Work - Volume 35, issue 4

Article Type: Other

DOI: 10.3233/WOR-2010-0977

Citation: Work, vol. 35, no. 4, pp. 409-410, 2010

Authors: Cherniack, M.G. | Dussetschleger, J. | Bjor, B.

Article Type: Research Article

Abstract: There is conflicting evidence on the extent that medical conditions, particularly musculoskeletal conditions related to work, cause disability and premature retirement in dentists. Reports based on data from disability insurance in the United States suggest dentists are not susceptible to work related musculoskeletal disability. Surveys of symptom rated debility suggest higher rates of dysfunction, however, as do compulsory employment injury reports from European countries. These data, including information on Swedish dentists, analyzed …for this study, tend to put dentists at the higher end of health care professionals in terms of musculoskeletal injury and lost work time. Because compensation patterns and proprietorship vary between national systems, the relationship between exposure and injury and retirement from the active work force may include differing national characteristics. Show more

Keywords: Injury, disability insurance, work-related, MSD (musculoskeletal disorder), paresthesias, carpal tunnel syndrome (CTS)

DOI: 10.3233/WOR-2010-0978

Citation: Work, vol. 35, no. 4, pp. 411-418, 2010

Authors: Morse, Tim | Bruneau, Heather | Dussetschleger, Jeffrey

Article Type: Research Article

Abstract: The prevalence of and risk factors for neck and shoulder disorders among dental practitioners (dentists, dental hygienists, and dental assistants) is reviewed. Dentists report 26–73% period prevalence of neck symptoms over the previous year, and 20–65% with shoulder symptoms. Dental hygienists report even higher rates, from 54–83% for neck and 35–76% for shoulder, and dental assistants in between (38–62% and 27–62% respectively). Symptoms begin to appear early in the career, with significant …increases upon starting clinical practice. Significant social and economic consequences have been reported, including leaving the profession or reducing hours. While ergonomic improvements appear to have some positive impact, these have not been well studied, and some changes (such as the historic shift from standing to seated posture) may have moved risk from the lower back to the upper extremities. Static awkward posture, particularly those with isometric contractions of the trapezius, has been identified as a risk factor particular to these occupations. Ergonomic improvements, health promotion, and organizational interventions have been suggested as needs for reducing risk. Show more

Keywords: Ergonomics, cumulative trauma disorders, musculoskeletal disorders, dental hygienists, dental assistants, risk factors, neck and shoulder disorders

DOI: 10.3233/WOR-2010-0979

Citation: Work, vol. 35, no. 4, pp. 419-429, 2010

Authors: Bylund, Sonya Hörnqwist | Ahlgren, Christina

Article Type: Research Article

Abstract: Vibrating machines are used in a variety of occupations. Exposure to hand-arm vibration can cause vascular, neurological, and muscular symptoms in the hands and arms. This qualitative study provides a deeper understanding of the consequences of vibration injuries in women. In depth interviews were conducted with eight women with vibration injuries. The women were metal and wood product assemblers and dental personnel. The transcribed interviews were analyzed in accordance with the grounded theory method. …The core category in the findings was "{another life}". This was constructed by the categories "consequences for everyday activities", "work performance", "household duties", "leisure", and "self perception" and shows that the injury had affected most parts of the women's lives and decreased their quality of life. The importance of well-functioning hands in all activities was highlighted. Reduced hand function due to numbness, muscle weakness, and pain caused restricted abilities to perform activities at work, at home, and during leisure time. The women described impact on their self-perception, as the injury had affected them in their roles as a worker, mother, and woman. The findings indicate that a vibration injury is a multidimensional problem that can affect every aspect of an individual's life. Health care providers should be aware of these complex consequences. Show more

Keywords: Consequences, women, dental personnel, hands, directive

DOI: 10.3233/WOR-2010-0980

Citation: Work, vol. 35, no. 4, pp. 431-439, 2010

Authors: Warren, Nicholas

Article Type: Research Article

Abstract: Objective: The purpose of this study is to address the high prevalence and costs of musculoskeletal disorders in dental hygienists and dental hygiene students by assessing the combined role of biomechanical and psychosocial risk factors. The paper explores new methods for measuring the effects of psychosocial risk factors (job stress) in hygienists. Methods: In a sample of practicing dental hygienists and dental hygiene students in Connecticut, the study assessed biomechanical exposures, psychosocial exposures, and …symptom status by survey. Study participants were examined by physicians, providing measures of symptom and disease status. Two methods of bio-monitoring the potential effects of stress on the sympathetic nervous system were used: vibrotactile perception thresholds and nerve conduction velocity. Results: Biomechanical and psychosocial exposures have independent and additive associations with the wide variety of outcomes, often of similar magnitude. Biomechanical exposures tend to be associated with negative outcomes in identifiable body areas, whereas job stress had fewer identifiable associations with outcomes by body area. Conclusions: The results of this study indicate that, in addition to identifying and controlling biomechanical risk factors, dental schools, dental practices, and dental hygienists themselves should pay attention to the identification and control of psychosocial risk factors in the workplace. Show more

Keywords: Job stress, biomechanical exposures, psychosocial exposures, sympathetic nervous system

DOI: 10.3233/WOR-2010-0981

Citation: Work, vol. 35, no. 4, pp. 441-454, 2010

Authors: Sanders, Martha J. | Turcotte, Claudia Michalak

Article Type: Research Article

Abstract: Occupational stress represents a cause of attrition from the field of dental hygiene. However, few studies have examined occupational stress in dental hygienists with a focus on the dynamics of the organization and the concept of emotional labor. The purpose of the study was to investigate the nature of occupational stress (organizational stress and emotional labor) in experienced dental hygienists and to examine the relationship between occupational stressors and manifestations of stress (or personal strain). Two …hundred invitations were sent to randomly selected dental hygienists in the Northeast. Only 40 dental hygienists met the inclusion criteria for the study and 30 individuals participated in the study. Participants completed a demographics questionnaire, an Emotional Labor Survey, the Occupational Stress Inventory, and a Musculoskeletal Discomfort Body Map. Overall, levels of occupational stressors, personal strain, and coping resources were within norms. The sample indicated high frequency of musculoskeletal discomfort in the neck (87%), upper back (63.3%), lower back (63.3%), shoulders (53%), and wrists (36.7%). Moderate correlations existed among occupational stressors related to organizational ambiguity, emotional labor, personal strain, and musculoskeletal discomfort. Emotional labor emerged as an occupational stressor that may warrant future investigation. Show more

DOI: 10.3233/WOR-2010-0982

Citation: Work, vol. 35, no. 4, pp. 455-465, 2010

Authors: Branson, Bonnie G. | Black, Marsha A. | Simmer-Beck, Melanie

Article Type: Research Article

Abstract: Purpose: Evidence suggests that using magnification loupes will improve the posture of dental clinicians, thus decreasing work-related musculoskeletal disorders. The purpose of this case study was to document the experiences of a dental hygienist during a four week acclimatization period. Methods: Documentation was comprised of self-reports from the dental hygienist's reflective journaling and postural measurements made by a trained observer using Branson's Posture Assessment Instrument (BPAI), a validated posture assessment instrument. …Journal reports and postural measurements were made prior to the use of the magnification loupes and over the subsequent three week trial. Conclusion: Use of the magnification loupes was a positive experience. The BPAI results indicated a positive change in neck and low back posture. Further trials of the effectiveness of magnification loupes in reducing musculoskeletal disorders with this occupational group are recommended. Show more

Keywords: Ergonomics, Branson's Posture Assessment Instrument, reflective journaling

DOI: 10.3233/WOR-2010-0983

Citation: Work, vol. 35, no. 4, pp. 467-476, 2010

Authors: Simmer-Beck, Melanie | Branson, Bonnie G.

Article Type: Research Article

Abstract: Objectives: The purpose of this paper is to describe the research identifying dental hygiene risk factors, outline the structural characteristics of the various tools that dental hygienists use and discuss the evidence to support ergonomic tool re-designs. Methods: Two databases, Medline and Cinahl, were used to identify epidemiological research studies from 1998--2008 that describe the prevalence of musculoskeletal disorders in dental hygienists. The length, diameter, mass and padding of twenty-one (n=21) dental instruments and instrument …grip combinations and twenty-two (n=22) mirrors and mirror grip combinations are described. Results: The length, mass and diameter of dental instruments and dental mirrors ranged from 16.3 cm to 17.5 cm and 15.9 cm to 18.5 cm, from 10.0 g to 25.0 g and 5.0 g to 30.0 g, and from 6.5 mm to 11 mm and 6 mm to 14 mm, respectively. Padding instruments and mirrors increased the mass by approximately 5.0 g. The literature does not suggest an optimal length for dental instruments or dental mirrors. The literature suggests that the optimal diameter for dental instruments and mirrors is at least 10 mm, the optimal weight is 15.0 g or less, and padding decreases muscle activity. Conclusions: Dental hygienists should be educated to select a variety of instrument handles based upon the parameters described above. Show more

Keywords: Ergonomics, dental hygiene, tools, instrumentation, force, grasp

DOI: 10.3233/WOR-2010-0984

Citation: Work, vol. 35, no. 4, pp. 477-485, 2010

Authors: James, Debra M. | Branson, Bonnie G. | Simmer-Beck, Melanie | Bray, Kimberly K.

Article Type: Research Article

Abstract: Strengthening exercises like those used to treat carpal tunnel syndrome have been recommended for prevention however their effectiveness when used in this manner are not known. The purpose of this study was to determine the effects of the Flextend Orthotic Device® on grip strength of dental hygiene students. This study used a convenience sample of 24 (n=24) first year dental hygiene students. Students were randomly assigned to either the Flextend Orthotic Exercise glove group …or a control group. A series of grip strength measurements were taken periodically throughout the study using a hydraulic hand dynamometer. In a repeated measures analysis of covariance there were no significant effects for study group (p=0.812) time (p=0.954), nor was there a significant interaction between group and time (p=0.858). Use of the Flextend Orthotic Device® did not additionally increase grip strength among dental hygiene students over the eight week time period. In none of the weeks post baseline was there a significant difference between the Flextend Orthotic Device® group and control groups. Show more

Keywords: Work-related musculoskeletal disorders, repetitive motion injuries, bio-mechanics

DOI: 10.3233/WOR-2010-0985

Citation: Work, vol. 35, no. 4, pp. 487-494, 2010

Authors: Ahearn, David J. | Sanders, Martha J. | Turcotte, Claudia

Article Type: Research Article

Abstract: The increasing complexity of the dental office environment influences productivity and workflow for dental clinicians. Advances in technology, and with it the range of products needed to provide services, have led to sprawl in operatory setups and the potential for awkward postures for dental clinicians during the delivery of oral health services. Although ergonomics often addresses the prevention of musculoskeletal disorders for specific populations of workers, concepts of workflow and productivity are …integral to improved practice in work environments. This article provides suggestions for improving workflow and productivity for dental clinicians. The article applies ergonomic principles to dental practice issues such as equipment and supply management, office design, and workflow management. Implications for improved ergonomic processes and future research are explored. Show more

Keywords: Ergonomics, dental office workstation, dental practice, workflow, just-in-time

DOI: 10.3233/WOR-2010-0986

Citation: Work, vol. 35, no. 4, pp. 495-503, 2010