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.     

Work-related musculoskeletal complaints: some ergonomics challenges upon the start of a new century

Three themes likely to be important within health-related ergonomics in the coming years are discussed. The first two themes concern methods for risk analysis of low-level biomechanical and psychosocial exposures. The third theme is approaches to successful implementation of ergonomics interventions. Evidence on the assessment of low-level biomechanical and psychosocial exposures by instrumented measurements is discussed. It is concluded that, despite recent advances in our understanding of exposure-effect associations under these exposure conditions, we must at present rely on more subjective methods, employed in a collaboration between expert and worker. This approach to risk analysis identifies in most cases critical exposures in a work situation. The focus should then be on the successful implementation of measures against those exposures, as identification alone does not solve problems. The aim of improved health for the workers further requires that the full complement of risk factors be considered, including work, leisure time and person-based risk factors. Finally, the need to put ergonomics intervention initiatives in an organisational context is emphasised, and examples of approaches used by Norwegian companies are presented.     

Assessment of musculoskeletal and other health complaints in female hospital staff

Musculoskeletal and other health complaints were investigated in a sample of 586 female hospital staff. Health complaints, including musculoskeletal pain, were assessed by the Ursin Health Inventory (UHI). Factor analyses of the UHI favoured a seven-factor solution in which musculoskeletal pain emerged as an independent factor of complaints. Other complaint factors could be labelled lower digestive, upper digestive, cardiorespiratory, allergy, cold/influenza and headache. Factor analyses of the extended version of the Nordic Questionnaire (NQ-EV), which focuses specifically on musculoskeletal pain from nine body areas, favoured a three-factor solution in which complaints from the upper back, low back and extremities emerged as the independent factors. Product-moment coefficients of correlation between factor-based sum scores in the two survey measures stated that the UHI factor 'musculoskeletal pain' and the NQ-EV factor 'upper back' were significantly correlated. This indicated an orientation of the UHI 'musculoskeletal pain' factor to pain in the upper part of the back. Only very moderate coefficients of correlation emerged between the NQ-EV factor scores and the remaining UHI scores. The results support the assumption that musculoskeletal complaints are not closely related to other types of health complaints, and that musculoskeletal complaints among female hospital staff should be assessed with separate items for upper back (neck/shoulders), low back and the extremities.     

Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints

It is well established that psychosocial work stressors relate to employees' work-related musculoskeletal disorder (WRMSD) symptoms. Using a model investigating psychological strain as a mediator between work stressors and WRMSD complaints, this study demonstrated that high levels role conflict, low job control, and low safety-specific leadership are associated with increased employee strain. Strain, in turn, was related to higher levels of WRMSD symptoms of the wrist/hand, shoulders, and lower back. Partial mediation of some relationships was also found, suggesting that additional meditational mechanisms for the relationships between stressors and musculoskeletal symptoms are plausible. This work supports the notion that psychosocial stressors in the work environment have important links to employee health, especially WRMSDs.     

Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing

As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders.

Practitioners’ Summary

With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.     

Physical risks of work-related musculoskeletal complaints among quarry workers in East of Iran

Quarry workers are at high risk of developing musculoskeletal complaints. The aim of this study was to evaluate the working postures and prevalence of musculoskeletal problems among quarry workers. In this cross-sectional study 78 male quarry workers were assessed using the method of Rapid Entire Body Assessment (REBA), and musculoskeletal complaints data were obtained by the Standardized Nordic Musculoskeletal questionnaire (NMQs). Results of the prevalence of musculoskeletal problems in body parts of stonemasonry workers was higher found than in the stonecutting workers. The highest prevalence rate of musculoskeletal problems in both stonemasonry and stonecutting workers was 65.7% and 54.8% respectively related to waist. The stonemasons with 62% had high level of risk and stone cutting workers with 47.6% had moderate risk level. Significant correlation was found among age, work experience, BMI, and prevalence of musculoskeletal problems. There was also a significant relationship between the wrist and lower back pain with the risk level of REBA score. The study results showed that musculoskeletal problems of workers had high prevalence and accordingly most of the work conditions and postures needed to be improved, so prioritizing the necessity of corrective actions and intervention are to be gained.     

The use of ergonomic measures and musculoskeletal complaints among carpenters and pavers in a 4.5-year follow-up study

The primary aim of this follow-up study was to evaluate the association between the use of ergonomic measures and musculoskeletal complaints among construction workers during an informational campaign on sector level. A questionnaire was sent twice to a cohort of 914 Dutch carpenters and pavers, once in 2000 and once in 2005. Relative risks (RR) were calculated for the regular use of ergonomic measures and regular or sustained lower back and shoulder pain among workers at baseline and 4.5 years follow-up. The response percentages were 78% (n = 469) for carpenters and 64% (n = 202) for pavers. Regular use of specific ergonomic measures varied from 15–66% at baseline to 17–66% at follow-up. Four specific ergonomic measures showed a statistically significant increase in usage. Regular or sustained lower back and shoulder complaints among carpenters decreased from 38 to 34% (p = 0.07) and 24 to 22% (p = 0.18), respectively. Among pavers, lower back (34%) and shoulder (17 to 18%) complaints remained the same or increased. Regular use of a height-adjustable working platform was associated with a lower likelihood of shoulder complaints at baseline (RR = 0.68; 95% CI: 0.46–<1.00) and low back complaints at follow-up (RR = 0.66; 95% CI: 0.50–0.88) among carpenters. Also regular use of aids for handling heavy loads was associated with no shoulder complaints at baseline RR = 0.62 (95% CI: 0.40–0.97) among carpenters. In conclusion, despite a large informational campaign, regular use of ergonomic measures remained low in a 4.5 year period. Regular use of the majority of ergonomic measures was associated, although not statistically significantly, with a lower likelihood of lower back or shoulder complaints. It is recommended to select, apply and monitor powerful implementation strategies to ensure the use of effective ergonomic measures at construction sites.     

Postural muscle strain as a causal factor in the development of musculo-skeletal illnesses

Musculo-skeletal complaints account for 30% of time loss through sick leave. A study was made at a small manufacturing plant in Norway among workers subjected to static muscle load, with particular reference to the relationship between such illness and muscle strain due to working conditions. The paper covers old working standards and ergonomic improvements made in 1975. The results show an increase in musculo-skeletal illness with increased length of employment and increased age.     

Sustained muscle tension as a risk factor for trapezius myalgia

Thirty female chocolate packers were included in a prospective study to relate trapezius muscle activity during work to the development of myalgia. Electromyographic (EMG) recordings and interviews on risk factors were performed at start of employment and every 10th week. The muscle activity was characterized by the averaged static and median level. Only data obtained before a possible development of severe symptoms of trapezius myalgia (patient) was used in the analysis. Seventeen of the subjects became patients within the first year of employment. Machine-stops occurred accidentally during work. At one task the stops induced a pause where the subjects passively waited for the machine to start. Twenty-one subjects experienced machine-stops of a sufficient duration to be evaluated for a potential “resting tension”. Future patients showed significantly higher “resting tension” compared to healthy controls.     

Self-assessed and directly measured occupational physical activities--influence of musculoskeletal complaints, age and gender

This study compares questionnaire assessed physical activity with direct technical measurements among cleaners and office workers, stratified regarding age, gender and self-reported neck/shoulder complaints. During two full working days number of steps was recorded by a pedometer, sitting/standing positions by a posimeter and heart rate by a Sport-Tester. In addition the subjects kept a work task diary for 10 days. There were high intra-individual variations in exposure between the days. Subjects with complaints rated their exposure higher than those without, although they in fact showed lower direct measured exposure. This may imply underestimation of exposure-effect relationships. Rate of perceived exertion showed low correlation with heart rate ratio within the two occupational groups, but high, 0.64 when the two groups were combined. Age and complaints explained 31% of the variance for the cleaners.     

Ergonomics interventions to reduce musculoskeletal risk factors in a truck manufacturing plant

Ergonomic interventions may potentially reduce MSDs, but the context of industries (barriers, ever-changing situations, dialogue processes) might play a significant role in the success of interventions. This study evaluates the effectiveness of ergonomic interventions including engineering/technical and organizational interventions, and the involvement of the stakeholders in reducing musculoskeletal risk factors/symptoms. A pre-post-test experimental study in non-randomized groups was performed over three years in a sector of a truck assembly plant. The mean age of the operators in the sector for the initial and second assessment time was 42.0 (±7.6) years and 39.0 (±8.7), respectively. The mean length of work experience in the current job was 15.2 (±7.2) years and 13.9 (±7.3) for the initial and second assessment times, respectively. Five engineering ergonomic solutions and organizational interventions were implemented after a comprehensive ergonomic analysis. The organizational interventions consisted mostly of transferring and redistributing the tasks, i.e., ergonomically balancing and redesigning of the workstations. Before performing the interventions, the findings of the ergonomic study were presented at several meetings to encourage the involvement of the stakeholders (including managers, engineers, and operators) in the interventions. This study showed that a combination of ergonomic measures—engineering and organizational interventions—could reduce physical workloads. Musculoskeletal symptoms decreased after interventions although the difference was not significant.     

Wrist and tendon dynamics as contributory risk factors in work‐related musculoskeletal disorders

Many studies have shown that repetitive wrist motion is a major risk factor for work‐related musculoskeletal disorders (WMSDs). Specific contributory factors include wrist and tendon dynamics. The authors present recent methodological advances, epidemiological studies, and biomechanical models estimating the effects of wrist dynamics on internal tendon force as a theoretical basis for the risk of incurring a WMSD. These biomechanical models utilize either the reduction method or the optimization method to solve the indeterminate problem resulting from too many internal variables. Generally, the optimization methods show the best agreement with direct in vivo tendon force studies. For the models of pinch grips, the average ratio of tendon forces to external forces ranges from 1.8 to 3.5, while for direct tendon measurements, the ratio ranges from 1.73 to 7.92. Similarly, high contributions of flexor tendons for pinches and grasps are found in both the models and direct tendon measurements. These high tendon forces combined with wrist dynamics may be a significant factor in the development of WMSDs. © 2006 Wiley Periodicals, Inc. Hum Factors Man 16: 83–105, 2006.     

Ergonomic assessment of musculoskeletal risk among a sample of Portuguese emergency medical technicians

The prevalence of musculoskeletal disorders in healthcare professionals is high, patient handling tasks being one of the main causes. This article focused on the analysis of the risk of musculoskeletal disorders in patient handling tasks, performed by emergency medical technicians. The study included 20 technicians from the National Institute of Medical Emergency and a total of 292 analysed postures. REBA results indicated that, of the 292 postures, 47% presented a medium risk and 29% high risk. The task “transport of the chair on the stairs - bottom position” obtained the most critical REBA score and the task “placement of the stair chair into the ambulance - top position” involved higher effort, according to the technicians’ perception. With this study, it was possible to diagnose the risk level of musculoskeletal disorders in tasks of manual handling performed by these professionals, allowing to identify specific actions that can compromise their health and safety. Hereafter, based on risk factors identification, it is relevant to the sector to develop solutions for these first responders, focusing on design features, based on an ergonomics participatory methodology.     

Working conditions of Iranian hand-sewn shoe workers and associations with musculoskeletal symptoms

The working conditions and the prevalence of self-reported musculoskeletal symptoms among 180 Iranian hand-sewn shoe workers were evaluated in this cross-sectional study. Data were collected using both questionnaire (for assessing musculoskeletal symptoms and associated risk factors) and direct observations of posture (by the Rapid Upper Limb Assessment [RULA] method). The prevalence and severity of symptoms was very high among the study population. The mean RULA grand score of 6.2 indicates that in most cases the workers' postures at their workstations need to be investigated and some changes are required immediately. Multiple logistic regression models indicated that the job experience, daily working hours, duration of continuous work without breaks, feeling pressure due to work and working postures were significantly associated with musculoskeletal symptoms of different body regions. The results are discussed in terms of their implications for hand-sewing tasks. These findings can help to better understand the working conditions of those jobs involving hand-sewing operation and highlight the potential for ergonomic interventions to reduce musculoskeletal symptoms among these working groups.

Practitioner Summary: Working conditions of hand-sewn shoe workers and their musculoskeletal symptoms were investigated. The prevalence and severity of musculoskeletal symptoms was very high among the study population. Poor working postures, feeling pressure due to work, long duration of work without breaks and prolonged daily working hours were positively associated with musculoskeletal symptoms.     

Reproducibility of a self-report questionnaire for upper extremity musculoskeletal disorder risk factors.

A self-report questionnaire was developed to evaluate the potential for assessment of possible risk factors for musculoskeletal disorders. Visual-analog and categorical scales were designed to represent responses relating to primary work as well as a second job and hobbies or non-work activities. 71 tree nursery workers completed the scales twice in consecutive weeks. Agreement between means of the two questionnaire administrations was 0.80 or higher for all scales. Intraclass correlation coefficients ranged between 0.59 and 0.69 for the primary job hand/wrist responses and between 0.49 and 0.82 for non-work/hobby neck and upper arm scales. These results show potential for future application of similar scales in industry or temporary and seasonal work to evaluate exposure to upper extremity risk factors.     

The development of the Quick Exposure Check (QEC) for assessing exposure to risk factors for work-related musculoskeletal disorders

This paper describes the development and evaluation of the Quick Exposure Check (QEC), which is an observational tool developed for Occupational Safety and Health (OSH) practitioners to assess exposure to risks for work-related musculoskeletal disorders and provide a basis for ergonomic interventions. The tool is based on epidemiological evidence and investigations of OSH practitioners' aptitudes for undertaking assessments. It has been tested, modified and validated using simulated and workplace tasks, in two phases of development, with participation of 206 practitioners. The QEC allows the four main body areas to be assessed and involves practitioners and workers in the assessment. Trials have determined its usability, intra- and inter-observer reliability, and validity which show it is applicable to a wide range of working activities. The tool focuses primarily on physical workplace factors, but also includes the evaluation of psychosocial factors. Tasks can normally be assessed within 10min. It has a scoring system, and exposure levels have been proposed to guide priorities for intervention. Subsequently it should be used to evaluate the effectiveness of any interventions made. The QEC can contribute to a holistic assessment of all the elements of a work system.     

Flexible work in call centres: Working hours, work-life conflict & health

Call-centre workers encounter major psychosocial pressures, including high work intensity and undesirable working hours. Little is known, however, about whether these pressures vary with employment status and how they affect work-life conflict and health. Questionnaire data were collected from 179 telephone operators in Sydney, Australia, of whom 124 (69.3%) were female and 54 (30.2%) were male. Ninety-three (52%) were permanent full-time workers, 37 (20.7%) were permanent part-time, and 49 (27.4%) were casual employees. Hypothesised structural relationships between employment status, working hours and work organisation, work-life conflict and health were tested using partial least squares modelling in PLS (Chin, 1998). The final model demonstrated satisfactory fit. It supported important elements of the hypothesised structure, although four of the proposed paths failed to reach significance and the fit was enhanced by adding a path. The final model indicated that casual workers reported more variable working hours which were relatively weakly associated with greater dissatisfaction with hours. The interaction of schedule control and variability of hours also predicted dissatisfaction with hours. Conversely, permanent workers reported greater work intensity, which was associated with both lower work schedule control and greater work-life conflict. Greater work-life conflict was associated with more fatigue and psychological symptoms. Labour market factors and the undesirability of longer hours in a stressful, high-intensity work environment appear to have contributed to the results.     

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.     

Developing a comprehensive approach to risk management of musculoskeletal disorders in non-nursing health care sector employees

This study of selected jobs in the health care sector explored a range of physical and psychosocial factors to identify those that most strongly predicted work-related musculoskeletal disorders (WMSD) risk. A self-report survey was used to collect data on physical and psychosocial risk factors from employees in three health care organisations in Victoria, Australia. Multivariate analyses demonstrated the importance of both psychosocial and physical hazards in predicting WMSD risk and provides evidence for risk management of WMSDs to incorporate a more comprehensive and integrated approach. Use of a risk management toolkit is recommended to address WMSD risk in the workplace.