Dissertations / Theses on the topic 'Musculoskeletal disorder – MSD'

This study is a subset of a larger body of research that examined shoulder time to fatigue during overhead work in an attempt to reduce the prevalence and impact of work-related musculoskeletal problems in the shoulder associated with overhead work, particularly during automobile assembly. Existing evidence suggests that shoulder injuries are diverse in terms of tissues affected and symptoms presented. Furthermore, the cause of these injuries is multifactorial. The work presented here assumes that musculoskeletal injuries of the shoulder mechanism are at least related to, if not caused by, fatigue localized to the shoulder musculature. While the exact relationship between fatigue and injury has not been clearly established, there is consensus among researchers that fatigue plays and important role. Muscular fatigue, therefore, is viewed as a surrogate measure of risk, and task design to avoid fatigue is seen as a rational method to minimize this risk. An experiment to determine the effects of tool weight on shoulder fatigue and performance during overhead work with work/rest cycles was performed. Times to fatigue were derived based on dependent measures including total task duration, controlled maximum muscle contractions, subjective ratings based on Borg's CR-10 RPE scale, electromyogram behavior (MdPF), and hand force performance measures. Experimental findings indicated that duty cycle (percentage of total task cycle time spent working) significantly affected task duration (p<0.0001), changes in maximum voluntary contraction values for the infraspinatus (p<0.05), and the minimum time for any shoulder muscle to fatigue as determined by changes in the EMG power spectrum (p<0.05). Time to fatigue for the mid deltoid as determined by changes in the median frequency of the EMG power spectrum was shown to change significantly (p<0.05) with change in tool weight. Large intersubject variation was observed for the dependent measures, which showed subjects experiencing different levels of fatigue while performing the same task. Limitations of the study and recommendations for future direction are also discussed.<br>Master of Science

L’objectif de cette recherche est double. Etudier les causes et conséquences du Burnout des soignants, dans un premier temps, et comprendre l’effet de la présence d’un jardin dans un secteur gériatrique hospitalier dans un second temps. Les infirmiers et aides-soignants de neuf services de gériatrie ont répondu à un questionnaire construit à partir des théories et échelles de Karasek et Theorell (1990), Siegrist (1996), Shirom (2004) et Kurorinka (1987). Ainsi, le Burnout est confronté aux facteurs psychosociaux, à la Vigueur (bien être) et aux douleurs physiques pour extraire les causes et conséquences de ce trouble psychologique. Ces mêmes équipes ont également participé à des entretiens de type « focus groups » et à des entretiens individuels semi-dirigés afin de s’exprimer sur leurs conditions de travail, ainsi que sur leur vécu et leur ressenti de la présence ou l’absence d’un jardin aménagé ou non aménagé dans leur environnement de travail. Ces équipes de soins appartenaient à trois types de services gériatriques : unité cognitivo-comportementale, soins palliatifs, soins de réadaptation. Les résultats principaux du questionnaire mettent en cause le manque de soutien de la hiérarchie comme aspect augmentant les risques de Burnout. Ce résultat est par la suite confirmé par les entretiens. De plus, le Burnout semble moins présent dans les services avec jardin que sans jardin, et il existe également une amplification de ce bénéfice dans les jardins thérapeutiques. On observe une sensation de Vigueur, tant physique que psychologique, plus importante dans les services avec jardin, et une tendance à l’augmentation des T.M.S. dans les services avec jardin thérapeutique. Cette constatation amène à s’interroger sur l'ergonomie du travail dans ce type d'environnement. En conclusion, le jardin apparaît comme un dispositif systémique favorable aux interactions de travail dans un lieu spécifiquement aménagé, permettant par là-même de combattre les sources de Burnout et de défendre la Vigueur. Il favorise l’épanouissement des soignants et la réduction du Burnout mettant tout de même en lumière un principe de précaution sur la charge physique et l’ergonomie de ce lieu à explorer<br>The aim of this research was twofold. Study the causes and consequences of Burnout caregivers, initially, and understand the effect of the presence of a garden in a hospital geriatric sector in a second time. Nurses and caregivers of nine geriatric services answered a questionnaire constructed from the theories and scales of Karasek and Theorell (1990), Siegrist (1996), Shirom (2004) and Kuorinka (1987). So, the Burnout is faced with psychosocial factors, the vigor (wellness) and physical pain to extract the causes and consequences of this psychological disorder. These same teams also participated in such conversations "focus groups" and semi-structured individual interviews to speak about their working conditions, as well as their experience and felt the presence or absence a arranged garden or undeveloped in their work environment. These care teams belonged to three types of geriatric services: cognitive behavioral unit, palliative care, rehabilitation care. The main results of the questionnaire involve lack of support from the hierarchy appearance as increasing the risk of Burnout. This result is confirmed by interviews. In addition, Burnout was a lesser incidence of Burnout in care services with a garden that those without a garden, and and there is also with an amplification of the benefit with specially-designed gardens. The feeling of strength, both physical and psychological, was less present when the care services did not have a therapeutic garden. A trend toward an increase in musculoskeletal disorders in services with a therapeutic garden versus no garden was observed. Upon analyzing the results, the authors recommend particular attention in the designing of hospital gardens in order to facilitate the ergonomics of nursing work. In conclusion, the overall results advocate the use of the garden as a systemic structure conducive to work interactions in a specially designed area by allowing the same to combat the sources of Burnout and defend Vigor. It encourages the development of nursing and reducing Burnout highlighting a precautionary principle on the physical load and ergonomics of this place to explore

With a view to improving the efficacy of MSDs interventions, this work examined the applicability of the stage of change approach to occupational health interventions. An initial study explored the current practices of ergonomics consultants in tackling MSDs, and revealed that consultants' recommendations generally focused on physical aspects of the work environment, and did not take explicit account of employees' knowledge or attitudes. A second study evaluated leaflets aimed at helping employers and/or employees tackle MSDs, and revealed that leaflets generally overlooked the maintenance of risk reducing measures. Due to the importance of maintaining risk reducing measures on an ongoing basis, this may be a fundamental limitation to their effectiveness. Tools were developed to assess both managerial and worker stage of change, and were found to possess high levels of reliability. To evaluate these tools in practice, 24 interventions aimed at reducing MSDs were monitored within a variety of organisations. In half of these cases, approaches were tailored according to managers' and workers' stage of change. Significant reductions were found in self-reported musculoskeletal pain in the upper arm, elbow, forearm, wrist, hand, lower back, and legs. No significant differences in self-reported musculoskeletal pain were identified following standard interventions. To gain qualitative information regarding the intervention process, post-intervention interviews were also conducted with managers. Interviewees identified issues relating to knowledge, attitudes, perceptions, and behaviour change, in addition to structural factors, as the main barriers and facilitators in the process of implementing interventions to tackle MSDs. Both the quantitative and qualitative findings of this work are compatible with calls for the application of the stage of change approach to the workplace. The findings suggest that scope exists for improving the success of health and safety interventions by tailoring approaches according to stage change. By tackling the attitudes, beliefs, and behavioural intentions that underpin an individuals' current stage, tailored approaches can increase the uptake, implementation, and maintenance of risk-reducing measures.

One of the causes of work-related Musculoskeletal Disorders (MSDs) is the manual handling of heavy objects. To reduce the risk of such injuries, workers are instructed to follow general guidelines on how to lift and carry objects depending on their mass. Current ergonomic assessments using wearable sensors can differentiate correct from incorrect body postures but are limited. Being able to estimate the mass of an object during ergonomic assessment would be a great improvement. This work investigates a combination of Inertial Measurement Units (IMUs) and Electromyography (EMG) sensors for offline estimation of an object’s mass for different movements. 10 participants performed 26 lifting and carrying trials with loads from 0 to 19 kg, while wearing a 17IMU motion capture system and EMG sensors on both biceps brachii and both erector spinae. Two methods were considered to estimate the carried mass: (1) supervised machine learning and (2) musculoskeletal modeling. First, the data was used to select features, train, and compare regression models. The lowest Mean Squared Error (MSE) for 10-fold cross-validation for lifting and carrying combined was 5.8113 for a Gaussian Process Regression (GPR) model with an exponential kernel function. Then, a MSE of 4.42 and a Mean Absolute Error (MAE) of 1.63 kg were obtained also with a GPR for Leave-One-Subject-Out Cross-Validation (LOSOCV) only for lifting and frontal carrying trials. For the same trials, the upper-extremity musculoskeletal model, scaled to each participant, estimated the mass with a MSE of 1.78 and a MAE of 0.95 kg. The study was restricted to lifting and frontal carrying, but the combination of the two technologies showed great potential for object mass estimation.

Bakgrund Det är välkänt att musiker, studerande såväl som praktiserande, ofta drabbas av smärtproblematik och det finns en hög prevalens för smärta i nacke, skuldra, arm och handområden hos violinister.   Syfte Syftet var att belysa och beskriva violiniststudenters upplevelser av att spela med smärtor/skador och upplevelser om underlättande och försvårande faktorer för spel samt deras upplevelser om behandlingar/möjlighet till behandlingar.   Design och metod Studien har en kvalitativ ansats med en explorativ design med semistrukturerade intervjuer som datainsamlingsmetod.   Resultat Ur analysen identifierades fem kategorier: ”Konsekvenser av smärta och skada vid spel”, ”smärtans påverkan i vardagen”, ”underlättande faktorer för spel”, ”försvårande faktorer för spel”, och ”upplevelser av behandling”. God kunskap hos musikläraren, ergonomi och fysisk träning upplevdes som underlättande faktorer och minskade smärtan. Instrumentets utformning och höga krav upplevdes som försvårande faktorer för spel och påverkade smärtproblematiken negativt. Deras upplevelser av behandling var att vården var oförstående för deras problematik och att mer kunskap om hur de kan få hjälp behövs.   Konklusion Fysisk träning, ergonomi och coping är exempel på faktorer som underlättat för spel och minskat smärtproblematiken hos studenterna. Detta kan vården och specifikt fysioterapeuter hjälpta till med men det behöver utforskas ytterligare för att kunna utveckla anpassade behandlingar för att minska smärtproblematik hos violiniststudenter.<br>Background It is well known that musicians, both students and working professionals, often are affected by pain related problems and there is a high prevalence for violinists to get pain in the neck, shoulders, arms and hands.   Purpose The purpose of the study was to describe the violin student experiences of pain and/or injuries whilst playing, experiences of aggravating and mitigating factors for playing music and their experiences with therapy/possibilities for therapy.   Design and method The design used was a qualitative and explorative design with semi-structured interviews as the method to collect the data.   Result From the analysis five categories were identified: “Consequences of pain and injurie when playing”, “the pains effect in day to day life”, “aggravating factors for playing”, “mitigating factors for playing” and “experiences with treatments”. The music teacher’s knowledge, ergonomics and physical training was perceived as aggravating factors. The instruments form and high demands was described by the students as mitigating factors for playing music and that it had a negative impact on their pain. Their experiences with therapy/possibilities for therapy was of the sort that the healthcare professionals were uncomprehending about their complex of problems and that more knowledge about how to sufficiently help the students is needed.   Conclusion Physical training, ergonomics and coping are examples of factors that is aggravating for playing and that it has decreased the pain for the students. Healthcare and especially physical therapy can help with this but further research is needed to develop proper treatments to minimize pain for violinist students.

This master thesis report presents a 20 weeks long project within Industrial design engineering at Luleå University of Technology, performed at Volvo Group Trucks Operations in Umeå. Since the company from a previous study knew that the operators on segment two work in unfavorable work postures, a further investigation of the operators’ work environment was needed. Therefore, the subject of investigation in this project became the physical workload and more specifically, the factors related to the appearance of work related musculoskeletal disorders (MSDs). Segment two is positioned at the end of Volvos’ production line called finishline where the work is primarily done manual by two shift teams with approximately 14 operators in each one. The project objective was to map the current situation for the manual welding operators at segment two and identify potential ergonomic risks within their everyday work. The focus was placed on finding improvements that could decrease the operators’ risk for developing MSDs during work. The project aim was to develop improvements that direct, and over a longer time span, could ease and improve the operators work situation. By observing, filming, interviewing and hand out questionnaires, the current state for the operators could be mapped. Three interviews were held, 22 questionnaires were answered and almost 50 film sequences were made. The work on segment two are station based where the operators are allocated a specific time for each operation within the station. Usually, the operators rotate after ten truck cabs and then move to the next station. The work consists of screwing, welding, grinding, drilling and controlling. The situation analysis was done by investigating the questionnaire responses further, explore the body postural MSD risks with help of RULA and REBA and using the software AviX to let the operators self-estimate the strain in different muscle groups during work. According to the questionnaires, the operators are highly or partly strained physical and psychological where the experienced psychological strain variates more than the physical strain. Furthermore, most of the operators experienced the occurring work acceleration as positive and the manager and coworker relationship as good. Also, ten operators expressed that they had experienced pain in their body the last 12 months caused by their work and over 70 % of the operators wanted to have a greater opportunity to affect the number of work tasks. By relating this to the findings in the study made at Volvo in 2011, where the investigators identified knee-standing work together with some critical work postures that caused the operators an unfavorable strain in mainly the neck, the back and the arms, I assume that the work on segment two today is performed during similar circumstances and in a similar way. The concept development started with an ideation session together with the operators. Here, the analysis findings were discussed, and my own ideas and improvement suggestions were presented. From these discussions, three tests were arranged including a step construction to facilitate when entering and leaving the truck cab, new knee pads and a stretch program, developed by Volvos’ ergonomist. The findings from the two first tests showed how different the operators found the concepts where some operators appreciated both the step construction and the knee pads, and some didn’t. The stretch test on the other hand, were appreciated by all operators where over 50 % felt an improvement in their body. Also, an educational approach including an additional introduction, updated work instructions and a continuous dialogue about work environmental risks during the group meetings were proposed. The tests resulted in a concept development, a concept evaluation with help of previous established specifications of requirements and the ergonomist, together with an implementation strategy. The strategy proposes an implementation of stretch during the workday within the following months, a further investigation of the knee pads and the step construction, and an implementation of the complete educational approach within 5-10 years. Also, based on the results of this thesis, Volvo are recommended to establish guidelines for how to measure work environmental factors linked to physical and psychosocial work environment. Further, the company are recommended to prioritize their employees’ health, well-being and work environment by working systematically in a close cooperation with the workforce to not risk costs in terms of dissatisfaction, sick leaves and poor reputation.

Localized muscle fatigue (LMF) has been proposed as a surrogate measure to injury, since the onset of fatigue is rapid rather than months or years required to the onset of work related musculoskeletal disorders (WMSDs). The objectives of this study were to estimate LMF and quantify muscle activity of select forearm muscles during simulations of high pressure cleaning lance tasks common in the chemical production industry. Twenty participants, twelve males and eight females, with no musculoskeletal injuries and meeting criteria for upper extremity fitness, performed the simulated task. Independent variables studied include work height (shoulder, waist, and knuckle), lance orientation (parallel to the operator and parallel to the ground), and duty cycle (33, 50, and 67%) based on task analyses of actual work tasks. Dependent variables included mean RMS and rates of change in mean RMS, mean and median power frequency, MVE, and subjective ratings of fatigue. Repeated measures ANOVA was used to test the main effects of the independent variables and appropriate interactions. In general it was found that working at waist height, at higher duty cycles, and with the lance oriented parallel to the operator resulted in higher fatigue measures. Subjective ratings of fatigue were not well correlated with objective measures, similar to findings in previous studies. The simulated task was found to be extremely fatiguing and modifications to task design or job rotation schedules are required to reduce risk associated with injury development.<br>Master of Science

Background: European and Italian statistics have reported in the past decade a significant increase of work-related musculoskeletal disorders including the construction sector. Objectives: To check this issue, the EPM Research Unit in collaboration with the Craftmanship Territorial Joint Committee in Bergamo, have started a research in the field of musculoskeletal disorders with special reference to lumbar spine and upper limbs. Methods: The health survey was carried out by ad hoc trained staff. Results: between November 2009 and November 2010, data on 2755 subjects with a variety of jobs were obtained, over 50% being masons. The whole sample and the group of masons were investigated and both exhibited prevalence of upper limb diseases definitely higher than the reference group of non-exposed subjects. At the same time, risk assessment on painters and carpenters was performed, showing very hogh levels of risk o upper limb biomechanical overload due to awkward postures and force application. Conclusions: Hence the need for active research to be included in the protocol of health surveillance (with appropriate clinical protocol), of upper limb and spine MSDs. They also highlight the need for other biomechanical overload exposure data aimed at reconstructing risk profiles (from biomechanical overload) but above all at identifying the technological and organizational solutions to erase this particular risk.

ABSTRACT The association between biomechanical risks and musculoskeletal disorders in agriculture is well known, but within the dairy industry, the literature is still sparse on the precise exposure. This project, addressed at fulfilling some of the knowledge gaps and at creating exposure and risk Profiles for specific milking parlor activities, has been conducted in order to: a) estimating the effects on wrists of parlors’ workers of repetitive motions, pointing out an ultrasonography approach; b) developing screening tools useful in the periodical health surveillance of dairy workers to detect early wrists’ changes; c) compare the levels of muscle activation in milking work between large herd and small herd operations; d) define preventive criteria addressed at risk control in dairy activities. The project has been carried out in 4 single studies, In the first, 14 parlor workers and 22 controls were studied through a) personal anamnesis collection; b) wrists ultrasonography; c) upper limb clinical evaluation. The study confirmed the wrist as target of biomechanical risk factors and identified the two wrist’s acoustic window characterized by the highest predictive value for wrist’s structure alteration. The second study was conducted on 40 dairy workers, studied with the approach defined in the first study. Main objective was evaluating the levels of concordance between questionnaire results and clinical and ultrasound evidences. The questionnaire showed a high level of specificity (82.15%. C.I.95%: 62.4%-93.2%) if compared with clinical investigation outcomes and/or ultrasound findings. The study allowed us to conclude that 1) the administration of a questionnaire can be predictive of early wrist’s changes. 2) The questionnaire created is adequate for the periodical screening of parlor workers’ wrist. The same population was involved in the third study, addressed to defining risk Profiles of wrist biomechanical overload of parlor workers. Anthropometric measurements, personal and occupational variables, surface electromyography data of dominant upper limb muscles were collected to define activation profiles. Strain Index for each single milking subtask (pre dipping, wiping/stripping, attaching, post dipping) was evaluated. The study defined three main risk profiles: low, medium and high risk. Main risk determinants were: characteristics of the workstation, organization of the work, milking routine. We concluded that organization of the milking routine, and cluster weight not major than 2.4 Kg are useful interventions to be carried out. The fourth study was conducted to compare upper limb muscle activity between US and Italian industrialized Dairy operations. Twenty-nine workers were recruited from large herd US herd (>1000 head) dairies and 39 from small herd Italian dairies. Surface electromyography was used to assess muscle exertion levels of all workers, measuring intensity, expressed as root mean square of the raw signal, amplitude probability distribution function percentiles, and the percent muscular rest of the interested muscles. The statistical analyses indicated significantly greater average muscle activity during milking tasks among large herd versus small herd dairy workers in the biceps brachii (p<0.001), upper trapezius (p=0.002), and the wrist flexors (p<0.001) between the two dairy types. The final study demonstrated that, independently from the size and the country, parlor activities pose significant biomechanical wrist risk.

Background: Work-related musculoskeletal disorders represent a serious concern for industrialized countries. The biomechanical overload is a risk commonly noticed in several workplaces such as industry, agriculture and services. Until now, the effectiveness of ergonomic intervention as prevention instrument of low back pain, is still discussed; as well few studies are now available about the effectiveness of corrective physical activity performed on work place. Aim: The aim of this study is to evaluate the effectiveness of ergonomic interventions and corrective physical activity, in workers exposed respectively to manual material handling and to repetitive strain of upper limbs. Methods: A manual material lifting risk assessment was performed, by NIOSH Method, in a metalworking factory involved in the production of refrigerators, while an upper limb repetitive strain risk assessment was performed by OCRA Index, in a metalworking factory involved in the production of gas stoves and ovens. In both factories employees' clinical data were collected by an interview. In the first industrial plant 170 workers were interviewed, 122 exposed to the risk of manual material handling and 48 unexposed, as control group. In the second industrial plant 89 workers were interviewed, 75 exposed to upper limb repetitive strain and 14 unexposed, as control group. In particular the presence of "positive anamnestic threshold", respectively referred to their Low Back Pain or Upper limb symptoms, was investigated in association with medical treatment occurrence and number of days of sickness absence. If necessary a Physical examination was performed and medical documentation was required as well. After the clinical evaluation, in the first production plant, ergonomic intervention were made in order to reduce the risk exposure. Afterwards a group of 14 exposed workers, started to work in the modified workstation for 6 month, while the other 108 exposed worker kept on working in not-modified workstations. After this period a second clinical data collection was performed, and a comparison between these two group was made. In the second production plant, a group of 24 volunteers (belonging to the exposed group) performed a 5 month long corrective physical activity focused on upper limb, while the other 75 exposed worker were excluded from this activity. In the meanwhile, both groups kept on working in usual workstations. After this period, a second clinical data collection was performed, and a comparison between these two group was made. Results: In the metalworking factory involved in the production of refrigerators, the risk assessment, performed by NIOSH Method, has shown the presence of bio-mechanical overload risk (of the back) in the majority of analyzed workstations. The results of the first clinical evaluation have shown a significant correlation between manual material lifting exposure and the development of Low Back Pain. After the production of ergonomic interventions, the follow up has shown an improvement of workers' health in the group of employees, who has worked in modified workstation, even if it wasn't statistically significant. In the metalworking factory involved in the production of gas stoves and ovens, the risk assessment, performed by OCRA Index, has shown the presence of uncertain/very light bio-mechanical overload risk (of the upper limb), in the majority of analyzed workstations. Results of the first clinical evaluation, focused on the upper limb, were consistent with the results of repetitive strain risk assessment. After the performance of corrective physical activity, the second clinical evaluation has shown a significant improvement of workers' health in the group of employees who has done it. Conclusions: Overall this study has proved a good correlation between bio-mechanical overload risk exposure and the development of work-related musculoskeletal disorders. In particular it has been shown a reduction of workers' symptoms after the development of ergonomic interventions and the performance of corrective physical activity.<br>Presupposti dello studio: Le patologie muscolo-scheletriche correlate al lavoro costituiscono uno dei principali problemi nei paesi industrializzati. Il sovraccarico biomeccanico è un fattore di rischio spesso presente nei posti di lavoro dell’industria, dell’agricoltura e dei servizi. L’efficacia degli interventi ergonomici come strumento di prevenzione della lombalgia è tutt’ora oggetto di discussione; in maniera analoga sono ad oggi disponibili pochi studi sull’efficacia dell’attività motoria compensativa eseguita sul posto di lavoro. Scopo dello studio: Lo scopo di questo studio è di valutare l’efficacia della realizzazione di interventi ergonomici e dello svolgimento di una specifica attività motoria compensativa, in lavoratori esposti rispettivamente al rischio derivante da movimentazione manuale dei carichi e da movimenti e sforzi ripetuti degli arti superiori. Materiali e Metodi: E’stata eseguita una valutazione del rischio da movimentazione manuale dei carichi, presso un’ azienda metalmeccanica adibita alla produzione di banchi frigo, mediante il metodo NIOSH, mentre una valutazione del rischio da movimenti e sforzi ripetuti degli arti superiori è stata eseguita, mediante Indice OCRA, presso un’azienda metalmecanica adibita alla produzione di piani di cottura e forni. In entrambe la aziende è stata svolta una raccolta di dati clinici mediante intervista. Nella prima azienda sono stati intervistati 170 soggetti, dei quali 122 esposti al rischio derivante da movimentazione manuale dei carichi e 48 non esposti, come gruppo di controllo. Nella seconda azienda sono stati intervistati 89 soggetti, dei quali 75 esposti a movimenti e sforzi ripetuti degli arti superiori e 14 non esposti, come gruppo di controllo. In particolare è stata valutata la presenza di sintomi, con soglia anamnestica positiva, a carico del tratto lombare e degli arti superiori, unitamente al ricorso a terapie ed alla presenza di giorni di assenza dal lavoro per malattia. Ove necessario è stato eseguito anche un esame obiettivo e, se disponibile è stata raccolta la documentazione sanitaria. Presso la prima azienda, dopo la valutazione clinica, sono stati realizzati degli interventi ergonomici al fine di ridurre l’esposizione al rischio. Successivamente un gruppo di 14 lavoratori esposti ha iniziato a lavorare per 6 mesi nelle postazioni modificate, mentre gli altri 108 lavoratori esposti hanno continuato a lavorare nelle postazioni non modificate. Al termine di questo periodo è stata eseguita una nuova valutazione clinica e sono stati confrontati i due gruppi. Presso la seconda azienda, un gruppo di 24 volontari (appartenenti al gruppo di soggetti esposti) ha svolto per 5 mesi un’attività motoria compensativa dell’arto superiore, mentre gli altri 75 lavoratori esposti sono stati esclusi da tale attività. Nel frattempo entrambi i gruppi hanno continuato a lavorare nelle loro abituali postazioni di lavoro. Al termine di suddetto periodo, è stata condotta una nuova valutazione clinica ed è stato fatto il confronto tra i due gruppi. Risultati: Nell’azienda metalmeccanica adibita alla produzione di banchi frigo, la valutazione del rischio, eseguita con il Metodo NIOSH, ha evidenziato la presenza del rischio da sovraccarico bio-meccanico a carico del rachide nella maggior parte delle postazioni analizzate. I risultati della prima valutazione clinica hanno dimostrato una correlazione statisticamente significativa tra l’esposizione a movimentazione manuale dei carichi e lo sviluppo di lombalgia. Dopo la realizzazione degli interventi ergonomici, il follow-up eseguito ha evidenziato un miglioramento dello stato di salute dei lavoratori che ha lavorato nelle postazioni modificate, per quanto non statisticamente significativo. Nell’azienda metalmeccanica adibita alla produzione di piani di cottura e forni, la valutazione del rischio eseguita con l’Indice OCRA, ha evidenziato una esposizione a sovraccarico bio-meccanico dell’arto superiore di grado incerto/molto lieve, nella maggior parte delle postazioni analizzate. I risultati della prima valutazione clinica, per quanto riguarda i disturbi dell’arto superiore, si sono dimostrati coerenti con quanto emerso dalla valutazione del rischio. Dopo lo svolgimento dell’attività motoria compensativa, la seconda valutazione clinica ha dimostrato un significativo miglioramento dello stato di salute dei lavoratori che l’hanno eseguita. Conclusioni: In generale questo studio ha dimostrato una buona correlazione tra l’esposizione al rischio da sovraccarico bio-meccanico e lo sviluppo di disturbi muscolo scheletrici correlati al lavoro. In particolare è stato dimostrato un miglioramento della sintomatologia dei lavoratori dopo la realizzazione di interventi ergonomici e dopo lo svolgimento di una attività motoria compensativa.

In New Zealand, the highest incidence of musculoskeletal disorders (MSD) is found in meat processing, accounting for over half the injury compensation costs for the sector. This thesis reports on a two-year study of MSD in the New Zealand meat processing industry, with the aims of identifying MSD risk factors and interventions using an industry-level participative ergonomics approach. A review of the literature on occupational musculoskeletal disorders and participatory ergonomics identified gaps in knowledge, notably contextual factors for MSD and a limited scope for participatory ergonomics. The studies described in this thesis contribute to addressing these knowledge gaps. The first stage of the study established a profile of MSD injury data in the industry. Data were collected from four injury data sources for meat processing. A number of priority tasks were identified for beef and sheep processing, based on triangulation of these data, and findings were approved by the industry stakeholders, the Meat Industry Health and Safety Forum (MIHSF). The second stage of the study was the assessment of these tasks in a representative sample of processing plants, with the purpose of identifying risk factors that contribute to the occurrence of MSD, implementation barriers and MSD interventions. The study involved interviews with 237 workers, management, union and safety personnel in 28 meat processing sites. MSD risk factor data were separated into those concerning the high MSD-risk tasks (task-specific), and the wider work system (task-independent). From these data a list of contextual factors was developed which it is proposed may create conditions under which greater exposure to physical and psychosocial factors can occur in meat processing. Some 276 interventions were also identified. The third and final stage of the study involved working with the MIHSF in developing the interventions for use by the industry in reducing MSD risk. MSD intervention ideas were collated, summarised and prioritised. A document containing interventions, implementation barriers and risk factors was developed with the MIHSF and distributed to all levels of the industry. The thesis reflects on the effectiveness of an industry-level participative ergonomics approach to the achievement of the study aims, notably the identification of contextual risk factors and interventions for MSD.

Today and in past years, specific improvements in manual handling safety have been attributed to micro-level ergonomic interventions and mechanical factors. Yet, manual handling work injury and related musculoskeletal disorders [MSDs] continue to increase. This highlights the need for systems (International Ergonomics Association [IEA], 2014) to consider both macro-level and micro-level organisational factors as precursors to safe manual handling outcomes. This study reports on the actions that a trial special school took to achieve higher levels of safety in the manual handling of students with disabilities. The study explored the impact of macro-level organisational climate and micro-level manual handling safety climate on people in these workplaces and on incidences of work injury and MSDs, in order to understand and inform current processes surrounding the minimisation of work injury risks associated with the manual handling by staff of students with disabilities in Queensland special schools. The conceptual framework for the study was underpinned by Giddens’ (1984) Structuration Theory and Rogers’ (1995) Diffusion of Innovations Theory, utilising theoretical research framework categories derived from the organisational theories of Mortenson, Smith and Cavanagh (1989), English (2002), Harris (2004), Fullan (2004), Goleman (2000); and theoretical research framework categories constructed from state and national government policy and legislation and relevant manual handling safety climate protocols and regulations (National Safety Council of Australia [NSCA], 2003). The aim was to investigate the relationships existing among organisational climate, manual handling safety climate and work injury and MSDs. The Trial School and fifteen like Sample Schools provided qualitative data from principals [n=15] and staff [n=236] together with quantitative survey and injury data.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Education and Professional Studies<br>Arts, Education and Law<br>Full Text

There is large debate in the literature about the relationship between job mobility and health. This thesis contributes to this topic by estimating the impact of work mobility on either cardiovascular, musculoskeletal or neuropsychological diseases in a longitudinal study on a sample of Belgian workers followed-up for seven-years. The occurrence of such diseases was assessed through medication use as proxy. In the first part of this thesis, the focus was on CVD and MSD diseases. To this aim, a logistic regression model for autocorrelated data with repeated measures was applied (while controlling for the time-variant and time-invariant confounders). This longitudinal model was adequate to take into account time-dependent covariates and included a Markov chain mechanism that regulates serial dependence. The main characteristic of this model is the ability to handle a series of different lengths of observations across individuals. In the second part, the focus was on the impact of work mobility on the onset of neuropsychological diseases. Therefore, a quasi-experimental approach was used to evaluate the causal effect of a time-varying treatment through the propensity score matching with time-dependent covariates. The optimal (sequential) matching algorithm was used to balance the distribution of the time-dependent covariates at every time point. The hazard of receiving the treatment was estimated using the Cox hazard model with time-fixed and time-varying covariates for a patient receiving the treatment at different times. Data was obtained from IDEWE, the largest Belgian occupational service for well-being at work (external service for prevention and protection at work). Its database includes data on medical history, work conditions, biometrics, vaccinations, medication use and sickness absence of more than 150.000 Belgian workers divided by employment sectors. The association with external job mobility, identified by a change in the 2-digit ISCO code of the employee in the IDEWE database, was statistically significant and positive for CVD. Moreover, psychosocial loads also played an important role in the onset of CVD. Regarding medication for MSD, a positive association was found with BMI, age, manual and repetitive tasks, the handling of static loads, noise exposure of 87 dB, mechanical and/or manual handling with loads, and shift work. Finally, another important finding of this thesis was that external job mobility impacted mental health. Furthermore, being on medication for NPD showed a significant positive association with age, BMI, smoking habits, noise of 80 dB(A), dealing with physical loads and night work (without task-specific risk), while doing physical activity and reporting higher skill levels were found to be protective factors.

The purpose of this thesis is to explore the subject of industrial exoskeleton in accord-ance to the applicability of the technology preventing musculoskeletal disorders within the automotive industry. The modern technology of exoskeletons has a limited field of research and knowledge and is in need to be studied to provide organisations with proper findings for understanding the applicability of the technology. In the auto-motive industry musculoskeletal disorders (MSDs) is one of the most common disor-ders among employees and industries work constantly to decrease and prevent MSDs within their work environments. By conducting literature reviews, the status of exo-skeleton research and development concluded that academic research mostly focuses on technological development of exoskeletons, and not laboratory and/or field testing of currently available industrial exoskeletons. However, through database and website searches, twenty-four available industrial exoskeletons were identified which could be applicable within the automotive industry. Through literature and a case illustration, a number of potential causes for MSDs within the automotive industry were identified and a framework was developed in order to match appropriate available industrial ex-oskeleton to be used in potentially preventing common MSDs. The discussion of the thesis highlights the benefits and challenges of implementing an industrial exoskele-ton within an industry. Proper research on the currently available industrial exoskele-tons is lacking and creates questions of reliability for the technology. However, devel-opment of industrial exoskeletons have shown to focus on prevention of the most common causes of MSDs within industries in their design and development, making the applicability of industrial exoskeletons highly possible.

Background: Work-related musculoskeletal disorders (WRMDs) represent a considerable public health problem in industrialized societies. In the last 5-year, data highlighted a 158% increase on such diseases. In general, physical activity has been showed a useful tool to prevent musculoskeletal disorders; for these reasons, in 2009, the Italian Workers' Compensation Authority (INAIL: Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro), in partnership of University of Padua, financed a Ph.D. grant entitled “Workplace physical activity program to prevent upper limb and neck musculoskeletal disorders”, aiming to investigate the potential benefits of physical activity programs carried out in this environment. Objective: To determine the effectiveness of a workplace physical activity program in workers at risk of upper extremity and neck musculoskeletal disorders. This study was performed in two industries of Padua and Venice. Methods: Occupational Medicine of Padua analyzed the risk for biomechanical overload; then participants underwent functional evaluation. Upper limbs strength and flexibility, range of motion during shoulder elevation and abduction and during head-flexion, extension, lateral inclination and rotation were measured. Furthermore subjects were asked to complete two questionnaires for the arm and neck function. Finally Visual Analogue Scales were used to evaluate pain on neck, shoulder, elbow and wrist. In the settlement of Padua, a metalworking factory, 30 volunteers were involved into the program, and 55 subjects assigned to a control group. Exercise sessions were organized during lunch break, 3 time-a-week, for 30 minutes each, the intervention lasted 10 months. In the settlement of Venice, the industry belongs to the eyewear sector. Here it has been evaluated 58 participants, which, in turn 30 were allocated to to the experimental group while 30 were assigned to the control group. Exercise sessions were set twice a week and the intervention lasted 5 months. Results and Conclusions: Both intervention groups showed significant improvements on range of motion and strength of upper limbs, in addition, shoulder elevation and abduction has been improved. Finally, also head inclination and rotation gained benefits as well as reduction of upper-limb disability. Metal workers referred a decrease in disability for neck region and a fainting on perceived pain, even in neck region and wrists. Eyewear workers showed only pain reduction on wrists. Several limitations arose, especially related to the economical crisis which involved both industrial settlements; however, exercise programs, when properly administered, contributed to the improvement to the physical efficiency and functional status. This further document confirms the benefits of a physical activity program as tool to prevent WRMDs.<br>Introduzione: Negli ultimi anni le patologie muscolo-scheletriche correlate al lavoro sono diventate fonte di notevole preoccupazione per l’entità e la gravità delle conseguenze che possono comportare. In Italia, infatti, le denunce muscolo-scheletrico sono in costante aumento, che nel 2010 ha raggiunto il 158% rispetto al 2006 Per arginare il problema, nel corso del 2009 l’INAIL, in collaborazione con l’Università di Padova, ha promosso un Dottorato di Ricerca dal titolo “Prevenzione attraverso l’attività motoria compensativa nei lavoratori a rischio di patologie muscolo-scheletriche”. Scopo dello studio: Verificare l’efficacia di un protocollo di specifica attività motoria di tipo compensativo nei lavoratori di due aziende della provincia di Padova (settore metalmeccanico) e di Venezia (settore ottico), i quali, per lo svolgimento delle loro mansioni, sottopongono gli arti superiori ad un sovraccarico biomeccanico potenzialmente dannoso. Metodi: Dopo la valutazione del rischio, eseguita dalla Medicina del Lavoro di Padova, i lavoratori di ciascuna azienda sono stati sottoposti ad alcuni test di efficienza fisica per la valutazione della flessibilità e della forza dell’arto superiore e per il range di movimento di elevazione ed abduzione della spalla e di flessione, estensione, inclinazione e rotazione del capo. Sono, inoltre, stati impiegati due questionari per determinare la capacità funzionale dell’arto superiore e del collo nello svolgimento delle attività della vita quotidiana e la scala VAS del dolore, per quantificare il dolore connesso ai DMS di collo, spalle, gomiti, polsi/mani. Presso l’azienda metalmeccanica, sono stati valutati 85 soggetti, 30 dei quali hanno volontariamente preso parte al gruppo d’intervento, mentre gli altri 55 hanno formato il gruppo di controllo. In accordo con i responsabili, il programma motorio si è svolto con una frequenza di 3 sedute settimanali di 30 minuti ciascuna, organizzate durante la pausa pranzo e si è concluso dopo 10 mesi. Presso l’azienda del settore ottico, invece, sono stati valutati 58 soggetti, 30 dei quali hanno formato il gruppo sperimentale e 28 quello di controllo. Le lezioni sono state organizzate durante l’orario di lavoro, con una frequenza settimanale di 2 sedute e una durata complessiva di 5 mesi. Risultati e Conclusioni: In entrambi i gruppi di intervento si sono verificati significativi miglioramenti della mobilità e della forza degli arti superiori, del range di elevazione ed abduzione delle spalle e di inclinazione e rotazione del capo, oltre ad un’apprezzabile riduzione dei livelli di disabilità del braccio. I lavoratori metalmeccanici hanno inoltre riferito una diminuzione della disabilità anche per quanto riguarda il collo e un’attenuazione del dolore, prevalentemente a livello del collo e del complesso articolare mano/polso di entrambi i lati. Per le operaie del settore ottico, invece, la riduzione del dolore si è limitata al solo complesso mano/polso. In definitiva, nonostante alcune difficoltà di svolgimento legate alla crisi economica intercorrente, si conferma che un programma di attività motoria, adeguatamente somministrato, può contribuire al miglioramento di alcune componenti di efficienza fisica e funzionale ed essere considerato un utile strumento di prevenzione dei disturbi muscolo-scheletrici dell’arto superiore e del collo.

An ergonomically designed work environment may decrease work related musculoskeletal disorders, lead to less sick leaves and increase production time for operators and companies all around the world. Volvo Construction Equipment wants to deepen the knowledge and investigate more carefully how operators are actually sitting whilst operating the machines, how this affects placement of controls and furthermore optimize controls placements accordingly. The purpose is to enhance their product development process by suggesting guidelines for control placement with improved ergonomics based on operators’ sitting postures. The goal is to deliver a process which identifies and transfers sitting postures to RAMSIS and uses them for control placement recommendations in the cab and operator environments. Delimitations concerns: physical ergonomics, 80% usability of the resulted process on the machine types, and the level of detail for controls and their placements. Research, analysis, interviews, test driving of machines, video recordings of operators and the ergonomic software RAMSIS has served as base for analysis. The analysis led to (i) the conclusion that sitting postures affect optimal ergonomic placement of controls, though not ISO-standards, (ii) the conclusion that RAMSIS heavy truck postures does not seem to correspond to Volvo CE’s operators’ sitting postures and (iii) and to an advanced engineering project process suitable for all machine types and applicable in the product development process. The result can also be used for other machines than construction equipment. The resulted process consists of three independent sub-processes with step by step explanations and recommendations of; (i) what information that needs to be gathered, (ii) how to identify and transfer sitting postures into RAMSIS, (iii) how to use RAMSIS to create e design aid for recommended control placement. The thesis also contains additional enhancements to Volvo CE’s product development process with focus on ergonomics. A conclusion is that the use of motion capture could not be verified to work for Volvo Construction Equipment, though it was verified that if motion capture works, the process works. Another conclusion is that the suggested body landmarks not could be verified that they are all needed for this purpose except for those needed for control placement. Though they are based on previous sitting posture identification in vehicles and only those that also occur in RAMSIS are recommended, and therefore they can be used. This thesis also questions the most important parameters for interior vehicle design (hip- and eye locations) and suggests that shoulder locations are just as important. The thesis concluded five parameters for control categorization, and added seven categories in addition to those mentioned in the ISO-standards. Other contradictions and loopholes in the ISO-standards were identified, highlighted and discussed. Suggestions for improving the ergonomic analyses in RAMSIS can also be found in this report. More future research mentioned is more details on control placement as well as research regarding sitting postures are suggested. If the resulted process is delimited to concern upper body postures, other methods for posture identification may be used.

Purpose: To establish to what degree musculoskeletal disorders (MSDs) impacted employee productivity, and to compare the impact of an On-Site, verses an Off-Site care strategy in the context of MSD related productivity losses, absenteeism and the associated costs. Theoretical Foundation: MSDs have been shown to be the single greatest cause of long, short and permanent work disability globally and a primary driver of direct and indirect costs. Presenteeism, has been shown to cost organization more in productivity losses than absenteeism or direct medical costs. Methods: Two studies were performed to evaluate similar, seated computer-based employees from three large corporations. Productivity study, done in two phases to measure the impact that MSDs have on employee productivity and to measure the impact of the On-Site MSD treatment. The instrument used was; the WLQ or Work Limitations Questionnaire. The Absenteeism study measured and compared absenteeism rates between employees who used the On-Site clinics in the past year, with employees with MSDs who chose Off-site options. An Absenteeism Questionnaire was used to measure MSD related absenteeism in the context of disability days, treatments, medical consults and diagnostics. An average wage method was used to calculate the average cost per-year, per-case (employee). Findings: Phase 1: WLQ average Lost Productivity Score of 10.5% which translated into an average total lost productivity cost of €1,478.25 per year. The Phase 2 follow up revealed the study group WLQ score dropped from 10.5% to 1.86% at a saving of €1,197.71 per person per year. The Control group average WLQ score was 11.2% and rose to 12.06%, or an additional loss of €118.13 per person per year. Absenteeism study; Total average absenteeism in working hours per-person, per-year, On-Site vs. Off-Site were, 16.62 hours and 68.38 hours respectively costing €108.07 and €444.72 respectively. The average time an employee needed to wait, from the time of onset of symptom, to the time of first treatment, was 3.6 days (28.8 working hours) for On-Site and 14.09 days (119.2 working hours) for Off-Site respectively. Conclusion: MSDs contributed greatly to costly employee productivity losses and presenteeism, and an On-Site treatment strategy significantly reduced productivity losses. The On-Site intervention demonstrated significantly lower absenteeism rates and lower disability rates, required fewer treatments, external consults and external diagnostics and less waiting time than employees seeking Off-Site care. Originality: Measuring the comparative economic impact on organizations between On-Site and Off-Site treatment strategies for MSDs. This study measured productivity losses as presenteeism, and absenteeism, in terms of days and hours lost for medical treatments and exams as well as the impact of a presenteeism lowering strategies for MSDs. Limitations: On-Site MSD clinics are rare. The sample did not represent the general Portuguese population. The average wage formula did not allow for actual costs. Study was not blinded. Practical and Research Implications: The On-Site model can be used with larger samples representing a wider spectrum of the population which could potentially lead to a cost-effective strategy for the government (SNS), and a decreased burden on the health care systems.

Dissertação de mestrado em Engenharia Industrial<br>As diferentes condições que o trabalho oferece, influenciam diretamente na qualidade do serviço e no desempenho dos processos de abastecimento de cargas perecíveis no carregamento de caixas de verduras em centrais de abastecimentos e feiras. O presente estudo tem como objetivo analisar a situação ergonômica em trabalho com sobrecarga física onde são realizados carregamento e descarregamentos de legumes na feira Manaus Moderna. A metodologia utilizada tratou-se de uma pesquisa qualitativa, exploratória, através de entrevistas semiestruturadas, observação sistemática e aplicação da ferramenta EWA nos postos de trabalho identificados. A partir da análise observacional, verificou-se que não são respeitadas as condições básicas necessárias para a realização das atividades, não havendo um acompanhamento especializado para sua efetiva execução. Durante as entrevistas, os trabalhadores informaram constantes queixas de fadiga, esforço físico elevado, um faturamento mensal variado mínimo, além de estar submetidos às condições ambientais do dia, o que muitas vezes atrapalha seu rendimento. A adoção de técnicas simples, porém eficazes, atenuam problemas físicos de saúde. É necessário reconhecer o risco a que se está sendo exposto, estudar as medidas de minimização desse risco. Pequenas paradas na jornada de trabalho, movimentação, descontração e hidratação não resolvem totalmente o problema, mas auxiliam de maneira significativa a minimizar os problemas. Diante disso, os resultados alcançados, ressaltam que os serviços desempenhados pelos carregadores não cumprem os requisitos estabelecidos pela Norma Regulamentadora NR 17. As principais recomendações como reorganização do trabalho, a implantação de um programa de ginástica laboral objetivam na criação de uma capacitação técnica para organizar a movimentação correta da carga, descentralização de sobrecarga e a criação de um mapa de risco. A partir de tais recomendações propostas, garante-se uma melhor qualidade de vida ao carregador e a melhora na qualidade e nas formas como são realizadas atividades e tarefas efetuadas por estes, já que seu trabalho será realizado com mais segurança, sua saúde e bem-estar serão colocados em primeiro lugar, considerando não somente uma meta, mas uma prioridade.<br>The different conditions that work provides directly influence the quality of service and performance of perishable cargo supply processes in loading vegetables boxes in central supplies and fairs. This study aims to analyze the ergonomic situation at work with physical overload which are carried out loading and unloading of vegetables at the fair Modern Manaus. The methodology treated is a qualitative, exploratory research through semi- structured interviews, observation and systematic application of EWA tool in the identified jobs. From the observational analysis, it was found that the basic conditions necessary for the realization of the activities are not respected, there is no specialized monitoring for their effective implementation. During the interviews, workers reported constant complaints of fatigue, high physical exertion, a varied minimum monthly billing, in addition to being subjected to the environmental conditions of the day, which often hinders their performance. The adoption of simple techniques, but effective, mitigates physical health problems. It is necessary to recognize the risk to which it is being exposed, study the mitigation measures that risk. Short breaks in the working day, movement, relaxation and hydration do not fully solve the problem, but help significantly to minimize the problems. Therefore, the results achieved, point out that the services performed by shippers do not meet the requirements established by Regulation Standard NR 17. The main recommendations as reorganization of work, the implementation of a corporate wellness program aimed at creating a technical capacity to organize the correct handling of load, overload decentralization and the creation of a risk map. From such recommendations proposed, this will ensure a better quality of life to the charger and the improvement in quality and in the ways in activities and tasks are performed made by them, since their work will be performed with more security, health and well- They will be placed first, considering not only a target, but a priority.

As lesões músculo-esqueléticas (LME) são das doenças mais comuns relacionadas com o trabalho. Afetam milhões de trabalhadores europeus, estando associadas a custos muito elevados para as entidades patronais. O setor HORECA, foco principal deste estudo (Copa e Bistrô), é um dos setores que apresenta um elevado índice de sinistralidade, no que refere as LMERT.O estudo compreendeu quatro etapas: caracterização das situações de trabalho (Copa e Bistrô), quantificação do nível de risco para o desenvolvimento de uma LME, análise e tratamento de resultados e, por fim, a elaboração de propostas e recomendações. A recolha de dados foi feita através de observações livres, recorrendo ao registo de imagem e vídeo, questionários aos operadores e informação fornecida pela empresa. Para a quantificação do nível de risco para o desenvolvimento de uma LME recorreu-se ao método Rapid Upper Limb Assessement (RULA). Para o tratamento dos dados recorreu-se ao software informático Statistical Package for the Social Sciences (SPSS©) - versão 22. Para testar a existência de associação entre as variáveis (sociodemográficas e do trabalho) e a presença de dor (por região corporal avaliada) ou por penosidade associada ao trabalho (recorreu-se ao teste de independência do Qui-quadrado e ao coeficiente de Cramer’s V. Em todos os testes foi utilizado um nível de significância de 0,05. Globalmente a zona com mais queixas foi a zona lombar (57,1%), seguida dos ombros (35,7%) e dos punhos (32,1%). De modo geral os operadores consideram a penosidade do seu trabalho leve (60,7%). De acordo com os resultados da aplicação do método RULA, em ambos os postos de trabalho avaliados (Copa e Bistrô), o risco de desenvolvimento de uma LME está presente em todas as tarefas avaliadas (Score final ≥ 3) revelando assim a necessidade de investigações e alterações urgentes. De um modo geral não foram encontradas associações estatisticamente significativas tendo, na sua maioria, os resultados apresentados revelado uma fraca ou moderada potência de associação.<br>Throughout Europe they affect millions of workers and cost employers billions of euros. The HORECA sector, which represents the main focus of this study (Copa e Bistrô), is one of the sectors with a high rate of accidents in terms of MSDs related with the workforce. This study integrated four stages: Characterization of the Work Situations (Copa e Bistrô), MSD risk characterization, analysis and processing of results, and finally the development of proposals and recommendations. Data collection was made resorting to different kinds of tools and methods such as free and systematized observations, an application of a questionnaire specifically developed for this purpose and information provided by the company. To quantify the risk association of MSDs development the Rapid Upper Limb Assessment (RULA) was used. Data processing was performed with Statistical Package for the Social Sciences (SPSS©) (version 22). The Chisquare test and Cramer’s V coefficient was used to assess associations between variables (demographic and work-related characteristics) and the prevalence of complains (in each body region assessed) or by painfulness level of work situation. In all cases a significance level of 0.05 was adopted as a criterion to reject the null hypothesis. The body region with the highest percentage of complains was the lumbar back (57,1%), followed by shoulders (35,7%) and wrists (32,1%). In spite of these results 60,7% of the workers consider their work with low level of painfulness. Considering the RULA results, the risk for the development of MSD is present in all tasks and in both sectors assessed (Copa e Bistrô) (Score final ≥ 3). These results suggest that investigation and alteration in the work situation is an important issue. In general there were no statistically significant associations between variables (demographic and work-related characteristics) and the prevalence of complains (in each body region assessed) or painfulness level of work situation.

As lesões músculo-esqueléticas são patologias que afetam cada vez mais pessoas, estas podem ser causadas ou agravadas pelo trabalho. No setor florestal não existem muitos estudos que contemplem as várias tarefas que os operadores florestais realizam, por isso ser importante este estudo. Este estudo teve como objetivo avaliar o risco de desenvolvimento de lesões músculo-esqueléticas associado às tarefas realizadas pelos operadores florestais, para isto a recolha de dados foi feita através de observações livres e de questionários aos operadores. Para realizar a avaliação de riscos utilizou-se um método de matrizes desenvolvido pela Direção geral das relações laborais da Catalunha. Para testar a existência de associação entre as variáveis (sociodemográficas e de trabalho) e a presença de dor nas várias regiões corporais, recorreu-se ao teste de independência do Qui-Quadrado e ao Cramer’s V. As regiões com mais queixas foram o punho direito (53%) e a zona lombar (42%), sendo as queixas maioritariamente classificadas com uma intensidade moderada e uma frequência superior a 4 vezes/ano. Os resultados da avaliação de riscos evidenciaram, para muitas das tarefas, um nível grave sugerindo a necessidade de se realizarem alterações. Globalmente não se encontraram associações estatisticamente significativas (p>0,05); das poucas associações encontradas, estas revelaram uma intensidade entre o moderado e o forte.<br>Musculoskeletal disorders (MSDs) are injuries that affects more and more people, these injuries can be caused or aggravated by the work. In the forest sector there are not many studies that contemplate the various tasks that forest operators perform, that's why it's so important do this study. The main objective of this study was to evaluate the risk of developing musculoskeletal disorders associated with the tasks performed by forest operators. Data collection was done through free observations and using questionnaires, specifically developed for this purpose. A matrix method, developed by Direção geral das relações laborais de Catalunha, was the method used to quantify the risk associated to MSDs development. The Chi-square test and Cramer’s V coeficiente were used to assess associations between variables (demographic and work-related characteristics) and the prevalence of complains in each body region assessed. The main regions affected were the right wrist (53%) and lower back (42%), which are in accordance with the results reported by other studies. The majority of complaints were classified with a moderate intensity and a frequency more than 4 times a year. The results of the risk assessment revealed, for many of the tasks, a serious level suggesting the need to make changes. In general, there were no statistically significant differences (p> 0.05). However, of the few cases found, Cramer’s V test revealed moderate and strong associations (> 0.60).

A tese está em acesso fechado para cumprir o prazo de 60 dias (obrigatório fazer o depósito neste período) mas a mestranda não prencheu a parte do documento que nos permite colocar o acesso aberto/ou fechado. Por isso aguardamos contato da mestranda.<br>Este trabalho teve por objetivo a realização de uma análise ergonómica ao trabalho realizado nos Viveiros de uma Câmara Municipal com particular ênfase na avaliação do risco de desenvolvimento das LMERT. Para avaliação do risco de LMERT recorreu-se a dois métodos: REBA (Rapid Entire Body Assessment) e QEC (Quick Exposure Check). A existência de associação entre as variáveis (sociodemográficas e do trabalho) e a presença de dor (por região corporal) foi testada com recurso ao teste exato de independência do Qui-quadrado. Para comparar os resultados obtidos por método e por tarefa recorreu-se aos testes não paramétricos de Wilcoxon e Kruskal-Wallis, respetivamente. Onze tarefas foram analisadas e avaliadas com ambos métodos. Considerando a auto-referenciação de queixas, foram destacadas cinco regiões coporais. Tendo em conta os resultados REBA e QEC, o risco para o desenvolvimento de LME está presente em todas as tarefas (Nível de risco ≥2). Em geral não se encontraram diferenças estatisticamente significativas entre os resultados alcançados por ambos os métodos contudo, uma sobrestimação foi obtida em 45% e 25% dos casos avaliados com o REBA e QEC, respetivamente.<br>An Ergonomic Work Analysis was accomplished at plant nurseries of a Portuguese Municipality aiming at assessing the actual working conditions and the complaints presented by the workers; characterizing each task in terms of the associated MSD development risk and proposing preventive measures. MSD developing risk assessment relied on two methods: Rapid Entire Body Assessment (REBA) and Quick Exposure Check (QEC). The Chi-square test was used to assess associations between variables (demographic/work-related characteristics) and reported MSD symptoms. To compare REBA and QEC results the non-parametric Wilcoxon test was used whereas to compare the tasks risk level the non-parametric Kruskal-Wallis test was used. Eleven tasks were analyzed and assessed with the both methods. Considering the self-reported complaints, five body region, with the highest percentage of complaints, were highlighted. Globally, considering the REBA and QEC results, the risk for the development of MSDs is present in all tasks (Risk Level ≥ 2). Despite these results, in general there were no statistically significant differences between the results obtain by both methods. Overestimation was obtained in 45% and 25% of the cases assessed with REBA and QEC, respectively.