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Researches indicate that sheep shearing can be classified as a very heavy work where the spine and hips are flexed for long periods of time, while handling awkward and heavy loads, expending high amounts of energy. The results of this study demonstrate the production of high levels of compressive and sheer forces within the spine of shearers during the three shearing tasks studied and that the use of a back support can substantially reduces the forces.

Background: The spatial arrangement of primary health care (PHC) services is influenced by many factors and varies across provider types. In Canada, unlike physician services, certain PHC services (i.e., dentistry, physiotherapy) are not fully funded under the health care system. As a result, one might expect the arrangement of these services to differ by neighbourhood, even in dense metropolitan areas. Objective: This study examines the intra-urban variability of geographic access to dental (DS) and physiotherapy (PT) services in relation to family physician (FP) services in an urban area and identifies underserviced neigh-bourhoods. Methods: Practice location information was gathered from publicly available and routinely updated provincial sources (physician, physiotherapy and dentistry regulatory colleges). A neighbourhood accessibility score for all 3 PHC services was calculated using a GIS-based, 3-step floating catchment area method. A set of parameters, such as catchment type (road network buffer), size (3 km radius) and census centroids (dissemination areas), was used. Results: The overall access scores for FP, PT and DS services (based on the 281 FPs, 226 PTs, and 152 DSs) were 1.45 (SD 0.94), 1.18 (SD 0.81) and 0.79 (SD 0.53) providers/1000 population, respectively. Spatial comparison of the accessibility scores indicated a greater proportion of the Saskatoon population has lower access scores (< 0.5/1000 population) for both physiotherapy (n = 79 450) and dental (n = 101 270) services compared with family physician services (n = 64 420). Exploration of the relation between PHC service arrangement and key sociodemographic variables (e.g. low income, education levels) showed that a considerable proportion of those in each sociodemographic group has poor PT and DS access. Conclusion: This research has identified accessibility gaps and serves to inform the development of health policies focused on equitable distribution and funding of PHC services based on population health needs. [ABSTRACT FROM AUTHOR]

Background Exposure to whole body vibration (WBV) is common in construction, agriculture, mining, and transportation. There is strong epidemiological evidence linking WBV with adverse health outcomes in the long-term, including low back pain. Fortunately, WBV exposure guidelines to prevent long-term musculoskeletal disorders and discomfort exist. In the shorter-term, it has been speculated that occupational levels of WBV may lead to increased risk of vehicle accidents and falls during egress; however, the acute effects of different vibration intensities remain poorly understood and it is uncertain whether established standards protect the worker from injurious short-term effects. Objective The aim of this study was to investigate the acute sensorimotor, physical, and cognitive effects of occupationally-relevant, simulated whole body vibration (WBV) at levels equivalent to international standard guideline thresholds for long-term discomfort and musculoskeletal disorder risk. Method Eighteen participants were recruited to perform four, 60-min conditions: (i) Control—no vibration, (ii) Low vibration—equivalent to the exposure action value, (iii) Shock—transient impacts at 1-min intervals superimposed on the Low condition, and (iv) High vibration—equivalent to the exposure limit value. Whole body vibration was simulated using data based on field-collected accelerations experienced by rural workers while operating an all-terrain vehicle. This vibration signal was manipulated to achieve required intensities for each condition and simulated with a 6 degree-of-freedom hexapod platform. Before and after each condition, we collected: rating of perceived body discomfort, rating of perceived headache, postural sway, blink frequency, King-Devick test, and psychomotor vigilance task. Pre- and post-condition data in each condition were submitted to either a paired t -test (parametric) or Wilcoxon signed-rank test (non-parametric). To determine differences between conditions, each condition’s post-condition data was normalized to its pre-condition value and entered as the dependent variable in a repeated measures analysis of variance. Results All conditions, including Control, led to increased upper body discomfort when compared to pre-exposure baseline. The Low condition led to increased discomfort in seven body locations, headache (91% increase from baseline; t = −2.44, P = 0.03), and postural imbalance (53% increase from baseline; t = −2.88, P = 0.01), but the effect on cognitive functioning was less clear. Shock condition led to whole body discomfort, specifically at nine upper body and lower body locations. The High condition led to increased whole body discomfort at all 10 body locations, headache (154% increase from baseline; t = −2.91, P = 0.01), postural imbalance (61% increase from baseline; t = −2.57, P = 0.02), and decrements in vigilance (mean reaction time: 6% increase from baseline, t = −3.27, P = 0.005; Number of lapses: 100% increase from baseline, S = −42.5, P = 0.002). Conclusion Although the number of pre-post condition effects increased with higher vibration intensity, these effects were not significantly different from sitting without vibration. Therefore, current guideline thresholds might not protect the worker from acute WBV effects. However, further research is needed to discern these effects from other sources of WBV. Based on this study, future WBV interventions and action controls should not only address vibration reduction, but also consider potential effects from prolonged sitting. [ABSTRACT FROM AUTHOR]

Introduction Permanent functional impairment (PFI) of the spine is a rating system used by compensation authorities, such as workers compensation boards, to establish an appropriate level of financial compensation for persistent loss of function. Determination of PFI of the spine is commonly based on the assessment of spinal movement combined with other measures of physical and functional impairments; however, the reliability and validity of the measurement instruments used for these evaluations have yet to be established. The aim of this study is to systematically review and synthesise the literature concerning measurement properties of the various and different instruments used for assessing PFI of the spine. Methods Three conceptual groups of terms (1) PFI, (2) spinal disorder and (3) measurement properties will be combined to search Medline, EMBASE, CINAHL, Web of Science, Scopus, PEDro, OTSeeker and Health and Safety Science Abstracts. We will examine peer-reviewed, full-text articles over the full available date range. Two reviewers will independently screen citations (title, abstract and full text) and perform data extraction. Included studies will be appraised as to their methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments criteria. Findings will be summarised and presented descriptively, with meta-analysis pursued as appropriate. Ethics and dissemination This review will summarise the current level of evidence of measurement properties of instruments used for assessing PFI of the spine. Findings of this review may be applicable to clinicians, policy-makers, workers’ compensation boards, other insurers and health and safety organisations. The findings will likely provide a foundation and direction for future research priorities for assessing spinal PFI. [ABSTRACT FROM AUTHOR]

Whole body vibration is a significant physical risk factor associated with low back pain. This study assessed farmers’ exposure to whole body vibration on the Canadian prairies according to ISO 2631-1. Eighty-seven vibration measurements were collected with a triaxial accelerometer embedded in a rubber seat pad at the operator-seat interface of agricultural machinery, including tractors, combines, pickup trucks, grain trucks, sprayers, swathers, all-terrain vehicles, and skid steers. Whole body vibration was highest in the vertical axis, with a mean (range) frequency-weighted root mean squared acceleration of 0.43 m/s2(0.19−1.06 m/s2). Mean crest factors exceeded 9 in all 3 axes, indicating high mechanical shock content. The vertical axis vibration dose value was 7.55 m/s1.75(2.18−37.59 m/s1.75), with 41.4% of measurements within or above the health guidance caution zone. These high exposures in addition to an ageing agricultural workforce may increase health risks even further, particularly for the low back. Practitioner Summary: Agricultural workers are frequently exposed to whole body vibration while operating farm equipment, presenting a substantial risk to musculoskeletal health including the low back. Assessing vibration exposure is critical in promoting a safe occupational environment, and may inform interventions to reduce farmer’s exposure to vibration. [ABSTRACT FROM PUBLISHER]

Direct workplace whole-body vibration exposure assessment provides ecological validity for evaluating health risk in epidemiological studies, yet it is complex and expensive in practical applications. Exposure prediction modeling could be a cost-efficient alternative to directly assessing occupational vibration exposures. The objective of this study was to model directly measured whole-body vibration exposures with predictors from machinery, farm, and self-reported characteristics among Canadian prairies farmers. As per ISO 2631-1, whole-body vibration data were measured on the seat surface at three axes (x, y, z), then summarized into vector sums of the root-mean-squared (RMS) acceleration and the vibration dose value (VDV). All candidate predictors were obtained via questionnaires and onsite observations. A total of 87 whole-body vibration measurements were collected from 40 male farm workers located at 21 central Saskatchewan farms. Using log-transformed RMS and time-standardized VDV outcomes, modeling started from the bivariate analysis where predictors with P-values < 0.2 were considered eligible for multivariate analysis. With random effects of 'farm' and 'farmer', a series of mixed-effects models were constructed through the manual backward elimination method. Final models were internally validated by 1000 bootstrapped samples. The RMS model explained 47.7% of the variance in the directly measured RMS vector sum, with 42.7% obtained from five predictors of 'horsepower', 'transmission', 'vehicle year', 'jerk/jolt frequency', and 'seat bottom-out frequency', while the VDV model explained 19.5% of the variance in the directly measured VDV vector sum, with 11.6% described by the same five predictors as the RMS model. Predictive ability of the RMS model among 1000 bootstrapped samples can be anticipated to range from 14.3 to 69.1%, which may be considered adequate as exposure assessment tool for uses of epidemiological studies. The percentage of variance explained ranged from 0 to 40.5% for the VDV model, which is not robust and therefore likely not appropriate for use in survey-based exposure prediction. Whole-body vibration exposure modeling remains valuable, but is challenging in farming; the described model variance may increase with a more comprehensive list of candidate variables collected and quantified at machinery, farm, and farmer level. Predictors identified in the current and future models may provide a better understanding of how whole-body vibration exposure is modified, guide farmer's future decision on updating equipment, and allow for the development and initiation of interventions. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain (LBP) is the most common, costly and disabling musculoskeletal disorder worldwide, and is prevalent in healthcare workers. Posture is a modifiable risk factor for LBP shown to reduce the prevalence of LBP. Our feasibility research suggests that postural feedback might help healthcare workers avoid hazardous postures. The Effectiveness of Lumbopelvic Feedback (ELF) trial will investigate the extent to which postural monitor and feedback (PMF) can reduce exposure to hazardous posture associated with LBP. Methods: This is a participant-blinded, randomised controlled trial with blocked cluster random allocation. Participants will include volunteer healthcare workers recruited from aged care institutions and hospitals. A postural monitoring and feedback device will monitor and record lumbopelvic forward bending posture, and provide audio feedback whenever the user sustains a lumbopelvic forward bending posture that exceeds predefined thresholds. The primary outcome measure will be postural behaviour (exceeding thresholds). Secondary outcome measures will be incidence of LBP, participant-reported disability and adherence. Following baseline assessment, we will randomly assign participants to 1 of 2 intervention arms: a feedback group and a no-feedback control group. We will compare between-group differences of changes in postural behaviour by using a repeated measures mixed-effect model analysis of covariance (ANCOVA) at 6 weeks. Postural behaviour baseline scores, work-related psychosocial factors and disability scores will be input as covariates into the statistical models. We will use logistic mixed model analysis and Cox's proportional hazards for assessing the effect of a PMF on LBP incidence between groups. Discussion: Posture is a modifiable risk factor for low back disorders. Findings from the ELF trial will inform the design of future clinical trials assessing the effectiveness of wearable technology on minimising hazardous posture during daily living activities in patients with low back disorders. Trial registration number: ACTRN12616000449437. [ABSTRACT FROM AUTHOR]

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