bims-cieche 2025-06-22 papers

Issue of 2025–06–22
three papers selected by
Jonas Stefaan Steel, IDEWE

JMIR Hum Factors. 2025 Jun 18. 12 e68522

Effectiveness of Participatory Ergonomic Interventions on Work-Related Musculoskeletal Disorders, Sick Absenteeism, and Work Performance Among Nurses: Systematic Review.

Guganesan Krishnanmoorthy, Sanjay Rampal, Sumitra Ropini Karuthan, Faiz Baharudin, Rama Krishna.

Background: Nurses face a higher risk of developing work-related musculoskeletal disorders (WMSDs) due to their primary roles in patient care. Participatory ergonomics (PE), an approach that integrates large-scale interventions performed at organizational and systems levels with small-scale interventions, is widely considered a promising approach to mitigate health problems at the workplace. However, its effectiveness in addressing WMSDs and secondary outcomes such as sickness absence and work performance among nurses is not fully understood.
Objective: This systematic review assessed the effectiveness of PE interventions in preventing WMSDs and mitigating two related outcomes, sickness absence and work performance, among nurses.
Methods: A literature search was performed in four electronic databases, PubMed, ScienceDirect, Scopus, and PsycNet, guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to retrieve relevant papers published between 2017 and 2023. Papers fulfilling the eligibility criteria were analyzed and subjected to quality appraisal.
Results: Overall, 19 papers were included in the final analysis. Various categories of ergonomic interventions were identified, with the predominant being exercise and physical activities, health promotional activities and training, educational programs, and patient handling devices. Multicomponent interventions, especially those involving physical activities and exercise, demonstrated stronger effects in reducing the risk of WMSDs at 6 months (OR 1.64, 95% CI 1.12-4.54) and 12 months postintervention (OR 2.70, 95% CI 1.52-4.51) compared with single interventions. However, most ergonomic interventions had no statistically significant effect (P>.05) on sickness absence and work performance. More than half (n=13) of the studies demonstrated moderate to high risk of bias, reflecting the need for better quality interventions.
Conclusions: Multicomponent interventions, particularly those involving physical activities and exercise, are more effective in reducing the risk of WMSDs among nurses compared with individual interventions. However, their long-term effects in addressing WMSDs, sick absenteeism, and work performance are still unclear. These gaps could be addressed by integrating organizational factors and prevention policies into existing ergonomic interventions, thereby offering opportunities to improve psychological health, job satisfaction, and work dynamics.

Keywords: ergonomics; musculoskeletal disorders; nurses; sick absenteeism; work performance

DOI: https://doi.org/10.2196/68522

Front Physiol. 2025 ;16 1507398

Mapping the evidence on the impact of heat stress on exercise and work performance in females: a scoping review.

Rachel E Gilworth, Bethany D Skinner, Daniel D Hodgkiss, Samuel J E Lucas, Rebekah A I Lucas.

Increasing numbers of females are performing in increasingly hot environments. This scoping review aimed to 1) collate evidence on the effects of environmental heat stress on aerobic exercise performance and work productivity in females specifically, and 2) explore sex differences in the existing literature. A systematic search across four databases (PubMed, MEDLINE, Web of Science and SPORTDiscus) was developed based on MeSH terms and keywords, with all permutations relating to 'FEMALE', 'WOMAN', 'HEAT' AND 'PERFORMANCE'. Identified articles were screened against pre-defined inclusion criteria related to age (16-60 years), environmental heat stress (≥23°C), and physical activity duration (≥5 min). We identified 35,696 articles, of which 41 met the inclusion criteria. Of the included studies, 19 reported female-specific comparisons, two of which also investigated sex differences. Four studies investigated sex differences alone, while 18 studies included females within the participant cohort. Thirty-eight of the included studies assessed athletic performance and three studies examined occupational performance (i.e., work output/productivity) in females. Existing data on the effect of heat stress on performance was predominantly from pre-menopausal cohorts (mean age 29 years, range 20-46 years), with no studies investigating peri- or post-menopausal cohorts. We uncovered limited research investigating the effect of menstrual cycle phase (six studies) or hormonal contraceptive use (two studies) on performance in the heat. Thirteen included studies examined interventions pre or during performance test(s), with four studies showing their interventions attenuated heat stress performance impairments in female cohorts. We highlight notable gaps in the literature regarding female performance in the heat; specifically, the influence of peri-post menopause, heat stress interventions for females, and impacts on females in the occupational sector. We recommend that researchers undertaking exercise and thermal physiological research aim for gender balance where possible and adhere to guidelines when designing and reporting research that encompasses females. Addressing these research gaps would provide workers, athletes, and practitioners with a better understanding of how to protect females and enhance their physical performance in the heat, across different stages of life, amidst a changing climate.

Keywords: exercise; female; heat; performance; productivity; work

DOI: https://doi.org/10.3389/fphys.2025.1507398

Telemed J E Health. 2025 Jun 19.

Economic Impact of an Employer-Sponsored Integrated Digital Intervention Targeting Substance Use Disorders: Return on Investment Analysis.

Suzette Glasner, Alfonso Ang, Darcy Michero.

Background: In light of the limited accessibility of evidence-based treatments for substance use disorders (SUD), coupled with the excess health care costs associated with untreated SUD, digital health has the potential to be transformative in addressing substance use and related chronic co-occurring conditions. This research aimed to evaluate the economic impact of Pelago (PEL), an integrated digital intervention combining psychosocial and pharmacological treatment targeting alcohol, tobacco, and opioid use disorders in a commercially insured adult population (N = 7,586). The model provided telehealth services using a smartphone application, from which clinician-facilitated videoconferencing and asynchronous messaging were delivered, along with digital, evidence-based therapy content and pharmacotherapy. Methods: Using a longitudinal model, a return on investment (ROI) analysis was undertaken to evaluate the impact of PEL on all-cause medical plan utilization costs 12 months before and after treatment initiation, relative to a matched control group. Results: In the 12 months following PEL registration, the intent-to-treat cohort who received the digital intervention evidenced an average all-cause medical plan utilization cost savings of $6,758 or 33% less per participant (4.5 ROI; p = 0.001). Among 1,172 participants who received PEL, a total savings of $7,920,376, relative to total program costs of $1,747,452 yielded a 4.5:1 ROI. Conclusions: Evidence-based treatment for SUD delivered via telehealth is associated with a significant positive ROI. Employers and payers willing to offer access to digital SUD care can mitigate morbidity and mortality while concurrently reducing medical costs and service utilization.

Keywords: digital therapeutic; health economics; return on investment; substance use disorder; telemedicine; workforce

DOI: https://doi.org/10.1089/tmj.2025.0102