title: Predictors of shoulder and back injuries in nursing home workers: a prospective study.
abstract: BACKGROUND
  Nursing assistants (NAs) working in nursing homes have among the highest back and shoulder injury rates in the US. Incidence, severity, and cost of non-traumatic soft tissue musculoskeletal disorders in the nursing home industry in Washington State are quite high.
  
  
  METHODS
  To determine whether resident characteristics data reported on the Health Care Financing Administration Minimum Data Set (MDS) could be used as a surrogate measure of cumulative exposure to physical loads, we conducted an 18-month prospective study in one nursing home.
  
  
  RESULTS
  The combined NA injury incidence rate (IR) was 45.8 self-reported back and shoulder injuries per 100 [FTE] workers per year. In general, MDS reported resident characteristics failed to predict risk with the exception of exposure to loss of voluntary leg mobility (OR = 1.11 per person-shifts of exposure, 95% CI [0.97-1.27]), with the highest risk on the day shift (OR = 1.15, 95% CI [0.95-1.40]).
  
  
  CONCLUSIONS
  These findings suggest social integration and work organization issues may be more important predictors of back and shoulder injuries in nursing assistants than reported resident characteristics as measured by the MDS.
authors.affiliation: Safety & Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries, PO Box 44330, Olympia, WA 98504-4330, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Myers
authors.forename: Barbara
authors.initials: B
authors.lastname: Silverstein
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019567:Back Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D017770:Lifting / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D009728:Nursing Assistants; D009735:Nursing Homes; D009740:Nursing Staff; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D000070599:Shoulder Injuries; D014861:Washington / Q000453:epidemiology