WORK: A Journal of Prevention,Assessment & Rehabilitation

Brazil is one of the leading global pork exporters, operating approximately 1100 slaughterhouses where manual labor often exposes workers to repetitive strain and poor postural conditions.

This study aimed to evaluate the effectiveness and usability of an exoskeleton in reducing upper-limb physical effort during dynamic, repetitive tasks common in meat processing lines.

Seventeen workers performed 17 production tasks involving repeated arm elevations above 45°, both with and without the use of an exoskeleton. Muscle activity in the medial and anterior deltoids was measured using surface electromyography (sEMG). Subjective workload was assessed using the BORG scale and a usability questionnaire.

Among the four muscles analyzed based on normalized mean values relative to maximum voluntary contraction (MVC), a statistically significant reduction in activity was observed in the right medial deltoid when using the exoskeleton (p = 0.0440). For normalized peak values, no muscle showed statistically significant reductions (left anterior deltoid, p = 0.3192; left medial deltoid, p = 0.0552; right anterior deltoid, p = 0.3708; right medial deltoid, p = 0.0552). However, Cohen's d indicated medium-to-large effect sizes for the right and left medial deltoids and the left anterior deltoid, suggesting reduced biomechanical demand during exoskeleton-assisted tasks.

The exoskeleton demonstrated potential to reduce the load on specific muscles, indicating possible ergonomic and industrial benefits. However, limitations include the need for anthropometric adjustments and additional operating space. These findings support the device's relevance and highlight the need for further research on optimization and industrial adaptation.

The Incident Command System is a critical framework for coordinating emergency response; however, large-scale disasters often expose operational, structural, and communication gaps. Understanding how Emergency Medical Services personnel navigate these challenges is essential to strengthening disaster readiness and improving coordinated field operations.

This study aimed to explore the challenges faced by prehospital Emergency Medical Services personnel in adapting to the Incident Command System during the Kahramanmaraş Earthquakes.

A qualitative phenomenological design was employed to investigate the lived experiences of Emergency Medical Services professionals who participated in disaster response operations. Twenty participants were recruited through purposive sampling from the Paramedic and Pre-Hospital Emergency Medicine Association. Semi-structured interviews were conducted via Microsoft Teams between March and May 2024. Data were analyzed using inductive content analysis following Braun and Clarke's six-phase framework, supported by MAXQDA 2020 software.

Seven major themes were identified: absence of a pre-incident plan, communication breakdown, inadequate scene safety, lack of inter-agency coordination, resource insufficiency, challenges in disaster triage, and inefficiencies in patient transport. These findings highlight systemic and organizational weaknesses that hindered Emergency Medical Services professionals adaptation to the Incident Command System.

Findings demonstrate that fragmented command structures, disrupted communication, and insufficient logistical planning impeded effective Emergency Medical Services coordination under chaotic disaster conditions. Strengthening scenario-based Incident Command System training, communication infrastructure, and inter-agency governance mechanisms is essential to improve Emergency Medical Services adaptability and resilience in future large-scale emergencies.

Ergonomics plays a critical role in musculoskeletal health, yet validated tools such as ROSA may be impractical in high-demand clinical settings. This study compared ergonomics knowledge, awareness, and behaviors between individuals with and without musculoskeletal pain using a concise yes/no-based tool.

To compare ergonomic behaviors, knowledge, and awareness between individuals with and without musculoskeletal pain, and to identify behavioral factors associated with chronic pain.

A cross-sectional study was conducted among adults aged 18–65 in a tertiary healthcare facility. Participants completed a binary-response ergonomics questionnaire assessing posture, workstation adjustment, screen use, and ergonomic equipment habits. Group comparisons used Chi-square and Mann–Whitney U tests (p < 0.05).

Among 222 participants, chronic pain was significantly associated with female gender, being a housewife, poor posture, lack of chair height adjustment, and reduced screen-time awareness. (p < 0.05) Correct posture, chair adjustment, and screen-time awareness were protective. Elbow support use was associated with lower chronic pain prevalence (p = 0.033).

A rapid, binary ergonomics assessment effectively identified behavioral risk factors for chronic musculoskeletal pain. This format may support scalable ergonomic screening in diverse occupational environments.

In the structure of military traumatism, the number of multiple and combined wounds and injuries has increased significantly due to the increase in the destructive properties of modern weapons. Most blast wounds are characterized by multiple damage to blood vessels and nerve fibers and significant defragmentation of muscles and skin. All such wounds are considered initially infected, which is an additional aggravating factor. The establishment of a correct rehabilitation diagnosis and subsequent stage-by-stage assessment of the results of rehabilitation therapy should be based on adequate functional assessment tools. The FIM is one such tool that had not been previously recommended for use in any Ukrainian guideline.

The aim of the study was to investigate the possibility of using the Functional Independence Measure as an additional tool for assessing the effectiveness of rehabilitation of military personnel in Ukraine with combined injuries over a long period of time.

A retrospective study was conducted of 807 wounded Ukrainian servicemen with complex injuries of varying severity. Examination included a meticulous analysis of medical records, a comprehensive physical examination, and a survey using the FIM scale. Due to the nature of the injuries, the servicemen were provided with standard rehabilitation programs.

All patients were classified as lightly injured and moderately injured according to the Abbreviated Injury Scale. The examined wounded had an initial assessment of more than 6 points on the FIM scale. Initial data in the assessment of functioning on the FIM scale allowed the identification of two different subgroups of patients: one with a predominance of motor function impairment, and the other, predominant cognitive impairment. Reliable positive changes of the total FIM indicator were observed in all patient groups. The primary improvement in the groups with traumatic brain injury (TBI) was attributed to enhancements in cognitive abilities. Patients with the lowest initial motor abilities (combined upper and lower extremity trauma group) demonstrated the highest increase in this area.

Inclusion of the FIM scale in the recommended toolkit for assessing the effectiveness of rehabilitation will allow for additional objectification of rehabilitation care and the formulation of individual recommendations for achieving the best rehabilitation results.

Dementia is a major public health concern, especially in low- and middle-income countries. While structured exercise benefits cognition, occupational physical activity may not.

To investigate the association between lifetime occupational physical demand and cognitive impairment among older adults in Brazil.

Cross-sectional baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed (n = 9412). An algorithm was used to estimate the number of participants aged 60+ (n = 5432) with dementia and participants reported the physical demand of the job held for most of their life. Logistic regression models estimated the impact of physical demand on dementia status.

After exclusions, 4924 participants were analyzed. Compared with ‘never worked’, intense physical effort was associated with higher odds of dementia (OR 2.52; p = 0.013). Other categories showed no associations. On sensitivity analyses using ‘intense physical effort’ as reference, lower demand categories were associated with less dementia, and this effect was only present among women.

Intense occupational physical demand was associated with greater odds of dementia. Given the cross-sectional design, reverse causation and residual confounding (such as job control) may explain these findings. Occupational physical activity differs from leisure-time exercise in psychosocial context, suggesting this association is unlikely to reflect physical effort alone and may instead be driven by unmeasured psychosocial job characteristics frequently linked with physical jobs. Therefore, solely reducing physical demands is insufficient without addressing job control and stress. Findings highlight the need for occupational health interventions addressing psychosocial risks in physically demanding jobs.

The design of valves in continuous process industries, such as on Floating Production, Storage, and Offloading (FPSO) platforms, often shows a significant gap between regulatory standards and the practical needs of operators and maintainers. While integrating ergonomics in the early project stages can improve efficiency and safety, a disconnect persists between a design's formal compliance and its usability.

This study aims to analyze the ergonomic challenges and systemic barriers that limit the integration of operational knowledge in the valve design process on FPSO platforms.

A qualitative, descriptive case study was conducted on two FPSO platforms operating on the Brazilian coast between September 2022 and March 2024. Data were collected from multiple sources, including technical document analysis, interviews, participatory observation, and valve design review sessions. Activity ergonomics guided the research to integrate user knowledge into design specifications.

The research identified that the rigid application of valve categorization criteria and a lack of adaptation to local anthropometric data lead to a design that does not fully meet user needs. Case studies show that compliance with standards fails to guarantee usability, resulting in design decisions that prioritize one component at the expense of another's accessibility.

The effective integration of ergonomics and operator knowledge in early stages is essential for safer and more efficient design, but participation alone is insufficient. This study concludes that project processes and tools must be enhanced to systematically transfer operational knowledge to engineering, aligning normative requirements with actual work demands.

Law enforcement officers are required to wear and carry loads as part of their occupation. Research detailing differences in loads carried across occupational subgroups in law enforcement is limited.

The aim of this study was to profile the loads carried by an Australian State police agency and investigate whether any occupational subgroup, or sex-based, differences existed.

Data from 88 officers across five different stations from the same agency were collected. Officers were weighed in their uniforms without, and with, their duty load. Duty load was calculated as both absolute and relative values. Independent samples t-tests were used to investigate differences between sexes. An ANOVA was used to compare loads between occupational subgroups. Alpha levels were set at 0.05.

Female officers were significantly shorter and lighter than male officers, carried significantly lighter absolute loads but similar relative loads. General Duties (9.47 ± 1.67 kg) and Bicycle officers (10.38 ± 0.37 kg) carried and wore significantly heavier absolute loads than plain clothes officers (6.71 ± 2.26 kg), while specialist police carried significantly heavier loads than all subgroups (15.72 ± 2.13 kg). A similar trend was found in relative loads (General Duties = 11.1 ± 2.1%, specialist police = 17.0 ± 3.6%) except for Bicycle officer relative loads (10.9 ± 1.6%) which were not significantly heavier than those of plain clothes officers (7.9 ± 2.9%).

Different subgroups of officers carry and wear different loads. These differences warrant consideration especially when considering the chronic impacts of wearing these loads across a career. Optimised load fit and physical conditioning are recommended to mitigate the occupational impacts of carrying these loads.

Rural residents with disabilities often experience healthcare disparities versus urban counterparts.

To meta-synthesize the rural rehabilitation disparities, including access barriers, and the strategies for improving rehabilitation access for rural underserved populations.

Umbrella review of the contemporary (2015–2024), English-language reviews focused on rural rehabilitation service-delivery gaps or strategies for adults or children with disabilities, with no country restrictions. Six scientific databases (Medline/PubMed, Scopus, CINAHL, Cochrane Library, PDQ-Evidence, REHABdata) were searched, supplemented by snowballing. Two independent reviewers performed full-text assessments and quality appraisals of the systematic reviews on intervention effects, using the Measurement Tool to Assess Systematic Reviews-2.

Of the 530 records identified, 366 were unique references and 16 reviews were finally included, including 8 systematic reviews, two of them with meta-analyses. The 16 reviews included collectively synthesized information from 484 studies. Rural rehabilitation-access disparities were identified. For instance, those derived from supply shortages in low-density markets, workforce recruiting and retention issues, long travel requirements and costs, waiting times or low intervention intensity, and generalist versus specialist skills of the therapist workforce. Rural rehabilitation strengthening strategies were also identified. These include telehealth service options – benefits and challenges; outreach, home and community-centered approaches; navigator programs; and finally, task-sharing with (remote) specialist support.

This umbrella review provides a meta-synthesis of the issues affecting equitable access to rehabilitation by rural populations and of the strengthening strategies to address those disparities. Alone or combined, these strategies might be tailored to and with local communities and interested parties for effective co-implementation.

Despite significant advancements in workplace equality, gender-based discrimination continues to hinder women's leadership aspirations and potential. In many non-Western societies, cultural and institutional structures intensify the influence of sexism on women's professional experiences.

This study explores how benevolent and hostile sexism, together with perceived organizational support, affect female employees’ worries about leadership roles. It also examines whether organizational support moderates the relationship between sexism and leadership-related anxieties.

Data were collected from 201 full-time female employees working in various occupations in Türkiye. An online survey included the Worries about Leadership scale, the Perceived Organizational Support Scale, and the Perceived/Experienced Sexism Scale. Hypotheses were tested using moderation analysis via the PROCESS macro.

Benevolent sexism and perceived organizational support were both negatively associated with worries about leadership. Perceived organizational support moderated the effect of benevolent sexism on leadership worries, such that higher support reduced its impact, demonstrating a crossover effect. Specifically, benevolent sexism was linked to fewer leadership worries when organizational support was low but associated with more worries when support was high. However, hostile sexism showed no main or interaction effect with POS on WAL.

This study highlights the complex role of benevolent sexism in shaping women's leadership concerns, showing both its potentially protective and harmful effects. It also emphasizes the need for culturally sensitive approaches that go beyond generic organizational support to actively challenge subtle sexism and promote gender-inclusive leadership readiness in non-Western contexts.

Healthcare workers faced immense challenges during the early COVID-19 pandemic, contributing to their psychological distress. Female workers have been shown to be at higher risk, but most studies only measured birth-assigned sex, thereby overlooking sociocultural (gender) differences.

To examine the respective roles of sex and gender in the association between COVID-19–related occupational stressors and psychological distress among healthcare workers over time during the early phase of the pandemic.

This longitudinal study examined 382 Canadian healthcare workers (12.8% male, 87.2% female; 92.9% white) monitored weekly over 8 weeks during the first two waves of the pandemic. Using sociodemographic and work data, we developed a composite gender index and investigated how sex, gender, and COVID-19-related stressors related to psychological distress (anxiety, depression, posttraumatic stress) using linear mixed models.

COVID-19-related stressors were associated with higher distress. A more feminine gender score, but not female sex, predicted higher distress. A modest interaction was observed based on a small subgroup, suggesting lower anxiety and posttraumatic stress among medically vulnerable workers with higher feminine gender scores. Overall distress decreased modestly over time, although models explained a limited proportion of variance.

These findings underscore the need to go beyond birth-assigned sex in mental health assessments of healthcare workers during public health crises.

Although research on persons with disabilities in self-employment is gaining traction, there is a lack of successful evidence-based frameworks used to facilitate self-employment.

To map existing literature on evidence-based frameworks for facilitating self-employment among persons with disabilities.

The three reviewers used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) process and steps to enhance this research's methodological reproducibility and transparency. Both published and grey literature were searched. Arksey & O’Malley's five sequential stages guided the scoping review process.

After screening 435 studies, only 10 were included. Of the ten included studies, the majority (n = 7, 70%) were from high-income countries. Evidence-based frameworks for persons with disabilities exist mainly in high-income countries and are referred to by various names, including programmes, training, models, and vocational rehabilitation. These are associated with internal and external barriers and facilitators. Moreover, a list of microenterprises for consideration by the key role players involved is available. These evidence-based frameworks’ individualised processes start with a referral and end with a follow-up.

Although the included studies did not use standardised terminologies for evidence-based frameworks, the findings suggest that self-employment for persons with disabilities is intersectoral and includes various key role players. Collaboration, positive attitudes, and the willingness of key role players involved foster the sustainability and continuity of these evidence-based frameworks. A central key role player is a skilled mediator who is aware of other key role players and their roles.

Non-regular workers in South Korea account for approximately 37% of the workforce and face elevated risks of occupational injury, yet empirical research on their return-to-work (RTW) outcomes remains limited.

This study aims to (1) compare RTW outcomes between regular and non-regular workers over a four-year observation period, and (2) identify group-specific predictors of RTW using a multidimensional framework encompassing individual, psychological, health-related, social, and workplace factors.

Data from 2643 occupationally injured workers were drawn from the Panel Study of Workers’ Compensation Insurance, a nationally representative dataset spanning four annual waves (2018 to 2021). Random-effects panel multinomial logistic regression models were estimated separately for each employment type, supplemented by a pooled interaction model to test between-group differences.

Non-regular workers were more likely to remain unemployed or be reemployed at a different workplace, whereas regular workers were more likely to return to their original jobs. Self-efficacy and social interaction were associated with RTW in both groups, though their effects operated through different pathways. Labor union presence was significantly associated with RTW only among regular workers.

Non-regular workers experience structurally distinct RTW patterns following occupational injury. The findings highlight the need for targeted interventions that strengthen psychological and social resources for non-regular workers, alongside institutional reforms to support their sustainable reintegration.

Occupational injuries persist as a significant challenge in high-risk industries, such as aluminum smelting. Despite extensive safety initiatives, injury rates continue to be driven by a complex interplay of organizational and workplace-level factors. A limited understanding of how these multilevel factors hinder the design of effective preventive strategies highlights the need for a deeper investigation.

This study aims to investigate the causal mechanisms linking organizational resilience, hazard perception, and occupational well-being to injury occurrence in aluminum smelting operations, thereby aiding in the development of targeted safety interventions.

This study employed a 1:4 case-control design, involving 600 shop floor workers (120 injured and 480 non-injured). Structural equation modeling (SEM) was employed to analyze interrelationships among organizational and local workplace-level factors.

The study revealed that organizational resilience exerted a direct negative influence on injury (B = −0.47, p < 0.01). The indirect effect of organizational resilience on injuries, mediated by hazard perception, was found to be negative (B = −0.19, p < 0.01). Hazard perception had a negative, moderate, and direct impact on injury (B = −0.33, p < 0.01). Moreover, occupational well-being did not significantly influence injury. Organizational resilience was identified as the crucial factor that influences both hazard perception and injury status within the workforce.

Strengthening organizational resilience through proactive safety measures and supportive policies provides a viable solution to reduce injury rates in aluminum smelting operations. These findings highlight the importance of system-level approaches in improving occupational safety outcomes.

Repetitive hand movements during mobile device use, such as texting and typing, may lead to cumulative stress on hand structures and result in musculoskeletal conditions with potential surgical relevance. The increasing ubiquity of smartphone use raises concern for the development of overuse injuries, particularly among younger individuals and high-frequency users.

To systematically review and characterize surgically relevant hand and wrist pathologies associated with mobile phone use.

We conducted a systematic search of Embase, PubMed, and Scopus using terms related to mobile device use (e.g., “texting,” “smartphone”) and hand conditions requiring or potentially requiring surgical intervention (e.g., “de Quervain,” “trigger thumb”). Studies were included if they reported hand or wrist injuries in mobile device users with surgical implications. Studies unrelated to hand anatomy or lacking relevance to surgical pathology were excluded. Abstract and full-text screening were followed by data extraction.

Of 588 articles initially identified, 42 met inclusion criteria, representing over 67,000 individuals. The mean age across studies was 24.6 years. The most commonly reported surgically relevant conditions included de Quervain's tenosynovitis (n=9), carpal tunnel syndrome (n=6), tendinitis (n=4), and trigger finger (n=1). Across studies, increased mobile phone use was associated with a higher risk of developing these pathologies.

As mobile device usage continues to rise, recognition of surgically relevant hand injuries is essential. Preventive strategies and ergonomic interventions may reduce the burden of these injuries, particularly in younger and high-use populations.

Climate change poses increasing risks to occupational health and safety, yet systematic tools for assessing employees’ awareness of climate-related workplace risks remain limited.

This study demonstrates the development of a scale to measure awareness of the risks posed by climate change.

The scale was developed by researching the literature on climate change and generating a question pool. The produced question pool was first eliminated independently and then offered to experts for feedback. The number of questions was reduced to 24 based on expert feedback. The survey included employees aged 18 to 65 in Türkiye.

The constructed scale had a Kaiser-Mayer-Olkin value of 0.933 and a significant Bartlett Sphericity Test result. The scale, which had a normal distribution in the normality test and was acceptable for factor analysis, underwent Explanatory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), with items with low factor loadings being deleted. As a result of the reliability test, the Cronbach's Alpha score was 0.918. The Goodness of Fit Indexes also indicate that the study is suitable for further investigation. The scale was designed with 21 items and three factors in a four-point Likert structure.

Within the framework of the analyses performed; this study has produced a scale with approved validity and reliability to measure climate change risk awareness for different occupational groups between the ages of 18–65.

A growing body of evidence suggests that a combination of physical, psychological, and environmental factors increases the likelihood of experiencing complaints related to the arm, neck, and/or shoulder (CANS), although the precise nature of these relationships and their potential long-term effects remain uncertain.

To synthesize evidence from prospective cohort studies investigating the risk factors associated with the development of CANS among workers who use computers.

A systematic search was conducted in PubMed, ProQuest, Scopus, Cochrane Library, and Google Scholar to identify prospective cohort studies published between January 2010 and 2025. Eligible studies investigated risk factors of CANS among workers using computers, with a follow-up period of at least one year. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle–Ottawa Scale. Relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects meta-analysis. Heterogeneity among studies was assessed using Cochran's Q test and the I² statistic.

Two studies indicated a low risk of bias, while the remaining studies were assessed as having a moderate risk. For overall exposures, the correlation with the prevalence of CANS was the duration of using computers or mouse >4 h/day and BMI, with RR = 1.25 (95% CI: 1.08–1.44) and 1.05 (95% CI: 1.02–1.08), respectively.

Prolonged computer use and higher body mass index were significant predictors of CANS, and the findings highlight the importance of ergonomic interventions and health promotion strategies to reduce work-related musculoskeletal complaints in sedentary occupational environments.

This study explored the optimal design of workplace emotional skills training, focusing on emotional blackmail, emotional intelligence, and emotional contagion. Emotional management is crucial to individual performance and organizational operations, particularly in high-stress or uncertain environments.

To identify key workplace emotional indicators, evaluate their importance, and provide practical recommendations for course design to improve employee well-being and organizational effectiveness in the high-tech industry.

A modified Delphi method was employed to establish workplace emotional indicators, and the fuzzy analytic hierarchy process was then used to determine the indicators’ relative weights. This study's expert panel included human resource managers, management personnel, and employees with substantial experience in the high-tech sector.

“Cultivating emotional intelligence” (0.468) was the most crucial dimension, with “self-motivation” (0.320) and “interpersonal relationships” (0.209) being the key indicators. In the “recognizing emotional blackmail” dimension, the key indicators were “work stress management,” “blackmailer characteristics,” and “blackmail victim characteristics.” The main focus of the “managing emotional contagion” dimension was “positive emotion cultivation,” which supports team performance.

Emotional intelligence is central to managing emotional blackmail and remaining resilient in high-stress environments. The present findings highlight the value of long-term emotional training programs, focusing on self-motivation and emotional regulation at the individual level and the cultivation of positive emotions at the organizational level. Employee turnover may serve as a contextual, long-term outcome, but short-term measures such as engagement and conflict reduction are more appropriate indicators of a program's effectiveness.