Study on ergonomic intervention to relieve work-related musculoskeletal disorders among assembly workers in a railway vehicle manufacturing enterprise / 环境与职业医学

Background Work-related musculoskeletal diseases (WMSDs) occur in a variety of occupational populations. Because of their various discomfort and serious disease burden, they have become an important issue worthy of attention in the field of occupational health. The prevention and control of WMSDs is one of the public health problems to be solved. Objective To evaluate the intervention effect on WMSDs among assembly workers in a railway vehicle manufacturing enterprise, so as to provide scientific basis for the prevention and control of WMSDs. Methods A total of 250 assembly workers in a railway vehicle manufacturing enterprise were selected using convenience sampling from August to December 2017. The Chinese Musculoskeletal Questionnaire was used for epidemiological investigation, and the Ergonomic Checkpoints was used for ergonomic inspection and worker interview. According to the above survey results, a six-month intervention plan including stepladder improvement and ergonomics training were implemented in the assembly workshop from September 2018 to February 2019. The intervention effects including the awareness of WMSDs, the exposure level of ergonomic load, and the occurrence of WMSDs symptoms were evaluated with relevant cross-sectional survey results before and after the intervention. The scores of WMSDs symptom intensity, symptom duration, and symptom frequency from low to high were 0-10, 1-4, and 1-5, respectively. Results After the intervention, the awareness rates of assembly workers on WMSDs types, affected body sites, influencing factors, preventive measures, and symptoms all increased from 52.3%, 51.9%, 25.5%, 19.1%, and 51.5% to 68.5%, 61.3%, 48.1%, 40.9%, and 61.3%, respectively (P<0.05). After the intervention, the proportion of assembly workers who "often" bend their head backwards frequently decreased from 34.6% to 21.8%, the proportion who "often" keep their trunk backward for a long time decreased from 26.6% to 15.0%, and the proportion who "never" raise their arms frequently increased from 3.4% to 9.0% (P<0.05). After the intervention, the scores of WMSDs symptom intensity in neck, shoulders, upper back, low back, elbows, hands/wrists, hips/thighs, knees, and ankles/feet all decreased, and the medians were mostly decreased from 6 to 3 (P<0.05); the scores of WMSDs symptom duration only decreased in neck (P<0.05) and there was no significant difference in the other body sites before and after the intervention; the median scores of WMSDs symptom frequency in low back, hands/wrists, and hips/thighs decreased from 3 to 2 (P<0.05). Conclusion The six-month intervention of stepladder improvement and ergonomics training among assembly workers in a railway vehicle manufacturing enterprise can improve workers' awareness of WMSDs, and reduce the exposure frequency of awkward postures and the intensity, duration, and frequency of WMSDs symptoms.

Work-related musculoskeletal disorders in Korean farmers

This paper evaluates the current state of work-related musculoskeletal disorders of Korean farmers. Korean farmers are exposed to a multitude of ergonomic risk factors, and have high rates of musculoskeletal disorders such as backpain and knee osteoarthritis, while hip osteoarthritis is relatively low. As of 2010, the average age of Korean farmers is 62.3, and the average period of their work in agriculture is 33.3 years. Therefore, it is difficult to distinguish the influence of natural aging and farm work on the development of musculoskeletal disorders. It is necessary to conduct research on a correlation between specific diagnosis such as rotator cuff syndrome, and farm work in general because farmers complain of a great deal of pain.

Tratamento de ler/dort: intervenções fisioterápicas: [revisão] / Treatment of the work related musculoskeletal disorders: therapy interventions: [review]

As lesões por esforços repetitivos e os distúrbios osteomusculares relacionados ao trabalho estão diretamente relacionados à realização de atividades ocupacionais e às condições de trabalho. Os sinais e sintomas atingem músculos, ligamentos, tendões, vasos, nervos e articulações das regiões do pescoço, dorso, membros superiores e inferiores. A importância desses distúrbios acompanha o avanço social e tecnológico, que traz como conseqüências os benefícios e as facilidades da vida moderna, além de uma série de problemas de saúde anteriormente incomuns. O objetivo deste trabalho foi identificar, por meio de revisão bibliográfica, intervenções fisioterápicas realizadas tanto para prevenção quanto para tratamento em trabalhadores com essas enfermidades na última década. Realizou-se busca nas bases de dados Lilacs, SciELO, Medline e Pubmed, compreendendo o período de 1998 a 2007. Buscou-se nos resumos a apresentação de dados e resultados específicos. Os trabalhos que não apresentavam intervenções fisioterápicas ou cujo resultado final não era claro foram excluídos. Os estudos foram então classificados seguindo uma pirâmide hierárquica, de acordo com a importância, validade e aplicabilidade. Conseguiu-se encontrar e incluir o total de trinta e um resumos de estudos. Nove trabalhos representaram o maior grupo, relativo aos ensaios clínicos aleatorizados, mostrando a alta qualidade dos métodos e práticas, além de abordagens de desfechos múltiplos e trabalhos multidisciplinares. Vinte e oito trabalhos demonstraram resultados positivos e três negativos ou sem alteração significativa. A revisão mostrou tendência de publicação de pequeno número de artigos com maior proporção de resultados positivos de intervenção fisioterápica associada a trabalho multidisciplinar.

Repetitive strain injuries and work-related musculoskeletal disorders are directly related to occupational activities and work conditions. The symptoms and signs affect muscles, ligaments, tendons, veins, nerves and joints of the neck, back and upper and lower limbs. The importance of these disorders accompanies social and technological developments, whose consequences are the benefits and comfortableness of modern life, in addition to a number of health problems that were uncommon in the past. The objective of this work was to identify, through a bibliographic review, physiotherapy interventions done both to prevent and treat workers with these disorders in the last decade. Searches in the following databases were done: Lilacs, SciELO, Medline and Pubmed covering the period from 1998 to 2007. The abstracts needed to contain specific data and results. The studies which did not present physiotherapy interventions or whose final result was unclear were excluded. The studies were classified according to a hierarchical pyramid, according to their importance, validity and applicability. A total of 31 abstracts were included. Nine studies represented the major group, related to random clinical trials, demonstrating the high quality of the methods and practices, besides approaches of multiple outcomes and multidisciplinary works. Twenty-eight studies demonstrated positive results and three emonstrated negative or insignificant results. The review found that a small number of articles were more likely to be published when they presented a higher proportion of positive results obtained when physiotherapy intervention was associated with multidisciplinary work.

Symptom prevalence and Primary intervention of work-related musculoskeletal disorders and their related factors among manufacturing workers / 대한산업의학회지

OBJECTIVES: To investigate the symptom prevalence and the primary intervention of work-related musculoskeletal diseases(WMSDs) and their related factors among manufacturing workers. METHOD: A self-administered questionnaire survey was conducted on 2,457 workers, at 22 enterprises in Chungnam province, Korea, from September 1 to December 1, 2003. The contents of the questionnaire included general and work-related characteristics, musculoskeletal symptoms and workers' past one-year experience of primary interventions. RESULTS 1. The overall symptom prevalence of the musculoskeletal diseases was 23.9%. The WMSD symptom prevalences at the neck/shoulder, arm/elbow, hand/wrist and back/leg were 14.8%. 2.7%. 7.3% and 12.0%, respectively. 2. In multivariate analysis, all WMSD symptom prevalences were high in the high workload, high force & high repetitiveness, and 'high job strain' groups. The WMSD symptom prevalence at neck/shoulder was also high in females and the group experiencing low social support from the supervisor. 3. The rates of the primary interventions were as follows : 13.7% for health education, 5.8% for health counselling, 18.8% for preventive exercise, 24.7% for ergonomic intervention, and 9.8% for administrative intervention. 4. In multivariate analysis, the size of the enterprises and the type of occupational health management system(OHMS) were significantly associated with all primary interventions except health counselling(p or =40 years), irregular employment, and the active group of Karasek's job strain model. Those for the preventive exercise were male, older age, longer tenure and regular employment. Those for the ergonomic intervention were longer tenure, job of physical force and/or repetitiveness, high job stain and the group experiencing high social support from the supervisor. The predictive factor for the administrative intervention was male (p<0.05). CONCLUSIONS: To establish an effective strategy for the primary prevention of WMSDs, approaches are needed which consider the individual nature of small and medium sized enterprises. IAlso necessary is to promote the participation of labor and management because the activation of the primary intervention was associated with the type of OHMS and union presence. Moreover the reduction of workload and increased intervention into the high risk group could be effective in the prevention of WMSDs.

Application of Participatory Action-Oriented Training (PAOT) to Small and Medium sized Enterprises for Prevention of Work-related Musculoskeletal Disorders / 대한산업의학회지

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.

Gender Difference in Work-related Musculoskeletal Disease / 항공우주의학회지

BACKGROUND: We studied gender difference in prevalence, risk factors, medical management, workplace activities for the prevention of work-related musculoskeletal diseases (WMSDs), and the role of gender in analysis of the factors affecting the prevalence of WMSDs. METHODS: In 3, 339 workers at 29 workplace, questionaire survey was conducted. The questionaire was consisted of personal factors, perceived workload and ergonomic factors (modified KOSHA code H-30), perceived job stress (modified Karasek model). musculoskeletal symptoms, medical management, workplace activities for the prevention of WMSDs. RESULTS: Female workers' overall prevalence of WMSDs (37.4%) was higher than that of male workers (18.9%), and there are many differences in the prevalence by the involved site of the body. The rate of personal risk factors, perceived workload, ergonomic risk factors, and the perceived job stress were higher in female workers than those of male workers. In gender-sensitive multivariate analysis, female worker's prevalence of WMSDs was higher in regular workers (OR=2.08), manufacturing, professional, service workers (OR, 2.25, 3.89, 3.26, respectively)). It was also associated with higher perceived workload (OR, 1.48~1.74), higher ergonomic risk (OR, 1.86~3.65), high job demand (OR=1.62), and low social support by co-workers (OR=1.29). The prevalence of WMSDs of male workers was higher in people living with dependent (OR=1.39), manufacturing workers (OR=1.54), but lower in service workers (OR=0.54). It was also associated with high workload (OR=1.98), higher ergonomic risk (OR, 3.26~5.55), and lower job control (OR=1.39). CONCLUSION: These results showed that female workers' high prevalence of WMSDs is the reflection of 'gendered' workplace, i.e. all aspects of WMSDs have profound association with gender from risk factors to medical management. Therefore, gender-sensitive analysis can reveal more realistic factors affecting WMSDs, and provide more valuable implications in prevention of WMSDs.