Claus Jordan1, Alwin Luttmann1, Andreas Theilmeier2, Stefan Kuhn3, Norbert Wortmann4, Matthias Jäger1. 1. Leibniz Research Centre for Working Environment and Human Factors (IfADo) Ardeystr. 67, 44139 Dortmund, Germany. 2. German Aerospace Center, Project Management Agency, Heinrich-Konen-Str. 1, 53227 Bonn, Germany. 3. BGW - Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Göttelmannstr. 3, 55130 Mainz, Germany. 4. BGW - Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany.
Abstract
BACKGROUND: The human spine is often exposed to mechanical load in vocational activities especially in combination with lifting, carrying and positioning of heavy objects. This also applies in particular to nursing activities with manual patient handling. In the present study a detailed investigation on the load of the lumbar spine during manual patient handling was performed. METHODS: For a total of 13 presumably endangering activities with transferring a patient, the body movements performed by healthcare workers were recorded and the exerted action forces were determined with regard to magnitude, direction and lateral distribution in the time course with a "measuring bed", a "measuring chair" and a "measuring floor". By the application of biomechanical model calculations the load on the lowest intervertebral disc of the lumbar spine (L5-S1) was determined considering the posture and action force data for every manual patient handling. RESULTS: The results of the investigations reveal the occurrence of high lumbar load during manual patient handling activities, especially in those cases, where awkward postures of the healthcare worker are combined with high action forces caused by the patient's mass. These findings were compared to suitable issues of corresponding investigations provided in the literature. Furthermore measurement-based characteristic values of lumbar load were derived for the use in statement procedures concerning the disease no. 2108 of the German list of occupational diseases. CONCLUSIONS: To protect healthcare workers from mechanical overload and the risk of developing a disc-related disease, prevention measures should be compiled. Such measures could include the application of "back-fairer" nursing techniques and the use of "technical" and" small aids" to reduce the lumbar load during manual patient handling. Further studies, concerning these aspects, are necessary.
BACKGROUND: The human spine is often exposed to mechanical load in vocational activities especially in combination with lifting, carrying and positioning of heavy objects. This also applies in particular to nursing activities with manual patient handling. In the present study a detailed investigation on the load of the lumbar spine during manual patient handling was performed. METHODS: For a total of 13 presumably endangering activities with transferring a patient, the body movements performed by healthcare workers were recorded and the exerted action forces were determined with regard to magnitude, direction and lateral distribution in the time course with a "measuring bed", a "measuring chair" and a "measuring floor". By the application of biomechanical model calculations the load on the lowest intervertebral disc of the lumbar spine (L5-S1) was determined considering the posture and action force data for every manual patient handling. RESULTS: The results of the investigations reveal the occurrence of high lumbar load during manual patient handling activities, especially in those cases, where awkward postures of the healthcare worker are combined with high action forces caused by the patient's mass. These findings were compared to suitable issues of corresponding investigations provided in the literature. Furthermore measurement-based characteristic values of lumbar load were derived for the use in statement procedures concerning the disease no. 2108 of the German list of occupational diseases. CONCLUSIONS: To protect healthcare workers from mechanical overload and the risk of developing a disc-related disease, prevention measures should be compiled. Such measures could include the application of "back-fairer" nursing techniques and the use of "technical" and" small aids" to reduce the lumbar load during manual patient handling. Further studies, concerning these aspects, are necessary.
Authors: Tim Mitchell; Peter B O'Sullivan; Anne Smith; Angus F Burnett; Leon Straker; Jenny Thornton; Cobie J Rudd Journal: Int J Nurs Stud Date: 2008-12-31 Impact factor: 5.837