Musculoskeletal disorders as a fatigue failure process: evidence,implications and research needs

Abstract

Mounting evidence suggests that musculoskeletal disorders (MSDs) may be the result of a fatigue failure process in musculoskeletal tissues. Evaluations of MSD risk in epidemiological studies and current MSD risk assessment tools, however, have not yet incorporated important principles of fatigue failure analysis in their appraisals of MSD risk. This article examines the evidence suggesting that fatigue failure may play an important role in the aetiology of MSDs, assesses important implications with respect to MSD risk assessment and discusses research needs that may be required to advance the scientific community’s ability to more effectively prevent the development of MSDs.

Practitioner Summary: Evidence suggests that musculoskeletal disorders (MSDs) may result from a fatigue failure process. This article proposes a unifying framework that aims to explain why exposure to physical risk factors contributes to the development of work-related MSDs. Implications of that framework are discussed.     

Risk factors analysis: Work-related musculoskeletal disorders among male traffic policemen using high-powered motorcycles

IntroductionThe occupational safety and health issues for police riders and other professional riders are often related to ergonomic hazards and risks. The purpose of this research was to identify the factors that contribute to the health effects in developing work-related musculoskeletal disorders (WMSDs) among male traffic policemen using high-powered motorcycles.Materials and methodsA cross-sectional study was conducted using 137 police riders. A set of questionnaires including the Standardised Nordic Questionnaire (SNQ) and human vibration meter (Svantek 106) was used in this study.ResultsThe prevalence of WMSDs was 67.9%. Multiple logistic regression analysis revealed that the duration of riding a motorcycle (OR = 0.175, 95% CI:0.052, 0.581), years of service (OR = 0.152, 95% CI: 0.040, 0.567), and hand-arm vibration, HAV (OR = 3.053, 95% CI: 1.126, 8.280) were significant risk factors for the prevalence of WMSDs.DiscussionThe majority of riders reported symptoms of WMSDs within the past 12 months. Riding duration, years of service, and hand-arm vibration (HAV) were found to be the most important risk factors for WMSDs in this rider group. The results highlight that in the context of ergonomic interaction, high-powered motorcycles and the police riders are not a good fit. Hence, further study is needed to improve the safety and health of the police riders.     

Application of MSD prevention practices by nursing staff working in healthcare settings

ObjectiveThe objective of this article is to examine the application of MSD prevention practices among nursing staff and to identify organizational factors that may or may not support their application.MethodsWe measured the application of prevention practices and its determinants by means of a questionnaire filled out by 399 nurses and nursing staff in Canada. A qualitative component was conducted with two focus groups in order to validate and enrich the interpretation of the survey results.ResultsResults show that most respondents “often” (4) apply MSD prevention practices in their daily professional tasks. Significant differences were observed based on position, mission of the institution, degree, and training.ConclusionsThe characteristics of the nursing staff (position, training, etc.) and the specificities of the setting must be taken into consideration in MSD prevention interventions for nursing staff.     

Neck pain prevalence and associated occupational factors in Portuguese office workers

ObjectiveThis study aimed to assess the prevalence of neck pain and to identify associated occupational factors in Portuguese office workers.BackgroundThere is still necessary to quantify the association of the use of new technologies with neck pain in office workers.MethodsSix hundred-and-one office workers completed online questionnaires with questions related to anthropometric parameters, work-related variables, workstation setup, and musculoskeletal pain from the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire.ResultsThe prevalence of neck pain was 56.1%. An average of 35.6% of the office workers with neck pain reported pain in more than three body segments. The significantly risk factors were “age between 50 and 65” [OR: 1.92 (1.26–2.91) P = 0.002], “working without break for 2 h” [OR: 1.82 (1.00–3.31) P = 0.05], “more than 3 h” [OR: 2.41 (1.35–4.10) P = 0.003], screen localization not centered” [OR: 2.01 (1.01–4.00) P = 0.045], and “use of computer mouse more than 50% of the worktime” [OR: 2.05 (1.14–3.71) P = 0.017].ConclusionThere was a high prevalence of neck pain and a considerable number of painful body segments in office workers. Age, working without break, screen localization and the use of computer mouse where the significant risk factors associated with the development of neck pain.Relevance to industryA high prevalence of neck pain and number of areas with pain in office workers require a detailed pain mechanism assessment. There were associated occupational risk factors for the development of neck pain. Call for concerted actions to explore optimal and efficient management plans.     

Ergonomic design visualization mapping- developing an assistive model for design activities

Ergonomic models and techniques are a fundamental issue in the design of comfortable and safe products and spaces. User studies, related to visualization tools are current issues in the ergonomics and design visualization literature. But researchers have begun to discover that user study is rarely straightforward, especially when drawing visualization data from interdisciplinary sources. The availability of a plethora of visualization techniques can make it difficult to determine the most appropriate technique to convey maximum possible understanding.The RT-MHV (“Real-time”– “Motion history volumes”) 3D computerized assessment model, developed by the authors, demonstrates a local risk evaluation of work-related musculoskeletal disorders (WMSDs), based on real-time and on motion history volumes. With the model, the visual display of the WMSD risk level for each body segment is defined by color-coding at points surrounding an avatar's segment, representing an actual user. The values associated with areas with an increased risk of WMSDs can be identified and iterated quickly, so as to determine the “optimal posture”. Designers can share this knowledge by recording the user's postural interactions, defined through the mapping of geometric comfort data and WMSD risk level categories.The challenge in the development process was to overcome existing “gaps” between ergonomics data and designer requirements. Further research on the RT-MHV model is recommended, principally for developing stand-alone CAD software. An aggregated statistical information database and complete body joints visualizations will be computerized in due course. 2D tabulation and statistical information relating to body joints will be made available on demand.     

Risk assessments of work-related musculoskeletal disorders among the TFT-LCD manufacturing operators

The thin film transistor liquid crystal display (TFT-LCD) industry is one of the major industries in Taiwan, yet few studies addressed its work-related musculoskeletal disorders (WMSDs). Thus, this study aims to evaluate the risk of WMSDs among the operators of a TFT-LCD manufacturing company in Taiwan by using the subjective questionnaire and ergonomic assessment tools. First, the NMQ survey was conducted among 393 operators, accounting for 94% of all operators in the TFT-LCD plant. The results showed that the prevalence of WMSDs was 31.8%. Among the various body parts, the highest prevalence of WMSDs was found in neck and shoulders (20.4%), while upper limbs were with the lowest prevalence (9.2%). Besides, the prevalence of WMSDs tends to be affected by both work factors and operator factors. Those who were more experienced, working in day shift and involved in the Array process tend to have a higher prevalence of WMSDs. Further, female and domestic operators reported a higher prevalence of WMSDs than male and foreign operators. Moreover, the jobs of 50 employees were analyzed using ergonomic assessment tools including OSHA MSDs, BRIEF, OWAS, 3D SSPP, and NIOSH lifting equation. The findings indicated that inadequate working height, restricted working space, awkward postures, overweight load, and high repetition were the major risk factors of WMSDs. Thus, countermeasures such as redesigning the workstations and material handling carts, proactive training of manual material handling, and providing safety clearance are recommended to enhance the occupational health and safety of the TFT-LCD operators.     

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.     

The investigation of work-related musculoskeletal disorders among female workers in a hazelnut factory: Prevalence,working posture,work-related and psychosocial factors

BackgroundWork-related musculoskeletal disorders (WMSDs) are the most common occupational health problems in the industrialized world. The identification of WMSDs specific to occupation is essential to plan and implement preventative programs. This study investigated the prevalence of WMSDs and determined the factors related to the severity of the most common disorders among female workers in a hazelnut factory.MethodsA total of 114 female workers were examined in this cross-sectional study using the Nordic Musculoskeletal Questionnaire, the Dutch Musculoskeletal Questionnaire, and an author-developed questionnaire (for socio-demographic characteristics and psychosocial factors). Working posture, craniovertebral angle, thoracic kyphosis angle (TKA), and lumbar lordosis angle were evaluated based on a photogrammetry method using the ImageJ program.ResultsThe prevalence of WMSDs in at least one body part during the last 12 months was 92.1%. The highest prevalence of WMSDs was in the lower back (61.4%), neck (57.9%), shoulder (53.6%), and upper back (45.6%). The least affected part was the elbow. Lower back, shoulder, and neck disorders were the most common causes of activity limitation. The severity of lower back pain was associated with stress in the workplace and work-related factors. The neck pain severity was related to craniovertebral angle and work-related factors. The shoulder pain severity increased with TKA and employment duration. TKA was related to upper back pain severity.ConclusionsWMSDs are common among female workers in a hazelnut factory. Reorganizing of working posture, work-related factors, and stress at work may be beneficial to decrease the prevalence of WMSDs and pain severity.Relevance to Industry; The female workers in the hazelnut factory are vulnerable to the work-related musculoskeletal disorders, particularly in the spinal region. The employers should endeavor to improve the health of the workers by the adjustment of the working posture and environmental factors.     

Analysis of worker strategies: A comprehensive understanding for the prevention of work related musculoskeletal disorders

By documenting the strategies developed by food processing workers to manage their musculoskeletal pain and discomfort in order to remain on the job, the present article seeks to increase awareness of a different “way of approaching” WMSDs inspired by the ergonomic approach centred on work activity analysis. Based on a mixed methods approach, an ergonomic work activity study combined with a multiple case study was conducted. Sixteen female seafood-processing workers were followed up during two consecutive work seasons using a range of interviews as well as observations of work activity throughout the entire study. A large variety of musculoskeletal pain management strategies developed by those workers to remain on the job were identified. This identification and the process of categorizing the strategies led to the development of a framework for studying worker strategies. The mixed methods approach made it possible to better pinpoint and understand obstacles to the development of workplace strategies and then identify avenues for change to improve working conditions.Relevance to industryThe framework constitutes a valuable contribution for the prevention of WMSDs by representing a methodological tool for documenting worker strategies. Very few tools of this kind are currently available for practitioners and researchers. In becoming aware of the existence of such coping strategies, companies can gain a better understanding of the difficulties workers have to cope with.     

Terminology in safety of collaborative robotics

Popular non-normative terms in robot safety, including “co-existence”, “collaboration”, “cooperation”, “collaborative robot”, “cobot”, are used inconsistently in technical literature and in practice. Comparison of terms and evidence of inconsistency are provided on the basis of recent works about safety of collaborative robotics. Frequency and energy of interaction are discussed as more appropriated classification figures for the purpose of risk assessment. Examples and recommendations about the classification of safety methods are discussed according to contemporary state-dependent, mixed modes safety strategies.     

Secure Software Engineering: Learning from the Past to Address Future Challenges

ABSTRACT

This paper provides a taxonomy of secure software systems engineering (SSE) by surveying and organizing relevant SSE research and presents current trends in SSE, on-going challenges, and models for reasoning about threats and vulnerabilities. Several challenging questions related to risk assessment/mitigation (e.g., “what is the likelihood of attack”) as well as practical questions (e.g., “where do vulnerabilities originate” and “how can vulnerabilities be prevented”) are addressed.     

Work-related musculoskeletal disorders in home care nurses: Study of the main risk factors

BackgroundNurses are a risk group for work-related musculoskeletal disorders (WMSDs). Several studies reveal that nurses have high prevalence rates of injuries and symptoms related to WMSDs. However, many of these studies focus mostly on hospital nurses. Worldwide, few studies include home care nurses.ObjectiveThis work aimed to identify the body region most affected by musculoskeletal complaints in home care nursing, and subsequently develop a statistical model, that includes the main risk factors, to predict the risk of having musculoskeletal complaints in the identified region.MethodsThe research method was based on the Standardised Nordic Questionnaire applied to home care nurses working at Health Centres of northern Portugal. Univariate and multivariate models of logistic regression were used to meet the goals of this work.ResultsHome care nurses have a three times greater chance of having lumbar complaints than their counterparts working only at Health Centres (OR = 3.19 (p < 0.05), with a 95% confidence interval [1.256; 8.076]). A statistical model with seven variables (forearm posture; static postures; arm posture; arm supported; bed height; job satisfaction; assistive devices) was obtained to predict lumbar complaints.ConclusionsThe lumbar region was identified as the most affected by musculoskeletal complaints. These complaints were associated with seven factors.     

Symptoms and risks for musculoskeletal disorders among male and female footwear industry workers

BackgroundConsidering the growing participation of woman in the labor market and the high prevalence of the musculoskeletal disorders (MSD) in the footwear industry workers, the aim of this study was to evaluate and compare female and male footwear industry workers in relation to their demographics, occupational characteristics, stress levels, MSD symptoms prevalence, physical activity levels, alcohol and tobacco use.MethodsThe study included 175 female and 182 male footwear industry workers. Data was collected using the Perceived Stress Scale – 10, the Standardized Nordic Questionnaire, the International Physical Activity Questionnaire, the Alcohol Use Disorders Identification Test, and the Fagerstrom test for Nicotine Dependence.ResultsThe female workers were younger, had less time in the company and in the current job. They reported more stress (p = 0.001), had less time for physical activity (p = 0.004), higher prevalence of MSD symptoms in the last 12 months (p = 0.003), and consumed less alcohol (p = 0.006) than the male workers.ConclusionsFemale and male footwear industry workers presented significant differences in their demographics, occupational characteristics, stress levels, MSD prevalence, physical activity levels, alcohol and tobacco use. These differences should be taken into consideration in the implementation of intervention programs for optimum outcomes.Relevance to industryFemale footwear industry workers were more stressed, presented higher prevalence of MSD symptoms, and reported less time for physical activity than male footwear industry workers. The differences between male and female workers should be taken into consideration in the implementation of MSD prevention programs.     

THE RISK ASSESSMENT: THE COMMON DENOMINATOR FOR PRIVACY AND SECURITY COMPLIANCE

ABSTRACT

In the words of Ferris Bueller, “life moves pretty fast. If you don't stop and look around once in a while, you could miss it.” Although this quote is from the iconic 1980s movie, Ferris Bueller’s Day Off, its application to risk assessments is apropos. A risk assessment enables a person to “stop and look around” on an annual basis to make sure that technical, administrative and physical safeguards are not missed. New NIST guidance underscores the importance of risk mitigation in relation to both privacy and security by highlighting the role of the risk assessment in relation to both legal requirements and best practices.     

Vibration of portable orbital sanders and its impact on the development of work-related musculoskeletal disorders in the furniture industry

The wood furniture industry has a strong presence in Canada, where it employs over 100,000 workers. Because of the extensive number of manual tasks required in this industry, several studies have been undertaken to characterize the health and safety risk factors to which these workers are exposed, such as awkward postures, repetitive movements and the application of undue force. However, very little research has been done on workers’ exposure to vibration from portable orbital sanders, one of the most common tools used in this industry. Vibration is responsible for a specific occupational disease called vibration syndrome, but is also recognized as a risk factor that increases the prevalence of more common work-related musculoskeletal disorders (WMSDs). This study proposed to determine the level of vibration to which sanders of furniture parts are exposed, and to analyze its impact on the risk of WMSDs. The results show that the level of vibration to which the workers are exposed is well above acceptable levels defined by recognized standards and directives and that this vibration is combined with many other risk factors, thus representing a risk for the development of WMSDs.     

Prevention of work‐related musculoskeletal disorders in a chemical plant in Taiwan and a comparison of three assessment tools

Work‐related musculoskeletal disorders (WMSDs) caused by a poor working environment or an improper work design are the most common occupational diseases seriously affecting workers’ health, causing huge economic losses in many countries. Thus, the prevention of WMSDs is considered a priority issue worldwide. In this study, three ergonomics analysis tools and a statistic analysis were used to assess the risk level of exposure to WMSDs and to find improvements for the operations in a chemical plant. The applicability of these tools was also evaluated. Results of the analysis suggest that, to greatly prevent the incidence of WMSDs, a mobile elevating platform should be adopted to adjust the handling height of material bags at 90 cm, allowing the operators to stand in front of them to hold their short or long sides. Among the tools, key indicator methods–manual handling operation methods (KIM‐MHO) have the highest sensitivity.     

Tool-supported requirements prioritization: Comparing the AHP and CBRank methods

Requirements prioritization aims at identifying the most important requirements for a software system, a crucial step when planning for system releases and deciding which requirements to implement in each release. Several prioritization methods and supporting tools have been proposed so far. How to evaluate their properties, with the aim of supporting the selection of the most appropriate method for a specific project, is considered a relevant question.In this paper, we present an empirical study aiming at evaluating two state-of-the art tool-supported requirements prioritization methods, AHP and CBRank. We focus on three measures: the ease of use, the time-consumption and the accuracy. The experiment has been conducted with 23 experienced subjects on a set of 20 requirements from a real project. Results indicate that for the first two characteristics CBRank overcomes AHP, while for the accuracy AHP performs better than CBRank, even if the resulting ranks from the two methods are very similar. The majority of the users found CBRank the “overall best” method.     

A study of the relationship between color-concept association and occupational background for Chinese

BackgroundThe use of colors in visual displays can facilitate visual search and perception, but their use may not be effective without consideration of differences in the interpretation of their connoted meanings between individuals of different occupational backgrounds.ObjectiveThis study examined color-concept associations for Hong Kong Chinese students and white-collar workers, and then compared their associations with those of two other occupational groups to assess whether occupational background is related to color-concept associations.MethodA questionnaire survey was used to examine color-concept associations among 100 university students and 100 white-collar workers in Hong Kong. The participants were presented with 16 safety-related concepts and were asked to choose one of 10 colors that best represented each concept. The associations reported by four groups with different occupations (the two groups in this study and the groups of managerial staff and steel workers examined in our previous study) were compared. A chi-square test was applied to determine whether significant color association(s) existed for each concept.ResultsOur results revealed that each concept was significantly associated with at least one color (p < 0.01). The Hong Kong white-collar workers and managerial staff in mainland China both expressed the same color associations for 14 of the tested concepts, and differed only over which colors were associated with “strong,” and “radiation hazard.” These findings generally suggest that populations with similar occupations can have similar color perceptions. However, the students and the other three employee groups reported different color associations with the concepts “normal,” “off” and “potential hazard.”ConclusionsOccupational background is associated with how color is interpreted for its connoted meaning. One should consider occupational background carefully when choosing colors in product designs, especially for safety.     

The relationship between work productivity and acute responses at different levels of production standard times

Work productivity is typically associated with production standard times. Harder production standards generally result in higher work productivity. However, the tasks become more repetitive in harder production standard time and workers may be exposed to higher rates of acute responses which will lead to higher risks of contracting work-related musculoskeletal disorders (WMSDs). Hence, this paper seeks to investigate the relationship between work productivity and acute responses at different levels of production standard times. Twenty industrial workers performed repetitive tasks at three different levels of production standard time (PS), corresponding to “normal (PSN)”, “hard (PSH)” and “very hard (PSVH)”. The work productivity and muscle activity were recorded along these experimental tasks. The work productivity target was not attainable for hard and very hard production standard times. This can be attributed to the manifestations of acute responses (muscle activity, muscle fatigue, and perceived muscle fatigue), which increases as the production standard time becomes harder. There is a strong correlation between muscle activity, perceived muscle fatigue and work productivity at different levels of production standard time. The relationship among these variables is found to be significantly linear (R = 0.784, p < 0.01). The findings of this study are indeed beneficial to assess the existing work productivity of workers and serves as a reference for future work productivity planning in order to minimize the risk of contracting WMSDs.