Nonpharmacological pain management approaches among U.S. construction workers: A cross-sectional pilot study.

BACKGROUND: U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers. METHODS: A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled. RESULTS: Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches. CONCLUSION: This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

Modelling for design and evaluation of industrial exoskeletons: A systematic review.

Industrial exoskeletons are developed to relieve workers' physical demands in the workplace and to alleviate ergonomic issues associated with work-related musculoskeletal disorders. As a safe and economical alternative to empirical/experimental methods, modelling is considered as a powerful tool for design and evaluation of industrial exoskeletons. This systematic review aims to provide a comprehensive understanding of the current literature on the design and evaluation of industrial exoskeletons through modelling. A systematic study was conducted by general keyword searches of five electronic databases over the last two decades (2003-2022). Out of the 701 records initially retrieved, 33 eligible articles were included and analyzed in the final review, presenting a variety of model inputs, model development, and model outputs used in the modelling. This systematic review study revealed that existing modelling methods can evaluate the biomechanical and physiological effects of industrial exoskeletons and provide some design parameters. However, the modelling method is currently unable to cover some of the main evaluation metrics supported by experimental assessments, such as task performance, user experience/discomfort, change in metabolic costs etc. Standard guidelines for model construction and implementation, as well as validation of human-exoskeleton interactions, remain to be established.

Occupational Traffic Accidents among Teachers in Spain.

Occupational traffic accidents are a leading cause of injuries or deaths among workers. Teachers in Spain are especially concerned about the problem of commuting due to their particular labor conditions. Multiple work-related factors are associated with the risk and severity of occupational traffic-related motor vehicle crashes. The objective of this research is to analyze the influence of the variables associated with the severity of occupational traffic accidents among teachers in Spain. A logistic regression model was used for the current study. The odds ratio (OR) and confidence interval (CI) were calculated for the injured worker on a sample of 20,190 occupational traffic accidents suffered by teachers. The results showed that women, Spanish nationality, younger than 55 years, and those driving a car were more likely to suffer a light crash. In contrast, men, foreign nationalities, older than 55 years, and those riding a motorbike were more likely to suffer a serious crash. Based on these findings, motor vehicle safety training could be designed and adapted to the riskiest profiles. Additionally, effective mobility plans for commuting could help reduce work-related traffic accidents.

Analysis of Falls from Height Variables in Occupational Accidents.

Fall-from-height accidents are linked to severe and fatal consequences for impacted workers. A better understanding of the related variables is necessary to improve worker safety. This study analyzed all fall-from-height occupational accidents recorded in Spain from 2009 to 2019, selected significant variables, and evaluated the influence concerning the seriousness of the falls from height. Based on a total of 290,583 fall-from-height accidents, the study shows that a male inexperienced worker in a small company working in a non-habitual workplace is more likely to suffer fatal consequences once the accident happens. An improved knowledge of fall-from-height accidents will improve safety conditions. The workers should be trained and informed about their specific risk depending on the variables analyzed. Safety training should consider more risky profiles. Results from the current study can help identify suitable fall prevention and risk mitigation actions in safety programs for companies.

Epidemiology of fall and its socioeconomic risk factors in community-dwelling Korean elderly.

Although falls in older people are a major public health problem globally, to date there are scarce reports on socioeconomic risk factors for falls. The aim of the present study was to investigate the epidemiology of fall, its associated socioeconomic risk factors and relative importance among community-dwelling Korean elderly. Secondary analysis of national survey data with 31,684 community-dwelling Korean elderly was performed. Eleven socioeconomic factors (age, gender, household type, marital status, education level, current occupation, past occupation, income, wealth, number of children, and relationship satisfaction) were selected for analysing their associations with the epidemiology of fall through complex sample analysis and logistic regressions. Results showed that 15.9%~25.1% of community-dwelling Korean elderly experienced fall yearly. The groups with significantly higher fall risks were identified as older aged, being female, not married or widowed, less educated, unemployed, and having lower relationship satisfaction. Gender (adjusted odds ratio-AOR = 1.548) and relationship satisfaction (AOR = 1.276) were the utmost important fall risk factors, indicating being older female with lower relationship satisfaction were the foremost socioeconomic characteristics for risk of falling. These findings could contribute to better understanding of the socioeconomic fall risk profiles among Korean elderly and effective strategies for fall prevention.

Emergency Evacuation Plan for Hazardous Chemicals Leakage Accidents Using GIS-based Risk Analysis Techniques in South Korea.

Despite improvements in chemical safety management systems, incidents involving the release of hazardous chemicals continue to happen. In some cases, they result in the evacuation of residents. For hazardous chemical release accidents, an evacuation plan needs to be selective enough to consider both the indoor and outdoor concentrations of nearby buildings and the time in which the maximum allowable concentration may occur. In this study, a real-time risk analysis tool was developed based on the geographic information system (GIS) in order to establish the emergency response and risk communication plan for effectively assisting decision-making personnel. A selective evacuation plan was also established by a proposed assessment module considering the indoor/outdoor pollution concentration of buildings and the release duration time of chlorine gas leakage. The GIS-based simulated modules were performed based on eleven buildings of Ulsan city, located near an industrial cluster and home to a high population density. As a result of the simulated real-time risk assessment, only four buildings were affected by chlorine gas concentration according to wind direction and diffusion time. In addition, it was considered effective to establish an indoor/outdoor evacuation plan as opposed to an outdoor evacuation plan which is outside the range of the damage. Subsequently, an emergency evacuation plan was established with the concentration of a hazardous chemical according to the decision-making matrix. This study can enlighten the real-time emergency risk assessment based on GIS while effectively supporting the emergency action plans in response to the release of hazardous chemicals in clustered plants and the community.

Awareness and perceptions of ergonomic programs between workers and managers surveyed in the construction industry.

BACKGROUND: Work-related musculoskeletal injuries and disorders (WMSDs) are among the most frequently reported causes of lost or restricted work time in the construction industry. Ergonomics is still a relatively new theme for the construction industry. Understanding of the workers' and managers' knowledge and perception of ergonomic issues in construction can play a critical role to develop and implement effective ergonomic programs and policies. OBJECTIVE: To study the similarities and differences of the workers' and managers' knowledge and perceptions of ergonomics matters in the construction industry. METHODS: A survey questionnaire was developed and distributed to both workers and management personnel employed by sixteen different construction contractors performing various types of construction work. The final questionnaire comprised of a total of forty questions and consisted of four major sections: background, safety and ergonomic programs, injuries and illnesses, and work conditions. RESULTS: Eighty-eight workers and managers completed the survey questionnaire. Nearly all of their employer had a written safety program, while only one third had an ergonomics program. Ergonomics was perceived as relatively less important compared to the safety issues. Managers were more likely to think that management encourages feedback from site employees than were workers. Managers appeared to be more likely to know that their companies have an ergonomic training program or policy than were workers. Workers were more likely to consider to purchase or select the ergonomic hand tools than were managers. Workers and managers alike reported having slight regard for the potential occurrence of a work-related musculoskeletal disorder. CONCLUSIONS: While the construction industry has done an admirable job developing safety programs, it has done far less to develop comprehensive ergonomic programs and policies that would help provide education and guidance to its workers and managers in the industry.

Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports.

This study analyzed the Construction FACE Database (CFD), a quantitative database developed from reports of the Fatality Assessment and Control Evaluation (FACE) program conducted by the National Institute for Occupational Safety and Health (NIOSH). The CFD contains detailed data on 768 fatalities in the construction industry reported by NIOSH and individual states from 1982 through June 30, 2015. The results show that falls accounted for 42% (325) of the 768 fatalities included in the CFD. Personal fall arrest systems (PFAS) were not available to more than half of the fall decedents (54%); nearly one in four fall decedents (23%) had access to PFAS, but were not using it at the time of the fall. Lack of access to PFAS was particularly high among residential building contractors as well as roofing, siding, and sheet metal industry sectors (∼70%). Although the findings may not represent the entire construction industry today, they do provide strong evidence in favor of fall protection requirements by the Occupational Safety and Health Administration (OSHA). In addition to stronger enforcement, educating employers and workers about the importance and effectiveness of fall protection is crucial for compliance and fall prevention.

Work-related musculoskeletal disorders among construction workers in the United States from 1992 to 2014.

OBJECTIVES: Examine trends and patterns of work-related musculoskeletal disorders (WMSDs) among construction workers in the USA, with an emphasis on older workers. METHODS: WMSDs were identified from the 1992-2014 Survey of Occupational Injuries and Illnesses (SOII), and employment was estimated from the Current Population Survey (CPS). Risk of WMSDs was measured by number of WMSDs per 10 000 full-time equivalent workers and stratified by major demographic and employment subgroups. Time series analysis was performed to examine the trend of WMSDs in construction. RESULTS: The number of WMSDs significantly dropped in the US construction industry, following the overall injury trends. However, the rate of WMSDs in construction remained higher than in all industries combined; the median days away from work increased from 8 days in 1992 to 13 days in 2014, and the proportion of WMSDs for construction workers aged 55 to 64 years almost doubled. By occupation, construction labourers had the largest number of WMSD cases, while helpers, heating and air-conditioning mechanics, cement masons and sheet metal workers had the highest rates of WMSDs. The major cause of WMSDs in construction was overexertion, and back injuries accounted for more than 40% of WMSDs among construction workers. The estimated wage loss for private wage-and-salary construction workers was $46 million in 2014. CONCLUSIONS: Construction workers continue to face a higher risk of WMSDs. Ergonomic solutions that reduce overexertion-the primary exposure for WMSDs-should be adopted extensively at construction sites, particularly for workers with a higher risk of WMSDs.

Exergame technology and interactive interventions for elderly fall prevention: A systematic literature review.

Training balance and promoting physical activities in the elderly can contribute to fall-prevention. Due to the low adherence of conventional physical therapy, fall interventions through exergame technologies are emerging. The purpose of this review study is to synthesize the available research reported on exergame technology and interactive interventions for fall prevention in the older population. Twenty-five relevant papers retrieved from five major databases were critically reviewed and analyzed. Results showed that the most common exergaming device for fall intervention was Nintendo Wii, followed by Xbox Kinect. Even though the exergame intervention protocols and outcome measures for assessing intervention effectiveness varied, the accumulated evidences revealed that exergame interventions improved physical or cognitive functions in the elderly. However, it remains inconclusive whether or not the exergame-based intervention for the elderly fall prevention is superior to conventional physical therapy and the effect mechanism of the exergaming on elderly's balance ability is still unclear.

Aging Workers and Trade-Related Injuries in the US Construction Industry.

The study was designed to identify any trends of injury type as it relates to the age and trade of construction workers. The participants for this study included any individual who, while working on a heavy and highway construction project in the Midwestern United States, sustained an injury during the specified time frame of when the data were collected. During this period, 143 injury reports were collected. The four trade/occupation groups with the highest injury rates were laborers, carpenters, iron workers, and operators. Data pertaining to injuries sustained by body part in each age group showed that younger workers generally suffered from finger/hand/wrist injuries due to cuts/lacerations and contusion, whereas older workers had increased sprains/strains injuries to the ankle/foot/toes, knees/lower legs, and multiple body parts caused by falls from a higher level or overexertion. Understanding these trade-related tasks can help present a more accurate depiction of the incident and identify trends and intervention methods to meet the needs of the aging workforce in the industry.

Work-related musculoskeletal risks associated with nurses and nursing assistants handling overweight and obese patients: A literature review.

BACKGROUND: Nurses and nursing assistants are susceptible to work-related musculoskeletal disorders and injuries (WMSDs) due to the increase in overweight and obese patients they are handling on a daily basis. OBJECTIVE: This study aimed to review work-related musculoskeletal hazards and risks associated with handling overweight and obese patients, and summarize the recommended interventions to mitigate musculoskeletal concerns among nurses and nursing assistants. METHODS: Approximately 350 publications were initially screened and 22 refereed articles were used to synthesize for this study on the bases of inclusion/exclusion relevance and strength of evidence on overweight or obese patient handling. RESULTS: Evidence suggested that the work-related musculoskeletal risks among nurses and nursing assistants included sprains/strains, low back pain, wrist, knee and shoulder injuries. The findings indicated that the WMSD risks increased when nurses and nursing assistants were manually moving or lifting patients, especially when the patients were overweight or obese. The recommended solutions included the lifting/transfer equipment and devices, ergonomic assessments and controls, no-lift policies, and training and education. CONCLUSION: To alleviate the risk of musculoskeletal disorders and injuries among nurses and nursing assistants handling overweight or obese patients, additional research and development into what safe patient handling interventions suit this growing population needs to be addressed.

Occupational safety issues in residential construction surveyed in Wisconsin, United States.

Residential construction is a high-risk industry in the U.S. due to the exposure to work-related safety hazards and fall injuries. This study aimed to examine the safety training and safe work practices of construction workers within the small residential construction industry. In order to achieve the study objectives, a survey was designed and sent to approximately 200 Wisconsin based residential construction contractors. About one third of the respondents stated that they did not have any form of safety programs. The study indicated that the most common types of work-related injuries in residential construction were slips/trips/falls and cuts/lacerations. The survey findings also suggested that the residential construction contractors needed to increase the utilization of fall protection safety equipment. Further education and subject matter expert training could provide benefits to improve occupational safety and health of the small business workforce in the residential construction industry.

Fatal falls in the U.S. residential construction industry.

BACKGROUND: Falls from heights remain the most common cause of workplace fatalities among residential construction workers in the United States. METHODS: This paper examines patterns and trends of fall fatalities in U.S. residential construction between 2003 and 2010 by analyzing two large national datasets. RESULTS: Almost half of the fatalities in residential construction were from falls. In the residential roofing industry, 80% of fatalities were from falls. In addition, about one-third of fatal falls in residential construction were among self-employed workers. Workers who were older than 55 years, were Hispanic foreign-born, or employed in small establishments (1-10 employees) also had higher proportions of fatal falls in residential construction compared to those in nonresidential construction. CONCLUSIONS: The findings suggest that fall safety within the residential construction industry lags behind commercial construction and industrial settings. Fall prevention in residential construction should be enhanced to better protect construction workers in this sector.

Fatal falls from roofs among U.S. construction workers.

INTRODUCTION: This study examined trends and patterns of fatal falls from roofs in the U.S. construction industry over an 18-year period (1992-2009), with detailed analysis for 2003-2009. METHODS: Two large national datasets were analyzed: the U.S. Bureau of Labor Statistics' Census of Fatal Occupational Injuries and the Current Population Survey. RESULTS: Roof fatalities accounted for one-third of fatal falls in construction in 1992-2009. A disproportionately high percentage (67%) of deaths from roof falls occurred in small construction establishments (1-10 employees). Roofers, ironworkers, workers employed with roofing contractors, or working at residential construction sites, had a higher risk of roof fatalities. A higher rate of roof fatalities was also found among younger (<20years) and older (>44years) workers, Hispanics, and immigrant workers. CONCLUSION: Roof fatalities corresponded with economic cycles and differed among construction subgroups and worksites. IMPACT ON INDUSTRY: Prevention strategies should target high-risk worker groups and small establishments.

A study of trade-specific occupational ergonomics considerations in the U.S. construction industry.

OBJECTIVE: The aim of this survey study was to identify trade-specific ergonomic issues, and discuss practical solutions to reduce work-related musculoskeletal disorders (WMSDs) and injuries in the construction industry. METHOD: Thirty-two construction firms in the Midwestern United States completed the final survey questionnaire. Twelve different construction skilled trades participated included: general contractor, road, heavy and highway, concrete, electrical, carpentry, landscaping, plumbing, roofing, steel erection, street lighting/traffic signal, and utility construction. Total workforce of the participating companies numbered 11,118 employees. RESULT: More than 90% of the participants in the survey had a written safety program; however, the majority of the firms did not have a trade-specific ergonomic intervention. The survey revealed that construction constructors perceived safety (worker well-being) as a high priority in their company. This study suggested that construction skilled-trade jobs the construction worker to employ trade-specific hand tools and working body positions that may contribute to different types of WMSD risks, body parts injured, and injury sources. Possible practical construction trade-specific ergonomic solutions might be considered includinge: selection of ergonomic hand tools, reduction of weight of construction materials, and promotion of wellness exercises. CONCLUSION: This paper may imply that need for more trade-specific ergonomics program elements to help alleviate the work-related musculoskeletal problems in the construction field.

Study of musculoskeletal risks of the office-based surgeries.

Due to the cost and time benefits associated with patients and physicians, outpatient surgeries continue to become more and more popular over time. With the increase in the number of office-based surgical procedures, the prevalence of work-related musculoskeletal disorders (WMSDs) associated with office-based surgeries has been reported. The purpose of this pilot study is to ergonomically evaluate the risk of work-related musculoskeletal disorders of physicians/surgeons performing office-based surgery (OBS). Ergonomic assessment tools included Questionnaire, the BodyMap and the Rapid Upper Limb Assessment for measuring potential ergonomic concerns. The findings have shown that the ergonomic issues of greatest concerns were the discomforts in the neck, shoulders, arms/wrists, and back. Some additional comments were provided by the participants regarding the duration of discomfort or clarification on the frequency of their body discomfort. This study suggests that there is a considerable risk of musculoskeletal injuries of physicians/surgeons performing the OBS tasks. By properly using the ergonomic assessment techniques, valuable information on ergonomic OBS workplace design and selection could assist in the early interventions of WMSD prevention.

Ergonomic assessment of musculoskeletal discomfort of iron workers in highway construction.

OBJECTIVE: The purpose of this study is to ergonomically evaluate the risk of work-related musculoskeletal injuries of the iron workers in highway construction. Two specific job duties are analyzed: (1) tying the vertical, pier support systems, and (2) tying rebar on a horizontal bridge deck. PARTICIPANTS: Eleven right-handed male subjects participated in this study. The eleven rodworkers (5 pier tiers and 6 deck tiers) were recruited from a heavy and highway/bridge building project. METHODS: The ergonomic assessment tools included the BodyMap instrument for measuring potential ergonomic concerns, and a handgrip dynamometer for measuring the maximum voluntary contraction (MVC) and applied grip force of the rebar-tying tasks. RESULTS: This study suggests that there is a significant risk for injury and musculoskeletal disorders among iron workers performing these designated tasks. Findings also show that the ergonomic issues of greatest concern are the discomforts in the lower back and right wrist/hand of the rodworkers. CONCLUSIONS: The ergonomic assessment techniques could assist the early identification of work-related musculoskeletal concerns and help prioritize jobs for intervention in the construction field.

Safety and ergonomic considerations for an aging workforce in the US construction industry.

The US construction workforce is aging as millions of baby boomers move toward retirement age. Older workers make a substantial contribution to construction in terms of skills and experience. However, construction is still one of the most physically demanding occupations, hence the health implications for older workers. Descriptions of injuries, illnesses and fatalities among older workers in the US construction industry from recent literature are presented along with the practical health and safety interventions that have been proposed including: ergonomic interventions, wellness programs, worksite housekeeping, training, and safety climate. Understanding the risks and hazards in specific industries could help identify training and intervention requirements to meet the challenges facing aging workers in these occupational groups.

Comparison of risk factors for falls from height between commercial and residential roofers.

INTRODUCTION: The purpose of this investigation was to compare commercial roofers and residential roofers in terms of their behaviors, beliefs, working conditions, and attitudes toward the use of fall protection devices, which could lead to fall accidents. METHODS: A cross-sectional sample of 252 roofers participated in the survey in the Midwest (Wisconsin, Illinois, Michigan, Indiana, and Iowa). RESULTS: Residential roofers were more likely to fall (prevalence ratio = 2.28, 95% CI = 1.58, 3.29) [corrected] than commercial roofers. Race/ethnicity, company size, work type, existence [corrected] of fall protection programs, enforcement of fall protection device use, actual use of fall protection devices, years of experience as a roofer, and perceived level of safety at roofing sites were [corrected] significantly associated with fall accidents. IMPACT ON INDUSTRY: This study adds insight into fall accidents from roofs in the construction industry and provides industry-specific cautions against fall accidents that can be reflected in regulatory agency implementation.