity. Applications: An intervention that can simply induce the worker to move throughout the day, such as a sit-stand table or simple software reminder about making a large posture change, can be effective in reducing discomfort in the worker, while not adversely impacting productivity.

Investigation of Select Ergonomic Interventions for Farm Youth. Part 1: Shovels

ABSTRACT There is some evidence that performing farm chores may place youth at risk of musculoskeletal injuries. However, actual investigations of interventions for farm youth have been sparse. The objective of the current study was to investigate two different types of interventions (add-on handles) for shovels, potentially reducing the risk of injury in farm youth. A lumbar motion monitor was used to capture trunk posture and motion while the youth performed a simulated shoveling task—removal of material from an animal stall. Ratings of perceived exertion and comfort of use were also assessed. The results indicate add-on handles decreased sagittal flexion but increased twisting as compared to regular shovels. Perceived ratings were worse for shovels with add-on handles. Overall, there appears to be a trade-off between sagittal and nonsagittal motion and appears to have minimal impact on risk of low back injury. However, further research is necessary to determine the complete ramifications of this trade-off with respect to the biomechanical load within the low back and on other joints.

Dynamic bone quality: a noninvasive measure of bone's biomechanical property in osteoporosis.

We describe a novel approach to characterize bone quality noninvasively, a measurement that quantifies aggregate shock-absorption capacity of load-bearing bones as a measure of mechanical structural integrity during exposure to real-time self-induced in vivo loading associated with heel strike. The outcome measure, damping factor, was estimated at 5 load-bearing anatomical sites: ankle, tibial tuberosity, femoral condyle, lower back (at 3rd lumbar vertebra), and upper back (7th thoracic vertebra) plus the forehead in 67 patients with postmenopausal osteoporosis with and without documented vertebral fractures. The damping value was significantly lower in patients with vertebral fractures compared with those without a fracture (range: -36% to -72%; median: -44%). In these women with osteoporosis, damping factor was able to discriminate between patients with and without vertebral fractures, whereas traditional measures of bone density and biomechanical measures obtained from bone geometry were not significantly different between the groups.

Influence of weight loss on musculoskeletal pain: Potential short-term relevance

OBJECTIVE With the recent trend of increasing obesity in the United States, more immediate health outcomes such as reduced musculoskeletal pain may be more effective in encouraging compliance. The study objective was to investigate the relationship between weight loss and changes in musculoskeletal pain. PARTICIPANTS Thirty-five females who recently enrolled into a weight loss program were enrolled into the study. METHODS The impact of weight loss on musculoskeletal pain in the short-term was assessed by tracking pain and weight loss during bi-weekly visits to a weight loss clinic. During a 12-week prospective study, the pain ratings in 9 body regions measured during the bi-weekly weigh-ins at the clinic. RESULTS A significant association was found between weight loss and reduction of pain in the elbow, upper back, lower back, and hip regions as well as overall pain. CONCLUSIONS The significant trends between weight loss and corresponding reduction in pain provide support to weight-loss management providers that may have more immediate relevance - a quick impact on pain may encourage compliance with weight loss programs. While the trends for weight and pain are intriguing, future research will need to indentify the underlying mechanism for the reduced pain. One potential mechanism may be that a reduction of weight reduces the biomechanical stress on the load bearing joints, reducing pain responses.

Combating the Effects of Sedentary Work: Postural Variability Reduces Musculoskeletal Discomfort

Long periods of intense data entry office work have been linked to increased pain and musculoskeletal disorders. The current study investigated how postural changes mediated by workstation intervention influences the discomfort, postures, and productivity of call center professionals. Thirty-five call center employees were evaluated over two-weeks while performing their job in four different workstation conditions: 1) conventional, 2) sit-stand, 3) conventional with reminder software, and 4) sit-stand with reminder software. The reminder software resulted in reductions in discomfort in the shoulder, hand/wrist, upper back, and lower back. Small increase in the productivity of the workers was also seen for the software reminders. The sit-stand workstation was also effective in reducing discomfort with out decreasing productivity. Periodic breaks that encourage postural changes may be effective in reducing the adverse effects of prolonged static postures commonly found in office work without adversely impact productivity.

Investigating reduced bag weight as an effective risk mediator for mason tenders.

Masonry workers face some of the highest physical demands in the construction industry where large bags of masonry material weighing 42.7 kg are commonly handled by mason tenders who mix the mortar, distribute mortar and bricks/blocks, and erect/dismantle scaffolding throughout the day. The objective of this study was to determine the effectiveness of using half-weight bags (21.4 kg) on reducing the biomechanical loading, physiological response, and perceived exertions. Ten male subjects performed asymmetric lifting tasks simulating unloading bags from a pallet. Muscle activity, trunk kinematics, heart rate, blood pressure and subjective rating data were collected. Spine loads were predicted from a well-validated EMG-assisted model. Bag weight, lift type, bag height at origin, and asymmetry at destination significantly impacted the spine loads. While there was a 50% reduction in bag weight, the peak loads for the half-weight bags were only 25% less than the more available full-weight bags (a reduction of about 320 N of shear and 1000 N of compression). Lifts allowing movement of the feet reduced the loads by about 22% in shear and 27% in compression compared to constrained postures. Interestingly, cumulative spine loads were greater for the lighter bags than the heavy bags ( approximately 40%). The subjective ratings of exertion and risk were significantly lower for the lighter bags. RELEVANCE TO INDUSTRY: The reduction in peak spine loading for the half-weight bags, particularly at the higher heights and when the feet were allowed to move could significantly reduce the injuries of masonry workers. However, there were trade-offs with cumulative loads that may minimize the reduced risk. Overall, given the limited amount of time lifting bags, the reduction of peak loads.

Can a transitional work grant program in a workers' compensation system reduce cost and facilitate return to work?

Although previous research has shown returning the injured worker to work as soon as possible is important to the long-term prospects of the worker remaining in the work force, there is limited economic support for implementing such programs. Thus, the purpose of this case control study was to determine the cost savings of the implementation of a Transitional Work Grant (TWG) program, which consisted of several components including job analyses, education, communication and transitional work (TW). Companies that enrolled in the TWG program were matched to nonparticipating companies (NTW) based on employer size, type of industry, number of overall claims, and number of claims with > 7 days lost time (LT claims) submitted the year prior to enrollment. The study analyzed economic data: number of claims, number of LT claims, indemnity costs, medical costs, and days lost (days away from the workplace). An additional outcome was the ratio of LT claims (> 7 days lost work) to medical only (MO) claims (LT/MO ratio). Overall, participation in the TWG program was associated with decreased indemnity cost and decreased LT/MO ratio. However, effectiveness of the program varied by employer size and industry. In terms of the state of Ohio, these costs translate into substantial savings: more than

The therapeutic effect of outpatient use of a peroneal nerve functional electrical stimulation neuroprosthesis in people with stroke: a case series.

2.3 million per year. Although the cost savings and reduction in lost time claims is encouraging, the true benefit of TW has yet to be completely quantified. Future work must account for other potential co-factors and programs that could also contribute to the savings as well as document further the indirect benefits associated with a TWG program, such as improved employee morale and increased productivity and product quality that could be four times greater than the direct savings. In summary, programs such as this one adopted by several companies in Ohio can reduce the cost burden of injuries.