Work Related Musculoskeletal Disorders (WRMSDs) account for a significant number of lost workdays worldwide according to the World Health Organization. Amongst the highest frequency of this per occupation you will find is amongst emergency services personnel (Imani et al 2019). This article discuss why repetitive lifting can lead to injury and discuss why it is so prevalent amongst emergency services personnel, and what commonalities can be found between emergency services personnel and other industry sectors.

Repetitive manoeuvre/ lifting

This can be any lift or manoeuvre that you repeat. It may involve a degree of static posture, this is a position held for one minute or more, also twisting can exacerbate the problem and lead to injury (Anghel et al 2007). Repeated postures such and getting into a position to talk to a seated patient in their home may be something that an Emergency Medical Technician (EMT) does daily. The EMT may kneel in proximity to the patient and might even lean against a nearby chair, thus spreading their weight across the chair for support whilst talking to the patient. This might be their ‘go to’ approach in this situation, keeping their back in a neutral position and supporting any weight they can to make the position easier. The EMT is more likely to sustain this technique over the many years of work, reducing the risk of a lower back injury for example.

Another EMT may choose to stand near the patient and bend over to speak to them, rather than kneel with a neutral back position. This flexed posture (bent over) stretches the accessory muscles in the lower back and is a position they will likely hold for over 1 minute as well as a position they repeat daily. However innocuous this position sounds, after a period of repeating this same position day after day, month after month those muscle will stretch and struggle to do the job, they were intended becoming very sore and painful. This could lead to further postural problems if unchecked and can be very painful. This could initially lead to taking time off work, or if unchecked over the longer term can lead to reduced mobility and even surgical intervention.

As well as emergency services, health professions also share a similar demographic when it come to the types of WRMSDs reported. Both these settings share common themes however, regardless of whether you work in a hospital or you’re an EMT, your employers should still have weighed up the risks and provided training and some equipment to help mitigate those risks. Despite this injury levels remain high particularly amongst emergency personnel (Aljerian et al 2018) as the impact of the repetitive tasks that can vary from speaking to client to potentially lifting clients of varying size and weight play an impact on the health of emergency service personnel.

Short term problems

As previously discussed, short term problems such as lower back pain or neck pain can be treated with some pain relief and physical therapy treatment to strengthen the affected area. This should also be accompanied by a risk assessment and some training also. The reason for this is the long-term problems that can be caused by not treating WRMSDs can be quite significant and can have an impact not just on work, but life roles too.

Long term problems

The long-term effects of not changing workplace habits that can lead to WRMSDs can be quite significant on health and life roles. Left unchecked the effect of lower back problems can vary from prolonged absences from work, to over stretched accessory muscles that can in turn lead to the spinal discs particularly in the lumbar region becoming overly compressed. This in turn can touch on the sciatic nerve leading to a debilitating pain. Left to progress it can also lead to spinal discs becoming compressed, also known as herniated discs (Howard 2019), rupturing which can lead to surgery.

All of these issues are very painful and can affect a person’s ability to do their job, but also have a significant impact on life roles such as partner, father, friend or carer, as well as effecting other things we enjoy in life such as sports and hobbies, spending time with friends, becoming dependent on others for support.

It is difficult to shoot hoops or pitch when you are in debilitating pain.

Solutions

Training and appropriate lifting equipment (supplied by employing authorities) such as lifting slings, inflatable lifting cushions and hoists reduce the need for emergency staff to manually lift their patient’s in often difficult situations. Hopefully changing the standard practice of emergency staff to a safer more sustainable approach, and potentially the culture. The knock-on effect of this is reducing the risk of injury from repetitive lifting, often associated with emergency services in the US.

WRMSDs are prevalent amongst emergency service personnel (Aljeran 2018). The effects of which can vary from minor pains and discomfort to quite life changing and sometimes requiring surgery. This can be reduced by robust risk assessment, training and appropriate equipment provision, alongside a change in culture towards using assistive technologies.

Ultimately there are cultural changes required to move away from testosterone driven decision making, to a position of understanding that tasks can be completed safely without compromising long-term health and well-being.

Reference list

Nawfal Aljerian, Saud Alshehri, Emad Masudi, Abdulaziz Mohammad Albawardi, Fiasal Alzahrani, Radhi Alanazi (October 2018). The Prevalence of Musculoskeletal Disorders among EMS Personnel in Saudi Arabia The Egyptian Journal of Hospital Medicine Riyadh Vol. 73 (1), Page 5777-5782 5777

American Association of Neurological surgeons (2020) Herniated Disc.https://www.aans.org/en/Patients/Neurosurgical-Conditions-and- Treatments/Herniated-Disc

Anghel, M. & Argesanu, Veronica & Talpos-Niculescu, Cristina & Lungeanu, Diana. (2007).    Musculoskeletal              disorders             (MSDs)-Consequences              of                        prolonged  static postures. Journal of Experimental Medical & Surgical Research. 14. 167-172. https://www.researchgate.net/publication/309104152_Musculoskeletal_disorders_M SDs-Consequences_of_prolonged_static_postures

American Academy of Orthopaedic Surgeons. (2016, March 1). One in two Americans have a musculoskeletal condition: New report outlines the prevalence, scope, cost and projected growth of musculoskeletal disorders in the U.S.. ScienceDaily. www.sciencedaily.com/releases/2016/03/160301114116.htm

Ali Imani , Jalal Borna , Ali Alami , Shahla Khosravan , Hadi Hasankhani , Mostafa Bafandeh Zende (2019) Prevalence of low back pain and its related factors among pre-hospital emergency personnel in Iran Journal of Emergency Practice and Trauma, 5(1), 8-13

Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities Washington (DC): National Academies Press (US); 2001. https://www.ncbi.nlm.nih.gov/books/NBK222434/

Howard S (2019) Herniated Disc Center. Spine Universe. Remedy Health Media.https://www.spineuniverse.com/conditions/herniated-disc

Workplace Testing.com (2020) Static Posture https://www.workplacetesting.com/definition/1598/static- posture#:~:text=Musculoskeletal%20harm%20from%20static%20exertion,to%20infla mmation%20or%20nerve%20damage.&text=Static%20posture%20can%20cause%2 0wrist,same%20position%20for%20extended%20periods

World Health Organisation (2013) Priority diseases and reason for inclusion. 6.24 Lower back pain. https://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf