Journal of Occupational Rehabilitation

, Volume 20, Issue 2, pp 199–219 | Cite as

Occupational Safety and Health Interventions to Reduce Musculoskeletal Symptoms in the Health Care Sector

  • Jessica M. TullarEmail author
  • Shelley Brewer
  • Benjamin C. AmickIII
  • Emma Irvin
  • Quenby Mahood
  • Lisa A. Pompeii
  • Anna Wang
  • Dwayne Van Eerd
  • David Gimeno
  • Bradley Evanoff


Introduction Health care work is dangerous and multiple interventions have been tested to reduce the occupational hazards. Methods A systematic review of the literature used a best evidence synthesis approach to address the general question “Do occupational safety and health interventions in health care settings have an effect on musculoskeletal health status?” This was followed by an evaluation of the effectiveness of specific interventions. Results The initial search identified 8,465 articles, for the period 1980–2006, which were reduced to 16 studies based on content and quality. A moderate level of evidence was observed for the general question. Moderate evidence was observed for: (1) exercise interventions and (2) multi-component patient handling interventions. An updated search for the period 2006–2009 added three studies and a moderate level of evidence now indicates: (1) patient handling training alone and (2) cognitive behavior training alone have no effect on musculoskeletal health. Few high quality studies were found that examined the effects of interventions in health care settings on musculoskeletal health. Conclusions The findings here echo previous systematic reviews supporting exercise as providing positive health benefits and training alone as not being effective. Given the moderate level of evidence, exercise interventions and multi-component patient handling interventions (MCPHI) were recommended as practices to consider. A multi-component intervention includes a policy that defines an organizational commitment to reducing injuries associated with patient handling, purchase of appropriate lift or transfer equipment to reduce biomechanical hazards and a broad-based ergonomics training program that includes safe patient handling and/or equipment usage. The review demonstrates MCPHI can be evaluated if the term multi-component is clearly defined and consistently applied.


Health care Occupational health Interventions Systematic review Musculoskeletal 



The authors wish to thank: Dan Shannon for obtaining bibliographic information and other materials; Jim Collins for providing references and input; Jane Gibson, Anita Dubey and Kiera Keown, and Jaime Wertman for their editorial advice; and Shanti Raktoe for administrative support. Jessica Tullar and Shelley Brewer were supported by an Occupational Injury Prevention Training Grant (T42 OH008421) from the U.S. National Institute for Occupational Safety and Health. The Prevention Reviews Program at the Institute for Work & Health has been supported by a grant from the Ontario Workplace Safety and Insurance Board. For the full report please visit the IWH web site at


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jessica M. Tullar
    • 1
    • 8
    Email author
  • Shelley Brewer
    • 2
  • Benjamin C. AmickIII
    • 3
    • 4
  • Emma Irvin
    • 3
  • Quenby Mahood
    • 3
  • Lisa A. Pompeii
    • 5
  • Anna Wang
    • 3
  • Dwayne Van Eerd
    • 3
  • David Gimeno
    • 6
  • Bradley Evanoff
    • 7
  1. 1.School of Public Health, Institute for Health PolicyThe University of TexasHoustonUSA
  2. 2.Chemplan, Inc.SarasotaUSA
  3. 3.The Institute for Work & HealthTorontoCanada
  4. 4.School of Public Health, Division of Health Promotion and Behavioral SciencesThe University of TexasHoustonUSA
  5. 5.School of Public Health, Division of Epidemiology and Disease ControlThe University of TexasHoustonUSA
  6. 6.School of Public Health at San Antonio Campus, Division of Environmental and Occupational HealthThe University of TexasHoustonUSA
  7. 7.School of MedicineWashington University at St. LouisSt. LouisUSA
  8. 8.HoustonUSA

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