Musculoskeletal symptoms among female garment factory workers in Sri Lanka

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.

Prevalence and risk factors of physical and psychological health among readymade garment workers in Bangladesh

Objective. Poor health outcomes of Bangladeshi readymade garment (RMG) workers tend to be associated with a variety of occupational factors. This study aimed to investigate the prevalence of, and risk factors associated with, the physical and psychological health outcomes of Bangladeshi RMG workers. Methods. Responses to a cross-sectional survey from a convenience sample of 411 adult Bangladeshi RMG workers (mean age = 26.24 years; SD 6.40 years; female = 80%) were analysed using bivariate and multivariate (logistic regression models) analyses. Results. More than half of the participants reported headaches (61.6%) and colds/flu (51.3%), followed by fever (37.2%), diarrhoea (32.8%), bodily pain (29.9%) and respiratory infections (20.9%). For psychological health, stress (69.1%), anxiety (66.2%) and boredom (64.5%) were most prevalent, followed by sleeplessness (51.3%), depression (48.2%) and fear (34.3%). RMG workers from the factories located in Chattogram (a peripheral region compared to Dhaka) reported poorer physical and psychological health outcomes than those working in factories in Dhaka (the capital city of Bangladesh). Overall, compared to males, female RMG workers were more likely to be vulnerable to both physical and psychological health outcomes. Conclusion. Improvement in workplace conditions and safety programmes is needed to safeguard the overall health outcomes of Bangladeshi RMG workers.

Prediction of work productivity outcomes by identifying critical risk factors among garment industry workers

Work productivity is one of the most important economic measures in the manufacturing industry. However, the physical, psychosocial and individual risk factors of an industrial work environment affect workers' physical or mental health, resulting in work productivity loss, absenteeism and presenteeism. Therefore, this study aims to identify the most critical risk factors and develop statistical models for predicting work productivity loss, absenteeism and presenteeism of garment industry workers. A sample of 224 sewing machine operators was taken for data collection through observation and self-reported studies. The results indicated that the average work productivity loss, absenteeism and presenteeism was 38.21, 2.35 and 37.23%, respectively. Finally, the statistical models of work productivity loss, absenteeism and presenteeism was developed using multiple linear regression with precision of 69.9, 53.7 and 84.0%, respectively. Hence, this study will help garment industries to improve their work productivity by taking initiatives based on the developed models.

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.

Health vulnerabilities of readymade garment (RMG) workers: a systematic review

Background

There is a paucity of literature that addresses the health vulnerabilities of readymade garment (RMG) workers in South and Southeast Asian regions. Therefore, the aim of this systematic review is to identify the distinctive types of health vulnerabilities along with the causes and consequences of these vulnerabilities of the RMG workers in South and Southeast Asian regions.

Methods

Systematic review search methods were applied utilising the PRISMA protocol. Literature published between July 2007 to June 2017 on health vulnerabilities of the RMG workers of South and Southeast Asian countries were identified through electronic databases and manual searches.

Results

A total number of 19 studies (16 quantitative studies, 3 mixed-method studies) were included from the primary 17,001 papers identified. The quality of these studies was assessed by using the EPHPP (effective public health practice project) and the CASP (critical appraisal skills programme) tools. From the identified studies, 14 were considered ‘strong,’ with the remainder assessed as ‘moderate’ quality. The findings reported in these studies suggest that RMG workers of South and Southeast Asian countries are prone to several health vulnerabilities which include physical and psychological issues. Further, many of these health vulnerabilities arise from the nature of the RMG workplace, and include unhygienic and unsafe working environments, hazardous conditions of the factories, and lack of safety equipment.

Conclusions

This systematic review suggests that RMG workers’ health vulnerabilities are an emerging area of inquiry that needs to be better understood and solutions identified. Little is currently known about the distinctive types of health vulnerabilities of the RMG workers of these countries, other than Bangladesh and India, due to the lack of robust studies in other South and Southeast Asian countries. Although the health vulnerabilities of the Bangladeshi and Indian RMG workers have been previously highlighted, the health vulnerabilities arising from sudden disasters in the sector remain a neglected issue.

Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015

Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.

Musculoskeletal symptoms and disorders among 350 garment workers in Bangladesh: A cross-sectional pilot study

OBJECTIVE

To study the prevalence of musculoskeletal (MSK) symptoms and disorders among garment workers in Bangladesh, to look for possible relationships between pain location and type of work performed and to estimate the prevalence of rheumatological diagnoses.

METHODS

A cross-sectional pilot study among 350 garment workers using the COPCORD (Community Oriented Program for Control of Rheumatic Disorders) methodology. Subjects with musculoskeletal pain were examined by rheumatologists for rheumatological diagnosis. The workers were classified into cutting, sewing, finishing and quality control operators.

RESULTS

Most of the workers were aged below 35 years (88%) and females (82.9%) and the majority had only primary education (74.6%). The prevalence of MSK pain within 7 days of the interview was 77.1%, a much higher figure than in the general population. The most affected sites were: shoulder (17.9%), lower back (15.2%), neck (13.8%) and knee (10.8%). Multiple regional pain was the commonest finding in 173 of 350 workers. In this pilot study rheumatoid arthritis was diagnosed in 0.9%, undifferentiated arthritis in 1.1%, nonspecific low back pain in 4.6%, soft tissue rheumatism in 3.7%, osteoarthritis in 0.9% and lumbar spondylosis in 1.1%, figures comparable with those observed in the general population; spondyloarthropathy was seen more often, in 1.42%, possibly explained by the small numbers.

CONCLUSIONS

Musculoskeletal pains are common among garment workers of Bangladesh and may cause morbidity, disability, and work loss. Our findings may be important to plan ergonomic measures preventing complaints and may be of interest for international companies ordering garments in Bangladesh.

The Current Working Conditions in Ugandan Apparel Assembly Plants

BACKGROUND

The present rapid shift of industrialization from developed to developing countries requires developing countries to understand issues related to work organization, management, and working conditions. There are many factors slackening production, of which working conditions is part. A complete inquiry into the workers' working conditions can enable managements to reduce risks in the workplaces and improve productivity. Understanding and awareness of the benefits of workplace research and a probe into the working conditions in the Ugandan apparel assembly plants are urgently required.

METHODS

A total of 103 (70 women and 33 men) workers from five different plants were interviewed. Together with the top management of various plants, questionnaires about the workers' opinions of their physical working conditions were prepared. Data was collected using two methods: (1) questionnaire; and (2) observation of the workers during their work.

RESULTS

The results indicated that poor plant working conditions were mainly contributed by the workers' social factors and the management policies.

CONCLUSION

The government, together with the management, should work to improve the working conditions in the apparel assembly plants, as it greatly affects both.

Associations between disc space narrowing, anterior osteophytes and disability in chronic mechanical low back pain: a cross sectional study

Background

Radiographic features of lumbar disc degeneration (LDD) are common findings in patients with chronic mechanical low back pain; however, its role in disability and intensity of pain is debatable. This study aims to investigate the associations of the x-ray features of LDD and lumbar spondylolisthesis with severity of disability and intensity of pain.

Methods

A cross-sectional study was conducted on 439 patients with chronic mechanical low back pain who attended the rheumatology clinic, National Hospital of Sri Lanka, Colombo, from May 2012 to May 2014. Severity of disability was measured using Modified Oswestry Disability Index and intensity of pain was assessed using numeric rating scale (0–100). X-ray features of LDD (disc space narrowing, anterior osteophytes and overall LDD) and spondylolisthesis were assessed in lateral recumbent lumbar x-rays (L1/L2 to L5/S1) and graded by a consultant radiologist blinded to clinical data. Generalised linear model with linear response was used to assess the associations of x-ray features of LDD with severity of disability and intensity of pain adjusting for age, gender, body mass index and pain radiating into legs.

Results

Mean age was 48.99 ± 11.21 and 323 (73.58%) were females. 87 (19.82%) were obese. Mean severity of disability was 30.95 ± 13.67 and mean intensity of pain was 45.50 ± 20.37. 69 (15.72%), 26 (5.92%) and 85 (19.36%) patients had grade 2 disc space narrowing, anterior osteophytes and overall LDD, respectively. 51 (11.62%) patients had lumbar spondylolisthesis. Grade of disc space narrowing and overall LDD were not associated with severity of disability or intensity of pain. The presence of lumbar spondylolisthesis was associated with severity of disability. Female gender and pain radiating into legs were associated with severity of disability and intensity of pain. Advancing age was associated with x-ray features of LDD and lumbar spondylolisthesis.

Conclusions

Lumbar spondylolisthesis is associated with severity of disability in patients with chronic mechanical low back pain. Associations of x-ray features of LDD with severity of disability and intensity of pain are inconclusive. Female gender and pain radiating into legs are significant confounders.

Prevalence and risk factors of musculoskeletal disorders among Sri Lankan rubber tappers

BACKGROUND

Rubber tapping exposes workers to risk factors for musculoskeletal disorders (MSDs).

OBJECTIVES

This cross-sectional study assessed the prevalence and factors associated with MSDs among Sri Lankan rubber tappers.

METHODS

Questionnaires were administered to 300 rubber tappers to measure MSDs and potential associated factors. Ergonomic exposure levels were measured for 90 tappers using the Quick Exposure Check instrument. MSD prevalence and prevalence ratios were calculated using log-binomial regression.

RESULTS

In the past 12 months, 66% of rubber tappers in our sample experienced an MSD. Ergonomic exposure levels were high or very high in the back (94.4%), shoulders (96.7%), and neck (83.3%). Being female, older, Tamil, working two jobs, alternating tapping hands, and depression were significantly associated with increased risk of MSDs.

CONCLUSIONS

MSDs are common among rubber tappers in Sri Lanka. These results suggest a need for work process modifications to prevent MSDs.

Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka

BACKGROUND

Approximately 5% of all households in Sri Lanka operate a three-wheeler as their primary source of income. However, very little is known about the occupational health risks associated with driving these vehicles.

OBJECTIVES

The aim of this study was to assess occupational risk factors, including the number of hours worked associated with the 4-week prevalence of low back pain (LBP) among drivers of three-wheelers.

METHODS

Questionnaires were administered to 200 full-time drivers of three-wheelers from the Galle District in Sri Lanka. Occupational, psychological, socio-demographic, lifestyle, and anthropometric variables were collected. Univariate and multivariate analysis were used to investigate the correlation between occupational risk factors of the prevalence of LBP.

RESULTS

15·5% of respondents reported experiencing LBP in the previous 4 months. Univariate analysis revealed that the number of hours worked per week, feeling pressure to compete with other drivers, and perceived stress scale scores were significantly associated with the 4-week prevalence of LBP. Multivariate analysis found that the number of hours worked per week and engine type were significantly associated with LBP.

CONCLUSIONS

LBP is common among drivers of three-wheelers in Sri Lanka. Long work hours and two-stroke engines were significantly associated with LBP. Results from this study point towards a role for educational, behavioral health, and policy interventions to help prevent and reduce LBP among these drivers.

Musculoskeletal problems and fluoride exposure: A cross-sectional study among metal smelting workers

Frequent and repetitive activities in job and awkward postures are shown as major contributors of musculoskeletal problems in most of the occupational health studies; however, efforts to explore newer risk factor are important to plan interventional measures. In this backdrop, this study examined contribution of fluoride exposure to musculoskeletal complaints. A cross-sectional interviewer-administered questionnaire survey was conducted involving 180 randomly selected subjects from a metal smelting industry. Clinical examination of the subjects was also performed to assess their health status and morbidity details. Assessment of personal exposure to particulate and gaseous fluoride at workplace was conducted. Urinary fluoride level was also examined in post-shift samples collected from study subjects. The mean age of the study subjects was 39.1 (±6.7) years. Majority of the workers (42.5%) were engaged in pot room. About 54% workers were suffering from backache and 66% subjects had joint pain. Exposure of workers to both particulate and gaseous fluoride and post-working shift urinary fluoride level was significantly higher in pot-room workers in comparison with all other workers. It was observed that age (odds ratio (OR): 1.62; 95% confidence interval (CI): 1.18-2.34), drinking untreated water (OR: 1.51; 95% CI: 1.03-2.76), working in pot room (OR: 1.44; 95% CI: 1.13-1.91) and urinary fluoride level (OR: 2.71; 95% CI: 1.81-3.75) had significant effects on musculoskeletal complaints. This study concludes that along with other predictors such as nature of work, posture at work and age of worker, exposure to fluoride also has significant role in the occurrence of musculoskeletal morbidity.