Differences in the prevalence of musculoskeletal symptoms among female and male custodians

Musculoskeletal disorders of the upper and lower limb: Prevalence among patients in Eastern province, Saudi Arabia

OBJECTIVES

To determine the prevalence of upper and lower limb musculoskeletal (MSK) disorders among adult patients referred to physical therapy.

METHODS

Data were retrospectively analyzed from electronic health records of patients referred to physical therapy between April 2021 and April 2023. MSK disorders were categorized based on the affected body region (upper or lower limb).

RESULTS

A total of 11,243 patients were referred to physical therapy, of whom 4,156 (37%) had MSK disorders. The 4 most commonly affected regions were the knee (27.7%), followed by the shoulder (26.9%), the ankle/foot (14.9%), and the wrist/hand (11.8%). Within each region, the most prevalent disorders were as follows: knee (arthritis [26.5%], sprain/strain [20.1%], pain [10.1%]); shoulder (pain [20.2%], rotator cuff-related syndrome [18.5%], adhesive capsulitis [8.5%]); ankle/foot (sprain/strain [23.3%], fracture [14.3%], pain [8.9%]); and wrist/hand (fracture [24.1%], pain [8.9%], sprain/strain [7.6%]). Cramer's V analysis revealed a strong association between age and the region of MSK disorders (Cramer's V=0.234, p<0.001) and between patient sex and the region of MSK disorders (Cramer's V=0.189, p<0.001).

CONCLUSION

This study demonstrates the prevalence of upper and lower limb MSK disorders among adult patients referred to physical therapy. Further research involving larger, representative samples is warranted to fully understand the prevalence and risk factors of MSK disorders in Saudi Arabia.

Risk Factors, Incidence and Mortality of Vertebral Artery Injury in Patients Undergoing Anterior Cervical Corpectomy: A Retrospective Large National Data Base Study

STUDY DESIGN

Retrospective Cohort Study.

OBJECTIVE

To determine the incidence of vertebral artery injury (VAI), risk factors, intervention, associated complications, and mortality in patients undergoing anterior cervical corpectomy.

METHODS

We performed a retrospective review of the incidence of VAI during anterior cervical corpectomy using the PearlDiver database from 2010-2017. The CPT code 63 081 to identify corpectomy patients. Patient data extracted included, incidence of VAI, demographic factors, intervention, and future complications of death and stroke. The risk were calculated compared with those patients who did not have VAI.

RESULTS

26 126 patients were identified to have undergone cervical corpectomy. Multivariate analysis of risk factors showed that younger age and male sex were associate with higher rate of injury (t = -11.5; P < .0001 and t = 3.8; P = .0001, respectively). Vertebral artery injuries occurred in 78 patients at an incidence of .3%. 11 (14%) VAI patients had a cerebral infarction compared with 1705 (7%) for non-VAI patients (OR = 2.13; 95% CI = [1.18 - 3.85; P = .0179]) during the follow up period. 1-year mortality rates were higher in patients who suffered a VAI (14%) compared to those who did not suffer a VAI (4%; OR = 3.85; CI = [2.04 - 7.14]; P < .0001).

CONCLUSION

Consequence of VAI may not be known for months following the injury. Although the same admission mortality is rare with this injury, there is a significant increase in post-discharge complications. This study suggests that further investigations into long term health risk of VAI is needed.

Risk Assessment and Prevalence of Work-Related Musculoskeletal Disorders Among Cranial and Spinal Neurosurgeons

OBJECTIVE

To assess the risk and prevalence of work-related musculoskeletal disorders (WMSDs) in spine and cranial surgeons.

METHODS

A cross-sectional analytic study composed of a risk assessment and a questionnaire-based survey was conducted. The risk assessment for WMSDs was performed on young volunteer neurosurgeons using the Rapid Entire Body Assessment tool. The survey-based questionnaire was distributed using the Google Forms software among the relevant official WhatsApp groups of the Egyptian Society of Neurological Surgeons and the Egyptian Spine Association.

RESULTS

Thirteen volunteers with a median service of 8 years were assessed for the risk of WMSDs, showing moderate to very high risk of WMSDs, with a Risk Index >1 for all assessed postures. A total of 232 respondents completed the questionnaire, 74% of whom reported WMSD symptoms. Pain was experienced by most (96%), with neck pain being the most common (62.8%), followed by low back pain (56.0%), shoulder pain (44.5%), and wrist/finger pain (43.9%). Pain was experienced for 1-3 years by most respondents; however, most did not reduce their case volume, seek medical advice, or stop working when they experienced pain. The survey showed shortage in the literature studying ergonomics, calling for more ergonomic education and furnishing of working environment of neurosurgeons.

CONCLUSIONS

WMSDs are prevalent among neurosurgeons, affecting their ability to work. Ergonomics need further awareness, education, and interventions to reduce WMSDs, especially neck and low back pain, which proved to substantially interfere with work ability.

Musculoskeletal pain among desk-based officials of Bangladesh: Association with mental health and individual factors

Musculoskeletal (MS) pain is widely prevalent and is an important health issue for desk-based employees which has a negative impact on both personal and work life. This study aimed to determine the MS pain status and its association with mental health and other individual factors among desk-based officials of Dhaka, Bangladesh. This cross-sectional study comprised a sample of 526 desk-based officials from Dhaka, Bangladesh. Data were collected between November 2020 to March 2021. MS pain was determined by the visual analog scale (VAS) and depression and anxiety were screened by Hospital Anxiety and Depression Scale (HADS). Logistic regression analyses were employed to estimate the adjusted effect of independent factors on MS pain. The overall prevalence of MS pain was 64% among desk-based officials. The corresponding prevalence were 19% severe, 21% moderate and 24% mild MS pain. In the adjusted model, gender (AOR: 0.19, 95% CI: 0.07-0.46), BMI (AOR: 0.28, 95% CI: 0.14-0.59), monthly income (AOR: 5.17, 95% CI: 2.18-12.25), organization type (AOR: 4.3, 95% CI:1.8-10.1), floor living (AOR: 4.7, 95% CI:2.1-10.8), physical activity (AOR: 0.16, 95% CI: 0.06-0.45), and lift facility in the house (AOR: 4.11, 95% CI: 2.06-8.23) were associated with MS pain. In addition, the prevalence of anxiety and depression was 17.7% and 16.4%, respectively. Depression was identified as a significant predictor for severe MS pain (AOR: 2.44, 95%CI:1.29-4.63). This study has revealed a relatively high prevalence of MS pain and mental health problems among Bangladeshi desk-based officials. Preventive measures need to be taken from both organizational and personal sides to delimitate MS pain and mental health problems.

Identifying occupational health and safety risks among environmental health officers in Australia and New Zealand through an online survey

To identify the occupational health and safety (OHS) risks among environmental health officers (EHOs) in Australia and New Zealand. The objectives were to profile and compare OHS experiences from different countries and regions to gain a regional perspective on OHS hazards that impact EHOs. An online hazard exposure survey was conducted among 339 EHOs (Australia: n = 301, 88.8%; New Zealand: n = 38, 11.2%). The Mann-Whitney U test was used to compare 2 ordinal data groups, the Kruskal-Wallis H test was used for more than 2 ordinal groups, and the independent samples t test was used to compare the means of 2 independent groups where the dependent variables were normally distributed. Multiple regression techniques were used to analyze workplace incidents and age groups. A high degree of similarity in the types of workplace exposures and risk perceptions as well as concerns with organizational OHS management commitment were observed among EHOs from the 2 countries. Workplace violence and physical and psychosocial demands were the most commonly reported OHS hazards. Employer type, sex, and age group were significantly related to workplace exposure and OHS experience among EHOs in both countries. This study provides a profile of workplace exposure in the environmental health profession in the 2 countries and offers recommendations for the implementation of preventive action.

Cleaning in the 21st Century: The musculoskeletal disorders associated with the centuries-old occupation - A literature review

Workers performing cleaning duties experience higher injury rates, especially in the form of musculoskeletal disorders (MSDs), than other industries. It is essential to understand the inherent risks associated with the nature of this occupation. Based on the Balance Theory (Smith & Carayon-Sainfort, 1989), this review surveys the current literature, especially those published since the previous review paper (Kumar & Kumar, 2008), and identifies which elements contributing to MSD risks were examined: task, technology, organization, environment, individual, and their interactions. Thirty-nine research papers published between 2005 and 2021 are identified and summarized. Among these papers, task and individual elements received the most attention, at 42 and 34 occurrences, respectively. The interaction elements of technology-organization, technology-environment, and organization-environment received less than three mentions. The goal of this literature review is to update the knowledge base and identify current trends for the cleaning occupation. Possible interventions for risk reduction and future research directions are suggested.

Musculoskeletal Pain in Undergraduate Students Is Significantly Associated with Psychological Distress and Poor Sleep Quality

Musculoskeletal pain (MSKP), psychological distress, and poor sleep quality are common among undergraduate university students. Yet, few studies have assessed the association between MSKP and psychological distress and poor sleep quality. This cross-sectional study was conducted to determine this association among undergraduate students at a major public university in Saudi Arabia. MSKP was assessed using the Nordic Musculoskeletal Questionnaire, psychological distress using the Depression, Anxiety and Stress (DASS-21) questionnaire, and sleep quality using the Pittsburgh Sleep Quality Index. A total of 339 undergraduate students from various specialties provided complete responses and were included. The most common site of MSKP in the past 12 months and the past 7 days were neck pain (54.6% and 41.9%, respectively) and low back pain (49.4% and 48.2%, respectively). There was no difference in the prevalence of MSKP across colleges. The reported MSKP in the past 12 months and 7 days were significantly associated with the students' level of anxiety and stress as well as sleep quality (p < 0.05 for all), while depression was only significantly associated with MSKP in the past 7 days.

Risk factors and impacts of slips, trips, and falls in janitorial populations: A literature review

The objective of this paper is to analyze the existing literature to determine the scope and risk factors of slips, trips, and falls (STFs) within the janitorial population in order to make evidence-based recommendations to prevent these incidents in the future. Selected for review were published peer-reviewed articles, conference proceedings, and gray literature relating to STFs among janitors and cleaners. Individuals employed as janitors and cleaners, specifically those that were older than 45-years of age and/or female, represented the highest risk populations for STFs. These STFs result in injuries, such as sprains, strains, dislocations, and tears. Among janitors and cleaners, 30% of nonfatal incidents are attributed to STFs, resulting in a median of 11 days away from work. Both non-observable/human factors and observable/organizational factors contribute to STFs within this population and must be addressed to protect public health. Preventive interventions focused on comprehensive approaches that target observable and non-observable factors are needed to reduce STFs within the custodial population. More research is needed on STFs in the janitorial population to identify successful preventive STF interventions. Addressing the issue of STFs within this job classification will improve the overall health and well-being of janitors as well as reduce the indirect and direct economic burden placed on the employer organization.

Influence of gender and age on musculoskeletal symptoms in white and blue-collar workers - cross-sectional study

OBJECTIVE

Identify the prevalence of musculoskeletal symptoms among blue- and white-collar workers stratified by gender and age.

METHODS

The sample was composed of 390 blue-collar and 510 white-collar workers. Musculoskeletal symptoms were evaluated using the Nordic Musculoskeletal Questionnaire. Independent t-test or Mann-Whitney test were used for the inter-group comparisons. The Chi-square (χ²) association test was applied for categorical variables. Logistic regression analysis was used to determine the influence of gender and age on musculoskeletal symptoms.

RESULTS

The prevalence of shoulder, lower back, and ankle/foot symptoms was higher among blue-collar workers compared to white-collar workers. In the analysis stratified by gender, female blue-collar workers had a higher frequency of shoulder symptoms and male blue-collar workers had a higher frequency of lower back symptoms. In the analysis stratified by age, younger blue collar-workers had a higher frequency of shoulder, lower back, and ankle/foot symptoms compared to young white-collar workers and older white-collar workers had a higher frequency of neck symptoms compared to older blue-collar workers.

CONCLUSIONS

Gender and age exerted an influence on self-reported symptoms in blue- and white-collar workers.

Risk factors for occupational injuries in schools among educators and support staff

INTRODUCTION

School districts employ a large number of employees who work in educational (e.g., teachers) or other support roles, including educational assistants, custodians, food service, bus drivers, and community and recreation workers. District employees perform a wide array of job tasks and experience a wide spectrum of work-related risks and injuries.

METHODS

Workers' compensation data were coupled with Minnesota Department of Education district employee denominator data to evaluate risk factors for injury and severity. Variables included district location and type, employee job classification, age, and gender. Rates of injury and rate ratios were calculated to measure comparative injury risk using negative binomial regression and 95% confidence internals. Incidence and frequency of injury cause, nature, and body part we calculated.

RESULTS

Saint Paul and Minneapolis metropolitan area (versus non-metro) districts had higher risk (RR = 1.35, 95%CI = 1.18-1.54) of employee injuries. All job classifications in support roles had increased risk of injury claims versus educators, however food service (RR = 5.14, 95%CI = 4.61-5.74), custodial (RR = 3.85, 95%CI = 3.41-4.34), and transportation (RR = 4.15, 95%CI = 3.38-5.10) exhibited the highest comparative risk to educators; significant risk of lost-time injury was also present in these workers. Males and females had similar risk of injury for all claims, however males had elevated risk of lost-time injury (RR = 1.46, 95%CI = 1.26-1.69) versus females. All age groups >41-years-old exhibited increased risk of injury as compared to 31-40-year-olds. The magnitude of lost-time injury risk also increased with age. Falls and slips (29.1%), strains/sprains/ruptures (45.2%), and upper extremities (31.3%) most frequent cause, nature, and body part injured, respectively.

CONCLUSIONS

Characteristics of districts, schools, workers, and their jobs tasks and hazards vary. Many categories of support staff in schools have elevated risk of injury, including lost-time injury, as compared to educators. Practical Applications: Injury prevention in schools should be approached by targeting job classifications; high risk jobs can be prioritized for prevention.

Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey

Background

Work-related musculoskeletal disorders (WMSDs) affect a significant percentage of the neurosurgical workforce. The aim of the current questionnaire-based study was to examine the prevalence of WMSDs amongst neurosurgeons, identify risk factors, and study the views of neurosurgeons regarding ergonomics.

Methods

From June to August 2020, members of the “European Association of Neurosurgical Societies,” the “Neurosurgery Research Listserv,” and the “Latin American Federation of Neurosurgical Societies” were asked to complete an electronic questionnaire on the topics of WMSDs and ergonomics.

Results

A total of 409 neurosurgeons responded to the survey, with a 4.7 male to female ratio. Most of the surgeons worked in Europe (76.9%) in academic public hospitals. The vast majority of the participants (87.9%) had experienced WMSDs, mainly affecting the shoulder, neck, and back muscles. The most common operations performed by the participants were “Craniotomy for convexity/intrinsic tumors” (24.1%) and “Open lumbar basic spine” (24.1%). Neurosurgeons agreed that ergonomics is an underexposed area in the neurosurgical field (84.8%) and that more resources should be spend (87.3%) and training curricula changes should be made (78.3%) in order to alleviate the burden of WMSDs on neurosurgeons. Univariate analysis did not reveal any associations between the development of WMSDs and age, gender, tenure, average duration of operation, operating time per week, type of operation, and surgical approach.

Conclusions

The problem of WMSDs ought to be more closely addressed and managed by the neurosurgical community. More studies ought to be designed to investigate specific ergonomic parameters in order to formulate practice recommendations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00701-021-04722-5.

Infrared thermography of the crânio-cervico-mandibular complex in wind and string instrumentalists

PURPOSE

Musculoskeletal disorders can be common in wind and string instrumentalists. The musical gesture technique associated to musical performance can promote an asymmetrical isometric contraction with the hyperactivity of specific muscular groups and the overload of articular surfaces which can cause discomfort or pain. The aim of this investigation was to assess specific anatomical regions of interest within the cranio-cervico-mandibular complex in order to determine and evaluate the presence of muscular hyperactivity associated to musical performance.

METHODS

An infrared imaging camera, FLIR®, was used to record the regions of interest in wind (n = 48) and string instrumentalists (n = 29). Bilateral temperature differences were considered as thermal asymmetries with a conventional threshold of 0.3 ºC to distinguish pathological from healthy states. The regions of interest (ROI) were the anterior triangle of the neck, the sternocleidomastoid and trapezius muscles regarding the postural and stabilizing muscles of the head and neck. On the orofacial region, the anatomical sites were the anterior temporal muscle, the masseter muscle and the temporomandibular joint. A Pearson chi-square test was performed to compare the assessed areas.

RESULTS

Between 30-37% of all participants showed ROI in an asymmetric pattern. The most affected sites were the temporal muscle and the TMJ for both groups. The anterior triangle of the neck showed statistical differences (p = 0.044) between string and wind instrumentalists, while the temporal (p = 0.034) and trapezius muscle (p = 0.028) when comparing large and small mouthpieces of brass instruments. Although female participants showed a higher prevalence of asymmetrical patterns regarding the ROI, no statistical differences were found between genders.

CONCLUSIONS

Infrared thermography exhibited significant differences between wind and string instruments within the CCMC. Regarding the issue of occupational health in performing arts, it is an advantage being able to quantify asymmetrical patterns sites of the CCMC to understand the underlying physiological responses to repetitive movements, overloading and muscular hyperactivity that occur during musical performance.

The impact of work-related risk factors on the development of neck and upper limb pain among low wage hotel housekeepers in Gondar town, Northwest Ethiopia: institution-based cross-sectional study

Background

Musculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers.

Methods

Institution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05.

Results

The overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders.

Conclusions

A higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers.