Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

https://doi.org/10.62574/at86vk90

Ergonomic hazards of primary health care medical personnel

Riesgos ergonómicos del personal médico de atención primaria en salud

Marian Elisa Paredes-Colina

marianp99.mp99@gmail.com

Universidad Iberoamericana del Ecuador, Quito, Pichincha, Ecuador

https://orcid.org/0009-0003-5580-257X

Michael Danny Pinargote-Galarza

michael10mpg@hotmail.es

Universidad Iberoamericana del Ecuador, Quito, Pichincha, Ecuador

https://orcid.org/0009-0006-3496-4651

Richard Andrés Cabrera-Armijos

rcabrera@unibe.edu.ec

Universidad Iberoamericana del Ecuador, Quito, Pichincha, Ecuador

https://orcid.org/0000-0001-9480-885X

ABSTRACT

Objective: to analyse the ergonomic risk of primary health care medical staff in type A health centres

in the Chillanes canton of Bolivar Province, Ecuador. Method: The research had an observational

design with a descriptive level. It addressed a purposive sample of 22 doctors who were administered

the modified Nordic questionnaire and were observed using the ROSA method. Results: the mean

age of the population was 36 years, most of them had a long working relationship and 86% reported

neck pain. When assessing the ergonomic risk, 90% are at very high risk and require the necessary

action as soon as possible. Conclusion: Ergonomic risks have a direct impact on the musculoskeletal

health of workers and a redesign of the work environment is required, along with comprehensive

interventions that address other elements that contribute to occupational health.

Keywords: ergonomics; occupational health; musculoskeletal diseases; medical personnel (Source,

DeCS).

RESUMEN

Objetivo: analizar el riesgo ergonómico del personal médico de atención primaria en salud de

centros de salud tipo A del cantón Chillanes de la Provincia de Bolívar, Ecuador. Método: La

investigación tuvo un diseño observacional con un nivel descriptivo. Abordó una muestra intencional

de 22 médicos a quienes se les administro el cuestionario Nórdico modificado y fueron observados

con el método ROSA. Resultados: la media de la población tiene 36 años, en su mayoría cuentan

con una relación laboral prolongada y el 86% manifestó dolor en el cuello. Al evaluar el riesgo

ergonómico, el 90% se encuentra en una situación de riesgo muy alto y requiere una actuación

necesaria cuanto antes. Conclusión: Los riesgos ergonómicos impactan directamente la salud

musculoesquelética de los trabajadores y se requiere de un rediseño del ambiente laboral, y junto a

ello, intervenciones integrales que aborden otros elementos que contribuyen a la salud laboral.

Descriptores: ergonomía; salud ocupacional; enfermedades musculoesqueléticas; personal

médico. (Fuente, DeCS).

Received: 15/08/2024. Revised: 18/08/2024. Approved: 23/08/2024. Published: 01/09/2024.

Original short

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

INTRODUCTION

Health work is a service activity centred on quality, continuity and sustainability of

care, without prejudice to the worker. (1,2,3). The work environment should be a safe

and ergonomic space, with healthy interaction, adapted to body dimensions and

technologically personalised for the worker (4,5). In particular, ergonomic hazards

lead to musculoskeletal disorders, manifested in chronic pain, fatigue and other

health problems (6). This affects the level of accident rates, sick leave, incapacity for

work and increases worker absenteeism (7). (7).

According to the World Health Organisation (8)work-related musculoskeletal

disorders are one of the most common problems among health professionals,

affecting 1.71 billion people worldwide, comprising more than 150 disorders of joints,

bones, muscles and associated systems. (5). Recent studies have shown that

inadequate working conditions, such as poorly designed furniture and lack of

ergonomic equipment, contribute to musculoskeletal injuries. (9).

The research conducted by Ortiz-Pazmiño and Brossard-Peña (10) identified that

the administrative staff evaluated are mainly exposed to ergonomic risks with 100%

of musculoskeletal symptomatologies. Similarly, the article published by Simbaña,

Cárdenas and Campos (11)showed that workers who used laptop computers, static

chairs and tables had symptoms in the lower back (75%), demonstrating the need

to redesign the workstations.

On the other hand, the study by Guimarães et al. (12)in assessing risks in

administrative staff, observed a prevalence of pain of 92.7%, with an association of

neck pain with mental overload due to stress, physical inactivity, the work table at

elbow height and the unsupported chair. Similarly, Vera-Márquez et al. (4) identified

that workers who had been working for more than 5 years presented pain and

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

discomfort in the neck, shoulder and dorsal region in 65% of the workers for more

than 12 months, together with sedentary lifestyles and the majority being overweight.

Abdollahi et al. (13)(13) also state that ergonomic risks are closely related to

musculoskeletal disorders but can be reduced with the correct training of staff.

Compatibility between the worker and the workspace, managing a healthy work

culture and a safe environment have an impact on worker comfort and job

satisfaction. (14).

Therefore, the article presents the research carried out in the population of doctors

working in the Chillanes Health Centre in the Province of Bolivar, which aimed to

analyse the ergonomic risk of primary health care medical staff in type A health

centres in the canton of Chillanes in the Province of Bolivar, Ecuador.

METHOD

This article presents a quantitative, analytical and observational research study. The

population consisted of 27 doctors working in type A primary care centres in the

Chillanes canton in the province of Bolívar, Ecuador. There was an intentional

sample of 22 for the survey, when the inclusion criteria were applied, such as

presenting the position of doctor, giving written consent to participate in the research

and being actively working in type A centres. Only 11 of these 22 professionals

agreed to be observed and assessed with the ergonomic risk sheet.

Data collection was carried out with the triangulation of instruments, with the

administration in a single contact of an observation form with the ROSA Method and

the modified Nordic Questionnaire. The research involved a documentary search in

PubMed, Scielo and Latindex, as well as consultation of the publications of the World

Health Organisation and OSHA. The analysis of the information took place in an

analysis matrix, which was subsequently processed in the SPSS statistical package

in version 29.

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

RESULTS

The socio-demographic results of the study are presented in table 1. All doctors work

8 hours per day.

Table 1. Socio-demographic characteristics.

VARIABLE

INDICATOR

FREQUENCY

Sex

Male

Female

Age group

20-29

30-39

40-49

Length of service

(years)

4-6 years

7-10 years

More than 10 years

Source: Own elaboration.

According to figure 1, the average age distribution of the work is 36 years, with the

50th quartile being 35 years.

Figure 1. Histogram of the ages of the study population.

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

Source: Own elaboration.

Figure 2 shows the frequency of these symptomatologies according to working

conditions.

Figure 2. Frequency of pain due to ergonomic actions in work furniture.

Source: Own elaboration.

The results shown in figure 2 indicate that neck pain is the most prevalent

symptomatology in all ergonomic elements of the workplace, being present in all five

study variants, with a prevalence in women of 56.3% and in men of 43.7%.

Mouse

ergonómico

Apoyo de teclado Escritorio de

acuerdo a su

altura

Silla regulable con

espaldar y apoya

brazos

No presentan

ninguna acción

ergonómica

Frequency of pain

per person

Neck pain Back pain in the lumbar region Shoulder pain Wrist pain Ankle pain

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

Figure 3. Body schema based on the percentage of involvement in the study population.

Source: Own elaboration.

As shown in figure 3, neck pain was the most prevalent in the study population with

86% recurrence followed by back pain with 64%. Regarding the frequency of risk

factors in relation to exposure time, 60% adopt positions that can cause fatigue and

53% perform repetitive movements for periods of 30 minutes to 2 hours. The risk

analysis based on the ROSA method applied to the study personnel showed that

90% of the workers observed had a high risk of contracting a skeletal

symptomatology.

Figure 4 presents a neural network with different input variables and their coding,

such as gender, work furniture, sitting time in front of the computer and age. The

model yielded seven neural layers, with two output variables as high and very high

risk. The interactions indicate that there is a direct connection of very high risk with

work furniture 3 and 4 in the coding corresponding to adjustable chair with backrest

and armrest.

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

Figure 4. Neural network of ergonomic risks and musculoskeletal symptomatology.

Source: Own elaboration.

Figure 5 shows the variables with the highest weights, age and work furniture. There

is no weight in the neural model with respect to time spent sitting in front of the

computer. The area under the curve was 1, indicating that there was no error in the

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

data processing, moreover, the simulation matched the risk level of the study

subjects.

Figure 5. Variables with the greatest weight in the neural network model with ergonomic risk and

musculoskeletal symptomatology as the response variable.

Source: Own elaboration.

DISCUSSION

Ergonomic risk has a significant impact on the occurrence of musculoskeletal

disorders, the work environment can cause cumulative effects resulting in adverse

health conditions, disability or, in extreme cases, loss of life of the worker. (15). These

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

problems are associated with exposure time to repetitive procedures, application of

forces and weight overloading (6).

The adult female population has a higher prevalence of musculoskeletal disorders

of the trunk and upper extremities, which increases with years of work service.

(16)Accordingly, for every 10 professionals with neck pain, 6 are women and for

every 10 professionals with back pain, 7 are women, most of whom have been

working for more than 10 years. Also, the prolonged work routine and the collective

psychological state can lead to physical and emotional exhaustion, leading to

burnout syndrome. (17).

The pre-professional stage of medicine can be a risky environment, so many of these

conditions start and go undetected. (18). Medical education, laboratory learning

activities involve neck flexion and upright sitting posture.(19). However, healthcare

workers are receptive to preventive and corrective ergonomics, safety and

occupational health programmes (13,19). (13,19).

Reducing risks in repetitive activities, adapting the workstation according to the

anthropometric measurements of the workers, encouraging the use of both hands

and the use of display screens instead of laptops (11,20).

The worker is often subjected to high levels of work pressure, workload and work

demands, developing stress and anxiety. (21). Systemic interventions are highly

successful, the use of techniques to increase motivation and resilience, such as

structural empowerment, recognition of achievements, conflict management, music

therapy and aerobic exercise, are favourable to help the professional cope with

organisational and personal challenges. (22).

CONCLUSION

There is a high ergonomic risk in the assessed medical staff, who already show latent

musculoskeletal disorders in the last 12 months and according to the assessment

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

require immediate intervention. The risks are mainly focused on the age of the

workers and the furniture, which leads us to recommend the redesign of the work

area and the strengthening of a healthy work culture in the work dynamics.

CONTRIBUTION OF THE AUTHORS

Marian Elisa Paredes-Colina and Michael Danny Pinargote-Galarza. They

contributed to the conceptualisation of the study, methodological design, data

collection, statistical analysis, writing the initial draft of the manuscript and critical

revision of the intellectual content. Richard Andrés Cabrera-Armijos, participated

in the interpretation of the data, supervision of the research process and final

approval of the manuscript for publication.

FUNDING

Non-monetary

CONFLICT OF INTEREST

There is no conflict of interest with persons or institutions involved in research.

ACKNOWLEDGEMENTS

To the Master's programme in Occupational Health and Safety. Ibero-American

University of Ecuador.

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Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

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Revista arbitrada de ciencias de la salud

Vol. 3(3), 1-13, 2024

Riesgos ergonómicos del personal médico de atención primaria en salud

Ergonomic hazards of primary health care medical personnel

Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

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Vol. 3(3), 1-13, 2024

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Marian Elisa Paredes-Colina

Michael Danny Pinargote-Galarza

Richard Andrés Cabrera-Armijos

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