Investigating the effect of education based on PRECEDE-PROCEED model on the preventive behaviors of musculoskeletal disorders in a group of nurses.

Background: One of the most important occupational complications that could occur in nurses is musculoskeletal disorders. In this study, we designed an educational intervention based on the PRECEDE-PROCEED model to investigate its effects on a group of nurses on preventive behaviors of musculoskeletal disorders. Methods: A total of 120 nurses working in Izeh City, Iran, participated in this semi-experimental study. The sampling was performed through a convenient sampling method, and the participants were randomly assigned to the experimental and control groups (60 participants for each group). Both groups filled out a questionnaire based on the PRECEDE-PROCEED model before and 2 months after the educational program as part of the data collection process. The data were examined using a paired t-test, an independent t-test, and a chi-square test after being entered into SPSS version 24. Results: According to the findings, prior to the intervention, there was no difference between the two groups in terms of their knowledge (p = 0.221), attitude (p = 0.136), enabling factors (p = 0.325), reinforcing factors (p = 0.548), self-efficacy (0.421), and behavior (0.257) levels. However, following the intervention, a substantial rise was witnessed in the experimental group in each of the mentioned variables (p = 0.001). Conclusion: In the current study, education based on the PRECEDE-PROCEED model led to the improvement of knowledge, attitude, enabling and reinforcing factors, self-efficacy, and finally preventive behaviors with musculoskeletal disorders in the participants. Considering the importance of the role of health education in promoting behaviors related to musculoskeletal disorders in nurses and the importance of observing related behaviors in preventing long-term complications, the necessity of education in a wider dimension and with different tools is felt more and more in society. Therefore, longer interventions with this aim could be carried out on nurses and other healthcare personnel.

Determining the effect of environmental factors, work postures and mental workload on musculoskeletal disorders in rescue workers and accidents of one of the water and sewage companies in Iran.

BACKGROUND: Musculoskeletal disorders are one of the most important problems faced by ergonomists today. OBJECTIVE: This study was conducted with the aim of investigating the effect of weather conditions, working conditions and mental workload on musculoskeletal disorders of rescuers and water and sewage company accidents in hot and cold seasons. METHODS: The present study was a longitudinal study that was performed on all employees of rescue and disaster teams of Shiraz Water and Sewerage Company in Iran (184 people) by census. Demographic and Nordic questionnaires, NASA Load Index (NASA-TLX), work environment assessment with temperature screening checklist and workplace ergonomic risk factor (WERA) assessment method were performed by the researcher. The collected data were analyzed using SPSS version 23 software and parametric and non-parametric statistical tests. RESULTS: The results showed that the highest and lowest prevalence of musculoskeletal disorders related to knee and back in winter and thigh in summer with prevalence of 57.1, 55.4 and 6% . The comparison of exposure to heat stress factors in summer and winter seasons showed that the temperature factors and work clothes of the workers in both seasons are in worse conditions than other factors (P <  0968). The results of the mental workload of people in two seasons showed that the highest and lowest mental workload is related to physical changes in the winter season and frustration in the summer season, and this relationship was significant (P <  0.001). Using multiple logistic regression model, the potential risk factors for musculoskeletal injuries including age, height, BMI, level of education and work experience in both hot and cold seasons were compared. The results showed that in summer, work experience (OR = 1.16 (1.06-1.28.)) and height (OR = 1.03(0.98-1.08) had a direct effect on the prevalence of pain and discomfort arranged in the back areas. One year of increase in work experience significantly increases the chance of a disorder in the back by 16% and a one centimeter increase in height increases the chance of a disorder in the lumbar region by 3%, although this relationship is significant. CONCLUSION: It is recommended that suitable solutions such as using appropriate and up-to-date mechanical tools, reducing activity time, increasing rest time, increasing the number of personnel in order to reduce mental workload, using work clothes suitable for the season and type of work, and ergonomics training for workers are on the agenda of company officials. Water and sewage should be placed.

The spatiotemporal gait parameters among people with visual impairment: A literature review study.

Gait is an individual's walking pattern, and it is a significant part of daily living activities. Quantitative gait assessments, like spatiotemporal parameters (STPs), are related to the functional conditions to provide useful information. This study reviewed the comprehensive differences in spatiotemporal gait variability measures between visually impaired people and the sighted. The search strategy was performed in three databases (PubMed/MEDLINE, Web of Science, and Scopus) from the start date to October 2022, and the utilized keywords for this search are related to gait and blindness. This review considered only those studies that evaluated gait parameters in people with visual impairment and blind people without any limitations in age and gender. In this review, studies without a control group (sighted people) were excluded. The Newcastle-Ottawa Scale (NOS) was applied for critical appraisal. Six full manuscripts were included. The sample size ranged from 19 to 91. The mean modified NOS critical appraisal scores for cross-sectional studies were 6.0. In these studies, among nine STPs: stride length, walking speed, stance and swing phase, step width, cadence, step length, double support, and single support, at least five and at most seven factors were examined. The gait pattern of blind and low-vision people is characterized by a slower walking speed, shorter stride length, increased step width, decreased cadence, prolonged duration of double support, and reduced single support compared to the controls.

Knee Extension Exercise Effects on Physiological and Psychophysical Performance: Normal Weight Versus Obese Office Workers.

BACKGROUND: Knee extension exercise is useful and practical for obese and overweight people as this form of exercise is effective in minimizing body weight loading on joints and improving the body's physiological function. This study aimed to compare the physiological and psychophysical parameters of office workers while computer-based working in an active workstation equipped with an active footrest (AFR) prototype with a mechanism for performing knee extension exercises in a sitting position, and also to compare the physiological and psychophysical parameters among normal-weight and obese office workers. METHODS: In this quasi-experimental study, the physiological parameters of heart rate (HR) and energy expenditure (EE) (measured with the Fitbit Charge HR smartwatch) were measured in two cross-over random sessions for 32 office workers (16 normal-weight and 16 obese) aged 28 to 50 years (M = 42.72, standard deviation [SD] = 4.37) while performing office tasks in sitting and active workstations (equipped with AFR). Perceived physical exertion, comfort, fatigue, and liking were also measured by rating the participants. FINDINGS: Short-term activity of the participants with AFR performing computer tasks significantly improved physiological and psychophysical parameters compared with the participants in sitting workstations. However, there was no significant difference in the effect of AFR on physiological and psychophysical parameters between normal-weight and obese participants. CONCLUSIONS/APPLICATION TO PRACTICE: Given the significant increase in EE and HR resulting from exercise with AFR compared with the conventional workstation, the use of AFR can help office workers achieve the minimum standard of physical activity at their workplace.

Investigating the short-term effects of using full-body hospital personal protective equipment and changes in physical workload intensity on human physiological and cognitive performance.

The present study investigated the short-term effects of using Personal Protective Equipment (PPE) and physical workload intensity on human physiological and cognitive performance among 21 males and 19 females. PPE1 consisted of a medical coverall and surgical mask, while PPE2 consisted of impermeable full-body coverall, shoe covers, latex gloves, N95 mask, and face shield. Objective assessments were heart rate, energy expenditure, core body temperature, clothing microclimate temperature and humidity, and cognitive performance were the continuous performance test and N-Back test. Subjective assessments included thermal sensation, perceived fatigue/skin wetness/clothing moisture. Using PPE2 and increased workload intensity significantly increased the values of all physiological parameters and the subjective ratings of fatigue, thermal sensation, skin wetness, and clothing moisture. Moreover, the participants' cognitive performance was not affected by the type of PPE.Practitioner summary: Healthcare workers are at the highest risk in the fight against pandemics. Therefore, these people are required to use personal protective equipment. Using this equipment may have difficulties. The results show physiological strain and higher subjective ratings associated with using full-body hospital PPE and increased physical workload.

Effect of a Developed Nursing Stretch Break Application on Work-Related Musculoskeletal Complications and Fatigue among Nurses: An Interventional Study.

Objective: The present study aimed to develop Nursing Stretch Break (NSB) application to relieve work-related musculoskeletal complications and fatigue among hospital nurses. Methods: This interventional study was conducted among 71 nurses (15 men and 56 women with a mean age of 33.32 ± 6.42) employed in Shiraz governmental hospitals, Southwest Iran, for four months. In this study, NSB was developed; it includes eight main menus for the user, including (1) Registration, (2) Stretches, (3) User panel, (4) Questions from the researcher, (5) About us, (6) Contact us, (7) Reports, and (8) Answers to questions. Data were collected pre and post-intervention via the Persian version of the Nordic Musculoskeletal Questionnaire (P-NMQ), the Persian version of the Multidimensional Assessment of Fatigue (P-MAF) Scale, the Persian version of the Numeric Rating Scale (P-NRS), and the Persian version of the Usefulness, Satisfaction, and Ease of use (P-USE) questionnaire. Results: NSB application usability testing showed that the mean scores of P-USE subscales were high. The prevalence of work-related musculoskeletal symptoms (WMSs) in the last 7 days in nurses' body parts, except the elbows and knees, was significantly lower after the intervention than before. In addition, the intensity of work-related musculoskeletal pain/discomfort in all body parts, except the knees, was significant relief after the intervention compared to before. The results demonstrated that the difference in the mean score of the total fatigue and its subscales, except "degree of interference with activities of daily living," was significant after the intervention compared to before. Conclusions: NSB could be a low-cost and feasible ergonomic solution to improve the nurses' musculoskeletal health.

A Mixed-Methods Investigation of Occupational Health Specialists' Knowledge and Application of Pen-and-Paper Observational Methods for Ergonomics Assessment.

OCCUPATIONAL APPLICATIONSErgonomic risk assessment is a key step in managing work-related musculoskeletal disorders. Diverse assessment methods exist, and errors may occur if inappropriate methods are selected. Understanding the level of knowledge, how to use methods, and exploring factors affecting erroneous usage of these methods, can provide useful information for health and safety regulatory authorities and decision-makers to identify problems and determine an action plan to eliminate them. We found that Iranian occupational health specialists have little knowledge about the types of pen-and-paper observational methods (OMs), and most of them use a limited number of these methods. Content analysis of interviews identified three main categories of influential factors and 12 subcategories. The main categories were educational, individual, and organizational factors. These results suggest the need for more effort to ensure that practitioners possess better knowledge and skills in the selection and application of pen-and-paper OMs.

Background Ergonomic risk assessment is a key step in managing ergonomics in the workplace. Errors in selecting risk assessment methods may occur during risk assessment and could invalidate the reliability of the results obtained.Purpose The aims of the present study were to investigate Iranian occupational health specialists' knowledge and application of pen-and-paper observational methods (OMs) for ergonomics assessment and to determine their influential factors.Methods We used a mixed-method design in two phases, combining quantitative and qualitative approaches. Quantitative data were collected from 237 occupational health specialists who were included in the study through purposive sampling of experts. In the qualitative phase, in-depth semi-structured interviews were conducted with participants from the first phase, and the factors associated with the selection and application of the pen-and-paper OMs were examined over a 6-month period.Results Participants were familiar with 13 out of 34 methods studied, and they had performed risk assessments with only nine of them. The most frequently used methods were RULA (95.4%), REBA (84.8%), QEC (65.4%), and ROSA (54.9%). Content analysis of interviews identified three main categories of influential factors and 12 subcategories. The main categories included educational, individual, and organizational factors.Conclusion Iranian occupational health specialists were found to have relatively limited knowledge about pen-and-paper OMs, and most of them use a limited number of these methods. These results suggest the need for more effort to ensure that practitioners possess better knowledge and skills in the selection and application of these methods. Creating stricter regulations regarding the qualifications of practitioners, modifying academic curriculum content, continuously monitoring the performance of practitioners, and holding retraining workshops in a purposeful manner could help minimize errors in selecting and applying pen-and-paper OMs.

Developing a Decision Aid Tool for selecting pen-paper observational ergonomics techniques: a quasi-experimental study.

BACKGROUND: A significant error that may occur during ergonomic risk assessment and invalidate assessment reliability corresponds to technique selection. This study aimed to develop a new tool called the Decision Aid Tool (DAT) to reduce pen-paper observational technique selection errors. METHODS: This quasi-experiment before-after study was performed in three phases. In the first phase, the participants' skills in technique selection were examined by showing them 20 videos of different single-task jobs. In the second phase, the DAT was designed using pen-paper observational techniques. Finally, in the third phase, 115 occupational health specialists included in the study through purposive sampling of experts evaluated the tool's efficacy. RESULTS: The results of the first phase showed that 62% of participants made an error in selecting the proper technique. The mean and standard deviation scores from the first and third phases were 11.4 ± 6.59 and 39.01 ±1.89, respectively. The mean scores increased significantly after using DAT, and 97.5% of participants could correctly select task techniques. CONCLUSIONS: The efficacy of DAT was confirmed in a quasi-experimental before-and-after study. Using DAT increases the participants' ability to choose the correct technique. The DAT can be functional for practitioners to select the pen-paper observational techniques correctly under the purpose of assessment, the body areas, and the characteristics of the task to be assessed.

Physical and psychological workloads and their association with occupational fatigue among hospital service personnel.

BACKGROUND: Physical and psychological workloads are a vital issue in the workplace. This study aimed to investigate the association between physical and psychological workloads and occupational fatigue among Iranian hospital service personnel. In Iran, hospital service personnel refers to a group of healthcare workers who undertake a range of duties, such as moving and carrying the hospital waste, transporting patients by wheelchair or gurney to the operating room, x-ray department, other wards, or other locations around the facility, performing cleaning tasks such as changing linens, mopping floors, and sterilizing equipment, and following infection control procedures to reduce the risk of spreading germs within the hospital setting. METHODS: This cross-sectional study was conducted on 198 Iranian hospital service personnel. The response rate was 86%. The data were gathered using 1) The Persian version of the Job Content Questionnaire (P-JCQ) for assessing physical and psychosocial workloads and 2) The Persian version of the Swedish Occupational Fatigue Inventory (P-SOFI-20) for assessing fatigue dimensions. RESULTS: According to the P-JCQ, the physical and psychological workload intensities were high in 72.7% and 47% of the participants, respectively. Based on the P-SOFI, the participants' mean scores of "physical fatigue" (21.73 ± 6.2), "psychological fatigue" (13.61 ± 5.76), and "fatigue due to shift work" (18.17 ± 5.6) were moderate, while the mean score of "general fatigue" was high (27.3 ± 6.98). The findings revealed that various types of fatigue are associated with age, gender, marital status, daily working hours, and psychological workload. CONCLUSIONS: Psychological workload was a determinant of occupational fatigue among Iranian hospital service personnel. Hence, an interventional program, including job enrichment, job rotation, and work-rest cycle, is recommended.

Adverse Effects of Sit and Stand Workstations on the Health Outcomes of Assembly Line Workers: A Cross-sectional Study.

Introduction: Sitting and standing workstations can affect individual's health outcomes differently. This study aimed to assess the effects of sit and stand workstations on energy expenditure and blood parameters, including glucose and triglyceride, musculoskeletal symptoms/pain and discomfort, fatigue, and productivity among workers of assembly line of a belt factory. Methods: This cross-sectional study was conducted on 47 male assembly line workers (24 workers in sitting workstation and 23 workers in standing workstation) with at least one year of working experience. Data were gathered via demographic/occupational characteristics, Fitbit system, medical records, the Persian version of the Nordic Musculoskeletal Questionnaire (P-NMQ), the Persian version of the Numeric Rating Scale (P-NRS), the Persian version of the Swedish Occupational Fatigue (P-SOFI), and Persian version of the Health and Work Questionnaire (P-HWQ). Results: The results showed that there were no statistically significant between the demographic/occupational details of the participants in sitting and standing groups, except work experience. The findings of the present study revealed that the energy expenditure, and blood glucose/triglyceride there are not statistically differences between sitting and standing groups. In addition, the prevalence of musculoskeletal symptoms in the neck, lower back, knees, and ankles/feet in standing group was significantly higher than the sitting group. The means of severity of discomfort/pain in all body regions were significantly higher in standing group compared to other group. Generally, occupational fatigue was higher among the standing group compared to sitting group. About productivity, the 'concentration/focus' and 'impatience/irritability' subscales in sitting group were higher than the standing group. Contrariwise, other subscales of the productivity, including 'productivity', 'supervisor relations', 'non-work satisfaction', 'work satisfaction' in the standing group were higher than the sitting group. Conclusions: To reduce the adverse effects of sitting and standing workstations on individual's health outcomes, planning to use sit-stand workstations is recommended.

Application of the HEART method to enhance patient safety in the intensive care unit.

BACKGROUND: The intensive care unit (ICU) is a complex, dynamic, high stress and time-sensitive place. While a variety of rules and regulations provided to reduce medication errors in recent years, many studies have emphasized that medication errors still happen. OBJECTIVE: The purpose of this investigation is to predict, reveal and assess medication errors among surgical intensive care unit (SICU) nurses. METHODS: This study was performed in one of the public hospitals in Shiraz, namely Shahid Faghihi hospital. The human error assessment and reduction technique (HEART) method was adopted to measure and assess medication errors in the ICU. RESULTS: Findings indicate that ICU nurses perform 27 main tasks and 125 sub-tasks. The results also showed that setting and using DC shock task has the highest human error probability value, and assessment of patients by a nutritionist has the lowest human error probability value. CONCLUSION: Medical errors are key challenges in the ICU. Therefore, alternative solutions to mitigate medication errors and enhance patient safety in the ICU are necessary. Although the technique can be used in healthcare; there is a need to localize the coefficients and definitions to achieve more accurate results and take appropriate controls. Employing experienced people and providing conditions that reduce the possibility of errors in nurses, increasing the number of staff, and developing specialized and simulated training were identified as the most important control strategies to reduce errors in nurses.

Comparison of physical workload and physical work capacity among municipality cleaners in Shiraz to determine number of workers needed to counterbalance physical workload.

BACKGROUND: Assessing physical workload is the most important step in deciding whether a workload is high and adopting appropriate control strategies to reduce physical workload. This study aimed to compare physical workload and Physical Work Capacity (PWC) among municipality cleaners in Shiraz to determine the number of workers needed to counterbalance physical workload. METHODS: The present cross-sectional study was performed on 97 municipality cleaners in Shiraz. In the first step, the participants' maximum aerobic capacity (VO2-max) was estimated in the laboratory using an ergometer bicycle and the Young Men's Christian Association (YMCA) protocol, based on which the PWC was estimated. Secondly, energy expenditure and heart rate during work were measured using a POLAR400 device in an eight-hour shift. At the end of the work shift, the workers' perceived physical exertion was assessed using a Rating of Perceived Exertion 6-20 (RPE 6-20) Borg scale. In the final stage, the physical workload was assessed based on the results of the two steps. RESULTS: The mean VO2-max of the cleaners and PWC were estimated to be 2.6 ± 0.66 l min-1 and 4.3 ± 1.088 kcal min-1, respectively. The average energy consumed during work was 4.122 ± 1.016 kcal min-1. The overall results of this study showed that physical workload was greater than PWC in 46% of the municipality cleaners. In addition, it was found that 12.45% workforce was required to be added to the street cleaners of Shiraz municipality to reduce the physiological workload on the employed workforce. CONCLUSIONS: With respect to the high level of physical activity in a significant proportion of the cleaners, measures such as increasing the workforce are suggested.

Cognitive and skill performance of individuals at sitting versus standing workstations: a quasi-experimental study.

Objectives. This study aimed to assess cognitive and skill performance at sitting and standing workstations among students from Shiraz University of Medical Sciences. Methods. Forty students (20 females and 20 males) participated in this quasi-experimental study. Tests were performed among randomly selected participants over two consecutive days: day 1, the Beck depression inventory and Beck anxiety inventory were used to assess the severity of depression and anxiety in the study participants, respectively, and Raven's general intelligence test was used to measure intelligence quotient; day 2, five performance assessment tests (cognitive performance assessment tests 'n-back', 'Stroop' and 'advanced reaction time'; skill performance assessment tests 'two-arm coordination' and 'Purdue pegboard') were randomly selected and presented to individuals at each workstation (sitting and standing workstations). At the end of each sitting and standing position, the comfort of the workstation was measured using a visual analog scale. Results. No statistically significant difference was shown between sitting and standing positions in terms of 'n-back', 'Stroop', 'advanced reaction time', 'two-arm coordination' and 'Purdue pegboard'. Participants were more comfortable in sitting positions and more easily distracted in standing positions. Conclusions. Sitting and standing positions had no significant effects on participants' cognitive and skill performance.

Common errors in selecting and implementing pen-paper observational methods by Iranian practitioners for assessing work-related musculoskeletal disorders risk: a systematic review.

Objectives. This study aimed to determine the types and frequency of pen-paper observational methods (OMs) used by Iranian practitioners and to identify their errors in selecting and implementing these methods. Methods. This was a systematic review and analytical study of papers in which the OMs had been used. Scientific databases were analyzed from September 1970 to September 2018. Errors were determined based on a list of wrong practices both in the selection and implementation of methods. Three ergonomists carried out the process of identifying errors independently. Results. The most frequently used methods were rapid upper limb assessment (RULA), quick exposure check (QEC) and rapid entire body assessment (REBA), respectively. Errors in selecting and implementing pen-paper OMs were 53.3 and 36.4%, respectively. Conclusions. Despite the abundant number of pen-paper OMs, Iranian practitioners use few of them. The high rate of errors can indicate a lack of knowledge and skills among practitioners for selecting and implementing OMs. The development of decision-making tools may help practitioners to select appropriate pen-paper OMs for assessing different types of tasks.

Investigation of office workers' sitting behaviors in an ergonomically adjusted workstation.

Objectives. Common ergonomic office workstations are designed for a few optimum postures. Nonetheless, sitting is a dynamic activity and the ideal sitting posture is rarely maintained in practice. Therefore, the present study aimed to investigate the sitting behavior of office workers in an actual working environment using ergonomically adjusted workstations to examine whether they promote maintaining appropriate sitting postures. Methods. Sitting behaviors (frequency of postures and position changes in different body parts) were explored among 26 office workers during a 60-min sitting duration, using the posture recording and classification method developed by Graf et al. The rapid upper limb assessment (RULA) method was also used to assess postural load. Then, the results of the RULA method were compared with the results from investigating the sitting behavior of office workers. Results. Common ergonomic workstations were effective in eliminating some awkward postures. However, some important risk factors such as holding postures with an inappropriate lumbar spine curve (86% of the observations) and maintaining a posture for a long time (for 7-12 min) were observed in the participants' sitting behaviors, while they were neglected in the RULA method. Conclusions. The common ergonomic workstations could not guarantee the users' appropriate sitting behaviors.

Designing and usability testing of a new prototype active footrest for knee extension exercise among office workers.

Objectives. The active factor along with light exercise can reduce static muscle work and increase muscle flexibility and endurance. Accordingly, this study aimed to design and prototype a new active footrest, implemented in conventional sitting workstations, and to test its usability among office workers. Methods. The steps taken to design and prototype the active footrest were: selection of an exercise appropriate for goals of ergonomic interventions; idea development; selection of the best conceptual design; design with SOLIDWORKS version 2016; and fabrication of a prototype. Afterward, usability of the active footrest prototype was assessed among 20 office workers (10 females) using field data by the system usability scale. Results. Upon completion of the design steps, the active footrest prototype was prototyped by taking into account design criteria (e.g., functionality, inclusive design, easy application and reduction of additional body movement), anthropometric data and mechanical properties. The participants rated the usability of the active workstation as 89 ± 8.21 (out of 100), indicating good usability results. Conclusion. In this study, an active footrest was designed and prototyped to perform knee extension exercise with the capability of being implemented in conventional sitting workstations.

Does food insecurity affect musculoskeletal symptoms, fatigue, and productivity of municipality cleaners? A cross-sectional study.

BACKGROUND: Municipality cleaners are exposed to food insecurity, Musculoskeletal Symptoms (MSs), and fatigue. OBJECTIVE: This study aimed to investigate the effect of food insecurity on MSs, fatigue, and productivity among municipality cleaners. METHODS: This study was conducted on 399 Iranian male municipality cleaners with at least one year of working experience. The data were gathered via a demographic/occupational questionnaire, the Persian version of the Household Food Insecurity Access Scale (P-HFIAS), the Persian version of Nordic Musculoskeletal Questionnaire (P-NMQ), the Persian version of the Multidimensional Assessment of Fatigue scale (P-MAF), and the Persian version of Health and Work Questionnaire (P-HWQ). Data were analyzed using descriptive statistics, multiple logistic regression (Forward Wald), and multiple linear regression (Stepwise). RESULTS: The findings revealed that 42.6%of the municipality cleaners were in the 'severely food insecure' category. The highest prevalence of MSs in the past week were related to knees (35.8%), lower back (35.1%), and ankles/feet (28.8%). Based on the results, the chance of MSs in the shoulders (OR = 1.66) and ankles/feet (1.60) regions, and MSs at least in one body region (OR = 1.47) was higher in the individuals with severe food insecurity than the others. Considering the P-MAF, food insecurity was associated with the 'degree and severity', 'distress that it causes', and 'timing of fatigue' subscales and 'total fatigue'. Considering the P-HWQ, food insecurity was associated with 'productivity', 'other's assessment', 'concentration/focus', 'supervisor relations', 'non-work satisfaction', and 'impatience/irritability' subscales. CONCLUSION: The study revealed an association between food insecurity and MSs in some body regions and fatigue and productivity subscales among the municipality cleaners. Nutritional and ergonomic programs are recommended to reduce municipality cleaners' food insecurity, MSs, and fatigue and enhance their productivity.

Ergonomic Design of Manual Assembly Workstation Using Digital Human Modeling.

Background: Manual assembly workers are exposed to risk factors of musculoskeletal disorders. The most important risk factor among the workers is static and awkward posture. This study aimed to the ergonomic design of manual assembly workstation using Digital Human Modeling (DHM). Methods: This cross-sectional study was conducted among manual assembly workers. Data was gathered via 1) demographic/occupational questionnaire, 2) The Persian version of the Nordic General Questionnaire (P-NMQ), 3) Rapid Upper Limb Assessment (RULA) using Kinect sensor, 4) Hierarchical Task Analysis (HTA), 5) Idea Rating Sheet (IRS), 6) Anthropometric data of the participants, 7) CATIA software and RULA technique. Results: The results of the evaluations showed that in the design of most workstations of assemblers in Shiraz electronics industries, complete ergonomic principles were not observed, and the implementation of targeted ergonomic interventions in them is necessary. Conclusion: The prevalence of musculoskeletal symptoms is high among manual assembly workers. The RULA technique showed that the designed manual assembly workstation using DHM effectively could improve the subjects' awkward postures.

Work-related musculoskeletal symptoms among Iranian nurses and their relationship with fatigue: a cross-sectional study.

BACKGROUND: The present study aimed to determine the prevalence of work-related musculoskeletal symptoms (WMSs), identify potential factors associated with WMSs, and determine the association between WMSs and fatigue among nurses. METHODS: This cross-sectional study was carried out among 500 Iranian nurses. Data was gathered by the 1) Persian version of the Nordic musculoskeletal questionnaire (P-NMQ) to examine WMSs, and 2) Persian version of the Multidimensional Assessment of Fatigue (P-MAF) Scale to evaluate fatigue among the study population. Then, data was analyzed by SPSS version 21 using the χ2 test, multiple logistic regression for detection of potential factors associated with WMSs, and multiple linear regression for detection of potential factors associated with fatigue. RESULTS: Ankles/feet, lower back, knees, and shoulders had the highest prevalence of WMSs among nurses within the last 12 months prior to the study. Independent variables including age, job tenure, gender, smoking, shift work, and type of employment were significantly associated with WMSs in different body regions with odds ratios (ORs) ranging from 1.635-2.835. Moreover, WMSs in some body regions were associated with subscales of fatigue and total fatigue. CONCLUSIONS: Ergonomic and organizational interventions for fitting the job to the nurses considering demographic/occupational characteristics are highly essential to improve musculoskeletal system health and relieve fatigue.

Investigating association between job stress dimensions and prevalence of low back pain among hospital nurses.

BACKGROUND: There are a few studies conducted on job stress dimensions and their relationship with Low Back Pain (LBP) among Iranian nurses. OBJECTIVE: The aim of the current study was to investigate the association between job stress dimensions assessed via Demand-Control-Social Support (DCS) and Effort-Reward Imbalance (ERI) models and prevalence of LBP among Iranian hospital nurses. METHODS: In this cross-sectional study, 495 randomly selected nurses of Shiraz University of Medical Sciences (SUMS) participated. Demographic/occupational questionnaire, the Persian version of the Job Content Questionnaire (P-JCQ) and the Persian version of the ERI Questionnaire (P-ERIQ) were used for data collection. Data were analyzed by SPSS software (version 19) using descriptive statistics, independent sample t-test, and logistic regression. RESULTS: The LBP prevalence was found to be 69.9%. The means±standard deviations of job stress dimensions were obtained as follows: decision latitude: 64.67±6.82, physical job demands: 15.52±2.6, social support: 23.18±3.65, psychological job demands: 38.02±4.98, effort: 8.73±2.62, reward: 23.12±5.31, over-commitment: 12.25±3.09, and effort-reward ratio: 0.86±0.3. The findings revealed that the work experience (OR = 1.56), psychological job demands (OR = 1.082), and effort-reward ratio (OR = 3.43) were predictors for LBP among the study population. CONCLUSION: The prevalence rate of LBP among studied nurses was high. About half of nurses had high psychological demands, low decision latitude and low social support. Based on the effort-reward ratio, nurses had experienced high level of stress. Interventional programs and coping strategies for reduction of work-related stress and, subsequently, prevention of LBP are recommended among hospital nurses.