Environmental and organizational factors associated with elbow/forearm and hand/wrist disorder among sewing machine operators of garment industry in Ethiopia

Prevalence of work-related musculoskeletal disorders and quality of life assessment among garment workers in Tiruppur district, Tamil Nadu

Objectives. The garment industry is a labour-intensive industry, with workers susceptible to musculoskeletal problems, especially those employed in smaller units that lack adequate occupational health provisions. This study aims to determine the prevalence of work-related musculoskeletal disorders (WMSDs) among workers in both large and small garment units and assess their quality of life (QoL). Methods. The study surveyed 746 garment workers, comprising 372 from large units and 374 from small units. Data were collected through the Nordic musculoskeletal questionnaire and the World Health Organization Quality of Life (WHOQOL)-BREF questionnaire, with posture analysis conducted using the rapid upper limb assessment (RULA) and rapid entire body assessment (REBA) scales. Results. The results showed that 32% of workers in large-scale garment units and 43.9% in small-scale garment units reported musculoskeletal symptoms. The occurrence of musculoskeletal disorders (MSDs) was significantly associated with increasing age, smoking, alcohol consumption, job duration, working in shifts and moonlighting. Conclusion. The workers in the garment industry, particularly of small units, are highly susceptible to WMSDs.

Patterns of common illness and injury of readymade garment workers and a review of safety practices in Bangladesh

BACKGROUND

Readymade garment workers globally experience distinctive vulnerabilities at the workplace. The situation is worse in many developing countries. However, there is a lack of scientific evidence about the health and safety of garment workers in the workplace.

OBJECTIVE

The objective of this study was to examine the patterns of illness and injury of garment workers, factory level health safety policies and programs, and views and perception of management staff at factories in Bangladesh.

METHODS

This mixed-method study was conducted among garment workers and management level staff between January 2018 and April 2019. We extracted 4000 health records of the workers who attended primary health care centers of the factories and conducted 11 key informant interviews using qualitative method from different management-level staff.

RESULTS

Half of the workers (51.0%) were working in the sewing section following 12.8% in quality control and 12.3% in the laundry section. A review of the medical records showed that peptic ulcer diseases (PUDs) (19.2%), fever (11.7%), loose motion (10.3%), and headache (9.4%). Needle injury was uncommon for taking medical care. Occupational safety and health management, safe drinking water, access to maternity leave and other facilities were better in large and medium factories compared with those in small factories.

CONCLUSIONS

Although the readymade garments sector is one of the largest sources of foreign currency revenue earnings in Bangladesh, occupational health and safety issues of workers remain a big concern. Thus, support from the government needs more focus on the health and safety of workers.

Relationship of Healthy Building Determinants With Musculoskeletal Disorders of the Extremities: A Systematic Review

Musculoskeletal disorders (MSDs) are a substantial societal burden and various factors affect their causation, recovery, and prognosis. Management of MSDs is complex and requires multifaceted interventions. Given the challenges of MSDs and their continued burden, it is possible that additional elements could impact these disorders that have not been fully researched, for example, indoor environmental quality. Our previous review provided preliminary evidence that healthy building determinants (HBDs) are associated with the risk of back and neck pain. However, the relationship of HBDs with extremity MSDs and general MSDs (i.e., MSDs involving multiple body regions or in which body regions were unspecified in the original reports) has not been formally studied. The purpose of this review was to conduct a systematic literature review to assess the relationship of HBDs with extremity and general MSDs (PROSPERO ID: CRD42022314832). PubMed, CINAHL, Embase, and PEDRo databases were searched through April 2022. Inclusion criteria for study eligibility were as follows: humans of ages ≥18 years, reported on one or more of eight HBDs (1. air quality and ventilation, 2. dust and pests, 3. lighting and views, 4. moisture, 5. noise, 6. safety and security, 7. thermal health, 8. water quality), and compared these HBDs with extremity MSDs or general MSDs, original research, English. Exclusion criteria were as follows: articles not published in peer-reviewed journals, full-text articles unavailable. Review procedures were conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Empirical evidence statements were developed for 33 pairwise comparisons of HBDs with MSDs. The search uncovered 53 eligible studies with 178,532 participants. A total of 74.6% (39/53) of the studies were cross-sectional and 81.1% (43/53) were fair quality. Overall, the majority of uncovered evidence indicates that HBDs are related to risk of extremity and general MSDs. Nineteen comparisons support that as HBDs worsen, the risk of MSDs increases. Six comparisons had conflicting evidence. Three comparisons support that poor HBDs are not related to increased risk of extremity and general MSDs. Five comparisons had no evidence. This systematic review builds upon previous work to provide useful starting points to enhance awareness about the HBD-MSD relationship. These findings can help inform research and public health efforts aimed at addressing suboptimal HBDs through appropriate interventions to improve the lives of those suffering from MSDs.

Frequency and risk factors of musculoskeletal disorders among kitchen workers

BACKGROUND

Kitchen work is associated with exposure to heavy workload which has been linked to work-related musculoskeletal disorders (WRMSDs) and many other occupational hazards. This study aimed to measure the frequency of WRMSDs related to working in kitchens of two major Egyptian students' hostels, to determine the associated risk factors, and determine the distribution of musculoskeletal problems in various joints in different job categories.

METHODS

A cross-sectional analytical study was carried out among 128 kitchen workers of two major students' hostels in Cairo, Egypt. A structured interview questionnaire was used to collect information on personal and occupational data and the prevalence of musculoskeletal pain in the past 12 months based on the valid Nordic musculoskeletal disorders questionnaire (NMQ).

RESULTS

The study revealed that the majority of kitchen workers (90.6%) at the students' hostel reported WRMSDs within the past 12 months. The lower back (64.8%), knee (46.9%), foot (46.1%), neck (29.7%), and shoulders (23.4%) were the most affected sites. Age, educational status, job category, job duration, and body mass index (BMI) were significantly associated with WRMSDs among kitchen workers.

CONCLUSION

kitchen workers are at a high risk of musculoskeletal disorders (MSDs) due to the poor work environment, the massive workload, and great time pressure to perform their duties. Interventions such as hiring more workers of younger age, providing rest breaks, and health education about occupational hazards to reduce the risk of musculoskeletal problems should be reinforced.

Improving Work-related Musculoskeletal Disorders for Sewing Machine Operators in Ethiopia

Purpose. The awkwardly designed sewing workstations in the garment industry cause work-related musculoskeletal disorders that cause global health concerns for industrial sewing operators. This study was conducted with the aims of evaluating health risks and improvement interventions for sewing operators in Ethiopia. Materials and methods. Strain index and standardized Nordic Musculoskeletal disorder questionnaires were used for data collection. Binary and multiple logistic regression analysis were used to analyze the data and identify significant factors. Results. The study revealed that operators sitting chair design in the sewing section has significant correlation with the occurrence pain in different body parts particularly in the upper and lower back body parts with a high odds ratio of more than 93% in the low and upper back areas. Hence, the sitting chair was redesigned considering operator's anthropometric measurements and workstation requirements to improve workers safety and productivity. Conclusion. The study concludes that work related musculoskeletal disorders were significant in different body parts was crucial for appropriate intervention in redesigning the sewing workstations particularly the sitting chair to ensure health and safety of industrial sewing operators. The study therefore recommends implementation of the proposed ergonomic sitting chair to improve operators safety and productivity.

Reduction of Fatigue and Musculoskeletal Complaints in Garment Sewing Operator through a Combination of Stretching Brain Gym® and Touch for Health

The purpose of this study was to assess the effect of using a combination of stretching and Brain Gym^®(BG) + Touch for Health (TfH) movements to reduce fatigue and musculoskeletal complaints (MSCs) in garment-sewing operators. A quasi-experimental study was performed on 53 respondents with two sessions of stretching movements and BG + TfH movements of 5 min duration, three times a week for four weeks. Fatigue was measured using a reaction timer and MSCs were measured using a Nordic Body Map questionnaire. Wilcoxon and Mann–Whitney U tests were performed to examine the differences of pre/post and between the intervention group (IG) and control group (CG). A significant difference was found in IG for pre- and post-fatigue (p < 0.001) and MSCs (p < 0.001), while in CG there was no difference in fatigue (p = 0.200) and MSCs (p = 0.086). Significant differences were found between the IG and CG groups in terms of fatigue (p = 0.046), as well as in MSCs (p < 0.001). A significant decrease in MSCs per part body in IG was found on the left wrist, left hand, and left knee. The percentage of MSC severity decreased in all parts of the body, except the right shoulder, left elbow, and right thigh.

Self-Reported Work-Related Musculoskeletal Disorders and Associated Factors among Restaurant Workers in Gondar City, Northwest Ethiopia, 2020

Introduction

Globally, work-related musculoskeletal disorders (WMSDs) have resulted in occupational disability and injury. Of these, restaurant workers are among the high-risk professionals usually affected by WMSDs. In Ethiopia, evidence on the burden of musculoskeletal disorder and contributing factors among restaurant workers were very limited. Therefore, this study was aimed at assessing the prevalence of self-reported WMSDs and contributing factors among restaurant workers in Gondar city, northwest Ethiopia, 2020.

Methods

An institutional-based cross-sectional study was conducted from February 2020 to March 2020 among restaurant workers in Gondar city. A two-stage sampling technique was used to choose 633 study subjects. A structured Nordic questioner was used to collect the data. Data was entered into EpiData version 3.1 and exported to Stata version 14.0 for analysis. Both bivariable and multivariable logistic regression analyses were computed. An adjusted odds ratio with a 95% confidence interval was used to measure the association between WMSDs and independent variables. In the multivariable analysis, a P value of <0.05 was used to declare a statistically significant association. To check the goodness of fit, the Hosmer and Lemeshow test was used.

Results

The prevalence of WMSDs among restaurant workers in the past 12 months was 81.5% [95% CI (78.18-84.44)]. Attending primary education [AOR: 2.14, 95% CI (1.17-3.90)], attending secondary education [AOR: 1.71 (1.02-2.86)], and job satisfaction [AOR: 1.90, 95%CI (1.13-3.19)] were significantly associated with WMSDs.

Conclusion

In this study, the prevalence of WMSDs among restaurant workers was high. The upper back, lower back, elbow, and wrist were the most affected body parts. Age above 30 years, educational status being primary and secondary, and being dissatisfied by their job were positively associated with a high prevalence of WMSDs.

Factors Associated with Musculoskeletal Disorders Among Female Readymade Garment Workers in Bangladesh: A Comparative Study Between OSH Compliant and Non-Compliant Factories

Purpose

Musculoskeletal Disorders (MSDs) are one of the most common occupational diseases responsible for work restriction and absenteeism. The purpose of the study was to compare the prevalence of MSDs between ready-made garment (RMG) factories that are compliant versus non-compliant with International Labor Organization (ILO) based Occupational Safety and Health (OSH) standards, and to identify other factors associated with a higher prevalence of MSDs.

Methods

A multicenter cross-sectional study was conducted among 410 randomly selected female workers (age: >18 years; ≥1 year of work experience) from 12 randomly selected RMG factories in the Dhaka district of Bangladesh from February to December 2019. Factories were stratified as OSH compliant or non-compliant. Data were collected using a structured questionnaire consist of socio-demographic, work-related factors, and Nordic Musculoskeletal Questionnaire (NMQ) for MSD assessment. Robust Poisson regression was used to investigate the association of MSDs with OSH compliance, socio-demographic and other work-related factors.

Results

Respondents’ mean age was 26.9 ± 5.9 years. A total of 235 (57%) of the workers reported musculoskeletal pain in at least one body part during the last month. Among the nine reported MSDs, the prevalence of lower back pain was highest (41%) followed by pain in the knees (33%). Multivariable analysis showed lower prevalence of any MSD among workers in OSH compliant factories [aPR = 0.43, 95% CI: 0.31–0.58], and workers with regular working hours (8 hrs/day) [aPR = 0.79, 95% CI: 0.62–1.00]. The risk of developing any MSD was significantly higher for age group 25–30 years [aPR = 1.16, 95% CI: 1.01–1.33] and age group ≥31 years [aPR = 1.21, 95% CI: 1.04–1.1.39].

Conclusion

The study found a high burden of musculoskeletal disorders among female RMG workers, especially those in non-OSH compliant factories that work long hours. Enforcement of minimum ILO-based OSH standards and introduction of low-cost interventions to improve working conditions in non-compliant factories would help sustain the pace of development in this sector in Bangladesh, and ensure the health of the women who work there.

Occupational Related Upper and Low Back Pain Among the Working Population of Ethiopia: Systematic Review and Meta-Analysis

BACKGROUND

Back pain, such as upper and low back pain are among the most common musculoskeletal conditions that can cause major public health and socioeconomic problems. Back pain is one of the leading causes of disability that reduces worker performance and well-being and increases absence from work, which can cause an enormous economic burden. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related upper and low back pain, and they remain less prioritized and empirically unrepresented. Therefore, this study aimed to determine the prevalence of occupational-related upper and low back pain among the working population of Ethiopia.

METHODS

This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published from 2017 to 2020. Articles were searched from 9 electronic databases (Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database, and Science Direct) using a combination of Boolean logic operators, Medical Subject Headings, and main keywords. The quality assessment of the articles was performed using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study. A random effects model was used to estimate the pooled prevalence, the 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyses were performed to identify the influence of outliers and to identify sources of heterogeneity.

RESULTS

Of the 1114 studies identified from the included databases, 20 studies were included in the systematic review and meta-analysis. The pooled prevalence of occupational-related upper and low back pain in the previous year was (27.1% [95% CI: 18.4, 37.9]) and (54.2% [95% CI: 48.2, 60.0]), respectively. Based on a subgroup analysis by publication year, study population, and regions where the studies were conducted, the prevalence of upper back pain was (43.8% [95% CI: 39.3, 47.7]), (34.7% [95% CI: 33.1, 36.2]), and (36.2% [95% CI: 33.6, 39.0]), respectively, while the prevalence of low back pain was (61.8% [95% CI: 58.9, 64.6], (52.8% [95% CI: 51.3, 54.3]), and (55.2% [95% CI: 51.4, 59.0]), respectively.

CONCLUSIONS

This systematic review and meta-analysis found that 54.2% of the included study participants experienced low back pain in the previous year, while 27.1% experienced upper back pain. The highest prevalence was reported among pedestrian back-loading women.

Upper extremity musculoskeletal symptoms among Iranian hand-woven shoe workers

BACKGROUND: Studies have demonstrated that upper extremity musculoskeletal disorders (UEMSDs) are highly prevalent among weavers. In Iran, little information is available regarding the prevalence of MSDs and their causal risk factors among hand-woven shoe workers. This cross-sectional study aimed to determine the prevalence of UEMSDs and to identify risk factors associated with UEMSDs symptoms among 586 Iranian hand-woven shoe workers. METHODS: The data were collected using the Nordic Musculoskeletal Questionnaire and by direct observation of working postures via the Rapid Upper Limb Assessment (RULA) technique to determine ergonomic risks. RESULTS: The prevalence of MSDs symptoms was high among the hand-woven shoe workers. The mean RULA grand score of 6.3 indicated that in most cases the workers’ postures at their workstations needs to be investigated and changed immediately to prevent musculoskeletal injuries. The highest prevalence rates of MSDs were observed in the shoulders, wrists and arms. The result of multiple logistic regression modeling showed that risk factors associated with UEMSD symptoms were job experience, daily working hours, job satisfaction, working posture, work pressure, and discomfort at workstation, as well as individual factors, such as age, gender, BMI, material status, working conditions, education level, and lack of regular sport/physical activities. CONCLUSIONS: The findings of the present study emphasize that any interventional program in this industry has to focus on improving working conditions particularly by designing ergonomics-oriented workstations and hand tools.

Physical environmental and occupational factors inducing work-related neck and shoulder pains among self-employed tailors of informal sectors in Ethiopia, 2019: results from a community based cross-sectional study

BACKGROUND

Musculoskeletal disorders (MSD) caused by occupational-related factors continue to place huge burdens on global workforces. Significant numbers of workers report potential adverse health outcomes related to the condition, such as physical injury, disability, and decline in quality of life. Occupational-related MSD also poses additional burdens to healthcare services and diminishes productivity at work. The condition usually worsens in informal sectors where the work environments are often poorly designed. This paper explored occupational and physical environmental factors that induce work-related neck and/or shoulder pains among self-employed tailors in Gondar city, Northwest Ethiopia.

METHODS

We conducted across-sectional survey from April to May 2019 on 422 tailors selected with systematic random sampling technique. Nordic Musculoskeletal questionnaire was used to measure pains in neck and/or shoulder, and the questionnaire was pretested and administered by interviewers. Work-related factors such as working posture, rest break, training in safety and health, and the availability of adjustable chairs at workplaces were assessed. The significance of associations was set at a < 0.05 p-value and adjusted odds ratios (AOR) with a confidence interval (CI) of 95% were used to determine strength of associations.

RESULTS

A total of 419 tailors participated with a response rate of 99.3%. The mean age and mean years of experience were 29.23 (SD ± 7.03) and 1.48 (SD ± 0.50) years, respectively. The study found that the prevalence of pain in either neck or shoulder or both sites in the last 12 months was 66.6% (N = 279) [95% CI (62.1, 71.1)]. Pains in shoulder and neck were observed in 72.1% (N = 302)[95% CI (67.8, 76.4)] and 68.3% (N = 286) [95% CI (64.0, 72.6)] of the interviewees, respectively. The majority, 78.1% (n = 218) of those with pains indicated they were prevented from doing normal daily activities. Work experience (AOR = 1.81), rest break (AOR = 2.13), awkward working posture (AOR = 2.60), prolonged sitting (AOR = 2.00) and inadequate light (AOR = 5.02) were significantly associated factors of neck and/ or shoulder pains.

CONCLUSION

Work-related neck and/or shoulder pain induced by physical factors of the work environment among self-employed tailors is pervasive in Ethiopia. Efforts to curb the condition, therefore, need to impalement diverse approaches addressing the physical environment and occupational factors. We also promote the integration of schemes for the effective use of rest breaks into health and safety programs in the workplace.

The prevalence and risk factors of work-related musculoskeletal disorders among adults in Ethiopia: a study protocol for extending a systematic review with meta-analysis of observational studies

BACKGROUND

Work-related musculoskeletal disorders impose a significant and most often underappreciated burden to the individual, nation, healthcare system, and society as a whole. To the best of our knowledge, there is a lack of reliable estimates on the prevalence of work-related musculoskeletal disorders in Ethiopia. The objective of this study will be to assess the existing literature on the prevalence rates and determinant factors of work-related musculoskeletal disorders in Ethiopia.

METHOD

We will search PubMed/MEDLINE, Embase, SCOPUS, PsycINFO, PEDro, and Ebsco (from January 2000 onwards). Gray literature will be identified through searching Google Scholar and dissertation databases. Observational studies reporting on the prevalence of work-related musculoskeletal disorders among adult Ethiopians will be included. The primary outcome will be the prevalence of work-related musculoskeletal disorders. Secondary outcomes will be the prevalence of any risk factors in association with work-related musculoskeletal disorders. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis of observational data. Subgroup analyses will be conducted to explore the potential sources of heterogeneity (e.g., gender, sample size, type of occupation). Publication bias and heterogeneity between the included studies will also be assessed and reported.

DISCUSSION

This systematic review will provide a synthesis of the literature on the prevalence of work-related musculoskeletal disorders and their risk factors in Ethiopia. The results of this review could help the policymakers in occupational health and healthcare sectors in identifying priority areas for interventions in work-related musculoskeletal disorders and will also serve as a baseline for the decision-making processes of musculoskeletal health promotion, work exposure implementations, and prevention programs in workplaces.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, CRD42020164240.

The magnitude and factors associated with work-related back and lower extremity musculoskeletal disorders among barbers in Gondar town, northwest Ethiopia, 2017: A cross-sectional study

BACKGROUND

Work-related back and lower extremity disorders often present remarkable health and economic burdens on societies. Occupational barbers are usually neglected in research and policy actions, mainly in developing countries, and are hence more vulnerable to the conditions. So far, information about the factors influencing back and lower extremity disorders among barbers in Ethiopia is unknown. Therefore, the aim of this study was to determine the prevalence and factors affecting back and lower extremity disorders among barbers in Gondar town, Ethiopia.

METHODS

A cross-sectional study was conducted from April to May 2017. A sample of 434 barbers recruited using the systematic random sampling technique. A pre-tested standardized Nordic Musculoskeletal questionnaire was interviewer-administered for data collection. Data were analyzed using statistical package for social sciences (SPSS) version 20. The significance of associations was evaluated at ≤0.05 p-value with a 95% confidence intervals (CI) and adjusted odds ratios (AOR).

RESULTS

The response rate was 98.8% (N = 429). The mean age and mean length of employment were 26.38 (standard deviations (SD) ± 4.78) and 4.91 years, respectively. The prevalence of work-related low back pain in the previous 12 months and in the last 7 days was 55.7% (N = 239) [95% CI (51.0, 60.4)] and 32.6% (N = 140), respectively. About 40.6% (n = 97) of the participants with back pains indicated their activities were limited. The prevalence of knee/leg and ankle pain was 39.4% (N = 169) and 25.6% (N = 110), respectively. Out of the participants, 17% (n = 41) sought treatment services. Less than half, 40.6% (n = 97) said they perceived high disability, while 38.1% (n = 91) explained their pain was intense (severe). Age [AOR: 2.001; 95% CI (1.174, 4.346)], alcohol use [AOR: 2.283; 95% CI (1.376, 3.789)], lack of safety training [AOR: 0.110; 95% CI (0.032, 0.271], working posture [AOR: 0.142; 95% CI (0.045, 0.215)], and length of employment [AOR: 1.650.132; 95% CI (1.107, 2.140] were significantly associated factors.

CONCLUSIONS

Back and lower extremity musculoskeletal pain and disability were found to be prevalent among Ethiopian barbers and to be associated with age, alcohol use, safety training, work postures, and length of employment. We believe that programs for management of musculoskeletal disorders need to address these factors.

Risk Factors Associated with Upper Extremity Musculoskeletal Disorders among Barbers in Gondar Town, Northwest Ethiopia, 2018: A Cross-Sectional Study

Background

Work-related upper extremity musculoskeletal disorders (WUEDs) often present remarkable health and economic burdens on society. Occupational barbers are usually neglected both in research and policy actions, mainly in developing countries, and hence are likely subjected to the conditions. So far, information about factors that influence WUEDs among barbers in Ethiopia is inconclusive. Therefore, this study aimed to evaluate prevalence and factors associated with WUEDs among barbers in Gondar town, Ethiopia.

Methods

We conducted a cross-sectional study from March to April 2018. A sample of 424 participants were recruited using systematic random sampling technique. A standardized Nordic Musculoskeletal Questionnaire was pretested and interviewer-administered for data collection. The data were analyzed by SPSS version 20 software. We set statistical significances at <0.05 p value with 95% confidence intervals (CI) and computed odds ratios to evaluate strength of associations.

Results

The response rate was 98.3% (N=417). The mean age was 26.39 (SD + 4.805) years. The prevalence of upper extremity musculoskeletal disorders over the past 12 months was 56.8% (N=237). Upper back pain was observed in 38.8% (N=162) participants, whereas shoulder (27.1% (N=113)), neck pain and elbow/forearms (each 29.3% (N=122)), and wrists/hand disorders (32.4% (N=135)) were the common body sites indicated. Age (AOR: 2.614; 95% CI (1.287, 5.307)), alcohol use (AOR: 3.556; 95% CI (2.212, 5.717)), frequent standing (AOR: 1.536; 95% CI (1.006, 2.346)), physical exercises (AOR: 1.938; 95% CI (1.216, 3.089)), and low monthly salary (AOR: 3.125; 95% CI (1.157, 5.441)) were factors associated with work-related upper extremity disorders.

Conclusions

Work-related upper extremity disorder is common among hairdressing professionals. Worksite health promotions targeted to lifestyle behaviors, like physical exercise and alcohol consumption require urgent public health actions in Ethiopia. Moreover, adaption of flexible work postures and proper management of workplace conditions related to aging workforces are also imperative to trace the complaints.