Musculoskeletal symptoms among dentists in relation to work posture

OBJECTIVE: To determine the effect of work posture on musculosketal complaints in Israeli dentists. METHODS: The population included 60 male dentists mean age was 46.0 (+/- SD 8.66), 30 worked in sitting position and 30 were altering positions. Study population completed the standardized Nordic questionnaire and informative form concerning recipient's practice of dentistry, bio-demographic variables and questions about workloads. RESULTS: Musculoskeletal symptoms in the last 12 months were localized primarily in the lower back and in the neck (55% and 38.3% respectively). There was a significant correlation between the time spent sitting and the severity of low back pain (r = 0.41, p = 0.01). On the other hand there was no significant correlation between time spent sitting and other musculoskeletal complaints (r = - 0.16). CONCLUSIONS: Dentists who work in the sitting position have more severe low back pain than do those who alternate between sitting and standing despite the fact that those who sat at least 80% of the time worked less hours and had less of a workload during their working hours. This suggests that altering position should be recommended to dentists. An intervention study, however, is needed to demonstrate that changing posture will decrease the prevalence of low back pain in dentists.     

Discrepancies in pain presentation caused by adverse psychosocial conditions as compared to pain due to high physical workload?

Disorders in the musculoskeletal system have been associated with a high physical workload as well as psychosocial and individual factors. It is however not obvious which of these factors that is most important to prevent. Musculoskeletal disorders in neck and upper extremity was assessed by interview and clinical examination in 79 teachers and 93 assisting nurses, all females. Psychosocial work environment was assessed by questionnaire. The physical workload was recorded by technical measurements of postures, movements and muscular load, in 9 teachers and 12 nurses. The physical workload was lower among the teachers, but they had a more demanding psychosocial work environment. Among the nurses, but not in the teachers, the neck-shoulder disorders were associated with a high body mass index (BMI). The teachers reported neck-shoulder complaints to a higher extent than the nurses, but had much lower prevalence of diagnoses in the clinical examination (12% vs. 25%; POR 0.3 CI 0.1 - 1.2; adjusted for age and BMI). The results suggest that adverse psychosocial conditions among the teachers give rise to a different kind of pain in the neck-shoulder region than from physical overload, troublesome but not as severe as the one afflicting the nurses.     

Low back pain disability and stay at work: contradiction or necessity?

The incidence of occupational diseases in the population is high and factors such as long working hours, poor posture, psychological and physical stress can contribute to its development. Among work-related musculoskeletal disorders, back pain has a high prevalence. The aim of the present study was to quantify and characterize pain complaints and to identify individuals with low back pain, in order to assess the degree of disability. Participated 226 employees of an institution of higher education. They answered a general questionnaire about location and quantification of pain complaints visual analog scale for pain and the Quebec Disability Questionnaire. Of all the workers, 69.60% had some type of musculoskeletal complaint; of those, 15.41% had low back pain. Considering workers who had back pain, 54.9% were female, 52.94% are under 30 years old and 43.14% between 1 and 5 years of work. As for the final score for the degree of disability, 41.17% had minimal disability and 37.25% moderate disability. The present study found large number of pain complaints and high prevalence of low back pain, resulting in individual's inability and difficulties in performing work activities.     

Musculoskeletal symptoms and work ability among agricultural machinery operators

Those subjects whose employment has physical demands present more frequently musculoskeletal symptoms than others. The agricultural sector activities include tasks with important physical demands that may have a negative impact in the workers health. The aim of this study was to evaluate the presence of musculoskeletal symptoms and its association with work ability in agricultural machinery operators. It is a cross-sectional study. The participants (n = 204) answered a self-administered questionnaire on demographics, work and lifestyle characteristics, Work Ability Index and the Nordic Musculoskeletal Symptoms Questionnaire. The response rate was 89.78%. The mean age of the workers was 32.3 years, and 47.1% of them reported musculoskeletal symptoms at least one body part over the past 12 months. Those subjects who presented work ability index <37 points, 87.5% reported some kind of musculoskeletal symptom. This study showed that the work ability was significantly (p ≤ 0.05) correlated to musculoskeletal symptoms presence. It is recommended that measures to promote and improve the work ability are designed and deployed based on musculoskeletal disorders prevention.     

Musculoskeletal reported symptoms among aircraft assembly workers: a multifactorial approach

The aim of this study was to evaluate factors associated with reported work-related musculoskeletal symptoms among aircraft assembly workers. Population consisted of 552 (491 men/61 women) workers who performed tasks related to the work of aircraft assembly. Participants completed a comprehensive questionnaire, including socio-demographic information, habits/lifestyles, working conditions, and work organization. Workers also answered the Nordic Musculoskeletal Questionnaire to obtain data on musculoskeletal symptoms. Multivariate logistic regression was performed to analyze factors associated with musculoskeletal reported symptoms. Results showed that body regions with the highest prevalence of reported musculoskeletal symptoms were similar when referred the past twelve months and the past seven days. Significant factors associated with musculoskeletal symptoms included variables related to conflicts at work, sleep problems, mental fatigue, and lack of time for personal care and recovery. Working time in the industry was associated only with reports for the last seven days and regular physical activity off-work seems to be a positive factor in preventing musculoskeletal symptoms for the past twelve months. The results highlight the multi-factorial nature of the problem. Actions to prevent musculoskeletal diseases at the aircraft assembly work should consider multiple interventions that would promote better recovery between work shifts.     

Ergonomics in the operating room

Surgical staff is considered to have several ergonomic risk factors, but their physical workload and musculoskeletal health have seldom been evaluated. Clinical examinations of neck and upper extremities were performed in 99 theatre nurses and 93 assisting nurses, all females. Their physical workload was assessed by questionnaire, and by technical measurements of postures, movements and muscular load in subgroups of both categories. The prevalences of diagnoses in neck/shoulders were not remarkably high in the nurses, compared to other occupational groups. In elbows/hands though, the prevalence was rather high among assistant nurses, 13 vs. 5 % in theatre nurses; POR 3.0 (CI 95 % 1.0 - 8.9). Theatre nurses experienced prolonged static postures in the questionnaire, whilst assistant nurses reported high physical load. Accordingly, the technical measurements showed more strenuous working postures in the theatre nurses, but lower wrist angular velocities. The time proportion of muscular rest in m.trapezius was rather high in both groups. Although both groups had some stressful loads they had relatively low prevalence of diagnoses in neck/shoulders. The high proportion of muscular rest may be protective. The elevated risk of elbows/hands diagnoses among assistant nurses may be explained by strenuous work tasks of short duration.     

Prevalence of discomfort/pain complaints and related factors in dental professionals of the public health service in Araucária, Paraná state, Brazil

This poster presents a study about the influence of gender related factors, age, body weight, time of service in the profession and practice of physical exercise on the prevalence of discomfort/pain complaints in dental professionals. The scope of this study was limited to 123 subjects, 84.24% of professionals in the public dental clinics, who answered the multidimensional analytical work questionnaire. The data suggest that the lack postural awareness can contribute to the maintenance of painful conditions and also the low commitment to self-care can perpetuate the state of musculoskeletal discomfort/pain, justifying the application of the ergonomics concepts in the workplace and systematic guidance to professionals to adopt a healthy lifestyle.     

An analysis of VDT monitor placement and daily hours of use for female bifocal users

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are correlated with hours of VDT work and that there appears to be a threshold at approximately five hours for pain symptoms among bifocal wearers. No such correlation can be made for monitor placement     

Participative development of packages in the food industry--evaluation of ergonomics and productivity by objective measurements

Rationalizations generally have a negative effect on health and known risk factors for musculoskeletal disorders. These effects may be reduced by paying attention to modifiers as worker participation and a resonant management style. In this study a participatory approach was used in the food industry in order to improve ergonomics and productivity. The food industry shows a high prevalence of musculoskeletal disorders, and repetitive manual work occurs extensively. Prototypes of new packaging solutions were developed in three cases, and compared in a simulated production to the existing production system through direct measurements of working postures and muscle activity, ratings of physical load, and general productivity data. Measured and rated ergonomic exposures showed that workload was significantly lower for the prototypes, in all three cases. In two cases, the number of handling operations included in the packaging operations were greatly reduced with the prototype package, as were production costs. The impact on disorders of the obtained load reductions is difficult to assess, but we believe that in "critical" situations like this, even small improvements may have an effect. This study shows that workloads during manual handling of packages as well as production costs can be reduced by applying participative development of packages.     

Self-reported musculoskeletal pain and working conditions among employees in the Swedish public sector

Musculoskeletal disorders constitute a considerable public health problem, often resulting in sickness absence, particularly in public sector employees. Increased knowledge on how this is related to individual and work-related factors is required. The objective of this study was to investigate the associations between self-reported musculoskeletal pain and the following factors: physical and psychosocial work conditions, lifestyle, psychosomatic symptoms and sick leave. A comprehensive questionnaire was completed by a total of 2523 people, of which 87% were women and 13% men. The participants were employed in public hospitals, educational institutions, home care services for the elderly and domestic/catering services in a Swedish county. The response rate was 92%. Multiple logistic regression analyses showed that the high level of self-reported musculoskeletal pain was highly associated with strenuous physical and psychosocial work conditions. The physical factor with the highest odds ratio (OR) was working in a forward-bent position. High work demands was the most prominent psychosocial factor and distinctly associated with musculoskeletal pain among men. Physical work strain and other demanding working conditions, which were associated with musculoskeletal pain, were frequent among employees in home care services for the elderly and domestic/catering services. There was a strong association between long-term sick leave and high musculoskeletal pain. Furthermore, there was a strong association between a high level of musculoskeletal pain and the exhibition of psychosomatic symptoms in both women and men; this is an interaction that may intensify the total experience of illness and thus needs to be further investigated.     

An ergonomic study on the onset of mental fatigue among the load handling workers of a central market area in Kolkata

It is a well recognized fact that manual material handling (MMH) entails enormous physical labor and associated discomfort feeling, which invariably culminate into musculoskeletal disorders. However mental fatigue, in such instances, becomes an unexplored parameter that needs definite attention during assessment of work status of MMH workers. The present study is being performed among 75 porters of a central market in Kolkata to ascertain the extent of physical and mental exhaustion among them. SF-12 health status questionnaire followed by another questionnaire involving psychosocial questions were performed among them. The analysis of both the questionnaires clearly revealed that most of the porters are under severe physical exertion as they alone carry about 120 kg load at a time and such activity is repeated at least 40 times throughout the day. They always suffer from pain and discomfort feeling at different body parts and this interferes with their normal work activity to a great extent. Moreover absenteeism means no financial return and even a day's rigourous work fetches meagre income. The inability to support family convincingly even after performing such hazardous tasks makes them feel low. Monotony, boredom, fatigue and mental trauma form an integral part of their daily work schedule.     

Ergonomic recommendations when texting on mobile phones

The aim of this report was to give ergonomic recommendations in order to prevent musculoskeletal symptoms/disorders among young people due to intensive texting on mobile phones. In a study of 56 Swedish young adults (19-25 years, 41 with musculoskeletal symptoms in neck and/or upper extremities and 15 without symptoms) registration of thumb movements with electrogoniometry, muscle activity with electromyography and observation of texting technique were conducted during texting on mobile phones. The results showed differences in physical load between the group with musculoskeletal symptoms and the group without symptoms. There were also found differences in muscle activity and kinematics between different texting techniques. These differences could not be explained by the asymptomatic group having symptoms but may be a possible contribution to their symptoms. According to these results it can be recommended to support the forearms, to use both thumbs, to avoid sitting with the head bent forward and to avoid texting with high velocity in order to prevent musculoskeletal disorders when using mobile phones for texting.     

Development of activity monitoring for determining load carriage patterns in school students

The loads that school students are carrying to, around and from school is an issue of increasing concern particularly as the long term effects of excessive load carriage on school students' musculoskeletal health is unknown. A greater understanding of the temporal patterns of students' load carriage, which usually involves backpacking, would assist in determining the magnitude of the problem that is faced by school students. The aim of this study was to determine the duration of school students' walking, running and stair climbing while backpacking and identify when students take off and put on their backpacks using activity monitoring and video, and therefore validate activity monitoring as a tool for measuring the temporal patterns of backpacking in school students. An activity monitor was secured in the backpacks of six school students while they completed a predefined physical activity course. Participants firstly completed the course following a set time pattern ('set course') and then repeated the course while performing activities as they pleased ('free course'). Video footage and activity monitor data were captured simultaneously. The activity monitor provided consistent visual differentiation between walking, running and taking off and putting on a backpack. The greatest variation between measures was for walking during the 'free course' (mean 8, SD 7 seconds), while the least variation between measures was for stair climbing during the 'set course' (mean 3, SD 2 seconds). There were no statistical differences between the activity monitor and video camera determined durations for any of the activities. These preliminary results suggest that activity monitoring may enable valid analysis of the temporal patterns of backpacking with little disruption to the user, although more work is required to verify this.     

Work and health in Gnosjö: a longitudinal study

This study includes women and men born between 1934 and 1953 in the municipality of Gnosj? in the south of Sweden and covers the period 1998 to 2001. Compared with the country, a large proportion of the population of the municipality of Gnosj? works in the manufacturing industry. The aim was to examine associations between physical and psychological stress factors in and outside work, sickness absence and cardiovascular and musculoskeletal diseases, from a gender perspective. Information about working conditions and other aspect of life was collected by a questionnaire in 1998, and register data about sickness absence, cardiovascular diseases and musculoskeletal diseases 1999-2001. The impact on sickness absence consisted mainly of demand and control aspects of the psychosocial working conditions, but also temporary employment and of low sense of coherence. In relation to musculoskeletal health, demand and control was important among women, but not among men. Very few physical factors in the work environment were related to musculoskeletal diseases. Low sense of coherence had an impact also on musculoskeletal diseases. Cardiovascular diseases among women were influenced by demand and control and by life style related factors. We hope that the knowledge gained from our study makes it possible to develop better tools for both the preventive work in Gnosj? and for the rehabilitation of the people already ill. Because of our holistic approach, both public health aspects and working life aspects are covered. The municipality of Gnosj? is small, and therefore foreseeable in a way that many municipalities are not. Still, we do believe that our finding, in this longitudinal study, can be of value also in the public efforts and the efforts to develop adequate and successful rehabilitation approaches.     

VDU workstations and vision in post office and bank operators

A cross-sectional study was carried out on a sample of 26 VDU operators in a post office and a bank, working regularly on video display units. The study aimed at (1) determining the physical working conditions, particularly lighting conditions, (2) assessing employees' complaints, (3) measuring visual defects among operators in VDU workstations. The following results are revealed: (a) ergonomic shortcomings in workplace and work station design were clearly noticed (b) noise level was between 60 db and 78 db, (c) illumination parameters did not much the task and caused ocular symptoms and visual fatigue, (d) visual tests revealed vision defects in 84.6% of the cases, (e) visual fatigue was noticed at the end of the working day. The abnormal frequency of operators' complaints can be explained by the association of visual defects and inadequate working conditions.     

Musculoskeletal disorders and psychosocial risk factors among workers of the aircraft maintenance industry

During the recent decades Brazil has experienced an exponential growth in the aviation sector resulting in an increasing workforce. The aircraft maintenance industry stands out, where the workers have to handle different kind of objects. The aim of this study was to evaluate psychosocial indicators as well as musculoskeletal symptoms and disorders among aircraft maintenance workers. One hundred and one employees were evaluated (32.69 ± 8.25 yr, 79.8 ± 13.4 kg, and 1.75 ± 0.07 m). Musculoskeletal symptoms and disorders were assessed through the Nordic Musculoskeletal Questionnaire (NMQ) and a standardized physical examination. The Job Content Questionnaire (JCQ) and the Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial indicators. Results of the NMQ indicate the lower back as the most affected body region. On the other hand, the physical examination has shown clinical diagnosis of shoulder disorders. Neck, upper back and ankle/foot were also reported as painful sites. Most of workers have active work-demand profile and high work engagement levels. We suggest that musculoskeletal symptoms may be related to high biomechanical demand of the tasks performed by workers, what must be further investigated.     

Need for recovery from work and sleep-related complaints among nursing professionals

The concept of need for recovery from work (NFR) was deduced from the effort recuperation model. In this model work produces costs in terms of effort during the working day. When there is enough time and possibilities to recuperate, a worker will arrive at the next working day with no residual symptoms of previous effort. NFR evaluates work characteristics such as psychosocial demands, professional work hours or schedules. However, sleep may be an important part of the recovery process. The aim of the study was to test the association between sleep-related complaints and NFR. A cross-sectional study was carried out at three hospitals. All females nursing professionals engaged in assistance to patients were invited to participate (N = 1,307). Participants answered a questionnaire that included four sleep-related complaints (insomnia, unsatisfactory sleep, sleepiness during work hours and insufficient sleep), work characteristics and NRF scale. Binomial logistic regression analysis showed that all sleep-related complaints are associated with a high need for recovery from work. Those who reported insufficient sleep showed a greater chance of high need for recovery; OR=2.730 (CI 95% 2.074 - 3.593). These results corroborate the hypothesis that sleep is an important aspect of the recovery process and, therefore, should be thoroughly investigated.     

Risk reduction in musculoskeletal practice assistance professional nursing pilot in semi intensive care unit

The hospitals mostly have a high level of complexity, diversity of services and, consequently, occupational risks. The tasks of mobilization and manual repositioning of patients may require professional of the physical demands due to the weight or excessive patient dependency, attitudes arising from inadequate to lean on a bed or work in a restricted area, sudden weight change that can occur if a patient loses balance or strength to change the position or while moving. These, among many other factors can cause or aggravate musculoskeletal problems in health care workers. These diseases translate into frequent musculoskeletal complaints, high rates of absenteeism, licenses and problems of prolonged labor, creating a vicious cycle that compromises patient safety and performance of institutions. The literature has suggested the administration of courses on handling and transportation of patients as one of the most important strategies to reduce the incidence of problems in the spine between the worker's healths. An exercise program emphasizing global distension and strength, mainly the posterior chain muscles (dorsal region), held twice a week, combined with an approach to ergonomics can reduce musculoskeletal symptoms and absenteeism in nursing.     

Musculoskeletal symptom survey among cement and concrete workers

Work in construction is associated with a high risk for musculoskeletal disorders and injuries. The symptom survey was conducted to determine the magnitude and musculoskeletal injury characteristics among the cement and concrete workers and identify the most problematic work-related activities and job factors that might have contributed to the occurrence of these disorders. Findings revealed that a large proportion of the laborers (77%) experienced at least one musculoskeletal disorder in the last year. Low back pain was reported as the most frequently experienced symptom (66%). 'Working while in pain' the concrete workers perceived as the major problem in the trade. Other problematic work-related activities included 'bending or twisting the back', 'work in hot, cold or wet conditions', and 'handling heavy objects'. Most of the laborers (82%) requested on-the-job safety training. Survey results combined with the outcomes of focus groups discussions and work site observations were used in the design of a training program aimed at the prevention of musculoskeletal morbidity in the trade. The program incorporated ergonomics principles, hazard recognition, safe work practices, problem solving and personal protection in the training curriculum for membership of the trade.