Spinal loading in the nursing professions

Status:

completed 06/2004

Aims:

Nursing staff are subjected to heavy physical loading during the care of patients (forced posture, high impacting forces). The nature and frequency of the loads depends strongly upon the area of nursing work concerned (intensive care, geriatric care, etc.). In order to evaluate cases of occupational disease BK 2108 and to prevent musculo-skeletal complaints, the institution for statutory accident insurance and prevention in the health and welfare services (BGW) planned to set up a register of the frequency of physical loading for various nursing areas with reference to the work shift.

Activities/Methods:

A CUELA measurement system adapted for the nursing sector was used to record a total of 21 load shift profiles in seven areas of nursing. For assessment of possible damage to the locomotor apparatus in the back region, the following methods sourced from standards and the literature were applied which permit classification and analysis of work posture: classification and assessment of trunk angles as a function of deviation from the neutral position; classification and assessment of trunk angles in consideration of static postures; assessment of trunk angles as a function of frequency; frequency analysis of the body postures assumed, according to the Finnish OWAS method; assessment of tasks identified by the BGW as being consistently hazardous in the nursing sector, by means of the Mainz-Dortmunder dose model (MDD). This assessment also took into account the results of laboratory studies of typical loads encountered in the nursing professions, conducted by the Institute of Occupational Physiology at the University of Dortmund (IfADo).

Results:

Results of the CUELA load measurements are now available in the form of 21 shift load profiles from seven different areas of nursing. These profiles form the basic data for an internal load database within the BGW for assessment of spinal loading in nursing staff, for the purpose of both prevention and the procedure for formal recognition of occupational diseases. Besides the load profiles, it was possible for the first time to quantify the frequency components of the nursing activities identified by the BGW as being "consistently hazardous" in terms of one working shift for the nursing areas studied. In future, the register of loads is to be extended by further measurements which will be conducted by means of the BGW-CUELA measurement system. The nursing/load shift profiles are also to be adopted in the BIA OMEGA database of spinal loads

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