Haemodialysis nurses' occupational health and work-related musculoskeletal hand pain after work: A cluster analysis.

AIM: To identify clusters based on haemodialysis nurses' self-rated work ability, work engagement and self-reported work hours and to compare the identified clusters regarding hand pain after work. DESIGN: Cross-sectional survey. METHODS: Data based on the Work Ability Index, Utrecht Work Engagement Scale and hand pain severity after work were collected through a web-based survey among 503 haemodialysis nurses working in Sweden and Denmark. A two-step cluster analysis was used to identify homogenous groups of cases within the dataset, followed by comparative analyses of the clusters. RESULTS: Four distinct clusters were identified, illustrating differing profiles of haemodialysis nurses' work ability, work engagement and working hours. Nurses who worked part-time and reported moderate work ability and average work engagement had significantly higher ratings of hand pain after work. CONCLUSIONS: Haemodialysis nurses are a heterogeneous group as regards work ability, work engagement and self-reported work hours. The four distinct clusters of nurses indicate a need for customized interventions for retaining each subgroup at work.

Work-related musculoskeletal complaints among haemodialysis nurses: An exploratory study of the work situation from an ergonomic perspective.

BACKGROUND: Haemodialysis nurses have a high prevalence of musculoskeletal complaints, but the reason for this is yet unknown. OBJECTIVE: The aim of this study was to carry out an exploratory analysis of the work situation of haemodialysis nurses from an ergonomic perspective. METHODS: Non-participant observations and reflective discussions to assess the work environment and explore possible potential hazards contributing to musculoskeletal complaints were conducted among nineteen nurses at five haemodialysis centres. Additional reflective notes from the observer's experiences and progress in the field were made. Analytic integration was applied to merge the collected data. RESULTS: Eight haemodialysis work tasks believed to increase the risk of developing work-related musculoskeletal complaints were identified. Different types of musculoskeletal complaints, mainly in the upper extremity, were mentioned. The design of the dialysis machine used and the physical demands of repetitive work procedures were implicated. CONCLUSIONS: Our findings add to the understanding of the work-related factors that contribute to musculoskeletal complaints among haemodialysis nurses. The findings support the hypothesis that there might be an association between materials used and the development of work-related complaints involving the fingers, hands and wrists of this population. Repetitive work tasks that have an impact on the development of musculoskeletal problems need to be further investigated.

Prevalence of musculoskeletal complaints among haemodialysis nurses - a comparison between Danish and Swedish samples.

Objective. The repetitiveness of priming and dismantling disposables for haemodialysis treatments might be an important contributor to musculoskeletal complaints. The objective was therefore to compare the prevalence of musculoskeletal complaints among haemodialysis nurses in Denmark and Sweden. Methods. For this cross-sectional study, nurses were recruited from haemodialysis centres in Denmark (n = 194) and Sweden (n = 351). Prevalence of musculoskeletal complaints was evaluated using the Nordic musculoskeletal questionnaire. Results. The percentage of nurses reporting musculoskeletal complaints from at least one part of their body was 90.2% in the Danish sample and 88.9% in the Swedish sample. The anatomical locations with the most complaints were the neck, lower back and hands. Except for the proportion of complaints concerning the neck, there were no differences between the countries. Absenteeism from work was mostly due to complaints regarding the hands. Conclusion. The prevalence of musculoskeletal complaints seems to be higher among haemodialysis nurses than among nurses in general. Because complaints concerning the hands are common, and also related to absenteeism from work, it is of particular importance that manufacturers of dialysis equipment and nurse managers acknowledge these occupational health and safety hazards in their efforts to create a good work environment.

Associations between materials used and work-related musculoskeletal hand complaints among haemodialysis nurses.

BACKGROUND: One in every two haemodialysis nurses has reported musculoskeletal complaints concerning their hands, which is twice that reported for hospital nurses in general. It is possible that there is an association between the materials used by haemodialysis nurses and the occurrence of hand complaints. OBJECTIVES: To examine the association between the type of dialysis machine and disposables used with the occurrence of hand complaints among haemodialysis nurses. To compare occupational risks of developing work-related musculoskeletal disorders based on the materials used for haemodialysis. DESIGN: Cross-sectional. PARTICIPANTS: Two hundred and eighty-two nurses working in 27 haemodialysis centres in Sweden participated in a survey, and 19 nurses at five centres were observed during priming procedures. MEASUREMENTS: Nurses supplied demographic data and answered the Nordic Musculoskeletal Questionnaire. Centre level data regarding machines and disposables used for haemodialysis during the past year were also collected. RESULTS: There were no differences in the prevalence of hand complaints based on the type of haemodialysis machines, dialysers or tubing used. There were no differences found in physical exposure to the hands during priming, based on machine type used. CONCLUSION: The results of this study could not reveal any association between disposable materials used and the occurrence of hand complaints among haemodialysis nurses. Additionally, there were no occupational risks detected based on the types of machines used. Hence, the results of the present study strongly indicate that a deeper ergonomic analysis of the work environment is needed to understand the prevalence of hand complaints among nurses working in haemodialysis settings.

Pathology of natural Francisella tularensis subsp. holarctica infection in two yellow-necked mice (Apodemus flavicollis).

BACKGROUND: Tularemia is a zoonosis caused by the bacterium Francisella tularensis. It has a wide host range, which includes mammals, birds and invertebrates. F. tularensis has often been isolated from various species of small rodents, but the pathology in naturally infected wild rodent species has rarely been reported. CASE PRESENTATION: Herein, we describe the pathology of tularemia in two naturally infected wild yellow-necked mice (Apodemus flavicollis). To visualize F. tularensis subsp. holarctica, indirect immunofluorescence and immunohistochemistry were applied on tissue sections. Real time polymerase chain reaction detected the bacterium in samples from liver and spleen in both mice. The only finding at necropsy was splenomegaly in one of the mice. Histological examination revealed necrotic foci in the liver associated with mild inflammation in both mice. Immunohistochemistry and indirect immunofluorescence showed bacteria disseminated in many organs, in the cytoplasm of macrophages, and intravascularly. CONCLUSIONS: The two yellow-necked mice died of an acute disease caused by tularemic infection disseminated to many organs. Further investigations of naturally infected small rodents are important to better understand the variability in pathological presentation caused by infection by F. tularensis subsp. holarctica, as well to elucidate the importance of small rodents as transmitters and/or reservoirs.

The occurrence of Chlamydia spp. in pigs with and without clinical disease.

BACKGROUND: Within the genera Chlamydia, the development of refined diagnostic techniques has allowed the identification of four species that are capable of infecting pigs. The epidemiology, clinical, and zoonotic impacts of these species are however largely unknown. The study aimed to investigate the presence of Chlamydia spp. in the intestines of growing pigs and in conjunctival swabs from finisher pigs, and relate the findings to clinical signs. RESULTS: By histology, 20 of 48 pigs had intestinal lesions that may be consistent with chlamydial infection. By PCR, forty-six of the pigs were positive whereas two samples were inhibited. Sequencing of 19 DNA extracts identified these as Chlamydia suis. By immunohistochemistry, 32 of 44 samples were positive and a significant relationship was detected between macroscopically visible intestinal lesions and a high degree of infection. By real-time PCR, a significant difference was detected between pigs with and without conjunctivitis when a Ct value of 36 was employed but not when a Ct value of 38 was employed. CONCLUSIONS: Chlamydia suis was demonstrated in most samples and overall, no correlation to clinical signs was detected. However, a correlation was noted between samples with a high degree of infection and the presence of clinical signs. It is possible, that the intensive pig production systems studied might predispose for the transmission and maintenance of the infection thus increasing the infectious load and the risk for disease in the pig.