Risk and related factors of elbow musculoskeletal diseases: A nationwide cross-sectional survey in China.

OBJECTIVE: Although studies have shown that Work-related Musculoskeletal Disorders (WMSDs) are common and continue to be a main source of disability and work time loss, there are few reports on elbow WMSDs. The aim of this study was to explore the prevalence and associated factors of elbow WMSDs. METHODS: The valid questionnaires of 57501 workers from 15 different industries nationwide were collected and the Chi-square test and logistic-regression-analysis were applied to reveal the prevalence and risk factors of elbow. RESULTS: The findings indicated that prevalence of elbow WMSDs among workers was 7.3%. The prevalence of elbow WMSDs in toy manufacturing was 21.3%, which significantly higher than that in other industries (P<0.05). Logistic regression analysis showed that aged 40 and above, married, very poor health, left-handed, lifting weights (more than 20 kg each time) , work requiring upper limb or hand force, work in an uncomfortable position, repetitive operations within one minute, using vibrating tools, work involves cold, cool winds or temperature changes, work being completed in the same workshop, work being done outdoors, frequent deal with customers , two shifts, often work overtime, staff shortage, often work for colleagues were the risk factors of elbow WMSDs.The higer education level and monthly income, and enough rest time were the protective factors of elbow WMSDs. CONCLUSION: The toy manufacturing is a high-risk industry for elbow WMSDs. The publicity and education of ergonomics knowledge should be strengthened, and the workers' ergonomics awareness should be improved to reduce the impact of WMSDs.

The association between adverse ergonomic factors and work-related musculoskeletal symptoms among medical staff in China: a cross-sectional study.

We investigated the prevalence of work-related musculoskeletal symptoms (WMSs) among medical staff and evaluated the associations of different levels of adverse ergonomic factors with WMSs. A total of 6099 Chinese medical staff were asked to complete a self-reported questionnaire to assess the prevalence and risk factors of WMSs from June 2018 to December 2020. A prevalence rate of 57.5% was observed for WMSs among overall medical staffs, which mainly affected the neck (41.7%) and shoulder (33.5%). 'Keeping sitting for long hours very frequently' (OR = 1.26, 95% CI: 1.04, 1.53) was positively associated with WMSs in doctors, while 'keeping sitting for long hours occasionally' (OR = 0.91, 95% CI: 0.85, 0.97) was identified as a protective factor of WMSs in nurses. The associations of adverse ergonomic factors, organisational factors, and environmental factors with WMSs were different among medical staff in different positions.Practitioner summary: We conducted a multi-city study concerning the risk factors of WMSs by carrying out a face-to-face one-to-multiple questionnaire survey among medical staff in China. As a risk factor of WMSs in medical staff, adverse ergonomic factors should be paid more attention by the standard setting department and policy makers.Abbreviations: WMSDs: work-related musculoskeletal disorders; WMSs: work-related musculoskeletal symptoms; MSDs: musculoskeletal disorders; NMQ: Nordic Musculoskeletal Questionnaires; DMQ: Dutch Musculoskeletal Questionnaires; NIOSH: National Institute for Occupational Safety and Health; ORs: odds ratios.

The risk factors for injuries in parachuting and load exposure in the training of Chinese paratroopers.

BACKGROUND: Parachutists are generally recognized as a "high-risk" group among military personnel. However, the findings came mostly from data analysis without soldiers as subjects. OBJECTIVE: This study aimed to investigate the injury prevalence in Chinese paratroopers on-site and determine the relationship between injury and risk factors encountered during parachuting and land-based training. METHODS: This study consisted of a field study with questionnaire and an experiment on muscle load during the simulated training exercise of platform jumping with surface electromyography (EMG), in which 7230 paratroopers and 38 soldiers were involved respectively. Chi-square test was used for the injury rate analysis, ANOVA and t-test for comparison of EMG data, and logistic regression for the analysis of multiple factors. Taking both intensity and time into consideration, jump-years (J-yrs) was used as a complex indicator for exposure to parachuting. Either injury per 1000 jumps or injured persons per 100 soldiers were calculated as injury prevalence. RESULTS: The overall injury rate among Chinese parachutists was found to be 13.9 injuries per 1000 parachute jumps and 24.5% based on personnel. The person-based injury rate increased with the exposure level significantly (χ2 = 142.06, 2-sided, P < 0.05; trend test also significantly). Among the identified risk factors the uneven terrain was ranked as the most important one by logistic analysis. The EMG amplitude in MVE% increased with the platform height of all the 8 measured muscles and even reached 100% in 4 muscles, showing a high impact at landing. In addition, some characteristics of parachuting injury were also revealed by the injury type and site analysis. CONCLUSION: A dose-response relationship between parachuting and injury was observed significantly in the survey of Chinese paratroopers. Their injury rate was found to be relatively higher than the reported internationally. Landing impact as a critical point for injury seemed to be proved by the investigation and also the experiment with EMG measurement. It is suggested for future studies, to use the person-based injury rate, landing studied in work physiology and with consideration of different landing skills.

Prevalence status and associated factors of wrist postural injury in the Chinese occupational population.

Objective: This study investigated the prevalence of wrist injuries in 15 industries and different types of work in China. Study on the associated factors of wrist injuries provides a scientific basis for prevention and treatment of wrist diseases in occupational workers. Methods: A cross-sectional study of musculoskeletal symptoms of related practitioners in 15 industries, including automobile manufacturing, was conducted to retrieve worker demographic information, working wrist posture, and pain conditions. Multivariable binary logistic regression analyses were performed to identify factors associated with work-related musculoskeletal disorders (WMSDs). Results: The prevalence of wrist injuries among the study population was 13.2%. Toy manufacturing, animal husbandry, automobile manufacturing, shoe manufacturing, and biopharmaceutical manufacturing had the highest wrist injury rates at 29.1, 19.1, 14.9, 14.9, and 14.0%, respectively. Among the types of jobs, enamel workers (63.0%), butchers (43.6%), combers (32.5%), welders (31.3%), and scaffolders (26.5%) had the highest prevalence rates. Based on the final multivariate logistic regression analysis: female [odds ratios (OR) = 1.24; 95% confidence interval (CI), 1.15-1.35], 6-10 years of service (OR = 1.11; 95% CI, 1.03-1.18), >10 years of service (OR = 1.15; 95% CI, 1.06-1.25), frequent upward and downward flexion in wrist posture at work (OR = 1.81; 95% CI, 1.84-2.11), and frequent wrist placement on the edge of angular objects increased the OR of injury (OR = 1.52; 95% CI, 1.44-1.61). Need to squeeze objects tightly while working (OR = 1.72; 95% CI, 1.57-1.89), prolonged wrist flexion (OR = 1.86; 95% CI, 1.75-1.97), and work hand position above the shoulder for prolonged periods (OR = 1.11; 95% CI, 1.04-1.19) also suggested the relationship between these factors and the higher prevalence of wrist injury in the workers. The associated factor was physical activity (OR = 0.86; 95% CI, 0.80-0.94). Conclusion: This study suggested the relationship between these factors and the higher prevalence of wrist injury in the toy manufacturing, animal husbandry, automobile manufacturing, and shoe-making industries, enamel workers, butchers, and combers. And are work types that require special attention. Females, working age, physical activity, and abnormal posture of the wrist were factors significantly associated with WMSDs.

Shoulder work-related musculoskeletal disorders and related factors of workers in 15 industries of China: a cross-sectional study.

BACKGROUND: Changes in modern industrial production practices can easily lead to shoulder work-related musculoskeletal disorders (WMSD). The current reports on shoulder WMSD are limited to some industries are less well studied, and the sample size is usually small. This study aimed to describe the prevalence and severity of shoulder WMSD in a large sample of Chinese workers from 15 industries, analyze the possible correlations with sociodemographic and work-related variables, and compare the differences between industries. METHODS: A cross-sectional study was conducted among a sample of 55,749 participants from 252 enterprises in 15 industries throughout China. A Chinese version of the musculoskeletal disease questionnaire was used to collect the demographic factors, shoulder symptoms in past 12 months, and work-related factors including posture-related factors, repetition, vibration, work organization, job control, and environmental factors as independent variables. Descriptive statistics were used, and the binary logistic regression analysis was performed to explore the association between shoulder WMSD and potential demographic and work-related factors. RESULTS: Nearly 35.5% of participants reported shoulder pain and discomfort in the previous 12 months. Biopharmaceutical manufacturing (56.2%), medical services (54.4%), and aviation services (50.1%) were the three industries with the highest prevalence of shoulder WMSD. The pain score of aviation services workers was the highest. The related factors for shoulder WMSD varied among the different industries. CONCLUSION: Our study found a relatively high prevalence of shoulder WMSD in China. There were large differences in the prevalence of shoulder WMSD among industries, and the related factors were particular to each industry. Such information is useful to help occupational health practitioners and policymakers conduct preventive programs to reduce shoulder disorders in these working populations.

Prevalence and risk factors analysis for low back pain among occupational groups in key industries of China.

BACKGROUND: With the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP. METHODS: We adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors. RESULTS: LBP annual incidence among workers in China's key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors. CONCLUSION: LBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers' health.

Incidence and Risk Factors of the Upper-Limb Musculoskeletal Disorders Among Occupational Groups in Key Industries - China, 2018-2021.

What is already known about this topic?: The burden of illness and economic losses due to upper-limb work-related musculoskeletal disorders (UL-WMSDs) is high; thus, they have become a major global public health problem. At present, the epidemiological characteristics of UL-WMSDs in China's occupational population are still unknown. What is added by this report?: The incidence of UL-WMSDs among key occupational groups in China is 22.5%, with distinct occupational characteristics. What are the implications for public health practice?: This study has primarily determined the occurrence and potential risk factors of UL-WMSDs in key industries in China and provided data support for recommending prevention and control of the occurrence of such diseases in key industries in China, and in facilitating the addition into the China's List of Legal Occupational Diseases.

Epidemiological Data of Work-Related Musculoskeletal Disorders - China, 2018-2020.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: In recent decades, work-related musculoskeletal disorders (WMSDs) have become increasingly prominent and have become an important issue that is of universal concern and an urgent need to be solved in all countries of the world. WHAT IS ADDED BY THIS REPORT?: The top three industries or occupational groups with the highest standardized prevalence rate of WMSDs were flight attendants, medical staff, and vegetable greenhouses in that order. Women workers were 1.5 times more likely to suffer from WMSDs than men workers. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: This study has found the prevalence and distribution characteristics of WMSDs in key industries in China. It is urgent to draw up relevant measures to prevent and control occupational populations with WMSDs.

Assessing and controlling infection risk with Wells-Riley model and spatial flow impact factor (SFIF).

The ongoing COVID-19 epidemic has spread worldwide since December 2019. Effective use of engineering controls can prevent its spread and thereby reduce its impact. As airborne transmission is an important mode of infectious respiratory disease transmission, mathematical models of airborne infection are needed to develop effective engineering control. We developed a new approach to obtain the spatial distribution for the probability of infection (PI) by combining the spatial flow impact factor (SFIF) method with the Wells-Riley model. Our method can be combined with the anti-problem approach, in order to determine the optimized arrangement of people and/or air purifiers in a confined space beyond the ability of previous methods. This method was validated by a CFD-integrated method, and an illustrative example is presented. We think our method can be helpful in controlling infection risk and making the best use of the space and equipment in built environments, which is important for preventing the spread of COVID-19 and other infectious respiratory diseases, and promoting the development of sustainable cities and society.

Occupational stress, burnout, and coping styles among medical staff from a tertiary first-class hospital in Hubei Province / 预防医学

Objective @#To investigate the status of occupational stress, burnout, and coping styles, and to explore the moderating effects of coping styles on the relationship between occupational stress and burnout among medical staff from one tertiary first-class hospital in Hubei Province, in order to provide the basis for mental health promotion of medical staff. @*Methods@#From June to October in 2020, using stratified cluster sampling, doctors, nurses, and medical or pharmaceutical technicians on the ratio of 2∶2∶1 were selected from the tertiary first-class hospital. Chinese version of Burnout Questionnaire, Core Occupational Stress Scale (COSS) and Trait Coping Style Questionnaire were used to investigate the levels of burnout, occupational stress and coping styles. A linear stratified regression model was used to analyze the moderating effect of coping styles on the relationship between occupational stress and burnout. @*Results@#Among 735 questionnaires issued, 679 valid ones were collected, with the response rate of 92.38%. The age of the respondents was ( 34.29±8.20 ) years old. There were 165 ( 24.30% ) males and 514 ( 75.70% ) females, including 241 ( 35.49% ) doctors, 358 ( 52.72% ) nurses and 80 (11.78%) medical or pharmaceutical technicians. The burnout score was 2.29±1.11 , and the positive rate of burnout was 44.33%; the COSS score was 47.32±8.31; the positive and negative coping style scores were 30.64±6.06 and 26.81±6.26, respectively. The linear stratified regression analysis suggested that the interactions between social support ( β=0.590, P<0.05 ), organization and reward ( β=0.523, P<0.05 ), and positive coping style were positively associated with burnout, and the interaction between organization and reward (β=-0.666, P<0.05) and negative coping style was negatively associated with burnout. @*Conclusions@#About 44.33% of medical staff investigated have burnout. Coping styles have a moderating effect on the relationship between occupational stress and burnout. Positive coping style helps to perceive social support and organizational support, to alleviate the adverse effects of occupational stress, and to reduce the risk of burnout.

Investigation on Work-Related Musculoskeletal Disorders - China, 2018-2019.

What is already known about this topic? Work-related musculoskeletal disorders (WMSDs) have a high prevalence and seriously harmful, which has attracted extensive attention in various countries in the world. Currently, the occurrence and rules of WMSDs in key industries are not known in China. What is added by this report? The prevalence of WMSDs is relatively high among professional populations in key industries in China, with the most commonly affected body parts concentrated in neck, shoulders, and low back and increasing with age and working years. What are the implications for public health practice? This study determined the prevalence and distribution characteristics of WMSDs in key industries in China and provided scientific evidence to recommend for inclusion of WMSDs in the new revision of the list of occupational diseases in China.

[Co-occurrence of musculoskeletal disorders and influence factors among Chinese auto workers].

OBJECTIVE: To analyze the prevalence and risk factors of multiple musculoskeletal disorders (MSDs) in auto workers and the associations between MSDs at different sites. METHODS: A cross-sectional survey was conducted in 3998 workers, who were selected from a Chinese auto corporation by cluster random sampling, using the revised Nordic MSDs standard questionnaire; 3800 completed questionnaires were returned. Multinomial logistic regression analysis was performed to assess the risk factors for multiple MSDs. The logbinomial model was used to calculate the prevalence ratios (PRs) of MSDs at different sites and evaluate the associations between MSDs at different sites. RESULTS: Of the 3800 subjects, 2452 (64.5%) had MSDs at two or more sites, and 469 (12.3%) had MSDs at one site. The PRs varied from 1.5 to 6.7, with significant differences among different sites (P < 0.01). Relatively close associations were found between the MSDs at neck and shoulders, back and shoulders/waist, elbows and wrists/hands, waist and neck, wrists/hands and waist, hip and waist, knees and waist, and ankles/feet and elbows. The multinomial logistic regression analysis indicated that the highest risk factor for MSDs was poor posture, including often working in an uncomfortable posture, neck bending forward, and neck twisting (ORs = 3.39, 1.93, and 1.38), followed by labor organization, in which break between tasks could decrease the risk of MSDs at three or more sites to 31%, staff shortage, which could increase the risk of MSDs by 75%, and pushing and pulling heavy objects (> 20 kg) (OR = 1.76). CONCLUSION: Most auto workers with MSDs have multiple sites affected, and there are high associations between the MSDs at different sites. The major risk factors for multiple MSDs in auto workers include poor posture, labor organization, and heavy physical labor.

[Risk factors analysis of low back pain among workers in a foundry factory of the automobile company].

OBJECTIVE: To study the main risk factors of low back pain of workers ina foundry factory of the automobile company using cross sectional epidemiological investigation, and to provide scientific base for preventing the disorder. METHODS: The low back pain and work loads of 1340 workers in a foundry factory of the automobile company were investigated using questionnaire, and logistic regression analysis was used to analyze the risk factors. RESULTS: The one-year morbidity of low back pain in workers was 58.9% the morbidities of low back pain in workers engaged in foundry, transportation and modeling were 64.6%, 64.6% and 62.5%, respectively. The lifting with squat postures, bending trunk heavily, bending trunk with twisting and moving the heavy objects were found to be the most dominant risk factors for low-back pain, the OR values were 2.085, 1.961, 1.967 and 1.956, respectively. The distributions of risk factors were different among the different jobs. The logistic regression analysis showed that moving the heavy objects, lifting with squat postures, bending trunk heavily, bending trunk with twisting existed simultaneously, also the work years and gender were the risk factors. CONCLUSION: The manual moving heavy objects, awkward working posture or both were the most important risk factors for low-back pain. The intervene ergonomic study should be performed in future to reduce the morbidity of low-back pain.