Effect of occupational pushing and pulling combined with improper working posture on low back pain among workers.

This study aimed to investigate the impact of occupational pushing and pulling combined with improper working posture on work-related low back pain (LBP) among workers. A web-based survey was conducted in 2022 to collect data from 15,623 workers, who were categorized into proper and improper working posture groups. Multiple logistic regression analysis was used to analyze the association between pushing and pulling loads and LBP in each group. In the proper working posture group, the odds ratios (ORs) of LBP for workers who pushed and pulled were not significantly different compared with those of no-handling workers. However, in the improper working posture group, the ORs of LBP were significantly greater among workers who pushed and pulled compared with those of no-handling workers, and this association became stronger with increasing weights. Therefore, improper working posture combined with pushing and pulling were strongly associated with LBP among workers, particularly with heavier weights.

Effect of relative weight limit set as a body weight percentage on work-related low back pain among workers.

INTRODUCTION: A quarter of work-related low back pain (LBP) cases result from handling heavy loads in Japan. The maximum weight male/female workers can handle is 40%/24% of their body weight but has set a constant load weight in ISO 11228-1 and NIOSH lifting equation. The preventive effect of the relative weight limit on LBP has not been clarified. This study aimed to identify the effect of relative weight limits set as body weight percentages on LBP prevalence. METHODS: Data from 21924 workers were collected via a web-based survey in 2022. The workers were categorized into three groups: group A, "no handling," group B, "handling loads up to 40%/24% or less of body weight," and group C, "handling loads over 40%/24% of body weight." Moreover, they were categorized into eight groups: no handling, 1-5 kg, 5-10 kg, 10-15 kg, 15-20 kg, 20-25 kg, 25-30 kg, and ≥30 kg. Multiple logistic regression analysis was used to identify the effects of the limits set to body weight percentages and constant load weights on LBP. RESULTS: In groups A, B, and C, 25.5%, 39.2%, and 47.3% of males or 16.9%, 26.4%, and 38.0% of females had LBP, respectively. The odds ratio (OR) of LBP was significantly greater in group B than in group A and even greater in group C. The OR of LBP among workers handling loads under 10 kg was not significantly different compared to no-handling workers. CONCLUSIONS: LBP prevalence was greater in group B than in group A but lesser than in group C. Weight limits based on body weight percentages could not eliminate the factor of handling loads. However, handling loads under 10 kg suppressed LBP. Relative weight limits set as body weight percentages were inappropriate and ineffective for preventing LBP.

Organization factors influencing quality of work life among seniors' care workers with severe low back pain.

OBJECTIVES: The prevalence of work-related low back pain (LBP) is high among care workers and can negatively affect quality of work life (QWL). To improve workplace satisfaction, this study aimed to identify factors influencing QWL among seniors' care workers with severe LBP. METHODS: A questionnaire survey including items on demographics, qualifications, basic job responsibilities, job stressors, LBP severity, QWL, and job satisfaction was conducted in 2018. In total, 1000 senior care facilities were selected via random sampling and eight care workers per institution were asked to complete the survey. Multiple logistic regression analysis was used to identify independent factors influencing QWL of care workers with and without severe LBP. RESULTS: Data from 1247 care workers with severe LBP and 2009 with nonsevere LBP were included in the analysis. Overall QWL was lower in the severe LBP group than in the nonsevere LBP group. In both groups, human relationships, workplace support, discretionary responsibility level, and working hours or time off were identified as common factors influencing QWL. In the severe LBP group, the salary was also a significant influence on QWL, while in the nonsevere LBP group, the number of workers, promotion or official position, and caregiving technique were identified as significant QWL factors. CONCLUSIONS: The QWL of care workers with severe LBP was strongly influenced by salary. Since care workers suffering from severe LBP are working for a salary while enduring the pain and do not have found a worth doing, they need to prevent LBP and get job satisfaction and self-progress.

Computer and Furniture Affecting Musculoskeletal Problems and Work Performance in Work From Home During COVID-19 Pandemic.

OBJECTIVES: We surveyed how home-working conditions, specifically furniture and computer use, affected self-reported musculoskeletal problems and work performance. METHODS: Questionnaires from 4112 homeworkers were analyzed. The relationship between subjective musculoskeletal problems or work performance and working conditions were determined by logistic regression analyses. RESULTS: More than half the homeworkers used a work desk, work chair, and laptop computer. However, approximately 20% of homeworkers used a low table, floor chair/floor cushion, or other furniture that was different from the office setup. Using a table of disproportionate size and height, sofa, floor cushion, and floor chair were associated with neck/shoulder pain or low back pain. Disproportionate table and chair, floor cushion, and tablet computer were associated with poor work performance. CONCLUSIONS: Disproportionate desk and chair, floor cushion/chair, and computer with small screen may affect musculoskeletal problems and home-working performance.

Relationship between using tables, chairs, and computers and improper postures when doing VDT work in work from home.

This study focused on everyday furniture and computers used in work from home and aimed to investigate how improper postures increase the risk of musculoskeletal disorders using different combinations of tables, chairs, and computers. Twenty-one healthy participants were asked to perform a visual display terminal task for 30 minutes in a laboratory modeled on the work from home concept. Seven experimental conditions were set up according to the different combinations of desks, chairs, and computers. Three-dimensional body posture was measured using a magnetic tracking device. The results showed that when using a low table, floor chair, and laptop computer, the body posture above the hip was similar to that when using a dining table, chair, and desktop computer. When using a sofa, and tablet computers, or laptop computer, severe neck flexion, which is stressful to the neck, was observed. Moreover, excessive low back flexion was observed when using a floor cushion and laptop computer. We suggest that computer work while sitting on a sofa or floor cushion without a backrest is harmful to the neck and low back.

[Factors affecting quality of working life among caregivers in care facilities for the elderly].

OBJECTIVE: Theshortage of caregivers in care facilities has become a problem in Japan. Building a comfortable workplace and improving the quality of working life (QWL) of caregivers are essential. However, the factors of QWL that should be prioritized remain unclear. The purpose of this study was to identify the major factors currently affecting the QWL of caregivers in care facilities for the elderly and recognize the priorities that should be addressed. METHODS: A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted from October to December in 2018. In total, 1,000 care facilities located throughout Japan were selected via random sampling. Eight caregivers who differed by sex, age, and years of experience were selected from each facility (a total of 8,000 caregivers). A logistic regression analysis was used to analyze the association between QWL and the factors affecting it. RESULTS: Ultimately, data from 504 facilities and 3,478 caregivers were included in the analysis. Human relationships (OR: 3.92, 95% CI: 3.09-4.97) had the highest odds ratio in terms of caregivers' QWL, followed by the number of workers (OR: 3.69, 95% CI: 2.56-5.32), communication (OR: 3.42, 95% CI: 2.66-4.40), support from the facility (OR: 3.37, 95% CI: 2.69-4.23), working hours or time off (OR: 3.20, 95% CI: 2.53-4.04), and discretion of responsibility level (OR: 3.09, 95% CI: 2.46-3.88). In contrast, salary (OR: 2.81, 95% CI: 2.19-3.61) was associated with QWL but the association was lower than that of human relationships and the other factors. Lower back pain among caregivers was also associated with QWL. CONCLUSIONS: Findings of this study show that improvement in human relationships is the primary factor for improved QWL among caregivers in care facilities. Thus, it should be prioritized. Secondary factors that affect QWL are the number of workers, communication, support from the facility, working hours or time off, and discretion of responsibility level. Considering the reasons for caregivers' dissatisfaction, improving their QWL requires promoting the exchange of information with superiors and colleagues. It also involves consulting with persons in charge about working hours, time off, and mental health. Salary is related to QWL but is less important than the aforementioned factors. The prevention of lower back pain, however, contributes to improving QWL.

Changes in risk factors for severe low-back pain among caregivers in care facilities in Japan from 2014 to 2018.

In Japan, the practice of the no-lift policy, which states that care recipients should be lifted with care equipment rather than by human power, has been increasing since around 2014. The purpose of this study was to examine whether severe low back pain (LBP) risk factors in caregivers changed between 2014 and 2018. A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted in 2014 and 2018. A total of 612 facilities and 2,712 caregivers responded to the questionnaires in 2014, and 504 facilities and 3,478 caregivers completed the questionnaires in 2018. The percentage of caregivers who experienced severe LBP did not differ significantly between 2014 (37.3%) and 2018 (38.3%). However, the number of facilities that introduced care equipment for transfer increased in 2018. Moreover, the number of participants who received training on care methods and using care equipment increased. Lifting a facility resident using human power and taking an unsuitable posture were associated with severe LBP in 2014, but only taking an unsuitable posture was associated with severe LBP in 2018. As taking an unsuitable posture remains to be a primary risk factor for severe LBP, it needs to be addressed in care facilities.

Priority approaches of occupational safety and health activities for preventing low back pain among caregivers.

OBJECTIVES: The incidence of occupational low back pain (LBP) is high among caregivers. The use of care equipment and training about care methods could prevent LBP among caregivers. However, in care facilities in Japan, these measures are not adequately employed. Moreover, the care facilities have faced issues regarding poor staffing in recent years. The present study investigated the relationship between LBP and occupational safety and health activities (OSHAs) for preventing LBP among caregivers and aimed to validate the priority approaches of OSHA. METHODS: This cross-sectional study was conducted in care facilities for the elderly in Japan. Questionnaires for administrators and caregivers were distributed to 1,000 facilities and 5,000 caregivers, respectively. Questionnaires completed by 612 facilities and 2,712 caregivers were analyzed. RESULTS: No direct association was observed between severe LBP and OSHA, but indirect association was done. A significant relationship was noted between severe LBP and the care methods. Direct factors causing severe LBP were lifting a resident using human power and taking an unsuitable posture. These care methods were associated with the following OSHAs: promoting the use of care equipment, training about care methods, and consultation regarding the use of care equipment and employing an appropriate care method with the person in charge. CONCLUSIONS: These OSHAs decreased lifting a resident using human power and taking an unsuitable posture, which are the primary risk factors of LBP. Therefore, these OSHAs should be implemented as priority approaches to prevent LBP among caregivers in care facilities for the elderly.

Effectiveness of re-education based on appropriate care methods using welfare equipment on the prevention of low back pain among care workers: a 1.5†year follow-up study.

Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the intervention facility, 49 care workers were enrolled in ergonomic education program for 1.5 yr in order to improve care methods using welfare equipment. At the non-intervention facility, 33 care workers were not enrolled in the program. Rates of severe LBP were not significantly different between the facilities. However, during the study period, the rate of severe LBP among care workers did not increase at the intervention facility, while it doubled among care workers at the non-intervention facility. The care workers at the intervention facility showed improvement in care methods using welfare equipment during the study period. Hence, we think that re-education regarding appropriate care methods using welfare equipment has the potential to prevent exacerbation of LBP.

White-collar workers' hemodynamic responses during working hours.

In the present study, two investigations were conducted at a communication center, to examine white-collar workers' hemodynamic responses during working hours. In investigation I, hemodynamic responses were measured on a working day; and in investigation II, cardiovascular responses were verified on both working and non-working days. In investigation I, blood pressure, cardiac output, heart rate, stroke volume, and total peripheral resistance were measured in 15 workers during working hours (from 9:00 am to 18:00 pm) on one working day. Another 40 workers from the same workplace participated in investigation II, in which blood pressure and heart rate were measured between the time workers arose in the morning until they went to bed on 5 working days and 2 non-working days. The results showed that blood pressure increased and remained at the same level during working hours. The underlying hemodynamics of maintaining blood pressure, however, changed between the morning and the afternoon on working days. Cardiac responses increased in the afternoon, suggesting that cardiac burdens increase in the afternoon on working days. The present study suggested that taking underlying hemodynamic response into consideration is important for managing the work-related cardiovascular burden of white-collar workers.

Positive emotion inducement modulates cardiovascular responses caused by mental work.

BACKGROUND: Positive emotion is considered as an important factor related to health-relevant biological processes, including cardiovascular responses. To explore the possibility of using positive emotion as a tool to manage cardiovascular response of white-collar workers, we examined the influence on cardiovascular response of positive emotion inducement before a mental work. METHOD: Seventeen healthy males participated and performed a 10-min, PC-based Stroop color word task as their mental work. Before the task, 60 pleasant pictures chosen from the International Affective Picture System were presented in a random order under a positive emotion inducement condition while a gray screen was presented under a control condition. A 30-min relaxation period after completing the task was provided to examine the aftereffects of positive emotion inducement. Throughout these periods, systolic and diastolic blood pressure, mean arterial blood pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were measured continuously. RESULTS: Blood pressure and total peripheral resistance were lower during the picture presentation period under the positive emotion inducement period compared to the control condition. All indices did not differ during the color word task period. During the relaxation period after the task, however, blood pressure and total peripheral resistance were lower under the positive emotion inducement condition compared to the control condition. CONCLUSION: Positive emotion inducement before a mental work beneficially modulates cardiovascular responses, suggesting that positive emotion inducement may be a useful tool to manage the cardiovascular response to mental work.

Low back pain among workers in care facilities for the elderly after introducing welfare equipment.

OBJECTIVE: The purpose of this study was to clarify the causes of low back pain among workers in care facilities for the elderly after the introduction of welfare equipment. METHODS: We conducted anonymous questionnaire surveys among administrators and care workers in eight elderly care facilities. The questionnaires were designed to investigate the status of both the care workers and facility. In reference to the care facility, the questionnaires were comprised items for investigating basic information, occupational safety, and health activities. For care workers, in addition to basic information, occupational safety, and health activities, the questionnaires also comprised items for investigating resident transfer and bathing methods, low back pain, and occupational stress. RESULTS: Completed questionnaires were returned by eight care facility administrators (response rate: 100%) and 373 care workers (response rate: 92.3%), among which 367 were used for analyses. Many care workers participated in a variety of occupational safety and health activities that were conducted in the facilities. Various types of welfare equipment were introduced into the care facilities and subsequently used by many care workers during resident transfer and bathing. As a result, 89.9% of the care workers reported having only slight or no low back pain. The remaining 10.1% reported having serious low back pain that interfered with their work. On the basis of logistic regression analysis, low back pain was associated with the following variables: failure to provide the appropriate method of care to each resident, failure of colleagues to discuss methods for improving care, lack of instructions regarding the use of welfare equipment, and inappropriate job rotation. An association was also found between low back pain and poor posture, poor resident-lifting technique, insufficient time to complete work, and a shortage of workers to assist with resident transfer or bathing. CONCLUSION: Although care workers received instructions on the health and safety activities extracted from the surveys, an association was still found between these activities and low back pain. This was thought to result from some care workers not establishing the appropriate method of care for each resident, not discussing methods for improving care with other colleagues, not using the welfare equipment, and failing to practice appropriate job rotation. These results suggest that low back pain among care workers in the facilities for the elderly that have introduced welfare equipment is caused by a failure to sufficiently conduct appropriate care methods.

Differences in cardiovascular and central nervous system responses to periods of mental work with a break.

The purpose of the present study was to examine how an inserted break influences the cardiovascular and central nervous system responses during periods of mental work. Twelve males conducted two 20-min periods of mental work with a 3-min break between them. Cardiovascular and central nervous system responses were measured continuously. In comparison to the baseline, cardiovascular responses increased continuously even after the inserted break, while, on the contrary, central nervous system activity did not significantly increase during the work periods but relaxed during the break. The work performance increased during the second work period. These results suggest that the inserted break proposed by VDT guidelines in Japan was effective in relaxing the central nervous system but was insufficient to prevent the increase in cardiovascular load. The results also imply that taking rests frequently is important not only to maintaining performance but also to preventing cumulative physiological workloads.

Musculoskeletal pain and night-shift naps in nursing home care workers.

BACKGROUND: Care workers in nursing homes are at high risk of developing musculoskeletal disorders (MSDs). Many care workers work in shifts, which may compromise both the quality of care they give and their working life. Taking a nap during night shifts has been proposed to ameliorate shift work-related problems, but its relationship with MSDs is not clear. AIMS: To explore how MSD pain differs according to frequency of night-shift naps. METHODS: A questionnaire study was conducted on 111 care workers at three nursing homes. Of 98 respondents, data from 66 shift workers (54 women) were analysed. Data on self-rated pain in multiple sites (neck, shoulder, arm, leg and low back), naps during night shifts and relevant variables were collected. Participants were categorized into three groups on the basis of frequency of night-shift naps taken during the previous month: non-nappers, <50% nappers and >or =50% nappers. RESULTS: Pain at all sites, with the exception of low back pain, differed significantly among the three groups. Pain scores were lowest at the arm and leg for the > or =50% nappers. Neck and shoulder pain was lower for the > or =50% nappers and the non-nappers compared to the <50% nappers. CONCLUSIONS: Reduced pain in the arm and leg was associated with taking a nap at least once every two night shifts among the nursing home care workers. No association was found between low back pain and night-shift naps in this sample.

Postural support by a standing aid alleviating subjective discomfort among cooks in a forward-bent posture during food preparation.

In this study, we evaluated the effects on subjective discomfort among cooks during food preparation through use of a standing aid that we developed to alleviate the workload on the low back in the forward-bent posture. Twelve female cooks who worked in a kitchen in a nursing home were asked to prepare foods in 2 working postures: (a) supported by the standing aid (Aid) and (b) without the aid (No aid). They were instructed to evaluate discomfort in 13-body regions during food preparation and the degree of fatigue at the day's end and to enter their ratings after the end of the workday. Since a significant correlation was observed between body height and the improvement effect of discomfort through use of the standing aid, cooks were divided into two groups according to the height, and ratings were analyzed in each group. Among the tall cooks, subjective discomfort in the low back and the front and back of thighs was significantly less with the Aid posture than with the No aid posture. However, in short cooks these values tended to increase in the Aid posture compared with the No aid posture. The results suggest that the standing aid was effective in alleviating tall cooks' workload on the low back in the forward-bent posture.

Work schedule differences in sleep problems of nursing home caregivers.

Nursing home caregivers (n=775; 604 women; mean age 33.6 years) were studied to examine how work schedules affect their sleep. The shift group (n=536) worked under a rotating two-shift system (n=365), a rotating three-shift system (n=66), or other types of shifts (n=78). The non-shift group included 222 caregivers. Participants completed a questionnaire about working conditions, sleep problems, health, lifestyle, and demographic factors. The two-shift caregivers reported the highest levels of difficulty initiating sleep (DIS, 37.6%), insomnia symptoms (43.0%), and poor quality of sleep (24.9%) among the groups. Adjusted odds ratios for these problems were significantly greater for the two-shift caregivers than for non-shift counterparts: DIS (odds ratio 2.86, 95% confidence interval 1.57-5.20), insomnia symptoms (2.33, 1.36-4.02), and poor sleep quality (2.15, 1.09-4.22). Our data suggest that working under a rotating two-shift system, which has a longer night shift, is associated with an elevated risk of sleep problems for nursing home caregivers.

Does leaning posture on the kitchen counter alleviate workload on the low back and legs during dishwashing?

In this study, we evaluated the effects of leaning posture on the kitchen counter, which was observed during dishwashing in a kitchen, on subjective discomfort and muscle activity in the low back and legs. Twelve female volunteers were asked to wash plates for 30 min in each of three working postures: (a) without support (No support), (b) supported by the kitchen counter (Counter), and (c) supported by a standing aid which was a stand equipment to support the shins and the counter (Aid and counter). In the "Aid and counter" posture, the angle of the bent trunk and the muscle activity in the low back were less than that in the "Counter" posture, which was less than that in the "No support" posture. Also, the muscle activities in the legs were greater in the "Counter" and "No support" postures than in the "Aid and counter" posture. We concluded that the effects of leaning posture on the kitchen counter were not enough to decrease the workload on the low back and legs. To improve the comfort of the dishwashing task, new measures, such as the standing aid, are needed.

[Usage survey of care equipment in care service facilities for the elderly].

Musculoskeletal disorders(MSD)have been increasing recently among care workers. Since providing care workers with appropriate equipment is effective for preventing MSD, we conducted a questionnaire survey in two nursing homes and a healthcare facility for the elderly to clarify equipment usage, problems and points for improvement. A total of 81 care workers(average age 32.2 yr; 63 females, 18 males)participated in the survey. The average number of residents and the average resident's care level were 70.0 and 3.6, respectively. Wheelchair and height adjustable beds were fully available and always used in all facilities. Portable lifts, ceiling lifts and transfer boards were, however, few in all 3 facilities and the proportion of use was 14.8%, 16.0%, and 23.5%, respectively. Participants reported that it is time consuming to move residents from place to place with lifts and there is a danger of dropping a resident. Although approximately 90% of care workers had received education and training on care techniques, the workload on the low back was found to be great. Therefore, we thought that care workers must consistently use care equipment. To achieve such increased usage, we must improve the usability of the equipment.