Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain

Aims: To describe the presence of musculoskeletal co-morbidity of the neck and upper extremities among industrial workers with low back pain, and to examine whether it has an impact on healthcare utilisation and sickness absence for low back pain.

Methods: A self administered questionnaire was used to collect data from 505 industrial workers (response 86%).

Results: The 12 month prevalence of low back pain was 50%. Among subjects with low back pain the 12 month prevalence of musculoskeletal co-morbidity of the neck and upper extremities was 68%. Among workers with low back pain, subjects with high pain intensity or disabling low back pain were more likely to have musculoskeletal co-morbidity. In comparison to the subjects who report back pain only, subjects with co-morbidity showed worse general health and health related quality of life. No impact of upper extremity co-morbidity was found on healthcare utilisation, and sickness absence due to low back pain.

Conclusions: This study provides no evidence that musculoskeletal co-morbidity of the neck and upper extremities influences the choice to seek care or take sick leave due to low back pain among industrial manual workers. For occupational health practitioners the finding of a high co-morbidity is important to consider when implementing workplace interventions aimed at the reduction of specific musculoskeletal complaints, since the controls for one musculoskeletal complaint may impact adversely on another musculoskeletal complaint. Researchers who perform low back pain intervention studies using generic health measures, should take into account the impact of musculoskeletal co-morbidity on these measures.

     

广州市某啤酒制造厂工人颈肩背多部位肌肉骨骼疾患危险因素研究

目的 调查啤酒制造厂工人多部位工作相关肌肉骨骼疾患（work-related musculoskeletal disorders,WMSDs）的现状,并分析其影响因素。方法 采用横断面调查方法,于2021年9月以广州市某啤酒制造厂的501名员工为研究对象,使用中文版《肌肉骨骼疾患调查问卷》调查WMSDs患病现状,应用多因素logistic回归方法分析颈、肩、背多部位WMSDs的危险因素。结果 啤酒制造厂员工WMSDs总患病率达39.7%,其中各部位患病率较高的是颈部27.1%、肩部25.0%、下背部24.0%和上背部23.2%。工人单一部位WMSDs患病率为10.8%,多部位WMSDs患病率为28.9%,2个部位同时患病的比例是3.8%,3个部位同时患病的比例是4.4%,4个部位同时患病的比例是16.4%,5个及以上部位同时患病的比例为4.6%,其中颈、肩、上背、下背4个部位同时患病的比例为17.8%(89/501),上肢部位（肘部、手腕部）同时患病的比例为3.2%(16/501),下肢部位（腿部、膝部、踝部）同时患病的比例为2.2%(11/501)。多因素logistic回归分析结果...     

Prognostic factors for musculoskeletal sickness absence and return to work among welders and metal workers

OBJECTIVES: To analyse factors that determine the occurrence of sickness absence due to musculoskeletal problems and the time it takes to return to work. METHODS: A longitudinal study with two year follow up was conducted among 283 male welders and metal workers. The survey started with a standardised interview on the occurrence of musculoskeletal complaints. 61 (22%) workers were lost to follow up. Data on sickness absence among 222 workers during the follow up were collected from absence records and self reports. Regression analysis based on proportional hazards models was applied to identify risk factors for the occurrence and duration of sickness absence due to various musculoskeletal complaints. RESULTS: During the follow up 51% of the workers attributed at least one period of sickness absence to musculoskeletal complaints which accounted for 44% of all work days lost. A history of back pain was not associated with sickness absence for back pain, partly because subjects with back pain were more likely to be lost to follow up. Neck or shoulder pain and pain of the upper extremities contributed significantly to neck or shoulder absence (relative risk (RR) 3.35; 95% confidence interval (95% CI) 1.73 to 6.47) and to upper extremities absence (RR 2.29; 95% CI 1.17 to 4.46), respectively. Company and job title were also significant predictors for sickness absence due to these musculoskeletal complaints. Absence with musculoskeletal complaints was not associated with age, height, body mass index, smoking, and duration of employment. Return to work after neck or shoulder absence was worse among metal workers than welders (RR 2.12; 95% CI 1.08 to 4.17). Return to work after lower extremities absence was strongly influenced by visiting a physician (RR 11.31; 95% CI 2.94 to 43.46) and by musculoskeletal comorbidity (RR 2.81; 95% CI 1.18 to 6.73). CONCLUSIONS: Complaints of the neck or shoulder and upper extremities in the 12 months before the study were associated with sickness absence for these complaints during the follow up. Workers with absence due to pain from back, neck or shoulder, upper extremities, or lower extremities were at higher risk of subsequent sickness absence in the next year.

 

     

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.     

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.     

Child labor and musculoskeletal disorders: the Pelotas (Brazil) epidemiological survey

OBJECTIVES: [corrected] This article describes the prevalence of musculoskeletal pain in several anatomic sites in children and teens, and investigates, while adjusting for potential confounders, the association between musculoskeletal pain and back pain and the following: age, gender, sports practice, use of computer/video games/television, school attendance, intensity of involvement in household domestic activities, care of other children, care of sick/elderly family members, work activities, and workloads. METHODS: We conducted a cross-sectional study interviewing 3,269 children aged 10-17 years in the low-income areas of Pelotas, Brazil. RESULTS: The prevalence of pain in the neck, knee, wrist or hands, and upper back exceeded 15%. Workers in manufacturing had a significantly increased risk for musculoskeletal pain (prevalence ratio [PR]=1.31) and for back pain (PR=1.69), while workers in domestic service had 17% more musculoskeletal pain and 23% more back pain than nonworkers. Awkward posture (PR=1.15) and heavy physical work (PR=1.07) were associated with musculoskeletal pain, while monotonous work (PR=1.34), awkward posture (PR=1.31), and noise (PR=1.25) were associated with back pain. CONCLUSIONS: Musculoskeletal pain is common among working children and teens. Knowledge of occupational risk factors can support actions to restructure work conditions to reduce or eliminate childhood exposure to hazardous conditions. Our results suggest that strategies to prevent musculoskeletal disorders in child workers should be developed.     

Musculoskeletal pain,depression, and stress among Latino manual laborers in North Carolina

The jobs of Latino manual laborers place their mental and physical health at risk. This study evaluates the associations among musculoskeletal pain, mental health, and work organization in Latino manual laborers. Farmworkers and nonfarmworkers (n = 189) in North Carolina were interviewed for self-reported musculoskeletal pain, depressive symptoms, stress, work safety climate, and precarious job status. More nonfarmworkers than farmworkers had neck and shoulder pain, but they did not differ in other areas of musculoskeletal pain. Depressive symptoms had a significant association with neck and shoulder pain (p < .05). Precariousness had a significant association with back pain (p < .05). Farmworker participants had H-2A visas and were afforded some protection compared to nonfarmworker manual workers. Research is needed to improve policy that relieves pain and improves mental health for all Latino manual workers.     

Hand-arm vibration syndrome with use of anti-vibration chain saws: 19-year follow-up study of forestry workers

Objectives: Hand-arm vibration syndrome (HAVS) consists of vascular and neurological component. Musculoskeletal component has not been delineated yet. In the present follow-up study, we evaluated the prevalence of HAVS and the cumulative exposure to vibration among a cohort of forestry workers. Special interest was given to numbness and musculoskeletal disorders of upper extremity and neck in forestry workers. Methods: A follow-up study starting from 1976 was conducted among forestry workers in Suomussalmi in Finland. Total exposure of hand-arm vibration was recorded during 11 cross-sectional surveys. The last study was carried out in 1995. The lifetime dose of vibration energy was calculated. A cohort of 52 forest workers participated to all 11 cross-sectional surveys 1976–1995. HAVS and musculoskeletal disorders were evaluated. Results: The prevalence of active vibration white finger (VWF) decreased from 13 to 4% in the cross-sectional study. In the cohort VWF decreased from 17 to 8% and numbness increased from 23 to 40%. Rotator cuff syndrome (P=0.034) and epicondylitis (P=0.004) associated with numbness. Regional neck pain was diagnosed in 38% of workers and associated with low back pain. In modeling VWF, the lifelong vibration energy (OR 1.03, CI 1.01–1.05), and smoking (OR 7.36, CI 1.07–50.76) were significant. Numbness was modeled by pain in upper extremities (OR 12.43, CI 2.42–63.80) and neck pain (5.97, CI 1.25–28.39), not by lifelong vibration energy. Right rotator cuff syndrome was modeled by age (OR 2.58, CI 1.04–6.41) and lifelong vibration energy (OR 1.04, CI 1.00–1.07). Conclusions: The prevalence of VWF constantly decreased. Numbness did not follow the vibration exposure profile. Numbness also associated with upper extremity musculoskeletal disorders. Hand-arm vibration associated with the right rotator cuff syndrome in forestry workers.     

Work related risk factors for musculoskeletal complaints in the spinning industry in Lithuania

OBJECTIVES: To describe the prevalence of self reported musculoskeletal complaints in the back, arms or neck, and legs among workers in the spinning industry, and to investigate the relations between these complaints and work related variables. METHODS: An interview based questionnaire survey was carried out in two spinning industry factories in Lithuania. RESULTS: The study group consisted of all workers in production (n = 363). Symptoms of the legs were the musculoskeletal symptom reported most often (61%). Many subjects had arms or neck (55%) or back problems (28%). 20% had experienced pain from all three sites. Almost 25% had had musculoskeletal pain every day and 16% had experienced constant pain during previous year. Packers had the highest risk of arms or neck problems whereas spinners had the highest risk of back or leg problems. Working in a strained posture (bending, work with arms raised up above shoulder level, and repetitive movements of the fingers) was associated with all three complaints. Only arms or neck complaints were associated with age. CONCLUSIONS: Musculoskeletal disorders are a common problem among workers producing gobelin or synthetic thread in Lithuania and working in a strained posture is a risk factor for developing musculoskeletal disorders in three body sites: legs, arms or neck, and back. To better understand the different aspects of physical load as risk factors, a more detailed study of the frequency of postural changes as well as an observation of individually adopted postures would be necessary. This applies to intervention studies in factories of the spinning industry to prevent complaints of the legs and shoulders.

 

     

The Prevalence of Musculoskeletal Complaints among Women in Tijuana,Mexico: Sociodemographic and Occupational Risk Factors

Abstract

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.     

广州市某造船厂工人颈部工作相关肌肉骨骼疾患影响因素分析

目的 调查广州市某造船厂工人工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)患病情况,探讨影响颈部WMSDs的主要因素.方法 以广州市某造船厂工作人员为研究对象,采用《北欧肌肉骨骼疾患问卷(修改版)》调查其WMSDs患病情况,运用多因素logistic回归...     

石油钻探工人躯体紧张反应与肌肉骨骼疾病的关系

目的探讨石油钻探工人的躯体紧张反应与肌肉骨骼疾病的关系,为制定相应的防治措施提供科学依据。方法采用自制简化的职业紧张量表修订版（OSI-R）,对某石油钻探公司的776名职工进行躯体紧张反应与肌肉骨骼疾病关系的横断面研究。结果石油钻探工人所患肌肉骨骼疾病以风湿性关节炎、下背或脊柱反复疼痛为主,上背或脊柱反复疼痛、四肢肌肉疼痛次之;躯体紧张反应与上背或脊柱反复疼痛、下背或脊柱反复疼痛、四肢肌肉疼痛和风湿性关节炎存在显著性相关;肌肉骨骼疾病的患病率随躯体紧张反应程度的增加呈上升趋势（P〈0.01）;躯体紧张反应的主要影响因素有心理紧张反应、任务过重和工作环境等5个因素。结论石油钻探工人肌肉骨骼疾病的发生与躯体紧张反应有关,可通过减轻工作任务、加强劳动组织、增加娱乐休闲活动等措施防治肌肉骨骼疾病。     

Frequency of musculoskeletal and eye symptoms among computer users at work

Computer users most often complain of the eye and locomotor system disorders. The goal of this paper was to find out the frequency and relation between musculoskeletal and eye symptoms among computer workers.The data on musculoskeletal and eye symptoms were provided by two questionnaires. Forty-nine workers were included in the study. Their mean age was 41 years and average length of service 16 years. The average amount of time they spent in front of computers was 6.73 hours per day. Women spent more time working at a computer per day than men (P=0.025). The most frequent complaint in the past year referred to the upper back pain (30.6 % of the workers). Every fourth worker, i.e. 24.5 % of them experienced neck pain in the past year; women more often than men (P=0.024). A health problem which reduced the range of motion and prompted the workers to ask for sick leave was lower back pain. The relation between eye symptoms and the upper back pain experienced in the past year (P=0.004), and in the last week (P=0.031) was statistically significant.Proper exercises for stretching musculoskeletal system, ergonomic computer equipment, and artificial tears could decrease muscular and eye problems, which in turn could enhance productivity and reduce sick leaves.     

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.     

Back and neck pain due to working in a cold environment: a cross-sectional study of male construction workers

Objective

To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.

Methods

This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine.

Results

The prevalence’s of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52–1.66) and 1.39 (95 % CI 1.30–1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature.

Conclusions

Outdoor work in a cold environment may increase the risk of low back and neck pain.     

The Prevalence of and Risk Factors for Neck Pain and Upper Limb Pain among Secondary School Teachers in Hong Kong

Objective: To investigate the prevalence and occupational risk factors of neck and upper limb disorders among secondary school teachers. Methods: One hundred secondary schools in Hong Kong were randomly chosen. Every full-time teacher received a questionnaire and a letter describing the purpose of the study. Questionnaires were collected 1 to 3 weeks later. Results: Among 3,100 secondary school teachers, the lifelong prevalence of neck pain and upper limb pain was 69.3% (2091/3018) and 35.8% (1088/3042) respectively. The lifelong cumulative incidence of both neck and upper limb pain was 31.6% (938/2966). Multiple logistic regression analysis showed that gender, age and working in head down posture were identified as risk factors for neck and upper limb pain. High workload, low colleague support and high anxiety were found to be significant on affecting the neck pain and upper limb pain developed after becoming teachers. Conclusions: Neck pain and upper limb pain were highly prevalent in secondary school teachers in Hong Kong. Gender, age, head down posture and some psychological factors were found to be significant risk factors.     

某电子制造企业工人职业性肌肉骨骼疾患现状与不良工效学因素的关联性探讨

  目的  探讨电子制造行业工人职业性肌肉骨骼疾患（work-related musculoskeletal disorders,WMSDs）的现状与不良工效学因素的关联性。
  方法  采用国内扩展版《肌肉骨骼疾患调查表》调查珠三角某市某电子制造企业生产工人的WMSDs患病情况,计算WMSDs的年患病率和各部位的检出率,并以VAS法评估研究对象患病期间最不能耐受的疼痛程度。
  结果  350名生产工人中,有203名工人（占58.0%）在过去12个月内曾发生WMSDs,各部位WMSDs检出率为:颈部75.37%、肩部56.16%、踝部36.94%、上背部35.96%,其他均低于35.00%。过去12个月内患WMSDs的工人VAS分值[M（P₂₅,P₇₅）]为4.0（3.0,6.0）分。二分类logistic回归分析显示:相对于未婚、不是一直坐位工作、工龄≤ 5年、不需要每分钟重复多次操作、工作时颈部直立（≤ 10°）,已婚（OR=2.39）、一直坐位工作（OR=1.83）、工龄 > 5年（OR=1.89）、每分钟重复多次操作（OR=1.87）、工作时颈部弯曲（> 10°）（OR=2.42）是罹患WMSDs的危险因素（P < 0.05）;“需要上肢或手用力” “以不舒服的姿势干活”的程度每增加一个等级,工人罹患WMSDs的危险性分别增加0.71、1.42倍（P < 0.05）。
  结论  珠三角某市电子制造行业WMSDs的患病率较高,但患病的持续时间和引起的疼痛感、不适感较轻。改善电子制造行业生产流程的工效学设计,加强对工人科学作业姿势和标准生产技能的培训,可能有助于预防电子制造行业WMSDs的发生。
     

Ergonomic risk factors of work processes in the semiconductor industry in Peninsular Malaysia

A cross-sectional survey of semiconductor factories was conducted to identify the ergonomic risk factors in the work processes, the prevalence of body pain among workers, and the relationship between body pain and work processes. A total of 906 women semiconductor workers took part in the study. In wafer preparation and polishing, a combination of lifting weights and prolonged standing might have led to high pain prevalences in the low back (35.0% wafer preparation, 41.7% wafer polishing) and lower limbs (90.0% wafer preparation, 66.7% wafer polishing). Semiconductor front of line workers, who mostly walked around to operate machines in clean rooms, had the lowest prevalences of body pain. Semiconductor assembly middle of line workers, especially the molding workers, who did frequent lifting, had high pain prevalences in the neck/shoulders (54.8%) and upper back (43.5 %). In the semiconductor assembly end of line work section, chip inspection workers who were exposed to prolonged sitting without back support had high prevalences of neck/shoulder (62.2%) and upper back pain (50.0%), while chip testing workers who had to climb steps to load units had a high prevalence of lower limb pain (68.0%). Workers in the assembly of electronic components, carrying out repetitive tasks with hands and fingers, and standing in awkward postures had high pain prevalences in the neck/shoulders (61.5%), arms (38.5%), and hands/wrists (30.8%).     

A Descriptive Study of Body Pain and Work-Related Musculoskeletal Disorders Among Latino Farmworkers Working on Sweet Potato Farms in Eastern North Carolina

Agricultural work is a physically demanding occupation. The purpose of this project was to describe the prevalence of work-related musculoskeletal disorders (WMSDs) and self-reported pain among Latino farmworkers who work extensively hand harvesting sweet potatoes. Data were obtained from a cross-sectional survey of farmworkers (N = 120) in eastern North Carolina. Univariate and bivariate analyses were used to describe personal, work characteristics, and self-reported pain associated with musculoskeletal injuries. Overall, 79% of farmworkers reported any type of pain or discomfort. The highest reported areas of pain were in the back (66%) and shoulder areas (31%). Younger participants experienced more shoulder pain (P = .04) than older workers, and working more than 5 years as a farmworker was significantly associated with back pain (P = .01). Interventions aimed at administrative and engineering controls for reducing risk factors that contribute to WMSDs are warranted.     

Prevalence of musculoskeletal disorders among plastics industry workers

The prevalence of musculoskeletal disorders among workers in the plastics industry in Salvador, Bahia State, Brazil was estimated. Cases were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or having monthly minimum frequency, which had given rise to restrictions at work or to seeking medical attention, or where respondents had a severity score greater than or equal to 3 (on a numerical scale of 0 to 5). A stratified proportional random sample of 577 workers was studied. The prevalence of musculoskeletal disorders, considering of all body segments, was 50.1%. The prevalence of musculoskeletal disorders was higher among women than among men at distal upper extremities (34.6% and 11.6% respectively) and also in the region of the neck, shoulder or upper part of the back (27.4% and 17.6% respectively). There was no difference between genders for the prevalence of lower back pain (21.2% and 21.4% respectively); 65% of cases in this region had reports of pain in the previous seven days. Due to the importance and prevalence of musculoskeletal disorders, it is necessary that their measurement in epidemiological studies be done properly.