WORK: A Journal of Prevention,Assessment & Rehabilitation

This article serves as a response to the Work article on scoping literature reviews by Harris et al. [1]. Conceptualizing scoping reviews as an exploratory approach to organizing literature and research findings in a content area that is still developing, we propose a mixed-methods approach to systematic reviews that enables researchers to capture the breadth and depth of existing knowledge, thereby facilitating the transfer of research findings into field practice.

BACKGROUND: In India varieties of hand tools have been used to cut the vegetables. Traditional vegetable cutter is a commonly used hand tool which has been used for years in the kitchen. The tool may have some design related problems. The present study was undertaken to reduce those problems.

OBJECTIVE: The study objective was to evaluate a new design of traditional vegetable cutters for use in the Indian kitchen.

PARTICIPANTS: One hundred and fifty Indian women who regularly used a vegetable cutter for cooking purposes participated in this study.

METHODS: The design of the vegetable cutter was modified based on the postural preference of the users and other anthropometric factors including the blade angle, length, breadth and width of the sitting area. The prevalence of musculoskeletal disorders was assessed by means of a questionnaire for subjects' feedback. New concepts of the design were proposed and a few prototypes were made and were tested by paired comparison using the EMG system.

RESULTS: A large number of subjects (61%) used the vegetable cutter while sitting on the floor with folded knees and the prevalence of MSD in most of the body parts was comparatively lower in this posture than that in squatting posture. In the new design, a broad platform was suggested to provide a more comfortable sitting when a subject sits on it with folded knees. For the vegetable cutter, the blade angle was made at 120° with a broad folded wooden base as the final prototype of the cutter. The length, breadth, and thickness of the base were selected based on the results of the anthropometric measurements among the prototypes of the cutters. The selected vegetable cutter showed the least myoelectric activity among the prototypes during cutting vegetables.

CONCLUSION: The modified vegetable cutter appeared to be ergonomically effective, less prone to muscular stress, and compatible for preferred posture of the users.

BACKGROUND: The etiology of the neck and back discomfort are highly associated with abnormal static posture such as forward head posture and flexed relaxed posture; such postures are regarded as the risk factors for work-related musculoskeletal disorders. Although, various ergonomic chairs and devices have been developed for computer workers, there are few reports of software that can alert users to their posture or work hours.

OBJECTIVE: Purpose of the present study was to investigate the difference of kinematics of the neck and trunk segments as well as muscular activation between condition with and without posture related auditory cueing.

METHODS: Twelve male computer workers were recruited in this study. A posture related auditory cueing (PAC) program used a media file that generated postural correction cue at intervals of 300 seconds. Surface electromyography was used to measure the activity of the erector spine and upper trapezius. Kinematic data were obtained using an ultrasonic three dimensional movement analysis system.

RESULTS: The results showed that the means of trunk flexion and forward head angle were significantly reduced with PAC. The muscular activity of the erector spine and upper trapezius was significantly higher with the PAC and significantly lower without the PAC.

CONCLUSIONS: Our findings suggested that the software providing PACs is an ergonomic device with positive effects for preventing habitual poor posture and potential for widespread practical usage.

BACKGROUND: Although there is a broad political consensus in Norway that the government should uphold the principles of "full employment" and "work for all", the majority of people with intellectual disabilities in Norway spend their days in segregated work arrangements or at day activity centres.

OBJECTIVE: The aim of the current study was to explore what constitutes work and work roles for people with intellectual disabilities and severely limited verbal communication abilities who attend a day activity centre.

METHOD: A qualitative ethnographic research design was adopted, and the data were gathered through observing the participants and through conducting conversational interviews with the staff members and the participants with intellectual disabilities. Data were analysed with a hermeneutic approach.

RESULTS: The findings showed that even though participants with intellectual disabilities engaged in specific work roles at the day activity centre, these work roles did not constitute work as it is ordinarily conceptualised and valued in society.

CONCLUSION: Despite the very real enjoyment that the participants derive from participating in organised occupation, the work that they do has little status or value, and the activity centre itself is not a satisfactory workplace for people with intellectual disabilities.

BACKGROUND: Direct estimation of VO $_{2}$ max involves labourious, exhaustive, hazardous, time consuming and expensive experimental protocols. Hence, application of various indirect protocols for prediction of VO $_{2}$ max has become popular, subject to proper population-specific standardisation of the indirect protocol.

OBJECTIVES: Application of Fox (1973) protocol in male sedentary university students of Kolkata, India led to premature fatigue in their leg muscles that hindered the muscular activity leading to inability in completing the exercise. The present study was aimed at modifying and validating the Fox (1973) protocol with a convenient workload of 110 W (i.e., modified Fox test or MFT) in the said population.

METHODS: Ninety (90) sedentary male students were recruited by simple random sampling from the University of Calcutta, India and they were randomly assigned into study group (n=60) and confirmatory group (n=30). VO $_{2}$ max was directly estimated by Scholander micro-gas analysis after incremental bicycle exercise. Predicted VO $_{2}$ max (PVO $_{2}$ max) was computed from MFT by using the submaximal heart rate (HR $_{sub}$ ).

RESULTS: In the Study Group VO $_{2}$ max (2216.63 ± 316.77 mL.min $^{- 1}$ ) was significantly different (P< 0.001) from PVO $_{2}$ max (3131.73 ± 234.32 mL.min $^{-1}$ ) measured by using the equation of Fox (1973). Simple and multiple regression equations have been computed for prediction of VO $_{2}$ max from HR $_{sub}$ and physical parameters. Application of these norms in the confirmatory group depicted insignificant difference between VO $_{2}$ max and PVO $_{2}$ max with substantially small limits of agreement and lower values of SEE.

CONCLUSION: The modified regression norms are therefore recommended for use in MFT for accurate assessment of VO $_{2}$ max in the studied population.

BACKGROUND: Glare is a very common source of image degradation when performing computer work. Since reading is a task that is very sensitive to image degradation induced disability glare affects reading performance.

OBJECTIVE: To assess the effect of different glare conditions on eye movements when reading on a computer screen. Glare conditions have an impact on reading. This observation is based on the results from a study where we investigated how reading eye movements were affected by glare.

PARTICIPANTS: Sixteen subjects with normal vision participated in this study.

METHOD: In a balanced repeated-measurement study, all subjects performed equal near-vision reading tasks. In addition to the condition of no glare three controlled conditions of glare were used: direct light, indirect light, and desk luminary. The subjects read three texts under each condition: First a short standardized text (IReST), secondly a longer newspaper text, and finally an additional IReST text. The texts were read on a Tobii T120 eye tracker.

RESULTS: The results show that glare does have a negative effect on reading performance. The more adverse the lighting condition was, the slower the reading speed became. The decrease was primarily a result of increased fixation durations. Both glare conditions of direct and indirect glare increased the fixation durations significantly (p < 0.05).

CONCLUSION: This study shows that even moderate glare conditions can have an impact on reading. The results show that it is important to follow recommendations of lighting design in computer work environment in order to avoid disability glare.

BACKGROUND: A workplace's design can have various positive or negative effects on the employees and since the 1970s the advantages and disadvantages of open-plan offices have been discussed.

OBJECTIVE: The aim of this study was to investigate perceived health, work environment and self-estimated productivity one month before and at three, six and twelve months after relocation from individual offices to an open-plan office environment.

METHODS: Employees from three departments within the same company group and who worked with relatively similar tasks and who were planned to be relocated from private offices to open-plan offices were invited to participate. Questionnaires comprising items from The Salutogenic Health Indicator Scale, The Work Experience Measurement Scale, the questionnaire by Brennan et al. about perceived performance and one question from the Work Ability Index were sent to participants one month before relocation (baseline) to open-plan offices and then at three, six and twelve months after relocation. At baseline, 82 questionnaires were sent out. The response rate was 85%. At the follow-ups 77–79 questionnaires were sent out and the response-rate was 70%–81%.

RESULTS: At follow-ups, perceived health, job satisfaction and performance had generally deteriorated.

CONCLUSIONS: The results of the study indicate that employees' perception of health, work environment and performance decreased during a 12 month period following relocation from individual offices to open-plan offices.

BACKGROUND: Musculoskeletal disorder is one of the major health hazards among the rice farmers. Both men and women rice farmers have been shown to experience elevated risks of prevalence of work-related musculoskeletal disorders (WMSD).

OBJECTIVE: To estimate the different ergonomic risk factors associated with rice farming identify potential gender differences and the prevalence of musculoskeletal disorders (MSDs) among the rice farmers.

PARTICIPANTS: Rice farmers – 110 men and 110 women were selected from the villages of West Bengal, India.

METHODS: Modified Nordic Questionnaires were administered to assess the prevalence of MSDs. Detailed posture analysis was performed along with the administration of the Body-part Discomfort Scale. Objective measurements of physiological parameters and lung function values were also recorded.

RESULTS: From this study it was revealed that the most subjects (99%) suffered discomfort at different parts of the body especially at low back (93.8%), shoulder (60.9%), hand (53.6%) and knee (80.9%) due to awkward posture (99%) and excessive repetitive task (95%) for a prolonged period of time. Both group of rice farmers suffered maximum discomfort feeling during digging (87.7%), sowing seeds (82.7%), harvesting (90.9%) and carrying crops (99%) activities. The farmers also suffered from severe physiological and thermal stress which hampered their other daily activities.

CONCLUSIONS: The study conclude that women farmers felt significantly (p< 0.001) higher discomfort feeling than men rice farmers due to perform numerous household activities which further enhanced their discomfort feeling in their different body parts.

BACKGROUND: Work-related musculoskeletal disorders of back among weavers are prevalent. Epidemiological studies have shown an association between poor working postures and back disorders among carpet weavers. Therefore, the present study aimed to evaluate the impact of the traditional (A) and ergonomically designed (B) workstations on trunk posture and cumulative compression load in carpet weavers.

METHODS: In this study, subtasks were identified in terms of stressful postures and carpet weaving process. Postural data were collected during knotting and compacting subtasks using inclinometer during four hours for each workstation. Postural data, weight and height of the weavers were entered into the University of Michigan three-dimensional static biomechanical model for estimation of the compression load and cumulative load were estimated from the resultant load and exposure time.

PARTICIPANTS: Thirteen healthy carpet weavers (four males and nine females) participated in the study.

RESULTS: Median trunk flexion angle was reduced with workstation B during knotting subtask (18° versus 8.5°, p< 0.01 in males; 18.5° versus 7°, p< 0.001 in females). Average cumulative compression load was reduced with workstation B (22.17MN-s versus 16.68MN-s, p < 0.01 in males; 13.05 MN-s versus 10.14, p < 0.001 in females).

CONCLUSIONS: Using workstation B led to significant decrease in cumulative compressive loading during an entire shift (8 hours), which indicates reduced level of stress on the back. It is suggested to conduct biomechanical studies on the shoulder and wrist regions in carpet weavers in order to achieve further development and improvement in the ergonomically designed workstation.

BACKGROUND: A disconnect in manual patient transfer (MPT) training practices for nurses, between what is taught and used in academic and clinical settings, could have implications for injury.

OBJECTIVE: This study aimed to determine: 1. what MPTs student and staff nurses use in clinical settings, and 2. if the MPTs used most often were also the ones they perceived that they received training for and had the most confidence performing.

METHODS: Survey responses from student nurses (n=163) (mid-sized university) and staff nurses (n=33) (local hospital) regarding 19 MPTs were analyzed to determine which transfers were perceived to be used most often, and which ones they had received training for and had the greatest confidence performing.

RESULTS: The MPTs nurses perceived using most often were the same transfers they had the greatest confidence performing and for which they perceived receiving training. However, these MPTs were not taught at the university at the time of this investigation.

CONCLUSION: Reducing the disconnect between manual patient transfer training obtained in the academic and clinical environments will hopefully reduce the risk of injury for nurses and improve the quality of care for patients.

BACKGROUND: Osteoarthritis (OA) is a multifactorial disease with strong genetic and occupational components. Although published studies have described several risk factors for OA, very few studies have investigated the occupational and genetic factors that contribute to this debilitating condition.

OBJECTIVE: To describe occupational and genetic factors that may contribute to the risk of developing (OA).

METHODS: A literature search was conducted in PubMed using the search terms osteoarthritis, occupation, work, and genetics.

RESULTS: Heavy physical work load was the most common occupational risk factor for OA in several anatomical locations. Other factors include kneeling and regular stair climbing, crawling, bending and whole body vibration, and repetitive movements. Numerous studies have also shown the influence of genetic variability in the pathogenesis of OA. Genetic variants of several groups of genes e.g., cartilage extracellular matrix structural genes and the genes related to bone density have been implicated in disease pathogenesis.

CONCLUSION: This review shows that occupational factors were extensively studied in knee OA unlike OA of other anatomical regions. Although genetic association studies performed to date identified a number of risk variants, some of these associations have not been consistently replicated across different studies and populations. Therefore, more research is needed.

BACKGROUND: Work ability depends on a balance between individual resources and work demands.

OBJECTIVE: This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry.

METHOD: We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry.

RESULTS: The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability.

CONCLUSIONS: Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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 controlled, could appreciably improve health outcomes.

BACKGROUND: Despite the high rate of work-related injuries among hospital nurses, there is limited understanding of factors that serve to motivate or hinder nurses return to work following injury.

OBJECTIVES: Perspectives of nurses with work related injuries, as they relate to obstacles and motivations to return to work, consequences of injury, and influences of work climate were documented.

METHODS: This was a sub-study of nurses taken from a larger investigation of hospital workers. A purposive sample of 16 nurses was interviewed. Analysis was carried out using grounded theory as the research method.

RESULTS: Nurses' responses fell into four concepts: organizational influences, personal conditions, costs and losses, and employee health as influenced by workers' compensation systems. Conceptualization of these concepts resulted in key categories: injury as an expected consequence of hospital work; nursing alone versus nursing together; the impact of injury on professional, family, and social roles; and nurses' understanding of and involvement with the workers' compensation system.

DISCUSSION: The findings provide new perspective into features that support or hinder nurses' with injuries return to work and corroborate existing occupational health research. Consideration of these findings by hospital and employee health managers may help promote more effective return to work programs within the hospital setting.

BACKGROUND: Shift-work, which is an ergonomics issue in workplaces, can negatively affect workers. The security personnel of medical centers in Iran have multiple responsibilities and consequently are exposed to such unwanted situations as observing patients, disputing with patient's attendants, unwanted shift schedules, and being away from family for long periods.

OBJECTIVE: This study assessed health problems of Iranian hospital security personnel (shift-worker personnel) using the Survey of Shift-workers (SOS) questionnaire (Persian version).

METHODS: This cross-sectional study was conducted in seven medical centers (4 hospitals and 3 clinics). A total of 416 workers were surveyed: shift-workers (exposed group) (n=209) and non-shift-workers (unexposed group) (n=207).

RESULTS: The prevalence of adverse health effects was higher in shift-workers than day-workers. The level of education and mean Body Mass Index (BMI) in shift-workers were significantly higher compared with day-workers. The prevalence of gastrointestinal disorders, cardiovascular and psychological problems were also significantly higher in shift-workers compared with day-workers.

CONCLUSIONS: Overall, the prevalence of health problems among the security personnel of medical centers was high. Hence, it is recommended that personnel be put under periodic monitoring and receive medical counseling and treatment if there is any disorder.

BACKGROUND: Although a strong sense of coherence, described as the dimensions of a person's response to a stressful situation, improves the prospects of coping with health problems, more knowledge is required about the association between initial anxiety levels and physical functioning after rehabilitation in relation to individuals' own experiences of their health-resources.

OBJECTIVE: To investigate if the associations between anxiety, pain, and functional health status differ with a strong and weak sense of coherence in employees with chronic musculoskeletal pain in rehabilitation.

METHODS: One thousand six hundred and sixty-five employees (mean age=45.2/SD=9.1) were included in the study. Self-reported sense of coherence (SOC), personal characteristics, anxiety, functional status, and pain were collected at the start (T1) and at the end of the rehabilitation period (12 weeks) (T2). Based on validated cut-off values the employees were divided into strong (> 75) (n=280) and weak (< 57) (n =433) SOC samples.

RESULTS: The strong SOC sample reported lower levels of anxiety (p < 0.001) and higher levels on functional health status (p < 0.001) at T1 and T2, compared to the weak SOC sample. Baseline anxiety predicted low functional health status in the weak SOC sample at T2. Anxiety had less negative consequences for function after rehabilitation in the strong SOC compared to the weak SOC sample.

CONCLUSIONS: The data suggest that appropriate interventions would strengthen the level of SOC in the most vulnerable, as well as resources that encourage SOC.

BACKGROUND: There is increasing theoretical consideration about the use of systematic and scoping reviews of evidence in informing disability and rehabilitation research and practice. Indicative of this trend, this journal published a piece by Rumrill, Fitzgerald and Merchant in 2010 explaining the utility and process for conducting reviews of intervention-based research. There is still need to consider how to apply such rigor when conducting more exploratory reviews of heterogeneous research.

OBJECTIVES: This article explores the challenges, benefits, and procedures for conducting rigorous exploratory scoping reviews of diverse evidence.

METHODS: The article expands upon Rumrill, Fitzgerald and Merchant's framework and considers its application to more heterogeneous evidence on the impact of social policy.

RESULTS: A worked example of a scoping review of the Americans with Disabilities Act is provided with a procedural framework for conducting scoping reviews on the effects of a social policy. The need for more nuanced techniques for enhancing rigor became apparent during the review process.

CONCLUSIONS: There are multiple methodological steps that can enhance the utility of exploratory scoping reviews. The potential of systematic consideration during the exploratory review process is shown as a viable method to enhance the rigor in reviewing diverse bodies of evidence.