The association between musculoskeletal disorders and driver behaviors among professional drivers in China

Musculoskeletal disorders among taxi drivers: a systematic review and meta-analysis

INTRODUCTION

Taxi drivers, as professional drivers, encounter numerous ergonomic risk factors related to musculoskeletal disorders (MSDs) because of the demands of their jobs. This study conducted as a systematic review and meta-analysis aimed to explore the prevalence of MSDs among taxi drivers.

MATERIALS AND METHODS

The present study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and its protocol was registered in the international prospective register of systematic review (PROSPERO) under the code CRD42024509258. Searches were carried out using various databases, such as PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, with no time restrictions until February 7th, 2024. A random effects model was utilized for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Lastly, data analysis was conducted using STATA software (version 14).

RESULTS

After the initial search, 1606 articles were extracted from the reviewed sources. Following screening, study selection, and quality evaluation, a total of 11 studies were chosen for meta-analysis, involving 5277 taxi drivers. Based on the results of the meta-analysis, the highest prevalence of MSDs among taxi drivers was related to the lower back region (53.87% (95% CI:40.89-66.84, I2= 98.7%, P < 0.001)). Additionally, the prevalence rates of MSDs in different body regions, such as the neck (38.15%), shoulder (34.97%), upper back (18.30%), and knee (14.10%), were also reported.

CONCLUSION

Based on the findings of this study, the prevalence of MSDs among taxi drivers is relatively high, and specific risk factors may contribute to the development of these disorders. Therefore, to prevent the occurrence of MSDs among taxi drivers, it is advisable to implement essential measures concerning the development of training programs, ergonomic interventions, and evaluation of the work environment.

Assessment of occupational musculoskeletal disorders (MSDs) among heavy vehicle drivers

BACKGROUND

Professional driving requires long hours of work, uncomfortable seats, negotiating rough terrain and highways, and possibly minor repairs and other auxiliary transportation duties. Heavy vehicle drivers driving vehicles such as trucks, bulldozers, etc. due to such working structures are more prone to various musculoskeletal disorders (MSDs) and pain, which is of great concern.

OBJECTIVES

In the present study, it is planned to investigate possible ergonomic risk factors such as age, weight, driving exposure, seat suspension systems, lifting heavy weights causing MSDs in drivers of various heavy vehicles. The results of the study are expected to help drivers reduce the risk of MSDs.

METHODS

For the present study, the Nordic questionnaire on musculoskeletal disorders was modified and standardized and was administered to the 48 heavy vehicle drivers randomly selected to collect the data.

RESULTS

The analysis divulged that over the past 12 months, lower back pain (LBP) emerged as the most dominant pain experienced by 56% of drivers, followed by knee pain (KP) (43%) and neck pain (NP) (39%) respectively. The prevalence of shoulder pain (SP) was observed to be much lower than in previous literature. The logistic regression model further revealed that increasing age, poor suspension system and poor body posture were significantly associated with lower back pain. Additionally, a poor suspension system and lifting heavy weights had significant effect on the drivers' knee pain.

CONCLUSION

The results demonstrated the evident necessity for ergonomic consideration in vehicle designing and ergonomic training for heavy vehicle drivers.

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

OBJECTIVES

Although studies have shown that work-related musculoskeletal disorders (WMSDs) are common and continue to be a major source of disability and work time loss, there are few reports about 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 c2 test and logistic regression analysis were applied to reveal the prevalence and risk factors of elbow WMSDs.

RESULTS

The findings indicated that the overall prevalence of elbow WMSDs among workers was 7.3%. However, the prevalence of elbow WMSDs in toy manufacturing was 21.3%, which was significantly higher than that in other industries (P < .05). Logistic regression analysis showed that age 40 and above, married, very poor health, left-handedness, lifting weights (more than 20 kg each time), work requiring upper limb or hand force, work in an uncomfortable position, repetitive operations within 1 minute, using vibrating tools, work involving cold, cool draughts, or temperature changes, work being completed in the same workshop, work being done outdoors, frequent dealings with customers, 2 shifts, often working overtime, staff shortage, and often working for colleagues were risk factors for elbow WMSDs. A higer education level, monthly income, and enough rest time were protective factors for elbow WMSDs.

CONCLUSIONS

Toy manufacturing is a high-risk industry for elbow WMSDs. Promotion of education about ergonomics should be strengthened, and workers' ergonomics awareness should be improved to reduce the impact of WMSDs.

Causal Relationship Between the Risk Factors and Work-Related Musculoskeletal Disorders Among Professional Drivers: A Systematic Review

OBJECTIVE

This review evaluates the evidence on the strength of causal relationship between categories of risk factors (RFs) and work-related musculoskeletal disorders (WRMSDs) among professional drivers.

BACKGROUND

A compilation of evidence on the causal relationship between RFs and WRMSDs among professional drivers is lacking.

METHODS

A systematic search of the literature was conducted in major electronic data bases that include Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, and Web of Science. The methodological quality of the studies was assessed and scored. A descriptive analysis on the categories of RFs associated with WRMSDs was conducted. The Bradford-Hill causation criteria and evidence interpretation tool were used to evaluate the causal relationship between RFs and WRMSDs in professional drivers.

RESULTS

Among the 54 studies reviewed, a strong evidence suggests a causal relationship between RFs such as whole-body vibration, awkward postures, lifting tasks, manual material handling, job stress, job demand, and previous pain episodes with WRMSDs. Moderate evidence was observed on RFs such as uncomfortable seat and low job satisfaction. The evidence on causal relationship between RFs such as years of professional driving, driving duration, and individual characteristics such as age and body mass index was inconclusive.

CONCLUSION

There is strong to moderate evidence on the causal relationship between the physical and psychosocial RFs and WRMSDs among professional drivers.

APPLICATION

Potential application of this review highlights evidence to occupational health practitioners, policy makers, and stakeholders on the strength of causal relationship between RFs and WRMSDs among professional drivers.

Opinions of taxi drivers regarding occupational risks and prevention strategies: A cross- sectional study in Turkey

BACKGROUND: Taxi drivers are prone to musculoskeletal problems and can suffer from cardiovascular disease, respiratory disease, and psychosocial problems. For occupational health and safety it is crucial to know the risk factors and initiatives to be taken for protection. OBJECTIVES: This study was carried out to evaluate the opinions of taxi drivers regarding occupational risks and prevention strategies. METHODS: This was a descriptive and cross-sectional study including 524 taxi drivers. A questionnaire was developed to determine the opinions of taxi drivers regarding occupational risks and intervention strategies. For the analysis of data, Mann-Whitney U (Z-table value), descriptive statistics (number, percentage) and Chi-square (χ2) test between dependent and independent variables were used. RESULTS: Among the taxi drivers, the occupation was reported to be risky for musculoskeletal system disorders by 67%, for cardiovascular diseases by 68.3%, for respiratory diseases by 46.9% and for psychosocial problems by 63.3%. When the opinions of taxi drivers regarding prevention from these risks were examined, 30.2% of them stated prevention from musculoskeletal system disorders, 34.0% from cardiovascular diseases, 31.3% from respiratory diseases and 40.1% from psychosocial problems. It was a prominent finding to see a decrease in the number of drivers who stated to show prevention behavior towards these risks compared to their states of recognizing them. CONCLUSİON: Drivers were insufficient both in recognizing health risks of their jobs and implementing intervention strategies. Education concerning health risks of their jobs and prevention from these risks is required.

Modeling and Validation of Fatigue and Recovery of Muscles for Manual Demolition Tasks

Manual demolition tasks are heavy, physically demanding tasks that could cause muscle fatigue accumulation and lead to work-related musculoskeletal disorders (WMSDs). Fatigue and recovery models of muscles are essential in understanding the accumulation and the reduction in muscle fatigue for forceful exertion tasks. This study aims to explore the onset of muscle fatigue under different work/rest arrangements during manual demolition tasks and the offset of fatigue over time after the tasks were performed. An experiment, including a muscle fatigue test and a muscle fatigue recovery test, was performed. Seventeen male adults without experience in demolition hammer operation were recruited as human participants. Two demolition hammers (large and small) were adopted. The push force was either 20 or 40 N. The posture mimicked that of a demolition task on a wall. In the muscle fatigue test, the muscle strength (MS) before and after the demolition task, maximum endurance time (MET), and the Borg category-ratio-10 (CR-10) ratings of perceived exertion after the demolition task were measured. In the muscle fatigue recovery test, MS and CR-10 at times 1, 2, 3, 4, 5, and 6 min were recorded. Statistical analyses were performed to explore the influence of push force and the weight of the tool on MS, MET, and CR-10. Both muscle fatigue models and muscle fatigue recovery models were established and validated. The results showed that push force affected MET significantly (p < 0.05). The weight of the tool was significant (p < 0.05) only on the CR-10 rating after the first pull. During the muscle fatigue recovery test, the MS increase and the CR-10 decrease were both significant (p < 0.05) after one or more breaks. Models of MET and MS prediction were established to assess muscle fatigue recovery, respectively. The absolute (AD) and relative (RD) deviations of the MET model were 1.83 (±1.94) min and 34.80 (±31.48)%, respectively. The AD and RD of the MS model were 1.39 (±0.81) N and 1.9 (±1.2)%, respectively. These models are capable of predicting the progress and recovery of muscle fatigue, respectively, and may be adopted in work/rest arrangements for novice workers performing demolition tasks.

Research on intervention methods for children's street-crossing behaviour: Application and expansion of the theory of "behaviour spectrums"

Due to immaturity in their physical and cognitive development, children are particularly vulnerable to road traffic injuries as pedestrians. Child pedestrian injury primarily occurs in urban areas, with a significant share at crosswalks. The aim of this study is to explore whether an intervention programme based on the theory of "behaviour spectrums" can improve the street-crossing skills of primary school children. Children were recruited near a local primary school through invitation letters and were randomly divided into two groups: a control group (n = 10, no intervention) and an experimental group (n = 10, intervention). The children in the experimental group received 30-45 min of training. The child participants were asked to wear an eye tracker and performed a crossing test in a real-world street environment; in this test, they were required to successively pass through an unsignalised intersection, an unsignalised T-intersection and a signalised intersection on a designated test route. A high-definition camera was used to record the children's crossing behaviour, and the Tobii Pro Glasses 2 eye tracker was used to derive indicators of the children's visual behaviour in the areas of interest (AOIs) in the street. The evaluation was conducted on children's crossing behaviour in the control group (which received no intervention) and the experimental group (tested at two time points after the intervention: children tested immediately after the intervention and children retested one month after the intervention). The results showed that compared with the control group, the children in the experimental group no longer focused on the small area around the body (e.g., the zebra crossing area) and the area in front of the eyes (e.g., the sidewalk area), which increased their visual attention to the traffic areas on the left and right sides of the zebra crossing; thus, unsafe crossing behaviour was reduced in the experimental group. Compared with the experimental group immediately after the intervention, the intervention effect on some indicators showed a significant weakening trend in the retest of the experimental group one month later. Overall, the results show that an intervention programme based on the theory of "behaviour spectrums" can improve children's crossing skills. This study provides valuable information for the development and evaluation of intervention programmes to improve children's street-crossing skills.

Current Status and Future Directions of Chronic Cough in China

Chronic cough is one of the most common complaints for which patients in China seek medical attention. However, there are no nationwide data on the prevalence and socioeconomic burden of chronic cough. Although approximately 50% of Chinese men smoke, the vast majority of patients presenting for evaluation of chronic cough are never smokers. An equal sex distribution and a middle-aged predominance have been observed in the Chinese chronic cough population, despite demonstration of a higher cough reflex sensitivity in females and older patients. The role of air pollution in the distinct age and sex distribution requires further study. In terms of the etiologies of chronic cough in China, cough-variant asthma, upper airway cough syndrome, nonasthmatic eosinophilic bronchitis, and atopic cough are the most common causes, comprising 75.2% to 87.6% of cases across different regions. Chinese Guidelines for Diagnosis and Treatment of Cough were initially published in 2005, and updated in 2009 and 2016. In addition, the China Cough Coalition was established in 2016. Great progress has been made in both cough-related clinical practice and research in recent years, however, there are still challenges ahead. To facilitate optimal management of chronic cough in China, efforts promoting the dissemination and application of published guidelines will be essential, especially in community-based healthcare and in rural regions. As chronic refractory cough has been identified as a huge challenge to clinicians worldwide, continued international cooperation will be essential in optimizing evaluation and management of chronic cough.

Prevalence of musculoskeletal pain among professional drivers: A systematic review

OBJECTIVES

Professional drivers are at high risk of developing musculoskeletal pain (MSP) due to risk factors such as prolonged sitting, whole body vibration, awkward posture, and repetitive actions. This review investigates the reported prevalence of MSP among professional drivers.

METHODS

An electronic search of Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, PubMed, and Web of Science from 1990 to July 2019 was performed. Methodological quality of studies was assessed using three quality assessment tools for cross-sectional, case-control, and prospective cohort studies. The prevalence of MSP was reported using descriptive analysis.

RESULTS

A total of 56 studies conducted in 23 different countries across a total of 14 types of occupational transport were reviewed. Data of a total pooled population of 18 882 professional drivers were analyzed for MSP. The prevalence of MSP ranged between 43.1% and 93%. The low back was the most frequently reported body region for MSP with a meta-prevalence rate of 53% (N = 9998). Neck, shoulder, and upper back were the other common regions with high prevalence.

CONCLUSION

There is a high prevalence of MSP in professional drivers and low back was the most frequently reported body region, followed by neck, upper back, shoulder, knee, hip/thigh, wrist, ankle, and elbow. MSP is complicated in nature and therefore in-depth exploration of causal relationships between MSP and risk factors is necessary so that appropriate healthcare programs can be initiated to prevent and treat MSP effectively.

Age and Sex Distribution of Chinese Chronic Cough Patients and Their Relationship With Capsaicin Cough Sensitivity

PURPOSE

An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients.

METHODS

We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers.

RESULTS

The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years.

CONCLUSIONS

In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02591550.