Risk factors for musculoskeletal disorders and their prevention among home health care workers

The objectives of this study were to (i) quantify hazards, risk factors and prevalence of musculoskeletal disorders (MSDs) among home health care workers (HHCWs) and (ii) perform an intervention study to determine effectiveness of battery-operated hoists in HHCWs. A questionnaire was rendered to 883 HHCWs in Wisconsin, Iowa, Utah and Canada to determine self-reported MSDs and tasks associated with these MSDs. We visited 125 homes, observing and measuring patient transfers and other tasks. The effectiveness of an intervention was studied in 238 homes, involving use of battery-operated hoists and other devices, to reduce stresses to HHCWs and improve patient safety and comfort. The 12-month prevalences for low back, shoulder and neck pain were 48.9%, 30.6% and 31.8%. The prevalence rates among aides and nurses were higher than those among therapists and office workers (p < 0.01). The primary cause for these MSDs was perceived to be manual lifting and transferring [lifting patients off the floor (71%), lifting/repositioning in bed (55%), transfers between beds and wheel chairs (51%), between toilets and wheelchairs (48%), etc.]. Other hazards faced by HHCWs included slips/trips/falls, motor vehicle crashes, animal bites, sharps injuries and assaults/violence. A comparison of post- with pre-intervention data showed that battery-operated hoists significantly reduced stresses to caregivers' low back and shoulders (p < 0.001). The caregivers found these devices to be easier and safer to use (p <0.001). Patients reported these devices were more comfortable (71%) and safer (50 %). This study has potential implications for reducing injuries in HHCWs