International Journal of Nursing Studies 41 (2004) 859–867 The physical workload of nursing personnel: association with musculoskeletal discomfort Nancy N. Menzel a, *, Stuart M. Brooks b , Thomas E. Bernard c , Audrey Nelson d a Department of Health Care Environments and Systems, College of Nursing, University of Florida, P.O. Box 100187, Gainesville, FL 32610, USA b Department of Environmental and Occupational Health, Colleges of Medicine and Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA c Department of Environmental and Occupational Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA d Patient Safety Center of Inquiry, James A. Haley Veterans Hospital, 11605 N. Nebraska Avenue, Tampa, FL 33612, USA Received 3 November 2003; received in revised form 11 March 2004; accepted 23 March 2004 Abstract Direct care-nursing personnel around the world report high numbers of work-related musculoskeletal disorders. This cross-sectional study examined the association between the performance of high-risk patient-handling tasks and self- reported musculoskeletal discomfort in 113 nursing staff members in a veterans’ hospital within the United States. Sixty-two percent of subjects reported a 7-day prevalence of moderately severe musculoskeletal discomfort. There was a significant association between wrist and knee pain and the number of highest-risk patient-handling tasks performed per hour interacting with the load lifted. On units where lifting devices are readily available, musculoskeletal risk may have shifted to the wrist and knee. r 2004 Elsevier Ltd. All rights reserved. Keywords: Work-related musculoskeletal disorders; Nurse; Lifting; Manual handling; Wrist pain; Knee pain 1. Introduction Direct care nursing personnel around the world report high numbers of work-related musculoskeletal disorders (Menzel, 2004). In the United States (US), nursing assistant (NA) 1 and registered nurse (RN) are among the ten occupations reporting the greatest number of nonfatal musculoskeletal disorders resulting in days away from work (US Bureau of Labor Statistics, 2003). Most of these work-related musculoskeletal disorders (WMSDs) among nursing personnel are back injuries, although they also include neck, shoulder, arm, wrist, and knee disorders (Daraiseh et al., 2003). For direct care nursing staff, manual patient handling (moving or repositioning a patient using their own body strength) is the major cause of these injuries (Harber et al., 1985; Hollingdale, 1997; Knibbe and Friele, 1996; Smedley et al., 1995). After such an injury, many health care workers leave the field, either temporarily or perma- nently (Helminger, 1997; Lewis, 2002). One of the major difficulties in reducing WMSDs is the multifactorial etiology, with many associated causes, including physical, work organizational, psychosocial, individual, and sociocultural factors (World Health Organization, 1985; US Department of Health and Human Services, 1997; National Research Council, ARTICLE IN PRESS *Corresponding author. Tel.: +1-352-273-6401; fax: +1- 352-273-6577. E-mail address: nmenzel@nursing.ufl.edu (N.N. Menzel). 1 Nursing assistants are also known as nursing aides, orderlies, and attendants. 0020-7489/$-see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ijnurstu.2004.03.012