Musculoskeletal Disorders in Northeast Lobstermen

Effects of different sorting table heights on low back and shoulders biomechanical loads during dungeness crab sorting

West Coast Dungeness crab fishers suffer a high prevalence of musculoskeletal injuries, especially low back pain. Substantial trunk flexion and associated low back loads during crab sorting tasks have been attributed to awkward sorting table heights. This study examined how varying table heights affect biomechanical loads on the low back and shoulders. Twenty-five participants performed crab sorting tasks at three table heights while trunk and shoulder joint angles, moments, muscle activity, perceived exertion, and discomfort were measured. Increasing table height reduced trunk flexion and lumbosacral (L5/S1) joint moments but increased shoulder flexion moments and upper trapezius muscle activity. Table height did not affect perceived exertion or discomfort. These findings indicate that increasing sorting table height can reduce biomechanical load on the low back but results in increased shoulder strain. This trade-off underscores the importance of adopting ergonomic designs balancing low back and shoulder biomechanics to determine appropriate sorting table height.

Adding Insult to Injury: The Impact of Musculoskeletal Pain on Fishermen's Sleep Patterns

OBJECTIVES

Commercial fishing is one of the most dangerous industries in the United States, and although injuries have been a prominent focus for research, some health and safety risk factors such as sleep are understudied. In this paper, data from a multi-modal research study of sleep patterns, lifestyle factors, occupational exposures, medical histories, and health assessments in four U.S. fisheries are used to explore the connections between pain and sleep.

METHODS

A mixture of randomized cluster sampling, study promotions, and dockside recruitment was utilized to gather a sufficient number of fishermen in the Alaska Salmon, Oregon Dungeness Crab, Massachusetts Scallop, and Massachusetts Lobster fisheries for the study. Fishermen were surveyed about sleep patterns, occupational exposures, and lifestyle factors. Surveyed fishermen were provided with free comprehensive health assessments by occupational health nurses and physicians or Advanced Practice Providers. Data were collected in REDCap and downloaded into SAS for analysis using a variety of analytic methods.

RESULTS

A total of 262 surveys and 162 physical examinations were completed with captains and crew members in the four fisheries targeted for study. The average self-reported consecutive hours of sleep for fisheries workers that spend several days at sea (i.e. Crab, Scallop, and Salmon fisheries) were roughly 3.5 to 4.0 h in a 24-h period. Of particular note, the majority of fishermen, regardless of fishery, suffered from back pain, and roughly 40% of fishermen noted pain and discomfort significantly impede their ability to sleep.

CONCLUSIONS

This study underscores the connections between musculoskeletal pain and sleep, providing yet further impetus for preventing musculoskeletal injuries among fishermen. Given the ties between existing sleep debt in the industry and the health and safety risks posed by repeated exposure to insufficient sleep, this study highlights the need for the prevention of these injuries and potentially better treatment options for fishermen who suffer from musculoskeletal disorders.

Occupational health and safety portrait of lobster fishers from a St. Lawrence Gulf community

Lobstering industry workers are known to have poor overall health and low safety records, but there is still a gap in information concerning Canadian lobster fishers. This study aimed to report occupational health and safety characteristics of an Atlantic Canada community of lobster fishers and to assess differences between captains and deckhands. Twenty-eight participants (10 captains, 18 deckhands) were questioned and self-reported on lifestyle, general health status, work-related musculoskeletal disorders and traumatic injuries. The data collected reveal both groups' high prevalence of cardiometabolic and musculoskeletal health issues. Captains reported more occupational exposition and health issues, and showed poorer lifestyle habits than deckhands. Fishers reported potential solutions to reduce occupational risks, presented as three types: lifestyle, working behaviours and leadership. This study evaluated a community of Canadian lobster fishers regarding their occupational health and safety. Potential avenues for mitigating occupational risk specific to this community will nurture future implementation.

Naloxone training and availability in the US commercial fishing industry

INTRODUCTION

Workers in physically demanding jobs with high injury rates, long hours, productivity pressures, and lack of job security, such as commercial fishing, are at higher risk for substance use and misuse. In the United States, the federal government is urging employers to consider having naloxone available to reverse the effects of an opioid overdose, especially in workplaces. This study examined naloxone training, naloxone availability, and level of concern over substance use in commercial fishing.

METHODS

As part of a larger study of commercial fishing vessel captains, we asked participants how worried they are about various potential problems, including substance use by crew members, using a five-point scale. We also asked whether they had completed naloxone training and whether their vessel was equipped with naloxone.

RESULTS

Of the 61 vessel captains who participated, 10 had naloxone training. Most were "not at all worried" about a crew member misusing alcohol (n = 52; 85.2%), a crew member using marijuana (n = 50; 82.0%), a crew member using other drugs (n = 49; 80.3%), or a crew member having a drug overdose (n = 52; 86.7%). Only five fishing vessels were equipped with naloxone.

CONCLUSION

Our results indicate that few fishing vessels are equipped with naloxone or have captains trained in its use. Fishing captains tend not to be worried about substance use in their crew. Given the higher rate of overdose deaths in the fishing industry compared to other industries, having more vessels equipped with naloxone and captains trained to administer it could save lives.

The risk of an incident hospital contact with a musculoskeletal disorder in Danish occupational fishers: a register-based study

BACKGROUND

The prevalence of musculoskeletal disorders (MSDs) among occupational fishers is high, yet knowledge of the risk factors is scarce and inconsistent. The aim of this study was to investigate the risk from various work-related characteristics on incident hospital contact due to a musculoskeletal disorders and other pain disorders among Danish occupational fishers.

METHODS

This register-based study comprised data from the Danish Occupational Cohort with eXposure (DOC*X) for all persons registered as occupational fishers between 1994 and 2017. Time-to-event analysis with Cox regression model was used with age as the time scale.

RESULTS

Among the 15,739 fishers, 40% (n = 5,669 cases) had an incident hospital contact with an MSD during follow-up. Back disorders were the dominant complaint. Male fishers working less than 5 years or more than 15 years had higher risks of MSD (HR 2.40 (95% CI: 2.06, 2.80), HR: 2.04 (95% CI: 1.76, 2.35), respectively, than those working for over 20 years. Period effects confounded and reduced the risk from occupational seniority.

CONCLUSION

Fishers occupational seniority vary in risk of MSDs across working life. Results showed a nonlinear relationship between the highest risk for fishers working less than 5 years and the lowest risk working more than 20 years as occupational fisher. More years in the workforce, a captain education, and primarily working part time significantly reduced the risk of experiencing a first MSDs for men. Healthy worker effect was documented.

Chronic lower back pain in aquaculture clam farmers: adoption and feasibility of self-management strategies introduced using a rapid prototype participatory ergonomic approach

Objectives. Lower back pain (LBP) is extremely prevalent in seafood harvesters who often have limited or no access to ergonomic consultation, occupational health support and rehabilitation services. This pilot study aimed to describe a participatory ergonomic approach and determine the feasibility and extent of adoption of self-management strategies in clam farmers with LBP. Methods. A rapid prototype participatory ergonomic approach was used to develop context-specific self-management strategies. Options to adjust lifting and repetitive stress were introduced using video clips, demonstrations and discussions in the workplace. Workers chose and implemented three strategies for 8 weeks with weekly reminders. Survey and qualitative data from focus groups were analyzed. Results. Team strategies were the most popular, but individual options were used more often. Strategies were considered feasible, acceptable and relatively easy to use. Strategies were implemented relatively consistently, and most improved productivity with decreased pain. Challenges for uptake included changing habit, culture and team dynamics. Conclusions. Participatory rapid prototyping provided a feasible and efficient option to introduce strategies for clam farmers with small teams, variable work processes and workloads, and time restrictions. Strategies were considered acceptable and easy to use, and most increased productivity. These methods show potential for future research.

Using Participatory Ergonomics to Improve Health and Safety in Commercial Lobstering in the United States: 2 Case Studies

The lobster-harvesting industry has a high occupational injury incidence compared to land-based industries. Participatory ergonomics methods were used to partner with lobstermen to develop and implement ergonomic improvements. The model included training in ergonomics principles, a forum for ergonomics discussions, and a sequence of meetings planned to focus on problem identification, intervention, evaluation, and dissemination of findings. One crew initiated 3 specific actions: the introduction of a conveyor belt to assist material handling at a local lobstering pier, the installation of a star block at the space for hauling traps onto the boat, and the initiation of a design process for improved mechanical assistance for hauling traps onto the boat. The other crew took action to reduce force and postural exposures by creating a short video intended to disseminate ergonomic ideas to other lobstermen. The influence of important cultural norms was observed for future research and development in the community.

Evaluation of Occupational Health and Safety Risk Factors in Turkish Marine Fish Hatcheries

In the study, the approaches of employees in marine fish hatcheries on occupational health and safety were determined. The Cronbach's α coefficient was calculated as 0.858 in the reliability of the scale and scale factors based on internal consistency. In addition, factor analysis according to the varimax method was found to be approximately 64%. It was determined that 68% of the employees were not aware of the relevant laws. In addition, 85% of the employees are aware of the dangers and risks in their workplaces. In the event of a negative situation in the workplace, the rate of those who know their legal rights is 73% (p≤0.05). In addition, 91% of the employees stated that they would use their right to object in a risky situation and quit the job. 60% of the employees stated that their jobs can satisfy them sociologically and economically throughout their life.

Health-Related Exposures and Conditions among US Fishermen

Commercial fishing is a high-risk occupation, yet there is a lack of surveillance documenting health conditions, health behaviors, and health care coverage among US fishermen. We used publicly available data sources to identify exposures and health outcomes common among fishermen. We utilized the National Institute for Occupational Safety and Health-Worker Health Charts to estimate the prevalence of general exposures, psychosocial exposures, health behaviors, and health conditions from the national surveys National Health Interview Survey - Occupational Health Supplement (NHIS-OHS, 2015) and Behavioral Risk Factor Surveillance System (BRFSS) (2013-2015). We compared fishing workers with both agricultural workers and all-workers. Fishermen commonly reported general exposures, psychosocial exposures, non-standard work arrangements, frequent night shifts, and shift work. The prevalence of musculoskeletal conditions such as carpal tunnel syndrome (33%) and severe low-back pain (27%) was also high. Smoking (45%) and second-hand smoke exposure (25%) were widespread, and 21% reported no health care coverage. National household surveys such as NHIS-OHS, and BRFSS can be utilized to describe the health status of fishermen. This workforce would benefit from increased access to health care and health promotion programs. More comprehensive evaluations of existing data can help to identify occupation-specific health challenges.

Emerging OSH Issues in Installation and Maintenance of Floating Solar Photovoltaic Projects and Their Link with Sustainable Development Goals

Objective

Emerging issues of occupational safety and health (OSH) in floating solar photovoltaic projects (FSPV) have rarely been addressed to achieve the Sustainable Development Goals (SDGs). The current scoping review has been planned to demonstrate OSH issues experienced by the workers engaged in the installation and maintenance of FSPV projects and existing ergonomics design interventions in the solar photovoltaic industry with a focus on the FSPV sector.

Methods

A literature review was conducted from four major electronic databases (Science Direct, Google Scholar, Web of Science, and Scopus) using predefined keywords and following the PRISMA framework for the period 1965–2020. A total of 49 studies under five headings, namely a) overview of key reasons for the emergence of floating solar photovoltaic projects, b) occupational risks of workers engaged in the solar PV industry/FSPV sector, c) occupational risks in workplaces/occupations similar to floating solar photovoltaics projects, d) availability of training modules and occupational standards, and e) design interventions/approaches in the solar PV industry/floating photovoltaics sector were analyzed.

Results

It emerged that workers are exposed to multifarious occupational risk factors such as heat, solar radiation, ergonomic risks, electrocution, fire, hazardous substances, adverse weather conditions, and psychosocial factors. These risks have not been adequately addressed with required interventions in the FSPV sector. Intervention opportunities include designing innovative tools, lowering of loads, redesigning workplace layouts, introducing job aids, automation, task rotation, job enlargement, design of training modules, OSH standards and changes in work organization/shift, etc.

Conclusion

This review is a first-of-its-kind effort to highlight the contextual risk factors in the emerging FSPV sector and the need for addressing them through ergonomics design interventions for successfully achieving the Sustainable Development Goals.

Injuries and illnesses to children in commercial fishing in Alaska: A brief report

BACKGROUND

Commercial fishing is the most hazardous occupation in the United States. While the epidemiology of adult injuries and fatalities are well documented, injuries to children (<18 years old) are not described. The purpose of this report was to describe the characteristics of nonfatal injuries to children involved in commercial fishing.

METHODS

Nonfatal commercial fishing injuries to children were identified in the Alaska Fishermen's Fund. The Alaska Fishermen's Fund is an emergency fund payor of last resort. Data on nonfatal injuries to victims aged 17 or younger were analyzed. Descriptive statistics were used to characterize demographics and injury characteristics.

RESULTS

Forty-four nonfatal child injury claims were made between 2012 and 2016. The mean age at the time of claim was 15.6 years (SD = 1.8) and 84% were male. The most common types of injuries among children were sprains and strains and the most commonly injured body parts were upper extremities and the trunk. Most injuries occurred in salmon fisheries.

CONCLUSIONS

Children are participating in commercial fishing. Based on the results of this analysis, children are also experiencing occupational injuries. The results of this analysis underscore the need for additional safety and health information, guidance for supervisors, and intervention to prevent injuries to children participating in commercial fishing.

Work-related musculoskeletal disorders among occupational fishermen: a systematic literature review

BACKGROUND

Commercial fishing constitutes an increased risk of musculoskeletal disorders (MSD), as it consists of heavy workloads and uncontrollable strenuous settings. The aims of this systematic review were to describe the prevalence of MSD among occupational fishermen and to identify risk factors for onset work-related MSD.

METHODS

All studies investigating MSD in occupational fishermen were systematically identified and reviewed. Searched databases were PubMed/MEDLINE, EMBASE and CINAHL. Two independent researchers performed the quality assessments of the studies.

RESULTS

From 292 articles identified, 16 articles consisting of 13 studies were suitable for inclusion. Prevalence of overall MSD ranged from 15% to 93%. The only consistent work-related risk factor was 'working part time', while other risk factors, such as vessel and job type showed conflicting results.

CONCLUSION

MSDs in occupational fishermen are common across countries. Variations observed in MSD prevalence might be due to differences in methodology, populations and definitions of MSD. Evidence on work-related risk factors for MSD is sparse and most studies were of poor methodological quality. Only working part time was identified as a consistent risk factor for MSD possibly caused by a healthy worker effect. There is a need for investigating causality in longitudinal studies, including both active and retired fishermen to better understand the complexity of MSD.

PROSPERO REGISTRATION NUMBER

CRD42020147318.

Back disorder incidence and occupation in Denmark: a cross-sectional register-based study

PURPOSE

The purpose of the present paper is (1) to describe the occupational distribution of persons with incident back disorders and (2) to determine the incidence rate ratio (RR) for back pain amongst patients working in specific occupation groups.

METHODS

Using Danish registries, a total of 20,921 employed persons with incidents back disorders aged 18-64 years were identified in 2016 based on the inclusion criteria from the Danish Back Register. RR was estimated to test for differences in incident back disorder diagnoses across occupations. Pearson's Chi-square test was used to test for homogeneity in back disorder incidence across occupations.

RESULTS

The distribution of back disorder incidence for employed is above the distribution of employment in the background population for all age groups above 35 years. For employed women the three occupation groups with the highest RR of back pain incidence are: 'water, sewage and waste'; 'residential institutions and home care'; and 'transport of passengers', while similarly, amongst employed men: 'hairdressers and other personal care'; 'hospitals'; and 'cleaning'. RR of incident back pain disorders is lowest for women employed in 'universities and research' and for men employed in 'IT and telecommunications'.

CONCLUSIONS

This study is the first to investigate the occupational status and RR of back disorder incidence across occupation groups in Denmark. The distribution of back pain disorder incidents in the cross-sectional study is weighted to occupation groups involving hard physical activity. This evidence may be useful for considering work environment or pension reforms. These slides can be retrieved under Electronic Supplementary Material.

Opioid-related overdose deaths by industry and occupation-Massachusetts, 2011-2015

BACKGROUND

Thousands of people in the United States continue to die from opioid overdoses every year. Work-related injuries and other factors associated with work may increase exposure to opioids and, subsequently, opioid-related overdose deaths (OROD). This study sought to determine whether OROD rates differed by industry and occupation and explored work-related factors that might contribute to these differences.

METHODS

We coded industry and occupation information on death certificates for all OROD among Massachusetts residents from 2011 to 2015. We estimated rates of OROD by industry and occupation using Massachusetts employment data. National survey data were used to explore whether work-related factors known to vary by occupation (occupational injury and illness, job insecurity, and paid sick leave) correlate to observed differences in OROD.

RESULTS

Several industries and occupation groups had rates of OROD that were significantly higher than the rates for other workers. Construction workers and fishing workers stood out for having OROD rates many times higher than the average for all workers. Occupation groups with high rates of occupational injuries and illnesses, high job insecurity, and low availability of paid sick leave had higher rates of OROD.

CONCLUSIONS

These findings underscore the need for policy and educational interventions to reduce OROD tailored to the needs of high rate worker populations. Interventions should address workplace hazards that cause injuries for which opioids are prescribed, as well as best practices in medical management and return to work following injury, safer prescribing, enhanced access to treatment for opioid use disorders, and overdose prevention education.

Lifejackets and Lobstermen: Giving Safety Equipment a Competitive Advantage

Background: Falls overboard are the most frequent cause of death in the Northeast lobster fishing industry. National Institute for Occupational Safety and Health (NIOSH) surveillance indicates every victim of a fall overboard who has been found was not wearing a lifejacket. Preliminary research conducted in Maine and Massachusetts indicates lifejacket use is relatively uncommon among lobstermen due to barriers such as comfort, practicality, and social norms.Methods: This study highlights an initiative to: (1) trial various lifejacket designs with lobstermen; (2) identify the most popular designs; and (3) identify other features that could encourage use of lifejackets. In 2017, nine designs were trialed with lobstermen in Maine and Massachusetts during the winter and summer fishing seasons. Participants were recruited dockside, and lifejackets were randomly assigned. Participants completed surveys at 1 week and 4 weeks to assess positive and negative design features and to understand the importance of survival technology that can be used in conjunction with lifejackets.Results: 181 lobstermen in Maine and Massachusetts agreed to participate. Recruitment rates were 90.5%, while the survey completion rate was 88.4%. Survey results identified no clear preference for a specific lifejacket design; however, the ability to choose from many options appeared to be an important factor.Conclusion: Previous studies have indicated that lifejacket preferences are fisheries specific. In the Northeast lobster fishery, however, individual preferences varied. Our research demonstrates that a range of devices covering different buoyancies, wear type, and retrieval systems should be made more available to lobstermen.

Preventing Opioid Use Disorders among Fishing Industry Workers

Fishing industry workers are at high risk for work-related musculoskeletal disorders (MSDs) and injuries. Prescription opioids used to treat pain injuries may put these workers at increased risk for developing substance disorders. Using a Community-Based Participatory Research approach, formative research was conducted to inform the eventual development of relevant interventions to prevent and reduce opioid use disorders among fishing industry workers. Qualitative interviews (n = 21) were conducted to assess: knowledge and attitudes about opioid use disorders; features of fishing work that might affect use and/or access to treatment; and community and organizational capacity for prevention and treatment. Participants reported numerous pathways connecting commercial fishing with opioid use. The combination of high stress and physically tasking job duties requires comprehensive workplace interventions to prevent chronic pain and MSDs, in addition to tailored and culturally responsive treatment options to address opioid use disorders in this population. Public health programs must integrate workplace health and safety protection along with evidence-based primary, secondary, and tertiary interventions in order to address opioid use disorders, particularly among workers in strenuous jobs.