Prevalence of musculoskeletal symptoms and associated factors among metal industry workers in Canoas--RS

Workers health is a field of community health that has opened spaces for identifying and preventing work-related diseases, especially musculoskeletal disorders in view of their extent and magnitude. We conducted thus a cross-sectional study in the biggest metal industry in the city of Canoas--RS, aimed at identifying the musculoskeletal symptoms of a group of metal industry workers and the association of these symptoms with socio-demographic and occupational variables. Two questionnaires were employed for gathering data: the first one was used to collect information on demographic and occupational variables and individual life habits and the second for identifying the prevalence of musculoskeletal symptoms (Nordic Musculoskeletal Questionnaire). Results showed that 75.2 % of the workers had related some kind of musculoskeletal symptom during the last 12 months, 53.3% during the last 7 days and 38.5% had already taken a time off due to this problem. There was also an association between the musculoskeletal symptom and the variables sex, age, occupation and educational level. We conclude that there is a high prevalence of work-related musculoskeletal disorders among workers, calling for preventive actions and health promotion in the work environment.     

Work-Related Musculoskeletal Disorders: Design as a Prevention Strategy. A Review

Work-related musculoskeletal disorders are of serious concern to many organizations, including industry, insurance, and health care. They are also of immediate concern to the workers and their families who are adversely affected by these disorders. Work-related musculoskeletal disorders are a substantial source of economic drain to these organizations. Sources of this drain include economic losses incurred from lost or decreased productivity as well as medical treatment and indemnity costs. Therefore, it is within the best interest of these organizations to prevent work-related musculoskeletal disorders from occurring, before they manifest into serious issues of medical, social, and economic concern. The purpose of this paper is to review the concept of work-related musculoskeletal disorders and discuss the basis of their prevention as a primary means of occupational injury and illness management. The principal contributory role of ergonomics/human factors is presented as a viable means of prevention and an important contributor to the comprehensive management of these disorders.     

Incidence of ulnar nerve entrapment at the elbow in repetitive work

OBJECTIVES: Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work. METHODS: In 1993-1994 and 3 years later, 598 workers whose jobs involved repetitive work underwent an examination by their occupational health physicians and completed a self-administered questionnaire. Predictive factors associated with the onset of ulnar nerve entrapment at the elbow were studied with bivariate and multivariate analyses. RESULTS: The annual incidence was estimated at 0.8% per person-year, on the basis of 15 new cases during the 3-year period. Holding a tool in position was the only predictive biomechanical factor [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.4-12.0]. Obesity increased the risk of ulnar nerve entrapment at the elbow (OR 4.3, 95% CI 1.2-16.2), as did the presence of medial epicondylitis, carpal tunnel syndrome, radial tunnel syndrome, and cervicobrachial neuralgia. The associations with "holding a tool in position" and obesity were unchanged when the presence of other diagnoses was taken into account. CONCLUSIONS: Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially medial epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes).     

参与式工效学在预防工作相关肌肉骨骼疾患中的应用

工作相关肌肉骨骼疾患是一种慢性非致死性疾病,是职业人群常见的健康问题,尤其在劳动密集型行业。在国外,参与式工效学已广泛应用于工作场所中肌肉骨骼疾患的预防。本文依据参与式工效学的组织、实施及其影响因素和特点,介绍参与式工效学在预防肌肉骨骼疾患中的应用。参与式工效学方式可帮助工人识别作业过程中的危险因素并制定相应的干预方案。企业可通过开展参与式工效学项目改善工作条件、减少肌肉骨骼疾患相关危险因素的暴露及预防相关疾患的发生,以促进职工健康。     

Results from a Community-based Occupational Health Survey of Vietnamese-American Nail Salon Workers

A community-university collaborative partnership assessed self-reported work-related health effects and environmental factors in Boston's Vietnamese immigrant community via an interviewer-assisted survey. Seventy-one nail technicians responded. Musculoskeletal disorders, skin problems, respiratory irritation and headaches were commonly reported as work-related, as were poor air quality, dusts and offensive odors. The reporting of a work-related respiratory symptom was significantly associated with the reporting of exposure factors such as poorer air quality. Absence of skin disorders was associated with glove use and musculoskeletal symptoms were associated with years worked as a nail technician. Work-related health effects may be common in nail salon work. Chemical and musculoskeletal hazards should be reduced through product and equipment redesign.     

Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

Background

High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD

Method

Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression.

Result

A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry.

Conclusion

Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.     

Occupational health and safety policy and psychosocial risks in Europe: The role of stakeholders’ perceptions

Introduction

Psychosocial risks are now largely acknowledged throughout Europe as important challenges in occupational health and safety. However, there appear to be wide gaps in perception between experts and the general population on the nature and the relevance of psychosocial risks that have a potential impact on policy development and implementation in this area.

Methods

This study investigated the level of knowledge among European stakeholders, of legislation on occupational safety and health, focusing particularly on psychosocial risk factors. 75 members of employers’ associations, trade unions and government institutions from 21 countries in the European Union (EU) participated in the study. In addition, to further elaborate the findings of the survey, focus groups were organised during a 2-day stakeholder workshop.

Results

The level of application of European Directive 89/391 for the assessment and management of psychosocial risks and work-related stress was largely reported by the stakeholders as inadequate. This opinion was more marked in the new EU27 countries than the older EU15, and the difference was significant as regards the impact of the Directive on the assessment and management of psychosocial risks. Overall, psychosocial risks and work-related stress were reported to be important occupational health and safety concerns; however there were important differences among stakeholders in different countries.

Conclusions

Despite the development of knowledge and activities on both the policy and practice levels in recent years, further work is still needed to harmonize stakeholder perceptions in this area in the various EU member states.     

Prevalence of musculoskeletal disorders in nursing professionals

A cross-sectional study estimated the prevalence of work-related musculoskeletal disorders among nursing assistants in Salvador, Bahia. Three hundred and eight workers, randomly selected, answered a questionnaire applied by trained interviewers during working hours. The majority of respondents worked the day shift and did not usually work overtime. About 34% reported having another regular job. Average time in the formal or informal labor market was 19 years. There was high occupational exposure to repetitive hand movements, standing posture, walking, inadequate postures of the trunk and manual handling of loads. The prevalence of work-related musculoskeletal disorders in at least one body segment was 83.4%.The most affected body segments were: low back (53.9%), legs (51.9%), neck (36.4%), upper back (35.7%) and shoulders (33.8%). There was high prevalence of work-related musculoskeletal disorders in the studied population, which points out to the need for improvements in the working conditions of those professionals.     

Musculoskeletal disorders and comorbid depression: implications for practice

Background:  The physical demands of work have a substantial impact on the incidence of work-related musculoskeletal disorders. Depression is often associated with work-related injuries and may influence a person's success or otherwise return to work. There is pressure for occupational rehabilitation providers to produce good return-to-work outcomes in a timely and financially responsible manner. The aim was to examine current evidence for any added impact of depression on return-to-work prospects among people with work-related musculoskeletal disorders.
Methods:  A review of the literature was conducted to determine the extent to which depression comorbid with musculoskeletal disorders affected labour force participation and the outcomes obtained in occupational rehabilitation.
Results:  Australian population level data show that people of working age with depression comorbid with musculoskeletal disorders have extensive labour force disadvantage and reduced return-to-work outcomes when participating in occupational rehabilitation.
Conclusions:  Although more research is needed, there is already sufficient evidence to support the introduction of systems and practices to detect and integrate treatment for comorbid depression in order to prevent occupational rehabilitation failure.     

The impact of work-related musculoskeletal disorders on workers' caregiving activities

BACKGROUND: The purpose of the study was to describe and quantify the impact of work-related musculoskeletal disorders on workers' caregiving activities. METHODS: A cross-sectional study was conducted in which a telephone survey was administered to 187 lost-time workers' compensation claimants from Ontario, of whom 49.2% were women. Forty-eight percent of the injured workers were providing unpaid care prior to the injury. RESULTS: Injured workers providing caregiving reported an average reduction in time spent in caregiving activities of 5.5 hr/week, 8 months post-injury. A Sex X Return-to-work status ANCOVA was conducted with difference in caregiving hours as the dependent variable, and with the following covariates: Mean number of caregiving hours, comorbidities, site of injury, and education. Independent of weekly hours of caregiving, decreases in caregiving hours were significantly higher if the worker was a woman or had not returned to work. CONCLUSIONS: Work-related musculoskeletal disorders have a significant impact on workers' time spent in unpaid caregiving activities, an example of the social consequences of occupational injuries. Occupational and caregiving roles are limited by work-related disorders in a parallel fashion.     

Work-related musculoskeletal disorders in Norway's offshore petroleum industry

BACKGROUND: Since 1992, physicians have reported work-related diseases among workers in Norway's offshore petroleum industry to the Petroleum Safety Authority, as required by law. AIMS: To analyse the number of reported work-related musculoskeletal disorders and risk factors (occupation and reported exposure) from 1992 to 2003. METHODS: Data from the Petroleum Safety Authority's registry of work-related diseases were analysed. RESULTS: During the 12 years, 3131 new work-related musculoskeletal disorders were reported and this was the category of work-related disease most frequently reported (47%). The number of work-related musculoskeletal disorders varied substantially from year to year. Disorders of the upper limb accounted for 53% and back disorders for 20% of all work-related musculoskeletal disorders. Lower limb disorders accounted for 16%, of which knee disorders dominated (12% of all cases). The dominant occupational categories were maintenance work (40%) and catering (21%). Frequently reported types of exposure were high physical workload, repetitive work and walking on hard surfaces/climbing stairs and ladders. CONCLUSION: Strategies for preventing musculoskeletal disorders should be carried out to reduce the burden of high physical workload and repetitive work, especially in maintenance work and catering. Further research is recommended on the association between walking on hard surfaces/climbing stairs and ladders and knee disorders. Reporting routines need to be improved to monitor trends over time and to assess the effects of interventions.     

Global estimates of fatal work-related diseases

BACKGROUND: Work-related mortality is a relatively new concept which aims to widen occupational health and safety; to take into account not only recognized fatal occupational accidents and diseases but also other work-related deaths. Few countries in the world have a register for work-related diseases. METHODS: Estimates are calculated using baseline world mortality scenarios of all diseases for the year 2000 and attributable fractions made for work-related diseases in Finland, as adjusted. RESULTS: It is estimated that about 2 million work-related deaths take place annually. Men suffer two thirds of those deaths. The biggest groups of work-related diseases are cancers, circulatory diseases and communicable diseases. CONCLUSIONS: Information about work-related diseases is needed for prevention, as people in developed countries are working longer, and the age of retirement is being raised in many countries. As a result, workers are being exposed to different kinds of substances and working conditions for a longer time. In developing countries, work exposures may already start in infancy. Due to industrialization, workers in developing countries are facing new conditions with a lack of relevant knowledge and skills. With the help of information, nations can direct resources and skills for appropriate purposes such as regulatory measures on health and safety at work.     

Work-Related Primary Care in Occupational Health Physician’s Practice

Introduction Primary care is frequently integrated in Finnish occupational health services (OHS). This study examines the frequency of work-related health problems in occupational health (OH) physicians’ consultations for primary care and associations between health problems and interventions carried out by OH physicians. Methods OH physicians assessed the health problems of 651 consecutive visits in a private OHS unit. The health problem was regarded as work-related if it was caused or aggravated by work, or involved impaired work ability. Interventions carried out by OH physicians were analysed by logistic regression analysis. Results The main health problem was caused either partially or mainly by work or symptoms were worsened by work (27%), or symptoms impaired work ability (52%). Musculoskeletal and mental disorders were the main work-related reasons for visits. In two-thirds of the cases of mental health problems, work caused or worsened symptoms, and the majority of long sickness absences were issued due to these problems. OH physicians carried out interventions concerning work or workplace in 21% of visits. Mental disorders were associated most strongly (OR 7.23, 95% CI 3.93–13.32) with interventions. The strongest association (OR 16.09, 95% CI 9.29–27.87) with work-related visits was, when the health problem was both work-induced and impaired work ability. Conclusions Work-related health problems comprise a considerable part of Finnish OH physicians’ work. OH physicians play an important role in early treatment, in the prevention of disability, and in interventions aimed at workplaces based on the knowledge they get through primary care in OHS.     

Modeling the economic burden of diseases imputable to stress at work

This study evaluated the costs of work-related stress in France. Three illnesses—cardiovascular diseases, depression, musculoskeletal diseases and back pain—that may result from exposure to stress are identified and the proportions of cases attributable to the risk factor are calculated from epidemiological studies. Two methodological hypotheses allow us to provide complementary evaluations of the social cost of occupational stress and raise the ethical questions inherent in the choice of methodology. For the year 2000 our model shows that of a working population of 23.53 million in France some 310,000–393,400 persons (1.3–1.7%) were affected by illnesses attributable to work-related stress, and that 2,300–3,600 persons died as a result of their illness. Work-related stress costs society between €1,167 million and €1,975 million in France, or 14.4–24.2% of the total spending of social security occupational illnesses and work injuries branch.     

Ergonomics in Modern Dairy Practice: A Review of Current Issues and Research Needs

ABSTRACT

Dairy farming is an ancient occupation. Traditionally, cows have been manually milked while tethered in stalls or stanchions. In the latter half of the 20th century as machine milking emerged, the parlor milking system has become more popular, especially among larger dairy farms. The transition from manual milking to automatic milking systems as well as the transition from stanchion to parlor milking systems involved a dramatic change in milking tasks. These transitions have resulted in changing patterns of occupational exposure to risk factors for work-related musculoskeletal disorders among dairy workers. However, aspects of the milking task such as sanitization of teats, stripping milk from teats, and attachment and detachment of milking equipment have remained relatively the same. Work-related musculoskeletal symptoms have been reported in the low back, shoulders, hands/wrists, and knees. Research that has measured exposures to risk factors for work-related musculoskeletal disorders among dairy farm workers has been limited, especially when using ergonomic tools to directly measure exposure, such as electrogoniometry or electromyography. Self-reported exposure measures have been most commonly used. The interventions that have been tested to reduce exposure to risk factors for work-related musculoskeletal disorders include assisted lift-hold devices, use of lighter-weight equipment, adjustable flooring, and use of rubber mats. However, research evaluating potential solutions to reduce dairy farm worker exposure to risk factors for musculoskeletal disorders is scarce. Future research efforts should further characterize hazards while simultaneously testing viable solutions that fit within the business model of the dairy farm industry.     

HBV- and HCV- infected workers in the Japanese workplace

Around three million Japanese are persistently infected with HBV or HCV. Though most of them work in various industries, little is known about the actual conditions in their workplaces. To clarify the workplace conditions of workers with hepatitis, three kinds of questionnaire surveys, answered by occupational health physicians and workers with hepatitis, were carried out. The rates of workers recognized as workers with hepatitis B or C by occupational health physicians were 0.82% and 0.48% of 130,092 workers, respectively. About 30% of workers with hepatitis were engaged in "hazardous work". The percentage of workers engaged in various types of hazardous work among workers with hepatitis was nearly the same as that among all Japanese workers. About 30% of occupational health physicians witnessed exacerbation of hepatitis in the workers at their workplaces, and 22% of workers with hepatitis experienced exacerbation of hepatitis. The rate of workers with hepatitis who had experienced exacerbation was not significantly different between workers with and without hazardous work. Workers with hepatitis have strong concerns about the relationship between work and exacerbation. As causes of exacerbation, occupational health physicians cited "unknown", "drinking" and "quit treatment" while workers with hepatitis answered "work-related causes", besides "unknown" and "drinking."     

Global Estimates of the Burden of Injury and Illness at Work in 2012

This article reviews the present indicators, trends, and recent solutions and strategies to tackle major global and country problems in safety and health at work. The article is based on the Yant Award Lecture of the American Industrial Hygiene Association (AIHA) at its 2013 Congress. We reviewed employment figures, mortality rates, occupational burden of disease and injuries, reported accidents, surveys on self-reported occupational illnesses and injuries, attributable fractions, national economic cost estimates of work-related injuries and ill health, and the most recent information on the problems from published papers, documents, and electronic data sources of international and regional organizations, in particular the International Labor Organization (ILO), World Health Organization (WHO), and European Union (EU), institutions, agencies, and public websites. We identified and analyzed successful solutions, programs, and strategies to reduce the work-related negative outcomes at various levels. Work-related illnesses that have a long latency period and are linked to ageing are clearly on the increase, while the number of occupational injuries has gone down in industrialized countries thanks to both better prevention and structural changes. We have estimated that globally there are 2.3 million deaths annually for reasons attributed to work. The biggest component is linked to work-related diseases, 2.0 million, and 0.3 million linked to occupational injuries. However, the division of these two factors varies depending on the level of development. In industrialized countries the share of deaths caused by occupational injuries and work-related communicable diseases is very low while non-communicable diseases are the overwhelming causes in those countries. Economic costs of work-related injury and illness vary between 1.8 and 6.0% of GDP in country estimates, the average being 4% according to the ILO. Singapore's economic costs were estimated to be equivalent to 3.2% of GDP based on a preliminary study. If economic losses would take into account involuntary early retirement then costs may be considerably higher, for example, in Finland up to 15% of GDP, while this estimate covers various disorders where work and working conditions may be just one factor of many or where work may aggravate the disease, injury, or disorders, such as traffic injuries, mental disorders, alcoholism, and genetically induced problems. Workplace health promotion, services, and safety and health management, however, may have a major preventive impact on those as well. Leadership and management at all levels, and engagement of workers are key issues in changing the workplace culture. Vision Zero is a useful concept and philosophy in gradually eliminating any harm at work. Legal and enforcement measures that themselves support companies and organizations need to be supplemented with economic justification and convincing arguments to reduce corner-cutting in risk management, and to avoid short- and long-term disabilities, premature retirement, and corporate closures due to mismanagement and poor and unsustainable work life. We consider that a new paradigm is needed where good work is not just considered a daily activity. We need to foster stable conditions and circumstances and sustainable work life where the objective is to maintain your health and work ability beyond the legal retirement age. We need safe and healthy work, for life.     

In search of a common European approach to a healthy indoor environment

Increasingly, policymakers in Europe and around the world are realizing the importance of healthy indoor environments for public health. Certain member states of the European Union (EU) have already achieved successes in improving indoor environmental quality, such as controlling certain contaminants (e.g., environmental tobacco smoke) or developing nationwide policies that address indoor air generally. However, a common European approach to achieving healthy indoor environments is desirable for several reasons including providing a broader recognition of the problem of unhealthy indoor air, setting a policy example for all 27 EU member states, and achieving greater public health equity across the different European nations. In this article we address the question "Why is it so difficult in the EU to develop a coherent approach on indoor environment?" We identify and describe four main barriers: a) the subsidiarity principle in EU policymaking, introducing decentralization of decision making to the member states; b) fragmentation of the topic of the indoor environment; c) the differences in climate and governance among different member states that make a common policy difficult; and d) economic issues. We discuss potential lessons and recommendations from EU and U.S. successes in achieving healthier indoor environments through various policy mechanisms.     

Occupational stress and work-related upper extremity disorders: concepts and models

BACKGROUND: While research has suggested that interventions targeted at occupational stress (job stress) factors may improve clinical and work outcomes related to work-related musculoskeletal disorders, the emerging hypotheses relating occupational stress to work-related upper extremity disorders (WRUEDs) are not particularly well known among occupational health providers and researchers. METHODS: Generic job stress and health models and multivariable models of WRUEDs were described and evaluated. RESULTS: Models on occupational stress and health/WRUEDs offer unique perspectives on the role of occupational stressors on WRUEDs. However, the limited support for the structure and proposed mechanisms of these models suggest that investigations examining and validating proposed biobehavioral pathways are still needed. DISCUSSION: Difficulties in conceptualizing occupational stress have, in the past, hindered its systematic incorporation into occupational health research and prevention/intervention strategies. The present paper provides a common basis for researchers and practitioners with diverse backgrounds to understand job stress and its relation to WRUEDs in order to enhance future efforts. Given the present limitations in the field and the need for comprehensive approaches to WRUEDs, there is great potential for occupational health researchers and clinicians to advance knowledge in this area.     

Global estimates of fatal work-related diseases by region and disease group, 2002

Work-related and occupational diseases are multifactorial diseases among the working population that have a heavy impact on workers, enterprises, and society. We calculated estimates for 2002, using global regional estimates of disease mortality, and adjusted attributable fractions produced for work-related diseases in Finland. The estimated number of fatal work-related diseases is about 2 million worldwide. The most common fatal work-related disease groups are cancers (25%), circulatory diseases (21%), and communicable diseases (28%). Though estimates of fatal work-related diseases have some limitations, they are needed for prevention.