key: cord-0258726-kgevlr8k
authors: Alwahaibi, N.; Al Abri, I.; Al Sadairi, M.; Al Rawahi, S.
title: Ergonomics knowledge, attitude, and practice among biomedical scientists
date: 2021-07-30
journal: nan
DOI: 10.1101/2021.07.25.21261088
sha: f80194201263b1b6738c8922a37d583b88877f09
doc_id: 258726
cord_uid: kgevlr8k

Biomedical scientists (BMSs) are important professionals for healthcare services as they help in the detection, diagnosis, and treatment of numerous diseases. To the best of our knowledge, this is the first study to assess ergonomics knowledge, attitude, and practice among BMSs. A cross-sectional study was carried out among BMSs using a self-constructed questionnaire. The association between these parameters and various risk factors was measured using the Chi-square test. The study included 110 BMSs. Females represented 68.2% and 45.5% were in the age of 25-34. Good ergonomics knowledge showed in 54.5% and 82.7% showed high positive attitude. However, poor ergonomics showed in 83.5%. There was no significant interrelation between the three parameters. A significant association was found between the male gender (0.040), more than 20 working experience (0.016), and good ergonomics practice. Biomedical scientists have good knowledge, high attitude but the poor practice of ergonomics. Ergonomics training and practice should be firmly enhanced among these healthcare professionals.

Biomedical scientists (BMSs) are important professionals for healthcare services as they help in the detection, diagnosis, and treatment of numerous diseases. However, in day-to-day practice, BMSs are continuously exposed to various hazards such as chemical, physical, mechanical, electrical, and biological, as well as they are prone to infectious specimens (1) . The most common daily activities for BMSs include pipetting, microscopy, and work on standing positions. With the time, this may affect body organs such as muscles, joints, tendons, nerves, ligaments, cartilage, and spinal discs (2) . These musculoskeletal disorders (MSDs) can affect the efficiency and speed of the work and eventually lead to a disruption in the healthcare system (3) . It has been reported that MSDs are one of the common health problems among all health professionals (4) .

The goal of laboratory ergonomics is to reduce as much as possible the MSDs among BMSs by providing safe and comfortable working environment. Due to the nature of their work in the medical laboratory, BMSs are at risk for many health problems. Previous studies have focused mainly on the dentistry as an important profession in the healthcare system. However, scanty studies have evaluated the knowledge, attitude, and practice of ergonomics among BMSs. Thus, this study aimed to assess those ergonomics parameters among biomedical scientists.

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The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint Methods This is a cross-sectional observational study that was conducted in the year of 2020 at the Sultan Qaboos University Hospital (SQUH) and Sultan Qaboos University (SQU). The study is approved from the Medical Research Ethics Committee, College of Medicine and Health Sciences, SQU (SQU-EC/095/2020). Preceding the study, a detailed procedure of the study was explained, a voluntary consent form was also signed by each participant before the study.

The sample size was calculated using the infinite population sample size formula:

where N : Population size (The total number of BMS working at SQU and SQUH ) = 170, Z ( Standard value with confidence level 95%) =1.96 ,d( Permissible error on either side) = 10%, p (Proportion of the characteristic under the study). At the present, there is no available information on the proportion of MSDs among BMS. Therefore, the P-value was obtained from a pilot study that was conducted among 20 participants who fulfilled the research criteria. Those who participated in the pilot study were excluded from the study. The P-value was found equal to 63.5%. The sample size was calculated as 97. After sampling, the number was increased 15% to avoid non-response or inappropriately filled questions and that number was randomly selected from the overall population. The reliability of the questionnaire was calculated by Cronbach alpha in the pilot study and found to be 0.675.

A self-constructed questionnaire was used to obtain knowledge, attitude, and practice among biomedical scientists. It was designed utilizing literature review and other questionnaires of other populations (5-6).

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The questionnaire contained a brief description of the study. It was designed to contain a mix of positive and negative questions to avoid the false-positive results because of the inappropriately filled questions.

The questionnaire used in this study consisted of four sections. The first section was sociodemographic characteristics such as age, sex, marital status, physical exercise, heavy work at home, nationalities, qualifications, number of working years, specialities, BMS grade, working hours, work shifts and overtime. The second section consisted of eight questions related to the ergonomics knowledge, such as meaning, benefits, and principles of ergonomics. The third section consisted of eight questions related to the ergonomics attitude such as ergonomics education, distribution of the work, and adjusting the workplace. The fourth section consisted of nine questions related to the ergonomics practice such as wearing comfortable shoes, using comfortable positions, and relaxing eyes and neck.

For the three categories: Yes, some extent, and no, the scores were two, one and zero, respectively.

The total score of knowledge ranged from zero to 16. Achievement of more than 66.66% of the maximum score considered as good knowledge. Attitude was assessed by strongly agree, agree, neutral, disagree, or strongly disagree. The score of each question ranged from 1-5 giving a total score range of 5 -40. Those who achieved more than 66.66% regarded as having a positive attitude. Practice was evaluated like the knowledge. The total score ranged from zero to 18. Achievement of more than 66.66% of the maximum score considered as good practice.

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The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint

The data were analyzed using Statistical Package for Social Science (SPSS) version 25 software (SPSS Inc., Chicago, USA). Frequencies and percentages were used to represent the categorical data such as age, gender, and specialty. Continuous data were presented as mean and standard deviation. A Chi-square test was performed to measure the significant association between risk factors and level of knowledge, attitude, and practice. The P-value was considered significant if it was equal to or less than 0.05.

A total of 110 BMSs were included in this study after excluding those who did not fit the inclusion criteria. The majority were females (68.2%) and 73.6% were married. The majority of the BMSs (45.5%) were in the age group of 25-34. Surprisingly, the number of those who were doing regular physical exercises was nearly equal to those who were not with 50.9% and 49.1%, respectively (Table 1) . 30.0% of BMSs reported to have heard of the term "ergonomics, 37.3% knew the benefits of ergonomics application, and 47.3% knew the health hazard of their work without ergonomics ( Table 2) .

Regarding the attitude, 59.1% of the BMSs strongly agreed that ergonomics education must be part of the biomedical curriculum, and 68.2% strongly agreed that distributing the work equally between the workers makes it easier. However, 20.0% of them strongly disagreed preferring to bend their head forward instead of adjusting workspace for better viewing (Table 3) .

Regarding the practice of BMSs, 72.8% wore comfortable shoes while standing at work, 46.8% found enough space to put their legs and feet comfortably, and 45.0% were trying to avoid pressure on their hands and arms from sharp edges (Table 4) .

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The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint There was no significant association between sociodemographic factors and ergonomics knowledge and attitude. However, male gender and more than 20 years work experience showed a significant association with good ergonomics practice (Table 5) .

Overall, BMSs showed good knowledge and attitude in 54.5%, 82.7%, respectively. However, good practice was seen in only 16.5% ( Figure 1 ). 86.7% of the BMSs with good knowledge have a positive attitude but without any significant association between knowledge and attitude. Good practice was seen in 18.6% of those who have good knowledge with no relationship between knowledge and practice. In addition, there was no relationship detected between attitude and practice ( Table 6 ).

The use of laboratory investigation is very important as 70% of all medical decisions are affected by the results of laboratory analysis (7) (8) (9) . The application of ergonomics guidelines in the field of medical laboratory helps to minimize MSDs. MSDs are one of the common health problems among all health professionals. Several studies reported high levels of MSDs among medical laboratory scientists (10) (11) (12) (13) (14) . These high MSDs among BMSs will eventually affect the healthcare service. Health, productivity, and well-being are important characters for BMSs (15). It is expected that good knowledge, positive attitude, and good practice of ergonomics would minimize MSDs among BMSs.

To the best of our knowledge, this is the first study to assess ergonomics knowledge, attitude, and practice among BMSs. In the literature review, we found only one study evaluated the ergonomics . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint knowledge only among medical laboratory scientists in Nigeria (15). It is important to note that several instruments and products have been modified in the clinical laboratory to minimize MSDs.

For example, laboratory chairs are made with comfort to adjust height, back, and legs. In addition, BMSs while purchasing any instrument, keep in their mind, the ergonomics part of these machines.

Although that 93.6% of the BMSs have high qualifications, the present study showed that only 54.5% of BMSs had a good ergonomics knowledge. This finding is higher than other study that reported 25.5% (27 of 106) knowledge of ergonomics among medical laboratory scientists in Nigeria (15). We did not observe any statistically significant association between ergonomics knowledge and gender, age, marital status, qualifications, designation, specialty, and work experience. In comparison with the study in Nigeria, they showed that ergonomics knowledge was significantly associated with male gender. Other risk factors such as qualifications, affiliations, work experience, and specialty did not affect the ergonomics knowledge (15).

The current study showed very high positive ergonomics attitude (82.7%) among BMSs. However, gender, age, marital status, qualifications, designation, specialty, and work experience did not statistically affect the ergonomics attitude. When we asked BMSs if ergonomics education must be a part of the biomedical curriculum, 90.9% (100 of 110) agreed with this concept. In addition, 98.2% (108 of 110) believed that it is important to distribute the work equally between colleagues as it makes the work easier.

Surprisingly, good ergonomics practice was noticed in only 16.5% among BMSs. In addition, there was a statistically significant association between male gender and good practice. This association could be related to the fact that males are less stress than females. Thus, males can do their job more ergonomically. Furthermore, there was a significant association between work experience . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint (more than 20 years) and good practice. Those with more work experience have adopted well to the occupational safety procedure in the medical laboratory.

Previously, we reported that the overall prevalence of laboratory-related musculoskeletal disorders (LMSDs) among BMSs in the last 12 months in any parts of the body was 77.1%. Neck complaint was the highest, followed by shoulders, lower back, upper back, knees, ankle or feet, wrists or hands, elbows, and thighs or hip, with 50.6%, 49.4%, 43.4%, 34.9%, 30.1%, 26.5%, 24.1 %, 9.6%, 10.8%, respectively. In addition, 65.57% of BMSs had irregular symptoms of LMSDs, 54.10% experienced moderate pain due to these symptoms, and 44.26% had symptoms that persisted from hours to days (16). Thus, poor ergonomics practice of BMSs resulted in high levels of LMSDs.

Despite that, BMSs had a reasonably good ergonomics knowledge, high positive attitude, and poor practice, we did not observe any statistically significant association between knowledge and attitude, knowledge and practice, or attitude and practice. Thus, BMSs have the ergonomics knowledge and attitude but did not result in a good daily practice. In the medical laboratory, good ergonomics practice leads to less MSDs. In fact, good knowledge, attitude, and practice of ergonomics would help BMSs in taking sufficient precautions during their laboratory work as well as adjusting their working environment accordingly. The findings of this study strongly recommend the use of laboratory ergonomics checklist that would assess BMSs at their workplace and subsequently minimize LMSDs. This study has some limitations. First, due to the COVID-19 pandemic, we were not able to spread the questionnaire face to face to the BMSs. Second, the study was restricted to BMSs from a single hospital and university, even though this hospital serves as a tertiary referral hospital in Oman and . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint the university is the national university of the Sultanate of Oman. Third, ergonomics practice was measured by questionnaire only and not by observation. Finally, the lack of similar and relevant studies for a better comparison.

In conclusion, biomedical scientists have a good knowledge, high attitude but poor practice of ergonomics. Ergonomics training and practice should be firmly enhanced among these healthcare professionals.

The authors would like to thank all BMSs who participated in this study.

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The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint * This cannot be considered as significant even though P value is less than 0.05 because more than 20% of cells have expected count less than 5 and the minimum expected count is less than 1 so, the chi square test cannot be used.

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The copyright holder for this preprint this version posted July 30, 2021. ; https://doi.org/10.1101/2021.07.25.21261088 doi: medRxiv preprint Figure 1 : Level of knowledge, attitude, and practice among biomedical scientists . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

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