Self-reported musculoskeletal problems amongst professional truck drivers

Occupational driving has often been associated with a high prevalence of back pain. The factors that contribute to cause the pain are diverse and might include prolonged sitting, poor postures, exposure to whole-body vibration and other non-driving factors such as heavy lifting, poor diet or other psychosocial factors. In Europe, truck drivers are likely to be considered an 'at risk' group according to the Physical Agents (Vibration) Directive and therefore risks will need to be reduced. This questionnaire-based study set out to examine the relationship between musculoskeletal problems and possible risk factors for HGV truck drivers to help prioritize action aimed at risk reduction. Truck drivers (n = 192) completed an occupational questionnaire with two measures of vibration exposure (weekly hours and distance driven). Items on manual handling, relevant ergonomics factors and musculoskeletal problems were also included. Reported exposures to vibration ranged from 12 to 85 h per week, with a mean of 43.8 h. Distances driven ranged from 256 to 6400 km (mean 2469 km). Most of the respondents (81%) reported some musculoskeletal pain during the previous 12 months and 60% reported low back pain. Contrary to expectations, vibration exposures were significantly lower among those who suffered musculoskeletal symptoms when distance was used as an exposure measure. Manual handling and subjective ratings of seat discomfort were associated with reported musculoskeletal problems.     

The impact of different seats and whole-body vibration exposures on truck driver vigilance and discomfort

Laboratory studies have shown that exposure to whole-body vibration (WBV) increases physical and mental fatigue, which are common issues professional drivers face. The objective of this study was to determine whether altering WBV exposures had any effect on driver vigilance and discomfort. A repeated measures crossover design of five truck drivers with regular 10-h routes was used. Active and passive suspension truck seats were evaluated. For each seat, WBV exposures were measured. Participants completed a discomfort questionnaire and a reaction time task before and after their shift for two weeks, one week per seat. Compared with the passive seat, the active seat significantly reduced WBV exposures, decrements in the optimal and mean reaction times (p = 0.02, 0.047, respectively), and discomfort in the lower back and wrist(s)/forearm(s) (p < 0.01, 0.01, respectively). Study results indicated that reducing WBV helps reduce discomfort and maintain vigilance, which may improve drivers’ health and reduce the risk of truck collisions.

Practitioner Summary: The active suspension seat used in this study reduced truck drivers’ exposure to whole-body vibration (WBV) by over 33% in relation to their current industry standard passive suspension seat. This study demonstrated that reducing truck drivers’ exposure to WBV reduced fatigue and discomfort development over a workday.     

Whole body vibration exposure patterns in Canadian prairie farmers

Abstract

Whole body vibration is a significant physical risk factor associated with low back pain. This study assessed farmers’ exposure to whole body vibration on the Canadian prairies according to ISO 2631-1. Eighty-seven vibration measurements were collected with a triaxial accelerometer embedded in a rubber seat pad at the operator-seat interface of agricultural machinery, including tractors, combines, pickup trucks, grain trucks, sprayers, swathers, all-terrain vehicles, and skid steers. Whole body vibration was highest in the vertical axis, with a mean (range) frequency-weighted root mean squared acceleration of 0.43 m/s² (0.19?1.06 m/s²). Mean crest factors exceeded 9 in all 3 axes, indicating high mechanical shock content. The vertical axis vibration dose value was 7.55 m/s^1.75 (2.18?37.59 m/s^1.75), with 41.4% of measurements within or above the health guidance caution zone. These high exposures in addition to an ageing agricultural workforce may increase health risks even further, particularly for the low back.

Practitioner Summary: Agricultural workers are frequently exposed to whole body vibration while operating farm equipment, presenting a substantial risk to musculoskeletal health including the low back. Assessing vibration exposure is critical in promoting a safe occupational environment, and may inform interventions to reduce farmer’s exposure to vibration.     

The role of whole body vibration, posture and manual materials handling as risk factors for low back pain in occupational drivers

It seems evident that occupational drivers have an increased risk of developing back pain. Not only are they exposed to whole body vibration (vibration), their work often includes exposure to several other risk factors for low back pain (LBP), particularly the seated posture (posture) and manual materials handling (MMH). Excessive demands on posture are likely to be aggravated by vibration and vice versa, and the risks may be further compounded when MMH is performed. This study investigated the relative role of vibration, posture and MMH as risk factors for LBP and the stated hypothesis was that the risks for LBP in drivers are the combined effect of vibration, posture and/or MMH. The findings showed that interaction effects due to posture and one or both of vibration and MMH, rather than the individual exposure effects, are the main contributors for precipitation of LBP.     

Association of Risk Factors with Musculoskeletal Disorders among Male Commercial Bus Drivers in Malaysia

A national study in Malaysia was conducted with the main objective being to determine the prevalence of musculoskeletal disorders (MSDs) and the association between risk factors and MSDs among Malaysian bus drivers. Cross‐sectional data were collected from 1,181 male commercial bus drivers in Malaysia using questionnaires to determine demographic, working characteristics and a translated Nordic questionnaire to determine MSD complaints. A Human Vibration Meter was used to measure whole body vibration (WBV) exposure, and postural analysis was used to evaluate awkward working posture. To assess psychological factors, the validated Profile of Mood States (POMS) was used. The overall prevalence of MSD was 81.8% and, by body parts, low back pain was reported to be the highest complaint of lifetime MSD (58.5%) compared to other body parts. The levels of WBV acceleration magnitude A(8) exceed the European Union Directive (0.54 m/s² root‐mean‐square [r.m.s.] acceleration), and only 1.2% of the bus drivers adopt more than 40% of awkward postures while driving. Logistic regression analysis, controlling for age, income, education level, and work activities, revealed that factors such as lack of seat adjustability, uncomfortable seat, seat's material, seat contour and design, WBV exposure, smoking, frequency of daily trips, duration of daily driving, prolonged sitting, working part time, and psychological factors (namely, feeling stress, feeling worried, feeling fatigued) were important risk factors of MSDs among Malaysian bus drivers. As a conclusion, bus drivers are exposed to a combination of risk factors that may lead to an increased risk of developing MSDs. © 2012 Wiley Periodicals, Inc.     

MAPO index for risk assessment of patient manual handling in hospital wards: a validation study

Manual handling of disabled patients – as regards movement – is one of the major factors affecting acute low back pain of exposed nursing staff. In the absence of quantitative methods assessing this kind of risk, the Research Unit Ergonomics of Posture and Movement of Milan developed in 1997 a risk assessment method called Movement and Assistance of Hospital Patients (MAPO), which is applicable in hospital wards.

A first study conducted in 1999 allowed the identification of three levels of MAPO index corresponding with increasing probabilities of being affected by acute low back pain. In accordance with the well-known traffic light model, for MAPO index values between 0 and 1.5 the risk is considered to be absent or negligible. For values between 1.51 and 5.00 the risk is considered to be moderate. For values exceeding 5.00 the risk is considered to be high. In view of the limitations of the previous study, the results needed confirmation and so, in 2000–2001, another cross-sectional study was carried out, which included 191 hospital wards for acute and chronic patients and 2603 exposed subjects. This paper presents the analytical results of the association between the MAPO index and acute low back pain in this new data sample.

The agreement between results of the two studies indicates that the MAPO index can be used as a risk index, although with some caution, as detailed in the paper. It can assess the risk exposure level of patient manual handling in wards and can be a useful tool for planning effective preventive actions to reduce the risk of work-related musculoskeletal disorders in health-care workers looking after disabled patients.     

A national cross-sectional study in the Danish wood and furniture industry on working postures and manual materials handling

Musculoskeletal disorders constitute a major problem in the wood and furniture industry and identification of risk factors is needed urgently. Therefore, exposures to different work tasks and variation in the job were recorded based on an observation survey in combination with an interview among 281 employees working in wood working and painting departments. A questionnaire survey confirmed high frequencies of symptoms from the musculoskeletal system: The one-year prevalence of symptoms from the low back was 42% and symptoms from the neck/shoulder was 40%. The exposure was evaluated based on: (1) classification of work tasks, (2) work cycle time, (3) manual materials handling, (4) working postures, and (5) variation in die job. Among the employees 47% performed feeding or clearing of machines, 35% performed wood working or painting materials, and 18% performed various other operations. Among the employees 20% had no variation in their job while 44% had little variation. Manual materials handling of 375 different burdens was observed, which most often occurred during feeding or clearing of machines. The weight of burdens lifted was 0·5-87·0 kg, where 2% had a weight of more than 50 kg. Among the lifting conditions 30% were evaluated as implying a risk of injury. An additional risk factor was the high total tonnage lifted per day, which was estimated to range from 132 kg to 58 800 kg. Working postures implied a risk of injury due to prolonged forward and lateral flexions of the neck, which was seen most frequently during wood working or painting materials. These data substantiate the finding that work tasks mainly during feeding or clearing of machines imply a risk of injury to the low back and a risk of injury to the neck and shoulder area mainly during wood working or painting materials. Optimal strategies for job redesign may be worked out by using these data in order to prevent occupational musculoskeletal disorders.     

A cross-sectional study of self-reported back and neck pain among English schoolchildren and associated physical and psychological risk factors

This study set out to identify the associations between ergonomics and other factors with back and neck pain among schoolchildren. Self-reported questionnaires were used to record health outcomes and potential risk factors in state schools. Six hundred and seventy-nine schoolchildren from Surrey in the United Kingdom aged 11–14 years took part. Twenty-seven percent of children reported having neck pain, 18% reported having upper back pain, and 22% reported having low back pain. A forward stepwise logistic regression was performed with pain categories the dependent variables. Neck pain was significantly associated with school furniture features, emotional and conduct problems, family history of low back pain and previous treatment for musculoskeletal disorders. Upper back pain was associated with school bag weight (3.4–4.45 kg), school furniture features, emotional problems and previous treatment for musculoskeletal disorders. Low back pain was associated with school furniture features, emotional problems, family history and previous injury or accident. It is important to recognise the influence of physical, psychological and family factors in children's pain.     

Perceived musculoskeletal symptoms among dental students in the clinic work environment

Musculoskeletal symptoms are a major concern among dental practitioners. Dental students perform the same clinical tasks as dentists in private practice, yet only recently has scientific evidence suggested a relationship between the tasks and musculoskeletal symptoms. This study investigates the clinical tasks that place students at physical risk and the relationship between the tasks and musculoskeletal symptoms. Student perceptions of physical symptoms were established with a questionnaire identifying variables on general health, tasks, physical demands, workload and environment. A total of 61% (358/590) reported that during the past year they experienced musculoskeletal symptoms related to work at dental school (second year (n = 212), third year (n = 201) and fourth year (n = 177)). Of those students, the neck represented 48%, shoulder 31%, back 44% and hands 20% (p < 0.001). Third year students reported the highest occurrence of symptoms in every body area (p < 0.001). Third and fourth year students reported significant relationships between the occurrence of symptoms and equipment utilisation, work efficiency and general health. Further studies are recommended to evaluate types and levels of potential risk factors. A total of 75% of dental practitioners are at risk for developing work-related musculoskeletal disorders. Results from this study have found that dental students were no exception. Third year dental students reported the highest level of musculoskeletal symptoms with the prevalence of pain in the neck, shoulder and lower back.     

Whole body vibration exposures in bus drivers: A comparison between a high-floor coach and a low-floor city bus

Low back pain (LBP) is common in occupational bus drivers and studies have shown a dose–response relationship between whole body vibration (WBV) exposure and LBP. Bus design may be an important factor in determining the WBV exposure a bus driver receives. The purpose of this study was to determine whether differences exist in WBV exposures between two buses commonly used in long urban commuter routes: a high-floor coach and a low-floor city bus. Each bus was driven over a standardized test route which included four road types: a newer smooth freeway, a rougher old freeway, a city street segment, and a road segment containing several speed humps. WBV exposures were calculated per ISO 2631-1 (1997) and ISO 2631-5 (2004) standards. WBV exposures were significantly higher in the high-floor coach bus on the road segment containing speed humps. There were primarily small differences between buses in WBV exposures encountered on the city street and freeway segments. With respect to the ISO 2631-1 and European Union's A(8) and VDV(8) action limit values, both buses could be operated on the smooth freeway without exceeding the 8-hour action limits but would have to be operated less than 8 h when operating on the other road types. On average, the seats only attenuated 10% of the floor transmitted vibration and amplified the vibration exposures on the speed humps. Due to the low vibration attenuation performance of the bus driver's seat, evaluating different types of seats and seat suspensions may be merited.Relevance to industryLow back Pain (LBP) is one of the leading causes for workplace disability; therefore, it would be beneficial for employers and workers to minimize WBV exposures resulting in LBP. To reduce WBV exposures, buses should be assigned to appropriate routes and drivers should rotate across routes to vary continuous and impulsive exposures.     

Assessing exposure to risk factors for work-related musculoskeletal disorders using Quick Exposure Check (QEC) in taxi drivers

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world. This study aimed to examine the risk factors that are involved in the development of WMSDs in taxi drivers. In total 382 taxi drivers were observed using Quick Exposure Check (QEC) observational tool, which allows practitioners and workers to assess four key areas of the body. Results of the QEC scores were found to be very high for the shoulder/arm, wrist/hand and neck, whereas the scores for the back were found to be high for static use and moderate for moving. The results also showed that the occupational risk factors for WMSDs were associated with restricted postures, repetitive movements, vibration, work related stress. Essential ergonomic interventions are needed to eliminate risk of exposures to WMSDs in taxi drivers.Relevance to industryThe study results have relevance for ergonomists, health and safety practitioners as well as the drivers themselves, and helpful for estimating the main physical risk factors for WMDSs before choosing a method prior to an ergonomic intervention in industry.     

Low-back disorders in agricultural tractor drivers exposed to whole-body vibration and postural stress

The occurrence of low-back pain (LBP) was investigated in a population of 1155 tractor drivers exposed to whole-body vibration (WBV) and postural stress (response rate 91.2%) and in a control group of 220 office workers (response rate 92.2%). The subjects were questioned about several types of low-back symptom (LBP, sciatic pain, acute LBP, transient and chronic LBP) and various work- and individual-related risk factors, by using a standardized questionnaire. Vibration measurements were performed on a representative sample of the vehicles driven by the tractor drivers in the last ten years. Vibration magnitude and duration of exposure were used to calculate a vibration dose for each tractor driver. Perceived postural load was assessed in terms of frequency and/or duration of awkward postures at work. The prevalence of LBP was found to be greater in the tractor drivers than in the controls. After controlling for potential confounders by logistic modelling, low-back disorders were found to be significantly associated with both vibration dose and postural load. Back accidents and age were also significant predictors for LBP. Quantitative regression analysis indicated that vibration exposure and postural load were independent contributors to the increased risk for LBP according to a multiplicative model. The exposure levels for WBV recently recommended by a proposal of European Directive on physical agents seem to be more adequate to prevent long-term health effects on the lower back than the exposure limits suggested by the International Standard ISO 2631/1.     

Reducing whole-body vibration and musculoskeletal injury with a new car seat design

A new car seat design, which allows the back part of the seat (BPS) to lower down while a protruded cushion supports the lumbar spine, was quantitatively tested to determine its effectiveness and potentials in reducing whole-body vibration (WBV) and musculoskeletal disorders in automobile drivers. Nine subjects were tested to drive with the seat in: 1) the conventional seating arrangement (Normal posture); and 2) the new seating design (without BPS (WO-BPS) posture). By reducing contact between the seat and the ischial tuberosities (ITs), the new seating design reduced both contact pressure and amplitude of vibrations transmitted through the body. Root-mean-squared values for acceleration along the z-axis at the lumbar spine and ITs significantly decreased 31.6% (p < 0.01) and 19.8% (p < 0.05), respectively, by using the WO-BPS posture. At the same time, vibration dose values significantly decreased along the z-axis of the lumbar spine and ITs by 43.0% (p < 0.05) and 34.5% (p < 0.01). This reduction in WBV allows more sustained driving than permitted by conventional seating devices, by several hours, before sustaining unacceptable WBV levels. Such seating devices, implemented in large trucks and other high-vibration vehicles, may reduce the risk of WBV-related musculoskeletal disorders among drivers.     

Inter-individual postural variability in seated drivers exposed to whole-body vibration

Long-term occupational exposure to whole-body vibration (WBV) is a cause of low back pain for seated drivers. Poor and long-term seated postures are considered as a cofactor in the risk. It depends on the vehicle's ergonomics and tasks. Differences in posture may also be observed between operators doing identical tasks. An experiment has been performed in order to simultaneously measure posture and WBV for 12 drivers in 3 vehicles (loader, dumper and excavator) during controlled tasks. The inter-individual postural variability has been evaluated. The positions and movements of the body were measured with the CUELA system (computer-assisted recording and long-term analysis of musculoskeletal loads). Significant differences were observed between the three vehicles in the WBV, positions and movements of the body. Significant postural differences were observed between drivers (EN 1005-4 2005). Individual strategies for performing a task were also identified.     

Combined exposures of whole-body vibration and awkward posture: a cross sectional investigation among occupational drivers by means of simultaneous field measurements

Abstract

Objective: Multifactorial workloads such as whole-body vibration (WBV), awkward posture and heavy lifting are potential predictors for low back pain (LBP). In this study, we investigate the association between LBP and these exposures among 102 professional drivers. Methods: The combined exposures of WBV and posture are measured at different workplaces. Health and personal data as well as information about lifting tasks are collected by a questionnaire. Results: The daily vibration exposure value (odds ratio 1.69) and an index for awkward posture (odds ratio 1.63) show significant association with the occurence of LBP. Awkward posture and heavy lifting appear to be more strongly associated with sick leave than WBV exposure. Furthermore, a combination of the measurement results of WBV and awkward posture into one quantity also shows significant correlation to LBP. Conclusion: The combined exposure of WBV and awkward posture can be described in terms of the daily vibration exposure and the index for awkward posture. This facilitates work place assessments and future research in this area.

Practitioner Summary: For the first time, quantitative measures combining whole-body vibration and awkward posture exposures have shown to correlate with the occurrence of low back pain significantly. This validates the proposed quantities and measurement methods, which facilitate workplace assessments and assist in the design of further studies which are necessary to establish a causal exposure–response relationship.     

Neck pain combined with arm pain among professional drivers of forest machines and the association with whole-body vibration exposure

The purpose of this study was to investigate the existence of neck pain and arm pain among professional forest machine drivers and to find out if pain were related to their whole-body vibration (WBV) exposure. A self-administered questionnaire was sent to 529 forest machine drivers in northern Sweden and the response was 63%. Two pain groups were formed; 1) neck pain; 2) neck pain combined with arm pain. From WBV exposure data (recent measurements made according to ISO 2631–1, available information from reports) and from the self-administered questionnaire, 14 various WBV exposure/dose measures were calculated for each driver. The prevalence of neck pain reported both for the previous 12 months and for the previous 7 d was 34% and more than half of them reported neck pain combined with pain in one or both arms. Analysis showed no significant association between neck pain and high WBV exposure; however, cases with neck pain more often experienced shocks and jolts in the vehicle as uncomfortable. There was no significant association between the 14 WBV measures and type of neck pain (neck pain vs. neck pain combined with arm pain). It seems as if characteristics of WBV exposure can explain neither existence nor the type of neck pain amongst professional drivers of forest machines. The logging industry is important for several industrialised countries. Drivers of forest machines frequently report neuromusculoskeletal pain from the neck. The type of neck pain is important for the decision of treatment modality and may be associated with exposure characteristics at work.     

A cohort study of sciatic pain and measures of internal spinal load in professional drivers

In a prospective cohort study of 537 male professional drivers, the occurrence of sciatic pain showed stronger associations with measures of internal lumbar load expressed in terms of daily compressive dose, S_ed (MPa), and risk factor, R (non-dimensional), according to ISO/WD 2631-5 (2013), than with measures of daily vibration exposure calculated as either 8-h energy-equivalent frequency-weighted acceleration (ms^? 2 r.m.s.) or vibration dose value (ms^? 1.75) according to the EU Directive on mechanical vibration (2002). Herniated lumbar disc, previous lumbar trauma and physical work load were also powerful predictors of the occurrence of sciatic pain over time. Psychosocial work environment was poorly associated with sciatic pain. The boundary values of risk factor (R) for low and high probabilities of adverse health effects on the lumbar spine, as proposed by international standard ISO/WD 2631-5 (2013), tend to underestimate the health risk in professional drivers.     

The role of whole-body vibration in back pain: A cross-sectional study with agricultural pilots

ObjectiveA cross-sectional study was conducted to investigate the role of whole-body vibration as a risk factor for spinal musculoskeletal symptoms among agricultural pilots.MethodThe study was conducted in two stages that included measuring the pilots’ exposure to whole-body vibration during the flight procedures and applying a self-administered questionnaire about musculoskeletal symptoms of the spine.ResultsNone of the four aircraft texted exposed the pilot above the Exposure Limit Value (ELV) established by the standards. However, in a few specific situations, two of them exceeded the Exposure Action Value (EAV). About 62% of the pilots who operated these aircraft reported some musculoskeletal symptoms of the spine in the last few 12 months.ConclusionUsing the data from this study, it was possible to calculate the odds ratio of the agricultural pilot suffering low back pain, based on eight personal and work-related factors.Relevance for the industryBased on the results of the present study, it was possible to define strategies to reduce whole-body exposure in agricultural aircraft and, consequently, improve the pilots’ health. Strategies included management of the exposure and aircraft improvement.     

An optimal sampling approach to modelling whole-body vibration exposure in all-terrain vehicle driving

Abstract

Exposure to whole-body vibration (WBV) presents an occupational health risk and several safety standards obligate to measure WBV. The high cost of direct measurements in large epidemiological studies raises the question of the optimal sampling for estimating WBV exposures given by a large variation in exposure levels in real worksites. This paper presents a new approach to addressing this problem. A daily exposure to WBV was recorded for 9–24 days among 48 all-terrain vehicle drivers. Four data-sets based on root mean squared recordings were obtained from the measurement. The data were modelled using semi-variogram with spectrum analysis and the optimal sampling scheme was derived. The optimum sampling period was 140 min apart. The result was verified and validated in terms of its accuracy and statistical power. Recordings of two to three hours are probably needed to get a sufficiently unbiased daily WBV exposure estimate in real worksites. The developed model is general enough that is applicable to other cumulative exposures or biosignals.

Practitioner Summary: Exposure to whole-body vibration (WBV) presents an occupational health risk and safety standards obligate to measure WBV. However, direct measurements can be expensive. This paper presents a new approach to addressing this problem. The developed model is general enough that is applicable to other cumulative exposures or biosignals.