Work activities and non-specific chronic low back pain in nursing workers

Cross-sectional study with 90 workers, including nursing assistants, nursing technicians and nurses. Two instruments were used: Work-Related Activities that may Contribute to Job-Related Pain and/or Injury and Visual Numeric Scale. Data were descriptively and analytically analyzed, compared using Chi-square or Fischer's exact tests, Pearson's or Spearman's correlations and the Mann-Whitney U test. The significance level adopted was p <0.05.

Results:

The work activities with higher risk and associated with low back pain involved poor postures, bending and twisting of the spine, uncomfortable positions, physical efforts such as weight lifting and movement, continuing to work even with pain and at the physical limit, characteristics of the work environment and the activities performed. The mean pain intensity was moderate and it was statistically associated with some activities.

Conclusion:

Ergonomic activities that predispose to low back pain should be considered in order to guide workplace changes.

Keywords
Low back pain; Pain measurement; Ergonomics; Nurse practitioners

WRAP^* * WRAPI- Work-related activities hat may contribute to job-related pain and/or injury, Occupational Activities	Mean/SD^† † SD - Standard deviation	Classification
Performing the same task over and over	6.59 (±2.57)	Moderate
Working very fast for short periods (lifting, grasping, pulling, etc.)	7.78 (±2.39)	Moderate
Having to handle or grasp small objects	1.30 (±2.09)	Not difffcult
Insufficient breaks or pauses during the work day	5.94 (±3.35)	Moderate
Working in awkward or cramped positions	7.98 (±2.17)	Moderate
Working in the same position for long periods (standing, bent over, sitting, kneeling, etc.)	8.00 (±2.40)	Difficult
Bending or twisting your back in an awkward way	8.02 (±2.42)	Difficult
Working near or at your physical limits	7.54 (±2.58)	Moderate
Reaching or working over your head or away from your body	6.29 (±3.19)	Moderate
Hot, cold, humid, wet conditions	5.52 (±4.04)	Moderate
Continuing to work when injured or hurt	8.57 (±1.84)	Difficult
Carrying, lifting, or moving heavy materials or equipment	8.91 (±1.75)	Difficult
Work scheduling (overtime, length of workday)	6.71(±3.31)	Moderate
Using tools (design, weight, vibration, etc.)	1.44 (±2.77)	Not difffcult
Training on how to do the job	5.91 (±3.70)	Moderate

Occupational activities	Nonsignificant pain (n=17) Median (Interquartile Range)	Significant pain (n= 73) Median (Interquartile Range)	p-value ^† † P-value: level of significance p<0.05 in the Mann-Whitney U Test
Performing the same task over and over	5(4)	7(3)	0.462
Working very fast for short periods (lifting, grasping, pulling, etc.)	8(3)	8(3)	0.685
Having to handle or grasp small objects	0(5)	0(2)	0.935
Insufffcient breaks or pauses during the work day	4(5)	7(6)	0.160
Working in awkward or cramped positions	7(3)	9(2)	0.037
Working in the same position for long periods (standing, bent over, sitting, kneeling, etc.)	9(7)	9(2)	0.441
Bending or twisting your back in an awkward way	6(6)	9(2)	0.004
Working near or at your physical limits	6(5)	9(3)	0.002
Reaching or working over your head or away from your body	6(5)	7(4)	0.268
Hot, cold, humid, wet conditions	7(9)	7(9)	0.239
Continuing to work when injured or hurt	7(5)	10(2)	0.008
Carrying, lifting, or moving heavy materials or equipment	8(3)	10(1)	0.019
Work scheduling (overtime, length of workday)	6(6)	8(5)	0.120
Using tools (design, weight, vibration, etc.)	0(2)	0(2)	0.685
Training on how to do the job	7(5)	7(9)	0.971

Occupational activities	rho ^‡ ‡ Rho- Spearman Correlation Coefficient;	p-value ^§ § P-value- level of significance p< 0.05
Performing the same task over and over	0.113	0.288
Working very fast for short periods (lifting, grasping, pulling, etc.)	0.141	0.186
Having to handle or grasp small objects	0.128	0.229
Insufficient breaks or pauses during the work day	0.086	0.420
Working in awkward or cramped positions	0.215	0.041
Working in the same position for long periods (standing, bent over, sitting, kneeling, etc.)	0.232	0.028
Bending or twisting your back in an awkward way	0.365	<0.001
Working near or at your physical limits	0.266	0.011
Reaching or working over your head or away from your body	0.091	0.392
Hot, cold, humid, wet conditions	0.128	0.229
Continuing to work when injured or hurt	0.238	0.024
Carrying, lifting, or moving heavy materials or equipment	0.266	0.011
Work scheduling (overtime, length of workday)	0.137	0.199
Using tools (design, weight, vibration, etc.)	0.139	0.191
Training on how to do the job	0.140	0.187

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author Zulamar Aguiar Cargnin, E-mail: zulamar.aguiar@gmail.com