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 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.     

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.     

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.     

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.     

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.     

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.     

Medium- and long-term reproducibility of self-reported exposure to physical ergonomics factors at work

INTRODUCTION: The literature is sparse on reproducibility of self-reported exposure to physical ergonomics risk factors for musculoskeletal disorders (MSDs). Aims of this study were to evaluate, in a cohort of workers interviewed up to three times: 1-year test-retest reliability; and 5- and 6-year recall of physical exposures. We also examined whether reproducibility was influenced by the presence of UE MSD or by technological changes introduced between the last two surveys. METHODS: A cohort of automobile manufacturing employees was interviewed at baseline, one and six years later about work history, physical and psychosocial exposures at work, upper limb symptoms, injury and medical history, and demographics. Agreement between interviews was evaluated by intraclass correlation and Spearman coefficients. Differences in exposure between 1- and 6-year follow-up were analyzed by Wilcoxon matched-pairs signed-ranks test. RESULTS: Large and significant decreases in work pace and physical effort were observed from baseline, although an upper extremity composite index was quite stable in the total population. One-year test-retest reliability was fair to good for the composite exposure index (ICC=0.58), whole-body vibration, handling parts, and tool use, but poor for the other variables considered. Long-term reproducibility, from baseline or 1-year follow-up to 6-year follow-up, was poor for the composite index and almost all single items. UE MSD case status influenced 1-year test-retest reliability, with subjects who changed case status from baseline displaying higher reliability, but not reproducibility of recalled exposures. A strong regression to the mean effect was observed on exposures reported at follow-up surveys. CONCLUSIONS: Recalled ergonomics exposures could be employed in retrospective cohort studies as a somewhat reliable and unbiased estimate of the self-reported exposures that would have been obtained up to one year earlier, but not over a longer period (5-6 years). These longer-term results may have been limited by difficulty in matching jobs between interviews; also the regression to the mean effect likely contributed to reduce agreement. Changes in production technology and work organization produced a decrease in physical workload intensity and job pace, but did not have a substantial impact on an exposure index for the upper limb.     

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.     

A survey of expert opinion on the effects of occupational exposures to trunk rotation and whole-body vibration

We present a review of current expert opinion on the effects of combined exposures to trunk rotation and whole-body vibration (WBV), commonly experienced by operators of agricultural machinery. We evaluate the level of agreement between academic experts in the field of ergonomics, human response to WBV and agricultural operators, on the effects of exposure to WBV and trunk rotation. A total of 83 individuals responded to the paper-based questionnaire, which included questions on risk levels from individual and combined exposures, discomfort development, exposure duration limits and tasks within agriculture. The results showed that all groups considered exposure to WBV and trunk rotation as risk factors for the development of back pain. The experts were not in consensus regarding acceptable exposure durations, areas of discomfort experienced or recommendations for cab developments.     

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.     

Ergonomic assessment for designing manual material handling tasks at a food warehouse in India: A case study

Manual handling of heavy grain bags is a commonplace activity across agriculture produce supply chain. In the present research, a manual material handling involving lifting, lowering, and carrying grain bags along the paths of variable characteristics is critically analyzed to explore the risk associated with it. The humans engaged in this activity are found to be facing discomfort, suffering from pain and musculoskeletal disorders, and undergoing medication for the same. This study proposes and demonstrates a structured ergonomic evaluation methodology to not only assess the level of discomfort/pain but also evaluate risk factors such as load handled, method of handling, frequency of handling, awkward postures, path characteristics, and so on. It employs a systematic multimethod approach consisting of Nordic Musculoskeletal Questionnaire and Borg Rating of Perceived Exertion, Ovako Working posture Assessment System, NIOSH Lifting Equation, Rapid Entire Body Assessment, and Key Indicator Method. The study reveals that about 94% of the sample population suffered from moderate to severe discomfort in ankle, knee, and lower back. Eight basic activities responsible for risky postures are identified. Frequency of handling, weight being handled, back bending/twisting, poor coupling, and walking surface are observed as major contributors to musculoskeletal discomfort. Carrying on shoulder is found to be riskier than carrying on back; however, the risk is found to be significantly lowered by carrying on backpack. The present study identifies the need for task redesign, proper gripping arrangements, auxiliary devices for lifting/carrying, and improvement in the path characteristics.     

Classroom posture and self-reported back and neck pain in schoolchildren

The study reported here aims to identify the extent of back pain experienced by 11-14 year old schoolchildren, and establish the intensity, duration and frequency of exposure to physical risk factors present in schools. This paper considers the sitting postures of schoolchildren in the classroom. The sitting postures of 66 children were recorded in normal lessons using the Portable Ergonomic Observation Method (PEO). The study found significant associations between flexed postures and low back pain. Static postures and neck and upper back pain were also associated. This study has implications for schools, designers and people in the field of work related musculoskeletal disorders. Further research is required to examine the association between sitting posture and pain reported at different spinal locations.     

The impact of operating heavy equipment vehicles on lower back disorders

Literature reviews examining the relationship between heavy equipment vehicle (HEV) operation and the development of musculoskeletal disorders have generally been qualitative in nature and have not employed an evidence-based assessment procedure. This research determines the extent to which whole-body vibration/shock and working postures are associated with lower back and neck disorders among HEV operators, while accounting for individual (i.e. age, gender, prior history of back or neck disorders) and occupational (i.e. material handling, climatic conditions, psychosocial factors) confounders. Published articles were obtained from a search of electronic databases and from bibliographies in the identified articles. A critical appraisal of these articles was conducted using an epidemiological appraisal instrument (Genaidy et al. 2007). The meta-analysis was conducted using statistical techniques employing fixed-effect and random-effect models. Eighteen articles reporting observational studies satisfied the inclusion criteria adopted for this research. The methodological qualities of the published studies ranged from marginal to average. The meta-relative risk was found to be 2.21, indicating that operators exposed to driving HEVs are at more than twice the risk of developing lower back pain in comparison to those not exposed to driving HEVs. Therefore, it seems possible that there is a causal relationship between working as a HEV operator and development of lower back disorders. Prospective cohort studies are urgently needed to confirm the outcomes of this evidence-based methodology (based in part on the meta-analysis) and the biological plausibility should be further explored. The reported findings point to a need for improved ergonomic design of HEVs.     

The effect of occupational whole-body vibration on standing balance: A systematic review

Adverse health effects from exposure to occupational whole-body vibration (WBV) are common among drivers. In particular some researchers consider that there is kinaesthetic and balance disturbance from WBV exposure in the workplace and this might be one of the aetiological factors responsible for occupational low back pain in drivers. The purpose of this study was to undertake a critical review of the literature to determine whether exposure to seated occupational WBV can affect standing balance performance in an actual or simulated occupational environment. Specific keywords and MeSH terms for three major areas included WBV, balance and occupation. These were used to conduct a systematic search of the following databases; PubMed, EMBASE (Ovid), Medline (Ovid), CINAHL (EBSCO), Academic Search Complete (ASC), AMED, Scopus, Web of Science, Science Direct, Proquest, Cochrane library(OVID), IEEExplore and ProQuest Dissertations and thesis, Google Scholar, WorldCat and related conference proceedings. Five articles met the inclusion criteria and were assessed for quality. Two were field studies conducted on actual vehicles (a long haul freight truck and a bulldozer), while the other three were laboratory studies simulating the characteristics of the following vehicles; long-haul-dump vehicle, underground mine shuttle car, and helicopter. The systematic review scored the methodological quality of the included articles with an average and standard deviation of 76 ±12.3% (range 59- 93%) indicative of high quality. Three of the five studies (two field and one laboratory) found evidence for seated WBV decreasing standing balance performance while two laboratory studies did not find such effects. Thus there is modest evidence to suggest there is a decrease in standing balance performance following exposure to seated occupational WBV.

Relevance to industry

This systematic review suggests that balance deficits may exist immediately following exposure to occupational seated WBV and may predispose driver/operator to low back injury during manual material handling tasks immediately post driving.     

Assessing the ergonomic exposures for drywall workers

Objective

The study was conducted to assess the ergonomic exposures to risk factors that may lead to the reported musculoskeletal injuries (especially back, neck and wrist injuries) of drywall workers.

Methods

A hierarchical taxonomy for construction of drywall panel hanging (drywall panel fitting and installation) was developed with activities defined within the interior wall systems tasks (drywall panel, studs and insulation). Exposures were characterized for the drywall panel work with the PATH (Posture, Activity, Tools, and Handling) work-sampling observation method. Data on working postures were collected for three main body parts: legs, arms and trunk. Activities performed for each task, tools used, and manually handled loads were also recorded for each observation.

Results

The study identified several ergonomic exposures in interior systems construction. Several risk factors were especially prevalent in the drywall panel installation task: awkward body postures such as overhead arm posture, trunk flexion, and handling of heavy drywall panels. Some tasks were observed to have combinations of these musculoskeletal risk factors, such as drywall panel installation, where the workers lifted heavy drywall panels in awkward body postures. In addition, a safety hazard frequently resulted when a worker's foot was poorly supported on a ladder while lifting heavy drywall panels to hang them on the ceiling or upper wall.

Conclusion

The drywall panel installation task poses a severe threat to the safety and musculoskeletal health of the drywall workers. Much of this could be eliminated by reducing the burden of handling heavy and bulky drywall panels.

Relevance to industry

The construction industry is well-documented to have high rates of injury and musculoskeletal disorders. Design of appropriate interventions requires specific knowledge of which tasks and activities involve the highest levels of exposure to relevant factors. Assessment of such factors in drywall panel hanging has provided data that will be useful to evaluate the ergonomics efficacy of future changes in task processes or tools. Feasible solutions appear to exist; effectiveness trials and worker input are needed in order to evaluate whether they could eliminate the observed exposures.