Vitamin D status in active duty Navy military personnel: a systematic review.

OBJECTIVES: Active duty Navy military personnel are prone to vitamin D deficiency due to an occupational environment detrimental to sunlight exposure. The main objective of this systematic review is to provide a worldwide overview of vitamin D status in this population. METHODS: The Condition, Context, Population (CoCoPop) mnemonic was used to define the inclusion criteria (vitamin D status; all contexts; active duty Navy military personnel). Studies with recruits or veterans were excluded. Scopus, Web of Science and PubMed/Medline databases were searched from inception to 30 June 2022. Joanna Briggs Institute and Downs & Black checklists were used for quality assessment and data were synthesised in narrative and tabular formats. RESULTS: Thirteen studies published between 1975 and 2022 and conducted in northern hemisphere Navies, including mainly young and male service members, were included. The prevalence of vitamin D deficiency was globally reported as significant. Nine studies included a total of 305 male submariners who performed 30-92 days submarine patrol and reported the effect of sunlight deprivation in the decrease of vitamin D levels. CONCLUSIONS: This new systematic review underlines the high prevalence of vitamin D deficiency in the Navy, especially in submariners, and the need to implement measures to prevent vitamin D deficiency. Serum 25(OH)D data available and the heterogeneity of the studies limited a pooled analysis. Most studies included only submariners, which may limit generalisability to all active duty Navy military personnel. Further research on this topic should be promoted. PROSPERO REGISTRATION NUMBER: CRD42022287057.

Vitamin D levels in Portuguese military personnel.

INTRODUCTION: In Portugal, most adults have inadequate levels of vitamin D. Active duty military personnel need to be always ready for duty, perform tasks in specific contexts and overcome high physical and mental demands, which raises the relevance of knowing their vitamin D levels. This study aims to characterise vitamin D levels of Portuguese active duty military personnel and evaluate the effect of military status on the prevalence of vitamin D sufficiency, adjusted for season of the year, age and gender. METHODS: A retrospective cross-sectional study, based on vitamin D measurements carried out at the Armed Forces Hospital between 2014 and 2020, was fulfilled including the variables age, gender, vitamin D level and dosing date for military personnel and civilians. Comparison of proportions test and the generalised linear regression model were used for data analysis with a significance level of 5%. RESULTS: Out of 2782 subjects, 62.7% were military personnel. Mean±SD level of vitamin D was 24.5±10.6 ng/mL and 23.7±11.5 ng/mL in military personnel and civilians, respectively. In the military personnel, the prevalence of vitamin D sufficiency, insufficiency and deficiency was, respectively, 25.2%, 40.1% and 34.6%. Prevalence of vitamin D sufficiency was similar in the civilians cohort and, also, between Armed Forces branches. Military status had no effect on the prevalence of vitamin D sufficiency, especially after adjustments. CONCLUSIONS: We present data on vitamin D levels of Portuguese active duty military personnel. Our results found that military personnel are no more at risk of vitamin D inadequacy than civilians, but only a quarter of active duty military personnel had vitamin D sufficiency. Therefore, they can benefit from vitamin D levels assessment towards vitamin D levels optimisation. Further studies are still needed, especially among military personnel with higher risk of vitamin D deficiency.

Vitamin D status in the active duty Navy military personnel: protocol for a systematic review.

INTRODUCTION: Vitamin D is critical for bone health and its deficiency has been linked to increased incidence and severity of multiple diseases. Even so, vitamin D inadequacy is a major public health problem worldwide. The main source of vitamin D is endogenous cutaneous synthesis through exposure to solar ultraviolet B radiation, which is influenced by several factors, including occupational. The active duty Navy military personnel may be prone to vitamin D inadequacy, but a worldwide overview of vitamin D status in this specific population is still lacking. METHODS AND ANALYSIS: The CoCoPop mnemonic will be used for determining the inclusion criteria. Scopus, Web of Science and PubMed/Medline will be searched for all studies including 25-hydroxyvitamin D concentrations of the active duty Navy military personnel. Data extraction and quality assessment (Joanna Briggs Institute's and Downs and Black checklists) will be performed by two reviewers and data will be synthesised in narrative, tabular and map formats. ETHICS AND DISSEMINATION: This study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in a peer-reviewed scientific journal and presentation at a scientific conference. PROSPERO REGISTRATION NUMBER: CRD42022287057.

Low back pain among hospital nursing assistants.

BACKGROUND: Occupational low back pain (LBP) is a relevant condition among hospital nursing assistants (NA). OBJECTIVE: To characterize the context of LBP among NA who sought medical care for this reason. METHODS: We conducted structured interviews to characterize the participants' sociodemographic profile, state of health and most relevant LBP episode. Next we subjected the participants to brief objective physical examination and reviewed their occupational health records. RESULTS: We interviewed 30 NA, most of whom were middle-aged women with excess weight and sedentary lifestyle. The most relevant LBP episodes were characterized by severe pain (93.3%) and resulted in functional restrictions for 63.3% of the sample. Job tasks most frequently associated with LBP were patient transfer (23.3%) and lifting/carrying loads >12 kg (20%). Although all the participants had sought medical care, 80% still complained of pain at the time of the interviews. On physical examination, the Lasègue and Bragard signs were found in 11 participants. We found significant association (p<0.05) between clinical signs, ongoing pain and incapacity for work. CONCLUSIONS: According to most participants, LBP episodes occurred while performing tasks involving high physical demands, such as patient transfer and lifting/carrying loads >12 kg. The influence of individual factors notwithstanding, prevention and treatment of LBP among NA requires integrated occupational health interventions to minimize its impact on health and absenteeism.

INTRODUÇÃO: Os auxiliares de enfermagem (AE) hospitalares constituem um grupo profissional para o qual a lombalgia ocupacional é relevante. OBJETIVO: Caracterizar os contextos da lombalgia num grupo de AE que, por esse motivo, solicitaram exame médico ocasional. MÉTODOS: Utilizou-se uma entrevista estruturada para a caracterização sociodemográfica, do estado de saúde e do episódio mais relevante de lombalgia e seu enquadramento, seguida de exame objetivo sumário e de consulta do processo individual do Serviço de Saúde Ocupacional (SSO). RESULTADOS: Foram entrevistados 30 AE: predomínio de mulheres de meia-idade, com excesso de peso e sedentárias. Os episódios mais relevantes de lombalgia caracterizaram-se por dor intensa (93,3%), tendo condicionado limitação funcional em 63,3% dos AE. As atividades mais relacionadas com o episódio de lombalgia foram a transferência de doentes (23,3%) e a movimentação/o transporte de cargas >12 kg (20%). Todos eles recorreram a serviços médicos, mas, à data da entrevista, 80% mantinham lombalgia ativa. Ao exame objetivo, oito apresentavam dismetria dos membros inferiores, e 11, escoliose. Os sinais de Lasègue e de Bragard estiveram presentes simultaneamente em 11 casos. Identificaram-se associações significativas (p<0,05) entre a presença de sinais clínicos, a presença de lombalgia atual e a incapacidade para o trabalho. CONCLUSÕES: A maioria dos AE afirmou que o episódio agudo de lombalgia ocorreu durante a realização de tarefas exigentes, como transferência de doentes e movimentação/transporte de cargas >12 kg. Assim, apesar da influência dos fatores individuais, a prevenção e o tratamento da lombalgia em AE passam por uma intervenção integrada do SSO, minimizando o seu impacto na saúde e no absentismo.

Lombalgias em auxiliares de enfermagem hospitalares / Low back pain among hospital nursing assistants

Introdução: Os auxiliares de enfermagem (AE) hospitalares constituem um grupo profissional para o qual a lombalgia ocupacional é relevante. Objetivo: Caracterizar os contextos da lombalgia num grupo de AE que, por esse motivo, solicitaram exame médico ocasional. Métodos: Utilizou-se uma entrevista estruturada para a caracterização sociodemográfica, do estado de saúde e do episódio mais relevante de lombalgia e seu enquadramento, seguida de exame objetivo sumário e de consulta do processo individual do Serviço de Saúde Ocupacional (SSO). Resultados: Foram entrevistados 30 AE: predomínio de mulheres de meia-idade, com excesso de peso e sedentárias. Os episódios mais relevantes de lombalgia caracterizaram-se por dor intensa (93,3%), tendo condicionado limitação funcional em 63,3% dos AE. As atividades mais relacionadas com o episódio de lombalgia foram a transferência de doentes (23,3%) e a movimentação/o transporte de cargas >12 kg (20%). Todos eles recorreram a serviços médicos, mas, à data da entrevista, 80% mantinham lombalgia ativa. Ao exame objetivo, oito apresentavam dismetria dos membros inferiores, e 11, escoliose. Os sinais de Lasègue e de Bragard estiveram presentes simultaneamente em 11 casos. Identificaram-se associações significativas (p<0,05) entre a presença de sinais clínicos, a presença de lombalgia atual e a incapacidade para o trabalho. Conclusões: A maioria dos AE afirmou que o episódio agudo de lombalgia ocorreu durante a realização de tarefas exigentes, como transferência de doentes e movimentação/transporte de cargas >12 kg. Assim, apesar da influência dos fatores individuais, a prevenção e o tratamento da lombalgia em AE passam por uma intervenção integrada do SSO, minimizando o seu impacto na saúde e no absentismo.

Background: Occupational low back pain (LBP) is a relevant condition among hospital nursing assistants (NA). Objective: To characterize the context of LBP among NA who sought medical care for this reason. Methods: We conducted structured interviews to characterize the participants' sociodemographic profile, state of health and most relevant LBP episode. Next we subjected the participants to brief objective physical examination and reviewed their occupational health records. Results: We interviewed 30 NA, most of whom were middle-aged women with excess weight and sedentary lifestyle. The most relevant LBP episodes were characterized by severe pain (93.3%) and resulted in functional restrictions for 63.3% of the sample. Job tasks most frequently associated with LBP were patient transfer (23.3%) and lifting/carrying loads >12 kg (20%). Although all the participants had sought medical care, 80% still complained of pain at the time of the interviews. On physical examination, the Lasègue and Bragard signs were found in 11 participants. We found significant association (p<0.05) between clinical signs, ongoing pain and incapacity for work. Conclusions: According to most participants, LBP episodes occurred while performing tasks involving high physical demands, such as patient transfer and lifting/carrying loads >12 kg. The influence of individual factors notwithstanding, prevention and treatment of LBP among NA requires integrated occupational health interventions to minimize its impact on health and absenteeism.