Hasheminejad Naser, Amirmahani Maryam, Tahernejad Somayeh
Department of Occupational Health Engineering and Safety at Work, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
Heliyon. 2023 Aug 28;9(9):e19442. doi: 10.1016/j.heliyon.2023.e19442. eCollection 2023 Sep.
As an important occupational group in the healthcare system, midwives face various ergonomic risk factors such as musculoskeletal disorders (MSDs) risks. Moreover, an accurate job evaluation can help to design appropriate ergonomic interventions and more accurately estimate the probability of developing MSDs. Therefore, the present study aimed to investigate musculoskeletal discomforts and biomechanical stresses using the Three-Dimensional Static Strength Prediction Program (3DSSPP Ver. 7.1.3) to find the association of these factors with the prevalence of MSDs among midwives.
A total of 91 midwives with at least two years of work experience participated in this cross-sectional descriptive study. All midwifery duties were analyzed using the hierarchical task analysis (HTA) method. Moreover, time analysis was performed for this job, and data were collected using the Nordic Musculoskeletal Questionnaire (NMQ) and body mapping. The 3DSSPP software was used to investigate the forces acting on the lumbar region, and finally, the association of individual characteristics and the forces exerted on the body with MSDs was investigated.
According to the results, the highest level of pain and discomfort was related to the back and neck regions. The software analysis of the four major midwifery tasks showed that the highest biomechanical forces were exerted on the L/S disc during lifting the mothers from bed (to help them sit or walk) and breastfeeding training. Accordingly, only in the task of lifting the mothers and helping them to sit or walk, the balance status was inappropriate and critical due to the improper distribution of forces. The analysis of the associations between variables showed that biomechanical forces, age, height, body mass index, and job tenure were among the risk factors affecting MSDs.
According to the results of this study, MSDs were highly prevalent, especially in the neck and back regions; this can be attributed to the nature of midwifery tasks. The software analysis results of the tasks showed that the biomechanical forces on the spine in each of the tasks can be affected by the weight of the mother, the height of the bed, static posture, and the bending/twisting of the whole body. Compression and shear forces were among the risk factors that can affect MSDs. To prevent MSDs in midwives, it is appropriate to improve the workstations.
作为医疗保健系统中的一个重要职业群体，助产士面临各种人体工程学风险因素，如肌肉骨骼疾病（MSD）风险。此外，准确的工作评估有助于设计适当的人体工程学干预措施，并更准确地估计患MSD的概率。因此，本研究旨在使用三维静态强度预测程序（3DSSPP Ver. 7.1.3）调查肌肉骨骼不适和生物力学应力，以找出这些因素与助产士中MSD患病率之间的关联。
共有91名具有至少两年工作经验的助产士参与了这项横断面描述性研究。所有助产工作均采用层次任务分析法（HTA）进行分析。此外，对这项工作进行了时间分析，并使用北欧肌肉骨骼问卷（NMQ）和身体映射收集数据。使用3DSSPP软件研究作用于腰椎区域的力，最后，研究个体特征和作用于身体的力与MSD之间的关联。
根据结果，疼痛和不适程度最高的部位是背部和颈部。对四项主要助产任务进行的软件分析表明，在将产妇从床上扶起（帮助她们坐起或行走）和进行母乳喂养培训时，L/S椎间盘上承受的生物力学力最大。因此，仅在扶起产妇并帮助她们坐起或行走这项任务中，由于力的分布不当，平衡状态不合适且很关键。变量之间的关联分析表明，生物力学力、年龄、身高、体重指数和工作年限是影响MSD的风险因素。
根据本研究结果，MSD非常普遍，尤其是在颈部和背部区域；这可归因于助产工作的性质。任务的软件分析结果表明，每项任务中脊柱上的生物力学力可能会受到产妇体重、床的高度、静态姿势以及全身弯曲/扭转的影响。压缩力和剪切力是可能影响MSD的风险因素。为预防助产士患MSD，改善工作场所是合适的。
