Occupational ergonomics: theory and applications, second edition. Bhattacharya A, McGlothlin JD, eds., Boca Raton, FL: CRC Press, 2012 Mar; :613-627
Workers in the health care industry who perform physically demanding tasks as part of their jobs, such as nurses, nurses' aides, physical therapists, and health care technicians, are at high risk for the development of work-related musculoskeletal disorders (MSDs). These workers are exposed to major risk factors for MSDs, such as lifting and moving heavy patients and equipment, pushing and pulling heavy equipment, working in extreme postures, and standing for long periods of time without adequate rest periods. When the demands of the job (physical demands, work environment, and workplace culture) exceed the capacity of the worker, the risk of an MSD is increased, and is highest when exposures are intense and prolonged and when there are several risk factors present at the same time. Although health care workers have widely reported that injuries to the shoulder and neck have prevented them from doing their work and caused them to leave their job, by far, the most common occupational injuries in the health care industry involve back disorders. Nurses working in the private sector had 11,800 MSDs reported in 2001, with the majority (nearly 9,000) of the reported injuries to the back, and more than a third (36%) of the injuries resulting in lost time from work were reported to be back injuries. Another study revealed that 12% of nurses planning to leave the profession indicated back injuries were either a main or contributing factor. Work-related MSDs are very important in the health care industry. Employees that experience pain and fatigue are less productive, less attentive, more prone to make consistent mistakes, more susceptible to injury, and may be more likely to affect the health and safety of others. Nurses suffering from disabling back injuries and fear of getting injured have contributed to nurses leaving the profession, thus increasing the nursing shortage. Workplaces with high incidences of MSDs report increases in lost/modified workdays, higher staff turnover, increased costs, and adverse patient outcomes. The extent of the problem is likely worse than reported in official injury reporting records due to likely widespread underreporting of injuries. In a study by Cato et a1., it was reported that 78% of nurses with back pain in the previous 6 months did not report it to management. In another study of nurses, Owen reported that 67% of nurses who reported low-back pain related to work did not report the incident in writing. Others have consistently demonstrated that injury reports on the Occupational Safety and Health Administration (OSHA) log are underreported. In the past decade, tremendous strides have been made in identifying high-risk tasks and in developing and implementing solutions for reducing the risk. Programs have been developed and many states have passed legislation mandating implementation of these safety programs. Ergonomic guidelines have been developed to provide useful information to the industry that will help them efficiently implement the programs that have been shown to be effective in reducing risks and costs associated with work-related MSDs. Most importantly, easy-to-use equipment that reduces the amount of physical demand required to perform these tasks has been developed for many of the high-risk tasks and is widely available. Also, studies have been conducted demonstrating that implementation of these programs and use of this equipment is cost effective, often paying for itself in less than 3 years time. Lastly, there has been recent evidence that implementation of a safe patient-handling (SPH) program can also increase the quality of care provided to the patient. It is clear that a large number of workers are routinely exposed to work-related risk factors for MSDs, often at very high levels of exposure. It is also clear that many of them develop one or more serious work-related MSDs as a consequence of their work during their working lifetime. Nevertheless, it should be recognized that these hazards can be Identified and controlled so that work-related MSDs can be prevented.
Task-performance; Work-capability; Risk-factors; Exposure-limits; Workers; Work-capacity; Work-environment; Work-performance; Musculoskeletal-system; Musculoskeletal-system-disorders; Muscle-tension; Muscle-physiology; Muscle-stress; Muscles; Health-care-personnel; Back-injuries; Nurses; Physiological-factors; Physical-stress; Physical-capacity; Physical-fitness