Trunk postural demands of occupational activities of some merchant pregnant women in Benin,West Africa

Strenuous physical work puts expectant mothers at risk of experiencing back pain during the gestational months. Pregnant women in Benin perform physically demanding occupational tasks that include the lifting and carriage of heavy loads on their heads for commercial activities. A large percentage of pregnant subjects (58%) reported having back pain episodes since the start of their pregnancy. However, the mean Oswestry score of the affected participants was relatively low with a mean score of 0.2 (SD: 0.12), on a scale form 0 to 1. An evaluation of the postural demands of the occupational activities of these women revealed that they performed on average 328 trunk flexions at angles exceeding 60°, with 66 of these flexions sustained for more than 4 s, during the average 7.9 h where trunk postures were recorded. They also spent on average 36% of the recording time at trunk flexion angles larger than 20°. These results show that the merchant pregnant women in the Porto-Novo area in Benin are at great risk for developing back disorders during pregnancy.

Practitioner Summary: Results will make a first contribution to the literature by identifying the stressful postures adopted during a typical day. The findings of this study can help in the development of preventative concepts and postural modification techniques to decrease the occurrence of back pain during pregnancy for women in Benin.     

Forging friendship,soliciting support: A mixed-method examination of message boards for pregnant teens and teen mothers

Among pregnant youth, relationships with parents and romantic partners are correlated with overall wellbeing; however, this relationship does not exist with friends. Friends who have also experienced a pregnancy, however, may offer more effective support than friends who have not. One way that pregnant and mothering adolescents can connect is through online message boards. We hypothesized that adolescents would use these sites primarily to establish friendships and develop a supportive community, rather than simply to solicit pregnancy-related advice. We randomly selected 200 threads from four message boards for pregnant and mothering teens and performed a mixed-methods content analysis of the original posts and responses. Most original posts were categorized as “Community Oriented Posts,” rather than “Soliciting Pregnancy or Motherhood Advice.” Furthermore, qualitative analysis revealed frequent instances of emotional support, instrumental support, and informational support in both categories. In message board communities where pregnant teens and teen mothers were in the majority, messages were predominantly positive. In sharp contrast, in the one message board in which they were in the minority, as they are in the adolescent community at large, messages were significantly more negative. The dynamics of these message boards indicate the possibility that social support from other pregnant or mothering teens may enhance the wellbeing of pregnant teens and explain why peer “support” from teens who have not had this experience may often have a negative influence on wellbeing.     

A comparison of sitting posture adaptations of pregnant and non-pregnant females

The postural differences between seated pregnant and non-pregnant subjects were studied, and the effects of various sitting workstation designs were assessed. Five pregnant and five non-pregnant subjects participated in this study. The experimental variables were the table-chair-vertical-distance (35 cm and 30 cm) and the seat-inclination-angle (0°, +10° and +20°). The seated working postures of the last 10 min of a 50-min sitting session were videotaped and analyzed using a 2D motion analysis system. Postural differences were observed between the pregnant and non-pregnant groups which may be attributed to the changes and/or mechanisms associated with pregnancy. The increased size of the abdomen requires more room in front of the body; in the pregnant subjects this was obtained by holding the upper-arm further from the body, inclining the upper trunk more anterior, and extending the hip more. A seat with a sloping angle of 10° was found to reduce the biomechanical loading on the lower back and in subjective ratings from both groups, was preferred over the other seat angles.

Relevance to industry

Pregnant women make up a small but significant part of the workforce. Changes in body form and working posture due to pregnancy change the effective working envelope and increase the biomechanical loads on the musculoskeletal system resulting in an increase in the risk of lower-back pain. This study examined the posture adaptations and the effects of workstation design on pregnant and non-pregnant subjects.     

Work organization and Low back pain in nursing personnel

Nursing personnel are at a high risk from occupational low back injury. Work organization has been suggested as one factor playing a part in the aetiology of occupational low back pain. Baseline data for a prospective epidemiology study were gathered by means of a questionnaire. One part of the questionnaire elicited characteristics of work organization, perceived autonomy, the relationship with head nurse and satisfaction in the relationship with co-workers. Information on history of musculoskeletal problems, reported frequency of lifting and personal characteristics was also gathered. Of 787 nursing staff at two acute care hospitals, 154 (19-6%) reported troublesome low back pain occurring within the previous 6 months. From univariate analyses, such characteristics of work organization as shift, type of schedule and primary versus functional nursing were not associated with low back pain. The relationship with head nurse and perceived autonomy of the job also were not related to recent back pain. Recent low back pain was significantly associated with younger age, the job category ‘registered nurse’ and greater satisfaction in relationships with co-workers. These associations were confirmed in multivariate analysis. None of the work organization factors examined, with the exception of satisfaction with co-workers, were associated with back pain in this study. Moreover, the positive association of satisfaction with coworkers suggests that interventions to improve working relationships may not be helpful in prevention programmes. To some extent, these results are susceptible to biases resulting from selective attrition from nursing and selective participation in the study.     

Physical demands of work and health complaints among women working late in pregnancy

Health complaints before, during and after pregnancy were collected from 2251 women in Montreal who had been in paid employment beyond the twenty-seventh week of their first or second pregnancy. Complaints of breathlessness, fatigue, back pain, varicose veins and haemorrhoids increased during pregnancy, the proportion of women reporting these symptoms being greatest in the third trimester. Complaints at this stage were found to be systematically related to job postures and other physical work demands, prolonged periods of standing, particularly with the back bent forward, twisting the trunk and lifting weights all being found troublesome by workers late in their pregnancy. Three months after delivery the level of health complaints had generally returned to that before pregnancy. This was so for all symptoms except varicose veins and haemorrhoids. No relation was found between trouble with haemorroids and the physical demands of work in pregnancy. Problems with varicose veins three months after delivery were however, more frequent than expected in those whose job had required them to stand during pregnancy for more than 2h at a stretch. There was also some indication that women in physically demanding jobs took longer to recover from their confinement.     

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.     

Stakeholder perspectives on managing the occupational health of UK business drivers: a qualitative approach

Musculoskeletal disorders are one of leading causes of work related ill health and sickness absence. Those drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using ‘Template Analysis’. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision.     

Does intense time pressure at work make older employees more vulnerable? A statistical analysis based on a French survey “SVP50”

Two general trends, the tightening of time constraints and the ageing of the working population, are likely to raise sensitive problems implying adjustment of both work and workers' characteristics. The statistical studies presented in this paper, referring to a French inter-professional survey conducted on health and work after fifty (11 213 employees), aim at verifying this assumption. The analyses presented are divided in four sub-questions: have part of employees over fifty been removed from time pressure situations? Is time pressure difficult to deal with for older workers (from their point of view)? Does intense time pressure imply increased prevalence of certain health disorders among senior employees? Does pressure increase the desire to end one's professional life early? The results show that intense time pressure raises serious problems for most of the employees in their fifties who are exposed to them. 80% consider this constraint to be “difficult”. They systematically show more frequent rates for most types of physical or psychological health disorders. “Sheltering from the job”, which implies being shifted from work “under pressure” to a job “without pressure”, is not uncommon but only solves a minority of situations. Lastly, the option of earlier retirement is not particularly developed in age group in its fifties working “under pressure”.     

Extended nonlinear waves in multidimensional dynamical lattices

We explore spatially extended dynamical states in the discrete nonlinear Schrödinger lattice in two- and three-dimensions, starting from the anti-continuum limit. We first consider the “core” of the relevant states (either a two-dimensional “tile” or a three-dimensional “stone”), and examine its stability analytically. The predictions are corroborated by numerical results. When the core is stable, we propose a method allowing the extension of the structure to as many sites as may be desired. In this way, various patterns of excited sites can be formed. The stability of the full extended nonlinear structures is studied numerically, which yields instability thresholds for such structures, which are attained with the increase of the lattice coupling constant. Finally, in cases of instability, direct numerical simulations are used to elucidate the evolution of the pattern; it is found that, typically, the unstable extended nonlinear pattern breaks up in an oscillatory way, leading to “lattice turbulence”.     

Women and work stress: evidence from the 1946 birth cohort

Abstract

Women at work throughout Britain, all members of the National Survey of Health and Development, were asked whether they were under nervous strain in their work. Data are presented for 826 women at work at age 26 years and 734 women at work at age 32 years. Two in every five women working full-time reported that they were under strain, this proportion being very similar to that for men in full-time work at the same age. Women in part-time work were much less likely to report strain. Strain at work was found to relate both to the level of work (jobs in higher social-group categories having a higher report of strain) and to the level of supervisory responsibility. Women reporting strain were also more likely to report problems with their sleep, frequent headaches, pain in the pit of the stomach and trouble with their back, but such reports seem more closely related to a prior susceptibility to anxiety than to the demands of the present job. It is concluded that, with the possible exception of pregnant women, it may not be helpful to consider women as a group of workers with particular problems in withstanding stress at work.     

Rates of back pain incidence associated with job attitudes and worker characteristics

By examining back pain risk, both its incidence and distribution, it becomes possible to focus on contributory factors bringing on its onset. Analyzing risks of back pain in a study of 250 employees from 9 organizations in Israel's labor force, demonstrated the link between attitudes, worker characteristics, job and back pain. Distinguishing between reported chronic and sporadic episodes demonstrates that rates of back pain incidence differ by the type of worker, arrangements of the workplace, and task requirements. Tracing the impact of physical factors on back pain risk led to negative results, as explained in this study. From the analysis of severity ratio, it may be concluded that work environments generally associated with less physically strenous work tasks, have less risk of severe back pain cases. The findings also lead to the conclusion that occupational status, in and of itself, does not appear to be linked to risk of back pain—even though lower status occupations do have a tendency toward greater risk of severe chronic back pain.     

Quantitative and qualitative assessment of musculoskeletal disorders and socioeconomic issues of workers of brick industry in Pakistan

Brick industry, in Pakistan, is prominent and provides job to 3.1 million people only in one province. The industry hires different percentage of workers for different stages of brick formation and these stages trigger musculoskeletal disorders (MSDs) in workers. This study identifies relation between 5 work stages and MSDs in 9 body parts and also finds socioeconomic sufferings inflicted by the industry and removal of research gap at national level. We conducted both qualitative and quantitative research. 105 men and 45 women from 15 brick kilns were selected as subject. Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) sheets, Standard Nordic MSDs Questionnaire along with general questionnaire, still photography and video recording were used to carry out the study. About 96% workers involved in mixing & molding complained tiredness at end of day. Similarly, 90% male and 83% female staff performing spreading task suffered tiredness after their duty hours. Workers engaged in different tasks reported varying levels of pain in observed body parts. Digging and carrying jobs caused significant pain in body parts including neck, upper back, shoulders, lower back and hips. Mixing and molding emerged most dangerous activities for most of the body parts and exhibited 7 score on RULA. Furthermore, mixing and molding demonstrated high to very high risk level by showing 9 and 13 higher score on REBA, respectively. The current study divulged that all observed work tasks during manufacturing and transportation of bricks are equally dangerous for pain generation in lower back. Many socioeconomic issues like residency of workers in muddy house (83%) low monthly income (<90.3 $) of 83% workers, higher tendency of alcoholism and smoking in men, lack of health facilities and higher illiteracy rate were also identified. The enhanced musculoskeletal disorders during brick making process render the brick industry unhealthy for work. This dismal picture requires an improvement in quality of life and occupational environment of workers of the industry. Well organized duty timings, modified working posture, job rotation and preliminary training perhaps manage these miseries and the output of the brick industry may increase many fold.     

Estimating investment worthiness of an ergonomic intervention for preventing low back pain from a firm's perspective

A mathematical model was developed for estimating the net present value (NPV) of the cash flow resulting from an investment in an intervention to prevent occupational low back pain (LBP). It combines biomechanics, epidemiology, and finance to give an integrated tool for a firm to use to estimate the investment worthiness of an intervention based on a biomechanical analysis of working postures and hand loads. The model can be used by an ergonomist to estimate the investment worthiness of a proposed intervention. The analysis would begin with a biomechanical evaluation of the current job design and post-intervention job. Economic factors such as hourly labor cost, overhead, workers' compensation costs of LBP claims, and discount rate are combined with the biomechanical analysis to estimate the investment worthiness of the proposed intervention. While this model is limited to low back pain, the simulation framework could be applied to other musculoskeletal disorders. The model uses Monte Carlo simulation to compute the statistical distribution of NPV, and it uses a discrete event simulation paradigm based on four states: (1) working and no history of lost time due to LBP, (2) working and history of lost time due to LBP, (3) lost time due to LBP, and (4) leave job. Probabilities of transitions are based on an extensive review of the epidemiologic review of the low back pain literature. An example is presented.     

The healthy back,its environment and characteristics: a pilot study

It is a well known fact that low back pain is a frequently existing symptom in Sweden and in other industrialized countries. It would be of interest for the prophylaxis of this common condition to study possible special characteristics of persons who have never experienced low back pain. In the present pilot study, 21 men aged 50–59 years were interviewed and clinically examined for the purpose of identifying ‘the healthy back person’. The group consisted of employees from two enterprises, both blue and white collar workers. The subjects shared the services of an occupational health centre and they claimed never to have had low back pain. Their statements were checked with the General Sick Insurance Company (Allmanna forsakringskas-san). The interview dealt with questions about education, profession, mechanical and mental stress during present and previous work, leisure activities, life conditions, health status in general, heredity concerning low back trouble, and the interviewed person's opinion about his healthy back. The clinical examination was directed towards flexibility and muscle strength. The most consistent results of the interviews were that 20 out of 21 subjects experienced a high degree of independence and 17 stated that their jobs were very satisfactory. The clinical examination showed that the group was flexible in the back and hamstrings and that the isometric extensor muscle strength was considerably higher than the isometric flexion strength.     

The musculoskeletal system complaints of office workers at a vehicle production factory

This study aimed to determine the prevalence of and factors contributing to musculoskeletal system complaints (MSC) in office workers of a vehicle production factory and absenteeism due to these complaints. A total of 86.2% (n = 333) of the workers completed the survey. Of the workers, 73 (21.9%) were women, and 260 (78.1%) were men, and the mean age was 36.9 ± 8.75 years. The majority of the personnel had more than one symptom with a prevalence of 80.8%. The most frequently observed discomfort was tension and pain in the back muscles (58.6%) and in the neck muscles (58.3%), followed by low back pain (41%) and shoulder pain (30.3%). Pain in the shoulders, neck, and the back and pain and numbness in the fingers were statistically significantly more prevalent in employees who spent more than 5 hours per day performing desk work. Furthermore, all of the complaints, excluding pain in the elbows and knees, were statistically significantly more common in the women. When each complaint and the effects of contributing risk factors were analyzed by logistic regression analysis, pain in the shoulders, neck, and back; pain that spread to the arms; and pain in the fingers were correlated with longer work hours and the female gender (p < 0.05). The number of employees who had used sick leave within the past year due to MSCs was 11.7%. In conclusion, duration of work hours, frequency of breaks, and gender were determined as the most important risk factors in computer users regarding MSCs. © 2011 Wiley Periodicals, Inc.     

Performance of physical tasks in pregnancy.

Two hundred women in the third trimester of a first pregnancy were interviewed, and 50 of them were interviewed again at 4 months post partum. They were asked whether they experienced greater current difficulty in performing 46 common tasks than they did before pregnancy and were asked to grade their responses. Additional information concerning specific factors affecting each activity, such as discomfort and fatigue, was obtained, together with data concerning socioeconomic status and stress perception. The data were analysed to identify the activities whose performance was most and least affected by pregnancy, indicating that the pregnant condition affects perceived difficulty of performance in many activities. Although some activities are not amenable to ergonomic intervention, the study highlighted some in which equipment design and selection could improve the match between a task and the pregnant.     

Task rotation effects on upper extremity and back muscle activity

Job rotation is an intuitive approach to distributing work to minimize muscular fatigue. The purpose of the current study was to evaluate rotation between lifting and gripping on muscle activity and effort. Ten male participants performed all 4 combinations of two 15 min tasks in 30 min trials split between separate days to prevent fatigue. The tasks of lifting a 12 kg box and gripping at 20% of maximum were performed 6 times per minute (5 s work: 5 s rest). Muscle activity (percentiles, gaps) and perceived effort were significantly affected by the task combinations. The forearm and upper erector spinae muscles did not benefit as greatly from rotating between lifting and gripping tasks as the lower erector spinae, deltoid or trapezius. In addition to gross task differences, overlaps in muscle activity between “low back” and “upper extremity” tasks must be considered when creating effective job rotation schemes.     

Pregnant women and working surface height and working surface areas for standing manual work

Physically loading aspects of work may have adverse effects on the health of both the pregnant woman and the unborn child. Improving the fit between the pregnant woman and the workplace layout contributes to minimizing the load associated with given tasks. The aim of this paper is to evaluate two layout aspects for standing manual work, namely working surface height and working surface areas, for the condition of pregnancy. Two approaches were used. (1) The effects of changed body dimensions were evaluated with regard to (a) fit problems while working at a workplace in accordance with common guidelines and (b) the validity of assumptions of these guidelines. (2) The appreciation of relevant aspects of workplace layout at a specific manual task was assessed. Twenty-seven women were examined in pregnant and non-pregnant conditions. The first approach showed that fit problems are likely: guideline working surface height is just (2-7 cm) under the most protruding abdominal point, and areas based on non-pregnant abdominal depth are relatively large in pregnant condition. Further, existing methods to assess working surface areas have various assumptions that are not valid in pregnant condition. The second approach showed that at a specific manual task, women in late pregnancy preferred a considerably lower table height than the common guideline heights. Possibly, abdominal height becomes a relevant design factor with regard to working surface height during pregnancy. The task position on the working surface at which effort started became closer to the table edge due to pregnancy. Both approaches show that common guideline working surface heights for manual work, and working surface areas assessed in non-pregnant condition seem not suitable in pregnant condition.     

Back pain in the working population: prevalence rates in Dutch trades and professions

An analysis of three health surveys in the Dutch working population is described, aimed at the identification of Dutch trades and professions with relative high and low prevalence rates of back pain. The sample was representative of the working population in the Netherlands and consisted of 5840 men and 2908 women. The analysis included 33 trades and 34 professions, with at least 50 respondents for each. A total of 26·6% of the workers reported back pain quite often. Almost 2% reported absence from work in the last two months, and 4% considered their back pain to be a chronic disabling disease. There was a substantial variation in prevalence rate of low-back pain between trades and professions ranging from 12% to 4%. Trades with relatively high prevalence rates were found to be the building materials industry, the construction industry and road transportation, and the wholesale industry. Trades with relatively low prevalence rates were found to be banking, public administration and commercial services. Workers in the construction industry and supervisory production workers, plumbers, drivers and cleaners have a relatively high prevalence rate of back pain. Chemists, scientists, bookkeepers, secretaries and administrative professions have a relatively low prevalence rate of back pain. It is concluded that high prevalence rates of back pain are found in particular in non-sedentary professions. Priorities in prevention of back pain should be directed towards the group with relatively high prevalence rates identified above.     

Standing working posture compared in pregnant and non-pregnant conditions

During pregnancy, an increase in body weight occurs together with changes in body weight distribution and in fit between body dimensions and workplace layout. These changes may cause alterations in working posture which may, in turn, have adverse consequences for the biomechanical load on the musculoskeletal system and so increase the risk of musculoskeletal disorders. Using photographic posture registration, the standing working posture was studied in 27 women during the last stage of pregnancy and after delivery (the experimental group). The women performed an assembly task while standing at various workplace layouts. The postural differences between the pregnant condition and the non-pregnant condition were studied and the effect of the various workplace layouts assessed. Ten non-pregnant controls were also studied twice to establish the effect of the time interval between the measuring occasions. We found that the women of the experimental group stood further from the work surface in the pregnant condition compared to the non-pregnant condition, the hips were positioned more backwards, and, in order to reach the task, they increased the flexion of the trunk, increased the anteflexion of the upper arms, and extended the arms more. At the workplace layout in which the work surface height was self-selected, the postural differences due to pregnancy were smallest or even absent, compared to the postural differences in the other workplace layouts studied. Ergonomists and workers in occupational health services should be alert to the consequences for the biomechanical load on the musculoskeletal system and the risk of development of health complaints caused by postural changes due to pregnancy. An adjustable workplace layout may prevent some problems.