Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme

Abstract

Objectives Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. Methods Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5–6 years (F5) post-SRHP implementation among workers also in at least one prior survey. Results LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and ‘intense’ aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work–family imbalance (RR=1.82 (1.12 to 2.98)). Conclusions In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk.

Knee pain in nursing home workers after implementation of a safe resident handling program

“…95 Due to the small sample sizes available for prospective analysis, there was insufficient power for nested models. It is not clear how this would have influenced our results (see 41 for a further discussion). Smoothing regression exercises, such as that used here to investigate the interaction between BMI and job strain, are typically used for exploratory hypothesis development rather than investigation of causal relationships.…”

“…Frequency of resident lift device usage, work-family imbalance, schedule control, and physical assault were defined as previously described. 40,41 …”

Priority approaches of occupational safety and health activities for preventing low back pain among caregivers

“…The incidence of occupational low back pain (LBP) is high among caregivers in care facilities . Previous studies have reported that the primary risk factors of LBP among caregivers are handling a patient and taking awkward postures .…”

Implementation of a resident handling programme and low back pain in elder care workers

“…The observational study by Gold and colleagues7 among nursing home workers (vast majority were clinical staff of nurses and nurses aides) provides documentation for the effect of implementing resident handling equipment on LBP. The study performed multiple surveys at the initiation, first year of follow-up, second year of follow-up and 5–6 years of follow-up after implementation of a safe resident handling programme.…”

“…The Gold et al study7 has several strengths such as a relatively high response rate, multiple measurements over several years of implementation of the safe resident handling programme and LBP, and investigation of the association of work and non-work factors for both prevalence and incidence of LBP. The study also has some limitations.…”