Hospitals are complex systems relying on an extremely diverse group of occupations, many of which are physically demanding.  So, hospital employees can be at particularly high risk for development of Work Related Musculoskeletal Disorders (WRMSD’s).  Injuries among Healthcare Workers rank among the highest by industry according to the Bureau of Labor Statistics. 

U.S. Bureau of Labor Statistics (2013) Postal Square Building, 2 Massachusetts Avenue, NE Washington, DC 20212-0001

Most studies have focused on patient handling in nursing staff.  A study focusing on design and implementation of observational techniques to assess physical risk factors for WRMSD’s among the full range of hospital workers was undertaken at two large tertiary hospitals by Janowitz etal (2006).  The goal was to document the development and validation of an integrated approach to ergonomics assessment of occupational exposures across the range of hospital workers.  The ergonomics tool used was the REBA (Rapid Entire Body Assessment) with refinement of its weighting and scoring algorithms and with addition of other elements to address sedentary tasks (such as laboratory and computer workstations).

Eligible participants were drawn from a study base of about 6000 hospital workers at two sites including nurses and other healthcare workers, technical workers, administrators, clerical, and skilled and unskilled craft workers.  Physicians were excluded for obvious reasons.  They were followed for 24 months.  From this pool, 494 subjects were selected for study.

The overall risk assessment profile included the REBA, the UBA-UC, LBA-UC, and the Dortmunder Questionnaire.    Other tools used were the UBA-UC (Upper Body Assessment – University of California) which compiles scores for neck and upper extremities; the LBA-UC (Lower Body Assessment – University of California) which compiles scores for the trunk, back, and lower extremities; and the Dortmunder Questionnaire which is a brief self-assessment for lifting and bending.  The Dortmunder was modified to add pushing and pulling exertions.  Also computer time was collected as a percentage of the workday.

The highest REBA score (risk level), UBA-UC, LBA-UC, and Dortmunder Score was in Support Positions (housekeepers, food service workers, supply and distribution, etc).  The highest computer time score was in Administrators in terms of total computer time.  Each tool, therefore co-validated the others.

For more information on this study, the article may be viewed at:  http://www.ncsu.edu/ehs/www99/right/handsMan/office/REBA_Hospital.pdf

For more information on The Back School’s Healthcare Ergonomics Online Course click here: http://www.thebackschool.net/coursesDetail.cfm?ItemId=98

Janowitz IL, Gillen M, Ryan G, Rempel D, Trupin L, Swig L, Mullen K, Ruglies R, Blanc PD (2006):  Measuring the physical demands of work in hospital settings:  Design and implementation of an ergonomics assessment.  Appl Ergon 37, 641-58.

– Vic Zuccarello, OTR/L, C.E.A.S. II, ABDA