Evaluation of work ability index and its association with job stress and musculoskeletal disorders among midwives during the Covid-19 pandemic.

BACKGROUND: Musculoskeletal disorders (MSDs) and work-related stress are among the factors that can negatively affect work ability. Given the importance of midwives' health, this study aims to evaluate the work ability of midwives and to investigate its association with the prevalence of MSDs and work-related stress in midwifery. METHODS: Ninety-one midwives participated in this study. Three questionnaires, including Nordic musculoskeletal questionnaire (NMQ) plus body map, Persian version of work ability index (WAI) questionnaire, and Health and Safety Executive (HSE) job stress questionnaire, were used to collect data. Finally, the association of MSDs, work-related stress, and individual characteristics with WAI among midwives was investigated. RESULTS: The highest rates of pain and discomfort were reported in the lower back and neck. The mean job stress was 116.08 with the highest scores on demand, role, and control subscales. The work ability among midwives was at an acceptable level of 39.07 on average. Inter-variable association analysis showed that the work ability was significantly associated with pain in the past 12 months and the number of coexisting MSDs. Job stress was not associated with work ability. CONCLUSIONS: Midwives' WAI was at an acceptable level despite high prevalence of MSDs in midwives, the confirmation of the possible correlation between MSDs and work ability, as well as the high job stress in midwifery. Since the present study was conducted during the Covid-19 pandemic, the high stress in midwives may be partly due to the pandemic and may not be permanent. However, this level of stress may reduce the midwives' work ability over a long time.

Prevalence of musculoskeletal disorders, ergonomics risk assessment and implementation of participatory ergonomics program for pistachio farm workers.

BACKGROUND AND OBJECTIVES: Pistachio farmers are exposed to a variety of risk factors for musculoskeletal disorders (MSDs). However, no study has been conducted to investigate MSDs in pistachio workers. Therefore, in the present study, besides investigating the prevalence of MSDs and their ergonomic risk factors, the participatory ergonomics (PE) method is used to provide an intervention program to reduce MSDs in this population in harvesting and processing pistachio. METHODS: The present study was conducted in two phases. In the first phase 138 workers participated. The prevalence of MSDs was assessed with Nordic Musculoskeletal Questionnaire and the ergonomic risk factors was identified with ManTRA method. In the second phase PE was used to perform ergonomic interventions for reducing MSDs and the effect of the intervention was investigated. Sixty-four workers participated in the second phase (32 in the case group and 32 in the control group). RESULTS: The highest prevalence of MSDs was in shoulders (63.7%), followed by the lower back (63%) and wrists/hands (52.1%). The comparison showed that after implementing the PE intervention program, the prevalence of MSDs in the intervention group was not significantly different from that in the control group. However, in the reassessment by the ManTRA method for five tasks that were identified as high risk in the first phase, a decrease in ManTRA final score was observed for all the five tasks. CONCLUSIONS: MSDs were prevalent in all body regions of workers. After implementing PE interventions exposure to ergonomic risk factors decreased.

Evaluation of the effect of corrective exercise intervention on musculoskeletal disorders, fatigue and working memory of office workers.

Objectives: The present study aimed to investigate the effect of corrective exercise intervention (corrective exercise reminding and training software) on musculoskeletal disorders (MSDs), fatigue, posture and working memory among office workers. Methods: A total of 66 office workers participated in the present study. Data collection was carried out using questionnaires (including the Nordic musculoskeletal questionnaire, multidimensional fatigue inventory and Borg rating scale), direct observations of work postures using rapid upper limb assessment (RULA) and rapid office strain assessment, and the n-back test. Results: There was a significant difference between the two groups (intervention and control) in terms of the severity of musculoskeletal discomfort after the intervention. There was a significant decrease in the mean score of trunk posture and the total RULA score in the intervention group after the intervention. The severity of perceived discomfort in all areas except the knee declined during the intervention. There was also a significant difference in physical and mental fatigue scores before and after the intervention. There was a significant difference in the accuracy score of office workers after the intervention compared to before the intervention. Conclusions: Overall, the results confirm the effectiveness of this low-cost, simple and easy-to-use ergonomic intervention.

Using fuzzy cognitive map in bow tie method for dynamic risk assessment of spherical storage tanks: A case study.

The present study aimed to perform a dynamic risk assessment of liquefied petroleum gas (LPG) in spherical storage tanks using the Hazard and Operability (HAZOP) method. The "LPG release from spherical storage tank" scenario was determined to be a top event based on the risk level. The causes and consequences of this scenario were then specified using the Bow-Tie method. Additionally, fuzzy cognitive mapping (FCM) was utilized to identify the most critical threats, consequences, and effective barriers in a dynamic approach. Results showed that fracture/rupture in pipelines/a storage tank due to fire had the highest output degree and was identified as the most influential threat in the occurrence of the LPG release. Fatality/injury due to fire and explosion had the highest input degree and was more influenced by the release of LPG as the main consequence in the selected scenario. The findings of this study enabled us to make a logical decision about effective barriers for avoiding and minimizing the release of LPG and its threats and consequences based on the fuzzy cognitive map. Moreover, the results of this study showed that the FCM method could determine the most critical nodes with a higher degree and represent their relationships.

Occupational Fatigue and Its Relationship with Musculoskeletal Disorders and Heat Stress among the Workers of Summer Crops in Southeast Iran in 2021.

Aims: This research aimed to evaluate work fatigue and its relationship with musculoskeletal disorders (MSDs) and heat stress (WBGT) among greenhouse workers in Jiroft County, southeast Iran. Materials and Methods: This cross-sectional study was carried out between September 2021 and February 2022 among 150 workers in summer crop greenhouses. Data were collected by a demographic questionnaire, the Swedish occupational fatigue inventory (SOFI-20), and the Nordic musculoskeletal questionnaire (NMQ), and wet bulb globe temperature (WBGT) was measured as per ISO 7243. The collected data were analyzed by the χ2 test, logistic regression, and multivariable linear regression in the Stata 17.0 software. Results: The results showed a higher total fatigue score among the studied workers (mean = 100.71 out of 200). Among the fatigue dimensions, the three dimensions of lack of energy, physical discomfort, and physical exertion had the highest scores of 27.28, 26.71, and 25.71, respectively. The highest rate of MSD prevalence was in the back (54.7%), neck (50.7%), and shoulders (49.3%). Based on ISO 7243, the mean WBGT was beyond the allowed level for most tasks for greenhouse workers. There was a statistically significant relationship between occupational fatigue with MSDs and WBGT. Conclusion: Given the relatively high score reported for fatigue and its relationship with MSDs and heat stress, it is recommended to conduct further and more applied studies to investigate the approaches to alleviating heat stress and physical ergonomic risk factors in greenhouses in this occupational group.

Biomechanical evaluation of midwifery tasks and its relationship with the prevalence of musculoskeletal disorders.

Introduction: As an important occupational group in the healthcare system, midwives face various ergonomic risk factors such as musculoskeletal disorders (MSDs) risks. Moreover, an accurate job evaluation can help to design appropriate ergonomic interventions and more accurately estimate the probability of developing MSDs. Therefore, the present study aimed to investigate musculoskeletal discomforts and biomechanical stresses using the Three-Dimensional Static Strength Prediction Program (3DSSPP Ver. 7.1.3) to find the association of these factors with the prevalence of MSDs among midwives. Materials and methods: A total of 91 midwives with at least two years of work experience participated in this cross-sectional descriptive study. All midwifery duties were analyzed using the hierarchical task analysis (HTA) method. Moreover, time analysis was performed for this job, and data were collected using the Nordic Musculoskeletal Questionnaire (NMQ) and body mapping. The 3DSSPP software was used to investigate the forces acting on the lumbar region, and finally, the association of individual characteristics and the forces exerted on the body with MSDs was investigated. Results: According to the results, the highest level of pain and discomfort was related to the back and neck regions. The software analysis of the four major midwifery tasks showed that the highest biomechanical forces were exerted on the L5/S1 disc during lifting the mothers from bed (to help them sit or walk) and breastfeeding training. Accordingly, only in the task of lifting the mothers and helping them to sit or walk, the balance status was inappropriate and critical due to the improper distribution of forces. The analysis of the associations between variables showed that biomechanical forces, age, height, body mass index, and job tenure were among the risk factors affecting MSDs. Conclusion: According to the results of this study, MSDs were highly prevalent, especially in the neck and back regions; this can be attributed to the nature of midwifery tasks. The software analysis results of the tasks showed that the biomechanical forces on the spine in each of the tasks can be affected by the weight of the mother, the height of the bed, static posture, and the bending/twisting of the whole body. Compression and shear forces were among the risk factors that can affect MSDs. To prevent MSDs in midwives, it is appropriate to improve the workstations.

Personal protective equipment-associated headaches in health care workers during COVID-19: A systematic review and meta-analysis.

Introduction: Health Care Workers (HCWs) use Personal Protective Equipment (PPE) during the COVID-19 pandemic to protect themselves and prevent the transmission of the disease. The use of PPE, especially respiratory masks, has adverse consequences, including headaches, which have been secondary and unusual. The aim of the present systematic review and meta-analysis study was to investigate the prevalence of PPE-associated headaches in HCWs during COVID-19 pandemic. Methods: The present review study was performed based on the PRISMA guideline. The protocol of the present study was registered in PROSPERO with the code CRD42022304437. Valid data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, Embase were used to identify and extract relevant studies. The searches were conducted between the beginning of 2020 and the end of January 2022. A random effects model was used for meta-analysis and I 2 index was used to investigate between-study heterogeneity. Data were analyzed using STATA ver. 14. Results: A total of 539 articles were first identified through initial search and finally 26 final studies were selected to undergo the meta-analysis phase. According to the results of meta-analysis, the prevalence of headache after and before the use of PPE was 48.27% (95% CI: 40.20-56.34, I 2 = 99.3%, p = 0 < 001) and 30.47% (95% CI: 20.47-40.47, I 2 = 97.3%, p = 0 < 001), respectively. Conclusion: The results of the present study showed that the prevalence of PPE-associated headache in HCWs was relatively high, so, the use of PPE during COVID-19 pandemic can be considered as one of the causes of headache. Therefore, management strategies such as regular screening of HCWs for headaches and regular rest periods without the use of PPE can be effective in reducing the prevalence of headaches.

Risk analysis and safety assessment of hospitals against disasters: A systematic review.

Both natural and man-made disasters are increasing in occurrence at the world. Hospitals and health-care centers are very complex and have a high potential for vulnerability depending on external and internal factors. Unfortunately, past experiences show that health-care centers and the health system are vulnerable to disasters. Therefore, risk analysis and safety assessment studies of hospitals and other health-care centers are absolutely necessary. This systematic review study was conducted on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English language international databases (Pub Med, Scopus, Embase, Web of Science, and Google Scholar) were searched through January 1, 2000 up to June 20, 2019. The quality of the studies was assessed using the International Narrative Systematic Assessment tool. From 3630 titles identified in this search, 24 studies were selected. The important findings of this study were grouped into five main categories: risk analysis method, type of disaster, hospital safety methods, hospital components and key outcomes of risk analysis, and hospital safety assessments. The nature of disasters is a threat to the lives and property of the people, and therefore hospitals must be available at the incidents and disasters and they must be able to respond to the needs of the disaster-affected community. The probability of an incident and its consequences can never be reduced to zero; because the severity of many natural and even man-made disasters is unpredictable and the probability of their occurrence is different; however, it is possible to identify weaknesses and strengths through risk analysis studies as well as hospital safety assessments and implement retrofitting programs based on the type of risks and safety status and reduce the level of risk to an acceptable level.

The association between wet-bulb globe temperature and other thermal indices (DI, MDI, PMV, PPD, PHS, PSI and PSIhr): a field study.

The current study aimed at comparing the correlation coefficients between wet-bulb globe temperature (WBGT) and a number of parameters, including the discomfort index (DI), modified discomfort index (MDI), predicted mean vote (PMV), predicted percentage of dissatisfaction (PPD), predicted heat strain (PHS), physiological strain index (PSI) and physiological strain index heart rate (PSIhr). In total, 30 workers of a pelletizing factory participated in this study. Environmental parameters and workers' physiological parameters were measured in 10 working stations. The results showed that effective WBGT (WBGTeff) strongly correlates with DI, MDI, PMV, PPD, PHS, PSI and PSIhr. WBGTeff had the highest correlation coefficients with PMV, MDI, PHS and PSIhr. Based on the obtained results, it was concluded that heat stress exceeded the standard limit for a number of indices in some of the working stations. Thus, some controlling measures should be taken to reduce heat stress in these stations.

Association of Handgrip Strength With Malnutrition-Inflammation Score as an Assessment of Nutritional Status in Hemodialysis Patients.

INTRODUCTION:   Protein-energy wasting (PEW) is very common in patients with chronic kidney disease and those undergoing maintenance dialysis. Reduced handgrip strength is associated with PEW and considered as a reliable nutritional parameter that reflects loss of muscle mass. This study aimed to evaluate the handgrip strength and its relationship with the Malnutrition-Inflammation Score (MIS) among Iranian dialysis patients. MATERIALS AND METHODS: The study population consisted of 83 randomly selected hemodialysis patients from the dialysis centers in Kerman, Iran. Handgrip strength was measured using a dynamometer according to the recommendations of the American Society of Hand Therapists. All the patients were interviewed and the MIS of the patients were recorded.  Results. The PEW was prevalent in Kerman hemodialysis patients, with 83% and 17% having mild and moderate PEW based on MIS, respectively. Handgrip strength was significantly associated with age, sex, height, weight, and diabetes mellitus. After adjustment for age, handgrip strength was significantly associated with nutritional assessment markers on the basis of the MIS. CONCLUSIONS: Handgrip strength can be incorporated as a reliable tool for assessing nutrition status in clinical practice. However, further research is needed to determine the reference values and cutoff points both in healthy people and in hemodialysis patients to classify muscle wasting.

Normative data of grip and pinch strengths in healthy adults of Iranian population.

BACKGROUND: Measuring and comparing grip and pinch strengths with their normative data is a valid method to detect intensity of the numerous damages of hand. This research was carried out with the aim of establishing normative data of grip strength and three types of pinch strengths (Tip, Key and Palmar) in healthy Iranian adults. METHODS: In this cross-sectional study, the study population was formed of 1008 people (526 men and 482 women) from healthy Fars race adults of over 20 years old in five cities of Iran. American Society of Hand Therapists (ASHT) recommendations were followed to establish normative data of grip and pinch strengths. Normative data of grip and pinch strengths were developed based on sex, 12 different age groups and dominant and non-dominant hands. Jamar dynamometer and Seahan pinch gauge were used to measure grip and pinch strengths, respectively. RESULTS: Normative data of grip and pinch strengths were provided. Grip and pinch strengths of men were significantly stronger than women. The maximum grip strength of men was obtained in the group of 20-24 years and among women it was in the age group 35-39 years. Regardless of gender, grip and pinch strengths were declined with aging. CONCLUSION: Normative data of grip and pinch strengths were developed for Iranian population.