Kermit Davis

The aim of this study was to determine the prevalence of musculoskeletal pain and reported injuries for nurses and nursing aides. Nurses and nursing aides suffer from work-related pain and musculoskeletal disorders (MSDs). Although there have been a plethora of studies on MSDs, an overall understanding of the prevalence of MSDs and pain can lead to better prioritization of research needs with respect to the health care industry. A total of 132 articles on prevalence of MSD pain and injuries were included in the review. All articles were published in peer-reviewed English-speaking journals and subjected to a quality review. Reported prevalence of MSD pain for nurses and nursing aides was highest in the low back, followed by shoulders and neck. However, the majority of the studies have been concentrated on 12-month pain in the low back and predominantly in hospitals. Few researchers have investigated pain in the upper and lower extremities (less than 27% of the studies). Even fewer re...

... Susan E. Kotowski1, Kermit G. Davis1, William S. Marras2 1 Low Back Biomechanics & Workplace Stress Laboratory, University of Cincinnati 2 Biodynamic Laboratory, The Ohio State University ... The RPE was rated on Borg's 6-20 scale. ...

Elevating the hospital head of bed (HOB) to at least 30° is recommended practice to reduce the risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. However, this common practice prescribes the position of the bed and not of the patient, which could be significantly different. The aim of this research was to determine the relationship between patient migration in bed and anatomic torso angle. Ten healthy participants were positioned in a hospital bed that was raised from flat to 30° and 45° HOB elevations. Prior to bed movement, participants were aligned to different locations along the length of the bed to represent different amounts of migration. A motion capture system was used to measure torso angle and migration toward the foot of the bed. The relationship between torso angle and migration was estimated by linear regression. Patient migration resulted in lower torso angles for both 30° and 45° HOB articulations. A migration of 10 cm resulted in a loss of 9.1° and 13.0° of torso angle for HOB articulations of 30° and 45°, respectively (for 30° articulations: (Equation is included in full-text article.)= -0.91, R = .96; for 45° articulations: (Equation is included in full-text article.)= -1.30, R = .98). Migration toward the foot of the bed flattens the torso. To maintain a torso angle that is likely to protect against VAP, healthcare providers need to manage both HOB angle and migration. Protocols and equipment that minimize patient migration will help support effective clinical practice. Future research on patient migration, as it relates to VAP or other outcomes, should measure patient torso angle to allow accurate translation of the results to care practice.

The ramifications of patient migration toward the foot of the bed in intensive care units are not well understood. Migration may cause shear and friction between the patient and the mattress, reduce elevation of the patient's torso, and require frequent repositioning of the patient. This study assesses how bed design impacts both the amount of migration that patients undergo during head section articulation to 30° and 45° and the extent of torso compression following the articulation.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

With expected changes in age demographics many industry sectors may see their workforce significantly increase in age. The impact of claims and costs associated with musculoskeletal disorders in these industries may also change accordingly. To determine the age-related trends in musculoskeletal disorders, including claims and costs, in different industrial sectors in the state of Ohio, USA. Worker's compensation claims for musculoskeletal disorders in the state of Ohio between 1999 and 2004 were analysed in respect of age, industry sector, body region, and impact on cost and medical care (percentage of claims associated with surgery and number of procedures costing in excess of US$600). More than 570000 claims were analysed. Patterns of cost and disability among the majority of body regions demonstrated an increasing trend until 55 years of age, decreasing in older age groups. However, many industries demonstrated a continued increasing trend in costs with age. Shoulder and lumb...

Farming is known to pose musculoskeletal disorder risk factors, although how risk factors differ between farmers in various countries is largely unknown. To identify ergonomic risk factors through a qualitative assessment of common tasks performed by South Korean farmers. A convenience sample of Korean farmers was videotaped performing typical jobs on farms that produced rice, fruits and vegetables, or raised animals. Ergonomists identified poor ergonomic risk factors that may lead to musculoskeletal disorders including poor postures of the shoulders, wrists, neck, low back, and knees. Severe flexion and lifting of heavy loads was common across farms. While many of the concerning risk factors identified were similar to those in other parts of the world, one was unique in this population - deep knee flexion while weeding, harvesting, and sorting. Given the Korean farm population is aging at an alarming rate and remains dominated by small farms, many of these potential risk factors ma...

In the United States, over 50% of the deaths of on-duty firefighters are classified as sudden cardiac deaths. A holistic view of the multiple risk factors and their relation to the prevalence of cardiovascular disease (CVD) is necessary to determine a baseline for prevention. This study surveyed 154 firefighters in a large Midwestern county about their individual exposure to particulates, noise, heat stress, skin contamination, and physical stress; lifestyle factors such as exercise, diet, smoking, and alcohol consumption; health status; and demographic factors. Consumption of whole grains and alcohol were associated with a reduction of the risk of heart disease, while higher Body Mass Index (BMI) scores and increasing age were associated with increased risk of heart disease. Although firefighters are exposed to substantial occupational risks, only lifestyle factors were found to significantly predict CVD and related health issues. BMI is a modifiable risk factor, which, if controll...

With the recent trend of increasing obesity in the United States, more immediate health outcomes such as reduced musculoskeletal pain may be more effective in encouraging compliance. The study objective was to investigate the relationship between weight loss and changes in musculoskeletal pain. Thirty-five females who recently enrolled into a weight loss program were enrolled into the study. The impact of weight loss on musculoskeletal pain in the short-term was assessed by tracking pain and weight loss during bi-weekly visits to a weight loss clinic. During a 12-week prospective study, the pain ratings in 9 body regions measured during the bi-weekly weigh-ins at the clinic. A significant association was found between weight loss and reduction of pain in the elbow, upper back, lower back, and hip regions as well as overall pain. The significant trends between weight loss and corresponding reduction in pain provide support to weight-loss management providers that may have more immedi...

The objectives of this study were to 1) describe the characteristics of the backpacks used by students 10-18 years of age, 2) describe self reported pain related to backpack use and 3) evaluate the relationship between self reported pain and perceived backpack weight, duration of backpack use and posture when wearing a backpack. A cross-sectional survey of 871 students assessed the features of the backpack carried; the self perceived backpack weight, duration and posture; and any backpack related pain. Results indicate that 99% of students surveyed carry backpacks, 83% carry their backpacks over both shoulders and the presence of adjustable shoulder straps were the most common feature of the backpacks. Half of the students perceive their backpack as heavy and 46% indicate they carry the backpack 10-20 minutes to and from school. Pain attributed to backpack use was reported by 33.5% of the students. Perceived backpack weight, duration of backpack carriage, posture, gender and school ...

Musculoskeletal pain in school-aged children is highly prevalent. While there are many potential factors relating to this discomfort, one unexplored factor is the ergonomic mismatch. The objective of this study was to determine whether the degree of mismatch between the body dimensions and the classroom furniture was associated with body discomfort. One hundred and thirty-nine children in a Midwestern U.S. school district participated in the study where demographic information, anthropometric measurements, self-reported regional body discomfort, and furniture measurements were collected. The results indicate an extremely high prevalence of ergonomic mismatch. Contrary to what was hypothesized, the ergonomic mismatch was not associated with body discomfort. The lack of association may have been a result of the extremely high prevalence of ergonomic mismatch as well as potential adaptations by the students. Although almost every student was found to not fit their desk and chairs, ergo...

... Susan Kotowski1,3 PhD, Kermit Davis1 PhD, and Lisa Lemen2 PhD 1 Low Back Biomechanics and Workplace Stress Laboratory, Dept. of Environmental Health, University of Cincinnati Medical Center 2 Dept. ... 8. Mooney, V., 1983, The syndromes of low back disease. ...

This study identified the nursing work activities that could be the primary sources of work-related acute fatigue in US hospital nurses. Continuous recording of working heart rate and random observations of nursing activities were applied to collect data from eight nurses during two consecutive 12 h day shifts. Using descriptive statistics and random-effect analysis of variance, the contributions of individual nursing work activities to acute fatigue were compared based on the activity frequencies and nurses' corresponding heart rate elevations. Of 860 observed nursing-related work activities, manual patient-handling, bedside-care, care-coordinating, and walking/standing activities accounted for 5%, 16%, 38%, and 41%, respectively. After controlling for the differences of participant and shift, the percentage of working heart rate to maximal heart rate of manual patient-handling (64.3%), bedside-care (59.7%), and walking/standing (57.4%) activities were significantly higher than...

Long periods of intense data entry office work have been linked to increased pain and musculoskeletal disorders. The current study investigated how postural changes mediated by workstation intervention influences the discomfort, postures, and productivity of call center professionals. ...

ABSTRACT Purpose of study: As more complex work tasks become more common in the occupational environment, new unexplored factors containing both physical and mental stressors may place workers at risk for low back pain. One such factor is placement control—how specific the box must be placed within a targeted destination. The objective of this study was to investigate the impact of the load placement control on the biomechanical responses of the lumbar spine.Methods used: Sixty subjects (30 males and 30 females) lifted boxes (weighing 6.8 and 11.4 kg) from a conveyor (sagittally symmetric) and placed them at an asymmetric destination (90 degrees clockwise and 90 degrees counterclockwise). Subjects were required to deliver the loads under two conditions: 1) general placement within the vicinity of a destination target, and 2) precise placement on a target. Individual characteristics, such as gender and personality, were evaluated as potential modifiers of the impact of placement control. An electromyograph assisted biomechanical model evaluated the three-dimensional spinal loads and trunk moments.of findings: Individuals responded to controlled placement by producing faster motions with more awkward postures, increased their muscle coactivity and higher spinal loads. The precise placement task resulted in increases in spinal loads of 160 N of lateral shear, 80 N of anteroposterior shear and 700 N of compression above and beyond the general placement task. Controlled placement was more detrimental to females than males (5% to 10% more). The impact of placement control was also influenced by certain personality traits (3% to 17%).Relationship between findings and existing knowledge: This study has identified a previously unreported risk factor for occupational risk. By requiring workers to precisely position loads, a spine loading cost is incurred as a result of musculoskeletal system compensations such as coactivity and postural adjustments.Overall significance of findings: With the proliferations of more repetitive yet precise materials handling (as in semiautomated product distribution), such factors as precision placement that tax multiple components of the musculoskeletal system may play an important role in occupational risk.Disclosures: No disclosures.Conflict of interest: Kermit Davis, PhD, grant research support: International Society for Biomechanics Dissertation Grant.

ABSTRACT Manual material handling is very prevalent in warehousing and large home improvement stores. Product is often shipped on pallets and then loaded to carts or pallet jacks. The objective of the current study was to evaluate two potential interventions: an adjustable pallet carousel and adjustable cart, using the NIOSH lifting index. Thirteen experienced males completed de-palletizing tasks under 4 conditions: pallet to flat cart, pallet to adjustable cart, carousel to flat cart, and carousel to adjustable cart. The carousel reduced the LI by about 20% while the adjustable cart had limited impact. Based on the NIOSH LI, the carousel provide a reduction in risk but remained elevated (e.g. LI>3.0) and the adjustable cart was less effective (LI>4.6). Caution is needed to interpret these results as the spine loads may be significantly reduced and provide a different picture.

ABSTRACT Serving staff are an integral part of restaurant establishments. Although over 2.2 million individuals are employed as wait staff in the US and experience a considerable number of musculoskeletal disorders each year, little is known about their work-related risk factors for MSDs. Using observational methods, a physical activity monitor, and surveys, this study quantified the physical demands experienced by servers over a shift. Twenty wait staff were evaluated for postures used during serving, tray weight, pain symptoms, and perceived workload. Results showed increases (upwards of 60%) in pain throughout their shift, substabtial time spent standing or walking (~75%), and potentially risky arm/wrist postures during serving, even though a majority of servers indicated lighter than normal workloads during the observation period. While further research is needed, this study provides a first glimpse at the physical demands experienced by wait staff.

The study investigated the status of acute fatigue, chronic fatigue and inter-shift recovery among 12-hour shift nurses and how they differed by organisational and individual factors. While the 12-hour shift has been a widely accepted staffing solution in hospitals, the fatigue-recovery process in nurses working 12-hour shifts remains unclear. A cross-sectional survey was completed by 130 full-time nurses working 12-hour dayshifts in three hospitals to assess the perceived levels of acute fatigue, chronic fatigue and inter-shift recovery, as well as their associations with selected organisational and individual factors. Nurses experienced a moderate to high level of acute fatigue and moderate levels of chronic fatigue and inter-shift recovery. Fatigue and recovery levels differed by the interaction between hospital and unit after controlling for individual factors. Lack of regular exercise and older age were associated with higher acute fatigue. An unhealthy fatigue-recovery process was found for nurses working a 12-hour shift during the day. There appears to be a need to establish fatigue intervention programmes for 12-hour shift nurses in hospitals. Hospital administration, unit managers and staff nurses need to collaborate to achieve a healthy fatigue-recovery balance when implementing 12-hour shifts.