Physical workload, work intensification, and prevalence of pain in low wage workers: results from a participatory research project with hotel room cleaners in Las Vegas

BACKGROUND: Occupational injury rates among hotel workers exceed the national service sector average. This study assesses the prevalence of back and neck pain, and its associations with physical workload, ergonomic problems, and increasing work demands. METHODS: Nine hundred forty-one unionized hotel room cleaners completed a survey about health and working conditions. Associations between job demands and pain were determined by logistic regression models adjusting for individual characteristics, cumulative work demands, care-taking responsibilities at home, and psychosocial job factors. RESULTS: The 1-month prevalence of severe bodily pain was 47% in general, 43% for neck, 59% for upper back, and 63% for low back pain. Workers in the highest exposure quartiles for physical workload and ergonomic problems were between 3.24 and 5.42 times more likely to report severe pain than workers in the lowest quartile. Adjusted odds ratios for work intensification ranged from 1.74 (upper back) to 2.33 (neck). CONCLUSIONS: Most room cleaners experience severe back or neck pain. Severe pain showed strong associations with physical workload, work intensification, and ergonomic problems.     

The Economic and Social Consequences of Work-related Musculoskeletal Disorders: The Connecticut Upper-extremity Surveillance Project (CUSP)

Abstract

A population-based telephone survey was conducted in Connecticut to determine the social and economic impact of work-related musculoskeletal disorders (WRMSDs). Only 10.6% of cases had filed for workers' compensation. Respondents had spent an average of 489 annually out-of-pocket. Only 21% of individuals who had had medical visitsor procedures reported having them paid for by workers' compensation. The WRMSDcases reported much higher levels of difficulty in daily tasks rated by the activities of daily living (ADL) scale, with odds ratios (ORs) ranging from 8.2 (child care) to 35.2 (bathing). The cases were significantly more likely to have moved for financial reasons (OR = 2.41), including having lost a home (OR = 3.44). The caseswere also significantly more likely to have lost a car due to finances (OR = 2.45), more likely to have been divorced (OR = 1.91), and less likely to have been promoted (OR = 0.45). The study supports significant externalization of costs for WRMSD out of the workers' compensation system and a substantial social and economic impact on workers.     

Chronic low back pain among tobacco farmers in southern Brazil

Background:

Despite tobacco farming involving intensive manual labor, chronic low back pain (CLBP) prevalence and associated factors are unknown among this occupational group.

Methods:

This was a cross-sectional study conducted in southern Brazil. A random sample of tobacco farmers was interviewed. Socioeconomic and individual characteristics, occupational tasks, workloads, and comorbidities were investigated. Chronic low back pain prevalence was described in relation to independent variables, and associations were examined with Poisson regression.

Results:

Chronic low back pain prevalence was 8·4%. Increasing age, rearing two or more species of livestock (PR 1·65), exposure to tasks that require heavy physical exertion (PR 2·00), working in awkward postures (PR 1·36), green tobacco sickness (GTS) (PR 1·63), pesticide poisoning (PR 2·37), and minor psychiatric disorders (PR 2·55) were associated with CLBP.

Conclusions:

This study found that CLBP is a relevant health problem among tobacco farmers and highlights understudied risk factors such as pesticide poisoning and GTS. Policies to minimize exposure to physiological and chemical workloads in tobacco planting to prevent CLBP are needed. Health professionals should be trained to diagnose and prevent acute low back pain episodes and thus prevent/minimize limitations and disabilities due to CLBP.     

Transient hand paresthesias in Champagne vineyard workers.

BACKGROUND: The aim of the study was to assess the prevalence of hand paresthesias (HP) and their relationship with pruning activities. METHODS: A cross-sectional study was conducted among 537 workers pruning grapevines in the region of Champagne. All workers completed a questionnaire about nocturnal HP and musculoskeletal pain during the preceding 12-month period. RESULTS: The 12-month prevalence of nocturnal HP and hand-wrist pain were 37 and 12%, respectively. HP, predominantly affecting the dominant hand, only began during the pruning period and ended after the pruning season in 90% of cases. HP were transient in most cases, with a mean duration of symptoms of 3.3 +/- 3.2 months. Risk factors associated with HP were: female gender (OR = 2.3 [1.3-3.0]), being overweight (OR = 1.6 [1.1-2.5]), payment on a piecework basis (OR = 2.0 [1.2-2.3]) and traditional blade sharpening method (OR = 1.7 [1.1-2.7]). HP were less frequent in employees who used electric pruning shears (OR = 0.5 [0.2-1.6], P = 0.09). CONCLUSIONS: The development of HP, which affected a third of employees, was different from HP observed in industrial workers since most vineyard workers recovered without medical treatment after the pruning season.     

Musculoskeletal Discorders in Industrial Workers of Delhi

Abstract

To study the musculoskeletal disorders in industrial workers in Delhi, 631 workers from 60 factories representing small and medium-sized enterprises located in Delhi were interviewed. Many (59.4%) of the workers had musculoskeletal disorders. Tailors, those working near furnaces, cooks, workers in buffing, checking and assembly work, and those working with chemicals had the most joint complaints. Cervical pain was more frequent in tailoring and packing work, whereas lumbar pain was more common in buffing, operators working on presses, those using hand and power tools, and those lifting heavy manual loads. Contract workers had less musculoskeletal morbidity than regular and temporary workers. Skilled workers also had less morbidity. Workers experiencing more job satisfaction reported fewer musculoskeletal disorders. The high prevalence of musculoskeletal disorders in workers needs urgent attention from the health and labor sectors. An ergonomic approach to prevention should be considered. The current manual load handling limits prescribed in the Indian Factory Rules potentially expose workers to back stress.It is also inappropriate to have separate load-lifting limits for men and women. Research is urgently required to determine the safe load handling limits for the Indian working population based on ergonomic principles. Until internationally acceptable safe limits are established, back pain should be a notifiable diseasein India.     

Work-related Musculoskeletal Disorders in Urban Bus Drivers of Hong Kong

Introduction: Work-related musculoskeletal disorders (WMSD) affect workers in many occupations including drivers of large vehicles. Urban bus drivers have been found to have high prevalence rates of back problems in overseas studies. Hong Kong is a densely populated city and has a large number of double-deck buses that constitute a major means of public transportation. The present study aimed at investigating the prevalence and characteristics of WMSD in male and female bus drivers who operate double-deck buses in Hong Kong. Method: Altogether 481 bus drivers (404 males, 77 females) participated in the study that consisted of a questionnaire survey as well as physical assessment. The questionnaire included questions on work, musculoskeletal complaints and perceived occupational risk factors associated with each discomfort. Physical assessment consisted of measurement of lumbar spine mobility, hand grip strength, sit-and-reach test, and observation of standing and sitting postures. Results: The results showed generally the male drivers had longer years of work experience but their daily workloads were similar to the females. On the average drivers worked 9–10 h per day, with 5 days on and 1 day off. Neck, back, shoulder and knee/thigh areas had the highest 12-month prevalence rates ranging from 35% to 60%, and about 90% of the discomfort was related to bus-driving. Occupational factors of prolonged sitting and anthropometric mismatch were perceived to be most related to musculoskeletal discomfort. On physical examination, grip strength was significantly related to neck and shoulder discomfort. Conclusions: The present results showed high prevalence rates of WMSD among bus drivers in Hong Kong which warrants further investigation.     

The impact of a change in work posture from seated to stand‐up on work‐related musculoskeletal disorders among sewing‐machine operators

Background

Work‐related postural change could lead to improved musculoskeletal health.

Method(s)

In a quantitative, retrospective, longitudinal study, data of work‐related musculoskeletal disorders of 123 sewing‐machine operators were captured for 4.5 years, and analysed using Poisson regression.

Results

Stand‐up work posture (SUWP) reduced the incidence for spinal disorders (SD) to 0.29 fold the incidence for sitting work posture (SWP) (P < 0.001). Morbid obesity had significantly increased (P = 0.04) incidence of upper limb disorders (ULD), 3.35 times that of normal body mass index (BMI) (regardless of work posture). SUWP was associated with increased IRR (1.49) for lower limb disorders (LLD). LLDs were associated with obesity (overweight (IRR = 2.58; P = 0.08), obese (IRR = 2.45; P = 0.09), and morbidly obese (IRR = 6.24; P = 0.001)).

Conclusions

The protective benefit of the SUWP was statistically significant for SD incidence. Owing to high mean BMI, SUWP had a negative impact on the incidence of LLDs for the first 2 months.

     

Self-Reported Musculoskeletal Pain in Latino Vineyard Workers

ABSTRACT

The agricultural economy in the United States is dependent on millions of Latino migratory workers. Despite the health risks associated with this line of work, many agricultural workers lack health insurance or access to health care services. The purpose of this study was to collect demographic data and investigate the musculoskeletal health of Latino migratory vineyard workers. A physical therapy team collected demographic data at health clinics held at vineyards in Oregon. Nearly half (48.4%) of all vineyard workers reported experiencing musculoskeletal symptoms (MSS) in at least one region of the body. The primary region of reported MSS was the back (32% of all men and 43.7% of all women). In most cases, those who reported MSS were significantly older than those who did not report MSS. Future research is necessary to identify personal and work related injury risk factors in order to develop prevention programs.     

Musculoskeletal symptoms among poultry processing workers and a community comparison group: Black women in low-wage jobs in the rural South

BACKGROUND: Poultry processing is characterized by rapid line speed and extreme division of labor. Morbidity associated with this work has been reported by scientists, journalists and workers in this fast growing industry. METHODS: Cross-sectional data from baseline measures of a cohort of black women employed in poultry processing (n = 291) and a community comparison group (n = 299) in rural North Carolina were used to evaluate musculoskeletal symptom reports and to explore factors associated with those reports. Recruitment of participants and collection of data were performed by women in the community circumventing the need to involve employers. RESULTS: Significant differences in musculoskeletal symptom prevalence were observed between women employed in poultry processing and those of similar economic status employed elsewhere in the same area of rural northeastern North Carolina. After adjusting for other factors independently associated with symptoms among these women including age, depression, and perceived isometric load at work, the prevalence of upper extremity and neck symptoms was 2.4 (95% CI 1.7, 3.2) times higher among women working in poultry processing. CONCLUSIONS: The findings add to the documentation of occupational health concerns among vulnerable workers employed in poultry processing in our state; in this economically depressed area of rural northeastern North Carolina poultry processing is the largest single employer of women. On a larger scale, the potential magnitude of upper extremity morbidity among women employed in poultry processing should be viewed with the knowledge that poultry processing is a growing industry in the U.S. with work done largely by blacks and immigrants.     

Upper-extremity Musculoskeletal Disorders in Keyboard Operators in Brazil: A Cross sectional Study

Abstract

This study sought to determine the prevalenee of upper extremity musculoskeletal disorders (UEMSDs) among keyboard operators in Sao Paulo, Brazil, and to compare this prevalence with that among other office workers. One hundred and thirty keyboard operators (mean age 33 years, 60 male/70 female) and 138 office workers (mean age 35 years, 82 male/66 female) from two computing centers were interviewed by a research assistant using a standardized questionnaire. Symptomatic subjects, defined as those who reported upper extremity pain or lost work time due to pain in the preceding 12 month, were examined by a rheum-tologist. Mean (SD) lengths of employment were 9 (6) years for keyboard operators and 8 (6) years for office workers. Upper-extremity pain during the preceding seven days was reported by 66 keyboard operators (51%) and by 18 office workers (13%) (p < 0.0001); during the preceding 12 months, by 90 keyboard operators (69%) and by 26 office workers (19%) (p < 0.0001). UEMSDs were diagnosed following physical examination in 50 keyboard operators and in 12 office workers (9%) (p < 0.0001). Tenosynovit is was the most common disorder diagnosed among the keyboard operators (n = 23). Among the keyboard operators the prevalence of UEMSDs was significanlly lower for males (p = 0.017, OR = 0.38, 95% CI = 0.17–0.86. The presence of a diagnosed UEMSD was significantly associated with duration of employment (p = 0.005) and lack of or insufficient rest breaks (p = 0.012). Keyboard operators had significantly more UEMSDs than did office workers. Strategies aimed at the reduction of repetitive strain injuries among keyboard operators, such as the provision of adequate work breaks, should be evaluated.     

Health Status of People with Work-Related Musculoskeletal Disorders in Return to Work Programs: A Malaysian Study

ABSTRACT

This study examined the health status of injured workers with musculoskeletal disorders enrolled in the Malaysian Return to Work (RTW) program. The 102 participants were categorized into three RTW groups: Off-work (n = 30, 29.4%), Re-entry (n = 44, 43.1%), and Maintenance (n = 28, 27.5%). Overall health status, as measured by the SF-36 version 2, of the workers exhibited below average compared to the internationally established normative population, with their physical health component summary rated lower than mental health. Across the different groups, significant differences were found in role-physical, vitality, bodily pain, general health, and mental health. However, the mean values of these variables were higher in the Maintenance group and were found significant. The current health status of injured workers at Off-work and Re-entry phases was significantly low and warranted to be improved by involving other health professionals such as occupational therapists, ergonomists, and psychologists.     

Musculoskeletal disorders among rural Australian nursing students

AIM: To investigate the prevalence of musculoskeletal disorders (MSD) among rural Australian nursing students and compare the results with other international studies. METHOD AND ANALYSIS: A self-reporting questionnaire adapted from previous research, was administered to 260 students from all three grades of a major nursing school in regional north Queensland, Australia. RESULTS: A high proportion of students reported an MSD at some body site (80.0%), with low back pain being the most common condition (59.2%). This was followed by MSD of the neck (34.6%), knee (25.0%), shoulder (23.8%), feet (16.5%), wrist (12.7%) and legs (11.9%). MSD of the shoulder was slightly more common among males when compared to females (39.3% vs 22.0%, P = 0.0424). Previous paid employment as a nurse or nursing assistant was found to increase the risk of upper arm MSD by a factor of 10.8 (odds ratio 10.8, 95% confidence interval 1.9-205.8, P = 0.0276). CONCLUSION: Overall, this investigation suggests that MSD is more frequent among rural Australian nursing students, when compared to their counterparts around the world. Their high rate of MSD is also comparable to that reported by hospital nurses in other countries.     

Measurement Properties of a New Quality of Life Measure for Patients with Work Disability Associated with Musculoskeletal Pain

INTRODUCTION: The Quality of Life Systemic Inventory (QLSI) measures patients' goal attainment based on the system control theory. It quantifies the perceived impact of the disorder and the gap between the present and aspired states. PURPOSE: To evaluate concurrent validity and responsiveness of the QLSI among workers on sick leave due to musculoskeletal disorders (MSDs). METHODS: Participants (10 women; 29 men) were recruited at a work rehabilitation centre and had more than 4 weeks of absence from work due to MSDs compensated by the Workers' Compensation Board. Concurrent validity and external responsiveness were based on baseline and post-treatment measures of external criteria. Criteria and related instruments were the following: perception of disability (Roland-Morris Disability Questionnaire); health-related quality of life (SF-12); stress (Psychological Stress Measure) and distress (Psychological Distress Index). RESULTS: Regression analyses revealed significant correlations between QLSI scores and the Psychological Distress Index (r2 = .11 to .19 and .66; p < .001), with either the SF-12 mental component scale (r2 = .18 and .11; p < .01) or the Roland-Morris Disability Questionnaire (r2 = .04 and .10; p < .05). All measures showed highly significant change over time. CONCLUSION: Results support the concurrent validity and responsiveness of the QLSI, with an MSD population. SIGNIFICANCE: This instrument could serve in future research as an outcome measurement instrument in the evaluation of more long-term effects of rehabilitation programs.     

Nutritional Risk is Associated with Chronic Musculoskeletal Pain in Community-dwelling Older Persons: The PAINEL Study

Malnutrition is a risk factor for noncommunicable diseases related to ageing, and it can also contribute to musculoskeletal health. This study investigated whether nutritional risk is associated with chronic musculoskeletal pain in community-dwelling older persons. Nutritional risk was assessed by the DETERMINE Checklist. Chronic musculoskeletal pain was defined as the presence of pain in the past six months that did not disappear for at least 30 consecutive days. Multivariate logistic regression including confounding variables was used for the analysis. The sample was comprised of 383 participants (age 75.6 ± SD 6.1); the majority were at moderate-to-high nutritional risk (69%) and approximately one third presented chronic musculoskeletal pain (30%). The nutritional risk score was independently associated with chronic musculoskeletal pain: adding one unit in the risk score produces an 11% increment in the odds of presenting pain (OR 1.109, 95% CI 1.022–1.204). Individuals classified into moderate- or high-risk categories also had substantially higher odds (～90%) of presenting chronic musculoskeletal pain when compared to those in the low-risk category, although our findings were only marginally significant. This is the first study to demonstrate the association between nutritional risk and chronic musculoskeletal pain above and beyond the contributed effects from relevant confounders.