Exoskeleton or arm holder: which equipment to limit musculoskeletal disorders among our pharmacy technicians?

Introduction
Musculoskeletal disorders are common among hospital pharmacy technicians. Various solutions exist to limit them: maximum reduction of volumes to be transferred, use of preparation aids, purchase of ergonomic chairs, robotization (although not suitable for the whole production)… Despite the implementation of such measures, musculoskeletal disorders may persist. Our preparation unit has been able to test 2 new ergonomic equipments designed to limit shoulder pain: an exoskeleton and an arm holder. We would like to share the results of our initial tests, as to our knowledge no other unit has been equipped with such ergonomic equipments.

Methods
Each ergonomic equipment was tested for 2 days. Two surveys were designed: 8 questions focusing on the hospital pharmacy technicians (pre-existing pains) and the preparations made (type, duration). A score between 1 (very unsatisfied) and 4 (very satisfied) was attributed to 10 items, grouped into 3 categories: setting-up (ease to fitting, adjustment, removal), mobility (weight, comfort, movement fluidity, accessibility to all isolator areas), pain relief (shoulder, back, lumbar); followed by a free field for comments.

Results
The exoskeleton was tested by 8 hospital pharmacy technicians, 5 of whom had pre-existing pains (4 shoulder pain, 1 shoulder and back pain). Median scores of 2,3; 2,4 and 3 were obtained respectively for setting-up, mobility and pain relief (for each item). Accessibility to all isolator areas received a median score of 1. The exoskeleton does not make filling infusors any easier, but relieves the shoulders when handling baskets in the isolator.
The arm holder was tested by 9 hospital pharmacy technicians, 5 of whom had pre-existing pains (3 shoulder pain, 2 back pain). Median scores of 3; 2,3 and 1,7 were obtained respectively for setting-up, mobility and pain relief (2 for shoulder, 1 for back and lumbar). Accessibility to all isolator areas received a median score of 3. The arm holder does not stay in place at elbow level and systematically rises to armpit level after arm extension in the isolator.

Discussion-conclusion
The arm holder seems to be easier to use than the exoskeleton (setting up, adjustments, accessibility of isolator areas). However, it does not meet expectations regarding shoulder pain relief, especially as it does not stay in place. Improvements are underway, as the arm holder manufacturer has taken our comments on board. The exoskeleton allows a “straight back” posture to be maintained, which relieves the back and lumbar vertebrae as well as the shoulders. Access to the various areas of the isolator could be facilitated by oval cuff supports. Following these test results, our unit will be equipped with 2 exoskeletons.

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