Work-related Musculoskeletal Symptoms among Agricultural Workers: A Cross-sectional Study in Iran

Musculoskeletal symptoms among workers of the pulp and paper industry: the contribution of age, gender, body mass index and physical activity level

Objectives. This study aimed to investigate 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry, and assess the contribution of age, gender, body mass index (BMI) and physical activity (PA). Methods. The sample comprised 904 workers. Musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. χ2 tests assessed the association between musculoskeletal symptoms and age/gender/BMI/PA, and multivariate logistic regression models predicted the 12-month occurrence of symptoms in the five most prevalent regions. Results. The five most affected body regions were the lower back, shoulders, neck, knees and wrists/hands. Older workers presented more symptoms in all body regions, except dorsal; female gender was associated with neck symptoms (p = 0.001); overweight was associated with a higher prevalence of lower back (p = 0.01), knee (p = 0.017) and ankle/foot (p = 0.037) symptoms; and a moderate PA level was associated with thigh/hip symptoms (p = 0.006). Age was a significant predictor in all five most affected regions; gender was a significant predictor for shoulders, neck and wrists/hands; and BMI was a significant predictor for lower back symptoms. Conclusion. The 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry is higher in the lower back, shoulders, neck, knees and wrists/hands.

De Quervain's tenosynovitis as an occupational disease in agricultural worker: A case report

BACKGROUND

De Quervain's tenosynovitis is upper-limb disorder, more frequent in women. It is rarely recognized as an occupational disease.

OBJECTIVE

In this paper we reported work related de Quervain's tenosynovitis in cow milker.

METHODS

Ergonomic risk factors were assessed by utilizing assessment of repetitive tasks (ART) of the upper limbs method. Physical examination and imaging exams were used.

RESULTS

We presented a 36-year-old female agricultural worker (workplace cow milker) exposed to work factors (forceful hand/wrist exertions, repetition, extreme postures) for 14 years. She was suffering the pain in the right hand, mainly near the thumb for few years. She was treated conservatively and surgically, however disability was permanent. Clinical examination showed slight edema of the right hand, increased palm's sweating. Patient had reduced range of movements and grip strength.

CONCLUSIONS

Report shows that work-related factors were strongly associated with diagnosed de Quervain's tenosynovitis. Hand function plays an essential role in carrying out activities of daily living and this disorder pose a relevant burden of disease. Exposure to biomechanical factors should be an important initial target for the prevention of De Quervain's tenosynovitis in the working population.

Musculoskeletal disorders and pain in agricultural workers in Low- and Middle-Income Countries: a systematic review and meta-analysis

Agricultural workers constitute two-thirds of the population of Low- and Middle-Income Countries (LMIC) and are at increased risk of developing musculoskeletal disorders (MSD) due to high-risk activities. This systematic review and meta-analysis aim to synthesise the prevalence, predictors, and outcomes of musculoskeletal pain amongst agricultural workers to identify priority areas for prevention and development of early interventions. This systematic review and meta-analysis included Studies published from the inception of global electronic databases until 30 September 2022 were included. Prevalence estimates for MSDs among agricultural workers aged over 18 years in LMIC were extracted. Narrative synthesis summarized study findings and pooled estimates for 12-month pain prevalence were calculated. 7502 potential studies were identified. 64 studies (68,684 participants from 23 countries) were included in the systematic review; 33 studies were included in the meta-analysis. Low back pain was the most widely investigated symptom. The 12-month pooled prevalence of low back pain was highest in Africa [61.96% (45.69-76.22)] compared to Asia [54.16% (47.76-60.50)] and South/Central America [28.52%(10.91-50.33)]. Narrative synthesis found associations between MSDs, particular activities including heavy lifting and repetitive movements, and outcomes including reduced productivity. MSDs are common in agriculture workers in LMIC. Global prevalence of low back pain in farmers, particularly in Africa, is greater than in previously reported global prevalence in the general population. This may be attributed to environmental factors and high-risk activities which could be targeted for prevention and early intervention strategies to support individuals, prevent disability, and reduce loss of productivity.

Effect of a Developed Nursing Stretch Break Application on Work-Related Musculoskeletal Complications and Fatigue among Nurses: An Interventional Study

Objective

The present study aimed to develop Nursing Stretch Break (NSB) application to relieve work-related musculoskeletal complications and fatigue among hospital nurses.

Methods

This interventional study was conducted among 71 nurses (15 men and 56 women with a mean age of 33.32 ± 6.42) employed in Shiraz governmental hospitals, Southwest Iran, for four months. In this study, NSB was developed; it includes eight main menus for the user, including (1) Registration, (2) Stretches, (3) User panel, (4) Questions from the researcher, (5) About us, (6) Contact us, (7) Reports, and (8) Answers to questions. Data were collected pre and post-intervention via the Persian version of the Nordic Musculoskeletal Questionnaire (P-NMQ), the Persian version of the Multidimensional Assessment of Fatigue (P-MAF) Scale, the Persian version of the Numeric Rating Scale (P-NRS), and the Persian version of the Usefulness, Satisfaction, and Ease of use (P-USE) questionnaire.

Results

NSB application usability testing showed that the mean scores of P-USE subscales were high. The prevalence of work-related musculoskeletal symptoms (WMSs) in the last 7 days in nurses' body parts, except the elbows and knees, was significantly lower after the intervention than before. In addition, the intensity of work-related musculoskeletal pain/discomfort in all body parts, except the knees, was significant relief after the intervention compared to before. The results demonstrated that the difference in the mean score of the total fatigue and its subscales, except "degree of interference with activities of daily living," was significant after the intervention compared to before.

Conclusions

NSB could be a low-cost and feasible ergonomic solution to improve the nurses' musculoskeletal health.

Ergonomic Evaluation of Young Agricultural Operators Using Handle Equipment Through Electromyography and Vibrations Analysis Between the Fingers

Background

Agricultural handle equipment is present on all production areas' farms. They are handy and portable; however, excessive use can lead to acute traumas or accidental injuries. Repetitive movements, awkward postures, and hand-arm vibrations predispose them to pain and work-related musculoskeletal disorders. The purpose of this study was to observe the interaction of handle equipment in terms of electromyographic activity and analyze the postural work-related alterations.

Materials and methods

Twenty male agricultural operators, mean age 24 ± 1.54 years, underwent the electromyographic analysis testing their muscular activities with a brushcutter, electric saw, and hedge trimmer in four different test conditions.

Results

The brushcutter proved to be the agricultural handle equipment with the higher mean frequency (3.37 ± 0.38 Hz) and root mean square (5.25 ± 1.24 ms^-2). Furthermore, the digital postural analysis showed a general asymmetry of the main arm and the respective side of the trunk. The head resulted right inclined in the anterior frontal plane by 5.7° ± 1.2°; the right scapula lower than the left in the posterior frontal plane (8.5° ± 1.8°), and a working trunk inclination of 34.15° ± 5.7°.

Conclusions

Vibrations of handle equipment and awkward working postures represent a risk for agricultural operators. Preventive measures are required to avoid young operators from experiencing musculoskeletal disorders all lifelong.

Safety behavior of agricultural workers around face mask-wearing during the COVID-19 pandemic

BACKGROUND

Agricultural labor-intensive activities have been threatened by COVID-19. Wearing a face mask has been introduced as one of the personal protective equipment (PPE) to reduce COVID-19 risk.

OBJECTIVE

The present study aimed to investigate the safety behavior of urban green space workers around wearing a face mask in the time of COVID-19 before vaccination.

METHODS

The personal and safety backgrounds of 61 male participants were collected using a designed questionnaire. The nonparametric correlation coefficients of Spearman and logistic regressions were used to investigate the relationships among variables.

RESULTS

Above one-third of workers (37.7%) got COVID-19 in the past year. Although all of the participants were aware of wearing a face mask is a protocol against COVID-19, only about half of them (50.8%) completely wear face masks at work. Non-smoking participants were 5.5 times more likely to influence their personal preference on wearing the mask.

CONCLUSION

Safety attitude may be a key variable in relation to the factors that influence the wearing face mask. The causes of face mask-wearing during a pandemic such as COVID-19 as well as safety attitudes may be behind the factors studied in this study. Although some significant linkages were found, they were not enough to conclude a comprehensive action program. This concern is still open to discovering factors that influence wearing face mask.

A novel risk assessment model for work-related musculoskeletal disorders in tea harvesting workers

Work-related musculoskeletal disorders (WMSDs) are the most common occupational health problems in agriculture workers due to repetitive and excessive force movement activities involved in their job processes. The Fine-Kinney method has been commonly used as a quantitative evaluation method in risk assessment studies. Classically, the risk value via Fine–Kinney is calculated by the mathematical multiplication irrespective of the degree of importance of each risk parameter (probability (P), exposure (E), and consequence (C)). Hence, a novel risk management model was proposed based on integrating Fine-Kinney and spherical fuzzy AHP-TOPSIS. First, each risk parameter is weighted using the spherical fuzzy AHP (SF-AHP). Second, the spherical fuzzy TOPSIS (SF-TOPSIS) method is used for hazard ranking. The proposed model is applied to evaluate risks in tea harvesting workers for work-related musculoskeletal disorders. Subsequently, a sensitivity analysis is carried out to test the proposed model. Finally, we compare the proposed model’s applicability and effectiveness with the spherical fuzzy COmbinative Distance-based ASsessment (SF-CODAS) method based on Fine-Kinney. The ranking similarity between the proposed Fine-Kinney-based SF-TOPSIS and SF-CODAS methods is checked by applying Spearman’s rank correlation coefficient, in which 92% of rankings are matched.

Musculoskeletal Symptoms and Assessment of Ergonomic Risk Factors on a Coffee Farm

In Honduras, some coffee farms must comply with strict standards of social, economic, and environmental sustainability, due to their organic, gender and fair-trade certifications. The principal research aim is to evaluate the musculoskeletal risks in occupations in a Honduran coffee farm certified in sustainable environments and to know the status of its workers within the farm. Musculoskeletal symptom perception during the last twelve months was consulted, assessing exposure to risk factors for work-related musculoskeletal disorders using the Quick Exposure Check method. Data regarding 48 workers were analyzed to provide the results. Within the body regions where discomfort is concentrated, the back, shoulders, wrists, knees, and feet stand out, and the highest risk exposures are presented for the coffee cutters at the neck level and in the wrist/hand segment, in the coffee pickers at the back, shoulder–arm segment, and wrist/hand segment, and in the processors in the back area and shoulder–arm segment. It is concluded that, in all the coffee fruit harvesting processes, the people who work in these jobs are exposed to ergonomic risks.

Ergonomic problems in agricultural farms: Explainable relationship between awkward postures and body discomforts in Iranian leafy vegetable cultivation

BACKGROUND: Many agricultural activities excessively need human power and are associated with musculoskeletal disorders (MSDs). Leafy vegetable cultivation (LVC) is one of these. OBJECTIVE: The postural workload, body discomfort, and explainable linkage between these among Iranian wintry LVC workers were investigated. METHODS: Postures and body discomfort were evaluated using Ovako working posture analyzing system (OWAS) and a body map, respectively. The explainable body discomforts by working postures for each body region were descriptively discussed using some of the literature. RESULTS: Considering the maximum MSD risk value of 400%, irrigation and manual harvesting had the highest MSD risks with index risks of 313% and 305% respectively. Low back discomfort was the most common body discomfort in LVC which was reported for the operations of moldboard plowing, disking, manure application, chemical broadcasting, spraying, and manual harvesting. LVC operations seemed to rely heavily on the use of low back and shoulders. Bent and/or twist postures were the most common postures for the back. CONCLUSIONS: Almost all the body discomforts were explained by awkward postures shown by postural workload analysis. Therefore, the working posture analysis results may be reliable and utilized in future decisions around ergonomic interventions. Future studies may be conducted to investigate the simple and inexpensive ergonomic interventions to mitigate MSD risks.

Ergonomic Task Analysis for Prioritization of Work-Related Musculoskeletal Disorders among Mango-Harvesting Farmers

This paper proposes a mixed ergonomic tool analysis algorithm to prioritize work-related musculoskeletal problems. This study is a cross-sectional study assessing the prevalence of work-related musculoskeletal disorders (WMSDs) with associated risk factors among 14 male mango-harvesting farmers (all right-handed) with the mean age of 52.28 ± 7.75 years. Four tasks following mango-harvesting processes were analyzed: (1) mango harvesting, (2) mango transporting, (3) mango size sorting, and (4) mango weighing and transporting to the truck. The perceived physical exertion while working on a mango-harvesting farm was based on the Borg CR-10 with a modified Standardized Nordic Questionnaire. Physical risk level due to awkward posture was evaluated by the Rapid Upper Limb Assessment (RULA), and risk due to whole-body posture in association with the level of WMSDs risk was evaluated by the Rapid Entire Body Assessment (REBA) score sheets. The subjective feelings of fatigue and posture analysis were normalized and combined using the theorem of power superposition to establish the fatigue effective index (FEI) for determining priorities to solve ergonomics-based task problems. This study indicated clearly that WMSDs are highly prevalent in mango-harvesting farmers, whereas the highest prevalence of WMSDs was reported in the right shoulder, right upper arm and lower back. The result provided the FEI of mango-harvesting farmers, ranked as follows: (1) size-sorting task, (2) weight-lifting task, (3) harvesting task, and (4) transporting task. The authors concluded that mango size sorting should be the first task to be improved to resolve the muscle fatigue problems among male mango-harvesting farmers.

Assessing the effectiveness of an ergonomics intervention program with a participatory approach: ergonomics settlement in an Iranian steel industry

PURPOSE

Work-related musculoskeletal disorders (WMSDs) are common occupational problems affecting the health and productivity of workers worldwide. Ergonomic intervention programs (EIPs) can play an effective role in preventing these disorders in the workplace. Assessing the effectiveness of an EIP is a challenge faced by both industries and researchers. This study was aimed at assessing the effectiveness of an EIP on human resources productivity (HRP), musculoskeletal disorders (MSDs), general health and occupational fatigue in a steel industry.

METHODS

This study was conducted in a steel industry in Isfahan, Iran, between 2018 and 2021. To assess the effectiveness of the EIP with a participatory approach, training and redesign of workstations, the criteria of HRP, MSDs, general health and occupational fatigue were investigated before and after the intervention, using HRP Questionnaire, Nordic musculoskeletal questionnaire (NMQ), 28-item General Health Questionnaire (28-GHQ), Swedish Occupational Fatigue Inventory (SOFI-20) and Occupational Fatigue/Exhaustion Recovery (OFER-15) Questionnaire, as data collection tools, respectively.

RESULTS

The implementation of EIP in the studied industry significantly led to an increase in HRP (p < 0.05). The prevalence of MSDs decreased significantly in most regions of the body after the interventions (p < 0.001). In addition, the program significantly improved general health (p < 0.001) and reduced occupational fatigue among employees (p < 0.001).

CONCLUSIONS

The implementation of EIP was significantly effective in working conditions improvement. Therefore, implementing EIP with participatory approach, workforce training, as well as redesigning of workstations are recommended in industries.

Prevalence of musculoskeletal disorders, ergonomics risk assessment and implementation of participatory ergonomics program for pistachio farm workers

Background and objectives:

Pistachio farmers are exposed to a variety of risk factors for musculoskeletal disorders (MSDs). However, no study has been conducted to investigate MSDs in pistachio workers. Therefore, in the present study, besides investigating the prevalence of MSDs and their ergonomic risk factors, the participatory ergonomics (PE) method is used to provide an intervention program to reduce MSDs in this population in harvesting and processing pistachio.

Methods:

The present study was conducted in two phases. In the first phase 138 workers participated. The prevalence of MSDs was assessed with Nordic Musculoskeletal Questionnaire and the ergonomic risk factors was identified with ManTRA method. In the second phase PE was used to perform ergonomic interventions for reducing MSDs and the effect of the intervention was investigated. Sixty-four workers participated in the second phase (32 in the case group and 32 in the control group).

Results:

The highest prevalence of MSDs was in shoulders (63.7%), followed by the lower back (63%) and wrists/hands (52.1%). The comparison showed that after implementing the PE intervention program, the prevalence of MSDs in the intervention group was not significantly different from that in the control group. However, in the reassessment by the ManTRA method for five tasks that were identified as high risk in the first phase, a decrease in ManTRA final score was observed for all the five tasks.

Conclusions:

MSDs were prevalent in all body regions of workers. After implementing PE interventions exposure to ergonomic risk factors decreased.

Work-related musculoskeletal symptoms among Iranian nurses and their relationship with fatigue: a cross-sectional study

Background

The present study aimed to determine the prevalence of work-related musculoskeletal symptoms (WMSs), identify potential factors associated with WMSs, and determine the association between WMSs and fatigue among nurses.

Methods

This cross-sectional study was carried out among 500 Iranian nurses. Data was gathered by the 1) Persian version of the Nordic musculoskeletal questionnaire (P-NMQ) to examine WMSs, and 2) Persian version of the Multidimensional Assessment of Fatigue (P-MAF) Scale to evaluate fatigue among the study population. Then, data was analyzed by SPSS version 21 using the χ2 test, multiple logistic regression for detection of potential factors associated with WMSs, and multiple linear regression for detection of potential factors associated with fatigue.

Results

Ankles/feet, lower back, knees, and shoulders had the highest prevalence of WMSs among nurses within the last 12 months prior to the study. Independent variables including age, job tenure, gender, smoking, shift work, and type of employment were significantly associated with WMSs in different body regions with odds ratios (ORs) ranging from 1.635–2.835. Moreover, WMSs in some body regions were associated with subscales of fatigue and total fatigue.

Conclusions

Ergonomic and organizational interventions for fitting the job to the nurses considering demographic/occupational characteristics are highly essential to improve musculoskeletal system health and relieve fatigue.

Occupational safety and health in traditional date palm works

OBJECTIVE

Date palm is mostly cultivated in Western Asia and North Africa and is the main wealth for the people of these regions. Traditional date palm crown access via manual climbing, as the main activity in date fruit production, suffers from occupational hazards. Mitigation of these problems through interventions or new designs initially needs to complete knowledge of safety and health aspects and relationships between them and characters of date palm climbers. This study provided detailed information about this concern.

METHODS

A questionnaire consisting of personal, operational, safety, satisfaction, financial and ergonomic demographics was used for data collection. 117 climbers participated in the study. Nonparametric correlations using Spearman's coefficient and logistic regressions investigated the linkage between characters obtained by the questionnaire.

RESULTS

The annual mortality rate of falls from height was calculated by 3.4 per one thousand men. Fall was a major challenge in traditional date palm crown access and its rate was highly greater in comparison with the estimation of International Labor Office (ILO) about fatal agricultural injuries. Safety and health condition was the main contributing factor in the status of date palm climbing and was significantly linked to job satisfaction. Safety risk-taking and non-awareness of technology had a significant linkage with together (r = - 0.195, p = 0.035). Safety risk-taking, also, had significant correlations with discomfort in back (r = - 0.201, p = 0.030). Regressions showed heavier climbers (> 75 kg) were expected about 4.3 (1/0.230) times than more lightweight ones to have an upper leg discomfort with high severity relative to low severity (p = 0.018).

CONCLUSION

Obesity, senescence, and awareness of technology as three personal characteristics of climbers need to be addressed. Future strategies are required to improve the safety condition of climbing and manage the workforces as well as governmental decision making to address the financial aspects of climbers for sustainable date production and reduction in reasons causing unemployment. Considering current status and modification of the present tool and equipment is recommended.

Active and passive work breaks during simulated laparoscopy among laparoscopic surgeons: study protocol for a controlled, randomised cross-over laboratory trial

INTRODUCTION

Laparoscopy has partially replaced open surgery due to the lower infection rate for the patient and hence better and shorter recovery. However, the surgeon's physical load is higher due to longer duration static and awkward body postures, increasing the risk for developing work-related musculoskeletal disorders. Interventions of an organisational nature are work breaks, being either passive or active. The primary objectives of this study are to determine whether passive and active work breaks lead to less discomfort than no work breaks and whether active work breaks lead to less discomfort than passive work breaks.

METHODS AND ANALYSIS

A controlled, randomised cross-over trial will be performed in the laboratory, of which its protocol is described here according to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement. Recruitment of 21 laparoscopic surgeons started in April 2019 and the study is ongoing. The participating surgeons will perform three 1.5 hour experimental conditions, one without work breaks, one with 2.5 min passive work breaks including rest, and one with 2.5 min active work breaks including mobility and stretching exercises. The work breaks will be taken after 30 and 60 min of work. During the experiments, outcomes will be recorded. The primary outcome is rating of perceived discomfort measured on an 11-point numeric rating scale. The secondary outcomes are performance, muscle activity of selected muscles, upper body angles, heart rate, workload and subjective evaluation of both interventions. The collected data will be tested using a one-way or two-factorial repeated-measures analysis of variance.

ETHICS AND DISSEMINATION

Ethical approval of the study protocol was received by the local medical ethical committee of the University of Tübingen in February 2019 (no 618/2018BO2). The results of this study will be presented at national and international conferences, submitted for publications in peer-reviewed journals and serve as the starting point for a feasibility study.

TRIAL REGISTRATION NUMBER

NCT03715816.