Prevalence of upper extremity symptoms and possible risk factors in workers handling paper currency

The prevalence of upper extremity symptoms in the workforceis high, particularly in industries characterized by forceful,repetitive or awkward movements. A study was undertaken to assessthe prevalence of upper extremity symptoms in bank workers ina paper currency processing operation and to examine the roleof possible risk factors for these complaints. Thirty-nine workersof a total workforce of 47 were assessed with a questionnaireand physical examination. The questionnaire collected informationabout demographics, health status, symptom reporting, psychosocialwork stressors and other work exposure characteristics. Overall,59% of the workers reported having significant work-relatedupper extremity musculoskeletal symptoms in the preceding year,including 49% with neck and shoulder symptoms and 49% with armand wrist symptoms. In this study the key predictive factorfor upper extremity musculoskeletal symptoms was psychologicaljob demands. The workers had similar ergonomic stressors (withlittle gradient of exposure) and therefore our results do notcontradict the importance of ergonomic factors in the developmentof upper extremity symptoms. However, the results do suggestthat within a group exposed to similar ergonomic stressors,psychological job demands may be an important factor associatedwith musculoskeletal symptoms.     

The actual condition of musculoskeletal disorders of workers working at new special nursing homes for the aged in Osaka Prefecture--comparison of musculoskeletal disorder between manager's awareness and care workers' complaints by questionnaire survey]

In order to examine the actual condition of health problems of workers working at new special nursing homes for the aged, we conducted an interview survey with the managers and a questionnaire survey among the workers. Subjects of the interview survey were managers at the 7 nursing homes. Subjects of the questionnaire survey were 362 workers employed at the 7 nursing homes, 214 care workers (CWs) and 104 workers other than care workers (non-CWs); 299 questionnaires were returned. The response rate was 82.6%. We asked the managers "How many CWs are complaining of low back pain (LBP) and upper extremity pain at your nursing home?" One manager answered that 80% of CWs were complaining of LBP, but other managers answered that a few but no more than 5 CWs were complaining of LBP. On the other hand, the prevalence of LBP among CWs by the questionnaire survey was high. The point prevalence of LBP was 70.0%, the one month prevalence of LBP was 81.6%, and the period prevalence of LBP in present job was 88.6%. The managers had less interest in upper extremity pain than in LBP. But more than 60% of CWs had complained of upper extremity pain in the previous 1 month. Seventy-three percent of CWs had not received any education about work-related musculoskeletal disorders although about half of them had got some education or training to minimize the risk of injury in training school. Regarding female workers (77% of all CWs, 73% of all non-CWs), the percentages of current smokers and night shift workers were higher in CWs than in non-CWs with statistically significant differences. The percentages of workers working without work breaks and working overtime were higher in non-CWs than in CWs with statistically significant differences. For prevalence of LBP among female CWs and female non-CWs, the workers having LBP now, having had LBP in present job, and having first experienced LBP in present job were higher in CWs than in non-CWs with statistically significant differences. All nursing homes surveyed had provided no special health examination for LBP. For managers to grasp the actual condition of musculoskeletal disorders of workers working at the nursing homes for the aged, we recommend that care workers should have a special health examination for LBP.     

职业应激与下肢肌肉骨骼系统疾患的关系

目的 探讨职业应激与下肢肌肉骨骼系统疾患的关系.方法 采用横断面研究设计和自报式问卷调查方法对13家企业5338名工人进行整群调查,采用修订的工作内容问卷和付出-回报失衡模式问卷调查职业应激状况.采用肌肉骨骼系统疾患调查表调查过去1年内下肢肌肉骨骼系统疾患和不良姿势情况.使用logistic回归分析职业应激因素与下肢肌肉骨骼系统疾患检出率之间的关系.结果 2个职业应激模式主要因子中,躯体需求和付出是臀部疾患的危险因素,而工作控制是臀部疾患的保护因素.当2个模式的主要因素一起分析时,仅有躯体需求是臀部疾患的危险因素.以4种工作类型的分类变量进行分析时,工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.随着患病部位的增多,工作紧张和付出-回报失衡的危险增加.工作控制的保护作用随患病部位的增加而增大.以连续变量进行分析时,以躯体需求计算的工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.结论 职业应激与下肢肌肉骨骼系统疾患存在统计学意义的相关,下肢肌肉骨骼系统疾患的预防应考虑控制职业应激因素和增加工作控制.     

Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb

Objectives: To investigate potential interactions between physical and psychosocial risk factors in the workplace that may be associated with symptoms of musculoskeletal disorder of the neck and upper limb. Methods: 891 of 1514 manual handlers, delivery drivers, technicians, customer services computer operators, and general office staff reported on physical and psychosocial working conditions and symptoms of neck and upper limb disorders using a self administered questionnaire (59% return rate). Of the 869 valid questionnaire respondents, 564 workers were classified in to one of four exposure groups: high physical and high psychosocial, high physical and low psychosocial, low physical and high psychosocial, and low physical and low psychosocial. Low physical and low psychosocial was used as an internal reference group. The exposure criteria were derived from the existing epidemiological literature and models for physical and psychosocial work factors. The frequency and amplitude of lifting and the duration spent sitting while experiencing vibration were used as physical exposure criteria. Ordinal values of mental demands, job control, and social support with managers and coworkers were used as psychosocial exposure criteria. Results: In the multivariate analyses, the highest and significant increase in risk was found in the high physical and high psychosocial exposure group for symptoms of hand or wrist and upper limb disorders after adjusting for years at the job, age, and sex. A potential interaction effect was found for the symptoms of the hand or wrist and upper limb disorders but not for the neck symptoms. Conclusion: This study showed that workers highly exposed to both physical and psychosocial workplace risk factors were more likely to report symptoms of musculoskeletal disorders than workers highly exposed to one or the other. The results suggest an interaction between physical and psychosocial risk factors in the workplace that increased the risk of reporting symptoms in the upper limbs. Psychosocial risk factors at work were more important when exposure to physical risk factors at work were high than when physical exposure was low. Ergonomic intervention strategies that aim to minimise the risks of work related musculoskeletal disorders of the upper limb should not only focus on physical work factors but also psychosocial work factors.     

汽车制造业工人肌肉骨骼疾患工效学因素分析

目的研究汽车制造行业工人患肌肉骨骼疾患(MSDs)的工效学危险因素。方法采取分层整群抽样的方式,从广东省3家汽车生产企业随机抽取冲压、焊装、涂装及总装工人共1 065名,对其进行问卷调查,内容包括个人一般情况、工效学危险作业活动及肌肉骨骼疾患症状。结果颈部(38.87%)与背部(31.83%)的大角度弯曲及高度重复性伴手部大角度高度用力活动(39.34%)是汽车企业作业过程最为突出的工效学危险姿势或动作,各工种的暴露与患病情况各有不同;在MSDs的多因素Logistic分析中,各部位的危险姿势或动作与相应部位的肌肉骨骼疾患有关,此外,颈部的不适症状还与工龄(OR=1.238)相关,膝盖的不适症状与体重(OR=1.644)相关。结论汽车制造企业工人的职业性肌肉骨骼疾患与其作业中相应部位典型工效学危险活动或姿势有关,应采取措施改善和控制作业过程中的高危因素,预防肌肉骨骼疾患的发生。     

Prevalence of work related musculoskeletal disorders in active union carpenters

OBJECTIVES: To determine the prevalence and risk factors for work related musculoskeletal disorders among union carpenters. METHODS: A detailed questionnaire on musculoskeletal symptoms and work history was administered to 522 carpenters. The symptom questions assessed if carpenters experienced pain, numbness, or tingling in a particular body region. A subset of this group then received a physical examination of the upper extremities and knees. RESULTS: The study group was primarily white (94.9%) and male (97.8%) with a mean age of 42.3 years. The highest prevalence of work related musculoskeletal disorders cases by carpentry specialty ranged from 20%-24% for those doing drywall or ceiling, finishing or framing, and the building of concrete forms. Generally, as duration of employment increased, the prevalence of symptoms increased. An adjusted logistic regression analysis showed that the group with the longest (> or = 20 years) duration of employment in carpentry was significantly associated with work related musculoskeletal disorders of the shoulders (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.1 to 8.9), hands or wrists (OR 3.1, 95% CI 1.1 to 8.4), and knees (OR 3.5, 95% CI 1.3 to 9.2). Also, analyses showed that carpenters who reported that they had little or no influence over their work schedule had significant increases of work related musculoskeletal disorders of the shoulders, hips, and knees with ORs of 1.9 (95% CI 1.1 to 3.2), 2.9 (95% CI 1.1 to 7.2), and 2.3 (95% CI 1.2 to 4.1), respectively. Feeling exhausted at the end of day was also a significant risk factor for work related musculoskeletal disorders of the knee (OR 1.8, 95% CI 1.1 to 3.1). Upper extremity disorders were the most prevalent work related musculoskeletal disorders reported among all carpenters. Drywall or ceiling activities involve a considerable amount of repetitive motion and awkward postures often with arms raised holding heavy dry walls in place, whereas form work is notable for extensive lumbar flexion and had the two highest rates of work related musculoskeletal disorders. The psychosocial element of job control was associated with both upper and lower extremity disorders. These union carpenters, who were relatively young, already were experiencing considerable work related physical problems. CONCLUSION: This study supports the need for vigilant ergonomic intervention at job sites and early ergonomic education as an integral part of apprenticeship school training to ensure that carpenters remain fit and healthy throughout their working lifetime.     

Musculoskeletal disorders among healthcare workers in Belo Horizonte, Minas Gerais State, Brazil

This cross-sectional study investigated the prevalence of musculoskeletal disorders and associated factors in a sample of 1,808 workers (from a total of 13,602) in the municipal health system in Belo Horizonte, Minas Gerais State, Brazil. Prevalence was calculated according to self-reported pain in the upper or lower limbs and/or back, and size of associations was estimated by univariate (p < 0.20) and multivariate Poisson regression (p < 0.05). Musculoskeletal disorders showed a prevalence of 49.9% and were statistically associated with female gender, living with a partner, physical activity less than twice a week, self-reported common mental disorder, certain job positions (dentists, dental technicians, and community health workers), high physical demand, and inadequate working conditions. The results confirm the complexity of musculoskeletal disorders and suggest areas for development of health promotion programs in health services.     

职业因素对汽车制造业工人肌肉骨骼疾患影响的研究

目的了解作业场所职业病危害因素与工效学危险因素等对工人几个主要身体部位肌肉骨骼疾患（MSDs）的影响。方法选取南方3家汽车生产制造企业,采用分层、整群抽样的方法,随机从冲压、焊装、涂装、总装、树脂、质检等生产部门中抽取1个班组的生产工人作为调查对象,对其进行问卷调查,收集个人一般情况、职业病危害因素接触情况、典型不良劳动姿势与活动的暴露情况及肩臂部、手部、下背部的阳性症状。影响肌肉骨骼症状发生的单因素分析采用X^2检验,多因素分析采用logistic回归。结果共调查794名工人,其中男性765人,女性29人,平均年龄为（23．34±4．52）岁,工龄中位数2年,其文化程度以中专及以上为主（97．8％）。车企工人总体的MSDs年患率分别为下背部47．0％、肩臂部42．9％、手腕／手掌41．3％。不同工种间不同身体部位MSDs的年患率的差异均有统计学意义（均P〈0．01）,其中肩臂部、手彬手掌的年患率以焊装工的最高,下背部的年患率以总装工的最高。多因素分析结果显示,背前屈〉30°的工作（OR=1．691）等2项与下背部阳性症状年患率有关,手部高力量大角度屈伸的上肢重复活动（OR=1．685）等3项与肩臂阳性症状年患率有关,手部高力量高度重复活动（OR=1．956）等4项与手腕／手掌的阳性症状年患率有关。结论被调查的汽车制造企业工人下背部、肩臂部、手部3个身体部位MSDs的患病情况较突出,各部位的MSDs年患率主要与不良的工作姿势、活动及搬举负荷强度等工效学不良因素有关,需针对其采取有效的控制措施。     

心理因素及物理负荷对职业性肌肉骨骼疾患的影响分析

目的 探讨心理因素与物理负荷的交互作用及其对职业性肌肉骨骼疾患(WMSDs)的影响.方法 选取653名来源于电子行业流水线作业、缝纫行业、制造行业的工人及行政管理人员作为调查对象.采用改良的北欧国家肌肉骨骼疾患标准调查表调查肌肉骨骼疾患情况,心理社会状况调查采用工作内容量表(JCQ),进行流行病学横断面调查,并应用快速暴露检查法(QEC)问卷对其进行工效学的物理负荷评价.结果 不同暴露等级下,肩部、上背、下背、手/腕的肌肉骨骼疾患的年患病率的差异有统计学意义(P＜0.05或P＜0.01),同时暴露在高的物理和心理负荷时,工作人员各部位的年患病率明显高于暴露在其他等级时的肌肉骨骼疾患的患病率.调整工龄、年龄、性别后,用logistics回归分析结果表明,在肩部、上背、下背和手/腕部的WMSDs影响中可能存在物理负荷和心理负荷的交互作用(P＜0.05).结论 高物理负荷下,不良心理因素对工人WMSDs的发生造成的影响远大于工人处于低物理负荷工作时,实施工效学干预不仅要从过度负荷,不良姿势,静态负荷等物理因素方面进行干预来降低WMSD的发生,也要关注心理因素方面的干预.

Abstract：

Objective To investigate the interactive effect of job task and psychosocial factors on the outcomes of musculoskeletal disorders. Methods 653 workers from different type of manufacturing industries and administration office recruited in a cross-sectional epidemiological survey. The Quick Exposure Check (QEC) was applied to assess the ergonomic load of job task, Job Content Questionnaire (JCQ) for identifying psychological characteristics, and Nordic Standardized Questionnaire for investigating outcomes of WMSDs.Results The prevalence of WMSD in shoulder, upper back, lower back and hand/wrist were significantly different under a variety of combined job task and psychosocial characteristics (P＜0.05 or P＜0.01 ). The more physical and psychological loads, the higher prevalence of WMSDs were revealed. By using multivariate analyses, a potential interactive effect was found in terms of the WMSDs symptoms in hand/wrist shoulder,upper back and lower back after adjusted by work year, age, and gender. Conclusions Higher physical load and greater psychosocial risk are more frequent self-reported symptoms of WMSDs than those of lower exposures. Ergonomic intervention strategies aimed at reducing the incidence of WMSDs should not only be focused on control of physical work factors but also psychosocial risks of relevance.     

Work-organisational and personal factors associated with upper body musculoskeletal disorders among sewing machine operators

Objective

To assess the contribution of work-organisational and personal factors to the prevalence of work-related musculoskeletal disorders (WMSDs) among garment workers in Los Angeles.

Methods

This is a cross-sectional study of self-reported musculoskeletal symptoms among 520 sewing machine operators from 13 garment industry sewing shops. Detailed information on work-organisational factors, personal factors, and musculoskeletal symptoms were obtained in face-to-face interviews. The outcome of interest, upper body WMSD, was defined as a worker experiencing moderate or severe musculoskeletal pain. Unconditional logistic regression models were adopted to assess the association between both work-organisational factors and personal factors and the prevalence of musculoskeletal pain.

Results

The prevalence of moderate or severe musculoskeletal pain in the neck/shoulder region was 24% and for distal upper extremity it was 16%. Elevated prevalence of upper body pain was associated with age less than 30 years, female gender, Hispanic ethnicity, being single, having a diagnosis of a MSD or a systemic illness, working more than 10 years as a sewing machine operator, using a single sewing machine, work in large shops, higher work–rest ratios, high physical exertion, high physical isometric loads, high job demand, and low job satisfaction.

Conclusion

Work-organisational and personal factors were associated with increased prevalence of moderate or severe upper body musculoskeletal pain among garment workers. Owners of sewing companies may be able to reduce or prevent WMSDs among employees by adopting rotations between different types of workstations thus increasing task variety; by either shortening work periods or increasing rest periods to reduce the work–rest ratio; and by improving the work-organisation to control psychosocial stressors. The findings may guide prevention efforts in the garment sector and have important public health implications for this workforce of largely immigrant labourers.     

Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian national population health survey (NPHS) 1994-5 data

OBJECTIVES—To describe the prevalence of musculoskeletal problems in the Canadian working population and to determine cross sectional associations between such problems and work factors, particularly job strain and physical demand variables.
METHODS—The Canadian 1994 national population health survey (NPHS) sampled 4230 working men and 4043 working women (ages 18-64) who answered an abbreviated version of the job content questionnaire. Workers were classified into four strain categories: high, passive, active, and low. Outcomes were restricted activity due to musculoskeletal disorders and the diagnosis of a back problem (both yes or no). Survey weights were incorporated to allow for different probabilities of selection. Logistic regression analyses were carried out separately for women and men, controlling for sociodemographic factors.
RESULTS—Prevalence of chronic back problems diagnosed by a health practitioner was 14.5% among men and 12.5% among women. Men had a 6.6% prevalence of restricted activity due to musculoskeletal disorders, whereas the corresponding figure for women was 5.3%. Women, but not men, in high strain jobs were more likely to report both back problems (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.14 to 2.28) and restricted activity (OR 1.98, 95% CI 1.16 to 3.48) compared with those in low strain jobs. High physical exertion was an independent predictor of back problems in both sexes. For both men and women, low social support at work and high job insecurity were independent predictors of restricted activity due to musculoskeletal disorders. Conversely, chronic back problems contributed to explanation of high job strain among women (OR 1.76, 95% CI 1.30 to 2.39) and high physical exertion among men (OR 1.39, 95% CI 1.09 to 1.77), whereas restricted activity due to musculoskeletal disorders contributed to explanation of high job insecurity in both sexes.
CONCLUSIONS—Associations of interest between work stressors and musculoskeletal problems in this cross sectional study provide evidence for physical and psychosocial factors both affecting disability and being affected by disability in a working population.


     

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.     

Work-related musculoskeletal complaints among workers of Iranian aluminum industries

In developing countries, musculoskeletal complaints are considered as main cause of occupational complications and disability. Economic burden of these complications more than workers has impact on organization and society in general. In Iranian aluminum industries, workers are directly involved in production process and physical activities such as manual material handling and awkward postures are very common. The present study was performed for assessment of musculoskeletal complaints prevalence among workers of Iranian aluminum industries. Participants in this cross-sectional study were 493 workers of 3 Iranian aluminum industries with random selection. Data of musculoskeletal complaints were gathered by means of the standardized Nordic self-reporting questionnaire. Demographic and work-related data were collected into the checklist. Findings of this study showed that 65.5% of workers in past week and 77.5% of workers in past year had claimed one of the musculoskeletal complaints in their work places. Lumbar, knee(s), and upper back had the most musculoskeletal complaints prevalence in participants. Musculoskeletal complaints in past week and year had significant association with job duration and age in these workers. Musculoskeletal complaints in Iranian aluminum industries happened in high rate. Ergonomic intervention strategies in the workplaces must be the focus for elimination of environmental hazards such as apposition on the time of work and manual handling of heavy loads.     

Accuracy of a Disability Instrument to Identify Workers Likely to Develop Upper Extremity Musculoskeletal Disorders

Background Work related upper extremity musculoskeletal disorders (MSD) result in substantial disability, and expense. Identifying workers or jobs with high risk can trigger intervention before workers are injured or the condition worsens. Methods We investigated a disability instrument, the QuickDASH, as a workplace screening tool to identify workers at high risk of developing upper extremity MSDs. Subjects included workers reporting recurring upper extremity MSD symptoms in the past 7 days (n = 559). Results The QuickDASH was reasonably accurate at baseline with sensitivity of 73% for MSD diagnosis, and 96% for symptom severity. Specificity was 56% for diagnosis, and 53% for symptom severity. At 1-year follow-up sensitivity and specificity for MSD diagnosis was 72% and 54%, respectively, as predicted by the baseline QuickDASH score. For symptom severity, sensitivity and specificity were 86% and 52%. An a priori target sensitivity of 70% and specificity of 50% was met by symptom severity, work pace and quality, and MSD diagnosis. Conclusion The QuickDASH may be useful for identifying jobs or workers with increased risk for upper extremity MSDs. It may provide an efficient health surveillance screening tool useful for targeting early workplace intervention for prevention of upper extremity MSD problems.     

Physical discomfort among visual display terminal users in a semiconductor manufacturing company: a study of prevalence and relation to psychosocial and physical/ergonomic factors

The associations among several alleged psychosocial and physical/ergonomics risk factors and the visual and musculoskeletal discomforts were assessed in a cross-sectional study of 119 video display terminal (VDT) users in a semiconductor manufacturing company. Cases of discomfort were identified using self-reported discomfort symptoms through questionnaire surveys. Data on individual, physical/ergonomic, and psychosocial aspects were obtained. Multivariate logistic regression models were developed to predict physical discomforts of 11 body areas. The prevalence of upper extremity discomfort found in this semiconductor manufacturing company was 42%, which is similar to the prevalence among VDT users in telecommunication companies and the newspaper industry. Full-time VDT users (data-entry personnel, programming engineers, and CAD engineers) had significantly higher rates of physical discomfort (66%) than part-time VDT users (fabrication engineers) (41%). Physical/ergonomic variables were found more dominant than psychosocial factors for visual and upper extremity discomforts. However, psychosocial variables were the dominant for back and lower extremity discomfort, when compared with the subjectively characterized physical/ergonomic factors. Because both physical/ergonomics variables and psychosocial factors and some of their interactions were associated with visual and musculoskeletal discomfort, integrating psychosocial prevention with physical/ergonomic design improvements is an effective approach to reducing the prevalence of discomfort.     

Musculoskeletal problems among workers of an Iranian rubber factory

Musculoskeletal disorders (MSDs) are a common health problem throughout the world and a major cause of disability among the work force. Assessment of exposure level to MSD risk factors can be an appropriate base for planning and implementing interventional ergonomic programs in the workplace. This study was conducted among workers of an Iranian rubber factory with the objectives of (a) determination of the prevalence of MSDs among production line workers, and (b) assessment of the level of exposure to MSD risks. In this study, all 16 production units of the factory were studied. In each unit, 50% of the workers were randomly selected and included in the study. A total of 454 workers participated. The Nordic Musculoskeletal Questionnaire was used to study the prevalence of MSDs and the Quick Exposure Check (QEC) technique was applied to assess physical exposure to the risks. The videotaping technique was used to collect the required data for each worker. The vast majority of the workers (73.6%) had suffered from some kind of musculoskeletal symptoms during the last 12 months. The highest prevalence was reported in the lower back (50.2%), knees (48.5%) and upper back (38.1%). In 85.5% of the workers studied, the QEC score was high or very high. Statistical analysis showed a significant association between the QEC level of risk and MSDs symptoms (p<0.001). The most common ergonomics problems were found to be awkward postures and manual material handling. MSDs had occurred with a high rate among workers of this rubber factory. Corrective measures for reducing risk level seemed essential. Elimination of awkward postures and manual material handling in the workplace were recommended.     

制造业工人肌肉骨骼疾患和劳动负荷及工作姿势分析

目的 分析制造业工人肌肉骨骼疾患和劳动负荷及工作姿势在不同企业、性别、文化程度、年龄和工龄组间的分布.方法 采用横断面研究设计和问卷调查方法对12家制造业企业5134名工人进行近1年内肌肉骨骼疾患发生情况调查.结果 调查对象在近12个月内身体腰、颈、肩、腕、踝足、膝、髋臀、肘部肌肉骨骼疾患发生率分别为59.7%、47.9%、38.1%、33.7%、26.9%、25.4%、15.2%、14.9%.不同企业工人身体各部位肌肉骨骼疾患发生率的差异有统计学意义(P＜0.05或P＜0.01).耐火材料厂和化纤厂工人肘、腰、腕、足(踝)等部位肌肉骨骼疾患发生率高于其他企业,而服装厂和金刚石厂工人肌肉骨骼疾患发生率低于其他企业.女性工人颈、肩、腕部肌肉骨骼疾患发生率高于男性,差异有统计学意义(P＜0.01).不同文化程度工人身体各部位肌肉骨骼疾患发生率差异有统计学意义(P＜0.05或P＜0.01).颈、肩、肘、腰、髋臀和膝部肌肉骨骼疾患发生率的年龄和工龄组间差异有统计学意义(P＜0.01),肌肉骨骼疾患发生率随年龄和工龄增长而增加.耐火材料厂和化纤厂工人劳动负荷大者和不良姿势者比例较高,金刚石和服装厂工人较低.结论 制造业工人腰、颈、肩、腕部肌肉骨骼疾患发生率较高,性别、文化程度、年龄和工龄对肌肉骨骼疾患的发生存在影响.

Abstract：

Objective To analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers. Methods In a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires. Results The morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period.There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P＜0.05 or P＜0.01 ). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P＜0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels(P＜0.05 or P＜0.01 ). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P＜0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher;, but those in garments and diamond factories were lower.Conclusion The morbidities for musculoskeletal symptoms in waist, neck, shoulder and wrists of workers in manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.     

A Review of Occupational Knee Disorders

Introduction Lower extremity knee disorders, like other cumulative disorders of the body, build up over time through cumulative exposures. 2006 data from the U.S. Bureau of Labor Statistics reveal that cumulative knee disorders account for 65% of lower extremity musculoskeletal disorders and 5% of total body musculoskeletal disorders. Methods The objective of the literature review was to find papers on work-related musculoskeletal disorders (WMSDs) common to the knee region. From these, symptoms of the disorders, affected industries, and potential risk factors were assessed. Results A review of the literature divulges that knee disorders primarily consist of bursitis, meniscal lesions or tears, and osteoarthritis. Though kneeling and squatting are considered to be two of the primary risk factors correlated to these knee disorders, 12 other risk factors should also be contemplated. These 14 contributing risk factors include both occupational (extrinsic) and personal (intrinsic) variables that affect the labor industries. Example industries include mining, construction, manufacturing, and custodial services where knee bending postural activities exist as a commonality. Conclusion The understanding of the types of knee disorders, the affected occupations, and the job related risk factors will allow ergonomic practitioners and researchers to create and adjust work environments for the detection and lessening of knee work-related musculoskeletal risk. Further studies need to be conducted to (1) justify the presence of risk from certain risk factors and (2) enhance the understanding of risk factor dose–response levels and their temporal development.     

A Cross-Sectional Assessment of the ACGIH TLV for Hand Activity Level

The ACGIH Worldwide Threshold Limit Value (TLV) for hand activity considers average hand activity level or HAL and peak hand force. We report cross-sectional data that assess the validity of the TLV with respect to symptoms and selected upper extremity musculoskeletal disorders among workers. The prevalence of symptoms and specific disorders were examined among 908 workers from 7 different job sites in relation to the TLV. Worker exposures were categorized as above the TLV, above the TLV Action Limit but below the TLV, or below the TLV Action Limit. Symptoms in the distal upper extremities did not vary by TLV category. Tendonitis in the wrist/hands/fingers did not vary by TLV category, but elbow/forearm tendonitis was significantly associated with TLV category. All measures of carpal tunnel syndrome were associated with TLV category. In all instances, prevalence of symptoms and specific disorders were substantial in jobs that were below the TLV action limit, suggesting that even at acceptable levels of hand activity, many workers will still experience symptoms and/or upper extremity musculoskeletal disorders, which may be important in the rehabilitation and return to work of injured workers. Future analyses need to examine the incidence of symptoms and upper extremity musculoskeletal disorders prospectively among workers in relation to the TLV for hand activity.