{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:11:39Z","timestamp":1789042299130,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"S&T Program of Baoding","award":["2640ZZ009"],"award-info":[{"award-number":["2640ZZ009"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Operating room (OR) nurses face elevated risks of work-related musculoskeletal disorders (WMSDs) due to sustained awkward postures, heavy patient handling, and prolonged static loading. However, procedure-level ergonomic risk profiles across the full spectrum of OR nursing tasks remain inadequately characterized. A cross-sectional observational study was conducted among 25 OR nurses in a tertiary hospital in Baoding, China. Twelve common nursing procedures were systematically evaluated using the Swedish Ergonomic Hazard Identification Method (PLIBEL) for qualitative hazard screening and the Rapid Upper Limb Assessment (RULA) for quantitative risk scoring. Joint angles were measured using Kinovea (version 2025.1.0) motion analysis software to ensure objective RULA scoring. Inter-rater reliability was maintained through dual-assessor evaluation and consensus. PLIBEL identified a total of 243 adverse ergonomic factors across the 12 procedures, with individual procedures ranging from 13 to 25 factors. All procedures shared two common exposures: unsupported standing posture and fatiguing leg work. RULA grand scores ranged from 4 to 7, corresponding to risk levels II through IV. Five procedures achieved the maximum score of 7 (Level IV, very high risk): lateral positioning, prone positioning, postoperative patient transfer, stretcher transport, and equipment transport. These high-risk procedures were characterized by severe trunk flexion, asymmetric leg loading, and external loads exceeding 10 kg. Six procedures scored in the medium-risk range (RULA 5\u20136), while needle threading scored 4 (Level II, low risk). PLIBEL and RULA findings converged to identify patient positioning and transfer tasks as the highest-priority targets for ergonomic intervention. Adverse ergonomic factors are prevalent across common OR nursing procedures, with patient positioning and transfer tasks posing the most prominent risks. The combined application of PLIBEL and RULA offers complementary strengths\u2014PLIBEL enabling comprehensive hazard identification and RULA providing graded risk quantification\u2014generating actionable, procedure-specific risk profiles that identify the highest-priority targets for ergonomic intervention.<\/jats:p>","DOI":"10.1038\/s41598-026-67002-1","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:45:53Z","timestamp":1787075153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined PLIBEL and RULA assessment of ergonomic risks across 12 operating room nursing procedures: a cross-sectional observational study"],"prefix":"10.1038","volume":"16","author":[{"given":"Yichao","family":"Yao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijing","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"3","key":"67002_CR1","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1002\/ajim.20750","volume":"53","author":"BR da Costa","year":"2010","unstructured":"da Costa, B. R. & Vieira, E. R. Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies. Am. J. Ind. Med. 53 (3), 285\u2013323. https:\/\/doi.org\/10.1002\/ajim.20750 (2010).","journal-title":"Am. J. Ind. Med."},{"issue":"1","key":"67002_CR2","doi-asserted-by":"publisher","first-page":"841","DOI":"10.3390\/ijerph20010841","volume":"20","author":"J Jacquier-Bret","year":"2023","unstructured":"Jacquier-Bret, J. & Gorce, P. Prevalence of body area work-related musculoskeletal disorders among healthcare professionals: a systematic review. Int. J. Environ. Res. Public. Health. 20 (1), 841. https:\/\/doi.org\/10.3390\/ijerph20010841 (2023).","journal-title":"Int. J. Environ. Res. Public. Health"},{"issue":"1","key":"67002_CR3","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1186\/s12891-021-04087-3","volume":"22","author":"M Clari","year":"2021","unstructured":"Clari, M. et al. Prevalence of musculoskeletal disorders among perioperative nurses: a systematic review and META-analysis. BMC Musculoskelet. Disord. 22 (1), 226. https:\/\/doi.org\/10.1186\/s12891-021-04087-3 (2021).","journal-title":"BMC Musculoskelet. Disord"},{"issue":"4","key":"67002_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/00368504231216540","volume":"106","author":"R Tavakkol","year":"2023","unstructured":"Tavakkol, R. et al. Ergonomic risk assessment of working postures of nurses working in a medical faculty hospital with REBA and RULA methods. Sci. Prog. 106 (4), 1\u201318. https:\/\/doi.org\/10.1177\/00368504231216540 (2023).","journal-title":"Sci. Prog"},{"key":"67002_CR5","doi-asserted-by":"publisher","first-page":"7808208","DOI":"10.1155\/2025\/7808208","volume":"2025","author":"N Ocaktan","year":"2025","unstructured":"Ocaktan, N. & Karabacak, U. An overlooked hazard for operating room nurses: ergonomic risks and consequences related to working position. Nurs. Res. Pract. 2025, 7808208. https:\/\/doi.org\/10.1155\/2025\/7808208 (2025).","journal-title":"Nurs. Res. Pract."},{"issue":"3","key":"67002_CR6","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0003-6870(95)00022-5","volume":"26","author":"K Kemmlert","year":"1995","unstructured":"Kemmlert, K. A method assigned for the identification of ergonomic hazards \u2014 PLIBEL. Appl. Ergon. 26 (3), 199\u2013211. https:\/\/doi.org\/10.1016\/0003-6870(95)00022-5 (1995).","journal-title":"Appl. Ergon."},{"issue":"2","key":"67002_CR7","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/0003-6870(93)90080-S","volume":"24","author":"L McAtamney","year":"1993","unstructured":"McAtamney, L. & Corlett, E. N. RULA: a survey method for the investigation of work-related upper limb disorders. Appl. Ergon. 24 (2), 91\u201399. https:\/\/doi.org\/10.1016\/0003-6870(93)90080-S (1993).","journal-title":"Appl. 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Effect of an ergonomics educational program on musculoskeletal disorders in nursing staff working in the operating room: a quasi-randomized controlled clinical trial. Int. J. Environ. Res. Public. Health. 17 (19), 7333. https:\/\/doi.org\/10.3390\/ijerph17197333 (2020).","journal-title":"Int. J. Environ. Res. Public. Health"},{"issue":"5","key":"67002_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4236\/jbm.2018.65006","volume":"6","author":"P Meepradit","year":"2018","unstructured":"Meepradit, P., Panyadee, K. & Yingratanasuk, T. The effectiveness of the lateral patient transfer device to reduce musculoskeletal risk among practical nurses in a hospital, Thailand. J. Biosci. Med. 6 (5), 1\u20137. https:\/\/doi.org\/10.4236\/jbm.2018.65006 (2018).","journal-title":"J. Biosci. Med."},{"key":"67002_CR12","unstructured":"Gwet, K. L. 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