Risk Factors of Work-related Upper Extremity Musculoskeletal Disorders in Male Shipyard Workers: Structural Equation Model Analysis

Interactions between work-related factors, perceived fatigue and musculoskeletal disorders among handicraft artisans: structural equation model analysis

The cross-sectional study aimed to investigate the relationship between work-related factors, perceived work fatigue (PWF) and musculoskeletal disorders (MSDs) among handicraft artisans. 364 artisans participated in a questionnaire survey, and a structural equation model (SEM) was developed to explore the direct and indirect relationships between these factors using partial least squares analysis. The SEM explained 98.2% of the variance in MSDs and revealed that exposure to biomechanical factors had a direct impact on PWF and MSDs, with PWF mediating the effect of biomechanical factors on MSDs. Additionally, job demand was found to be positively associated with MSDs, while job control and social support reduced the risk of MSDs. The findings underscore the importance of strategic initiatives to mitigate the risk of developing MSDs among artisans. The study also highlights the potential of SEM as a novel framework for understanding the complex pathogenesis of MSDs in occupational health research.Practitioner summary: The study sought to comprehensively examine the intricate relationships among work-related factors, PWF, and MSDs. To achieve this, an SEM approach was employed to capture both direct and indirect relationships between these factors, employing partial least squares analysis. Findings revealed SEM as an innovative framework for understanding the intricate development of MSDs.

Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran

Background

Prevention of musculoskeletal disorders as one of the most common occupational health problems among the working population in both developed and developing countries is an important necessity and priority. The aim of this study was to evaluate the effectiveness of an educational intervention program based on the Health Belief Model (HBM) to increase awareness, perceived sensitivity, perceived severity, perceived benefits, and self-efficacy in adopting neck health-promoting behaviors in school teachers.

Methods

The present study was a quasi-experimental of the randomized clinical trial that was conducted for 6 months (December 2020 to July 2021). Participants were 146 junior high school teachers were selected from 26 schools through random sampling and divided into two groups of intervention and control. The data collection instrument was the self-design questionnaire and was completed in three points of time (before, immediately, and 3 months after the intervention). The data were analyzed by software version 24 SPSS.

Results

The results showed that awareness, perceived sensitivity, perceived severity, perceived benefits and barriers, and self-efficacy in adopting neck health-promoting behaviors in the intervention group increased in two points of time (immediately after the intervention and 3 months of follow-up) (P <  0.05).

Conclusion

Designing and implementing an educational intervention based on HBM could affect in adopting neck health-promoting behaviors among teachers.

Trial registration

IRCT20210301050542N1, 16/03/2021 first registration has been approved in Iranian Registry of Clinical Trials at (16/03/2021).

The Role of Job Resources in the Relationship between Job Demands and Work-Related Musculoskeletal Disorders among Hospital Nurses in Thua Thien Hue Province, Vietnam

(1) Background: This cross-sectional study aimed to determine the moderating effect of job resources (JR) in the relationship between job demands (JD) and work-related musculoskeletal disorders (WRMSDs) among hospital nurses in the Thua Thien Hue province, Vietnam. (2) Methods: Data were collected via a self-reporting questionnaire administrated to 225 nurses from two hospitals in the Thua Thien Hue province of Vietnam from August to September 2020. The questionnaire included information on musculoskeletal symptoms, JD and JR, and the demographics and job characteristics of participants. The simple moderation analysis was used for data analysis. (3) Results: The findings indicated that 87.6% of nurses had experienced WRMSDs in at least one body region during the previous 12 months, with lower back (65.3%), neck (61.8%), and shoulders (61.8%) being the three most common sites. Physical workloads (PW) and psychological demands (PDs) were significantly correlated with WRMSDs severity (p < 0.05). This study further underlined the moderating role of coworker support (CS) on the relationship between PW and WRMSD severity. WRMSDs severity significantly increased when PW was high alongside a low level of CS. (4) Conclusions: The current study indicated that nurses should be provided with appropriate CS to minimize WRMSDs severity. Furthermore, an intervention program for managing WRMSDs in nurses may involve minimizing physical risk factors and PDs.

Association of Physical Activity and Quality of Life with Work-Related Musculoskeletal Disorders in the UAE Young Adults

Background: Work-related musculoskeletal disorders (WRMSDs) pose threat to the global economy and work productivity. Though growing evidence shows physical activity and quality of life are major determinants for WRMSDs, the association between physical activity and the quality of life among the young adults of the United Arab Emirates (UAE) remains unclear. Methods: In a cross-sectional study, a total of 507 young adults who were between the ages 18–35 years were administered an interviewer-based survey on musculoskeletal disorders, physical activity, and quality of life. The association between the potential determinants and the WRMSDs was analyzed using linear and logistic regression models. Results: High prevalence (75%) of WRMSDs was found among the UAE young adults. Participants with low leisure-time physical activity had few WRMSDs. There was no significant association between physical activity or quality-of-life scores with the incidence of WRMSDs although physical activity time was highly associated with the quality of life, especially the social domain. Conclusion: Though a high prevalence of WRMSDs among UAE men and women was found, neither physical activity nor the quality-of-life scores determined the incidence of WRMSDs.

Risk factors for shoulder disorders among French workers: prospective cohort study

Objectives

Shoulder disorders are common in the working population. This longitudinal study aimed to explore the relationships between personal factors and occupational organisational, psychosocial, and biomechanical factors and the incidence of shoulder disorders.

Methods

A total of 3710 workers in the Pays de la Loire region (Loire Valley area, France) were randomly included by their occupational physician in the Cosali cohort between 2002 and 2005. All workers completed a self-administered questionnaire about personal factors and work exposure, and using a standardised physical examination, occupational physicians diagnosed shoulder disorders. Between 2007 and 2010, 1611 workers were re-examined by their occupational physician. The 1,320 workers free of shoulder disorders at baseline were studied. A conceptual model was developed in which relationships between organisational, psychosocial, biomechanical, and personal factors at baseline and the incidence of shoulder disorders were assumed. Structural equation modelling was used to test the model.

Results

Shoulder disorders were directly associated with biomechanical factors and age but not with psychosocial factors. However, skill discretion and psychological demand influenced shoulder disorders indirectly through biomechanical factors. Exposure to a work pace dependent on an automatic rate and to a work pace dependent on customers’ demands were associated with biomechanical and psychosocial factors, but not directly to shoulder disorders.

Conclusions

This study identified the complex direct and indirect relationships between occupational factors and shoulder disorders. Our data confirmed our conceptual causation model: organisational and psychosocial factors were associated with biomechanical factors, while biomechanical factors were associated with the incidence of shoulder disorders.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-022-01853-9.

Development of modified rapid entire body assessment (MOREBA) method for predicting the risk of musculoskeletal disorders in the workplaces

Background

Rapid Entire Body Assessment (REBA) technique is one of the tools developed for predicting the risk of musculoskeletal disorders based on the effective risk factors. This method has several limitations. The present study was aimed to develop the Modified Rapid Entire Body Assessment (MOREBA) method to more accurately predict the risk of musculoskeletal disorders.

Materials

This cross-sectional study was performed on 300 male workers of a steel factory with a variety of job tasks in Iran. Then, the information related to the various physical risk factors was extracted through observation of their duties and conversation with them. Also, the subjects were asked to complete the Persian version of Cornell musculoskeletal discomfort questionnaires (CMDQ). Then, a theoretical model was drawn in AMOS software. Computed coefficients were used to develop the MOREBA equation. In the end, the final scores were categorized by ROC curves, and the validation of the novel method was investigated using linear regression analysis.

Results

The parameters evaluated in the MOREBA method included contact stress, rapid and sudden movement, throwing motion, hand-arm vibration, whole-body vibration, temperature, and work-rest cycle in addition to the parameters of the REBA method, including awkward posture, coupling, force, load, static activity, and repetitive activity. The results showed that the strain produced by the physical risk factors with the total effect coefficient of 0.783 could significantly affect the musculoskeletal symptoms. The computed coefficients of the risk factors were applied to develop a novel index. The final score of the MOREBA method was categorized into four levels by optimal cut-off points of 12.37, 16.51, and 24.35. Based on the results, the MOREBA and REBA methods could justify 67 and 55% of the variations of musculoskeletal symptoms, respectively.

Conclusions

The results revealed that modifications conducted in the REBA method were effective, and the MOREBA method can provide a more accurate prediction of the risk of musculoskeletal disorders.

Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach

This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), psychosocial (job strain model), biomechanical (Borg's rating perceived exertion, wrist bending, pinching, and hand-transmitted vibrations), and personal factors at baseline. Symptomatic CTS risk was directly increased by biomechanical factors (standardized coefficient = 0.19, P = 0.011), female gender (0.25, P < 0.001), and age (0.15, P = 0.042). No psychosocial factors had a direct impact on CTS, but decision authority and skill discretion had an indirect impact by influencing biomechanical exposure. Exposure to machine-paced work had an indirect impact on increasing CTS, either by raising biomechanical exposure (0.19, P < 0.001) or by lowering decision authority (-0.18, P < 0.001) and skill discretion (-0.20, P < 0.001), which in turn increased biomechanical exposure. Similar complex relationships were observed between risk factors and CTS defined by a more strict case definition. Biomechanical exposure had a direct impact on CTS, while organizational factors and psychosocial factors had an indirect impact on CTS. The findings support conceptual models linking work organization to CTS.

Study on the Associations of Individual and Work-Related Factors with Low Back Pain among Manufacturing Workers Based on Logistic Regression and Structural Equation Model

Work-related musculoskeletal injuries are one of the major occupational health issues of the workers, especially low back pain (LBP). The aim of this study was to survey the prevalence of LBP among manufacturing workers and to identify associations of individual and work-related factors with LBP. A cross-sectional questionnaire study was performed with 1173 participating manufacturing workers. The questionnaire included individual factors, psychosocial and physical exposures, and musculoskeletal discomfort. It was analyzed by logistic regression and structural equation modeling (SEM). The 1-year prevalence of LBP among Chinese manufacturing workers was 33.6%. Logistic regression analysis showed that job tenure, awkward postures, vibration and job demand were positively—while social support and job control were negatively associated with LBP (p < 0.05). The SEM results indicated that, as shown in other studies, job types, job tenure, postural load, high job demand, low job control and vibration were directly associated with LBP, but also that job types, high job demand, low social support and vibration may have indirect effects on LBP—mediated by postural load.

Risk Factors for Work-Related Musculoskeletal Disorders Among Intensive Care Unit Nurses in China: A Structural Equation Model Approach

PURPOSE

This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs).

METHODS

A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors.

RESULTS

Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p < .05). In the structural equation model, the occurrence of WRMDs was directly affected by the following: physical factors, risk perception, and job stress. Physical factors and a safe environment indirectly affected WRMDs through risk perception and job stress. The strongest correlations with WRMDs were physical factors.

CONCLUSION

The model provided a new perspective for understanding the associations among physical factors, workplace safety environment, risk perception, job stress, and WRMDs. To improve the practice setting of the ICU, efforts should be made to help prevent WRMDs from physical, psychosocial, and environmental factors.

Shoulder pain among male industrial workers: Validation of a conceptual model in two independent French working populations

This study aims to validate a conceptual model for shoulder pain risk factors in two independent samples of male industrial workers: the Cosali cohort (n = 334) and one pharmaceutical company (n = 487). Direct and indirect relationships between work organization factors (automatic speed of a machine or movement of a product and work pace dependent on customers' demand), psychosocial factors (Job strain model), biomechanical factors (working with abducted arms, working with arms at or above shoulder level, and perceived physical exertion), perceived stress, and shoulder pain were explored using structural equation models. Shoulder pain was positively associated with biomechanical exposure in both samples, and with perceived stress only in the pharmaceutical preparation manufacturer, while factors related to work organization and psychosocial factors had indirect impacts on the risk of chronic shoulder pain in both samples. The results provide a deeper understanding of the complex relationships between workplace risk factors and shoulder pain.

A model for predicting the risk of musculoskeletal disorders among computer professionals

Objective. This study aimed to develop a model for predicting the risk of musculoskeletal disorders among computer professionals. Materials and methods. A preliminary study with a modified Nordic musculoskeletal questionnaire was conducted to identify the risk in different body parts of the professionals during their work. A discrete postural evaluation of the dynamic postures involved in the work was assessed using rapid upper limb assessment. Postural, physiological and work-related factors were considered as attributes of the model. The model was developed using various machine learning algorithms, and was then tested and validated. Results. The postural factor of the computer professionals was found to be significantly (p < 0.01) correlated with the musculoskeletal disorders. Results of the logistic regression analysis showed that physiological and work-related factors were also significantly (p < 0.05) associated with musculoskeletal disorders. The Random Forest algorithm and Naïve Bayes Classifier predicted the risk of musculoskeletal disorders with the highest accuracy (81.25%). Conclusion. Postural, physiological and work-related factors contribute to the development of musculoskeletal disorders. The Random Forest algorithm or Naïve Bayes Classifier model developed based on these factors could be used to accurately predict the risk of musculoskeletal disorders among computer professionals at any instance of time, during their work.

Physical activity participation and the association with work-related upper quadrant disorders (WRUQDs): A systematic review

BACKGROUND

Workers in various occupations often report work-related upper quadrant disorders (WRUQDs). Research has shown that associative factors for WRUQDs include psychosocial and environmental elements, gender and physical activity levels. To date, no review has investigated whether physical activity participation is associated with and/or predicts the development of WRUQDs, so the present study set out to determine this.

METHODS

A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to 31 March 2017. Quantitative studies, including any outcome measure of physical activity participation and its association with and/or prediction of WRUQDs, were included. One reviewer conducted the search and two reviewers independently assessed eligibility and completed methodological quality assessment using a modified Downs and Black checklist. Data were analysed narratively.

RESULTS

Eight studies were eligible for inclusion in the final review. The quality of these ranged from moderate to high quality. Three studies reported no statistical difference between physical activity participation and the risk of developing WRUQD. Three studies reported a negative and one study a positive association between physical activity participation and WRUQDs. One study reported that little or no physical exercise participation was a risk factor for WRUQD.

CONCLUSIONS

There is limited evidence for a negative association between physical activity participation and the development of WRUQDs. However, this was not a consistent finding across all studies included. Further research is indicated in standardizing diagnostic criteria and the measurement of physical activity participation in this patient population.

Risk Factors for Shoulder Pain in a Cohort of French Workers: A Structural Equation Model

Shoulder pain is common in the working population and causes loss of productivity, high economic costs, and long absences. Simultaneous evaluation of the complex relationships between work organization (e.g., work pace, application of quality standards), psychosocial and physical risk factors, stress, and shoulder pain is rare. The aim of this study was to explore the direct and indirect relationships between workplace risk factors, perceived stress, and occurrence of shoulder pain in workers of the Cohorte des Salariés Ligériens study. A total of 3,710 workers in a French region were randomly selected for inclusion between 2002 and 2005. They completed a self-administered questionnaire about musculoskeletal symptoms, individual factors, and exposure to work constraints. In 2007, they responded to a follow-up questionnaire. The study sample comprised 1,400 workers free of shoulder pain at baseline. Structural equation models were used. For both sexes, exposure to factors related to work organization had an effect on physical and psychosocial risk factors. Psychological demand was the only psychosocial constraint that increased perceived stress. Shoulder pain was influenced directly by physical risk factors for both sexes and by perceived stress for men. In view of their distal action, work organization is an important target for strategies to prevent shoulder pain in the working population.

Factors associated with the prevalence of back pain and work absence in shipyard workers

Background

We conducted a questionnaire survey of shipyard workers to identify difficulties experienced due to orthopedic or musculoskeletal disorders.

Methods

The subjects were 375 workers (male, 361; female, 14) who worked for a single shipbuilding company. Questionnaire items covered the working environment, including work environment, working posture, and the weight of objects that the subject dealt with, as well as physical and lifestyle characteristics, namely smoking habits, drinking habits, sleeping hours, medications, exercise habits, and any weight gain of 20 kg or more since the age of 20. Subjects were also asked to indicate if they regularly experienced any of 17 listed difficulties in their daily lives, and to use an illustration of the human body to mark any body parts that were painful or hard to move.

Results

The mean age was 41.8 years (19–73 years). The lower and/or upper back was the most frequent site of pain (46.5%), followed by the shoulders (11.4%), knees (9.6%), and neck (5.3%). Maintaining a half-sitting posture was the most problematic activity of daily living. Back pain was less frequent in subjects who exercised regularly, and more common in those who worked with heavy loads or in narrow spaces. A multinomial logistic regression analysis showed that absence from work was more common in subjects with back pain who had gained weight since their youth, who smoked, who used fire while welding metal, or who worked in a lying posture. While 35.4% of subjects had experienced absence from work due to musculoskeletal pain, only 5.1% were permitted by their employer to alter their work content or reduce their workload.

Conclusions

These results indicate that a large number of shipyard workers have difficulties in their work and daily life activities due to back pain. To prevent worsening of pain and to reduce work absence, it is important to provide appropriate training to minimize the risk factors for back pain that were identified in this study.

Association between psychosocial, organizational and personal factors and prevalence of musculoskeletal disorders in office workers

The purpose of this study was to investigate the relationship between organizational and personal (individual) factors with the prevalence of musculoskeletal disorders (MSDs) in office workers of the Iranian Gas Transmission Company. The participants rated two questionnaires - the standardized Nordic Musculoskeletal Questionnaire to measure the prevalence of MSDs, and the Veterans Healthcare Administration All Employee Survey questionnaire (2004 version) - to measure psychosocial, organizational and individual aspects of job satisfaction and workplace climate. The highest prevalence of MSDs was found in the lower back (49.7%) and neck (49.0%) regions. Results of the logistic regression models showed that some psychosocial and organizational factors and also some individual factors were associated with prevalence of MSDs (p < 0.05).These findings illustrate the need to consider all elements of the work system as a whole in future studies and in organizational planning.

Risk factors of work-related upper extremity musculoskeletal disorders in male cameramen

OBJECTIVE

The aim of this study is to determine the risk factors related to upper extremities work-related musculoskeletal disorders (WRMSDs) in cameramen.

METHODS

A questionnaire survey was performed on 166 cameramen in a broadcasting station. The questionnaire consisted of questions on the general characteristics, the health behavior, work type and duration, physical burden, ergonomic posture, and musculoskeletal symptoms. Definition of musculoskeletal disorders was based on NIOSH criteria.

RESULTS

The positive rate of WRMSDs symptoms by parts of the body was turned out to be the highest in the shoulder (14.5%) and the lowest in arm and elbow (6%). Logistic regression analysis revealed that symptoms in the shoulders increased with BMI (OR = 3.62, 95% CI = 1.03-12.71), physical burden (OR = 9.29, 95% CI = 1.72-61.78 in the very hard group) and ergonomic factors (OR = 4.50, 95% CI = 1.03-19.68). Ergonomic factors were only related to the symptoms of hand and wrist (OR = 10.21, 95% CI = 1.02-102.20). WRMSDs symptoms, in the whole upper extremities, were higher in the 50 or older age group (OR = 5.86, 95% CI = 1.03-33.26), higher BMI group (OR = 3.26, 95% CI = 1.28-13.53), non-exercise group (OR = 2.37, 95% CI = 1.24-12.59), high physical burden group (OR = 7.6, 95% CI = 1.34-52.74), and high grade ergonomic risk group (OR = 4.82, 95% CI = 1.29-16.06).

CONCLUSION

The most serious musculoskeletal disorders of male cameramen were shoulder pain. Ergonomic factors and physical burden were the most significant factors affecting WRMSDs in cameramen in this study. Cameramen should be educated to be able to improve the ergonomic occupational environment and to set up preventive measures against the risk factors during work.

Mental Health Levels and Incidence of Musculoskeletal Complaints among Speed Boat Crew Members

Background

The occupational health is an important issue. In some jobs, the working conditions contribute to musculoskeletal complaints and the overall health of the individual is compromised. Musculoskeletal complaints have gained credence in the public as one of the most important problems in the field of occupational diseases. Physical and mental health of crew members with critical jobs and stressful environments must be considered as well.

Objectives

This study performed an assessment on levels of mental health and the correlation with the frequency of accompanying musculoskeletal complaints (such as neck, back and knee pain) of crew members of speed boats.

Material and Methods

149 onboard crew members of speed boats were recruited in a descriptive-correlation study by nonrandom sampling using conducted GHQ12, NMQ and demographic questionnaires.

Results

Although 63.8% (95 people) had what is conventionally defined as normal mental health, 36.2% (54 cases) had an inherent mental health condition. Overall, 61.1% (91 cases) suffered from back pain, 60.4% (90 cases) complained of knee pain, and 40.3% (60 patients) complained of neck pain. The combination of knee and back pain (48.3%) were the most common complaints whereas the combination of neck and knee pain (31.5%) were the least frequent; 28.2% complained of pain in all three areas. Interestingly, there was correlation between the presence of musculoskeletal complaints and less than optimum mental health.

Conclusions

Due to the high number of musculoskeletal complaints and the compromised mental health conditions among one-third of the onboard crew members of speed boats, attention for maintaining and improving the health of these members must be considered.