Battevi N, Menoni Olga, Alvarez-Casado E
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Med Lav. 2012 Jan-Feb;103(1):37-48.
International standards draw attention to the steps that risk assessment should follow to first identify hazards, then proceed to risk evaluation and lastly, if necessary, risk assessment. The same logic also applies to risk assessment of manual patient handling.
To check appropriateness of approach to "risk evaluation" of manual patient handling using MAPO, a cross sectional study was carried out aimed at checking the relationship between this new risk assessment model (MAPO screening) and occurrence of acute low back pain.
After proper training the MAPO screening method was used to assess risk of manual handling of patients in 31 wards, covering 411 exposed subjects employed in geriatric hospitals belonging to the UNEBA (National Union Institutions and Social Welfare Initiatives) of the Veneto Region. At the same time health data were collected on the occurrence of low back pain episodes during the last year both in the group of exposed subjects and in an external reference group (237 subjects). Risk and clinical assessment data were verified and checked by the EPM research unit. Logistic analysis was used as a method to evaluate the relationship between MAPO screening risk index and acute low back pain.
Investigating the relationship between acute low back pain episodes and levels of MAPO screening index, carried out only on exposed subjects who reported working for at least 30 hours per week (N=178), showed definitely positive trends: for MAPO screening index of exposure levels between 1.51 and 5, OR were double (OR=2.22; IC 95% 0.88-5.63) whereas for index levels exceeding 5, OR were about 4 (OR=3.77; IC 95% 1.33-10.74). These results did not show significant differences when correcting the analysis for confounding factors such as gender and age classes.
The results of the study indicate that the proposed method, "MAPO screening", can be a useful tool to estimate risk due to manual handling of patients and can also be used to test the efficacy of preventive measures.
国际标准关注风险评估应遵循的步骤，即首先识别危害，接着进行风险评估，最后在必要时进行风险评价。同样的逻辑也适用于人工搬运患者的风险评估。
为检验使用MAPO进行人工搬运患者“风险评估”方法的适宜性，开展了一项横断面研究，旨在检验这种新的风险评估模型（MAPO筛查）与急性腰痛发生之间的关系。
经过适当培训后，使用MAPO筛查方法评估了31个病房中人工搬运患者的风险，涵盖了威尼托地区UNEBA（国家联盟机构和社会福利倡议）所属老年医院雇用的411名暴露对象。同时收集了暴露对象组和外部参照组（237名对象）过去一年中腰痛发作的健康数据。EPM研究单位对风险和临床评估数据进行了核实和检查。采用逻辑分析方法评估MAPO筛查风险指数与急性腰痛之间的关系。
仅对报告每周工作至少30小时的暴露对象（N = 178）进行急性腰痛发作与MAPO筛查指数水平之间关系的调查，呈现出明确的正相关趋势：对于暴露水平在1.51至5之间的MAPO筛查指数，比值比翻倍（比值比 = 2.22；95%置信区间0.88 - 5.63），而对于超过5的指数水平，比值比约为4（比值比 = 3.77；95%置信区间1.33 - 10.74）。在对性别和年龄组等混杂因素进行分析校正时，这些结果没有显示出显著差异。
研究结果表明，所提出的“MAPO筛查”方法可作为估计人工搬运患者所致风险的有用工具，也可用于测试预防措施的效果。
