Fish processing work: the impact of two sex dependent exposure profiles on musculoskeletal health

Task based exposure assessment in ergonomic epidemiology: a study of upper arm elevation in the jobs of machinists, car mechanics, and house painters

AIMS

To explore the precision of task based estimates of upper arm elevation in three occupational groups, compared to direct measurements of job exposure.

METHODS

Male machinists (n = 26), car mechanics (n = 23), and house painters (n = 23) were studied. Whole day recordings of upper arm elevation were obtained for four consecutive working days, and associated task information was collected in diaries. For each individual, task based estimates of job exposure were calculated by weighting task exposures from a collective database by task proportions according to the diaries. These estimates were validated against directly measured job exposures using linear regression. The performance of the task based approach was expressed through the gain in precision of occupational group mean exposures that could be obtained by adding subjects with task based estimates to a group of subjects with measured job exposures in a "validation" design.

RESULTS

In all three occupations, tasks differed in mean exposure, and task proportions varied between individuals. Task based estimation proved inefficient, with squared correlation coefficients only occasionally exceeding 0.2 for the relation between task based and measured job exposures. Consequently, it was not possible to substantially improve the precision of an estimated group mean by including subjects whose job exposures were based on task information.

CONCLUSIONS

Task based estimates of mechanical job exposure can be very imprecise, and only marginally better than estimates based on occupation. It is recommended that investigators in ergonomic epidemiology consider the prospects of task based exposure assessment carefully before placing resources at obtaining task information. Strategies disregarding tasks may be preferable in many cases.

Feeling cold at work increases the risk of symptoms from muscles, skin, and airways in seafood industry workers

BACKGROUND

Norwegian workers in seafood industry plants are exposed to a cold and often wet environment.

METHODS

1,767 seafood industry workers participated in a questionnaire study. Seventeen plants were visited for thermal measurements.

RESULTS

15.9% of industrial workers and 1.7% of administrative workers reported that they often felt cold at work. Mean finger temperatures after 1 hr work varied between 16 and 22 degrees C. Foot temperature dropped from morning measurement until lunch time in 85% of the measurements. Industrial workers who reported that they often felt cold, had significantly increased prevalence of symptoms from muscles, skin, and airways while working, compared to workers who reported that they never felt cold at work.

CONCLUSIONS

Moderate cooling, caused by a cold indoor working environment, may increase muscle-, airway-, and skin symptoms. The prevalence of feeling cold may be a useful exposure estimate in moderate cold exposure situations.

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study

The aim of the study was to present the prevalence of clinical signs and symptoms among female computer users above 45 years, both in a group with self-reported neck/shoulder trouble (NS cases) and in a group without such trouble (NS controls). The hypothesis was that computer users with self-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower in subjects with self-reported trouble as well as in the subgroup of NS cases with clinical diagnoses. In conclusion, the present clinical diagnoses and physical function tests differed between NS cases and NS controls, and are therefore recommended to be included as quantitative objective measures in assessing musculoskeletal health. Physical function tests should be further developed in order to be able to detect pre-stages of work-related disorders for preventive strategies.

Gendered work conditions, health, and work outcomes

This cross-sectional study of nonfaculty university employees examined associations among gendered work conditions (e.g., sexism and discrimination), job demands, and employee job satisfaction and health. Organizational responsiveness and social support were examined as effect modifiers. Comparisons were made by gender and by the male-female ratio in each job category. The relationship of gendered conditions of work to outcomes differed on the basis of respondents' sex and the job sex ratio. Although the same predictors were hypothesized for job satisfaction, physical health, and psychological distress, there were some differing results. The strongest correlate of job satisfaction was social support; perceived sexism in the workplace also contributed for both men and women. Organizational factors associated with psychological distress differed between female- and male-dominated jobs.

Gender differences in prevalence of upper extremity musculoskeletal disorders

A literature review was conducted on the current literature base to determine the strength of support for the hypothesis that women experience higher prevalences of upper extremity musculoskeletal disorders (UEMSDs) than men. Fifty-six articles were reviewed for data on gender differences in frequency, incidence or prevalence rates for musculoskeletal disorders specific to the upper extremities. These articles included both general and working populations. The majority of the studies showed that women had significantly higher incidences of various types of UEMSDs than men. This trend was consistently observed in studies based on self-report or plant/workers compensation records, with and without physical examination, and after adjusting for potential confounders such as age and physical work factors. With men as the referent, the odds ratio (OR) or prevalence ratio (PR) for UEMSDs ranged from 0.85 to 10.05 for self report. For self report combined with physical examination, the OR/PR ranged from 0.66 to 11.4. The OR/PR for carpal tunnel syndrome (CTS) ranged from 0.6 to 2.87 with confounder adjustment. These findings suggest that women do have significantly higher prevalences than men for many types of UEMSDs, even after controlling for the type of data source and confounders such as age or work factors.

Musculoskeletal pain in the obese: a comparison with a general population and long-term changes after conventional and surgical obesity treatment

Obesity is associated with musculoskeletal pain and osteoarthritis. This study compares the prevalence of work-restricting musculoskeletal pain in an obese and a general population and investigates changes in the incidence of and recovery from musculoskeletal pain after bariatric surgery or conventional obesity treatment. A random sample of 1135 subjects from a general population was compared with 6328 obese subjects in the Swedish obese subjects (SOS) study. For the obese subjects, information about musculoskeletal pain was also collected 2 and 6 years after obesity surgery or the start of non-surgical treatment. In both sexes, self-reported work-restricting pain in the neck and back area and in the hip, knee and ankle joints was more common in the obese subjects than in the general population (odds ratios (ORs) ranging from 1.7 to 9.9, P<0.001). Operated obese women had a lower incidence of work-restricting pain in the knee and ankle joints compared with the conventionally treated control group over 2 and 6 years (ORs 0.51-0.71). Among subjects reporting symptoms at baseline, the recovery rate for pain in the knee and ankle joints in men and pain in the neck and back and in the hip, knee and ankle joints in women improved in the surgical group compared with the control group after 2 years (ORs 1.4-4.8). Obese subjects have more problems with work-restricting musculoskeletal pain than the general population. Surgical obesity treatment reduces the long-term risk of developing work-restricting musculoskeletal pain and increases the likelihood of recovering from such pain.

Work-related cumulative trauma disorders of the upper extremity: navigating the epidemiologic literature

BACKGROUND

Cumulative trauma disorder of the upper extremity (CTDUE) is an umbrella term used to describe disorders resulting from repeated use of the upper extremity over time rather than a specific incident. The primary purpose of this article is to summarize the literature regarding the rate of work-related CTDUE, while drawing attention to the various factors contributing to the wide range of reported findings.

METHODS

The Cumulative Index to Nursing and Allied Health and Medline databases were searched for articles focusing on etiology or rates of occurrence of work-related CTDUE and their findings were summarized.

RESULTS

Potential reasons for rising rates, a gender differential, and the substantial range in rates and rate ratios are delineated and important factors to consider when interpreting rates derived from workers' compensation data are detailed.

CONCLUSIONS

Future research should attempt to correctly identify more specific categories of CTDUE in well-defined and accurately-quantified "at risk" populations to provide more meaningful information regarding the epidemiology of CTDUE and the effectiveness of control activities.

Short term influence of mechanical factors on regional musculoskeletal pain: a study of new workers from 12 occupational groups

OBJECTIVES

To determine the influence of short term exposure to mechanical factors on regional musculoskeletal pain.

METHODS

Full time newly employed workers were recruited from 12 occupational groups and information collected by questionnaire. Subjects indicated on a blank body manikin any low back, shoulder, wrist or forearm or both, or knee pain which had occurred during the past month and had lasted more than 1 day. Data were also collected with a previously validated questionnaire on working postures, manual handling activities, and repetitive movements of the upper limb. The relations between mechanical factors and each area of pain were calculated as odds ratios (ORs) with 95% confidence intervals (95% CIs). Adjustment was made for age and sex.

RESULTS

1081 subjects (median age 23; interquartile range 20--27) were recruited to the study (a participation rate of 91%). 261 (24%) reported low back pain, 221 (20%) shoulder pain, 93 (9%) wrist or forearm pain, and 222 (21%) knee pain. Several specific manual handling activities were found to be associated with low back, shoulder, and knee pain. Carrying weights of more than 50 lbs (23 kg) on one shoulder was the factor which was most strongly associated with low back pain (OR 2.4 (95% CI 1.5 to 3.8)), shoulder pain (OR 3.1 (95% CI 1.9 to 4.8)), and knee pain (OR 3.5 (95% CI 2.2 to 5.5)), whereas forearm pain was most strongly associated with repetitive movements of the wrists (OR 1.8 (95% CI 1.04 to 3.1)). By contrast very few postures were associated with regional pain, although bending forwards in an uncomfortable position for at least 15 minutes was associated with shoulder pain (OR 1.6 (95% CI 1.2 to 2.2)) and kneeling for at least 15 minutes was associated with knee pain (OR 1.8 (95% CI 1.2 to 2.6)). Exposure to mechanical factors was most strongly associated with pain at multiple sites rather than with pains in individual regions.

CONCLUSIONS

Even among workers with only short term exposure to mechanical factors, musculoskeletal pain is increased.

Sex differences in musculoskeletal pain

Epidemiologic, clinical, and experimental evidence points to sex differences in musculoskeletal pain. Adult women more often have musculoskeletal problems than do men. Discrepant findings regarding the presence of such differences during childhood and adolescence continue. Biologic and psychosocial factors might account for these differences. The authors review evidence showing that mechanically induced pressure is more likely to show sex differences than other noxious stimuli and to discriminate between individuals suffering from musculoskeletal pain and matched controls. The authors suggest that a state of increased pain sensitivity, with a peripheral or central origin, predisposes individuals to chronic muscle pain conditions, and that there are sex differences in the operation of these mechanisms; women are vulnerable to the development and maintenance of musculoskeletal pain conditions.

Identification of neck-shoulder disorders in a 1 year follow-up study. Validation Of a questionnaire-based method

A cohort of 243 female sewing machine operators were studied by questionnaire and clinical examinations with the purpose to study the efficiency of a screening questionnaire-based method to identify prevalent and incident cases of neck-shoulder disorders. The cross-sectional correlation between self-reported neck-shoulder complaints scores and clinical signs of a neck-shoulder disorder was high. An assessed cut-of point of complaints could identify 90% of all cases fulfilling the criteria of rotator cuff tendinitis, while the complaint score with regard to clinical signs of myofascial pain syndrome was about 67%. In the follow-up analyses, incident clinical signs of disorders at 1 year follow-up were used as 'golden standard' in the validation of screening criteria, which included a defined increase of symptoms. Apparently increase of symptoms did not seem to be the optimal criteria for identification of incident cases. Alternatively a cut-of point of regional complaints in close relation to clinical examinations is recommended.