A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons.

OBJECTIVE: Work-related musculoskeletal disorders in ENT surgeons are common and detrimental, yet few are aware of preventative measures. We evaluate the evidence for interventions to prevent work-related musculoskeletal disorders in ENT surgeons. METHOD: A systematic search of databases up to 8 June 2021 was performed using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and predetermined inclusion criteria. RESULTS: Seven prospective cohort studies and 2 case series were identified (51 participants). Interventions included novel equipment (n = 3), patient positioning (n = 2), clinician positioning (n = 3) and operative technique (n = 1). Five studies reported Rapid Upper Limb Assessment scores as outcome measures of strain. Strain decreased when adopting a favourable operating posture, using a supportive chair and keeping patients supine for clinic procedures. CONCLUSION: A small number of low-quality studies were identified. Modifiable risk factors exist, and ergonomic education may help prevent work-related musculoskeletal disorders. Further studies with longer term follow up are required.

Prospective evaluation of mental health training for occupational health practitioners.

BACKGROUND: Occupational health (OH) practitioners need to be confident in identifying and managing mental health problems in the workforce. AIMS: To evaluate the effectiveness of a one-day workshop in improving the knowledge, attitude and confidence of OH practitioners in detecting and managing depression, anxiety, suicide risk, alcohol misuse and drug abuse. METHODS: Interactive mental health workshops for 164 OH practitioners held in five regions in England were evaluated by self-administered questionnaire. Data were collected immediately prior to the workshop (T1), immediately after the workshop (T2) and 4 months following the workshop (T3). RESULTS: At T1, the response rate was 97% (159/164), 90% at T2 and 63% at T3. The mean improvement in participants' knowledge was 8% (95% CI 6-10) at T2 compared with T1. The biggest improvement was in participants with no previous training in the management of common mental health problems in the workplace, mean improvement 9% (95% CI 6-12). Participants' confidence improved in all areas assessed at T2, and the improvement in confidence compared with that at baseline was sustained at 4 months (T3). Participants reported using the knowledge gained in clinical practice in all topic areas covered. Use of knowledge gained at the workshop was significantly higher in those who had had previous training in managing common mental health disorders. CONCLUSIONS: This one-day interactive workshop was a feasible and effective method of improving OH professionals' confidence, knowledge and application of skills in practice in key areas of mental health.

Occupational health advice in NICE guidelines.

BACKGROUND: Sickness absence is a major concern for society costing > pound 13 billion annually. Seeking medical advice is highly recommended in managing sickness absence. The National Institute for Health and Clinical Excellence (NICE) provides guidance on treating ill-health and promoting public health. NICE has published >500 guidelines. There are three versions of each guideline including full (comprehensive version), NICE (summary of recommendations) and public version. AIMS: To evaluate the availability of occupational health advice within relevant NICE guidelines. METHODS: Guidelines were selected on the basis of the impact of the disease and its treatment on work ability. All selected guidelines were reviewed for occupational health advice. The findings were categorized in five main domains: impact of the disease on work, impact of work on the disease, rehabilitation, fitness to work and modifications. RESULTS: Thirty-one published guidelines met the inclusion criteria. Advice on rehabilitation is most frequently referred to with 12 (39%) full, 8 (26%) NICE and 4 (13%) public information guidelines offering advice on this domain. Advice on return to work is the least frequent. The public versions of guidelines rarely offer advice on the studied domains. Occupational health organizations are enlisted as stakeholders in one guideline only. Two occupational health professionals have contributed to the development of two guidelines. CONCLUSIONS: This study suggests that occupational health professionals and organizations should participate more actively in developing NICE guidelines to integrate work-related issues and occupational health advice into NICE guidelines.