[The manual lifting of patients: the results of an assessment of exposure to the specific risk and of a clinical study in a rehabilitative institute].

An investigation was carried out in a rehabilitation centre in the Province of Milan in order to quantify exposure to patient handling and assess impairment of the spine induced by this risk factor. Altogether 5 departments were analyzed, with different rehabilitation aims (cardiological, respiratory and neurological); 97 of the 104 exposed staff underwent physical examination by an occupational health physician. Both exposure assessment and identification of impairment were performed using the methods proposed by the EPM Research Group. The exposure indices (MAPO Index) were high in 4 departments (5.6, 6.75, 8.81 and 13.8) and only one department had an index of 2.95 which is considered low-medium. The prevalences of impairment of the lumbar region of the spine were also higher in this group of workers compared to those found in other hospitals. In particular, the disorders of the lumbar spine reported were 45.4% in the males and 62.6% in the females. Of these 13% showed a third grade SAP. About 11% of the workers who underwent physical examination reported episodes of acute low back pain in the previous 12 months with a frequency 4 times higher than that found in group of unexposed workers. Analysis of the rehabilitation centre drew attention to the need for improvement measures that took into account the particular nature of the care services involved as in some cases it is not always possible to use equipment and aids to assist certain manual handling. In these cases the solutions involve the organization aspects especially. The results of this study were used by the rehabilitation centre management in order to plan the interventions for improvement. On the whole it was shown that analysis of this risk factor and health surveillance of exposed workers in such particular structures as rehabilitation centres is of considerable importance.