Effectiveness and usability of real-time vibrotactile feedback training to reduce postural exposure in real manual sorting work.

Vibrotactile feedback training may be used as a complementary strategy to reduce time in demanding postures in manual handling. This study evaluated the short- and medium-term effects of concurrent posture-correction vibrotactile feedback training on trunk inclination exposure in real manual sorting work. Fifteen warehouse workers completed the training and the follow-up sessions. Trunk inclination angles were recorded using the ambulatory Smart Workwear System. Questionnaires were used for assessing system usability, perceived physical exertion, and work ability. The results showed reduced time in trunk inclination >30°, >45°, and >60°, and reductions in the 90th, 95th, and 99th percentile trunk inclination angles, when receiving feedback and immediately after feedback withdrawal. No significant reduction was retained after one and three weeks. The wearer's comfort was scored high, and the feedback did not increase the perceived cognitive demands. No significant effects attributed to changed trunk inclination exposure were observed for perceived physical exertion or work ability. The training program has the potential of contributing to reduced trunk inclination exposure in the short term. Future studies are needed to evaluate if improvements in the feedback training can transfer the short-term results to retained median- and long-term effects.Practitioner summary: A two-day training program with concurrent posture-correction vibrotactile feedback can contribute to reduced exposure of trunk inclination in real manual sorting work in the short term. More research is needed on how to design the feedback training programs in order to be effective in the long term.

Screening of Work-Related Musculoskeletal Upper Limb Disorders Using the SALTSA Protocol: A Work-Site Study in Belgium.

BACKGROUND: Long-term absenteeism continues to rise in Belgium and musculoskeletal disorders (MSDs) have been considered a primary cause. However, there is still uncertainty about the prevalence of MSDs, and about the contribution of work-related factors in the etiology of MSDs. SALTSA, which was developed in 2001, is a European diagnostic criterion document that aims to standardize the reporting of work-related upper limb MSDs (ULMSDs). The purpose of this work-site study was to implement SALTSA in daily occupational health practice and to determine the prevalence of ULMSDs in a Belgian company. METHODS: During health examinations, occupational health nurses and an occupational health physician screened employees in a company with ergonomically high-risk activities for the occurrence of ULMSDs using the SALTSA protocol. In order to explore associations between ULMSDs and lifestyle and work-related factors, bivariate and logistic regression analyses were performed. FINDINGS: Three hundred and eight (94.0%, 308/328) employees were screened resulting in an ULMSD prevalence of 20.5% (95% CI = [16.0-25.3]). Rotator cuff syndrome was the most common condition. Prevalence varied significantly between men (9.6%, 95% CI = [5.6-14.9]) and women (35.0%, 95% CI = [26.9-43.9]). Being female (p < .001) and working in the cabling assembly unit (p = .002) were found to be significant predictors of ULMSDs. CONCLUSION/APPLICATION TO PRACTICE: By using the SALTSA protocol in occupational health practices, ULMSDs can be screened unequivocally, enabling comparisons between different occupational sectors and countries. Occupational health nurses can play an important role in detecting and screening MSDs among workers.

General Practitioners and Community Pharmacists' Collaboration in Primary Care: Small Steps for a Major Change.

BACKGROUND: Healthcare authorities worldwide search for ways to develop integrated care and interprofessional collaboration. In Belgium, Medical-Pharmaceutical Concertation (MPC) was introduced as a format to promote constructive dialogues between GPs and community pharmacists (CPs) with a focus on pharmacotherapy. OBJECTIVE: To evaluate the implementation of MPC from the perspective of healthcare authorities and GPs/CPs. METHODS: Mixed-methods approach, including semi-structured interviews with stakeholders and service users, observations of MPC meetings and surveys in GPs/CPs. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed inductively. RESULTS: The implementation of MPC took a slow start. Parties involved had divergent views on the goals of the MPC: stakeholders focused on measurable results, while service users aimed on improving interprofessional communication. Additionally, service users felt that the lack of local structures hindered consensus building and implementation of agreements in daily practice. Support from professional associations was considered indispensable for the implementation of MPC. In order to organize this efficiently, the establishment of an independent institution, coordinating the MPC initiative, was highly recommended. CONCLUSION: The study confirms that a thorough context assessment prior to implementation of a complex project is needed and that a step-wise approach should be respected to achieve effective interprofessional relationships.

Exposure to Indoor Ferromagnetic Particulate Matter Monitored by Strawberry Plants and the Occurrence of Acute Respiratory Events in Adults.

Exposure assessment of air pollution in epidemiologic research remains a challenge. Previous studies showed that magnetic monitoring of strawberry leaves, based on Saturation Isothermal Remnant Magnetization (SIRM), is a valid tool for estimating the concentration of ambient particulate matter (PM). This study uses this assessment method for the first time in epidemiologic research to quantify indoor exposure to PM. In a nested case control study, we evaluated the association between 'waking up by cough' and indoor air pollution measured by SIRM of dust deposition on leaves of strawberry plants located in the bedroom in the general adult population. A multiple logistic regression was used to estimate the association between 'waking up by cough' and exposure to ferromagnetic particles of PM controlling for age, gender and smoking status. A cut-off of 10 µA was decided to define exposure status (high versus low). Using logistic regression, a crude odds ratio (OR) of 1.80 (95% CI: 0.90-3.60) for 'waking up by cough' was found. This association remained approximately the same after controlling for age, gender and smoking status (adjusted OR: 1.76; 95% CI: 0.60-5.30). We found an association between exposure to ferromagnetic particles and 'waking up by cough' in adults; however, it was not statistically significant. This environmental exposure assessment method could be a valuable alternative for expensive personal exposure measurement devices.