Biomechanical Exposure to Upper Extremity Musculoskeletal Disorder Risk Factors in Hospital Laboratories
Abstract
:1. Introduction
2. Methods
2.1. Study Site and Subjects
2.2. Job Documentation
2.3. PATH Data Collection
2.4. Data Management
2.5. Data Analysis
3. Results
3.1. Exposure to Biomechanical Risk Factors
3.2. Comparison of Measures by Exposure Variable
4. Discussion
4.1. Findings and Implications
4.2. Exposure Assessment and Methodological Issues
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Observation Period (Work Shift) | Subject * | Whole Body Template | Hand/Forearm Template | Hand Activity Template | Obs. Duration, min | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Obs. No. | Shoulder/Arm Elevation, % | Elbow Posture, % | Obs. No. | Wrist/ Forearm Deviation, % | Gross Grasp, % | Pinch Grip, % | Obs. No. | Slow, % | Moderate, % | Rapid, % | |||
1 | A | 63 | 12 | 7 | 80 | 73 | 55 | 35 | 80 | 22 | 61 | 17 | 165 |
2 | A | 115 | 7 | 8 | 137 | 64 | 61 | 50 | 137 | 17 | 68 | 15 | 380 |
3 | B | 62 | 35 | 15 | 58 | 78 | 78 | 50 | 58 | 38 | 41 | 21 | 122 |
4 | C | 44 | 33 | 22 | 45 | 86 | 93 | 74 | 45 | 10 | 83 | 7 | 120 |
5 | D | 38 | 19 | 11 | 39 | 84 | 86 | 38 | 39 | 19 | 81 | 0 | 111 |
6 | E | 150 | 24 | 17 | 155 | 72 | 60 | 52 | 155 | 18 | 55 | 27 | 375 |
7 | E | 115 | 14 | 12 | 114 | 58 | 44 | 38 | 114 | 28 | 65 | 7 | 260 |
8 | F | 52 | 4 | 2 | 50 | 40 | 42 | 20 | 50 | 34 | 50 | 16 | 157 |
9 | F | 69 | 6 | 1 | 65 | 62 | 57 | 12 | 65 | 22 | 69 | 9 | 215 |
10 | G | 131 | 8 | 5 | 125 | 72 | 80 | 67 | 125 | 37 | 52 | 11 | 316 |
11 | H | 150 | 16 | 7 | 143 | 75 | 71 | 59 | 143 | 39 | 49 | 12 | 335 |
12 | H | 70 | 29 | 19 | 69 | 77 | 67 | 64 | 69 | 10 | 74 | 16 | 181 |
13 | I | 137 | 11 | 2 | 129 | 78 | 81 | 55 | 129 | 24 | 45 | 31 | 354 |
14 | I | 138 | 4 | 5 | 139 | 80 | 71 | 56 | 139 | 14 | 60 | 26 | 335 |
15 | J | 40 | 18 | 13 | 44 | 80 | 71 | 55 | 44 | 10 | 80 | 10 | 122 |
16 | K | 139 | 9 | 6 | 129 | 77 | 78 | 49 | 129 | 40 | 49 | 11 | 302 |
17 | L | 44 | 9 | 9 | 44 | 72 | 79 | 49 | 44 | 5 | 69 | 26 | 105 |
18 | M | 76 | 9 | 5 | 79 | 58 | 73 | 70 | 79 | 16 | 59 | 25 | 154 |
19 | N | 89 | 0 | 0 | 97 | 85 | 84 | 43 | 97 | 7 | 49 | 44 | 255 |
20 | O | 65 | 10 | 16 | 73 | 75 | 68 | 50 | 73 | 14 | 62 | 24 | 200 |
21 | P | 124 | 26 | 10 | 120 | 77 | 71 | 60 | 120 | 42 | 53 | 5 | 375 |
22 | Q | 113 | 9 | 17 | 111 | 76 | 66 | 35 | 111 | 23 | 58 | 19 | 259 |
23 | R | 63 | 3 | 8 | 65 | 74 | 87 | 48 | 65 | 21 | 74 | 5 | 153 |
24 | R | 78 | 8 | 23 | 76 | 80 | 81 | 55 | 76 | 16 | 52 | 32 | 190 |
Mean | - | - | 13 | 10 | - | 73 | 71 | 49 | - | 22 | 61 | 17 | - |
Total | - | 2165 | - | - | 2186 | - | - | - | 2186 | - | - | - | - |
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Laboratory Type | Operation | Description | Example Work Element |
---|---|---|---|
Specimen processing | Pre-sample processing | Specimens are received from different places including departments of a facility, local clinics (laboratories), and residents. Specimens are registered (each accession number is assigned). | Sample manual handling (reception; capping and decapping of specimen tubes); VDU (keyboarding for registration); opening specimen bullets (a delivery box); labeling/writing; phone. |
Sample processing | Samples are preliminarily prepared using instruments (e.g., centrifuge or stirrer) or tools (e.g., pipette) before delivery. Minor testing is performed. | Sample manual handling (capping and decapping of specimen tubes); pipetting; VDU (result recording; test report); instrument use or operation; labeling/writing; phone. | |
Post-sample processing | Specimens are delivered to lab sections, using VDU to track specimens and make sure they have been properly handled. | VDU (tracking, result report); sample manual handling (delivery to lab sections); phone. | |
Laboratory chemistry | Automated chemistry | Placing specimens on the appropriate instrument according to the tests ordered. | Pipetting; instrument operating (sample analysis, result report); phone |
Manual chemistry | Like osmometry and acetone testing, specimens are tested manually. Blood and gas samples are analyzed. | Sample manual handling (sample preparation); pipetting; labeling/writing; phone. | |
Hematology | Automated hematology | Placing test tubes on the appropriate instrument for analysis. | Instrument operating (sample analysis, result report); sample manual handling (sample preparation); pipetting; phone. |
Manual hematology | CBC (complete blood count), differentials, and urine microscopy are performed. Dipstick urines are performed on a CLINITEK. | Sample manual handling (sample preparation); pipetting; microscopy (making test slides; microscope use); VDU (result report); Instrument operating (centrifuging; sample test), labeling/writing; phone. | |
Blood bank | Blood testing (type, cross match, HIV) | Blood type (ABO/RH) and cross-match are tested. HIV testing is conducted on semi-automated equipment. | Sample manual handling (sample preparation); pipetting; Instrument operating; VDU (record results, result report); labeling/writing; phone |
Blood bank database review | Record or review blood information in blood bank database (paperwork and statistics) | VDU (record or review database; check stock status). | |
Microbiology | Automated microbiology | Tests performed on instrumentation; some biochemical tests on bacteria. | Sample manual handling (sample preparation); instrument operating; pipetting; VDU (result review and report); phone. |
Manual microbiology | Agar plates are inoculated with various specimens and examined for the presence of bacteria; gram stains, ova, and parasite examinations are performed. Other work (immunology/serology) may exist. | Sample manual handling (inoculating culture plates; storage; opening and closing plates; reading plates); pipetting; microscopy (microscope use); labeling and writing; VDU (result review and report); phone. | |
Pathology (histology, cytology) | Automated sample preparation | Tissue samples are prepared as ordered for analysis by fixation or staining. | Sample manual handling (sample preparation; fixation; staining); instrument operating; VDU (result review and report); phone. |
Manual sample preparation | Sample preparation includes cutting and cover mounting. During preliminary examination, samples are handled on a microscope (gross examination may be conducted). | Sample manual handling (cutting tissues; cover mounting); microscopy (pre-examination); instrument operating; VDU (result review and report); labeling and writing; phone. | |
Administration and laboratory support services | Staffing | Workforce is managed for shifts and rotation work; supervision. | VDU (data review and report); phone. |
Planning and budgeting | Planning and budgeting for lab department; coordinating with other departments. | VDU (data review and report); phone. | |
Phlebotomy | Blood is sampled from outpatients and inpatients by phlebotomists. Information of patients is recorded and reviewed in the databases. | Specimen sampling (e.g., drawing blood); sample handling (blood rocker); VDU (record or review patient information); phone. | |
Specimen transport | Samples are delivered to the specimen processing section (manually or mechanically). | Carrying delivery box; lifting and lowering; preparing and loading specimens to the pneumatic transport system (“the bullet”). | |
Material stock | Supply and storage of lab materials; inventory and ordering. | Push-pull carts; carrying lab materials; VDU (data review, material order, and report); phone. | |
Data processing | Information on phlebotomy work or specimen transport will be entered at PCs. | Document and record review; VDU work; phone |
Laboratory Type | Operation | %Time: Mean ± Standard Deviation ** | Number of Observation Period (Work Shift) | |
---|---|---|---|---|
Name | Notation * | |||
Specimen processing | Pre-sample processing | M | 47 ± 32 | 4 |
Sample processing | SA | 33 ± 31 | ||
Post-sample processing | M | 10 ± 4 | ||
Others | M | 10 ± 7 | ||
Laboratory chemistry | Automated chemistry | A | 85 ± 13 | 3 |
Manual chemistry | M | - | ||
Others | M | 15 ± 13 | ||
Hematology | Automated hematology | A | 52 ± 48 | 3 |
Manual hematology | M | 40 ± 40 | ||
Others | M | 8 ± 10 | ||
Blood bank | Blood testing (type, cross match, or HIV) | SA | 94 ± 6 | 2 |
Blood bank database review | M | - | ||
Others | M | 6 ± 6 | ||
Microbiology | Automated microbiology | A | - | 4 |
Manual microbiology | M | 93 ± 12 | ||
Others | M | 7 ± 2 | ||
Pathology (histology or cytology) | Automated tissue preparation | A | - | 2 |
Manual sample preparation | M | 95 ± 0 | ||
Others | M | 5 ± 0 | ||
Administration and laboratory support services | Staffing | M | 5 ± 12 | 6 |
Planning and budgeting | M | 9 ± 22 | ||
Phlebotomy | M | 25 ± 39 | ||
Specimen transport | SA | 2 ± 4 | ||
Material management and stock | M | 16 ± 41 | ||
Data processing | M | 35 ± 47 | ||
Others | M | 8 ± 8 | ||
Total | 24 |
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Park, J.-K.; Boyer, J.; Punnett, L. Biomechanical Exposure to Upper Extremity Musculoskeletal Disorder Risk Factors in Hospital Laboratories. Int. J. Environ. Res. Public Health 2022, 19, 499. https://doi.org/10.3390/ijerph19010499
Park J-K, Boyer J, Punnett L. Biomechanical Exposure to Upper Extremity Musculoskeletal Disorder Risk Factors in Hospital Laboratories. International Journal of Environmental Research and Public Health. 2022; 19(1):499. https://doi.org/10.3390/ijerph19010499
Chicago/Turabian StylePark, Jung-Keun, Jon Boyer, and Laura Punnett. 2022. "Biomechanical Exposure to Upper Extremity Musculoskeletal Disorder Risk Factors in Hospital Laboratories" International Journal of Environmental Research and Public Health 19, no. 1: 499. https://doi.org/10.3390/ijerph19010499