POSTURAL ANALYSIS IN EMERGENCY HEALTH SERVICES: COMPARISON OF OWAS, RULA, REBA RESULTS

Yıl 2024, , 157 - 171, 15.08.2024

Melek Hatiboglu , Özkan Ayvaz , Ahmet Tasdelen

https://doi.org/10.33439/ergonomi.1411694

Öz

This study focused on analyzing the postural loads created by the working postures of emergency healthcare workers on the main joints of the musculoskeletal system and the risk of work-related MSD injuries.
In postural analysis; OWAS, RULA and REBA observation methods were used and the three methods were compared according to the analysis results. The population of the research is the Emergency Medical Technicians working at Istanbul 112 emergency health services stations. According to the postural analysis results, the risk level of the reference working postures according to REBA and RULA methods is at 'Very High' level. According to the OWAS analysis, the action level of working postures showed an unstable distribution. Postural stress is more evident in the trunk-neck-leg regions in working postures analyzed by the REBA and RULA methods. It has been observed that OWAS is insensitive to neck flexion, shoulder height, upper arm, lower arm and wrist angles. The findings led to the conclusion that of the three methods, REBA may be the best analysis tool for estimating postural stress under the conditions of this study.

Anahtar Kelimeler

OWAS, RULA, REBA, Ergonomics,, Emergency Health Services

ACİL SAĞLIK HİZMETLERİNDE POSTÜRAL ANALİZ: OWAS, RULA, REBA SONUÇLARININ KARŞILAŞTIRILMASI

Öz

Bu çalışma acil sağlık hizmetleri çalışanlarının çalışma duruşlarının kas iskelet sistemi ana eklemleri üzerinde oluşturduğu postüral yükleri ve işle ilgili KİS yaralanma riskini analiz etmeye odaklanmıştır. Postüral analizde; OWAS, RULA ve REBA gözlem yöntemleri kullanılmış ve analiz sonuçlarına göre üç yöntem karşılaştırılmıştır. Araştırmanın evreni, İstanbul 112 acil sağlık hizmetleri istasyonlarında görevli Acil Tıp Teknisyenleri/Teknikerleridir.
Postüral analiz sonuçlarına göre referans alınan çalışma duruşlarının REBA ve RULA yöntemlerine göre risk seviyesi ‘Çok Yüksek’ düzeydedir. OWAS analizine göre ise çalışma duruşlarının eylem seviyesi kararsız bir dağılım göstermiştir. REBA ve RULA yöntemi ile analiz edilen çalışma duruşlarında postüral stres gövde-boyun-bacak bölgelerinde daha belirgindir. OWAS'ın boyun bükülmesi, omuz yüksekliği, üst kol, alt kol ve bilek açılarına duyarsız kaldığı görülmüştür.
Bulgular, üç yöntemden REBA’nın bu çalışmanın koşulları altında postüral stresi tahmin etmek için en iyi analiz aracı olabileceği sonucuna götürmüştür.

Anahtar Kelimeler

OWAS,, RULA,, REBA,, ERGONOMİ,, Acil Sağlık Hizmetleri

Kaynakça

• Ayvaz, Ö., Özyıldırım, B. A., İşsever, H., Öztan, G., Atak, M., & Özel, S. (2023). Ergonomic risk assessment of working postures of nurses working in a medical faculty hospital with REBA and RULA methods. Science Progress, 106(4), 00368504231216540.
• Burdorf, A. (2009). The role of assessment of biomechanical exposure at the workplace in the prevention of musculoskeletal disorders. Scandinavian journal of work, environment & health, 36(1), 1-2.
• Chiasson, M. È., Imbeau, D., Aubry, K., & Delisle, A. (2012). Comparing the results of eight methods used to evaluate risk factors associated with musculoskeletal disorders. International Journal of Industrial Ergonomics, 42(5), 478-488.
• Cohen, A. L. (1997). Elements of ergonomics programs: a primer based on workplace evaluations of musculoskeletal disorders. DIANE Publishing.
• Çalışma Gücü ve Meslekte Kazanma Gücü Kaybı Oranı Tespit İşlemleri Yönetmeliği. (2008). T.C. Resmî Gazete, 27021, 11 Ekim 2008
• Davison C, Cotrim Tp, Gonçalves S. (2021). Ergonomic assessment of musculoskeletal risk among a sample of Portuguese emergency medical technicians. International Journal Of İndustrial Ergonomics, 82, 103077.
• Deros, B. M., Daruis, D. D., Thiruchelvam, S., Othman, R., Ismail, D., Rabani, N. F., ... & Zakaria, N. I. M. (2016). Evaluation on ambulance design and musculoskeletal disorders risk factors among ambulance emergency medical service personnel. Iranian Journal of Public Health, 45(Supple 1), 52-60.
• Doormaal, M. T. A. J., Driessen, A. P. A., Landeweerd, J. A., & Drost, M. R. (1995). Physical workload of ambulance assistants. Ergonomics, 38(2), 361-376.
• European Agency for Safety and Health. (2019). Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU. https://op.europa.eu/en/publication-detail/-/publication/5819be4f-0393-11eb-a511
• Ferreira, J., & Hignett, S. (2005). Reviewing ambulance design for clinical efficiency and paramedic safety. Applied ergonomics, 36(1), 97-105.
• Friedenberg, R., Kalichman, L., Ezra, D., Wacht, O., & Alperovitch-Najenson, D. (2022). Work-related musculoskeletal disorders and injuries among emergency medical technicians and paramedics: A comprehensive narrative review. Archives of Environmental & Occupational Health, 77(1), 9-17.
• Garrison, H. G. (2007). Feasibility for an EMS workforce safety and health surveillance system. Annals of emergency medicine, 50(6), 711-714.
• Gentzler M, Stader S. (2010). Posture stress on firefighters and emergency medical technicians (EMTs) associated with repetitive reaching, bending, lifting, and pulling tasks. Work, 37(3):227-239.
• Hansen CD, Rasmussen K, Kyed M, Nielsen KJ, Andersen JH. (2012) Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a crosssectional study. BMC Public Health. 12,1-13
• Hatiboglu, M., Dayioglu, H., İssever, H., & Ayvaz, B. (2023). Selection of ergonomic risk assessment method with pythagorean fuzzy sets: practice in emergency medical services. Journal of Intelligent & Fuzzy Systems, 45(1), 391-405.
• Helander, M. (2005). A guide to human factors and ergonomics. CRC press.
• Hignett, S., & McAtamney, L. (2000). Rapid entire body assessment (REBA). Applied Ergonomics, 31(2), 201-205.
• Hita-Gutiérrez, M., Gómez-Galán, M., Díaz-Pérez, M., & Callejón-Ferre, Á. J. (2020). An overview of REBA method applications in the world. International journal of environmental research and public health, 17(8), 2635.
• International Labor Organization (ILO). World Day for Safety and Health at Work, 28 April 2015: Global Trends in Occupational Accidents and Diseases.https://www.ilo.org/legacy/english/osh/en/story_content/external_files/fs_st_1ILO_5_en.pdf (Accessed 08 August 2022 ).
• Kahya, E., & Sakarya, S. (2020). Ambulans Çalışanlarının Kas İskelet Sistemi Rahatsızlıklarının Değerlendirilmesi. Ergoterapi ve Rehabilitasyon Dergisi, 8(2), 99-106.
• Karhu, O., Kansi, P., & Kuorinka, I. (1977). Correcting working postures in industry: A practical method for analysis. Applied Ergonomics, 8(4), 199-201.
• Kee, D. (2021). Comparison of OWAS, RULA and REBA for assessing potential work-related musculoskeletal disorders. International Journal of Industrial Ergonomics, 83, 103140.
• Kee, D. (2022). Systematic comparison of OWAS, RULA, and REBA based on a literature review. International Journal of Environmental Research and Public Health, 19(1), 595.
• Keyserling, W. M. (1986). Postural analysis of the trunk and shoulders in simulated real time. Ergonomics, 29(4), 569-583.
• Kumar, S. (2001). Theories of musculoskeletal injury causation. Ergonomics, 44(1), 17-47.
• Lanfranchi, J. B., & Duveau, A. (2008). Explicativemodels of musculoskeletal disorders (MSD): From biomechanical and psychosocial factors to clinical analysis of ergonomics. European Review of Applied Psychology, 58(4), 201–213.
• Larouche D, Bellemare M, Prairie J, Hegg-Deloye S, Corbeil P. Overall risk index for patient transfers in total assistance mode executed by emergency medical technician-paramedics in real work situations. Applied Ergonomics, 2019; 74: 177-185.
• Lowe, B. D., Dempsey, P. G., & Jones, E. M. (2019). Ergonomics assessment methods used by ergonomics professionals. Applied ergonomics, 81, 102882.
• McAtamney, L., & Corlett, E. N. (1993). RULA: a survey method for the investigation of work-related upper limb disorders. Applied Ergonomics, 24(2), 91-99.
• Middlesworth, M. (2015). A step-by-step guide to the REBA assessment tool. Dipetik Mei, 17.
• Oakman, J., Clune, S., & Stuckey, R. (2019). Work-related musculoskeletal disorders in Australia. Safe Work Australia: Canberra, Australia.
• Radwin, R. G., Marras, W. S., & Lavender, S. A. (2001). Biomechanical aspects of work-related musculoskeletal disorders. Theoretical Issues in Ergonomics Science, 2(2), 153–217.
• Rahma, R. A. A., & Faiz, I. (2019, November). Work posture analysis of gamelan craft center workers using quick methods of ergonomic risk assessment. In Journal of Physics: Conference Series (Vol. 1381, No. 1, p. 012027). IOP Publishing.
• Roberts, M. H., Sim, M. R., Black, O., & Smith, P. (2015). Occupational injury risk among ambulance officers and paramedics compared with other healthcare workers in Victoria, Australia: analysis of workers’ compensation claims from 2003 to 2012. Occupational and environmental medicine, 72(7), 489-495.
• Silverstein, B., & Clark, R. (2004). Interventions to reduce work-related musculoskeletal disorders. Journal of Electromyography and Kinesiology, 14(1), 135-152.
• Sosyal Güvenlik Kurumu,https://www.sgk.gov.tr/Istatistik/Yillik/fcd5e59b-6af9-4d90-a451-ee7500eb1cb4/, Erişim Tarihi: 25.03.2024
• Stanton, N. A. (2004). Human factors and ergonomics methods. In Handbook of human factors and ergonomics methods (pp. 27-38). CRC press.
• Tang, D. K. H., Leiliabadi, F., & Olugu, E. U. (2017). Factors affecting safety of processes in the Malaysian oil and gas industry. Safety science, 92, 44-52.
• Tang, K. H. D. (2022). The Prevalence, Causes and Prevention of Occupational Musculoskeletal Disorders. Global Acad J Med Sci, 4, 56-68.
• Tay, B. (2022). Hastane öncesi acil sağlık çalışanlarının kas iskelet sistemi rahatsızlıklarının yaşam kalitesi üzerine etkisi (Master's thesis, Çanakkale Onsekiz Mart Üniversitesi, Lisansüstü Eğitim Enstitüsü)
• US Bureau of Labor Statistics. (2020). Fact sheet - Occupational injuries and illnesses resulting in musculoskeletal disorders (MSDs) - May 2020. https://www.bls.gov/iif/oshwc/case/msds.htm
• Van Der Beek, A. J., & Frings-Dresen, M. H. (1998). Assessment of mechanical exposure in ergonomic epidemiology. Occupational and Environmental Medicine, 55(5), 291-299.
• Verjans, M., Schütt, A., Schleer, P., Struck, D., & Radermacher, K. (2018). Postural workloads on paramedics during patient transport. Current Directions in Biomedical Engineering, 4(1), 161-164.
• WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium, & World Health Organization. (2003). The burden of musculoskeletal conditions at the start of the new millennium: report of a WHO Scientific Group (No. 919). World Health Organization
• World Health Organization. (2019). Musculoskeletal conditions. https://www.who.int/news-room/factsheets/ detail/musculoskeletal-conditions]. Erişim Tarihi: 25.03.2023
• Yıldız, A.N., Sandal, A. (Ed.). 2020. İş Sağlığı Ve Güvenliği Meslek Hastalıkları. Ankara: Hacettepe Üniversitesi Yayını. ISBN: 978-975-491-506-8