The impact of work rest scheduling for prolonged standing activity

Changes in Baropodometric Evaluation and Discomfort during the Workday in Assembly-Line Workers

Prolonged standing at work is associated with health risks. The appearance of lower-limb and lower-back discomfort is one of the most prevalent factors in prolonged standing workers. The aim of this research was to evaluate the effect of an eight-hour workday on foot pressure and musculoskeletal discomfort in standing workers. Thirty-six assembly-line workers (six women) were recruited to participate in a cross-sectional study to assess foot pressure and surface, foot, knee, and lower-back discomfort before and after a real workday. Baropodometry outcomes (surface and pressure) were evaluated by the pressure platform SensorMedica and musculoskeletal discomfort was evaluated by Cornell's Musculoskeletal Discomfort Questionaire. Total foot surface (p = 0.01) and foot discomfort (p = 0.03) increased significantly at the end of the workday. Prolonged standing during 8 h workday increased the foot discomfort and total foot surface in assembly-line workers. No foot pressure variable (forefoot, rearfoot, or total) was significantly modified after the workday in assembly-line workers.

Prevalence of work-related musculoskeletal disorders among professional rickshaw drivers in Aligarh, Uttar Pradesh, India

BACKGROUND

Professional rickshaw driving is a seemingly sedentary occupation and involves many risk factors for work-related musculoskeletal disorders (WMSD).

OBJECTIVE

To assess the prevalence of work-related musculoskeletal disorders and its associated risk factors among professional rickshaw drivers.

METHODS

263 rickshaw drivers were voluntarily recruited from Aligarh, Uttar Pradesh, India. MSD symptoms in the past 12 months and last 7 days were assessed using a self-modified musculoskeletal questionnaire (Nordic Questionnaire). Chi-square tests and binary logistic regression were performed to analyze associations of MSD symptoms between study variables.

RESULTS

155 (58.9%) study participants reported MSD symptoms in past 12 months, in lower back (n = 126, 81.3%), leg (n = 122, 78.7%), neck (n = 106, 68.4%) and knee (n = 105, 67.7%); and 121 (46.1%) in last 7 days, in leg (n = 107, 88.4%), lower back (n = 102, 84.3%), neck (n = 89, 73.6%), upper back and knees (n = 87, 71.9%). Binary logistic regression showed relationship between working hours, seat and road condition, average load per ride, rickshaw ride duration, and standing driving with MSD symptoms among rickshaw drivers, especially in the lower back, leg/calf muscles, neck and knees.

CONCLUSION

The results showed a high prevalence of MSD among all rickshaw drivers, with the neck, lower back, leg/calf muscles and knees being the most affected body parts. In order to avoid adverse effects on the occupational health of rickshaw drivers, ergonomic intervention training is necessary.

Risk factors associated with work-related musculoskeletal disorders among floor-sitting precision handicraft workers

PURPOSE

Precision handicraft workers are often exposed to stressful postures and poor working conditions while performing different jobs, that are directly associated with the development of musculoskeletal disorders (MSDs). This cross-sectional study aimed at evaluating the prevalence of MSDs and contributing risk factors among male precision handicraft workers.

METHODS

334 handicraft workers involved in different precision activities: 125 gemstone cutters, 98 miniature painters, and 111 metal craft workers, were surveyed. Information about the prevalence of musculoskeletal symptoms and work-related factors was collected using the self-reported questionnaire and direct observation methods, viz. rapid upper limb assessment (RULA) and rapid entire body assessment (REBA). Chi-square test was performed to analyze the association of MSD symptoms between the handicraft occupations. Further, binary logistic regression was used to identify the potential risk factors for MSD symptoms among workers.

RESULTS

In all occupational groups, most participants reported high prevalence of MSDs primarily in the neck (61.6%), lower back (74.8%), and knee (54.7%) regions. Results revealed that age, work experience, prolonged work hours, sustained awkward posture, continuous work without break, extensive work pressure, and poor job control increased the risk of MSD symptoms in different body regions, while with a higher level of education, MSDs in the neck and lower back regions reduced.

CONCLUSION

The findings indicated incompatibility between precision handicraft workers and the occupational environment. Logistic regression models showed significant contribution of physical and psychosocial work-related factors in developing MSD symptoms. Ergonomic interventions are imperative to evade adverse consequences on the occupational health of precision craft workers.

Methods in Experimental Work Break Research: A Scoping Review

The number of studies on work breaks and the importance of this subject is growing rapidly, with research showing that work breaks increase employees’ wellbeing and performance and workplace safety. However, comparing the results of work break research is difficult since the study designs and methods are heterogeneous and there is no standard theoretical model for work breaks. Based on a systematic literature search, this scoping review included a total of 93 studies on experimental work break research conducted over the last 30 years. This scoping review provides a first structured evaluation regarding the underlying theoretical framework, the variables investigated, and the measurement methods applied. Studies using a combination of measurement methods from the categories “self-report measures,” “performance measures,” and “physiological measures” are most common and to be preferred in work break research. This overview supplies important information for ergonomics researchers allowing them to design work break studies with a more structured and stronger theory-based approach. A standard theoretical model for work breaks is needed in order to further increase the comparability of studies in the field of experimental work break research in the future.

Work-break schedules for preventing musculoskeletal symptoms and disorders in healthy workers

BACKGROUND

Work-related musculoskeletal disorders are a group of musculoskeletal disorders that comprise one of the most common disorders related to occupational sick leave worldwide. Musculoskeletal disorders accounted for 21% to 28% of work absenteeism days in 2017/2018 in the Netherlands, Germany and the UK. There are several interventions that may be effective in tackling the high prevalence of work-related musculoskeletal disorders among workers, such as physical, cognitive and organisational interventions. In this review, we will focus on work breaks as a measure of primary prevention, which are a type of organisational intervention.

OBJECTIVES

To compare the effectiveness of different work-break schedules for preventing work-related musculoskeletal symptoms and disorders in healthy workers, when compared to conventional or alternate work-break schedules.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, SCOPUS, Web of Science, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, to April/May 2019. In addition, we searched references of the included studies and of relevant literature reviews.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) of work-break interventions for preventing work-related musculoskeletal symptoms and disorders among workers. The studies were eligible for inclusion when intervening on work-break frequency, duration and/or type, compared to conventional or an alternate work-break intervention. We included only those studies in which the investigated population included healthy, adult workers, who were free of musculoskeletal complaints during study enrolment, without restrictions to sex or occupation. The primary outcomes were newly diagnosed musculoskeletal disorders, self-reported musculoskeletal pain, discomfort or fatigue, and productivity or work performance. We considered workload changes as secondary outcomes.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts and full texts for study eligibility, extracted data and assessed risk of bias. We contacted authors for additional study data where required. We performed meta-analyses, where possible, and we assessed the overall quality of the evidence for each outcome of each comparison using the five GRADE considerations.

MAIN RESULTS

We included six studies (373 workers), four parallel RCTs, one cross-over RCT, and one combined parallel plus cross-over RCT. At least 295 of the employees were female and at least 39 male; for the remaining 39 employees, the sex was not specified in the study trial. The studies investigated different work-break frequencies (five studies) and different work-break types (two studies). None of the studies investigated different work-break durations. We judged all studies to have a high risk of bias. The quality of the evidence for the primary outcomes of self-reported musculoskeletal pain, discomfort and fatigue was low; the quality of the evidence for the primary outcomes of productivity and work performance was very low. The studies were executed in Europe or Northern America, with none from low- to middle-income countries. One study could not be included in the data analyses, because no detailed results have been reported.Changes in the frequency of work breaksThere is low-quality evidence that additional work breaks may not have a considerable effect on musculoskeletal pain, discomfort or fatigue, when compared with no additional work breaks (standardised mean difference (SMD) -0.08; 95% CI -0.35 to 0.18; three studies; 225 participants). Additional breaks may not have a positive effect on productivity or work performance, when compared with no additional work breaks (SMD -0.07; 95% CI -0.33 to 0.19; three studies; 225 participants; very low-quality evidence).We found low-quality evidence that additional work breaks may not have a considerable effect on participant-reported musculoskeletal pain, discomfort or fatigue (MD 1.80 on a 100-mm VAS scale; 95% CI -41.07 to 64.37; one study; 15 participants), when compared to work breaks as needed (i.e. microbreaks taken at own discretion). There is very low-quality evidence that additional work breaks may have a positive effect on productivity or work performance, when compared to work breaks as needed (MD 542.5 number of words typed per 3-hour recording session; 95% CI 177.22 to 907.78; one study; 15 participants).Additional higher frequency work breaks may not have a considerable effect on participant-reported musculoskeletal pain, discomfort or fatigue (MD 11.65 on a 100-mm VAS scale; 95% CI -41.07 to 64.37; one study; 10 participants; low-quality evidence), when compared to additional lower frequency work breaks. We found very low-quality evidence that additional higher frequency work breaks may not have a considerable effect on productivity or work performance (MD -83.00 number of words typed per 3-hour recording session; 95% CI -305.27 to 139.27; one study; 10 participants), when compared to additional lower frequency work breaks.Changes in the duration of work breaksNo trials were identified that assessed the effect of different durations of work breaks.Changes in the type of work breakWe found low-quality evidence that active breaks may not have a considerable positive effect on participant-reported musculoskeletal pain, discomfort and fatigue (MD -0.17 on a 1-7 NRS scale; 95% CI -0.71 to 0.37; one study; 153 participants), when compared to passive work breaks.Relaxation work breaks may not have a considerable effect on participant-reported musculoskeletal pain, discomfort or fatigue, when compared to physical work breaks (MD 0.20 on a 1-7 NRS scale; 95% CI -0.43 to 0.82; one study; 97 participants; low-quality evidence).

AUTHORS' CONCLUSIONS

We found low-quality evidence that different work-break frequencies may have no effect on participant-reported musculoskeletal pain, discomfort and fatigue. For productivity and work performance, evidence was of very low-quality that different work-break frequencies may have a positive effect. For different types of break, there may be no effect on participant-reported musculoskeletal pain, discomfort and fatigue according to low-quality evidence. Further high-quality studies are needed to determine the effectiveness of frequency, duration and type of work-break interventions among workers, if possible, with much higher sample sizes than the studies included in the current review. Furthermore, work-break interventions should be reconsidered, taking into account worker populations other than office workers, and taking into account the possibility of combining work-break intervention with other interventions such as ergonomic training or counselling, which may may possibly have an effect on musculoskeletal outcomes and work performance.