Prevalencia de síntomas musculo-esqueléticos en trabajadores de una institución de educación superior en el departamento de Arauca, Colombia, 2015

Introducción Los desórdenes musculo esqueléticos representan uno de los problemas de salud ocupacional más comunes de trabajadores, lo cual genera ausentismo laboral y aumento en los costos de enfermedades laborales. Objetivo Estimar la prevalencia de síntomas osteomusculares y su relación con factores de riesgo ocupacional, en personal docente y administrativo de una institución de educación superior en el Departamento de Arauca para el año 2015. Métodos Estudio analítico de corte transversal en una muestra de 116 trabajadores. Se utilizaron dos instrumentos: “La Encuesta Nacional de Condiciones de Trabajo” del Instituto Nacional de Seguridad e Higiene en el Trabajo de España (INSHT) y el “Cuestionario Ergopar”, validados al Español. Se obtuvo previa autorización del Comité de ética de la Universidad del Rosario. El análisis estadístico se realizó con el IBM SPSS Statistics versión 20.0. Resultados: Los síntomas osteomusculares con mayor prevalencia fueron en cuello (86,2%), espalda lumbar (61,2%), manos muñecas (59,5%) y pies (52,6%); no se observaron diferencias estadísticamente significantes entre administrativos e instructores. En el lugar de trabajo los factores de riesgo con mayor prevalencia fueron exposición a temperaturas extremas (48,3%), aberturas y huecos desprotegidos, escaleras, plataformas, desniveles (44%) significativamente mayor en instructores (52,6%) que en personal administrativo (27,5%) (p= 0,010). Conclusiones: Los síntomas osteomusculares más prevalentes fueron aquellos propios de la actividad docente: cuello, espalda lumbar, manos muñecas y pies. El personal de la institución en especial los docentes está expuesto a factores de riesgo físico, químico y ergonómico. Las condiciones de trabajo son adecuadas. No se encontró asociación estadística entre exposición a factores de riesgo en el puesto de trabajo y prevalencia de síntomas osteomusculares. Se debe establecer acciones dirigidas a evitar lesiones musculo esqueléticas en la población.

Physical and psychosocial risk factors for musculoskeletal disorders in Brazilian and Italian nurses

As part of the international CUPID investigation, we compared physical and psychosocial risk factors for musculoskeletal disorders among nurses in Brazil and Italy. Using questionnaires, we collected information on musculoskeletal disorders and potential risk factors from 751 nurses employed in public hospitals. By fitting country-specific multiple logistic regression models, we investigated the association of stressful physical activities and psychosocial characteristics with site-specific and multisite pain, and associated sickness absence. We found no clear relationship between low back pain and occupational lifting, but neck and shoulder pain were more common among nurses who reported prolonged work with the arms in an elevated position. After adjustment for potential confounding variables, pain in the low back, neck and shoulder, multisite pain, and sickness absence were all associated with somatizing tendency in both countries. Our findings support a role of somatizing tendency in predisposition to musculoskeletal disorders, acting as an important mediator of the individual response to triggering exposures, such as work-load.

Prevalencia de síntomas relacionados con desórdenes musculo esqueléticos en trabajadores de una empresa dedicada a la venta y distribución de medicamentos y equipos médicos - Colombia, 2015.

Introducción: Los Desórdenes Musculo-Esqueléticos (DME) tienen origen multifactorial. En Colombia corresponden al principal grupo diagnóstico en procesos relacionados con la determinación de origen y pérdida de capacidad laboral. Objetivo: Determinar la relación entre síntomas musculo-esqueléticos y factores relacionados con la carga física en trabajadores de una empresa dedicada a la venta y distribución de medicamentos y equipos médicos, Bogotá (Colombia), en el año 2015. Materiales y Métodos: Estudio de corte transversal en 235 trabajadores. Se incluyeron variables sociodemográficas, ocupacionales y las relacionadas con los síntomas musculoesqueléticos y carga física. Se utilizó en cuestionario ERGOPAR. Para el análisis se utilizó la Prueba Exacta de Fisher, el Odds Ratio (OR) con el Intervalo de Confianza (IC) del 95%. Se realizó el análisis Multivariado con Regresión Logística Binaria. Resultados: La prevalencia de síntomas relacionados con DME fue de 79,2%, siendo más prevalente en cuello, hombros y columna dorsal (48,1%), seguido por columna lumbar (35,3%). Se encontró una asociación entre síntomas en cuello, hombros y/o columna dorsal con el sexo femenino (p=0,005, OR=2,33, 95%IC: 1,2-4,2); adoptar postura bípeda menos de 30 minutos (p=0,004, OR=3,34, 95%IC: 1,4-7,6); adoptar postura cabeza/cuello inclinado hacia delante entre 30 minutos y 2 horas (p=0,007, OR=3,25, 95%IC :1,3-7,7) y en columna lumbar con adoptar postura espalda/tronco hacia delante entre 30 minutos y 2 horas (p=0,001, OR=4,27, 95%IC: 1,7-10,3); y la antigüedad en el cargo entre 1 y 5 años (p=0,009, OR=3,47, 95%IC: 1,3-8,8). Conclusión: Las posturas bípedas con y sin desplazamiento, inclinaciones de tronco y cabeza, transporte manual de cargas, sexo femenino, antigüedad en el cargo y edad están asociadas conjuntamente al riesgo para presentar DME.

Risk Factors for Latex Sensitization in Children with Spina Bifida

Background: Children with spina bifida represent the major risk group for latex sensitization. Purpose: To determine the prevalence of latex sensitization in these children and to identify risk factors. Material and methods: We studied 57 patients with spina bifida. The mean age was 5.6 years and the male/female ratio was 0.8/1. In all patients a questionnaire, skin prick test (SPT) with latex (UCBStallergènes, Lofarma and ALK-Abelló), common aeroallergens and fruits (UCB-Stallergènes) and serum determination of total IgE (AlaSTAT) were performed. Results: The prevalence of latex sensitization was 30 %; only two sensitized children (12 %) had symptoms after exposure. Risk factors for latex sensitization were age 5 years (p = 0.008; OR = 6.0; 95% CI = 1.7-22.1), having at least four previous surgical interventions (p < 0.0001; OR = 18.5; 95% CI = 3.6-94.8), having undergone surgery in the first 3 months of life (p = 0.008; OR = 5.4; 95% CI = 0.7-29.2) and total serum IgE 44 IU/ml (p = 0.03; OR = 3.8; 95 %CI = 1.1-13.1). Multiple logistic regression analysis showed that only a history of four or more surgical interventions (p < 0.0001; OR = 26.3; 95 %CI = 2.9-234.2) and total serum IgE 44 IU/ml (p = 0.02; OR = 8.6; 95% CI = 1.4-53.4) were independently associated with latex sensitization. Sex, family and personal allergic history, hydrocephalus with ventriculoperitoneal shunt, cystourethrograms, intermittent bladder catheterization and atopy were not related to latex sensitization. Conclusions: In children with spina bifida, significant and independent risk factors identified for latex sensitization were multiple interventions and higher levels of total serum IgE. A prospective study will clarify the clinical evolution of assymptomatic children sensitized to latex.

Prevalencia de síntomas musculoesqueléticos en personal que labora en una Central eléctrica en las actividades de Gestión y Control de Pérdidas de Energía en Norte de Santander, 2016

Introducción: Los trastornos musculoesqueléticos de origen laboral son la primera causa de baja en los trabajadores produciendo disminución de la capacidad productiva y reducción del salario y para las empresas suponen disfunciones de la actividad y pérdidas económicas. Objetivo: Identificar la prevalencia de síntomas musculoesqueléticos del personal tanto operativo como administrativo que laboran en la central eléctrica en Norte de Santander. Metodología: Estudio de corte transversal en una población de 184 trabajadores que laboran para la sección de gestión y control de pérdidas de energía en la Central eléctrica de Norte de Santander. Se utilizó como instrumento para la recolección de información el cuestionario Nórdico de Kuorinka en su versión en español, que permite realizar la detección y análisis de síntomas musculoesqueléticos de la población expuesta, el cual consta de dos partes, la primera que incluye datos socio demográficos tales como antecedentes personales y actividad laboral y la segunda que permite registrar síntomas músculo-esqueléticos en los segmentos corporales (cuello, hombros, codos, muñecas/manos, espalda superior, espalda inferior). El análisis descriptivo incluyó el cálculo de la media y los porcentajes y para estimar asociaciones se utilizó odds ratio (OR) Resultados: El 88% de los trabajadores eran hombres, con una media de edad de 36,1(±10,5) años. El 20,7% percibía molestias en el cuello y el 17,4 % en las muñecas. Tuvieron más riesgo de percibir molestias en la región del cuello las mujeres (OR 20,54), los trabajadores que pertenecen al sector administrativo (OR 15,9), los que no realizar actividad física (OR 2,33), los que tienen menos de 1 año en el cargo (OR 2,9) y los que tenían un Índice de masa corporal mayor de 25 (OR 1,31). Conclusiones: Ser mujer y trabajar en el sector administrativo influyen en la percepción de molestias y síntomas osteomusculares con mayor prevalencia en las zonas corporales de el cuello y las muñecas o manos. De acuerdo a lo encontrado en el estudio se sugiere la realización de actividades en salud laboral que prevengan el riesgo ergonómico.

Associations among working conditions and behavioral risk factors : The Helsinki Health Study with International Comparisons

Adverse health behaviors as well as obesity are key risk factors for chronic diseases. Working conditions also contribute to health outcomes. It is possible that the effects of psychosocially strenuous working conditions and other work-related factors on health are, to some extent, explained by adverse behaviors. Previous studies about the associations between several working conditions and behavioral outcomes are, however, inconclusive. Moreover, the results are derived mostly from male populations, one national setting only, and with limited information about working conditions and behavioral risk factors. Thus, with an interest in employee health, this study was set to focus on behavioral risk factors among middle-aged employees. More specifically, the main aim was to shed light on the associations of various working conditions with health behaviors, weight gain, obesity, and symptoms of angina pectoris. In addition to national focus, international comparisons were included to test the associations across countries thereby aiming to produce a more comprehensive picture. Furthermore, a special emphasis was on gaining new evidence in these areas among women. The data derived from the Helsinki Health Study, and from collaborative partners at the Whitehall II Study, University College London, UK, and the Toyama University, Japan. In Helsinki, the postal questionnaires were mailed in 2000-2002 to employees of the City of Helsinki, aged 40 60 years (n=8960). The questionnaire data covered e.g., socio-economic indicators and working conditions such as Karasek s job demands and job control, work fatigue, working overtime, work-home interface, and social support. The outcome measures consisted of smoking, drinking, physical activity, food habits, weight gain, obesity, and symptoms of angina pectoris. The international cohorts included comparable data. Logistic regression analysis was used. The models were adjusted for potential confounders such as age, education, occupational class, and marital status subject to specific aims. The results showed that working conditions were mostly unassociated with health behaviors, albeit some associations were found. Low job strain was associated with healthy food habits and non-smoking among women in Helsinki. Work fatigue, in turn, was related to drinking among men and physical inactivity among women. Work fatigue and working overtime were associated with weight gain in Helsinki among both women and men. Finally, work fatigue, low job control, working overtime, and physically strenuous work were associated with symptoms of angina pectoris among women in Helsinki. Cross-country comparisons confirmed mostly non-existent associations. High job strain was associated with physical inactivity and smoking, and passive work with physical inactivity and less drinking. Working overtime, in turn, related to non-smoking and obesity. All these associations were, however, inconsistent between cohorts and genders. In conclusion, the associations of the studied working conditions with the behavioral risk factors lacked general patters, and were, overall, weak considering the prevalence of psychosocially strenuous work and overtime hours. Thus, based on this study, the health effects of working conditions are likely to be mediated by adverse behaviors only to a minor extent. The associations of work fatigue and working overtime with weight gain and symptoms of angina pectoris are, however, of potential importance to the subsequent health and work ability of employees.

Prevalence and risk factors for foot and ankle musculoskeletal disorders experienced by nurses

Background Nurses are at high risk of musculoskeletal disorders (MSDs). Although the prevalence of MSDs of the lower back, upper limbs, neck and shoulders have been reported previously in nursing, few studies have evaluated MSDs of the foot and ankle. This study evaluated the prevalence of foot and ankle MSDs in nurses and their relation to individual and workplace risk factors. Methods A self-administered survey incorporating the Nordic Musculoskeletal Questionnaire (NMQ) was distributed, over a nine-week period, to all eligible nurses (n = 416) working in a paediatric hospital in Brisbane, Australia. The prevalence of MSDs for each of the NMQ body regions was determined. Bivariate and multivariable logistic regression analyses were conducted to examine the relationships between activity-limiting foot/ankle MSDs and risk factors related to the individual (age, body mass index, number of existing foot conditions, smoking history, general physical health [SF36 Physical Component Scale], footwear features) or the workplace (level of nursing position, work location, average hours worked, hours worked in previous week, time since last break from work). Results A 73% response rate was achieved with 304 nurses completing surveys, of whom 276 were females (91%). Mean age of the nurses was 37 years (±10), younger than the state average of 43 years. Foot/ankle MSDs were the most prevalent conditions experienced by nurses during the preceding seven days (43.8%, 95% CI 38.2-49.4%), the second most prevalent MSDs to impair physical activity (16.7%, 95% CI 13.0-21.3%), and the third most prevalent MSD, after lower-back and neck problems, during the preceding 12 months (55.3%, 95% CI 49.6-60.7%). Of the nurse and work characteristics investigated, obesity, poor general physical health, existing foot conditions and working in the intensive care unit emerged as statistically significant (p < 0.05) independent risk factors for activity-limiting foot/ankle MSDs. Conclusions Foot/ankle MSDs are common in paediatric hospital nurses and resulted in physical activity limitations in one out of every six nurses. We recommend targeted education programs regarding the prevention, self-management and treatment strategies for foot/ankle MSDs. Further research is needed into the impact of work location and extended shift durations on foot/ankle MSDs.

Psychosocial factors and musculoskeletal symptoms in a vulnerable working population in Nicaragua

This research is a secondary data analysis of the CUPID-INCA Nicaragua study, a cross-sectional study comparing psychosocial and physical factors on musculoskeletal symptoms among nurses, office workers and maquiladoras in Nicaragua. There were three objectives for this thesis. (1) To describe the study population according to their socio-demographic, psychosocial (i.e. work organization and health beliefs) and physical factors. (2) To estimate the prevalence of musculoskeletal disorders (MSDs) in the study population (nurses, office workers and maquilas). (3) To analyze and compare the trends of association between psychosocial factors and MSDs to that of physical factors and MSDs in the study population. Trends of association between MSDs and psychosocial factors were also compared between nurses, office workers and maquilas. ^ Majority of the total study population were females, middle aged, non smokers and had been on the job for more than five years. Prevalence rates of low back pain and upper extremity pain were 28% and 37% respectively in nurses, 17% and 34% in office workers and 18% and 31% in maquilas. Workers' health belief was significantly associated with MSDs in all three occupational groups. Psychosocial factors were not consistently associated more with MSDs than physical factors. Maquilas had more psychosocial factors statistically significantly associated with musculoskeletal symptoms than nurses and office workers. ^ The findings of this research suggest that both psychosocial and physical risk factors play a role on the prevalence of musculoskeletal symptoms in the three working populations in Nicaragua. Future research in this area should explore further, the risk of developing MSDs from workers' exposure to psychosocial factors as well as physical factors.^

Work related musculoskeletal disorders amongst therapists in physically demanding roles: Qualitative analysis of risk factors and strategies for prevention

Background Physiotherapy and occupational therapy are two professions at high risk of work related musculoskeletal disorders (WRMD). This investigation aimed to identify risk factors for WRMD as perceived by the health professionals working in these roles (Aim 1), as well as current and future strategies they perceive will allow them to continue to work in physically demanding clinical roles (Aim 2). Methods A two phase exploratory investigation was undertaken. The first phase included a survey administered via a web based platform with qualitative open response items. The second phase involved four focus group sessions which explored topics obtained from the survey. Thematic analysis of qualitative data from the survey and focus groups was undertaken. Results Overall 112 (34.3%) of invited health professionals completed the survey; 66 (58.9%) were physiotherapists and 46 (41.1%) were occupational therapists. Twenty-four health professionals participated in one of four focus groups. The risk factors most frequently perceived by health professionals included: work postures and movements, lifting or carrying, patient related factors and repetitive tasks. The six primary themes for strategies to allow therapists to continue to work in physically demanding clinical roles included: organisational strategies, workload or work allocation, work practices, work environment and equipment, physical condition and capacity, and education and training. Conclusions Risk factors as well as current and potential strategies for reducing WRMD amongst these health professionals working in clinically demanding roles have been identified and discussed. Further investigation regarding the relative effectiveness of these strategies is warranted.

Students' knowledge of symptoms and risk factors of potential life-threatening medical conditions

In order to assess medical students' knowledge of Basic Life Support (BLS) principles, we defined a minimal knowledge (MK) of three life-threatening medical conditions that should be universally known: cardiac arrest, heart attack and stroke, and compared the results with those of laypersons.

Incidence of Chronic and Other Knee Pain in Relation to Occupational Risk Factors in a Large Working Population.

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Interaction of psychosocial risk factors explain increased neck problems among female office workers

This study investigated the relationship between psychosocial risk factors and (1) neck symptoms and (2) neck pain and disability as measured by the neck disability index (NDI). Female office workers employed in local private and public organizations were invited to participate, with 333 completing a questionnaire. Data were collected on various risk factors including age, negative affectivity, history of previous neck trauma, physical work environment, and task demands. Sixty-one percent of the sample reported neck symptoms lasting greater than 8 days in the last 12 months. The mean NDI of the sample was 15.5 out of 100, indicating mild neck pain and disability. In a hierarchical multivariate logistic regression, low supervisor support was the only psychosocial risk factor identified with the presence of neck symptoms. Similarly, low supervisor support was the only factor associated with the score on the NDI. These associations remained after adjustment for potential confounders of age, negative affectivity, and physical risk factors. The interaction of job demands, decision authority, and supervisor support was significantly associated with the NDI in the final model and this association increased when those with previous trauma were excluded. Interestingly, and somewhat contrary to initial expectations, as job demands increased, high decision authority had an increasing effect on the NDI when supervisor support was low.

Obesity and comorbid risk factors for cardiovascular disease among physically inactive patients with musculoskeletal disorders : a targeted intervention for this priority patient group is warranted

Introduction The benefits of physical activity are established and numerous; not the least of which is reduced risk of negative cardiovascular events. While sedentary lifestyles are having negative impacts across populations, people with musculoskeletal disorders may face additional challenges to becoming physically active. Unfortunately, interventions in ambulatory hospital clinics for people with musculoskeletal disorders primarily focus on their presenting musculoskeletal complaint with cursory attention given to lifestyle risk factors; including physical inactivity. This missed opportunity is likely to have both personal costs for patients and economic costs for downstream healthcare funders. Objectives The objective of this study was to investigate the presence of obesity, diabetes, diagnosed cardiac conditions, and previous stroke (CVA) among insufficiently physically active patients accessing (non-surgical) ambulatory hospital clinics for musculoskeletal disorders to indicate whether a targeted risk-reducing intervention is warranted. Methods A sub-group analysis of patients (n=110) who self-reported undertaking insufficient physical activity level to meet national (Australian) minimum recommended guidelines was conducted. Responses to the Active Australia Survey were used to identify insufficiently active patients from a larger cohort study being undertaken across three (non-surgical) ambulatory hospital clinics for musculoskeletal disorders. Outcomes of interest included body mass index, Type-II diabetes, diagnosed cardiac conditions, previous CVA and patients’ current health-related quality of life (Euroqol-5D). Results The mean (standard deviation) age of inactive patients was 56 (14) years. Body mass index values indicated that n=80 (73%) were overweight n=26 (24%), or obese n=45 (49%). In addition to their presenting condition, a substantial number of patients reported comorbid diabetes n=23 (21%), hypertension n=25 (23%) or an existing heart condition n=14 (13%); 4 (3%) had previously experienced a CVA as well as other comorbid conditions. Health-related quality of life was also substantially impacted, with a mean (standard deviation) multi-attribute utility score of 0.51 (0.32). Conclusion A range of health conditions and risk factors for further negative health events, including cardiovascular complications, consistent with physically inactive lifestyles were evident. A targeted risk-reducing intervention is warranted for this high risk clinical group.

Hormone therapy in elderly women; a comparative study with alendronate of the effects on bone, cardiovascular risk factors, periodontal conditions and quality of life

Thirty percent of 70-year-old women have osteoporosis; after age of 80 its prevalence is up to 70%. Postmenopausal women with osteoporosis seem to be at an increased risk for cardiovascular events, and deterioration of oral health, as shown by attachment loss of teeth, which is proportional to the severity of osteoporosis. Osteoporosis can be treated with many different medication, e.g. estrogen and alendronate. We randomized 90 elderly osteoporotic women (65-80 years of age) to receive hormone therapy (HT)(2mg E2+NETA), 10mg alendronate, and their combination for two years and compared their effects on bone mineral density (BMD) and turnover, two surrogate markers of the risk of cardiovascular diseases, C-reactive protein (CRP) and E-selectin, as well as oral health. The effect of HT on health-related quality of life (HRQoL) was studied in the population-based cohort of 1663 postmenopausal women (mean age 68 yr) (585 estrogen users and 1078 non-users). BMD was measured with dual-energy X-ray absorptiometry (DXA) at 0, 12 and 24 months. Urinary N-telopeptide (NTX) of type I collagen, a marker of bone resorption, and serum aminoterminal propeptide of human type I procollagen (PINP), a marker of bone formation, were measured every six months of treatment. Serum CRP and E-selectin, were measured at 0, 6, and 12 months. Dental, and periodontal conditions, and gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels were studied to evaluate the oral health status and for the mouth symptoms a structured questionnaire was used. The HRQoL was measured with 15D questionnaire. Lumbar spine BMD increased similarly in all treatment groups (6.8-8.4% and 9.1-11.2%). Only HT increased femoral neck BMD at both 12 (4.9%) and 24 months (5.8%), at the latter time point the HT group differed significantly from the other groups. HT reduced bone marker levels of NTX and PINP significantly less than other two groups.Oral HT significantly increased serum CRP level by 76.5% at 6 and by 47.1% (NS) at 12 months, and decreased serum E-selectin level by 24.3% and 30.0%. Alendronate had no effect on these surrogate markers. Alendronate caused a decrease in the resting salivary flow rate and tended to increase GCF MMP-8 levels. Otherwise, there was no effect on the parameters of oral health. HT improved the HRQoL of elderly women significantly on the dimensions of usual activities, vitality and sexual activity, but the overall improvement in HRQoL was neither statistically significant nor clinically important. In conclusion, bisphosphonates might be the first option to start the treatment of postmenopausal osteoporosis in the old age.