ORIGINAL PAPER
Back and neck pain disability and upper limb symptoms of home healthcare workers:
A case-control study from Northern Italy
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1
Provincial Agency for Health Services of the Autonomous Province of Trento, Trento, Italy
(Department of Prevention, Occupational Health and Safety Unit)
2
University of Parma, Parma, Italy
(Specialization School in Hygiene and Public Health, Department of Biomedical, Biotechnological and Translational Sciences)
Online publication date: 2017-03-14
Corresponding author
Matteo Riccò
Provincial Agency for Health Services of the Autonomous Province of Trento, Department of Prevention, Occupational Health and
Safety Unit, Viale Verona SNC C/O Big Center corpo A, piano 1, 38123 Trento, Italy
Int J Occup Med Environ Health. 2017;30(2):291-304
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ABSTRACT
Objectives: Work-related musculoskeletal disorders (MSD) are quite frequent in healthcare workers (HCWs), but data
about MSD in home-based healthcare workers (HHWs) are lacking. In this study we describe the prevalence of MSD among
Italian HHWs. Material and Methods: A case-control study was carried out among 300 random-selected female HCWs,
the sample comprising 100 HHWs, 100 HCWs with a low exposure to patient handling (MAPO – Movimentazione e Assistenza
Pazienti Ospedalizzati – Movement and Assistance of Hospital Patients index 0–5) and 100 HCWs with high exposure
to patient handling (MAPO index ≥ 5.01). As a negative control group, 200 visual display unit workers were also randomly
selected. Musculoskeletal disorder cases were collected using a standardized case definition. A multivariate logistic
regression analysis was performed comparing the MSD prevalence in the 4 groups. Results: The overall prevalence of MSD
was 17% in the reference group and 28.3% for HCWs. HHWs and HCWs with MAPO index ≥ 5.01 had similar prevalence
of neck pain (9% and 11%, respectively), whereas lumbosacral pain prevalence was higher in the HHWs group (31%), with
similar results in residential HCWs groups (21% in MAPO index 0–5 group and 25% in MAPO index ≥ 5.01 group). HCWs
of group MAPO index ≥ 5.01 and HHWs showed the higher prevalence of upper limb complaints, with a prevalence of 20%
and 10%, respectively. In multivariate regression analysis, prevalence of MSD complaints was quite similar in HHWs (adjusted
odds ratio (ORadj) = 2.335, 95% confidence interval (CI): 1.318–4.138) and in HCWs of the group MAPO ≥ 5.01
(ORadj = 2.729, 95% CI: 1.552–4.797). Conclusions: The prevalence of MSD in the examined HCWs was relatively high,
with HHWs appearing as a particularly high-risk group for lumbosacral back pain. In higher exposed HCWs, upper-limb
symptoms were particularly frequent, probably reflecting the different tasks required to manage residential and homebased
patients. In conclusion, this study reaffirms the high prevalence of MSD in HHWs, seemly similar to high-risk residential
groups. Int J Occup Med Environ Health 2017;30(2):291–304