Frequent musculoskeletal symptoms and reduced health-related quality of life among industrial workers

The moderating effect of work-related musculoskeletal disorders in relation to occupational stress and health-related quality of life of construction workers: a cross-sectional research

BACKGROUND

This study aimed to investigate work-related musculoskeletal disorders (WMSDs), occupational stress, and health-related quality of life (HRQoL); identify the factors that affect HRQoL; and investigate the moderating effects of WMSDs on occupational stress and HRQoL.

METHODS

The participants were construction workers who had worked in the construction industry for over three months. A total of 178 construction workers voluntarily participated and anonymously completed the musculoskeletal symptoms questionnaire, the Korean Occupational Stress Scale, short-form 36. The moderation effect of WMSDs on occupational stress and HRQoL were analyzed by Haye's Process Macro Model.

RESULTS

The results of the study showed that 96 subjects (53.9%) had WMSDs, and the most common pain site was the lower back (33.3%). The group with WMSDs had higher occupational stress than did the group without WMSDs (p < 0.01). Compared with the group without WMSDs, the group with WMSDs displayed significant differences in HRQoL (p < 0.001). Furthermore, the factor affecting HRQoL was WMSDs (p < 0.001). In the impact of occupational stress on HRQoL, WMSDs had a significant moderating effect (p < 0.001).

CONCLUSION

The results of this study indicate that construction workers' WMSDs significantly impact occupational stress and HRQoL, and WMSDs have a significant moderating effect on the relationship between occupational stress and HRQoL. Therefore, to improve the HRQoL of workers in the construction industry, it is necessary to develop methods to reduce occupational stress and prevent and treat WMSDs.

Shoulder pain, shoulder disability, and depression as serial mediators between stress and health-related quality of life among middle-aged women

This study analyzed the mediating effects of shoulder pain, disability, and depression on the relationship between stress and health-related quality of life among middle-aged women using a serial mediation model. Methods. Data on stress, health-related quality of life, shoulder pain, shoulder disability, and depression were collected from 565 women aged 35–64 years living in Seoul, South Korea, from May 13 to 23, 2021, using a self-reported, structured survey. SPSS PROCESS macro (Model 6) and serial mediation analysis were used to analyze the relationship between stress and health-related quality of life among participants, with shoulder pain, shoulder disability, and depression as mediators. Results. The results indicate that stress had a statistically direct impact on health-related quality of life. In the serial mediation analysis, shoulder pain, disability, and depression were found to be statistically significant, thus affecting the relationship between stress and health-related quality of life, with an explanatory power of 33%. Therefore, the relationship between stress and health-related quality of life was partially mediated by these variables. Conclusions. Thus, this study suggests the need for healthcare workers to develop methods, such as exercise intervention programs based on various degrees and types of physical activity, to improve health-related quality of life and reduce stress caused by shoulder pain, shoulder disability, and depression among middle-aged women.

Alarmins S100A8/A9 promote intervertebral disc degeneration and inflammation-related pain in a rat model through toll-like receptor-4 and activation of the NF-κB signaling pathway

OBJECTIVE

The molecules released from cells undergoing necrosis are recognized as alarmins, and S100A8/9, a typical alarmin, is associated with several inflammation-related diseases. This study was to investigate the molecular role of S100A8/A9 on the process of intervertebral disc degeneration (IVDD) and inflammation-related pain.

METHODS

The expression pattern of S100A8/A9 in different degenerated human nucleus pulposus (NP) tissues were measured by Real-time quantitative reverse transcription PCR (RT-qPCR) and immunohistochemical (IHC). The effects of S100A8/A9 on matrix production were assessed by RT-qPCR, western blotting, and cell immunofluorescence. Involvement of TLR4 and NF-κB signaling pathways were studied by pharmachemical inhibitors and small interfering RNAs (siRNAs). The development of degenerative and pain features in the IVDD model were examed by IHC and pain-behavior testing.

RESULTS

The expression of S100A8/A9 was significantly elevated in severely degenerated human NP tissue with similar expression pattern of TNF-α. In NP cells, S100A8/A9 increased MMP-3/13, TNF-α, IL-6 expression and inhibited aggrecan and collagen II expression. RT-qPCR and western blotting showed that the regulatory effects of S100A8/A9 on IVD were TLR4 dependent. Pharmacological inhibition or siRNA knockdown of the NF-κB signaling attenuated S100A8/A9-induced upregulation of MMP-3/13, TNF-α and IL-6. In vivo, S100A9 inhibitor treatment inhibited disc-puncture induced IVDD and inflammation-related pain.

CONCLUSIONS

This study showed that S100A8/A9 bound to TLR4 and increased the expression of MMPs, TNF-α, and IL-6 through NF-κB signaling pathways in NP cells. Furthermore, S100A8/A9 inhibitor could prevent development of IVDD and inflammation-related pain in the rat model.

Prevalence of depression disorder in industrial workers: a meta-analysis

Objectives. Depression is known to be associated with a variety of occupational factors. The aim of this study was to meta-analyze the prevalence of depressive disorder in industrial workers. Methods. Three databases indexing abstracts of articles were selected and searched until August 2020: PubMed, Web of Science and Scopus. For each study, the sample size and number of depression events were extracted, and after extracting these data, the random effects method was used to assess the prevalence. I² and χ² values were used to investigate the heterogeneity. Results. The prevalence of depressive disorder in industrial workers is 21%. The prevalence of depressive disorder in men and women industrial workers is 23 and 28%, respectively. The prevalence of depressive disorder in Asia, Europe and America is equal to 22, 18 and 20%, respectively. The result of the heterogeneity test showed that the heterogeneity is high. Conclusion. The prevalence of depression in industrial workers is higher than in the general population. These differences can be due to the working conditions of industrial workers. Therefore, the work environment and the promotion of occupational health can play an important role in preventing depression.

Prevalence, pattern and correlates of work-related musculoskeletal disorders among school teachers in Enugu, Nigeria

Introduction. There is insufficient literature on the prevalence of and risk factors for work-related musculoskeletal disorders (MSDs) among teachers in Nigeria. This study aimed to investigate the prevalence of work-related MSDs and their associations with occupational and socio-demographic factors of Nigerian-based school teachers. Materials and methods. Socio-demographic and occupational characteristics, prevalence and pattern of work-related MSDs of 352 school teachers (age 24-60 years) were investigated using a standard Nordic questionnaire. Data were summarized with descriptive statistics. Univariate and multivariate analyses were used to assess predictors of work-related MSDs. Results. The results showed that 70.2% of the teachers had work-related MSDs predominantly in the shoulder (62.3%) and neck (57.9%) regions. Most of the studied socio-demographic features and anthropometric and occupational characteristics were significantly associated (p < 0.05) with MSDs in at least one body region. Conclusions. There was a prevalence of work-related MSDs among the teachers. Advanced educational qualification, elevated teaching boards, teaching experience over 10 years and age range of 35-50 years were the major predictors of MSDs.

Associations between work-related musculoskeletal disorders, quality of life, and workplace stress in physical therapists

This study was performed to determine the associations between work-related musculoskeletal disorders (WMSDs), quality of life (QoL), and workplace stress among physical therapists (PTs) in South Korea. Self-reporting questionnaires were given to 855 PTs. Variables examined included general characteristics, WMSDs, QoL, and workplace stress. Of the 788 PTs who responded, 745 (94.5%) reported WMSDs affecting at least one body site. The most affected WMSDs site was the shoulder (23.3%), and the most reported number of body sites affected by WMSDs was one (50.9%). QoL was significantly improved (p<0.05) among PTs over 39 years old, who had 10-15 years of professional experience, worked in general/university hospitals, and had only one site affected by WMSDs. Factors influencing QoL included number of body sites affected by WMSDs, presence/absence of WMSDs, working venues, workplace stress, and age. Factors affecting workplace stress included number of body sites affected by WMSDs, QoL, work hours, and gender. The results showed a high prevalence of WMSDs among PTs in South Korea, and this negatively affected both QoL and workplace stress.

Qualidade de vida de trabalhadores com LER/DORT e lombalgia ocupacional atendidos no Cerest de Guarulhos, São Paulo

Resumo Objetivo: descrever a qualidade de vida (QV) dos trabalhadores com lesões por esforços repetitivos / distúrbios osteomusculares relacionados ao trabalho (LER/DORT) e lombalgia ocupacional (LO) atendidos no Centro de Referência em Saúde do Trabalhador Regional de Guarulhos, São Paulo, Brasil e verificar se fatores sociodemográficos, ocupacionais e relacionados ao quadro clínico interferem na sua QV. Métodos: estudo descritivo com delineamento transversal, utilizando-se o instrumento WHOQOL-Breve e uma entrevista estruturada. Dados colhidos entre 2011 e 2013. Resultados: participaram 192 sujeitos com LER/DORT e/ou LO. Os escores médios foram inferiores para todos os domínios do WHOQOL-Breve quando comparados à população saudável (p<0,001). Os trabalhadores com LER/DORT e LO simultaneamente apresentaram menores pontuações na QV geral e nos domínios físico, psicológico e ambiental. Aqueles que possuíam menor escolaridade apresentaram pontuação inferior na QV geral, e os que estavam afastados do trabalho, menores pontuações no domínio físico e na QV geral. Conclusão: as limitações do estudo permitem relacionar os resultados apenas com os sujeitos que efetivamente participaram dele. Todavia, os resultados encontrados corroboram várias pesquisas que têm constatado os efeitos deletérios dos distúrbios osteomusculares e de outras doenças crônicas na QV dos indivíduos afetados.

Assessing the impact of waste picking on musculoskeletal disorders among waste pickers in Mumbai, India: a cross-sectional study

OBJECTIVE

To assess the prevalence of musculoskeletal disorders (MSDs) as well as the impact of the occupation of waste picking on complaints of MSDs among waste pickers. The study attempts to understand the risk factors for MSDs in various areas of the body.

DESIGN

A cross-sectional household survey was conducted using a case-control design. The survey instrument for measuring musculoskeletal symptoms was adopted from a standardised Nordic questionnaire. The impact of the occupation of waste picking on MSDs was analysed using the propensity score matching (PSM) method.

PARTICIPANTS

The study population consisted of waste pickers (n=200) who had been working for at least a year and a control group (n=213) selected from among or living close to the same communities.

RESULTS

The 12-month prevalence of MSDs was higher among waste pickers (79%) compared to controls (55%) particularly in the lower back (54-36%), knee (48-35%), upper back (40-21%) and shoulder (32-12%). Similar patterns were observed in the 12-month prevalence of MSDs which prevented normal activity inside and outside the home, particularly for the lower back (36-21%), shoulder (21-7%) and upper back (25-12%) for waste pickers and controls. Analysis of the impact of waste picking on complaints of MSDs suggests that the occupation of waste picking raises the risk of MSDs particularly in the shoulder, lower and upper back. Older age and longer duration of work are significant risk factors for MSDs.

CONCLUSIONS

The findings suggest a relatively higher prevalence of MSDs among waste pickers, particularly in the lower and upper back and shoulder, compared to controls. Preventive measures and treatment to minimise the burden of MSDs among waste pickers are strongly recommended.

Health status and health-related quality of life of municipal waste collection workers - a cross-sectional survey

Background

Waste collection workers are exposed to several occupational stressors which may affect their quality of life. Our aim was to assess the health status and health-related quality of life (HRQoL) of municipal waste collection workers of a big German city.

Methods

Cross-sectional study with a non-random sample of 65 (62 male, 3 female) workers of the Hamburg sanitation department, volunteering to participate in the study. We assessed the prevalence of reported health complaints and health problems. HRQoL was assessed with the self-administered EQ-5D-5L questionnaire and its visual analogue scale (VAS).

Results

The most common health problems were musculoskeletal complaints (back pain reported by 67.2 %, other musculoskeletal complaints 15.4 %). Asthma or chronic obstructive pulmonary disease (COPD) was reported by 15.4 % of the workers. All participants reporting having a diagnosis of asthma or COPD had been or were active smokers. Our findings indicate an impaired HRQoL among the investigated occupational group. Regarding EQ-5D 68.3 % reported at least “slight” problems in one or more dimensions, and almost one third (31.7 %) reported “no problems” in any dimension. Problems were most frequently reported in the dimension “pain/discomfort” (64.1 % of the workers). The mean VAS value was 80.9 (13.2). The presence of back pain was associated with limitations in HRQoL (RR 3.1; 95 %-CI 1.5-6.1). The EQ5D VAS score was statistically significantly lower among waste collectors with back pain (77.9 SD 14.1) compared to those with no back complaints (88.0 SD 7.6, p < 0.01).

Conclusions

Back complaints are common among municipal waste collectors and are associated with considerable impairments in their HRQoL. Interventions to enhance ergonomic work are needed in order to reduce back complaints and enhance HRQoL in this occupational group.

Reference values for the SF-36 in Canadian injured workers undergoing rehabilitation

PURPOSE

The Medical Outcomes Study 36-item Short Form Survey (SF-36) is a widely used measure of health-related quality of life and normative reference values have been published for the general population of several countries. Since injured workers often experience pain, disability and other health challenges, we evaluated SF-36 reference values for Canadian workers' compensation claimants undergoing rehabilitation.

METHODS

Descriptive cross-sectional design. Data were gathered as part of a study aimed at developing a tool for selecting rehabilitation programs. Data were available on a wide variety of measures, including the SF-36. We calculated age- and sex-adjusted reference values, and stratified analyses based on type of rehabilitation, employment status and diagnostic group.

RESULTS

Data were available on 5,622 claimants undergoing rehabilitation. Claimants reported significant limitations on all SF-36 scales, but were especially limited on the Role Emotional and Bodily Pain scales (~3 standard deviations below typical Canadian norms). Unemployed, middle-aged claimants undergoing chronic pain programs reported the lowest health status, but SF-36 scores varied minimally across diagnoses.

CONCLUSIONS

Claimant scores on the SF-36 were below population norms across all health scales and differed depending on age, employment status and type of rehabilitation. These data will be useful for assessing the health status of injured workers and evaluating the effect of rehabilitation interventions.

Health-related quality-of-life of coal-based sponge iron plant workers in Barjora, India: a cross-sectional study

OBJECTIVES

During the last decade, coal-based sponge iron plants, a highly polluted industry, have grown rapidly in Barjora, India. Understanding their workers' perception of health is essential in people-centered healthcare. The aim of the study was to assess their health-related quality-of-life (HRQoL), and to determine factors that independently predict their HRQoL.

DESIGN

Cross-sectional study.

SETTING

Coal-based sponge iron plants in Barjora, India.

PARTICIPANTS

258 coal-based sponge iron plant workers.

PRIMARY OUTCOME MEASURE

HRQoL was measured using the EuroQol-5D-5L.

RESULTS

The response rate was 100%. Participants with problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 23.3%, 5.1%, 10.9%, 39.5% and 45.5%, respectively. 36.8% of participants reported health state 11111 (no problem in any EQ-5D dimension). The mean visual analogue scale (EQ-VAS) was 69.8 (18.5 SD). The odds of mobility problems decreased with age (OR 0.95, 95% CI 0.91 to 0.99, p=0.016), were lower in participants with presence/history of any respiratory disease (0.27, 0.13 to 0.55, p<0.001), scheduled caste/scheduled tribe/other backward class workers (0.44, 0.22 to 0.89, p=0.021), manual workers (0.40, 0.16 to 0.99, p=0.047) and non-smokers (2.63, 1.27 to 5.46, p=0.009). The odds of pain/discomfort and anxiety/depression were lower in participants with any respiratory disease (0.44, 0.24 to 0.79, p=0.006; and 0.52, 0.29 to 0.92, p=0.026, respectively). The EQ-VAS was worse in manual participants (coefficient -6.91, 95% CI -12.40 to -1.41, p=0.014), with any respiratory disease (-8.13, -13.12 to -3.13, p=0.002), alcohol drinkers (-4.81, -9.47 to -0.15, p=0.043), literates (7.70, 0.97 to 14.43, p=0.025) and Hindus (13.41, 2.62 to 24.20, p=0.015).

CONCLUSIONS

Many coal-based sponge iron plant workers in Barjora have problems in their HRQoL, and the predictors of different aspects of HRQoL were identified. The study findings could be taken into consideration in future interventional studies aimed at improving the HRQoL of these workers.

Impact of musculoskeletal pain on health-related quality of life among fishing sector workers

This study aims to determine the impact of musculoskeletal pain (in terms of intensity of the pain, location and functional disability due to back pain) and other factors (socio-demographic, lifestyle and co-morbidity) on the health-related quality of life on a group of shellfish gatherers. This observational transversal study included 929 shellfish gatherers (18-69 years, 98.7 % women) who completed a self-administered questionnaire, including socio-demographic and lifestyle questions, co-morbidity, intensity and location of musculoskeletal pain, and Roland-Morris Disability Questionnaire (RMDQ). Health-related quality of life was assessed using the 36-item Short Form Survey (SF-36). Physical component summary (PCS) and mental component summary (MCS) of the SF-36 were considered as outcome variables. The impact of the different factors on the PCS and MCS scores was evaluated using a stepwise linear regression analysis. Physical health was found to be independently associated to intensity of musculoskeletal pain (regression coefficient, B = -0.96), number of locations with musculoskeletal pain (MSP) (B = -0.77), presence of pain in the hip-knee (B = -2.26), self-reported rheumatic disorders (B = -2.79), lower back pain (B = -1.62) and age (B = -0.06). Mental health was associated with the presence of self-reported depressive syndrome (B = -1043.1) and RMDQ score (B = -42.2). The sample had significantly lower values than the reference population in all of the dimensions of the SF-36. Intensity of the pain, pain in the hip-knee, lower back pain, functional disability due to back pain and number of locations with musculoskeletal pain were found to have a detrimental impact on the physical health of the workers. Depressive syndrome and greater functional disability due to back pain, in turn, predict worse mental health.

Differences in health complaints among Taiwanese workers in different occupational categories

OBJECTIVES

The objectives of this study were to determine the prevalence of and differences in certain health complaints, including physical symptoms and psychological distress, among workers in different occupational categories and to explore the associations between occupational category and each complaint.

METHODS

A cross-sectional study was conducted using a self-administered questionnaire. A total of 1,628 workers representing seven occupational categories from ten companies in different industries submitted completed questionnaires. The self-administered questionnaire contained three parts: personal data, physical symptoms and psychological distress. Physical symptoms were measured using nine questions developed by a panel of ten general practitioners; the questions included nine common physical symptoms across main organ systems. Psychological distress was measured using the Chinese Health Questionnaire.

RESULTS

Muscle pain (44.7%) and dizziness (30.1%) were the most common symptoms reported by participants, and 16.6% of participants suffered from psychological distress. Significant differences in physical symptoms and psychological distress were found among workers in different occupational categories (Χ(2)=53.59, p<0.001). Compared with service workers, office workers and managers had higher prevalence rates of physical symptoms; office workers also showed a higher prevalence of psychological distress.

CONCLUSIONS

The study merits attention in terms of prevention of health problems in the workplace by focusing on a set of physical symptoms and psychological distress (not merely morbidity). Occupational category should be taken into consideration when planning workplace health promotion. Our findings highlight the need for health promotion programs that specifically target office workers and managers.

The predictive validity of the RSI QuickScan questionnaire with respect to arm, shoulder and neck symptoms in computer workers

The aim of this study was to determine whether results from the RSI QuickScan questionnaire on risk factors for arm, shoulder and neck symptoms can predict future arm, neck and shoulder symptoms in a population of computer workers. For this prospective cohort study, with a follow-up of 24 months, 3383 workers who regularly worked with a computer were approached. Generalised estimating equations (GEE) with 6, 12, 18 and 24 months time lags were used to determine whether high exposure was related to symptoms at follow-up. The results showed that high scores on 9 out of 13 scales, including previous symptoms, were significantly related to arm, shoulder and neck symptoms at follow-up. These results provide support for the predictive validity of the RSI QuickScan questionnaire.

PRACTITIONER SUMMARY

The results showed that high scores on 9 out of 13 scales, including previous symptoms, were significantly related to arm, shoulder and neck symptoms at follow-up. The RSI QuickScan questionnaire may be recommended as a tool in the identification of computer workers who should be targeted with interventions aimed at prevention of future symptoms.

Workplace interventions for neck pain in workers

BACKGROUND

Musculoskeletal disorders are the most common cause of disability in many industrial countries. Recurrent and chronic pain accounts for a substantial portion of workers' absenteeism. Neck pain seems to be more prominent in the general population than previously known.

OBJECTIVES

To determine the effectiveness of workplace interventions (WIs) in adult workers with neck pain.

SEARCH STRATEGY

We searched: CENTRAL (The Cochrane Library 2009, issue 3), and MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, OTseeker, PEDro to July 2009, with no language limitations;screened reference lists; and contacted experts in the field.  

SELECTION CRITERIA

We included randomised controlled trials (RCT), in which at least 50% of the participants had neck pain at baseline and received interventions conducted at the workplace.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted data and assessed risk of bias. Authors were contacted for missing information. Since the interventions varied to a large extend, International Classification of Functioning, Disability and Health (ICF) terminology was used to classify the intervention components. This heterogeneity restricted pooling of data to only one meta-analysis of two studies.

MAIN RESULTS

We identified 1995 references and included10 RCTs (2745 workers). Two studies were assessed with low risk of bias. Most trials (N = 8) examined office workers. Few workers were sick-listed. Thus, WIs were seldom designed to improve return-to-work. Overall, there was low quality evidence that showed no significant differences between WIs and no intervention for pain prevalence or severity. If present, significant results in favour of WIs were not sustained across follow-up times. There was moderate quality evidence (1 study, 415 workers) that a four-component WI was significantly more effective in reducing sick leave in the intermediate-term (OR 0.56, 95% CI 0.33 to 0.95), but not in the short- (OR 0.83, 95% CI 0.52 to 1.34) or long-term (OR 1.28, 95% CI 0.73 to 2.26). These findings might be because only a small proportion of the workers were sick-listed.

AUTHORS' CONCLUSIONS

Overall, this review found low quality evidence that neither supported nor refuted the benefits of any specific WI for pain relief and moderate quality evidence that a multiple-component intervention reduced sickness absence in the intermediate-term, which was not sustained over time. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There is an urgent need for high quality RCTs with well designed WIs.

Upper-extremity musculoskeletal symptoms and physical health related quality of life among women employed in poultry processing and other low-wage jobs in northeastern North Carolina

BACKGROUND

The purpose of this study was to evaluate the association between upper-extremity musculoskeletal symptoms (MS) and diminished physical health related quality of life (PHRQoL) in a population of women, mostly African-American working in poultry processing and other low-wage jobs in rural northeastern North Carolina.

METHODS

A cross-sectional analysis was performed on baseline data of self-reported PHRQoL and musculoskeletal symptoms for 291 poultry processing workers and 299 community comparison women. Logarithmic binomial regression was performed to assess the relationship between moderate to severe MS on low PHRQoL.

RESULTS

Prevalence of poor PHRQoL was 35.5% among poultry processing workers, and 14.7% among community comparison group. Moderate to severe upper-extremity musculoskeletal symptoms were present in 34.4% of the poultry workers and 10.7% of the comparison group. After adjusting for age and other chronic conditions, moderate to severe musculoskeletal symptoms were associated with low PHRQoL in both groups. Although the observed effect was stronger among the comparison group (adjusted prevalence ratios (95% confidence interval): poultry workers = 1.89 (1.36, 2.64), community comparison = 4.26 (2.51, 7.24), the population attributable risk percent was similar (poultry workers = 28.9, community comparison = 31.3%)) due to the higher prevalence of moderate to severe symptoms in the poultry workers.

CONCLUSIONS

Significant upper-extremity musculoskeletal symptoms were associated with poor PHRQoL among both groups of women employed in low-wage jobs. Nationwide, poultry work is over-represented by minorities and immigrants. Though challenging, we need to search for ways to improve the conditions of these women as a matter of social justice.

Sickness absence for upper limb disorders in a French company

BACKGROUND

Many studies have shown that musculoskeletal disorders (MSDs) have important economic and social consequences, including substantial costs and loss of productivity for industries. However, little is known about the impact of these conditions on sickness absence in industries.

AIM

To describe the sickness absence taken for MSDs of the upper limb (ULD) in a French company and to study their association with demographic and socioeconomic factors.

METHODS

Sickness absence from 2000 to 2004 (5543 episodes) was studied using data from the company's epidemiology registry and a questionnaire for each episode was completed by physicians. Incidence rates were calculated according to the gender, socioeconomic status and age.

RESULTS

The incidence rate of absence for ULD was six episodes per 1000 person-years. Rotator cuff syndrome and carpal tunnel syndrome were the most frequent diagnoses. Less frequent diagnoses, such as Guyon's canal syndrome, had longer sickness absence (55.3 days). Incidence was higher for women and blue-collar workers. Incidence also increased with age.

CONCLUSIONS

These results are consistent with other studies. Although absenteeism cannot be a surrogate for disease burden or incidence, it may be useful in the prevention of ULD, as it identifies the most disabling diagnoses and the working groups most at risk.

Physical activity is associated with a low prevalence of musculoskeletal disorders in the Royal Norwegian Navy: a cross sectional study

BACKGROUND

Despite considerable knowledge about musculoskeletal disorders (MSD) and physical, psychosocial and individual risk factors there is limited knowledge about physical activity as a factor in preventing MSD. In addition, studies of physical activity are often limited to either leisure activity or physical activity at work. Studies among military personnel on the association between physical activity at work and at leisure and MSD are lacking. This study was conducted to find the prevalence of MSD among personnel in the Royal Norwegian Navy and to assess the association between physical activity at work and at leisure and MSD.

METHODS

A questionnaire about musculoskeletal disorders, physical activity and background data (employment status, age, gender, body mass index, smoking, education and physical stressors) was completed by 2265 workers (58%) 18 to 70 years old in the Royal Norwegian Navy. Multiple logistic regression with 95% confidence intervals was used to assess the relationship between physical activity and musculoskeletal disorders.

RESULTS

A total of 32% of the workers reported musculoskeletal disorders often or very often in one or more parts of the body in the past year. The most common musculoskeletal disorders were in the lower back (15% often or very often), shoulders (12% often or very often) and neck (11% often or very often). After adjustment for confounders, physical activity was inversely associated with musculoskeletal disorders for all body sites except elbows, knees and feet.

CONCLUSION

The one-year prevalence of musculoskeletal disorders among workers in the Royal Norwegian Navy was rather low. A physically active lifestyle both at work and at leisure was associated with fewer musculoskeletal disorders among personnel in the Royal Norwegian Navy. Prospective studies are necessary to confirm the cause and effect in this association.

Back pain exacerbations and lost productive time costs in United States workers

STUDY DESIGN

Cross-sectional with follow-up case-control component.

OBJECTIVES

To measure the prevalence of back pain (BP) and back pain exacerbations, describe BP features and functional impairment, estimate BP-related lost productive time (LPT) and costs, and assess the relation between pain exacerbations and lost productive time.

SUMMARY OF BACKGROUND DATA

BP is associated with substantial lost work time. However, little is known about the extent to which BP with or without exacerbation explains lost work time.

METHODS

A national telephone survey of the U.S. workforce identified 320 workers 40 to 65 years of age with BP defined by NHANES I criteria and 91 matched non-BP controls. Participants self-reported pain characteristics, lost productive time (absenteeism and presenteeism) in the previous 2 weeks, activity limitations, and demographics. A population-weighting adjustment was applied to estimates to account for selection bias and ensure that estimates of certain sample demographic subgroups' totals conformed to the Current Population Survey.

RESULTS

The 2-week period prevalence of BP was 15.1%; 42% of workers with BP experienced pain exacerbations. BP prevalence was associated with demographic factors, but BP exacerbations were not. BP was reported by 42.6% of all workers. Workers with exacerbations reported more days with BP than those without exacerbations. Workers with exacerbations were significantly more likely than those without such exacerbations to report activity limitation (88.4% vs. 60.7%; P < 0.0001) and BP-related LPT (22.1% vs. 13.0%; P = 0.0259). BP in workers 40 to 65 years of age costs employers an estimated $7.4 billion/year. Workers with BP exacerbations account for 71.6% of this cost.

CONCLUSIONS

Workers with BP exacerbations account for a disproportionate share of the cost of BP-related lost productive time.

Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism

Background

It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD) also play an important role in the determining consequences of MSD in terms of sickness absence and health care use.

Methods

A cross-sectional study was conducted among 853 shipyard employees. Data were collected by questionnaire on physical and psychosocial workload, need for recovery, perceived general health, occurrence of musculoskeletal complaints, and health care use during the past year. Retrospective data on absenteeism were also available from the company register.

Results

In total, 37%, 22%, and 15% of employees reported complaints of low back, shoulder/neck, and hand/wrist during the past 12 months, respectively. Among all employees with at least one MSD, 27% visited a physician at least once and 20% took at least one period of sick leave. Various individual and work-related factors were associated with the occurrence of MSD. Health care use and absenteeism were strongest influenced by chronicity of musculoskeletal complaints and comorbidity with other musculoskeletal complaints and, to a lesser extent, by work-related factors.

Conclusion

In programmes aimed at preventing the unfavourable consequences of MSD in terms of sickness absence and health care use it is important to identify the (individual) factors that determine the development of chronicity of complaints. These factors may differ from the well-know risk factors for the occurrence of MSD that are targeted in primary prevention.

Self reported musculoskeletal symptoms in the neck/shoulders and/or arms and general health (SF-36): eight year follow up of a case-control study

AIMS

To explore and compare the prevalence after eight years of self reported musculoskeletal symptoms and general health (SF-36) for groups with initially different degrees of severity of symptoms in the neck/shoulders and/or arms.

METHODS

A case-control study was performed in 1989 comprising 129 clinically examined cases and 655 survey controls. The study population was followed up in 1997 with a postal survey. The controls, none of which were clinically examined at baseline (1989), were divided into groups according to degree of severity of self reported symptoms in the neck/shoulders and/or arms at baseline: no symptoms, light symptoms, and severe symptoms. Cases were clinically diagnosed with a musculoskeletal disorder of the neck/shoulders and/or arms at baseline.

RESULTS

At the 1997 follow up, there was a trend of increasing prevalence of musculoskeletal symptoms, as well as decreasing health status as rated in the SF-36 over the three severity groups among controls. Only small differences were seen between the cases and the controls reporting severe musculoskeletal symptoms or the neck/shoulders and/or arms.

CONCLUSION

The degree of questionnaire based self reported musculoskeletal symptoms of the neck/shoulders and/or arms clearly indicate different degrees of future health problems (both in terms of self reported musculoskeletal problems and health in general as captured by the SF-36). Therefore, there is a need for improved intervention and health promotion strategies. Such effort should be implemented before musculoskeletal symptoms have developed to clinical cases, particularly in the realm of the workplace.

Ergonomic Pain-Part 1: Etiology, Epidemiology, and Prevention

Work-related musculoskeletal disorders (MSDs) have reached a costly epidemic proportion in recent years, producing ergonomic pain as their most frequent clinical consequence. While work-related MSDs have declined in incidence, their prevalence continues. Individuals develop symptoms as a consequence of numerous factors that include force, sustained posture, repetitive motion, and vibration. Different combinations of these factors lend to different pathomechanical and pathophysiological consequences that appear to be unique to different regions of the body and related to distinctive work environmental and task characteristics. Federal and state agencies have made considerable attempts to regulate the work environment in a preventative fashion in order to reduce the incidence of ergonomic pain and other sequelae of work-related MSDs.