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1.
J Vasc Surg ; 79(5): 1217-1223, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38215953

RESUMEN

BACKGROUND: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being. METHODS: A confidential, voluntary survey was administered after the 2022 Vascular Surgery In-Service Examination to trainees in all Accreditation Council for Graduate Medical Education-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as "no to mild pain" (0-2) vs "moderate to severe pain" (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (eg, burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study. RESULTS: We included 527 trainees who completed the survey (82.2% response rate); 38% reported moderate to severe pain after a full day of work, of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%; P < .01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (odds ratio, 2.52; 95% confidence interval, 1.48-4.26) and using physiotherapy as pain management (odds ratio, 3.06; 95% confidence interval, 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change after adjustment. CONCLUSIONS: Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should consider mitigating this occupational hazard by offering ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.


Asunto(s)
Agotamiento Profesional , Internado y Residencia , Pruebas Psicológicas , Autoinforme , Masculino , Humanos , Femenino , Agotamiento Profesional/diagnóstico , Agotamiento Profesional/epidemiología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Procedimientos Quirúrgicos Vasculares/educación , Factores de Riesgo , Encuestas y Cuestionarios , Dolor
2.
Am J Obstet Gynecol ; 230(6): 583-599.e16, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38109950

RESUMEN

OBJECTIVE: A decline in musculoskeletal health during pregnancy is an underappreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for nontraumatic musculoskeletal disorders in the general working population. Evidence from meta-analyses suggest that occupational lifting and prolonged standing during pregnancy may increase risk of adverse pregnancy outcomes. This systematic review examined associations between occupational lifting or postural load in pregnancy and associated musculoskeletal disorders and related sequalae. DATA SOURCES: Five electronic databases (Medline, Embase, CINAHL, NIOSHTIC-2, and Ergonomic Abstracts) were searched from 1990 to July 2022 for studies in any language. A Web of Science snowball search was performed in December 2022. Reference lists were manually reviewed. STUDY ELIGIBILITY CRITERIA: Eligible studies reported associations between occupational lifting or postural load and musculoskeletal health or sequelae (eg, employment outcomes) among pregnant and postpartum workers. METHODS: Data were extracted using a customized form to document study and sample characteristics; and details of exposures, outcomes, covariates, and analyses. Investigators independently assessed study quality for 7 risk-of-bias domains and overall utility, with discrepant ratings resolved through discussion. A narrative synthesis was conducted due to heterogeneity. RESULTS: Sixteen studies (11 cohort studies, 2 nested case-control studies, and 3 cross-sectional studies) from 8 countries were included (N=142,320 pregnant and N=1744 postpartum workers). Limited but consistent evidence with variable quality ratings, ranging from critical concern to high, suggests that pregnant workers exposed to heavy lifting (usually defined as ≥22 lbs or ≥10 kg) may be at increased risk of functionally limiting pelvic girdle pain and antenatal leave. Moreover, reports of dose-response relationships suggest graded risk levels according to lifting frequency, ranging from 21% to 45% for pelvic girdle pain and 58% to 202% for antenatal leave. Limited but consistent evidence also suggests that postural load increases the risk of employment cessation. CONCLUSION: Limited but consistent evidence suggests that pregnant workers exposed to heavy lifting and postural load are at increased risk of pelvic girdle pain and employment cessation. Job accommodations to reduce exposure levels may promote safe sustainable employment for pregnant workers.


Asunto(s)
Empleo , Elevación , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Humanos , Femenino , Embarazo , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/etiología , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Complicaciones del Embarazo/epidemiología , Postura/fisiología , Factores de Riesgo
3.
J Surg Res ; 295: 864-873, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37968140

RESUMEN

INTRODUCTION: Bariatric surgery is routinely performed using laparoscopic and robotic approaches. Musculoskeletal injuries are prevalent among both robotic and laparoscopic bariatric surgeons. Studies evaluating ergonomic differences between laparoscopic and robotic bariatric surgery are limited. This study aims to analyze the ergonomic, physical, and mental workload differences among surgeons performing robotic and laparoscopic bariatric surgery. MATERIALS AND METHODS: All primary laparoscopic and robotic bariatric surgeries, Roux-en-Y gastric bypass, and sleeve gastrectomy between May and August 2022 were included in this study. Objective ergonomic analysis was performed by an observer evaluating each surgeon intraoperatively according to the validated Rapid Entire Body Assessment tool, with a higher score indicating more ergonomic strain. After each operation, surgeons subjectively evaluated their physical workload using the body part discomfort scale, and their mental workload using the surgery task load index. RESULTS: Five bariatric surgeons participated in this study. In total, 50 operative cases were observed, 37 laparoscopic and 13 robotic. The median total Rapid Entire Body Assessmentscore as a primary surgeon was significantly higher in laparoscopic (6.0) compared to robotic (3.0) cases (P < 0.01). The laparoscopic and robotic approaches had no significant differences in the surgeons' physical (body part discomfort scale) or mental workload (surgery task load index). CONCLUSIONS: This study identified low-risk ergonomic stress in surgeons performing bariatric surgery robotically compared to medium-risk stress laparoscopically. Since ergonomic stress can exist even without the perception of physical or mental stress, this highlights the importance of external observations to optimize ergonomics for surgeons in the operating room.


Asunto(s)
Cirugía Bariátrica , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Robótica , Cirujanos , Humanos , Ergonomía
4.
Evol Anthropol ; : e22045, 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-39109525

RESUMEN

The evolution of Paleolithic stone tool technologies is characterized by gradual increase in technical complexity along with changes in the composition of assemblages. In this respect, the emergence of retouched-backed tools is an important step and, for some, a proxy for "modern" behavior. However, backed tools emerge relatively early and develop together with major changes in Middle-Upper Pleistocene stone tool technologies. We provide an updated review of the emergence and development of the "backing" concept across multiple chrono-cultural contexts and discuss its relationship to both the emergence of hafting and major evolutionary steps in the ergonomics of stone tool use. Finally, we address potential mechanisms of context-specific re-invention of backing based primarily on data from the late Middle Paleolithic of Western Europe.

5.
Int J Colorectal Dis ; 39(1): 144, 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39289218

RESUMEN

PURPOSE: A novel robotic platform-Hugo™ RAS (robotic-assisted surgery) system-has been introduced with several innovations that may prove advantageous for surgeons, such as an open console and four interchangeable modular arms. Our study aims to evaluate this platform's safety, efficacy, and potential impact on the surgical treatment of colorectal pathology. METHODS: Patients underwent robotic-assisted colorectal procedures with the Hugo™ RAS system at the General University Hospital of Elche from October 2023 to July 2024. Patient characteristics, intraoperative and postoperative variables, and robotic technical issues were recorded. RESULTS: Forty consecutive patients were included (14 right, 13 left, and 8 rectum neoplasms; 4 left diverticulitis; and 1 ileocecal Crohn's disease). The patients' characteristics were as follows: median age, 69.5 years; 24 males and 16 females; 45% ASA III-IV; and Charlson Comorbidity Index > 5:42.5%. We recorded four medical (2 anemia, 1 phlebitis, and 1 admission to the intensive care unit) and three surgical (1 hematoma of the incision, 1 intestinal occlusion, and 1 dehiscence of the anastomosis) postoperative complications. We had no conversions neither open nor laparoscopic surgery. The average hospital stay was 3 days, with no mortality or readmission. CONCLUSIONS: The Hugo™ RAS system is safe and feasible for colorectal procedures. The modularity of the arms provides the versatility of configurations adjusted depending on the patient's body features and the surgeon's preferences and greater adaptability to operating rooms. The open console is highly comfortable and ergonomic for the surgeon, allowing communication with the operating room environment. TRIAL REGISTRATION: NCT06512480.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Centros de Atención Terciaria , Humanos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Femenino , Masculino , Anciano , Resultado del Tratamiento , Persona de Mediana Edad , Cirugía Colorrectal , Complicaciones Posoperatorias/etiología , Anciano de 80 o más Años , Tiempo de Internación , Adulto
6.
Occup Environ Med ; 81(8): 417-424, 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39160073

RESUMEN

OBJECTIVES: The aim was to examine exposure-response relations between occupational hand exposures and carpal tunnel syndrome (CTS) and to compare the relation between surgery-treated and non-surgery-treated CTS. The secondary aim was to study sex-specific differences in exposure-response relations. METHODS: We conducted a nationwide register-based cohort study of all persons born in Denmark (1945-1994). During follow-up (2010-2013), we identified first-time events of CTS. Occupational hand exposure estimates the year before each follow-up year were obtained by linking individual occupational codes with a job exposure matrix. We used multivariable logistic regression equivalent to discrete survival analysis based on sex and surgery. The excess fraction of cases was calculated. RESULTS: For both sexes, exposure-response relations were found for all occupational hand exposures. Among men, we found ORadj of 3.6 (95% CI 3.2 to 3.8) for hand-related force, 2.9 (95% CI 2.5 to 3.2) for repetitive hand movements, 3.8 (95% CI 2.7 to 5.2) for non-neutral hand posture and 2.5 (95% CI 2.2 to 2.7) for hand-arm vibration in the highest exposure groups. For combined exposure (hand load), ORadj was 3.5 (95% CI 3.1 to 4.0). Slightly higher ORsadj were generally found for surgery-treated CTS compared with non-surgery-treated CTS for both sexes. When comparing sex, somewhat higher ORsadj were found among men. The excess fraction was 42%. CONCLUSIONS: Occupational hand exposures carried a 3-5-fold increased risk of CTS with slightly higher risks for surgery-treated compared with non-surgery-treated CTS. Even though CTS occurs more frequently among women, somewhat higher exposure-response relations were found for men compared with women. In the general working population, a substantial fraction of first-time CTS could be related to occupational hand exposures.


Asunto(s)
Síndrome del Túnel Carpiano , Mano , Enfermedades Profesionales , Exposición Profesional , Humanos , Síndrome del Túnel Carpiano/epidemiología , Síndrome del Túnel Carpiano/etiología , Dinamarca/epidemiología , Masculino , Femenino , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Adulto , Persona de Mediana Edad , Estudios de Cohortes , Factores Sexuales , Modelos Logísticos , Factores de Riesgo , Sistema de Registros , Vibración/efectos adversos , Trastornos de Traumas Acumulados/epidemiología , Trastornos de Traumas Acumulados/etiología , Postura , Síndrome por Vibración de la Mano y el Brazo/epidemiología , Síndrome por Vibración de la Mano y el Brazo/etiología , Anciano
7.
Occup Environ Med ; 2024 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-39304344

RESUMEN

OBJECTIVES: This study investigates the impact of different work paces on cardiorespiratory outcomes, perceived effort and carried load (CL) in industrial workers. METHODS: A randomised cross-over trial was conducted at a mid-sized steel company. We included 12 healthy industrial workers (8 females, age: mean 44±SD 9 years, height: 1.70±0.08 m, body mass: 79.5±13.4 kg) with at least 6 months of working experience. All participants performed 5 min of piece work at 100% (P100), 115% (P115) and 130% (P130) of the company's internal target yielded in a randomised order, separated by 5 min familiarisation breaks. The primary outcome was energy expenditure (EE), calculated from a respiratory gas exchange using a metabolic analyser. Secondary outcomes were total ventilation, oxygen uptake, carbon dioxide release, respiratory exchange ratio, heart rate and rating of perceived effort (0-10). Furthermore, the metabolic equivalent and the CL were calculated. Data were analysed with repeated measure analyses of variance. RESULTS: For EE, a large 'pace' effect with a small difference between P100 and P130 (165.9±33.4 vs 178.8±40.1 kcal/hour-1, p=0.008, standard mean difference, SMD=0.35) was revealed. Additionally, a large difference in CL between all paces (p<0.001, SMD≥1.10) was revealed. No adverse events occurred. CONCLUSIONS: Cardiorespiratory outcomes rise with increased work pace, but the practical relevance of these differences still needs to be specified. However, the CL will add up over time and may impact musculoskeletal health in the long term.

8.
Occup Environ Med ; 2024 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-39317441

RESUMEN

The risk of developing Dupuytren's disease among workers exposed to occupational mechanical exposures has been reported in few systematic reviews, mainly related to vibration. Expanding the investigation to all occupational mechanical exposures is essential for advancing scientific knowledge, health policies and improving workplace safety. The aim of this systematic review and meta-analysis was to study the association between occupational mechanical exposures and Dupuytren's disease.We conducted a systematic review and meta-analysis using guidelines stated by PRISMA. The systematic literature search was performed in Medline, EMBASE, CINAHL, Cochrane Library and Web of Science databases in April 2023. Inclusion criteria were conducted using the PECOS. Two independent authors conducted the literature screening, data extraction and risk of bias assessment. In the meta-analyses, data was pooled using random-effects models and stratified by the risk of bias and study design. The level of evidence was evaluated using GRADE.The literature search identified 563 unique articles and 15 were deemed eligible for inclusion, categorised into hand-transmitted vibration, lifting/carrying loads and combined mechanical exposures. Exposure to hand-transmitted vibration showed an OR of 2.0 (95% CI 1.5 to 2.7, I2=64%), lifting/carrying loads had an OR of 1.5 (95% CI 1.1 to 2.0, I2=77%) and combined mechanical exposures had an OR of 2.1 (95% CI 1.4 to 3.1, I2=94%). When grading the level of evidence, we found moderate evidence for hand-transmitted vibration, while low evidence was found for lifting/carrying loads and combined mechanical exposures.We found an association between hand-transmitted vibration, lifting/carrying loads and combined mechanical exposures. The level of evidence was considered moderate for hand-transmitted vibration and low for lifting/carrying loads and combined mechanical exposures.

9.
Surg Endosc ; 38(8): 4445-4456, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38902409

RESUMEN

BACKGROUND: The rising prevalence of work-related musculoskeletal disorders has numerous physical, financial, and mental repercussions for surgeons. This study aims to establish whether the use of a wearable posture device can improve the operating time spent in suboptimal, high-risk postures. METHODS: Surgeons were recruited in Phase 1 of this prospective randomised study and baseline postural data was obtained. In Phase 2, participants were randomised to receive either a traditional educational workshop or intraoperative vibrations from the device to correct postural lapses. During minor elective day cases, intraoperative postural data was collected and stratified by forward flexion angle, into five risk categories (negligible to very high). Participants' experience with the sensor was also assessed. RESULTS: A total of 100 surgical procedures (Phase 1: n = 50; Phase 2: n = 50) were performed by eight surgeons of varying seniority. Exposure to the educational intervention increased time spent in suboptimal posture (Phase 1 vs. Phase 2); 47.5% vs. 67.8%, p = 0.05. However, the vibrational intervention significantly reduced this time; 50.0% vs. 20.7%, p = 0.005. Procedure type didn't influence posture although, laparoscopic interventions spent most time in negligible-risk postures; 47.7% vs. 49.3%, compared to open procedures. Surgical consultants spent less time in suboptimal posture compared to fellow/registrars; 30.3% vs. 72.6% (Phase 1) and 33.8% vs. 65.3% (Phase 2). CONCLUSION: Vibrational intervention from the device significantly decreased the time spent in suboptimal, high-risk postures. As procedure type wasn't correlated with postural changes, surgeon-specific factors in regulating posture are paramount. Finally, surgeon experience was positively correlated with improved surgical ergonomics.


Asunto(s)
Ergonomía , Quirófanos , Postura , Dispositivos Electrónicos Vestibles , Humanos , Proyectos Piloto , Estudios Prospectivos , Masculino , Femenino , Adulto , Cirujanos/educación , Niño , Vibración/uso terapéutico , Enfermedades Profesionales/prevención & control , Enfermedades Profesionales/etiología , Enfermedades Musculoesqueléticas/prevención & control , Tempo Operativo
10.
Surg Endosc ; 2024 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-39285040

RESUMEN

BACKGROUND: Surgical specialists experience significant musculoskeletal strain as a consequence of their profession, a domain within the healthcare system often recognized for the pronounced impact of such issues. The aim of this study is to calculate the risk of presenting musculoskeletal injuries in surgeons after surgical practice. METHODS: Cross-sectional study carried out using an online form (12/2021-03/2022) aimed at members of the Spanish Association of Surgeons. Demographic variables on physical and professional activity were recorded, as well as musculoskeletal pain (MSP) associated with surgical activity. Univariate and multivariate analysis were conducted to identify risk factors associated with the development of MSP based on personalized surgical activity. To achieve this, a risk algorithm was computed and an online machine learning calculator was created to predict them. Physiotherapeutic recommendations were generated to address and alleviate each MSP. RESULTS: A total of 651 surgeons (112 trainees, 539 specialists). 90.6% reported MSP related to surgical practice, 60% needed any therapeutic measure and 11.7% required a medical leave. In the long term, MSP was most common in the cervical and lumbar regions (52.4, 58.5%, respectively). Statistically significant risk factors (OR CI 95%) were for trunk pain, long interventions without breaks (3.02, 1.65-5.54). Obesity, indicated by BMI, to lumbar pain (4.36, 1.84-12.1), while an inappropriate laparoscopic screen location was associated with cervical and trunk pain (1.95, 1.28-2.98 and 2.16, 1.37-3.44, respectively). A predictive model and an online calculator were developed to assess MSP risk. Furthermore, a need for enhanced ergonomics training was identified by 89.6% of surgeons. CONCLUSIONS: The prevalence of MSP among surgeons is a prevalent but often overlooked health concern. Implementing a risk calculator could enable tailored prevention strategies, addressing modifiable factors like ergonomics.

11.
Surg Endosc ; 38(10): 6128-6138, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39187727

RESUMEN

BACKGROUND: The ergonomic advantages and potential challenges that robotic surgery poses to the well-being of surgeons are mainly unexplored. The most recent surgical robot introduced on the European market is the Hugo™ RAS System by Medtronic. This study aims to evaluate the ergonomic benefits of the Hugo™ RAS System, which is available in our training laboratory, CeMIT (Center for Medical Innovation and Technology Cologne). METHODS AND PROCEDURES: Using the previously established Cologne Ergonomic Measurement Setup for Robotic Surgery (CEMRobSurg), we measured three parameters related to ergonomic posture from subjects with different levels of surgical expertise (laypeople, medical students, surgical residents, and expert robotic surgeons). The heart rate was measured continuously using a polar band. The noise level was measured while using the Hugo™ RAS System, and automated photographs using our locally developed methodology were captured of the participant every 2 s to assess body posture. The ergonomic measurements were conducted while the subject performed the same standardized robotic training exercises (Peg Board, Rope Walk, and Ring Walk). RESULTS: A total of 53 participants were enrolled in this study. The average noise level during all measurements was 54.87 dB. The highest stress level was measured in surgical residents with a sympathetic nervous system index (SNS index) of 1.15 (min - 1.43, max 3.56). The lowest stress level was measured in robotic experts with an SNS index of 0.23 (min - 0.18, max 0.91). We observed a risk-prone positioning of the neck and elbow in medical students (mean 39.6° and 129.48°, respectively). Robotic experts showed a risk positioning in the knee and hip region (mean 107.89° and 90.31°, respectively). CONCLUSION: This is the first study to analyze and objectify the ergonomic posture of medical students, surgical trainees, surgeons, and laypeople using the open console, modular Hugo™ RAS System. Our findings offer recommendations for operating surgeons and allow for a comparative analysis between the different robotic systems. Further evaluations in real-time operative scenarios will follow.


Asunto(s)
Ergonomía , Postura , Procedimientos Quirúrgicos Robotizados , Humanos , Masculino , Femenino , Postura/fisiología , Adulto , Internado y Residencia , Adulto Joven , Frecuencia Cardíaca/fisiología , Estudiantes de Medicina , Cirujanos
12.
Surg Endosc ; 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39327296

RESUMEN

OBJECTIVE: During the advent of laparoscopy, surgeons directly explored the abdominal cavity with a telescope-like device through a small incision. Since then, numerous technological advances have transformed minimally invasive surgery (MIS). Yet, in our wireless world, various devices crowd the surgical field, with long wires and light sources posing fall and fire risks. The primary objective of this study was to analyze the first reported human use of a novel wireless laparoscopy system or WLS (ArthroFree™, Lazurite®, Cleveland, Ohio). METHODS: The utility and convenience of the WLS was assessed via two avenues: (1) by analyzing surgical outcomes from first human use and (2) by surveying healthcare professionals regarding its quality and utility. RESULTS: Eighteen patients (mean age 44.2, 83.3% female, mean BMI 33.4) underwent operations with the WLS. Operations included gynecologic and general surgical procedures. There were no intraoperative or postoperative complications, and no conversions to traditional laparoscopy or laparotomy. Mean operating time was 71.94 ± 20.41 min, and estimated blood loss was minimal. Survey results revealed varied individual experiences. Strengths included adequate illumination, improved ergonomics, and simplicity of setup and ease of operation. One respondent criticized the image resolution. Feedback indicated an overall positive impact, and 67% of respondents supported inclusion of the device at their facility. Moreover, its deployment in resource-limited settings abroad has demonstrated its efficacy in global surgery, indicating its potential in various healthcare environments. CONCLUSIONS: This is the first reported human use of a novel WLS. Clinical results supported efficiency and safety of the technology. The successful deployment of the WLS in diverse surgical environments, including resource-limited settings, highlights its potential as a universally adaptable tool in global surgery. This report represents a strong first step toward a wireless operating room with the promise of redefining surgical standards as well as bridging gaps in surgical care worldwide.

13.
Langenbecks Arch Surg ; 409(1): 142, 2024 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-38676748

RESUMEN

PURPOSE: Minimally invasive surgery benefits patients but poor operating ergonomics causes musculoskeletal injuries in surgeons. This randomised controlled trial aims to assess whether robotic-assisted surgery with the open-console Versius® system can reduce surgeons' ergonomic risks during major colorectal resections. METHODS: Prospectively registered at ClinicalTrials.gov (NCT05262296) in March 2022. Adult patients requiring a minimally invasive colorectal resection were potentially eligible. Photographs taken at 2-min intervals were analysed using the objective Rapid Entire Body Assessment (REBA) posture analysis scale to calculate intraoperative surgeon ergonomic risk. Secondary outcomes included team communication (Oxford NOTECHS II), surgeon cognitive strain (modified NASA-TLX scale), and clinical outcomes. RESULTS: Sixty patients were randomised in a 2:1 ratio (40 robot, 20 laparoscopic). Mean age was 65yrs and 34 (57%) were male. Body Mass Index did not differ between the 2 groups (overall mean 29.0 ± 5) and there were equal proportions of left and right-colonic resections. REBA was significantly lower in the robotic arm (median robot REBA score 3 vs lap REBA 5 [p < 0.001]), equating to an injury risk category drop from "medium" to "low risk". There were no significant differences in team communication, operative duration, or patient outcomes. Surgeon cognitive strain was lower in robotic cases (mean robot 32.4 ± 10.3 vs lap 45.6 ± 14.3 [p < 0.001]). CONCLUSIONS: This trial demonstrates that robotic surgery with an open-console system reduces ergonomic risk scores and cognitive strain during colorectal resections, with no apparent detriment to team communication. This may therefore be a safe & feasible solution to the increasing problem of work-related musculoskeletal injuries in surgeons.


Asunto(s)
Ergonomía , Procedimientos Quirúrgicos Robotizados , Humanos , Masculino , Procedimientos Quirúrgicos Robotizados/efectos adversos , Femenino , Anciano , Persona de Mediana Edad , Estudios Prospectivos , Procedimientos Quirúrgicos Mínimamente Invasivos , Laparoscopía/efectos adversos , Colectomía/efectos adversos , Colectomía/métodos , Cirujanos
14.
Int Arch Occup Environ Health ; 97(1): 45-55, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37971680

RESUMEN

OBJECTIVE: Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD). METHODS: A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP. RESULTS: Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures. CONCLUSION: Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).


Asunto(s)
Capacidad Cardiovascular , Enfermedades Cardiovasculares , Enfermedades Musculoesqueléticas , Masculino , Adolescente , Humanos , Estudios de Cohortes , Suecia/epidemiología , Carga de Trabajo , Estudios de Seguimiento , Factores de Riesgo , Pensiones , Enfermedades Cardiovasculares/epidemiología , Enfermedades Musculoesqueléticas/epidemiología , Aptitud Física
15.
Int Arch Occup Environ Health ; 97(6): 661-674, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38755483

RESUMEN

OBJECTIVE: This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs). METHODS: The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees. RESULTS: Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs. CONCLUSION: Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.


Asunto(s)
Ergonomía , Lugar de Trabajo , Humanos , Masculino , Estudios Longitudinales , Femenino , Adulto , Persona de Mediana Edad , Salud Laboral , Encuestas y Cuestionarios , Postura , Enfermedades Profesionales , Diseño Interior y Mobiliario , Condiciones de Trabajo
16.
Pediatr Radiol ; 54(6): 936-943, 2024 05.
Artículo en Inglés | MEDLINE | ID: mdl-38483592

RESUMEN

Human factors engineering involves the study and development of methods aimed at enhancing performance, improving safety, and optimizing user satisfaction. The focus of human factors engineering encompasses the design of work environments and an understanding of human mental processes to prevent errors. In this review, we summarize the history, applications, and impacts of human factors engineering on the healthcare field. To illustrate these applications and impacts, we provide several examples of how successful integration of a human factors engineer in our pediatric radiology department has positively impacted various projects. The successful integration of human factors engineering expertise has contributed to projects including improving response times for portable radiography requests, deploying COVID-19 response resources, informing the redesign of scheduling workflows, and implementation of a virtual ergonomics program for remote workers. In sum, the integration of human factors engineering insight into our department has resulted in tangible benefits and has also positioned us as proactive contributors to broader hospital-wide improvements.


Asunto(s)
Ergonomía , Pediatría , Ergonomía/métodos , Humanos , Pediatría/métodos , Servicio de Radiología en Hospital/organización & administración , Radiología/organización & administración , Radiología/métodos , COVID-19/prevención & control , SARS-CoV-2
17.
BMC Musculoskelet Disord ; 25(1): 64, 2024 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-38218812

RESUMEN

BACKGROUND: This study aims to investigate the prevalence of musculoskeletal disorders (MSDs) and associated sociodemographic and work-related factors among dental assistants (DAs) in the hail province, Saudi Arabia. METHODS: Participants were 119 DAs with an average age of 28.9 years (SD ± 4.8 years), of whom 86.6% were females. A self-administered questionnaire which included Nordic Musculoskeletal questionnaire and questions on socio-demographic and work-related factors was used. Descriptive statistics were used to calculate the prevalence of MSDs during the past 12 months and 7 days. Multivariate binary logistic regression statistical tests were used to calculate the association between MSDs and socio-demographic and work-related factors. RESULTS: The overall prevalence of MSDs among DAs was significantly high, with 85.7% reporting symptoms during the past 12 months and 47.9% during the past 7 days. The shoulders, followed by the lower back, were the most common complaints among participants in the past 12 months and 7 days, followed by the upper back and neck. Multivariate binary logistic regression analysis results show significant associations between MSDs and age, Body-Mass-Index (BMI), physical demands during working hours, work environment and posture awareness, and years of experience. CONCLUSIONS: The prevalence of MSDs among DAs is high, and sociodemographic and work-related factors play an important role in exacerbation of MSDs in DAs.


Asunto(s)
Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Femenino , Humanos , Adulto , Masculino , Estudios Transversales , Asistentes Dentales , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/epidemiología , Encuestas y Cuestionarios , Prevalencia , Factores de Riesgo
18.
BMC Musculoskelet Disord ; 25(1): 663, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39180030

RESUMEN

INTRODUCTION: Taxi drivers, as professional drivers, encounter numerous ergonomic risk factors related to musculoskeletal disorders (MSDs) because of the demands of their jobs. This study conducted as a systematic review and meta-analysis aimed to explore the prevalence of MSDs among taxi drivers. MATERIALS AND METHODS: The present study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and its protocol was registered in the international prospective register of systematic review (PROSPERO) under the code CRD42024509258. Searches were carried out using various databases, such as PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, with no time restrictions until February 7th, 2024. A random effects model was utilized for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Lastly, data analysis was conducted using STATA software (version 14). RESULTS: After the initial search, 1606 articles were extracted from the reviewed sources. Following screening, study selection, and quality evaluation, a total of 11 studies were chosen for meta-analysis, involving 5277 taxi drivers. Based on the results of the meta-analysis, the highest prevalence of MSDs among taxi drivers was related to the lower back region (53.87% (95% CI:40.89-66.84, I2= 98.7%, P < 0.001)). Additionally, the prevalence rates of MSDs in different body regions, such as the neck (38.15%), shoulder (34.97%), upper back (18.30%), and knee (14.10%), were also reported. CONCLUSION: Based on the findings of this study, the prevalence of MSDs among taxi drivers is relatively high, and specific risk factors may contribute to the development of these disorders. Therefore, to prevent the occurrence of MSDs among taxi drivers, it is advisable to implement essential measures concerning the development of training programs, ergonomic interventions, and evaluation of the work environment.


Asunto(s)
Conducción de Automóvil , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Humanos , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Profesionales/epidemiología , Conducción de Automóvil/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Ergonomía
19.
BMC Musculoskelet Disord ; 25(1): 675, 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39210354

RESUMEN

BACKGROUND: Sometimes during breastfeeding women adopt positions that may cause problems with musculoskeletal system, resulting in back pain. The aim of this study was to determine the prevalence of lower back, upper back and neck pain in breastfeeding women and how this may be related to the act of breastfeeding. METHODS: An online survey within Poland was conducted among 395 breastfeeding women who were 1 to 48 months postpartum and were divided into two groups; "no back pain" and "back pain present". The measurement tools used included an original questionnaire, the International Physical Activity Questionnaire (IPAQ), a Numerical Pain Rating Scale (0-10), and the Roland-Morris Disability Questionnaire. Pearson's chi-squared tests, Mann-Whitney U tests, Student's t-tests, and Kruskal-Wallis ANOVA tests were used to compare the groups. RESULTS: It was found that 84% of breastfeeding mothers suffered from back pain at least once a month. Pain was experienced at least once a week in the cervical, thoracic and lumbosacral regions in 48%, 36%, and 66% of the women, respectively. A dysfunctional state was present in 27.6% of breastfeeding mothers who suffered from back pain. Mothers experiencing back pain spent significantly more time on single breastfeeding episodes (p < 0.05) and had an increased total time breastfeeding per day (p < 0.01) compared to mothers with no back pain. Neck pain was significantly less intense in mothers preferring to breastfeed in a lying position as compared to mothers preferring a sitting position in a chair or an armchair (p < 0.05). CONCLUSIONS: This survey of Polish breastfeeding mothers revealed a very high prevalence of lower back, upper back and neck pain. The amount of time spent on breastfeeding and the choice of body position for breastfeeding were important factors differentiating the prevalence and intensity of the pain. It is recommended that breastfeeding mothers do not extend the single-feeding time in the adopted position beyond the required time. It is of utmost importance to choose a breastfeeding position in which all parts of the mother's body are supported. To prevent neck pain, lying and semi-lying positions with head support are recommended.


Asunto(s)
Dolor de Espalda , Lactancia Materna , Dolor de Cuello , Humanos , Lactancia Materna/estadística & datos numéricos , Dolor de Cuello/epidemiología , Femenino , Adulto , Prevalencia , Polonia/epidemiología , Dolor de Espalda/epidemiología , Dolor de Espalda/diagnóstico , Adulto Joven , Encuestas y Cuestionarios , Dimensión del Dolor , Madres , Postura , Internet
20.
BMC Musculoskelet Disord ; 25(1): 692, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39223549

RESUMEN

BACKGROUND: The COVID-19 pandemic has led to the broad acceptance of distance education (DE), with university professors and students conducting the teaching-learning process remotely from their homes. The propose of this study to investigate the prevalence of musculoskeletal disorders (MSDs) before and during the COVID-19 pandemic and identify risk factors associated with DE that may contribute to an increased incidence of these disorders among university professors. METHODS: This cross-sectional analytical study took a comparative approach and involved 310 university professors in Iran. Data were gathered using an online questionnaire. Initially, demographic and occupational information of the professors, hours of physical activity, and hours spent using electronic devices were recorded. Participants were then asked to report MSDs in various body areas throughout the previous year and the previous seven days. Finally, MSDs risk factors such as workstation ergonomics during computer, laptop, smartphone, and tablet use, as well as working postures during online teaching or offline content development during the COVID-19 pandemic, were examined. RESULTS: The majority of the participants were male (66.13%), with a PhD (46.77%) and a faculty member position (74.2%). On average, the use of computers and laptops increased by 2.67 h and 2.72 h, respectively, during the pandemic compared to before the pandemic. This increase was statistically significant (P < 0.001). MSDs incidence increased significantly before and during the COVID pandemic was observed in the areas of the neck, shoulders, lower and upper back, arms, forearms, wrists and fingers (P < 0.05). The highest cumulative incidence (Cin) of MSDs was related to the neck (Cin = 24.20%), upper back (Cin = 21.29%), low back (Cin = 18.06%) and fingers (Cin = 16.13%). The prevalence of MSDs during the COVID pandemic was significantly associated with employment status (P = 0.042), work experience (P = 0.016), age (P = 0.027), increase in the use of computers/ laptops (P < 0.001), decrease of the smartphone/tablet distance from the body (P = 0.047), workstation (smartphone-tablet, computer, laptop) (P < 0.05), head position (smartphone-tablet) (P = 0.029), display height (computer/laptop) (P = 0.045) and physical activity (P = 0.006). CONCLUSIONS: It appears that the increased duration of smartphone, computer, and laptop use, combined with decreased physical activity and detrimental changes in ergonomic conditions of workstations during the quarantine period caused by the COVID-19 pandemic, has resulted in a shift from dynamic to static tasks and an increase in the prevalence and incidence of MSDs among university professors.


Asunto(s)
COVID-19 , Docentes , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Masculino , Estudios Transversales , Enfermedades Musculoesqueléticas/epidemiología , Femenino , Prevalencia , Incidencia , Adulto , Irán/epidemiología , Factores de Riesgo , Enfermedades Profesionales/epidemiología , Persona de Mediana Edad , Educación a Distancia , Ergonomía , Encuestas y Cuestionarios , SARS-CoV-2 , Universidades , Pandemias , Postura
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