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ARTICOLI SPECIALI / SPECIAL ARTICLES 323 Comfort lavorativo negli ipermercati: dalla sperimentazione alle buone pratiche Comfort conditions for hypermarket workers: from experimental data to best practices F. Martellotta, Sabrina Della Crociata, A. Simone, L. Calderoni, M. D’Alba, M. Cervellati, N. Papapietro
SETTEMBRE - OTTOBRE 2014
337 A rare occupation causing mesothelioma: mechanisms and differential etiology Una rara causa professionale di mesotelioma: meccanismi ed eziologia differenziale G. Mastrangelo, Emanuela Fadda, Vera Comiati, M. dell’Aquila, E. Zamprogno, U. Fedeli, E. Bellini ARTICOLI ORIGINALI / ORIGINAL ARTICLES 346 Disturbi e infortuni dell’apparato muscolo scheletrico tra gli operatori sanitari giornalieri e turnisti nell’ambito ospedaliero Musculoskeletal disorders and work-related injuries among hospital day and shift workers Flavia D’Agostin, C. Negro 357 Foot and Anckle Ability Measure: traduzione e validazione della versione italiana del modulo ADL (FAAM-I/ADL) Foot and Anckle Ability Measure: cross-cultural translation and validation of the Italian version of the ADL module (FAAM-I/ADL) F. Sartorio, S. Vercelli, Elisabetta Bravini, Serena Bargeri, Michela Moroso, G. Plebani, G. Ferriero 366 Le schede di dati di sicurezza del comparto vernici e rivestimenti: analisi degli elementi di maggior interesse per la salute e sicurezza nei luoghi di lavoro The safety data sheets of the paint and coatings sector: analysis of the items of most interest to health and safety in the workplace L. Boniardi, Zulejka Canti, Susanna Cantoni, Silvia Fustinoni 382 I comportamenti controproduttivi e il disimpegno morale degli infermieri quali possibili conseguenze dello stress lavoro correlato: validità e affidabilità delle relative scale di misura Counterproductive behaviors and moral disengagement of nurses as potential consequences of stress-related work: validity and reliability of measurement scales A. Sili, Roberta Fida, F. Zaghini, C. Tramontano, Marinella Paciello LETTERE IN REDAZIONE / LETTERS TO THE EDITOR 395 Work-related musculoskeletal disorders in nursing: current knowledge and ongoing challenges for occupational health (F. Serranheira, D.R. Smith)
Mattioli 1885 casa editrice
398 77° Congresso Nazionale SIMLII - Bologna, 15-17 Ottobre 2014 La Medicina del Lavoro è entrata nel circuito ISI Web of Knowledge con Impact Factor La Medicina del Lavoro is now part of the ISI Web of Knowledge circuit with Impact Factor
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POSTE ITALIANE S.P.A. - SPED. IN A. P. - D.L. 353/2003 (CONV. IN L. 27/02/2004 N. 46) ART. 1, COMMA 1, DCB PARMA - FINITO DI STAMPARE NEL MESE DI SETTEMBRE 2014
Rivista Bimestrale di Medicina del Lavoro e Igiene Industriale Italian journal of Occupational Health and Industrial Hygiene
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Rivista Bimestrale di Medicina del Lavoro e Igiene Industriale Italian journal of Occupational Health and Industrial Hygiene Già diretta da Luigi Devoto (1901-1935) Luigi Preti (1936-1941) Enrico C. Vigliani (1942-1991) DIRETTORE Vito Foà REDATTORI Lorenzo Alessio, Pier Alberto Bertazzi, Antonio Colombi, Silvia Fustinoni Angela Cecilia Pesatori, Carlo Zocchetti CONSIGLIO DI REDAZIONE Pietro Apostoli, Massimo Bovenzi, Pierluigi Cocco, Giovanni Costa, Antonio Mutti, Pietro Sartorelli, Leonardo Soleo, Francesco S. Violante REVISIONE LINGUISTICA Kathleen White SEGRETERIA DI REDAZIONE Lilly Visintin INTERNET http://www.lamedicinadellavoro.it E-MAIL
[email protected] REDAZIONE La Medicina del Lavoro Clinica del Lavoro «L. Devoto» Via San Barnaba, 8 - 20122 Milano (Italy) Tel. 02/50320125 - Fax 02/50320126 CASA EDITRICE Mattioli 1885 srl - Casa Editrice Strada di Lodesana 649/sx, Loc. Vaio - 43036 Fidenza (PR) Tel. 0524/530383 - Fax 0524/82537 e-mail:
[email protected] www.mattioli1885.com (CCP N. 11.286.432) Pubblicazione bimestrale Direttore Responsabile Prof. Vito Foà Autorizzazione del Presidente del Tribunale di Milano 10/5/1948 - Reg. al N. 47 La Medicina del Lavoro è recensita su: Index Medicus/MEDLINE; Embase/Excerpta Medica; Abstracts on Hygiene; Industrial Hygiene Digest; Securité et Santé au Travail Bit-CIS; Sociedad Iberoamericana de Informaciòn Cientifica (SIIC); Science Citation Index Expanded (SciSearch®); Journal Citation Report/Science Edition; ISI Web of Science Inoltre è inserita nel ISI Web of Knowledge con un impact factor di 0,482 (2013)
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Work-related musculoskeletal disorders in nursing: current knowledge and ongoing challenges for occupational health Work-related Musculoskeletal Disorders (MSD) represent a major occupational health concern for the nursing profession and one which has been increasingly studied in recent years, Serranheira et al. 2012 (1), Smith et al. 2006 (2). Nurses’ MSD is often divided into two categories relating to: (i) patient lifting and moving (often involving high physical demands), and (ii) patient treatment that includes static or repetitive tasks (both with and without the use of upper limbs). From an epidemiological perspective, nurses are known to be one of the health care professions most often affected by MSD, especially Low Back Pain (LBP), Lorusso et al. 2007 (3), Trinkoff et al. 2003 (4). This probably relates to heavy physical work tasks such as lifting and transferring patients (which may require sudden movements), spending considerable time working in non-neutral postures (often using awkward postures), working under organizational strain, and the operation of hazardous equipment, Kee et al. 2007 (5). Various MSD risk factors have been documented, including prolonged working hours, physical job demands, and demographic items Attar 2014 (6), Heiden et al. 2013 (7). Aside from professional nurses, an increasing body of research suggests that nursing students may also be at risk, with relatively high MSD prevalence rates reported in some studies Backåberg et al. 2014 (8), Smith et al. 2005 (9). The most frequently reported MSD body sites associated with nursing work tend to involve the back, neck and shoulders, Alexopoulos et al. 2003 (10). In occupational health, it is often suspected that muscular discomfort and/ or pain indicates an impending MSD episode, Hambergvan Reenen et al. 2008 (11), Wahlstrom 2005 (12), which in turn, flags this issue for more detailed work-related risk assessment. The etiology of MSD is multifactorial, Larsson et al. 2007 (13), with various reported associations between work-related MSD and specific factors such as poor posture (including awkward and static postures), lifting patients, transferring patients in and out of bed, and other factors. There has also been an increasing focus on psychosocial and organizational issues in nursing during recent
years, including reductions in the number of staff, high perceived workloads, time pressure, job stress and hospital safety climate, Camerino et al. 2008 (14); Alexopoulos et al. 2003 (10), Smith et al. 2006 (2), Smith et al. 2011 (15). Indeed, it has been suggested that effort-reward imbalance may have an even greater influence on MSD rates than some physical factors, Lee et al. 2014 (16). Not all MSD research in the nursing profession has documented consistent results, however, and various epidemiological challenges remain. Some studies on the relationships between nursing work demands and MSD that have been conducted in different wards, hospitals, and among different countries have reported different findings, Alexopoulos et al. 2006 (17), Fonseca et al. 2006 (18), Kee et al. 2007 (5), Serranheira et al. 2012 (1), Smith et al. 2006 (2). Some of the underlying issues have been epidemiological in nature, such as a lack of random sampling, suboptimal follow-up, focusing on nurses undergoing education and training, and not properly identifying the different work tasks and equipment demands between different workplaces. It has also been suggested that variations in the definition of MSD can have a major impact on MSD prevalence rates, Hegmann et al. 2014 (19). Despite these methodological caveats, it is reasonable to suspect that various tasks which nurses regularly perform might be hazardous to the musculoskeletal system. There remains, therefore, an urgent need for more comprehensive task analysis in nursing, Silverwood et al. 2006 (20), and one which should aim to develop more specific intervention programs to reduce this worldwide burden. Another issue concerns the intrinsic differences between theory and practice, given that under the real world conditions of working hospitals, MSD risk assessment is not necessarily straightforward and theoretical assessment methods may be impractical and unrealistic. Relatively few ergonomics studies have examined the association between real-world work tasks in nursing (incorporating multiple factors such as workplace layout, equipment, organizational demands, and individual characteristics) and the frequency in which
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they are performed, with respect to work-related MSD. Perhaps by necessity, a large proportion of research on this topic has utilized questionnaire surveys and other post-facto, self-reporting data collection methods. All data is still important however, given that it contributes to the increasing body of knowledge and understanding of nurses’ MSD. Some questions that remain to be fully investigated include: Are nurses’ work-related musculoskeletal symptoms and injuries dependent on the wards, the hospital organization and even the national occupational health policies where they work? Is their MSD related with workplace demands, equipment, and nurse-patient ratios? Do these factors highlight different nursing exposures to MSD hazards? What are the individual and psychosocial contributions to nurses’ MSD in different nursing contexts? With these questions in mind, a revised approach which integrates the assessment of more realistic working conditions, including real hospital equipment, workplace features, and individual information; will be an ideal way forwards in the addressing the current MSD epidemic among hospital nurses, worldwide. F. Serranheira Departamento de Saúde Ocupacional e Ambiental, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal E-mail:
[email protected] D.R. Smith School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, Australia E-mail:
[email protected]
REFERENCES 1. Serranheira F, Cotrim T, Rodrigues V, et al: Nurses’ working tasks and MSDs back symptoms: results from a national survey. Work: A Journal of Prevention, Assessment and Rehabilitation 2012; 41: 2449-2451 2. Smith DR, Mihashi M, Adachi Y, et al: A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses. Journal of Safety Research 2006; 37: 195-200 3. Lorusso A, Bruno S, Abbate N: A review of low back pain and musculoskeletal disorders among Italian nursing personnel. Industrial Health 2007; 45: 637 4. Trinkoff AM, Brady B, Nielsen K: Workplace prevention and musculoskeletal injuries in nurses. J Nurs Adm 2003; 33: 153-158 5. Kee D, Seo S.R: Musculoskeletal disorders among nursing personnel in Korea. International Journal of Industrial Ergonomics 2007; 37: 207-212
6. Attar SM: Frequency and risk factors of musculoskeletal pain in nurses at a tertiary centre in Jeddah, Saudi Arabia: a cross sectional study. BMC Research Notes 2014; 7: 61 7. Heiden B, Weigl M, Angerer P, Müller A: Association of age and physical job demands with musculoskeletal disorders in nurses. Applied Ergonomics 2013; 44: 652658 8. Backåberg S, Rask M, Brunt D, Gummesson C: Impact of musculoskeletal symptoms on general physical activity during nursing education. Nurse Education in Practice 2014 9. Smith DR, Choe M-A, Chae YR., et al: Musculoskeletal symptoms among Korean nursing students. Contemporary Nurse 2005; 19: 151-160 10. Alexopoulos EC, Burdorf A, Kalokerinou A. Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals. Int Arch Occup Environ Health 2003; 76: 289-294 11. Hamberg-van Reenen HH, van der Beek AJ, Blatter BM, et al: Does musculoskeletal discomfort at work predict future musculoskeletal pain? Ergonomics 2008; 51: 637-648 12. Wahlstrom J: Ergonomics, musculoskeletal disorders and computer work. Occup Med (Lond) 2005; 55: 168176 13. Larsson B, Sogaard K, Rosendal L: Work related neckshoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Practice & Research Clinical Rheumatology 2007; 21: 447-463 14. Camerino D, Estryn-Behar M, et al: Work-related factors and violence among nursing staff in the European NEXT study: a longitudinal cohort study. International Journal of Nursing Studies 2008; 45: 35-50 15. Smith DR, Muto T, Sairenchi T, et al: Examining the dimensions of hospital safety climate and psychosocial risk factors among Japanese nurses. Journal of Transcultural Nursing 2011; 22: 257-264 16. Lee SJ, Lee JH, Gillen M, Krause N: Job stress and work related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand control and effort reward imbalance models. American Journal of Industrial Medicine 2014; 57: 214-221 17. Alexopoulos EC, Burdorf A, Kalokerinou A: A comparative analysis on musculoskeletal disorders between Greek and Dutch nursing personnel. International Archives of Occupational and Environmental Health 2006; 79: 82-88 18. Fonseca R, Serranheira F: Sintomatologia músculo-esquelética auto-referida por enfermeiros em meio hospi-
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talar. Rev Port Saúde Pública Volume Temático 2006: 37-44 19. Hegmann KT, Thiese MS, Wood EM, et al: Impacts of Differences in Epidemiological Case Definitions on Prevalence for Upper-Extremity Musculoskeletal Dis-
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orders. Human Factors: The Journal of the Human Factors and Ergonomics Society 2014; 56: 191-202 20. Silverwood S, Haddock M: Reduction of musculoskeletal injuries in intensive care nurses using ceilingmounted patient lifts. Dynamics 2006; 17
