A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function.

INTRODUCTION: Firefighting is a high-risk job with a high prevalence of work-related musculoskeletal disorders (WMSDs). The aim of his study was to determine the prevalence of WMSDs, estimate the likelihood of subsequent disorders, and investigate the effect of NASM-based training protocol on firefighters function. METHOD: First, prevalence and region of WMSDs in all 524 male Isfahan firefighters were determined by Medical-history-questionnaire. Then, functional movement screen (FMS) separated firefighters to the 2-dimension FMS score (FMSCS≤14 or FMSCS>14) to show at risk firefighters. Finally, 40 Participants with both FMSCS≤14 and common WMSDs randomly assigned to either an intervention (IG) (n = 20) or control (CG) (n = 20) group. The IG received NASM-based training, while the CG engaged in daily activities. Outcomes included movement efficiency during landing error scoring system-real time, Y balance, single-leg squat, and deep squat, which were assessed in pretest and posttest. RESULTS: The prevalence of disorders was 52.1%, which lower limb, back, upper limb, and neck were the highest prevalence respectively. Only lower limb and back disorders could identify individuals at disorder risk with a likelihood of 89% and 71%, sequentially. Also, movement performance significantly improved in all functional tests in IG relative to CG. CONCLUSIONS: Considering high disorder rate in firefighters, the value of our study lies in alleging a systematic model periodically to reduce WMSDs and risk of subsequent disorders. Not only our model determined the prevalence of WMSDs, but it also identified those who are at risk. In addition, our model represents exercise therapy as a solution.

Association of Vibrotactile Biofeedback With Reduced Ergonomic Risk for Surgeons During Tonsillectomy.

Importance: Work-related musculoskeletal disorders are common among otolaryngologists and can be associated with decreased productivity, missed workdays, and reduced quality of life. Ergonomic risk for surgeons is elevated during common otolaryngology procedures; current ergonomic interventions lack the ability to provide real-time feedback. The ability to quantify and mitigate ergonomic risk during surgery may reduce work-related musculoskeletal disorders. Objective: To quantify the association of vibrotactile biofeedback with intraoperative ergonomic risk to surgeons during tonsillectomy. Design, Setting, and Participants: This cross-sectional study was conducted between June 2021 and October 2021 at a freestanding tertiary care children's hospital and included 11 attending pediatric otolaryngologists. Data analysis was conducted from August to October 2021. Interventions: Real-time quantification of ergonomic risk during tonsillectomy and the use of a vibrotactile biofeedback posture monitor. Main Outcomes and Measures: Association of vibrotactile biofeedback with objective measures of ergonomic risk. Assessment tools included the Rapid Upper Limb Assessment, craniovertebral angle, and time spent in an at-risk posture. Results: Eleven surgeons (mean [SD] age 42 [7] years; 2 women [18%]) performed 126 procedures with continuous posture monitoring in the presence (80 [63%]) and absence (46 [37%]) of vibrotactile biofeedback. No complications or delays associated with the device were reported. Intraoperative vibrotactile biofeedback was associated with improved Rapid Upper Limit Assessment neck, trunk, and leg scores by 0.15 (95% CI, 0.05-0.25), improved craniovertebral angle by 1.9 (95% CI, 0.32-3.40), and decreased overall time spent in an at-risk posture by 30% (95% CI, 22%-39%). Conclusions and Relevance: The results of this cross-sectional study suggest that use of a vibrotactile biofeedback device to quantify and mitigate ergonomic risk for surgeons is feasible and safe while performing surgery. Vibrotactile biofeedback was associated with reduced ergonomic risk during tonsillectomy and may have a role in improving surgical ergonomics and preventing work-related musculoskeletal disorders.

Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion.

BACKGROUND: Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment. OBJECTIVE: The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk. METHODS: Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP. RESULTS: Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs. CONCLUSION: The massages could be described as a combination of generic posture for a rapid ergonomic assessment.

Awareness, Use, and Opinions of Individual Fit Testing of Hearing Protection Devices Among Practicing Michigan Occupational and Environmental Medicine Association Health Care Providers.

OBJECTIVE: The aim of this study is to examine the awareness, opinions, and use of individual fit testing of hearing protection devices (HPDs) among occupational medicine practitioners. METHODS: Members of the Michigan Occupational and Environmental Medicine Association completed a 21-question survey on individual fit testing of HPDs. RESULTS: The survey response rate was 67%, 53% reported having heard of individual fit testing of HPDs, and 24% reported that their clinic/site performed the testing. Major barriers to its use were perceived time to perform (63%), cost (51%), lack of an Occupational Safety and Health Administration requirement (51%), and lack of long-term studies of its effectiveness (20%). CONCLUSIONS: Further work to educate practitioners about the availability, implementation, and potential benefits of fit testing of HPDs is needed if use of this technology is to become more widespread.

(Re-)Defining ergonomics in hand therapy: Applications for the management of upper extremity osteoarthritis.

STUDY DESIGN: Invited literature review BACKGROUND: Arthritis is the leading cause of disability in adults, and research shows that people living with arthritis experience work instability, loss of independence, financial difficulties, and overall decreased quality of life. Current nonpharmacological treatments can be beneficial for short term relief; however, the evidence on these long-term treatments is limited. Ergonomic modifications have been used in the workplace to address musculoskeletal conditions to ensure proper fit of one's environment, and research shows that these modifications can decrease pain and injury and increase work productivity. A broader perspective on ergonomic approaches may be important to supporting individuals with arthritis within hand therapy. PURPOSE OF THE STUDY: This review proposes an expanded perspective on ergonomic approaches within hand therapy and explores published literature to identify potential benefits of applying ergonomic approaches for individuals with upper extremity arthritis. METHODS: A systematic search and screening process was conducted to identify articles that implemented an ergonomic approach for the support of individuals with upper extremity osteoarthritis or rheumatoid arthritis. RESULTS: A total of 34 articles described interventions that employed ergonomics including task-based or general ergonomics (n = 17), contextualized supports (n = 8), or holistic, lifestyle approaches (n = 9). Only one study focused solely on individuals with osteoarthritis, whereas interventions for individuals with rheumatoid arthritis showed positive outcomes across these categories. Situational learning, building of patient self-efficacy, and development of new habits and routines are vital for carryover and implementation to support performance in daily life. CONCLUSION: There is an opportunity for hand therapists to extend the scope of interventions provided as part of an ergonomic approach to supporting patients. Specifically, therapists can consider use of emerging technologies and telehealth that promote contextualization and follow-up for long-term outcomes.

Prevalence of work-related musculoskeletal symptoms among tea garden workers in Bangladesh: a cross-sectional study.

OBJECTIVES: Occupational health is still in the developmental stage in Bangladesh. There is a lack of focus on agricultural workers. Statistics on musculoskeletal symptoms (MSS) of any occupational group can assist in developing intervention and ergonomics-based prevention. This study aimed to assess work-related MSS among tea garden workers. SETTING: This cross-sectional study was done in one tea garden in Moulvibazar district which has the highest number of gardens in Bangladesh. DESIGN AND PARTICIPANTS: 346 tea garden workers were interviewed using the Nordic Musculoskeletal Questionnaire Extended Version 2. Workers 18-60 years of age and of both sexes were interviewed individually. OUTCOME MEASURES: Prevalence of MSS among the tea garden workers, MSS in different body regions and MSS related informations. Sociodemographic and work-related factor associated with MSS. RESULTS: Among the tea garden workers, 276 were female and 70 were male. The study showed 80.9% had symptoms in the past 12 months while 80.1% and 76.6% had in the past 4 weeks and on the day of the interview, respectively. Symptoms were most commonly reported at the shoulder (78.2%) followed by upper back (56.1%) and lower back (32.5%). Workers engaged with plucking operation were found to be significantly associated with symptoms compared with non-pluckers (p<0.05). Female workers were more likely to display symptoms in the neck (p<0.05) than male workers. Increased work hours were significantly associated with symptoms in the lower back (p<0.05). Overtime was responsible for symptoms in the elbow and hip/buttock (p<0.05). Statistics from relevant studies in India, Malaysia and Thailand were compared with the results of this study. CONCLUSIONS: The prevalence of MSS among tea garden workers was found to be very high, and ergonomic interventions like reduction of weight load, job rotation and small breaks can reduce these symptoms.

Classification of kneeling and squatting in workers wearing protective equipment: development and validation of a rule-based model using wireless triaxial accelerometers.

Several professions in industries, such as petroleum, manufacturing, construction, mining, and forestry require prolonged work tasks in awkward postures, increasing workers' risks for musculoskeletal pain and injury. Therefore, we developed and validated a rule-based model for classifying unilateral and bilateral kneeling and squatting based on 15 individuals wearing personal protective equipment and using three wireless triaxial accelerometers. The model provided both high sensitivity and specificity for classifying kneeling (0.98; 0.98) and squatting (0.96; 0.91). Hence, this model has the potential to contribute to increased knowledge of physical work demands and exposure thresholds in working populations with strict occupational safety regulations. Practitioner summary: Our results indicate that this rule-based model can be applied in a human-factors perspective enabling high-quality quantitative information in the classification of occupational kneeling and squatting, known risk factors for musculoskeletal pain, and sick leave. This study is adapted for working populations wearing personal protective equipment and aimed for long-term measurements in the workplace.

Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data.

Objectives: National Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters. Methods: The observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants. Results: The standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group. Conclusions: The standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.

COVID-19: ¿una oportunidad para la toma de conciencia sobre el cuidado integral del odontólogo? / COVID-19: An opportunity to raise awareness about dentists' holistic wellbeing?

La pandemia de COVID-19 generó en la comunidad odon- tológica argentina un profundo desconcierto e incertidumbre frente a su práctica profesional, su economía y su cuidado. Mediante un cuestionario difundido a través de redes so- ciales en octubre de 2020, se formularon preguntas vinculadas al ejercicio profesional en ese contexto y otras en las que se incluyeron variables referidas a signos de ansiedad, depresión y resiliencia. Los odontólogos presentaron signos de estrés, ansiedad, tensión emocional, dificultad para conciliar el sueño, senti- mientos de culpa y sensación de soledad. Manifestaron casi en su totalidad que su esfuerzo y el cuidado de su persona frente a este nuevo paradigma no son valorados por el sistema de salud y que se evidencia en la escasa retribución que perciben por sus prestaciones. Las conclusiones tienen el mandato del cambio pues los datos arrojados por la encuesta y el sentir manifestado con vehemencia y desolación ponen sobre la mesa la necesidad de iniciar una nueva etapa (AU)

The COVID-19 pandemic created a profound state of be- wilderment and uncertainty among dentists regarding their professional practice, economy and personal care. An online survey posted on social media in October 2020 asked ques- tions about professional practice in this context and other variables such as signs of anxiety, depression and resilience. Dentists reported signs of stress, anxiety, emotional tension, difficulty to get to sleep, and feelings of guilt and loneliness. Most of them felt that the efforts they made to do their job and ensure their personal care in this new paradigm were not valued by the healthcare system, as reflected by the low compensation for their services. From the data obtained through the survey and the feelings of vehemence and grief expressed by respondents, it is concluded there is a need for action and change (AU)

[Medicinal products in the treatment and prevention of occupational diseases of the upper respiratory tract]. / Lekarstvennye sredstva v lechenii i profilaktike professional'nykh zabolevanii verkhnikh dykhatel'nykh putei.

Occupational diseases of the upper respiratory tract (URT) represent a significant section of occupational pathology of the respiratory system, since the mucous membrane of the nasal cavity and paranasal sinuses is the outpost that first comes into contact with inhaled agents (pollutants), including professional aerosols. The pathogenesis of occupational diseases of URT is based on long-term contact of pollutants with cells of the scintillating epithelium and violation of the function of the mucociliary system of URT. Occupational diseases of URT include: chronic catarrhal, subatrophic, atrophic, hypertrophic rhinitis, rhinopharyngolaryngitis; all forms of laryngitis, laryngotracheobronchitis, allergic diseases. Treatment and prevention of these diseases should be comprehensive with the use of personal respiratory protection equipment, mandatory preventive examinations and various local effects (inhalation, instillation, lavage, herbal medicine, etc.).

Prevention of Occupational Heat-Related Illnesses.

High ambient temperatures and strenuous physical activity put workers at risk for a variety of heat-related illnesses and injuries. Through primary prevention, secondary prevention, and treatment, OEM health providers can protect workers from the adverse effects of heat. This statement by the American College of Occupational and Environmental Medicine provides guidance for OEM providers who serve workers and employers in industries where heat exposure occurs.

Acclimatization to diving: a systematic review.

Multiday hyperbaric exposure has been shown to reduce the incidence of decompression sickness (DCS) of compressed-air workers. This effect, termed acclimatization, has been addressed in a number of studies, but no comprehensive review has been published. This systematic review reports the findings of a literature search. PubMed, Ovid Embase, The Cochrane Library and Rubicon Research Repository were searched for studies reporting DCS incidence, venous gas embolism (VGE) or subjective health reports after multiday hyperbaric exposure in man and experimental animals. Twenty-nine studies fulfilled inclusion criteria. Three epidemiological studies reported statistically significant acclimatization to DCS in compressed-air workers after multiday hyperbaric exposure. One experimental study observed less itching after standardized simulated dives. Two human experimental studies reported lower DCS incidence after multiday immersed diving. Acclimatization to DCS has been observed in six animal species. Multiday diving had less consistent effect on VGE after hyperbaric exposure in man. Four studies observed acclimatization while no statistically significant acclimatization was reported in the remaining eight studies. A questionnaire study did not report any change in self-perceived health after multiday diving. This systematic review has not identified any study suggesting a sensitizing effect of multiday diving, and there is a lack of data supporting benefit of a day off diving after a certain number of consecutive diving days. The results suggest that multiday hyperbaric exposure probably will have an acclimatizing effect and protects from DCS. The mechanisms causing acclimatization, extent of protection and optimal procedure for acclimatization has been insufficiently investigated.

Protective effects of vitamins/antioxidants on occupational noise-induced hearing loss: A systematic review.

OBJECTIVES: Occupational noise-induced hearing loss (NIHL) due to industrial, military, and other job -related noise exposure can cause harmful health issues to occupied workers, but may also be potentially preventable. Vitamins/antioxidant have been studied as therapeutic strategies to prevent and/or delay the risks of human diseases as well as NIHL .So, this study was conducted to systematically review the protective effects of vitamins/antioxidants on occupational NIHL. METHODS: Online databases including PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, and Google Scholar were systematically searched up to 12 January 2021. Based on 6336 potentially relevant records identified through the initial search in the databases, 12 full-text publications were retrieved, one of which can be viewed as two separate trials, because it has studied the effects of two different antioxidants (ginseng and NAC) on NIHL, separately. RESULTS: A review of the studies shows that vitamin B12, folic acid, and N-acetylcysteine (NAC) have a considerable protective effect on NIHL. However, these protective effects are not yet specified in different frequencies. The findings regarding the protective effects of other antioxidants are inconsistent in this field. CONCLUSION: Vitamin B12, folic acid, and NAC may have a protective effect as an antioxidant on reducing occupational hearing loss. For a conclusive evidence of vitamin/antioxidant protective therapies, future studies with precise criteria for noise exposure and similar outcome parameters are required.

COVID 19 - Possible interrelations with respiratory comorbidities caused by occupational exposure to various hazardous bioaerosols. Part II. Clinical course, diagnostics, treatment and prevention.

INTRODUCTION AND OBJECTIVE: The course of COVID-19 caused by the SARS-CoV-2 may be aggravated by bioaerosols containing other viruses, bacteria, and fungi, occurring mainly in the occupational environment. Hence, the diagnostics and treatment of COVID-19 should address such a possibility in the anamnesis, treatment and final recommendations for avoiding of adverse exposure. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: As SARS-CoV-2 attacks primarily the respiratory system and the severe manifestation of COVID-19 is interstitial pneumonia, diagnostics should include the following clinical and laboratory examinations: chest X-ray; high resolution computed tomography (HRCT); pulmonary function tests; arterial-blood gas test; genetic tests for the presence of SARS-CoV-2, in the future with the use of highly specific and sensitive nano-based biosensors; tests for the presence of specific immunity against the antigens of microorganisms causing other infectious or allergic pulmonary diseases (in the case of anamnestic indications). Because an universally accepted treatment for COVID-19 does not exist, the hitherto prescribed antiviral and immune-modulating drugs should be used be with caution. In many cases, a better alternative could be a safe supportive therapy, such as supplementation of the diet with probiotics, prebiotics, vitamins and microelements. SUMMARY: The most important preventive measures against COVID-19 should include: vaccination; the use of filter or surgical masks; disinfection and sterilization; maintaining of well-functioning ventilation and air conditioning systems; reduction of the community air pollution which has been identified as an important factor increasing the COVID-19 severity. In the choice of preventive measures, the above should be considered for their potential efficacy against other bioaerosols as potential disease-aggravating agents.

[Caring for the caregiver: The emotional impact of the coronavirus epidemic on nurses and other health professionals]. / Cuidar al que cuida: el impacto emocional de la epidemia de coronavirus en las enfermeras y otros profesionales de la salud.

The health crisis caused by the COVID-19 virus pandemic has once again highlighted the role of health professionals as a key element for their containment, who suffer from high tension marked by healthcare pressure and the lack of means of protection. Given this tension, it is relevant to analyze the emotional impact on health professionals of the coronavirus pandemic and the coping resources to reduce or mitigate this impact. Stress, sleep disorders and depressive symptoms stand out. Some strategies are recommended that have been used by professionals who have previously been under pressure from COVID-19 and have been helpful to them. Finally, some recommendations whose efficacy is known for managing emotional impact are pointed out.

Mindfulness, Posttraumatic Stress Symptoms, and Posttraumatic Growth in Aid Workers: The Role of Self-Acceptance and Rumination.

ABSTRACT: Objective: The risk for aid workers to develop posttraumatic mental problems highlights the importance of reducing the harm of posttraumatic stress symptoms (PTSS) and promoting the benefits of posttraumatic growth (PTG). This study examined the negative relationship between mindfulness and PTSS, and the positive relationship between mindfulness and PTG, and further explored the mediating roles of self-acceptance, intrusive rumination, and deliberate rumination. Methods: Aid workers from the Red Cross Organization (N = 298) were recruited in the study. They completed a series of questionnaires assessing mindfulness, self-acceptance, rumination, posttraumatic stress disorder (PTSD), and PTG. Results: Results showed that mindfulness was significantly and negatively associated with PTSD through positively predicting self-acceptance and negatively predicting intrusive rumination. Mindfulness was significantly and positively associated with PTG, although the mediating effect did not exist because the path between self-acceptance and deliberate rumination was impassable. Conclusion: The mechanisms between mindfulness, PTSD, and PTG were further explored. Limitations and implications for trauma intervention and future research were discussed.

On-site Clinical Care for Professional Dance Companies.

Thirty years ago the introduction of on-site health care for professional dance companies was a novel concept and dance medicine clinicians often had limited on-site hours, restricted treatment space, and small budgets. Companies are now developing fully staffed on-site clinics and backstage care that provide a multidisciplinary approach to dancer health and wellness. On-site dance medicine programs focus on holistic dancer health and preventive care rather than just triage and rehabilitation. Best practice recommendations for care of professional dancer patients allow for streamlined patient care within a network of medical professionals who understand the demands of a professional dance career.

COVID-19 pandemic: report on the use of auriculotherapy to optimize emergency workers' health.

OBJECTIVE: To report the use of auriculotherapy to optimize emergency workers' health during the COVID-19 pandemic. METHODS: Experience report of auriculotherapy application in 48 workers of a mobile emergency care service center located in a city in the Northeast of Brazil. RESULTS: Six auriculotherapy sessions were held, each lasting eight minutes, based on specific protocols in the area and Chinese energy physiology. The aim of the practice was to contribute to the improvement of physical (pain) and emotional (anxiety, stress) symptoms, and the promotion of greater health and willingness to work. In addition, the experimentation of this practice was thought of as a pilot for the creation of a care service for workers. FINAL CONSIDERATIONS: In the report of auriculotherapy, the description of its application and its positive and negative points in relation to professionals working in the pandemic scenario were considered and its continuity was requested.