Musculoskeletal disorders in farmers and farm workers

Analysis of Health Ailments and Associated Risk Factors in Small-Scale Fisherfolk Community of Indian Sundarbans: A Cross-Sectional Study

Background

Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans.

Material and Methods

Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families.

Results

Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population.

Conclusions

The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation.

Exoskeleton Usability Questionnaire: a preliminary evaluation questionnaire for the lower limb industrial exoskeletons

Exoskeleton robots are a promising solution to reduce musculoskeletal disorders (MSDs) in different work environments, but a specific usability scale for evaluating them is lacking. This study aimed to develop and verify a preliminary Exoskeleton Usability Questionnaire (EUQ) for the lower limb exoskeletons by creating a draft survey questionnaire from existing questions in prior studies. An experiment was conducted with 20 participants who performed a specific task while wearing three lower limb robots and provided subjective feedback using the developed questionnaire. Data were analysed using exploratory and confirmatory factor analysis (CFA), resulting in a usability evaluation questionnaire for exoskeleton robots clustered into four main factors: mobility, adjustability, handling and safety. This study's findings are expected to be useful in evaluating the usability of the lower limb exoskeletons in both general production sites and agricultural work, which can aid in reducing the prevalence of lower limb MSDs.Practitioner Summary: This study developed a preliminary subjective usability evaluation questionnaire for exoskeleton robots. The questionnaire is clustered into four main factors: mobility, adjustability, handling and safety. These findings provide a valuable tool for assessing exoskeleton usability, potentially reducing musculoskeletal disorders (MSDs) in various work environments.

Association Between Ergonomic Burden Assessed Using 20-Item Agricultural Work-Related Ergonomic Risk Questionnaire and Shoulder, Low Back, and Leg Pain in Korean Farmers

OBJECTIVES

This study aimed to determine the agricultural ergonomic burden in Korean farmers and to analyze its correlation with musculoskeletal pain.

METHODS

In total, 1001 farmers (525 females and 476 males; mean age, 59.6±7.5years) who owned or rented a farm and belonged to an agricultural cooperative unit were recruited. Ergonomic burdens were assessed using a 20-item Agricultural Work-related Ergonomic Risk Questionnaire (20 agricultural works). The presence of musculoskeletal pain (shoulder, low back, and leg/foot), Farm Stressor Inventory, subjective stress index, and agricultural workload (low, moderate, somewhat hard, or hard) were collected using structured questionnaires.

RESULTS

Factor analysis of the Agricultural Work-related Ergonomic Risk Questionnaire revealed a four-factor solution: neck and upper limb, trunk and push - pull, machine and heavy lifting, and repetitive trauma. Cronbach's alpha was greater than 0.65. For 18 of the 20 items, there was a significant association with the Farm Stressor Inventory, subjective stress index, and agricultural workload. The most frequent ergonomic burdens were squatting (51.2%), highly repetitive wrist movements (53.5%), shoulder flexion at 45-90° (51.2%), and trunk flexion or twisting at≥45° (48.8%). Ergonomic burdens were significantly different in 13 items between sexes. The musculoskeletal pain was associated with increased agricultural burdens in 10 items in male farmers and 14 items in female farmers.

CONCLUSION

Increased agricultural ergonomic burdens were associated with musculoskeletal pain. Ergonomic burden showed different patterns between male and female farmers, with female farmers appearing to be more affected by ergonomic burden than male farmers.

Work-related musculoskeletal disorders in agriculture: Ergonomics risk assessment and its prevention among Indian farmers

BACKGROUND

Indian farmers have musculoskeletal disorders as agriculture is a physically demanding occupation.

OBJECTIVES

The main aim of this study is to identify ergonomic and psychosocial risk factors associated with musculoskeletal disorders (MSDs) among different groups of farmers. The other objective is to investigate how MSDs affect farmers' daily lives and interfere with their activities.

METHODS

Farmers were evaluated for the repetitiveness of work and MSDs using the standard Nordic questionnaire, ergonomic assessment tool (REBA), and ART tool.

RESULTS

Low back portions were the most affected body parts, followed by the knees (OR = 0.352; 95% CI = 0.280-0.598), shoulder (OR = 0.657; 95% CI = 0.405-1.066), neck (OR = 0.510; 95% CI = 0.350-0.743), ankle or foot (OR = 0.815; 95% CI = 0.556-1.196), and upper back region (OR = 0.681; 95% CI = 0.463-1.002). The REBA method found that most of the postures in farming are very dangerous. The ART tool showed that most of the activities are repetitive. Working long hours (90%) and monotony at work (87.5%) are the main psychosocial factors, followed by pressure to finish within a given timeframe (71.4%) and injuries related to MSDs.

CONCLUSION

Farmers suffer from musculoskeletal disorders in various body parts (lower back, knee, neck, shoulder, and upper back) due to squatting, stooping, and other constrained working postures during agricultural activities. rolonged working hours, repetitive movements, and MMH are ergonomic risk factors forFurthermore, p MSDs.

Occupational health surveillance and detection of emerging occupational diseases among Taiwan farmers, through analysis of national-based farmers' and medico-administrative databases

OBJECTIVES

The purpose of this study was to identify occupational injuries and diseases associated with agriculture in Asia, to provide a reference for prevention and hypotheses for future research.

METHODS

We matched data on agricultural workers (n = 963,124) enrolled in Taiwan's national Farmers Health Insurance since its inception in 1989, to general population controls of the same age, gender, and township. The study population was linked to the National Health Insurance Research Database from 2001 to 2016 for inpatient cases. Logistic regression was used to assess odds ratios for outcomes.

RESULTS

Farmers had 2.76 times the risk of mycotic corneal ulcer (95% CI: 1.96-3.87) and 1.65 times the risk of typhus fever infections (95% CI: 1.47-1.85) compared to the general population. The odds ratio for poisonous animal bites was 2.22 (95% CI: 2.07-2.38), for falling into a storm drain or manhole was 2.04 (95% CI: 1.30-3.20), and for toxic effects from pesticides was 2.01 (95% CI: 1.92-2.11). The toxic effects of organophosphate and carbamate insecticides were correlated with the cultivation of rice, fruit trees, and flowers. Q fever and motorcycle accidents were associated with fruit tree cultivation.

CONCLUSIONS

The study identifies agricultural occupational injuries and diseases that may inform occupational health policy and the development of prevention priorities to prevent occupational hazards for farmers.

Hand-arm vibration syndrome among harvesting farmers: A cross-sectional study from Pakistan

BACKGROUND

Constant use of hand-held vibratory tools may cause health issues, including hand dysfunction, among farmers. Thus, exposure to these vibratory instruments may cause hand-arm vibration syndrome (HAVS).

OBJECTIVE

The study aimed to measure the prevalence of HAVS and evaluate neurological and vascular symptoms among farmers.

METHODS

This cross-sectional study included 20 villages in Pakistan and used a three-part questionnaire to collect data from farmers exposed to vibration while farming. The study included demographics, the Health Surveillance Questionnaire, and the Stockholm Workshop Classification Scale. SPSS version 22 was used for the data entry and statistical analysis.

RESULTS

433 (43%) participants had musculoskeletal discomfort and 568 (57%) had hand vibration. Raynaud phenomenon was evident in 430 (43%) participants, whereas carpal tunnel syndrome was found in 218 (22%). Tingling was reported by 255 participants (26%), and numbness was reported by 543 (54%). According to the grading of neurological symptoms, 461 (46%) participants were exposed to vibration but did not experience any symptoms, placing them in stage 0. 185 (18.5%) participants with HAVS with infrequent episodes affecting just the tips of one or more fingers were categorized in stage 01 based on grading of vascular symptoms.

CONCLUSION

HAVS are common among harvesting farmers, with the most noticeable vibrations occurring in the shoulder region. Similarly, most farmers had no vascular symptoms, and most were exposed to vibration but had no neurological symptoms.

Lessons Learned from an Attempted Pragmatic Randomized Controlled Trial for Improvement of Chronic Pain-Associated Disability in Green Professions: Long-Term Effectiveness of a Guided Online-Based Acceptance and Commitment Therapy  (PACT-A)

Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., farmers, foresters, gardeners). We conducted a pragmatic RCT comparing a guided ACT-based online intervention to enhanced treatment-as-usual in entrepreneurs, contributing spouses, family members and pensioners in green professions with chronic pain (CPG: ≥grade II, ≥6 months). Recruitment was terminated prematurely after 2.5 years at N = 89 (of planned N = 286). Assessments were conducted at 9 weeks (T1), 6 months (T2) and 12 months (T3) post-randomization. The primary outcome was pain interference (T1). The secondary outcomes encompassed pain-, health- and intervention-related variables. No treatment effect for reduction of pain interference was found at T1 (β = -0.16, 95%CI: -0.64-0.32, p = 0.256). Improvements in cognitive fusion, pain acceptance, anxiety, perceived stress and quality of life were found only at T3. Intervention satisfaction as well as therapeutic and technological alliances were moderate, and uptake and adherence were low. Results are restricted by low statistical power due to recruitment issues, high study attrition and low intervention adherence, standing in contrast to previous studies. Further research is warranted regarding the use of ACT-based online interventions for chronic pain in this occupational group. Trial registration: German Clinical Trial Registration: DRKS00014619. Registered: 16 April 2018.

Evaluation of working conditions, work postures, musculoskeletal disorders and low back pain among sugar production workers

BACKGROUND: It is generally agreed that musculoskeletal disorders (MSDs) are a severe health concern, particularly for agricultural laborers. OBJECTIVES: The study aimed to identify risk factors and work-related disorders among agricultural workers at Amirkabir agro-industry company in Iran. METHOD: A total of 158 workers, of which 66 were manual harvesting workers (four postures), 40 were fertilizer transportation workers (three postures), and 52 were spraying workers (one posture), were included in the study. The research used questionnaires to collect data, and the postures were analyzed using 3DSSPP software. Related risk factors such as age, body mass index, work experience, working hours, and sports activity were analyzed. RESULTS: The incidence rate of lower back pain (94%), knee pain (82%), neck pain (69%), upper-back (63%), and shoulder (63%) were calculated. The logistic regression revealed that working hours and sports activities are significantly correlated to the wrist/hand and neck MSD with 5.62 and 6.38 times more likely among manual harvesting workers. The 3DSSPP software estimated that the lower back pain, especially in the first posture, for manure transportation workers was very high. Maximum L5-S1 compression, shear, and moment forces in the first posture among manure transportation workers were 7113 N and 472 N, -381 N-m, respectively. CONCLUSION: The 3DSSPP results also illustrated that compression, shear, and moment forces exceeded the NIOSH limit for the other postures. After interventions, compression, shear, and moment forces among all farm workers decreased. These findings emphasize that farm workers need to be under surveillance continuously at their workstations where interventions and improvement in specific tasks are required.

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.

Health-related quality of life within agriculture in England and Wales: results from a EQ-5D-3L self-report questionnaire

BACKGROUND

Mental and physical health problems among the farming community are well documented but there is limited evidence regarding the overall health status of this population. This paper offers a unique insight into this issue through presenting the findings from a survey instrument, the EQ-5D-3L, which provides a standardised measure of health-related quality of life (HRQOL).

METHODS

We conducted the largest ever survey (n = 15,296) of people living and working in agriculture in England and Wales to gather baseline data on health and wellbeing within this community. The survey included an assessment of HRQOL through the use of the EQ-5D-3L self-report questionnaire. A variety of statistical approaches were used to test for significant associations between HRQOL and sub-group characteristics, including the Chi-square test for independence, the Kruskal-Wallis test, and Mann-Whitney U-test. Binary logistic regression models were also created to assess the influence of a set of respondent characteristics on the likelihood of respondents reporting health problems in the EQ-5D-3L.

RESULTS

24% of respondents reported problems with mobility; 4% reported problems with self-care; 21% reported problems with performing their usual activities; 52% reported problems with pain/discomfort; and 31% reported problems with anxiety/depression. The mean EQ-5D index value was 0.811 (median (Md) 0.796, interquartile range (IQR) 0.275). The mean self-rated health score (EQ-VAS) was 77.6 (SD 16.1) (Md 80.0, IQR 20). In general, holding other respondent characteristics equal, women reported fewer problems with mobility, self-care, performing usual activities and pain/discomfort than men, but more problems with anxiety/depression. HRQOL in the working-aged appears to be poorer among the survey population than the wider UK population.

CONCLUSIONS

Results reveal concerning levels of physical and mental health problems, especially pain/discomfort and anxiety/depression, which appear to be more prevalent within our sample than within the wider UK population. There were important gender and age-related differences in both mental and physical health. Combatting these problems through targeted support is essential for the wellbeing of the farming community and the future sustainability of UK food production.

Ergonomic and psychosocial risk factors for low back pain among rice farmers in West Bengal, India

BACKGROUND: Rice farming is considered the most crucial industry in India, where millions of farmers suffer from LBP. OBJECTIVES: The present study’s primary objectives were to evaluate the prevalence of low back pain among India’s rice farmers and determine the relationship between low back pain and ergonomic risk factors and psychosocial factors encountered by the farmers. METHODS: Socio-demographics, ergonomics risk factors and psychosocial factors that cause LBP among rice farmers were examined. Modified Nordic Musculoskeletal Questionnaire and Oswestry LBP Questionnaire were administered among the farmers to evaluate the LBP. Univariate analysis was done to find out the odds ratios and 95% confidence intervals among the farmers. RESULTS: The primary findings from this study regarding the psychosocial factors, such as perceived inadequacy of income (84.7%), job demands (78.1%), work demand targets specific productivity (76.5%), rigidity in work methods (75.3%), monotony at work (73.2 %), have a relationship with LBP. The results also revealed that the relationship between the low back pain and ergonomic risk factors, such as repetitiveness (OR- 4.215; 95% CI- 2.551–6.965), working in awkward posture (OR- 85.82; 95% CI- 43.134–170.77), lifting loads (OR- 0.281; 95% CI- 0.125–0.324), pulling loads (OR- 0.274; 95% CI- 0.173–0.434), showed significant relationship with LBP in the univariate analysis. CONCLUSIONS: The prevalence of LBP among rice farmers connected with ergonomic and psychosocial risk factors. The awkward posture, MMH (lifting and carrying) are the main causative factors of LBP.

Associations Between Trunk Muscle/Fat Composition, Narrowing Lumbar Disc Space, and Low Back Pain in Middle-Aged Farmers: A Cross-Sectional Study

Objective

To investigate the association of trunk fat and muscle composition, lumbar disc space narrowing, and low back pain in middle-aged farmers.

Methods

Fat and muscle areas were identified using standard Hounsfield unit ranges for adipose tissue and skeletal muscle with computed tomography images at the mid-L4 vertebral level. Trunk fat mass, muscle mass, and fat/muscle mass ratio were calculated. Low back pain was assessed using the Oswestry Disability Index (ODI). The L4/5-disc space and low back pain were also assessed.

Results

Male had a higher total trunk, back, psoas, and abdominal muscle mass, and visceral fat; female had a higher subcutaneous fat mass and fat/muscle ratio. Pearson correlation coefficients with ODI for waist circumference, total fat mass, visceral fat mass, and fat/muscle ratio were all significant in female; only the fat/muscle ratio was significant in male. Pearson correlation coefficients with L4/5-disc space narrowing grades for visceral fat mass, total, back, and psoas muscle mass, and fat/muscle ratio, were all significant in female; total and back muscle mass, and fat/muscle ratio in male.

Conclusion

There were significant relationships between: fat indicators with low back pain; trunk muscle mass with lumbar disc degeneration; and fat/muscle ratio with both lumbar disc degeneration and low back pain. The fat/muscle ratio may be a useful index for low back pain.

Prevalence and Factors Associated with Musculoskeletal Disorders among Thai Burley Tobacco Farmers

This cross-sectional analysis study aimed to identify the prevalence and factors associated with musculoskeletal disorders (MSDs) among Thai Burley tobacco farmers. Subjects included 603 burley tobacco farmers from Sukhothai province. Farmers were interviewed twice, (during planting and harvesting seasons), with a questionnaire consisting of demographic and health characteristics, musculoskeletal symptoms, and ergonomic exposure questions. The subjects average age was 49.5 years, more were female (58.5%), most had only a primary education (74.3%), 38% were overweight or obese. Farmers had a significantly higher prevalence of MSDs in the lower back (37.1%), knee (28.7%), shoulder (22.9%), wrist (19.9%), and hip (8.3%) during the harvesting season than in the planting season (p < 0.05). Models found that factors influencing MSDs prevalence during planting included long work hours in seedling, tasks such as topping tobacco plants, and using machine tools, after controlling for age, gender, and body mass index (BMI). While in the harvesting season, models found tasks conducted as a group had lower MSDs prevalence than individual work when carrying fresh tobacco to the barn, piercing/threading and curing the leaves, baling the bundles, and transporting the finished goods. We recommended working in groups to reduce workload and MSDs, especially during harvesting, in burley tobacco farming.

Factors Associated with Musculoskeletal Discomfort in Farmers and Ranchers in the U.S. Central States

Agricultural work involves ergonomic and psychosocial strain, which contribute to musculoskeletal conditions. The aim of this study was to assess if specific ergonomic, psychosocial, and preventive factors are linked to musculoskeletal pain or discomfort symptoms (MSS) in farmers and ranchers. We analyzed data from the Central States Center for Agricultural Safety and Health survey that was conducted in 2018 in a seven-state region of the central United States. MSS were assessed with questions from the Standardized Nordic Questionnaire. The survey included questions on demographic, ergonomic, psychosocial and preventive factors. Farm production variables were added from the Farm Market iD database. We analyzed the data using Generalized Estimating Equations. The overall prevalence of MSS for all body sites combined was 59% among 4,354 farmers and ranchers who responded (19% response rate). After controlling for age, sex, and operator status, three factors (high stress level, sleep deprivation, and exhaustion/fatigue) showed the strongest associations with MSS in any body site, with adjusted odds ratios (OR) ranging from 4.8 to 5.6. Forceful exertions, repetitive tasks, awkward postures, frequent manual labor, and vibration were also significantly associated with MSS, with adjusted ORs ranging from 1.8 to 3.3. Recommended preventive techniques were not protective for MSS. New effective strategies are needed to reduce the high burden of musculoskeletal outcomes among farmers and agricultural workers.

Effect of non-surgical interventions on pain relief and symptom improvement in farmers with diseases of the musculoskeletal system or connective tissue: an exploratory systematic review based on randomized controlled trials

Objective: There are many observational and clinical studies on pain treatment in farmers; however, little is known about the effects of interventions based only on randomized controlled trials (RCTs) on diseases of the musculoskeletal system or connective tissue (D-MSCT). This review aimed to summarize evidence on the effects of non-surgical interventions for pain relief and symptom improvement in farmers with D-MSCT.

Materials and Methods: We searched seven databases, including MEDLINE, and three clinical trial registries, including the International Clinical Trials Registry Platform, from inception up to February 15, 2021, to identify studies that included at least one treatment group wherein nonsurgical interventions were applied. We focused on 1) pain relief and symptom improvement and 2) quality of life and improvement in physical fitness.

Results: Four studies (three on low back pain and one on knee osteoarthritis) met all the inclusion criteria. Overall, the risk of bias was high, and meta-analysis could not be performed due to heterogeneity. However, a participatory ergonomic approach, exercise centered on strength training with a transtheoretical model, and/or a combination of both could be included in effective educational programs, at least in the short term, to prevent and/or reduce exacerbation of D-MSCT in farmers. Based on internal and external validity, we could postulate a future research agenda and a conceptual education model to prevent D-MSCT in farmers.

Conclusion: Participatory ergonomic intervention, exercise centered on strength training, and/or a combination of both could be included for effective educational programs to prevent and reduce exacerbation of D-MSCT in farmers. High-quality RCTs with a less risk of bias will be implemented for many agricultural work types in various parts worldwide (especially developing countries and regions) during the COVID-19 pandemic.

ANALYSIS OF PHYSIOLOGICAL SIGNALS ON THE WEARABLE ASSIST SUIT FOR REPETITIVE AGRICULTURAL TASK

Musculoskeletal disorders are the most common among farmers and farming constitutes the highest industrial accident rate. To prevent these, we developed a smart auxiliary workwear and investigated its effectiveness through human impact assessment experiments. In our method, the actuator of the waist elastic band was released when there was no need to directly adjust the length with the strength support of the waist, and the elastic band was held once the motion using the waist strength disappeared. To examine the performance, 15 workers were recruited; before the experiment, they were subjected to a basic fitness evaluation to examine their general characteristics. The lumbar peak torques before and after wearing the designed work clothes were measured using the Biodex System III to determine their lumbar assistance power, which was confirmed to have increased by approximately 17%. In addition, electromyographic comparison of the amount of muscle used before and after the wearing revealed that the muscle use was reduced by 26.41% and 19.38% after wearing the work clothes when the weight was lifted in the stooping and squatting postures, respectively. Based on these results, it can be stated that the proposed smart assistive work clothes could contribute to reduced muscle usage required for work and lessen related weariness by supporting the waist, and thus, would greatly help farmers in preventing musculoskeletal disorders.

Exploring "wear and tear" of joints and "muscle function" assumptions in skeletons with known occupation at death

OBJECTIVES

Changes in the joints are believed to result from "wear and tear," a consequence of activity, as entheseal changes (EC) result from muscle use. However, clinical data showed that activity does not necessarily increase the likelihood of degenerative joint changes (DJC) and that exercise results in healthier joints. We tested whether individuals with continuous repetitive biomechanical efforts (Group 1) were more likely to exhibit EC and if occupations known to exert strenuous but discontinued efforts (Group 2) would more likely cause DJC.

MATERIALS AND METHODS

Eighty-nine males with known occupations from Portuguese identified collections were used: shoemakers and carpenters (Group 1), workers (Group 2), and civil servants, and shop assistants as a control group. Major upper and lower limb joints and entheses sites were used. DJC and EC were tested between occupations - while controlling for age (overall approach) - and within occupation (occupation-specific approach).

RESULTS

The overall approach showed that age - as a covariant - had a significant impact on DJC and EC development (p < 0.05), with occupation being non-significant (p > 0.05) despite the variability in the mean-values of lesions. The occupation-specific approach showed a significant variability of DJC and EC correlations, within and between occupations, with no clear trend of DJC and EC development according to occupation.

DISCUSSION

The results showed that exploring overall patterns might conceal occupation-specific joint and muscle use, emphasizing age as a major contributor of changes; and that the occupation-specific approach highlighted particular aspects associated with occupations, allowing for a more informative assessment of strenuous repetitive or discontinuous activity-related technical gestures and their impact on skeletal biology.

The impact of a 6-week community-based physical activity and health education intervention-a pilot study among Irish farmers

BACKGROUND

There is a higher prevalence of lifestyle-related diseases among Irish farmers than the general adult population. Lifestyle interventions that increase physical activity and improve dietary patterns have been associated with reduced chronic disease risk and improved quality of life among high-risk populations. The impact of lifestyle interventions among Irish farmers is unknown.

AIM

To assess the effectiveness of a community-based intervention on farmer health, cardiovascular fitness, lower limb strength endurance, and dietary intake.

METHODS

A 6-week physical activity and lifestyle education intervention involving two 60-min circuit-based exercise training sessions and one 60-min health education workshop per week was implemented. Pre- and post-measurements included total body weight, body fat percentage, lean muscle mass, resting blood pressure, fasting blood glucose, cholesterol, triglycerides, cardiovascular fitness, lower limb strength, perceived physical and mental health, and dietary intake.

RESULTS

Thirty farmers completed the intervention giving an adherence rate of 75%. At baseline, mean BMI (32.7 ± 4.1 kg/m²), body fat percent (31.7 ± 6.7), waist circumference (110.2 ± 10.4 cm), systolic (128.7 ± 7.8 mmHg) and diastolic (86.2 ± 6.8 mmHg) blood pressure were higher than recommended levels. Significant improvements (p < 0.05) were found for total body weight, BMI, waist and hip circumferences, cardiovascular fitness, lower limb strength endurance, systolic blood pressure, total energy, total fat, total unsaturated fat, monounsaturated fat, saturated fat, trans fat, total carbohydrate, sodium, cholesterol and percentage energy intakes of total fat, saturated fat, protein, and physical and mental health scores.

CONCLUSIONS

Irish farmers remain at high risk of developing chronic diseases but respond positively to lifestyle intervention.

Work-Related Risk Factors of Knee Meniscal Tears in Korean Farmers: A Cross-Sectional Study

Background

Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation.

Methods

The participants included 486 farmers (238 men and 248 women), aged 40–69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression.

Results

A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000–19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears.

Conclusion

This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

Predominant lifetime occupation and associations with painful and structural knee osteoarthritis: An international participant-level cohort collaboration

Objective

With adults working to older ages, occupation is an important, yet less modifiable domain of physical activity to consider in the risk of knee osteoarthritis (OA). This study aimed to investigate the association between predominant lifetime occupation and prevalent knee OA.

Design

Participant-level data were used from five international community-based cohorts: Johnston County Osteoarthritis Project, the Hertfordshire Cohort Study, the Multicenter Osteoarthritis Study, the Tasmanian Cohort Study and Framingham Osteoarthritis Study. Self-reported predominant occupation was categorized into sedentary, light, light manual and heavy manual levels. Cross-sectional associations between predominant lifetime occupation and knee OA outcomes including prevalence of radiographic knee OA (RKOA), symptomatic RKOA and knee pain, were assessed using logistic regression, accounting for cohort clustering.

Results

Data for 7391 participants were included. 24.7% reported sedentary lifetime occupation, 30.0% light, 35.9% light manual and 9.4% heavy manual. 43.3% presented with RKOA, 52.1% with knee pain and 29.0% with symptomatic RKOA. There was over a two-fold increase in the odds of having RKOA, knee pain and symptomatic RKOA in those whose with heavy manual compared to sedentary occupations ((odds ratio (OR): 2.14; 95% confidence interval (CI): 1.79, 2.58), (OR: 2.19; 95% CI: 1.78, 2.70), (OR: 2.41; 95% CI: 1.94, 2.99) respectively).

Conclusion

This large international multi-cohort study demonstrated an association of heavy manual work with RKOA, symptomatic RKOA and knee pain. Measures that protect workers and are designed to reduce heavy manual related activities remain a priority to reduce the risk of knee OA.

Comparisons of physical exposure between workers harvesting apples on mobile orchard platforms and ladders, part 1: Back and upper arm postures

This study compared farmworkers' exposure to non-neutral postures using a new mobile platform apple harvesting method and the traditional method using ladders. Twenty-four workers were recruited and assigned into three groups: ladder workers (n = 8) picking apples from full trees using a ladder, mobile platform workers (n = 8) picking apples from upper part of the trees while standing on a moving platform, and ground-based mobile platform workers (n = 8) picking apples from lower part of the trees which the mobile platform workers left out. Upper arm and back inclinations were continuously monitored during harvesting using tri-axial accelerometers over full work shifts (~8 h). Upper arm posture was characterized as the percentage of time that upper arm flexion and abduction exceeded 30°, 60°, and 90°. Back posture was characterized as the percentage of time that torso angles (sagittal flexion or lateral bending) exceeded 10°, 20°, and 30°. The 10th, 50th, and 90th postural percentiles were also calculated. The platform workers had lower exposures to upper arm flexion and abduction than the ground and ladder workers. There were no differences in torso angles between the ladder and mobile platform workers; however, the ground workers were exposed to more and greater percentages of time in torso flexions.

Potential exoskeleton uses for reducing low back muscular activity during farm tasks

BACKGROUND

As the sustainability of the agricultural workforce has been threatened by the high prevalence of back pain, developing effective interventions to reduce its burden within farming will contribute to the long-term health and productivity of workers. Passive back-support exoskeletons are being explored as an intervention to reduce the physical demands on the back muscles, and consequently mitigate the risk of back pain, in many industrial sectors.

METHODS

This study investigated whether exoskeleton use could reduce farmers' low back muscle load. Electromyography was used to evaluate exoskeleton use in field and laboratory settings. A total of 14 farmers (13 males and 1 female) with a mean age of 49 (SD = 12) years and 6 female nonfarmers (mean age 28, SD = 5 years) performed a standardized set of tasks that included symmetric and asymmetric lifting and sustained trunk flexion. Following the standardized tasks, 14 farmers also performed regular, real-world, farm tasks with and without use of the exoskeleton at their farms.

RESULTS

Exoskeleton use decreased back muscular load during farming activities up to 65%, 56%, and 48% in static, median, and peak muscle activity, respectively. This indicates potential benefits of exoskeleton use to help farmers work under less muscular load. Paradoxically, exoskeleton use during standardized tasks increased muscle activity for some participants.

CONCLUSIONS

This study demonstrates the potential effects of using passive exoskeletons in agriculture through observational and experimental research, and is among the first that explores the potential for using exoskeletons during actual work tasks in farm settings.

Musculoskeletal Disorders of Garo Women Workers Engaged in Tea-Plucking Activity: An Ergonomic Analysis

Background:

The tea-plucking activity in Garo Hills, Meghalaya, India is performed in a traditional way making the majority of women workers, especially those who have spent more years in tea-plucking activity prone to musculoskeletal disorders.

Materials and Methods:

The present study was conducted on a sample of 40 women workers who had the highest field experience in tea leaf plucking. Pain as a musculoskeletal disorder was recorded using a 5-point scale ranging from very mild pain (1) to very severe discomfort (5) to quantify the stress on muscles used in work. The coefficient of correlation was used to explore the relationship between age, years of involvement, BMI of women, and their musculoskeletal problem. The analysis of discomfort in upper extremity was done by using a rapid upper limb assessment (RULA) technique. Analysis of discomfort in entire body parts was carried out using a rapid entire body assessment (REBA) technique.

Results and Discussion:

During tea plucking, women workers reported severe discomfort in the head (4.5), neck (4.3), both fingers (4.2), upper and lower back (4.3 and 4.4), and feet (4.3). The RULA grand score was observed seven indicating the need for immediate investigation and changes. REBA result was 11 for entire body parts leading to conclude that workers were working under high physical strain.

Conclusion:

Workers with severe musculoskeletal disorders can face permanent disability that prevents them from returning to their jobs or handling simple everyday tasks. Therefore, some rest periods, ergonomic intervention, and personal protective equipment are needed to minimize the discomfort of women workers in the tea-plucking activity.

Medicinal Plants for Treating Musculoskeletal Disorders among Karen in Thailand

Millions of people suffer from Musculoskeletal System Disorders (MSDs), including Karen people who work hard in the fields for their subsistence and have done so for generations. This has forced the Karen to use many medicinal plants to treat MSDs. We gathered data from 15 original references covering 27 Karen communities and we document 461 reports of the use of 175 species for treating MSDs among the Karen people in Thailand. The data were analyzed by calculating use values (UV), relative frequency of citation (RFC) and informant consensus factor (ICF). Many use reports and species were from Leguminosae and Zingiberaceae. Roots and leaves were the most used parts, while the preferred preparation methods were decoction and burning. Oral ingestion was the most common form of administration. The most common ailment was muscle pain. Sambucus javanica and Plantago major were the most important species because they had the highest and second-highest values for both UV and RFC, respectively. This study revealed that the Karen people in Thailand use various medicinal plants to treat MSDs. These are the main resources for the further development of inexpensive treatments of MSDs that would benefit not only the Karen, but all people who suffer from MSD.

A Review on Ergonomics in Agriculture. Part II: Mechanized Operations

Background: Musculoskeletal disorders (MSDs) have long been recognized as the most common risks that operation of agricultural machineries poses, thus, undermining the ability to labor and quality of life. The purpose of this investigation was to thoroughly review the recent scholarly literature on ergonomics in agricultural mechanized operations; Methods: Electronic database research over the last ten years was conducted based on specific inclusion criteria. Furthermore, an assessment of the methodological quality and strength of evidence of potential risk factors causing MSDs was performed; Results: The results demonstrated that ergonomics in agriculture is an interdisciplinary topic and concerns both developed and developing countries. The machines with driving seats seem to be associated with painful disorders of the low back, while handheld machines with disorders of the upper extremities. The main roots of these disorders are the whole-body vibration (WBV) and hand-arm transmitted vibration (HATV). However, personal characteristics, awkward postures, mechanical shocks and seat discomfort were also recognized to cause MSDs; Conclusions: The present ergonomic interventions aim mainly at damping of vibrations and improving the comfort of operator. Nevertheless, more collaborative efforts among physicians, ergonomists, engineers and manufacturers are required in terms of both creating new ergonomic technologies and increasing the awareness of workers for the involved risk factors.

A Review on Ergonomics in Agriculture. Part I: Manual Operations

Background: Agriculture involves several harmful diseases. Among the non-fatal ones, musculoskeletal disorders (MSDs) are the most prevalent, as they have reached epidemic proportions. The main aim of this investigation is to systematically review the major risk factors regarding MSDs as well as evaluate the existing ergonomic interventions. Methods: The search engines of Google Scholar, PubMed, Scopus, and ScienceDirect were used to identify relevant articles during the last decade. The imposed exclusive criteria assured the accuracy and current progress in this field. Results: It was concluded that MSDs affect both developed and developing countries, thus justifying the existing global concern. Overall, the most commonly studied task was harvesting, followed by load carrying, pruning, planting, and other ordinary manual operations. Repetitive movements in awkward postures, such as stooping and kneeling; individual characteristics; as well as improper tool design were observed to contribute to the pathogenesis of MSDs. Furthermore, low back disorders were reported as the main disorder. Conclusions: The present ergonomic interventions seem to attenuate the MSDs to a great extent. However, international reprioritization of the safety and health measures is required in agriculture along with increase of the awareness of the risk factors related to MSDs.

Tractor Rollover Protection: Is the Incorrect Use of Foldable Rollover Protective Structures Due to Human or to Technical Issues?

OBJECTIVE

To identify the critical behaviors that may hinder the correct use of foldable rollover protective structures (FROPS) on tractors and to explore the influence of user factors and FROPS technical characteristics.

BACKGROUND

FROPS are effective in preventing fatal injuries in rollover accidents if they are in the upright position. However, many farmers leave FROPS folded down.

METHOD

Twenty farmers and sixteen models of tractors were involved in the study. Operators were observed while raising the FROPS, and the observed behaviors were correlated with user factors and FROPS technical features.

RESULTS

In the initial rotation of the FROPS, higher lowered roll-bar to ground distance and FROPS pivot-pin to ground distance required more awkward and unbalanced postures (p = .02 and p = .01, respectively). When rotating the FROPS in upright position, smaller stature of the participants and higher FROPS pivot-pin to ground distance were significantly correlated with using the tractor's rear 3-point lower links as a supporting surface (p = .01 and p = .02, respectively).

CONCLUSION

FROPS might be revised considering users' comfort in use and anthropometric variability, to improve reachability, avoid risky behaviors, and enhance FROPS operation.

APPLICATION

Technical solutions to enhance FROPS accessibility may be developed, particularly by providing safe surfaces to support operators and highlighting the grasping points. Further best practices and information on correct gestures to handle the FROPS should be included in the tractor manual.

Biomechanical factors during common agricultural activities: Results of on-farm exposure assessments using direct measurement methods

Agricultural work is associated with increased risk of adverse musculoskeletal health outcomes. The purpose of this study was to quantify exposure to biomechanical factors among a sample (n = 55) of farmers in the Midwest region of the U.S. while they performed a variety of routine agricultural activities, and to compare exposure levels between these activities. Surface electromyography was used to estimate activity levels of the erector spinae, upper trapezius, forearm flexor, and forearm extensor muscle groups. Simultaneously, inertial sensors were used to measure kinematics of the trunk, upper arm, and wrist. In general, lower muscle activity levels, less extreme postures, and slower movement speeds were observed during activities that involved primarily the use of agricultural machinery in comparison to manual activities, suggesting a potential advantage of mechanization relative to musculoskeletal health. Median wrist movement speeds exceeding recently proposed exposure thresholds were also observed during many manual activities, such as milking animals and repairing equipment. Upper arm postures and movement speeds did not appear to confer excessive risk for shoulder-related outcomes (on the whole), but interpretation of the results is limited by a sampling approach that may not have captured the full extent of exposure variation. Not surprisingly, substantial variation in exposure levels were observed within each agricultural activity, which is related to substantial variation in the equipment, tools, and work practices used by participants. Ultimately, the results of this study contribute to an emerging literature in which the physical demands of routine agricultural work have been described on the basis of sensor-based measurements rather than more common self-report or observation-based approaches.

Farming Related Trauma Injuries in Southern West Virginia With a Focus on Risks, Injury Trends, and Associated Co-morbidities

Background

The implementation of safety policies in farming-related injuries in West Virginia has been lacking. Farming-related injuries have resulted in massive injuries that have resulted in life long injuries and death. Therefore, this study aims to review 12 years of our level 1 trauma data and describe the incidence rate and patterns of priority-related farming injuries in West Virginia, as well as the specific co-morbidities and related injuries that might be more susceptible to damage.

Methods

We examined 82 cases of farm-related injuries that required trauma-priority related intervention from 2005 -2016. We harvested data from the Charleston Area Medical Center Trauma registry to investigate associated injuries. We defined farm equipment as any mechanical or automated tool used on a farm for related farm upkeep or farm-related activity. Multinomial logistic regression was used to understand the overall impact on the differing effects of years of injuries.

Results

The total number of farming-related injury cases was 82. The most statistically suggestive finding was those that had a positive narcotics urine test at (p= 0.062) (-.3230-12.82). Those with a history of CHF (congestive heart failure) also had a significant statistical relationship at (p=0.001) (-5.477-1.394). Alcohol use disorder was also a significant statistical relationship (p=0.012) (-5.127--.6728). The most common injuries were concussions at 18 % ( 15/82) followed by rib fractures at 17 % ( 14/82).

Conclusion

Farming-related injuries appear to have increased risks on specific body and organ systems, as described in our initial data analysis. Specific co-morbidities also have been documented to show a higher risk of injury and would need further investigation. Specific years show a higher prevalence of farming injuries compared to other years. Further research is needed to explore these underlying findings.

Hand-arm Vibration Syndrome in Farmers and its Correlation with Degenerative Triangular Fibrocartilage Complex Injury

Context

Hand-arm vibration syndrome (HAVS) is an occupational disease that affects workers who are exposed to vibrations. Farmers are prone to various musculoskeletal and cumulative trauma disorders. These occur owing to overuse, degeneration, and excess physical efforts along with whole-body vibrations- owing to the use of farming equipment such as tractors and harvesters.

Aims

Aims of the study were to find out the prevalence of various symptoms of HAVS among farmers using tractors, harvesters, etc., and to find out the correlation of triangular fibrocartilage complex (TFCC) injury with HAVS.

Subjects and Methods

A prevalence study was conducted among farmers. Farmers were selected by random sampling method and were asked to fill-up a HAVS surveillance questionnaire. The handgrip strength was recorded with a hand dynamometer. Assessment of carpal tunnel syndrome was done, and correlation of HAVS with TFCC injury was assessed.

Results

Data from 100 farmers was obtained and analyzed. The musculoskeletal symptoms of HAVS, more specifically pain was prevalent (n = 65), followed by sensorineural symptoms (n = 70), and the vascular symptoms were less common (n = 43). HAVS accounts for a prevalence of 64% with 39% of farmers having TFCC injury along with HAVS (P value = <0.0001).

Conclusions

These findings reported in the study provide a better understanding of the impact and extent of HAVS in farmers. There is a significant prevalence of HAVS with mild symptoms of vascular component, mild to moderate symptoms of sensorineural component, and significant involvement of the musculoskeletal component. In addition, TFCC injury is correlated with HAVS.

Review on Seat Suspension System Technology Development

This review will focus on the necessity for developing seat vibration control systems as a part of manufacturers’ investigation into finding innovative methods to increase the comfort and safety of the vehicles’ drivers. Operators of either on-road or off-road vehicles are regularly subjected to an extended variety of various vibration levels, especially at low frequencies. Considering that exposure to such vibration in long term has some damaging effects on driver’s health, many comprehensive investigations have been carried out and researchers have proposed several measures for estimating discomfort and the suitability of various vehicles’ seats such as those of trucks, cars and agricultural vehicles in operating condition. Active, passive and semi-active suspension systems are employed in vehicle seats to alleviate the harmful and damaging effects due to the transmitted vibration to the human body. In order to improve riding comfort, the operator’s body displacement and acceleration must be reduced. According to the research, active suspension control systems are the best choice to reduce the transmitted vibration to the drivers’ body and provide the best ride comfort in comparison with passive and semi-active systems.

Multiple Exposures and Coexposures to Occupational Hazards Among Agricultural Workers: A Systematic Review of Observational Studies

BACKGROUND

Workers may be exposed to various types of occupational hazards at the same time, potentially increasing the risk of adverse health outcomes. The aim of this review was to analyze the effects of multiple occupational exposures and coexposures to chemical, biomechanical, and physical hazards on adverse health outcomes among agricultural workers.

METHODS

Articles published in English between 1990 and 2015 were identified using five popular databases and two complementary sources. The quality of the included publications was assessed using the methodology developed by the Effective Public Health Practice Project assessment tool for quantitative studies.

RESULTS

Fifteen articles were included in the review. Multiple chemical exposures were significantly associated with an increased risk of respiratory diseases, cancer, and DNA and cytogenetic damage. Multiple physical exposures seemed to increase the risk of hearing loss, whereas coexposures to physical and biomechanical hazards were associated with an increased risk of musculoskeletal disorders among agricultural workers.

CONCLUSION

Few studies have explored the impact of multiple occupational exposures on the health of agricultural workers. A very limited number of studies have investigated the effect of coexposures among biomechanical, physical, and chemical hazards on occupational health, which indicates a need for further research in this area.

Bayesian network model to diagnose WMSDs with working characteristics

Aim. It is essential to understand the extent to which job characteristics impact work-related musculoskeletal disorders (WMSDs), and to calculate the probability that an employee will suffer from a musculoskeletal disorder given their working conditions. The objective of this research is to identify the relationships between WMSDs and working characteristics, by developing a Bayesian network (BN) model to calculate the probability that an employee suffers from a musculoskeletal disorder. Methods. A conceptual model was constructed based on a BN. This was then statistically tested and corrected to establish a BN model. Results. Experiments verified that the BN model achieves a better diagnostic performance than artificial neural network, support vector machine and decision tree approaches, and is robust in diagnosing WMSDs given working characteristics. Conclusion. It was verified that working characteristics, such as working hours and pace, impact the incidence rate of WMSDs, and a BN model was developed to probabilistically diagnose WMSDs.

Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers

We aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden. Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

INTRODUCTION

The risks of hip fracture and hip arthroplasty are influenced by factors including socioeconomic status, education, urbanization, latitude of residence, and physical activity. Farming is an occupation encompassing rural living and high level of physical activity. Therefore, we aimed to study the risk of hip fracture and risk of hip arthroplasty among farmers in Sweden.

METHODS

We studied the risk of hip fracture, and hip arthroplasty due to primary osteoarthritis, in all men and women aged 35 years or more in Sweden between 1987 and 2002. Documented occupations were available in 3.5 million individuals, of whom 97,136 were farmers. The effects of age, sex, income, education, location of residence, and occupation on risk of hip fracture or hip arthroplasty were examined using a modification of Poisson regression.

RESULTS

A total of 4027 farmers and 93,109 individuals with other occupations sustained a hip fracture, while 5349 farmers and 63,473 others underwent a hip arthroplasty. Risk of hip fracture was higher with greater age, lower income, lower education, higher latitude, and urban area for all men and women. Compared to all other occupations, male farmers had a 20% lower age-adjusted risk of hip fracture (hazard ratio (HR) 0.80, 95%CI 0.77-0.84), an effect that was not seen in female farmers (HR 0.96, 95% CI 0.91-1.01). Both male and female farmers had a higher age-adjusted risk for hip arthroplasty.

CONCLUSIONS

Our results indicate that farming, representing an occupation with high physical activity, in men is associated with a lower risk of hip fracture but an increased risk of hip arthroplasty.

Identification of influential demographic and work-related risk factors associated to lower extremity pain perception among rice farmers

BACKGROUND

A high prevalence of musculoskeletal disorders and abnormal alignments of the lower extremities (LE) was found for rice farmers. It is important to investigate demographic and work-related risk factors associated with LE pain prior to developing intervention strategies addressing the problematic factors of the highest-risk task.

OBJECTIVE

To identify factors associated with LE pain in rice farmers for every stage of the cultivation process.

METHODS

Thirty experienced farmers (age of 45.9±6.21 (mean±SD)) rated LE pain experienced before and after each cultivation stage using the Standardized Nordic Questionnaire. Risk factors of pain were characterized based on expert risk assessment of tasks due to force, posture and motion, in addition to a conventional survey of demographic and other work-related information.

RESULTS

Ergonomic risk factors were found to be the strongest predictors of knee and foot pain perception, which induced a substantial increase of pain perception (up to 4.6 times) with varying extent for individual cultivation stages. The highest risk and pain perception was found during the planting performance. Age exhibited significantly positive association with foot pain during planting and harvesting. However, more experienced farmers perceived less foot pain, presumably by developing effective movement strategies.

CONCLUSIONS

The findings suggest that the planting process should be subject of further intervention development, especially for older farmers, with focus on reducing force, awkward posture and repetitive movement to minimize risk of LE pain.

Anatomical Parameters of the Acetabulum in Heavy Vehicle Operators

It has been suggested that long-term exposure by heavy vehicle operators to whole-body vibration (WBV) may be related to an increased risk of pathological changes in the anatomical parameters of the hip. The aim of this study was to explore the difference in anatomical parameters of acetabulum in drivers of heavy vehicles (experimental group; n=60) and subjects who have not been exposed to WBV (control group; n=60). The anteroposterior radiographic view of the hips was used to measure the following parameters: the vertical centre edge (VCE), the ‘horizontal toit externe’ angle (HTE), the neck shaft angle (NSA) and the acetabular depth (AD). Compared with the control group, the mean VCE angle values and AD were signifi cantly lower, while the average HTE and NSA values were signifi cantly higher in the experimental group. This study supports the hypothesis that exposure to whole-body vibration during operation of a vehicle causes an increased risk of acetabular dysplasia.

Association Between Whole-Body Vibration and Low-Back Disorders in Farmers: A Scoping Review

INTRODUCTION

Low-back disorders (LBDs) are the most common musculoskeletal problem among farmers, with higher prevalence rates than in other occupations. Farmers who operate tractors and other types of machinery can have substantial exposure to whole-body vibration (WBV). Although there appears to be an association between LBDs and WBV, the causal relationship is not clear.

OBJECTIVE

This scoping review investigates the association between WBV and LBDs specifically among farmers.

METHODS

Nine databases were searched using groups of terms for two concepts: 'farming' and 'low back disorder'. Screening, data extraction, and quality assessment were performed by two reviewers independently. Included studies met the following criteria: focused on adult farmers/agricultural workers; assessed exposure to operating farm machinery such tractor, combine, or all-terrain vehicle; assessed LBDs as an outcome; and reported an inferential test to assess the relationship between WBV and LBD.

RESULTS

After 276 full texts screened, 11 articles were found to analyze WBV as a risk factor for LBDs. Three were case-control, five cross-sectional, and three retrospective cohorts. Four studies showed no association between WBV and LBDs, four a positive association, and three results were mixed depending on the exposure/outcome measure.

CONCLUSION

A firm conclusion is difficult due to heterogeneity in, LBDs definition, type of farm commodity, study design, and statistical strategy. Direct comparisons and synthesis were not possible. Although retrospective cohort studies tended to show a relationship, future studies with a prospective cohort design could help clarify this association further.

Risk Factors for Developing Work-Related Musculoskeletal Disorders during Dairy Farming

BACKGROUND

Dairy farming work involves frequent use of poor postures. These postures may increase the risk of developing musculoskeletal disorders among dairy workers.

OBJECTIVE

To assess postural load during performance of various tasks related to dairy farming.

METHODS

This cross-sectional study was conducted on a dairy farm in Iran. In order to assess postural load, tasks related to dairy farming were divided into 3 categories: feeding, milking, and manure disposal. Each task was then divided into its constituent work subdivisions (tasks). Finally, the working posture for each work subdivision was evaluated using Rapid Entire Body Assessment (REBA).

RESULTS

Based on the results from the REBA score, the poorest risk scores (risk level 4) were associated with the following tasks: (1) manure disposal, (2) filling feed bags, and (3) pouring milk into a bucket. Other tasks such as filling corn containers, pouring corn into the milling machine, preparing the feed, pouring food into mangers, attaching the milking machine, and pouring milk from a bucket into a tank imposed high risk (risk level 3). The risk for the tasks of washing and disinfecting the udders were assessed as medium risks.

CONCLUSION

The risk levels associated with most of the tasks on the studied farm were unacceptably high. Therefore, it is essential to implement ergonomic interventions to reduce risk levels of the tasks.

Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET)

BACKGROUND

Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain.

METHODS

We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET).

RESULTS

Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%].

CONCLUSIONS

Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.

A Descriptive Study of Body Pain and Work-Related Musculoskeletal Disorders Among Latino Farmworkers Working on Sweet Potato Farms in Eastern North Carolina

Agricultural work is a physically demanding occupation. The purpose of this project was to describe the prevalence of work-related musculoskeletal disorders (WMSDs) and self-reported pain among Latino farmworkers who work extensively hand harvesting sweet potatoes. Data were obtained from a cross-sectional survey of farmworkers (N = 120) in eastern North Carolina. Univariate and bivariate analyses were used to describe personal, work characteristics, and self-reported pain associated with musculoskeletal injuries. Overall, 79% of farmworkers reported any type of pain or discomfort. The highest reported areas of pain were in the back (66%) and shoulder areas (31%). Younger participants experienced more shoulder pain (P = .04) than older workers, and working more than 5 years as a farmworker was significantly associated with back pain (P = .01). Interventions aimed at administrative and engineering controls for reducing risk factors that contribute to WMSDs are warranted.

Prevalence of Musculoskeletal Disorders Among Saskatchewan Farmers

The extent of the musculoskeletal disorder (MSD) problem is not well understood among Canadian farmers, and little too is known about their epidemiology. The purpose of this study was therefore to (1) determine the prevalence of MSDs among farmers in one Canadian province; and (2) describe the types and severities of these disorders and patterns in their occurrence. This cross-sectional analysis was conducted using baseline survey data from the Saskatchewan Farm Injury Cohort Study. Reports of MSDs, demographic and health-related variables, reports of farm-related injuries, and economic conditions of individual farms were available for 2595 adult participants from 1212 farms in Saskatchewan, Canada. Relationships between MSDs and time spent doing farm work were investigated using tests of association. The participation rate was 48.8%. Most (85.6%) of participants reported having musculoskeletal pain in at least one body part over the past year. The lower back was most frequently affected (57.7%), followed by shoulders (44.0%), and neck (39.6%). More serious pain prevented 27.9% of respondents from performing regular work activities. MSD prevalence did not vary by sex, commodity type, or by total hours of farm work completed; prevalence was significantly (P < .05) related to time spent performing biomechanically demanding tasks such as heavy lifting and working with arms overhead. The most common MSD site in farmers was the low back, followed by the upper and then lower extremities. Although this study aimed to identify high-risk groups, lack of differences between demographic groups suggests that the majority of farmers are at risk for MSDs.

Prevalence and occupational impact of arthritis in Saskatchewan farmers

Agricultural workers have physically demanding occupations. In this study of Saskatchewan farmers, the authors examined (1) self-reported prevalence of physician-diagnosed rheumatoid arthritis and osteoarthritis; and (2) the impact of these chronic arthridities on engagement in physical tasks related to farming. This study was conducted through a cross-sectional analysis of baseline data from the Saskatchewan Farm Injury Cohort Study in which 2,473 adult residents upon 1,216 farms participated. Collected survey data included demographic and health information; regional musculoskeletal symptoms for each participant assessed via the Standard Nordic Questionnaire; and engagement in various specific physical tasks or activities associated with mixed farming practices. Of the 2,473 respondents, 13% reported chronic arthritic diagnoses (10% osteoarthritis, 4% rheumatoid arthritis, with 1% from each category overlapping with both forms of arthritis). Participants reporting arthritis were more likely to also report disabling musculoskeletal symptoms involving their shoulders, elbows, hands, lower back, hips, knees, and ankles. Farmers with arthritis reported less participation in all physical farming activities studied, including various machinery operations, herd maintenance and veterinary activities, overhead work, shoveling/pitchfork work, and lifting/carrying. When adjusted for age, gender, and comorbidities, operation of combines and shoveling/pitchfork work continued to be significantly less engaged in by farmers with arthritis. The overall prevalence of arthritis was consistent with general population prevalence, although the category of rheumatoid arthritis was overrepresented. Farmers with arthritis were significantly less likely to participate in combine operation and shoveling/pitchfork chores compared with their counterparts without arthritis.

Design, simulation and modelling of auxiliary exoskeleton to improve human gait cycle

Exoskeleton is a walking assistance device that improves human gait cycle through providing auxiliary force and transferring physical load to the stronger muscles. This device takes the natural state of organ and follows its natural movement. Exoskeleton functions as an auxiliary device to help those with disabilities in hip and knee such as devotees, elderly farmers and agricultural machinery operators who suffer from knee complications. In this research, an exoskeleton designed with two screw jacks at knee and hip joints. To simulate extension and flexion movements of the leg joints, bearings were used at the end of hip and knee joints. The generated torque and motion angles of these joints obtained as well as the displacement curves of screw jacks in the gait cycle. Then, the human gait cycle was simulated in stance and swing phases and the obtained torque curves were compared. The results indicated that they followed the natural circle of the generated torque in joints with a little difference from each other. The maximum displacement obtained 4 and 6 cm in hip and knee joints jack respectively. The maximum torques in hip and knee joints were generated in foot contact phase. Also the minimum torques in hip and knee joints were generated in toe off and heel off phases respectively.

Ergonomic Evaluation of Manual Weeding Practice and Development of an Ergonomic Solution

Agricultural workers performing manual weeding are exposed to high risks of musculoskeletal disorders to the lower back. Hand weeding exposes workers to sustained static loading to spinal soft tissues, which can lead to the initiation of a cycle of inflammatory response. Assessment of injury risks and investigation of current and new methods of manual weeding are the focus of this study. Nine subjects (7 males and 2 females) participated in this study. Trunk kinematics were monitored while workers performed four weeding tasks using different methods; long- and short-handled weeding (hoe and weed Puller), hand weeding, and a newly developed “Eater”. The Eater consists of two conveyor belts working simultaneously in an intermesh design to simulate the pulling and grabbing action of the hands. Hoe weeding is considered a less hazardous alternative to hand weeding with regards to back injuries but, our results showed otherwise. The worker's sagittal position with the hoe weeding was not significantly different from the short-handled tool. Also, workers weeding with the hoe displayed the highest trunk velocities. On the other hand, the Eater showed promising results by significantly reducing biomechanical risk factors. However, productivity results are not as promising.

The effectiveness of rehabilitation on pain-free farming in agriculture workers with low back pain in India

BACKGROUND

Studies have shown that farming is associated with many agricultural workers experiencing low back pain (LBP). The rehabilitation of these workers should facilitate their functioning, activities and level of participation in an adequate way.

OBJECTIVE

The objectives of this study were to identify the health components associated with LBP and to evaluate the effectiveness of the interventions in returning agricultural workers with LBP to their vocation using the International Classification of Function (ICF) -based tools.

METHODS

Thirty-one full time agricultural workers from 3 different Indian states were prospectively assessed using the ICF core set for LBP. ICF core sets permitted analysis of limitations of function from both the participant and rehabilitation team's perspectives. Each ICF category was rated using an ICF qualifier. The components identified were linked to the ICF categorical profile and assessment sheet. The clinicians identified the global, service program and cycle goals based on ICF. The participants' functioning was followed over a 4-month period.

RESULTS

After intervention, the participants were able to undergo their routine activities without increases in pain. However, on returning to active farming, participants noted few improvements in the components d410 (changing basic body position), d415 (maintaining body position), d430 (lifting and carrying objects), d465 (moving around using equipment), d850 (remunerative employment) and d859 (work and employment, other specified and unspecified).

CONCLUSION

The results of the study conclude that the current interventions for LBP are not effective in returning agriculture workers with LBP in India to pain-free farming. There is an urgent need to individualize the health needs of agriculture workers.