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PubMed2000

Physical, chemical and biological hazards in veterinary practice.

OBJECTIVE: To identify major occupational hazards encountered by veterinarians and their staff in practice in Australia. PROCEDURE: A literature search of Medical (MEDLINE), Occupational Health and Safety (OSHRAM) and Nursing and Allied Health (CINAHL) electronic data bases plus continual monitoring utilising the Uncover alerting system using the key words, 'occupational injury', 'occupational disease' and 'safety' linked with use of the word 'veterinarians' has found relevant articles. Personal communication with people who have undertaken studies on occupational safety in veterinarians elicited further information. CONCLUSION AND RECOMMENDATIONS: Veterinarians often sustain animal-related injuries, the most common of which are dog and cat bites, cat scratches and being hit or crushed by large animals. The most costly to treat include strains and back injuries. Most veterinarians treat themselves. There is no single reporting system for injuries or disease in veterinarians and reported cases may greatly underestimate the total. There is a need to assess accurately the occupational hazards in veterinary practice, to determine the actual occurrence of injuries and to develop strategies to prevent them.

Animals↗
PubMed1997

A survey of croquet injuries.

Of 214 croquet players who responded to a questionnaire, 76 reported at least one injury to hand, wrist or forearm caused by striking the ball. There was no obvious relation to which of the three main grips the player applied to the mallet. Injuries were somewhat more frequent when the mallet shaft consisted of fibreglass than when it was wood, metal or carbon fibre, but a causal relation has not been established. Back injuries seem less troublesome in croquet than in golf.

Adult↗
PubMed1992

Factors important in the genesis and prevention of occupational back pain and disability.

Back injuries in the work place are rarely caused by direct trauma; typically, they are the result of overexertion. Although problems exist in epidemiological studies of risk factors for low back pain and sciatica, there are seven occupational factors that have been associated with an increased risk in several studies: six physical and one psychological and psychosocial. Of individual factors, age is the most important, while sex and smoking are probable risk factors.

Back Pain↗
PubMed1996

Muscular response to sudden load. A tool to evaluate fatigue and rehabilitation.

STUDY DESIGN: Subjects were exposed to fatiguing and restorative interventions to assess their response to sudden loads. OBJECTIVES: To investigate the erector spinae and rectus abdominis response characteristics to "sudden load" and the effect of fatigue and rehabilitation. SUMMARY OF BACKGROUND DATA: Unexpected loads which people often experience, can lead to high forces in the spine and may be a cause of low back injury. METHODS: Muscle responses to sudden load were mediated by fatigue, walking, expectation, method of load application, exposure to vibration, and cognitive-behavioral rehabilitation in patients with chronic low back pain. A novel technique, perfected in this work, called wavelet analysis, was used to analyze these data. RESULTS: Reaction time was affected by fatigue and expectation. Vibration exposure significantly increased the muscle response time. Walking was able to ameliorate that effect. Back muscles responded differently, depending on whether loads were applied to the back through the hands or through the trunk. Electromyographic reaction time and magnitude decreased in patients after a 2-week rehabilitation program. CONCLUSIONS: Sudden loads can exacerbate fatigue effects. Walking after driving reduces the risk to the back caused by handling unpredictable loads. Vibration exposure guidelines should be more conservative. Patients have longer response times than healthy subjects, but patients can improve their response to sudden loads via rehabilitation. Patients exhibit a flexion-extension oscillation at 5 Hz in response to a sudden load, suggesting that the 5-Hz, seated, natural frequency observed during whole-body vibration may result from neurophysiologic control limits.

Adult↗
PubMed1992

An analysis of 2846 industrial illnesses and injuries seen in a family practice.

We analyzed 2846 industrial illnesses and injuries in 2430 patients seen in a family practice with a large occupational medicine component over a three-and-a-half-year period. Of the 268 medical diagnoses made, back injuries and cumulative trauma disorders to the upper extremities comprised the majority. A large number of pesticide and chemical exposures were also seen. Consultations were obtained in 16.7% of the cases and 61.7% of the cases were closed as resolved. There were 17 patients hospitalized and no deaths. We recommend that family practice residents be trained in the procedures and laws of the workers' compensation system as well as in treating specific occupational health problems.

Adolescent↗
PubMed1987

Evaluation of the workplace. An introduction.

To reduce and optimize the work load imposed on the musculoskeletal system in a given situation, three main areas of interest are work technique, workplace design, and the produced work itself. Ergonomically sound work techniques should be taught early and should be repeatedly evaluated and encouraged. Workplace and tool design must be adapted and modified according to the task performed at the workplace. The work produced has to be evaluated in terms of handling comfort and discomfort by the employee: the greater the comfort, the greater the productivity will be. Especially in the rehabilitation of patients with back injuries, these factors must always be considered to avoid recurrent episodes of pain and disability.

Back Pain↗
PubMed1999

The clinical relevance of biomechanics.

Most neurologists are familiar with biomechanics but may be unsure of the relevance of this field to their practice. Actually those involved in musculoskeletal problems are undoubtedly using biomechanical principles. This article is limited to the spine, but the basic principles of biomechanics are applicable to other parts of the body. In this article, we describe the spine and trunk as a biomechanical organ, the biomechanical principles behind back injuries and their importance, the role of biomechanical issues in pain, the utility of clinical tests based on biomechanical principles, the effects of aging, and the future directions in spine biomechanical research.

Accidents, Occupational↗
PubMed1996

European Spine Society--the AcroMed Prize for Spinal Research 1995. Unexpected load and asymmetric posture as etiologic factors in low back pain.

Unexpected loads, which often occur in the working environment, can lead to high forces in the spine and, thus, may be a cause of low back injury. This paper discusses the effect of "sudden load" on the erector spine reaction and amplitude. Muscle responses were mediated by several factors, including fatigue, posture, expectation and rehabilitation, in chronic low back pain patients. The subjects were fatigued by holding a 20% maximum voluntary contraction for 1 min. A functional restoration program was tested for its efficacy in reducing reaction time and EMG amplitude in chronic low back pain patients. Reaction time was longer and EMG amplitude lower in patients than in their matched controls. EMG reaction time and magnitude decreased in patients after a 2-week rehabilitation program, including specific training of coordination and posture control. The results of the modelling showed higher spinal compressive load and lower shear forces when the load was expected than when the load was unexpected. The effect of sudden loads can be exacerbated if a worker is not standing on a flat surface or is fatigued. Chronic low back pain patients have less ability to protect themselves from sudden loads, but they can be trained to improve their response by means of an appropriate rehabilitation program.

Adult↗
PubMed1999

Low back three-dimensional joint forces, kinematics, and kinetics during walking.

OBJECTIVE: The purpose of this study was to examine the three-dimensional low back loads, spinal motions, and trunk muscular activity during gait. Specific objectives involved assessment of the effects of walking speed, and arm swing on spinal loads, lumbar spine motion, and muscular activation. DESIGN: An in vivo modeling experiment using five male participants. Thirty walking trials were performed by each participant yielding five repeats of each condition (3 walking cadences x 2 arm swing conditions). BACKGROUND: Walking is often prescribed as a rehabilitation task for individuals with low back injuries. However, there are few studies which have examined the joint loading, spinal motions, and muscular activity present when walking. Additionally, the majority of studies examining spine loading during gait have used an inverse dynamics model, commencing at the cranial aspect of the body, approach which does not include the impulsive phases of gait (i.e. heel strikes and toe offs). METHODS: Low back joint forces (bone on bone) and moments were determined using an anatomically complex three-dimensional model (detailing 54 muscles and the passive structures acting at the low back) during three walking cadences and with free arm swing or restricted arm swing. In order to assess the influence of the transient factors such as heel contact on the joint forces a bottom up (from the feet to the lumbar spine) rigid link segment analyses approach was used as one input to the three-dimensional anatomic model. Lumbar spine motion and trunk muscle activation levels were also recorded to assist in partitioning forces amongst the active and passive tissues of the low back. RESULTS: Net joint anterior-posterior shear loading was the only variable significantly affected by walking cadence (fast versus slow P < 0.0003). No variable was significantly affected by the arm swing condition. Trends demonstrated an increase in all variables with increased walking cadence. Similarly, most variables, with the exception of axial twist and lateral bend lumbar spine motion and lateral joint shear, demonstrated increasing trends caused by the restriction of normal arm swing. CONCLUSIONS: Tissue loading during walking appears to be below levels caused by many specific rehabilitation tasks, suggesting that walking is a wise choice for general back exercise and rehabilitation programs. Slow walking with restricted arm swing produced more 'static' lumbar spine loading and motion patterns, which could be detrimental for certain injuries and tissues. Fast walking produced a more cyclic loading pattern.

Adult↗
PubMedDate not supplied

Preventing back pain through education.

Nurses continue to suffer from the effects of back injuries; the cost in terms of lost production due to associated sickness leave is enormous, while the cost in human suffering is incalculable. Liz Gonet and Anna Kryzwon describe the development of a 'Back awareness' course in their neurological unit which aims to utilise the processes of cascade learning to ensure that all nurses receive instruction in both lifting technique and body posture. Formal evaluation methods are in the process of being designed and initial responses from course participants have been very encouraging.

Back Pain↗
PubMed1990

1990 Volvo Award in clinical sciences. Lumbar spinal pathology in cadaveric material in relation to history of back pain, occupation, and physical loading.

The occurrence of symmetric disc degeneration, anular ruptures, end-plate defects, vertebral body osteophytosis, and facet joint osteoarthrosis was examined radiographically and osteologically in 86 male cadavers for whom occupational, physical loading, and back pain histories were obtained from the men's families. History of back pain and the parameters of spinal pathology were related to the highest and lowest degrees of physical loading. In multivariate analyses, history of back injury was related to the occurrence of symmetric disc degeneration, anular ruptures, and vertebral osteophytosis. Symmetric disc degeneration was associated with sedentary work, and vertebral osteophytosis was related to heavy work. History of back pain was related to occupational physical loading after control for the effects of the other covariates. The results indicate that the least pathology stemmed from moderate or mixed physical loading, but the least back pain was associated with sedentary work.

Adult↗
PubMed1996

A Multilevel Approach to Manual Lifting in Manufacturing Industries.

Musculoskeletal injuries are often the consequences of wrong postural configurations used during Manual Materials Handling (MMH). This eventually leads to a large payout of worker's compensation and loss of production time. A simulated study of back injury risks has been carried out on seven selected manufacturing industries to identify and evaluate harmful working postures. For each MMH task, Ovako Working Posture Analyzing System (OWAS) codes have been identified with the help of motion study pictures. Also, Chaffin's biomechanical model was used to calculate L5/S1 load compression values on the spine during MMH activities. The multilevel approach adopted was a combination of OWAS and Chaffin's biomechanical model. The application of a digitizer enabled us to identify the coordinates and it made a subsequent evaluation of the angles of each body link possible.

OWAS↗
PubMed2006

An on-body personal lift augmentation device (PLAD) reduces EMG amplitude of erector spinae during lifting tasks.

BACKGROUND: A new on-body personal lift augmentation device was developed to support the back muscles during the repetitive lifting task. METHODS: Nine male subjects participated in the study. Three Fastrak units were used to record positions and rotations of the segments. Trunk muscle normalized and integrated electromyography of the left and right thoracic erector spinae, lumbar erector spinae, external obliques, and rectus abdominis, as well as the kinematic variables of peak lumbar angle, peak pelvis angle, peak trunk acceleration, peak load acceleration were compared in symmetrical lifting for three different loads (5 kg, 15 kg, 25 kg) with three different styles (stooped, squat, free) under two conditions of with and without personal lift assist device. FINDINGS: The lift assist device significantly reduced the required muscular effort of the lumbar (p = 0.001) and thoracic erector spinae with no significant differences in the level of abdominal muscle activity. The amount of integrated electromyography reduction ranged from 14.4% to 27.6% for the lumbar and thoracic erector spinae respectively. Simple measures of trunk posture and accelerations confirmed that there were no differences in lifting technique that would cause the integrated electromyography activity to be reduced. No major kinematic differences were found when the lift assist device was worn indicating that it did not alter these specific technique variables. INTERPRETATION: The lift assist device did reduce the required muscular effort of the lumbar and thoracic erector spinae without adversely affecting the level of abdominal muscle activity. This reduction may help reduce the risk of recurring back injuries or assist in the return to work phase, especially in repetitive tasks.

Adult↗
PubMed1999

The in vivo dynamic response of the spine to perturbations causing rapid flexion: effects of pre-load and step input magnitude.

OBJECTIVE: To evaluate the impact of muscle pre-activation levels and load magnitude on the response of the trunk to loading conditions causing rapid flexion. DESIGN: Eight male subjects were asked to maintain an upright standing posture while resisting the application of forward flexion moments produced by four different loading conditions consisting of combinations of two pre-loads (4% or 16% of the maximum extensor moment) and two added loads (12% or 24%). Pre-loading was used to develop different initial levels of trunk muscle activity prior to the application of the added loads. Of special interest were the two conditions that resulted in total final loads of 28%. BACKGROUND: Cocontraction of the antagonistic and agonistic muscles of the trunk are required to provide stability during normal physiological loading conditions. In several in vivo studies, levels of trunk muscle cocontraction have been observed prior to the application of unexpected or sudden loads. Forces from the abdominal muscles have been proposed to provide stability when extensor moments are generated. The response of trunk muscles to rapid flexor moments would provide further insight into the dynamic stability mechanisms of the spine. METHODS: Measurements were made of the trunk extensor moments, angular displacement of the trunk and unilateral surface EMG amplitudes of three abdominal and three trunk extensor muscles. Values were recorded during the isometric pre-load and for the maximum magnitude of each variable in response to the added load. RESULTS: Higher pre-loads resulted in lower flexion rotations of the spine and higher added loads caused larger rotations. With increasing magnitudes of final loads, a corresponding increase in trunk extensor moments and trunk muscle cocontraction was observed. The largest activations were observed in the lumbar erector spinae and thoracic erector spinae muscles, while smaller yet substantial EMG activity was observed in the internal oblique and external oblique. A comparison of the 28% loading conditions showed an increased response of the trunk to the [4 + 24] loading condition (with lower initial trunk stiffness) when compared to the [16 + 12] loading condition. CONCLUSIONS: Pre-activation of trunk extensor muscles can serve to reduce the flexion displacements caused by rapid loading. The abdominal oblique muscles, especially external oblique, will rapidly increase their activation levels in response to rapid loading. These changes are more pronounced when pre-activation levels are low, resulting in lower initial trunk stiffness and spine compression force. It is proposed that these factors will ultimately affect spine stability and the risk of injury. RELEVANCE: The results of this study provide insight into several mechanisms involved in the dynamic stability of the spine. Injuries can be caused by unexpected and rapid loading of the spine. A study of the mechanisms available to respond to such perturbations is important to an understanding of spine mechanics and the etiology of low back injury.

Adult↗
PubMed1994

The probability of recovery and return to work from work disability as a function of time.

This paper describes a prospective longitudinal cohort study of musculoskeletal soft tissue pain impairment following a work related injury. It focuses on specific, univariate prognostic factors indicated in previous research studies that might affect the likelihood that injured workers will return to work or remain on work disability at any point in time. These factors include gender, age, return to work attempts and site of injury. Life table analysis was used to model the probability of work disability. The results showed that different disability and return to work patterns emerged for males and females. Males were more likely to return to work; however, females had a higher probability than males of remaining at work once they returned to work. Older workers had the highest probability of being off work any given number of days after injury; were less likely to return to work, and if they did, had a higher probability of becoming disabled again. Efforts to return early to work contributed to a decrease in overall work disability. Workers with low back injuries had a greater likelihood of recurrence compared to injuries at other body sites.

Adolescent↗
PubMed1990

Providing high quality occupational medical services.

As people become more aware that their work and the environment can adversely affect their health, greater attention will focus on the role of occupational health in preventing and evaluating certain medical concerns. This wider awareness will further the demand for quality occupational medical services. Clearly, an opportunity exists for the business and health care communities to work in concert to prevent occupational and environmental health problems. Marketing efforts that can support occupational medical services range from seminars and newsletters to unique approaches of health care delivery. Examples of the latter include "fast-track" treatment of work related injuries that bypass customary delays in most emergency departments. In this manner, client organizations benefit from the special treatment, which encourages the use of the occupational health program. Conferences geared to the business community, where topics such as back injuries, drug testing or medical surveillance are presented, can enhance the credibility of the services. Moreover, since the role of occupational medicine, especially with respect to small businesses, is poorly understood, these meetings can help establish the capabilities of the program. Efforts that promote the institution itself can also be beneficial, especially regarding highly specialized equipment and services, including magnetic resonance imaging, physical therapy equipment and research efforts of its staff. As the issues evolve, occupational health professionals will need to adapt and keep abreast of the changes. Both health care providers and business should be aware of the specialized area of knowledge associated with occupational health professionals, especially the specialty of occupational medicine. Similarly, the business community is advised to take a critical review of any provision of health services to its employees. Attention to the type of staff at a medical facility as well as their training and protocols will help insure that appropriate and quality services are being provided.

Humans↗
PubMed1992

Reducing back stress to nursing personnel: an ergonomic intervention in a nursing home.

A prospective epidemiologic study was conducted in two units (140 beds and 57 nursing assistants) of a nursing home to demonstrate the efficacy of an ergonomic intervention strategy to reduce back stress to nursing personnel. The total programme involved the following: determining patient handling tasks perceived to be most stressful by the nursing assistants (NAs); performing an ergonomic evaluation of these tasks; and conducting a laboratory study to select patient transferring devices perceived to produce less physical stress than existing manual patient-handling methods. The intervention phase included training NAs in the use of these devices, modifying toilets and shower rooms, and applying techniques to patient care. Immediately after completing the intervention programme, a post-intervention analysis (which lasted eight months in unit 1 and four months in unit 2) was performed. A biomechanical evaluation of the physical demands required to perform stressful patient-handling tasks showed that the mean compressive force on the L5/S1 disc, the mean hand force required to make a transfer, and the strength requirements (expressed as percentage female population capable) were 1964 N, 122 N, and 83% after intervention as compared to 4751 N, 312 N, and 41% before intervention. Subjectively, the mean rating of perceived exertion was less than 'very light' after intervention as compared to between 'somewhat hard' and 'hard' before intervention. Overall, the mean acceptability rates for the walking belt and the mechanical hoist were 81% and 87% for patient transfers. The incidence rate for back injuries prior to the intervention, 83 per 200,000 work-hours, decreased to 47 per 200,000 work-hours after the intervention. There were no injuries resulting in lost or restricted work days during the last four months of the post-intervention. It is concluded that an appropriate ergonomic intervention programme offers great promise in reducing physical stress and risk of low-back pain to nursing personnel. However, large-scale studies in different nursing homes are needed to confirm the above findings.

Adult↗
PubMed2005

Spondylolysis and spondylolisthesis in the athlete.

Though athletes may be able to return to their sport after treatment of spondylolysis and spondylolisthesis, prevention of back injury in at-risk patient athletes should be the treating physician's primary goal.

Humans↗