title: The accident process preceding overexertion back injuries in nursing personnel. PROSA study group.
abstract: OBJECTIVE
  This prospective dynamic-population-based study investigated factors involved in the accident process preceding overexertion back injuries among nursing personnel.
  
  
  METHODS
  The study covered all reported occupational overexertion back injuries due to accidents among of the approximately 24 500 nurses in the Stockholm County hospitals during 1 year. It was assumed that several factors interact in the accident process. Detailed information was obtained for each injury by interviews with the injured nurse and head nurse. Risks in the physical environment were identified using an ergonomic checklist.
  
  
  RESULTS
  During the study 136 overexertion back injuries were reported. Of the 130 nurses participating in the study, 125 had been injured in connection with patient work. Cluster analysis yielded 6 clusters and their pattern of contributing factors. The most frequent injury occurred during patient transfer in the bed or to or from the bed, without the use of transfer devices, when the patient suddenly lost his or her balance or resisted during the transfer and the nurse had to make a sudden movement. However, there were physical conditions, such as shortcomings in the physical work environment or a lack of a transfer device, that compelled the nurses to perform the tasks under unsafe conditions.
  
  
  CONCLUSIONS
  The clusters showed a complexity of different kinds of accidents and indicated that the measures for preventing accidents, or for blocking an accident process once started, have to be of different kinds and placed at several different levels in the organization of a workplace.
authors.affiliation: National Institute for Working Life, Solna, Sweden. ingalill@niwl.se
authors.forename: I L
authors.initials: IL
authors.lastname: Engkvist
authors.forename: M
authors.initials: M
authors.lastname: Hagberg
authors.forename: E W
authors.initials: EW
authors.lastname: Hjelm
authors.forename: E
authors.initials: E
authors.lastname: Menckel
authors.forename: L
authors.initials: L
authors.lastname: Ekenvall
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D019567:Back Injuries / Q000209:etiology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D017770:Lifting / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009729:Nursing; D010360:Patient Transfer; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden