Work environment and neck and shoulder pain: the influence of exposure time. Results from a population based case-control study

Objectives: To study associations between long term and short term exposure to different work environmental conditions and the incidence of neck or shoulder pain. The results were obtained as part of the MUSIC-Norrtälje study, which is a population based case-control study conducted in Sweden in 1993–7.

Methods: The cases were people from the study base who sought medical care or treatment for neck or shoulder pain. Information on physical and psychosocial conditions in the work environment, currently and 5 years ago, and lifestyle factors, was obtained by self administered questionnaires from 310 cases and 1277 randomly selected referents.

Results: Associations between both physical and psychosocial exposures in the work environment and seeking care for neck or shoulder pain were found. The risk patterns differed for the sexes, and risk ratios exceeding 1.5 were more often found among women than among men. Generally, subjects who had experienced a recent increase of exposure were more likely (relative risk (RR) 2.1–3.7) to seek care than those who had been exposed long term (RR 1.5–1.8). Among women, an increased amount of visual display terminal (VDT) work, work above shoulder level, and reduced opportunities to acquire new knowledge, and among men, an increased amount of seated work were associated with neck or shoulder pain. This might indicate short induction periods for neck or shoulder pain for these exposures. However, for repetitive work with the hands and hindrance at work among women, and possibly also local vibrations among men, the induction periods seem to be longer. Interactive effects between factors, both at work and in the family, were found, but only among women.

Conclusions: Associations between some exposures in the work environment and seeking care for neck or shoulder pain were found. The high RRs for short term exposure might indicate that for many factors the induction period for neck or shoulder pain is short.

     

The influence on seeking care because of neck and shoulder disorders from work-related exposures

The aim of this study was to assess the influence of work-related physical and psychosocial factors on seeking care for neck or shoulder disorders among men and women in a general working population. The study population comprised gainfully employed (>17 hours per week) men and women in the municipality of Norrt?lje, altogether 392 cases and 1,511 controls. Cases were defined as persons seeking care because of neck or shoulder disorders by any caregiver in the region. The study began in 1994 and continued to 1997. We assessed physical and psychosocial exposures by questionnaires and interviews. The pattern of seeking care for neck or shoulder disorders differed between men and women. Among men, work with vibrating tools [relative risk (RR) = 1.6], not having a fixed salary (RR = 1.9), and low demands in relation to competence (RR = 1.5) were the strongest risk indicators obtained in analyses stratified for age and previous symptoms. Among women, repetitive hand or finger movements (RR = 1.6), constrained sitting (RR = 1.6), not having a fixed salary (RR = 2.0), and solitary work (RR = 1.8) were the strongest risk indicators. A large proportion of the general population was exposed to several of these moderately harmful conditions, and their concomitant effect may explain the high incidence of neck and shoulder disorders in the general working population.     

Chronic neck and shoulder pain,age, and working conditions: longitudinal results from a large random sample in France

Aims: To analyse the effects of age and occupational factors on both the incidence and the disappearance of chronic neck and shoulder pain after a five year follow up period.

Methods: A prospective longitudinal investigation (ESTEV) was carried out in 1990 and 1995 in seven regions of France. A random sample of male and female workers born in 1938, 1943, 1948, and 1953 was selected from the occupational physicians' files. In 1990, 21 378 subjects were interviewed (88% of those contacted), and 87% were interviewed again in 1995. Chronic neck and shoulder pain satisfying specific criteria, and psychosocial working conditions were investigated by a structured self administered questionnaire and a clinical examination.

Results: Prevalence (men 7.8%, women 14.8% in 1990) and incidence (men 7.3%, women 12.5% for the period 1990–95) of chronic neck and shoulder pain increased with age, and were more frequent among women than men in every birth cohort. The disappearance rate of chronic neck and shoulder pain decreased with age. Some adverse working conditions (repetitive work under time constraints, awkward work for men, repetitive work for women) contributed to the development of these disorders, independently of age. Psychosocial factors seemed to play a role in both the development and disappearance of chronic neck and shoulder pain. Data did not show specific interactions between age and working conditions.

Conclusions: The aging of the workforce appears to contribute to the widespread concern about chronic neck and shoulder pain. A better understanding of work activity regulation of older workers can open up new preventive prospects.

     

Work-related psychosocial and mechanical risk factors for neck/shoulder pain: a 3-year follow-up study of the general working population in Norway

Purpose

This study examines the impact of work-related psychosocial and mechanical exposure on the development of neck/shoulder pain in the general working population.

Methods

A randomly drawn cohort from the general population in Norway aged 18–66 was followed up for 3 years (n = 12,550, response rate = 67 %). Eligible respondents were in paid work during the reference week in 2006 and 2009, or temporarily absent from such work (n = 6,745). Four work-related psychosocial factors and six mechanical exposures were measured. Outcomes of interest were moderate or severe neck/shoulder pain at follow-up adjusted for baseline neck/shoulder pain.

Results

In total, 16.9 % (1,138 individuals) reported neck/shoulder pain during the last month at follow-up. Work related psychosocial predictors of neck/shoulder pain were high job demands (highest OR 1.41, 95 % CI 1.11–1.78) and low levels of supportive leadership (highest OR 1.66, 95 % CI 1.08–2.54). Mechanical factors were neck flexion (highest OR 1.77, 95 % CI 1.31–2.39) and lifting in awkward postures (highest OR 1.81, 95 % CI 1.21–2.71). The estimated population risk attributable to these factors was about 23 %. The relative risk for neck/shoulder pain associated with psychosocial exposure was slightly influenced by adjustment for physical risk factors, and vice versa. There was no substantial confounding related to age, gender, education, occupation or psychological distress.

Conclusions

Highly demanding jobs, neck flexion and awkward lifting appear as the most important predictors of neck/shoulder pain.     

Risk factors for neck and shoulder disorders: a nested case-control study covering a 24-year period

BACKGROUND: In 1969 a population-based study was conducted in the Stockholm region. From the 2,579 randomly selected participants (18-65 years of age in 1969), the youngest subset were asked to participate in a reexamination in 1993. Information regarding working conditions, conditions outside work, and neck and shoulder disorders was collected retrospectively for the period 1970-1993. METHODS: Of 783 eligible subjects (42-59 years of age in 1993), 484 responded. Cases of neck/shoulder disorders were defined by past sick leave or medical attention or recent symptoms, depending on available information. For each case (n = 271) two controls were randomly selected, matched by age and gender. Variables regarding both physical and psychosocial conditions were included in the matched analyses. RESULTS: Among women mainly psychosocial factors and among men mainly physical factors were associated with neck/shoulder disorders. The only gender common risk indicator found was repetitive hand work (OR approximately 1.5). Interactive effects were also observed. CONCLUSIONS: The impact on neck/shoulder disorders from separate factors was moderate but combinations of physical and psychosocial factors, as well as of work-related and non-work-related factors, produced relative risks above 2.     

Antecedents and consequences of work-family conflict: a prospective cohort study

This study examined both risk factors for the onset of work-family conflict and consequences in terms of need for recovery and prolonged fatigue for men and women separately. Two-year follow-up data from the Maastricht Cohort Study on "Fatigue at Work" (n = 12,095) were used. At baseline, the prevalence of work-family conflict was 10.8% (9.0% in women; 11.1% in men), the cumulative incidence at 1 year follow-up was 5.1%. For men, several work-related demands, shift work, job insecurity, conflicts with coworkers or supervisor, having full responsibility for housekeeping, and having to care for a chronically ill child or other family member at home were risk factors for the onset of work-family conflict, whereas decision latitude and coworker and supervisor social support protected against work-family conflict. In women, physical demands, overtime work, commuting time to work, and having dependent children were risk factors for work-family conflict, whereas domestic help protected against work-family conflict at 1 year follow-up. Work-family conflict was further shown to be a strong risk factor for the onset of elevated need for recovery from work and fatigue.     

Work-related risk factors for the incidence and recurrence of shoulder and neck complaints among nursing-home and elderly-care workers

OBJECTIVES: This study assessed the differences and similarities in the incidence and recurrence of shoulder and neck complaints with respect to work-related physical, psychosocial, and personal risk factors. METHODS: A prospective cohort study was carried out among 769 workers of nursing homes and homes for the elderly. At baseline, a questionnaire was used to collect data on personal characteristics, physical workload, psychosocial workload, and the presence of shoulder and neck complaints. After 1 and 2 years, follow-up data were collected on shoulder and neck complaints. Generalized estimation equations were used for analyzing risk factors for the participants with at least one follow-up measurement available (N=556, 72%). RESULTS: In the multivariate model, adjusted for age and gender, obesity [odds ratio (OR) 2.12, 95% confidence interval (95%CI) 1.23-3.65] was related to the incidence of shoulder complaints. The incidence of neck complaints was increased for obesity (OR 1.81, 95% CI 1.07-3.05), work in awkward postures (OR 1.76, 95% CI 1.11-2.78), and poor or fair general health (OR 1.53, 95% CI 1.02-2.31). The recurrence of both shoulder and neck complaints was associated with chronic complaints at baseline (shoulder: OR 1.91, 95% 1.36-2.67; neck: OR 1.71, 95% 1.14-2.55) but not with work-related risk factors. CONCLUSIONS: The results suggest that there are differences in risk factors for the incidence and recurrence of shoulder and neck complaints.     

Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malm? shoulder and neck study cohort

STUDY OBJECTIVE: To assess the impact of mechanical exposure and work related psychosocial factors on shoulder and neck pain. DESIGN: A prospective cohort study. PARTICIPANTS: 4919 randomly chosen, vocationally active men and women ages 45-65 residing in a Swedish city. Neck and shoulder pain were determined by the standardised Nordic questionnaire. Mechanical exposure was assessed by an index based on 11 items designed and evaluated for shoulder and neck disorders. Work related psychosocial factors were measured by the Karasek and Theorell demand-control instrument. MAIN RESULTS: High mechanical exposure was associated with heightened risk for shoulder and neck pain among men and women during follow up. Age adjusted odds ratios (OR) were 2.17 (95% confidence intervals (CI): 1.65, 2.85) and 1.59 (95% CI: 1.22, 2.06), respectively. In women, job strain (high psychological job demands and low job decision latitude) correlated with heightened risk (OR = 1.73, 95% CI: 1.29, 2.31). These risk estimates remained statistically significant when controlled for high mechanical exposure regarding job strain (and vice versa), and for sociodemographic factors. Testing for effect modification between high mechanical exposure and job strain showed them acting synergistically only in women. CONCLUSION: Job related mechanical exposure in both sexes, and psychosocial factors in women, seem independently of each other to play a part for development of shoulder and neck pain in vocationally active people. The effect of psychosocial factors was more prominent in women, which could be the result of biological factors as well as gender issues. These results suggest that interventions aiming at reducing the occurrence of shoulder and neck pain should include both mechanical and psychosocial factors.     

Basis for a Functional Capacity Evaluation Methodology for Patients with Work-related Neck Disorders

Background Neck pain is a common musculoskeletal complaint and a relationship with reduced work-related functional capacity is assumed. A validated instrument to test functional capacity of patients with neck pain is unavailable. The objective of this study was to develop a Functional Capacity Evaluation (FCE), which is content valid for determining functional capacity in patients with work related neck disorders (WRND). Methods A review of epidemiological review literature was conducted to identify physical risk factors for WRND. Results Evidence was found that physical risk factors contribute in development of WRND. Physical risk factors were related to repetitive movements, forceful movements, awkward positions and static contractions of the neck or the neck/shoulder region. An FCE was designed based on the risk factors identified. Eight tests were selected to cover all risk factors: repetitive side reaching, repetitive reaching overhead, static overhead work, front carry, forward static bend neck, overhead lift and the neck strength test. Content validity of this FCE was established by providing the rationale, specific objectives and operational definitions of the FCE. Conclusions Further research is needed to establish reliability and other aspects of validity of the neck-FCE.     

Factors affecting work-related shoulder pain

Background Work-related shoulder pain is a common problem. Ergonomic factors in the workplace are thought to be important but a number of other factors have also been associated with shoulder pain. Aims To identify risk factors for work-related shoulder pain in Alberta, focusing particularly on ergonomic risk factors. Methods A case referent design was used to compare individuals who made a Workers' Compensation Board (WCB) claim for work-related shoulder pain with individuals who made a claim for other types of injury. Data were collected using a postal questionnaire and analysed by logistic regression. Results There were 1263 participants (562 cases, 701 referents). The participation rate was 25% among cases and 21% among referents (P < 0.01). Factors associated with an increased likelihood of claim for shoulder injury included lifting ≥10kg above shoulder height for ≥15min per day, shoulder pain in the month prior to injury, working in the 'Government, education, and health services' industry sector and being occasionally/never satisfied with support from colleagues. Conclusions These results support the importance of ergonomic factors in work-related shoulder pain claims, particularly the lifting of weights above shoulder level for even short periods. Relatively simple ergonomic measures, such as restricting above shoulder lifting, could be adopted with the aim of reducing the risk of shoulder injury at work.     

Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?

OBJECTIVES: This study investigates whether an imbalance between physical capacity and exposure to work-related physical factors is associated with low-back, neck, or shoulder pain. METHODS: Data of the longitudinal study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), with a follow-up of 3 years (N=1789), were used. At baseline, physical capacity (isokinetic lifting strength, static muscle endurance, and mobility of the spine) and exposure to work-related physical factors were assessed. During the follow-up, low-back, neck, and shoulder pain were self-reported annually. "Imbalance" was defined as lower than median capacity combined with higher than median exposure, "high balance" was high capacity and high exposure, and "low balance" was low capacity and low exposure. RESULTS: For both the low-back and neck, imbalance between static endurance and working with flexed postures was a risk factor for pain [relative risk (RR) 1.35, 95% confidence interval (95% CI) 1.08-1.68, and RR 1.36, 95% CI 0.96-1.91, respectively]. Low balance was also associated with low-back pain (RR 1.29, 95% CI 1.04-1.68). Furthermore, low balance between isokinetic lifting strength and lifting exposure was a risk factor for low-back and neck pain [RR between 1.22 (95% CI 0.99-1.49) and 1.35 (95% CI 1.03-1.79)]. No associations were found with shoulder pain. CONCLUSIONS: Some relationship between low-back and neck pain and combined measures of physical capacity with exposure to work-related physical factors seems to exist, but an imbalance between physical capacity and exposure was not found to yield higher risks than high balance or low balance.     

Prevalence of musculoskeletal pain and associated factors in the Quebec working population

Background: While the determinants of musculoskeletal pain are numerous, few studies conducted among workers have taken into account, altogether, physical factors, psychosocial factors (personal and work-related) and individual characteristics. Objectives: To estimate the 1-year prevalence of musculoskeletal pain in the Quebec working population by gender and anatomical site, and to determine which factors are associated with these prevalence figures. Methods: Data came from the 1998 Quebec Health Survey and included 9,496 individuals. One-year period prevalences for neck pain, back pain and pain in the upper and lower extremities were calculated for men and women. Logistic regression analyses were conducted to estimate the associations between individual, physical and psychosocial work factors, on one hand, and musculoskeletal pain in the four body regions, on the other hand. Results: For both genders back pain was the most frequent musculoskeletal symptom that had disturbed their activities during the past year. The largest difference between genders was observed for neck pain (women: 18%; men: 11%). Multivariate analyses indicated that physical and psychosocial work factors, as well as psychological variables, were associated with musculoskeletal pain in different body regions. Body mass index was associated only with pain in lower extremities for both genders. Conclusions: The results of this study suggest that interventions aimed at reducing musculoskeletal pain should take into account personal and work-related psychosocial variables, in addition to physical workload.     

Associations of length of employment and working conditions with neck,shoulder and arm pain among nursery school teachers

A cross-sectional questionnaire study was carried out on nursery school (NS) teachers in public nursery schools in N city in Japan to determine the magnitude of associations of probable risk factors with neck, shoulder, and arm pain, adjusting for potential confounders in logistic regression models. Of 1438 subjects, responded to the questionnaire, 959 NS teachers in charge of a separate or mixed group of children were subjected to analyses. Prevalence of neck and/or shoulder pain was 33.6%-35.4% in NS teachers in charge of children aged 0, 0-1, 4, and 5 in contrast to 25.0-29.8% in those in charge of children aged 1,2, and 3. The prevalence of neck/shoulder pain tended to increase with the length of employment in all groups classified according to the age of children under care. In a logistic regression model that simultaneously adjusted demographic and personal variables, length of employment and care for children aged 0 in the workplace were found significantly associated with musculoskeletal pain. In further logistic models, pain in the neck/shoulders and arms had associations with some specific variables: care for children aged 0, holding/lifting a child/material, overwork, and poorly supported job situations. The odds ratios for those variables varied from 1.37 to 2.41. This results suggest that pain in the neck/shoulders and arms is induced by a wide variety of risk factors in NS teachers that include high physical workload, long working hours, job demand-support imbalance, and cumulative influence of workloads.     

A case-control study of psycholotical and psychosocial risk factors for shoulder and neck pain at the workplace

Risk factors associated with work-related shoulder and neck myalgia were investigated in a case-control study with pairs matched for age, gender, and physical exposure. Guided interviews with standardized and self-constructed questionnaires were performed among manual (n = 15 pairs) and office (n = 24 pairs) workers. Perceived general tension was the variable with the strongest association with shoulder and neck pain in both work groups. Otherwise, the results in the two groups were very different, indicating that different risk factors and mechanisms were associated with shoulder and neck pain in the two work groups. The study provides background information for future attempts to establish causal relationships between physical and psychosocial exposure and shoulder and neck pain, which can be more accurately investigated in a longitudinal rather than a cross-sectional experimental design.     

Work-related disease in general practice: a systematic review

OBJECTIVES: The objective was to answer the following questions: What is the prevalence of potentially work-related diseases in the general practice population? What is the incidence of consulting a GP for a potentially work-related disease? What is the relationship between diseases seen in general practice and work ability? METHODS: Cochrane standards and QUOROM principals were used. For this systematic review the available literature was identified in a computerized search of the bibliographical databases Medline, Embase and Osh-rom. A total of 22 publications (24 studies) met the inclusion criteria. RESULTS: In the general practice population high prevalence rates of potentially work-related diseases were found for low back pain, neck pain and shoulder pain. Incidence rates of consulting a GP for a potentially work-related disease were high also. Musculoskeletal disorders were the main reasons for work-related consultations in general practice. Work-related diseases can affect work ability. CONCLUSIONS: Work-related diseases are common, given the high incidence and prevalence of potentially work-related diseases found in the general practice population and seen by the GP. This review underlines the important role of GPs in identifying and managing work-related diseases. GPs should consider the work factor and pay special attention to the effects of work on health, because patients often link their work with their illness.     

Work-related musculoskeletal symptoms among sheet metal workers

We report results of two pilot studies of the relationship between musculoskeletal disorders and work tasks in sheet metal workers. These two studies were undertaken as pilot investigations to determine if symptoms of carpal tunnel syndrome or other work-related musculoskeletal symptoms are present in sheet metal workers, and to determine if we could begin to identify the factors in sheet metal work that cause them. In the first study, telephone interviews were conducted with 18 disabled sheet metal workers; the second survey entailed self-administered questionnaires completed by 47 active and retired sheet metal workers. Among the disabled workers, rotator cuff cases reported the greatest percent of time spent hanging duct, an overhead task commonly carried out during field work. Carpal tunnel cases reported more hand tool use than the rotator cuff cases. The questionnaire survey of active and retired workers found the proportion of time spent in a sheet metal shop (contrasted with field work) to be positively associated with hand symptoms; sheet metal workers who spent at least 65% of their time in the shop had an odds ratio of 3.4 for symptomatic hand cumulative trauma disorder (CTD) (p = 0.12). The proportion of time spent hanging duct was positively associated with both neck and shoulder symptoms, with odds ratios of 7.9 (p = 0.08) and 2.7 (p = 0.16), respectively. The results show that symptoms of neck, arm, and hand pain are common in sheet metal workers who are actively working, that carpal tunnel syndrome or hand pain is positively associated with more time spent working in the shop, and that shoulder pain or shoulder injuries is associated with work overhead (hanging duct). Ergonomic risks and cumulative trauma disorders have not been well characterized in the construction industry; these data strongly suggest that a subset of work tasks in construction increase the risk of cumulative trauma disorders.     

Life events and the risk of low back and neck/shoulder pain of the kind people are seeking care for: results from the MUSIC-Norrtalje case-control study

OBJECTIVE: To expand the knowledge about the occurrence of life events, and how they affect the risk of low back and neck/shoulder pain. DESIGN: A population-based case-control study. SETTING: Men and women 20-59-years old, living in and not working outside the municipality of Norrt?lje, Sweden, from November 1993 to November 1997. PARTICIPANTS: Cases (n = 1,148) were defined as all subjects from the study base who sought healthcare for a new episode of low back and/or neck/shoulder pain by any of the care givers in the municipality. Controls (n = 1,700) were selected as a stratified random sample from the study base, considering sex and age. Study subjects were interviewed about life events and critical life changes. Critical life changes were defined as events that brought about a marked psychosocial change. Odds ratios (ORs) associated with different numbers of life events or critical life changes were calculated. RESULTS: Having experienced at least two life events during the preceding 5 years was associated with an increased risk of neck/shoulder pain (OR = 1.6, 95% CI 1.1 to 2.4). At least two critical life changes were associated with an increased risk of neck/shoulder pain (OR = 1.9, 95% CI 1.3 to 2.7). In general, no associations were observed in relation to risk of low back pain. CONCLUSION: Life events and critical life changes are of importance for the risk of neck/shoulder pain of the kind that people are seeking care for. The study provides useful information for clinical practice and for future aetiological research on neck/shoulder pain.     

Fish processing work: the impact of two sex dependent exposure profiles on musculoskeletal health

OBJECTIVES: To evaluate the impact of work tasks, physical exposure, and psychosocial factors on the risk of musculoskeletal disorders in men and women, in a defined industrial setting. METHODS: 116 male and 206 female fish industry workers were compared with 129 men and 208 women with more varied work. Physical and psychosocial work load as well as musculoskeletal complaints were recorded by a questionnaire. A physical examination was performed and an observation method was used for work evaluation. 196 male and 322 female former fish processing workers received a postal questionnaire. RESULTS: The women workers in the fish industry had worse working conditions than the men for repetitiveness, constrained neck postures, and psychosocial work environment. They also had higher prevalences of complaints of the neck and shoulder (prevalence odds ratio (POR) 1.9; 95% confidence interval (95% CI) 1.1 to 3.2), neck and shoulder and elbow and hand complaints (POR 2.9; 95% CI 1.8 to 4.7 and POR 2.8; 95% CI 1.6 to 4.7, respectively). The women more often than the men left the industry because of neck and upper limb complaints. Also, women in other work had a higher prevalence of complaints of the neck and shoulder (POR 2.3; 95% CI 1.1 to 5.1) than the men. The men in the fish processing industry had a higher prevalence of complaints of the neck and shoulder than the men in other work (POR 3.6; 95% CI 1.6 to 8.0). This difference was not shown up by the questionnaire. CONCLUSIONS: Despite superficially similar work, there were clear sex differences in physical exposure and psychosocial work environment. Work in the fish processing industry was associated with a high risk of neck and upper limb disorders in women, which was probably mainly due to their extremely repetitive work tasks; the corresponding men had less repetitive work and less disorders. Also, a healthy worker effect on neck and upper limb disorders was found. The advantage of a physical examination compared with a questionnaire is clearly shown.

 

     

The prevalence of musculoskeletal complaints among women in Tijuana, Mexico: sociodemographic and occupational risk factors

The authors interviewed an age- and occupation-stratified sample of 466 women, aged 18-40, from 12 Tijuana neighborhoods, about sociodemographic characteristics, work and reproductive history, and musculoskeletal complaints. A total of 29.8% reported experiencing aches or pain in the low back, 38.3% in the upper back, 26.4% in the neck/shoulders, 18.2% in the hand/wrist, and 28.3% in the legs in the preceding year. Both sociodemographic and occupational factors were associated with these complaints. Very low educational attainment, having substandard housing, being the head of household, and being a migrant were each associated with an increased prevalence of one or more musculoskeletal complaints. In general, working outside the home increased the risk of musculoskeletal complaints. Compared with women who had not worked in the preceding 30-month period, those working in the maquiladora had 40-90% higher risks of upper back, neck/shoulder, and hand/wrist pain. Compared with women working outside the maquiladora, maquiladora women workers had 20% higher risks of low back, upper back, and neck/shoulder complaints. More detailed studies of the incidences of musculoskeletal disorders and of specific etiologic risk factors within the maquiladora industry are warranted. Future studies should concurrently evaluate sociodemographic risk factors.     

Work-related musculoskeletal problems among women workers in the semiconductor industry in Peninsular Malaysia

A cross-sectional study to identify the prevalence of musculoskeletal problems and work-related risk factors was conducted among 906 women semiconductor workers. Highest prevalences were pain in the lower limbs, neck/shoulders, and upper back, and highest exposures were prolonged (> or = four hours per workshift) hand/wrist movement, standing, and lifting with hands. After logistic regression, lower-limb pain was significantly associated with standing, neck/shoulder pain with sitting and lifting, upper-back pain with climbing steps, low back pain with hand/wrist movement, and hand/wrist pain with lifting. Neck/shoulder pain was significantly higher for workers with shorter working durations, while lower-limb pain was significantly higher for workers with longer working durations. End-of-line assembly workers had significantly higher odds ratios for pain at all sites, while middle-of-line workers had higher odds ratios for pain in neck/shoulders and upper back, and wafer-fabrication workers had higher odds ratios for pain in low back and lower limbs.