The epidemiology of work-related musculoskeletal injuries among chiropractors in the eThekwini municipality

Investigating the relationship between physical, cognitive, and environmental factors of ergonomics with the prevalence of musculoskeletal disorders: A case study in a car-parts manufacturing industry

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) is a multi-factorial disorder in most occupational setting and it has increased significantly in recent years.

OBJECTIVE

This study aimed to investigate the relationship between physical, cognitive, and environmental factors of ergonomics with the prevalence of WRMSDs in a car-parts manufacturing industry.

METHODS

This cross-sectional study was performed among 220 workers in a milling unit of a car parts manufacturing company in 2021-2022. The prevalence of WRMSDs was assessed using the Extended Version of the Nordic Musculoskeletal Questionnaire. Noise exposure was evaluated using dosimetry method. Mental and physical workload were evaluated by the NASA-TLX and key index methods (KIM-MHO and KIM-LHC), respectively. Data analysis was performed using SPSS version 25.0.

RESULTS

The subjects' mean age and work experience were 36.3±6.5 and 8.35±6.41 years, respectively. Eighty-five percent of the subjects reported WRMSDs in at least one area of the body. The results of mental workload assessment revealed a high workload mean range (73.23±14.89) in all of the subjects. Mean score of KIM-LHC and KIM-MHO were 738.18±336.42 and 201.86±36.41, respectively with odds ratio of 1.32 for KIM-LHC in creating the WRMSDs. There was a significant relationship between the noise exposure, mental and physical workload and the prevalence of WRMSDs (p-value <  0.05).

CONCLUSION

The results of the present study revealed that environmental, physical and cognitive factors can simultaneously be effective in the prevalence of WRMSDs. Therefore, performing effective control measures requires comprehensive attention to physical, environmental, and cognitive ergonomics in the algorithm of ergonomics management in the workplace.

Resilient responses to stressful events among chiropractic students: A cross-sectional survey

OBJECTIVE

Resilient students may better navigate the challenges of chiropractic training. This study explored the relationships between response to stressful experiences, perceived stress, and quality of life among students at 1 US chiropractic college campus.

METHODS

A cross-sectional survey was conducted with 873 students. The anonymous online questionnaire included demographics, quality of life, perceived stress, and the Response to Stressful Events Scale (RSES). Hierarchical multiple regression analyses assessed for significant relationships among variables.

RESULTS

A sample of 221 students (60% female) completed the survey (25% response rate). Male respondents reported greater psychological health. Participants reporting high quality of life exhibited higher resiliency on the RSES flat score and many RSES domains. Respondents who rated greater psychological health and social relationships exhibited greater spiritual resiliency. Respondents reporting higher psychological health and lower levels of perceived stress exhibited higher self-efficacy resilience. Psychological health was the most important predictor for RSES flat score and domains, except for spiritual resilience, for which social relationships were most important. Male gender was predictive of 3 RSES domains: meaning making, active coping, and cognitive flexibility.

CONCLUSION

More resilient responses to stressful events were reported by male chiropractic students and those who reported greater psychological health, higher quality of life, or lower perceived stress. Female students and those experiencing psychological challenges or lower quality of life might consider resilience training to increase the use of protective coping strategies. These findings may permit academic institutions to identify students at highest risk and employ interventions to prevent program withdrawal.

Assessment and evaluation of work-related musculoskeletal disorders among nuclear medicine professionals in India: A cross-sectional study

BACKGROUND

Musculoskeletal disorders (MSDs) are a severe occupational health issue among medical radiation practitioners. It is mostly linked to personal protective wear, working posture, tools employed and ergonomics.

OBJECTIVE

To assess and evaluate the musculoskeletal disorders among nuclear medicine professionals (NMP) in India.

METHODS

An online survey was distributed to 455 NMP throughout India between November 2021 and March 2022 covering the demographic characteristics and questions for evaluation of musculoskeletal symptoms using the Standardized Nordic Musculoskeletal Questionnaire (NMQ). Participants with any pre-existing musculoskeletal disorder or trauma were excluded. Descriptive statistics summarized the data from the demographics, discomfort, aches and work-related musculoskeletal injuries. Chi-square test was used to examine the association between the obtained values.

RESULTS

91 out of 124 respondents were included based on the inclusion and exclusion criteria. Results shows that there is a significant association between the height of the individual and neck pain, body mass index and elbows pain, age and low back pain, experience in the current work and upper back pain, the weight of the individual and knee pain, use of mobile lead screens and shoulder pain, use of gonad shield, trouble in the ankles and use of lead screens, and QC phantoms for gamma camera / PET and wrists/hands pain.

CONCLUSION

Work-related musculoskeletal disorders among NMP are resulting from factors of individual demographic variables (such as age, height, weight, body mass index), years of experience at the current workplace and of using instruments in their work area.

Development of a novel ergonomic index assessment in the workplace based on physical, cognitive, and environmental components

BACKGROUND

Currently, proper assessment of the existing ergonomic hazards, focusing on improving the health of individuals, is of great importance.

OBJECTIVE

This study aims to develop a new model for ergonomic index assessment in the workplace, focusing on physical, cognitive, and environmental components.

METHODS

To determine the parameters to be measured for each group of occupations, the most critical indicators in each ergonomic dimension were identified using a review of scientific texts and obtaining expert opinions. The opinions of 30 experts were studied in three stages Delphi study. Cronbach's alpha was used to calculate model reliability in SPSS version 25. An analytical hierarchy process was used to determine the weight values of each component and parameter. The weights were calculated in Expert Choice version 11.

RESULTS

The mean CVI and CVR values were 0.92 and 0.80, respectively. Cronbach's alpha values for each of the physical, environmental, and cognitive components and the entire model were 0.91, 0.87, 0.85, and 0.89, respectively. Physical components and parameters of physical condition during work, mental workload, lighting, and thermal stress in the workplace were among the most important parameters in the three groups of office, operational, and services jobs.

CONCLUSION

The model can be a practical step toward properly evaluating the ergonomic components and planning to implement control measures to reduce physical, cognitive, and environmental risk factors. Considering the study of different variables in occupational ergonomic risk assessment, this model can be a helpful tool in ergonomic management systems used in different occupational environments.

Development of an ergonomics management model in the workplace: Introduction of the TUGA ergonomics management and analysis model (TEMA)

BACKGROUND

Conducting practical studies in ergonomics requires attention to all aspects of ergonomics with a comprehensive approach and focus on continuous improvement cycles.

OBJECTIVE

This study aimed to develop and present an ergonomics management model in the workplace.

METHODS

This study was performed using a three-stage Delphi study with 30 experts and a fuzzy analytical hierarchy process. According to the literature review and experts' opinions, the general cycle of the ergonomics management system with eight steps was developed. New methods were formed in two of these eight steps: the 3rd step (developing an ergonomic evaluation method) and the 5th step (creating a cost-benefit evaluation method).

RESULTS

The eight implementation steps of the TEMA were determined as follows: 1) Performing task analysis (TTA), 2) Ergonomic hazard identification, 3) Estimating the ergonomic index, 4) Determining control measures, 5) Evaluating cost-benefit parameter, 6) Implementing control measures, 7) Continuous monitoring, and 8) Evaluating the effectiveness of control measures. The Delphi study revealed that the number of deleted parameters includes one item (burnout), and the remaining parameters were 16 items. The mean CVI and CVR values were 0.92 and 0.80, respectively. Cronbach's alpha values for each of the physical, environmental, and cognitive components and the entire model were 0.91, 0.87, 0.85, and 0.89, respectively.

CONCLUSION

Using the mentioned management model can be a practical step towards properly evaluating the most critical dimensions of ergonomics in the workplace and optimal planning to implement control measures to establish a dynamic management system to reduce ergonomic risk factors in the workplace.

Landscaping Work: Work-related Musculoskeletal Problems and Ergonomic Risk Factors

Background

Work-related musculoskeletal disorders (WRMSDs) are considered one of the foremost reason of disability globally with significant economic impact due to loss of productivity. Landscaping work is considered a high-risk industry in the service sector. Landscape workers are susceptible to WRMSDs as they are exposed to high physical demands at work, and exert significant physical effort to complete daily repetitive tasks during long working hours. The aim of this study was to determine the prevalence of WRMSDs and to identify the ergonomic risk factors among landscape workers in a university setting.

Methods

This was a cross-sectional study conducted among landscape workers at a public university in Kota Kinabalu, Sabah. Interviews were conducted due to low literacy of the participants, using structured questionnaires which consist of personal characteristics, work descriptions, ergonomic risk factors, as well as self-reported WRMSD symptoms using NORDIC questionnaire. Ergonomic risk assessment (ERA) using rapid entire body assessment (REBA) was then conducted.

Results

Fifty-five of 60 landscape workers agreed to participate (92% response rate). The overall prevalence of WRMSDs among landscape workers was 85.5%. The highest prevalence involving the shoulder (65.5%), followed by neck (23.6%), wrist/hand (23.6%), and lower back (20.0%) regions based on their self-reported WRMSD symptoms over the past 12 months. Awkward posture was the risk factor identified through ergonomic risk assessment (ERA) conducted by ERA trained personnel. None of the working postures during assessment was noted to be appropriate. Although no significant difference was associated with self-reported WRMSDs, majority of the landscape workers (71%) were classified as medium ergonomic risk group using REBA, with the remaining 29% considered to be high ergonomic risk group.

Conclusion

Improvement in awareness campaigns, modification of working tools, and enhanced administrative approaches are among the control and prevention measures recommended to delay or prevent the occurrence of WRMSDs.

Work-related musculoskeletal disorders among Egyptian physical therapists

Background

Physical therapists (PTs) are frequently exposed to work-related musculoskeletal disorders (WMSDs). There is limited evidence on the prevalence of these injuries and their potential risk factors in Egyptian PTs. This study aimed at estimating the prevalence of WMSDs among Egyptian PTs as well as potential risk factors and therapists’ coping strategies. Further, it investigated the association between WMSDs and socioeconomic factors.

Results

Three hundred eighty-five eligible participants completed a survey. The prevalence of WMSDs was 99.5%. The five top affected anatomic regions were lower back (69.1%), neck (65.7%), shoulder (47.7%), wrist/hand (39.1%), and upper back (37.0%). Therapists rated awkward positions and handling of heavy patients as the most common predisposing factors for sustaining injuries. Regarding coping strategies, seeking informal help from peers to treat injuries-related symptoms and changing the posture of therapists and patients while working were mostly used by PTs. Overall, female therapists had higher injury prevalence than males (Cramer’s V < 0.5, p ≤ 0.05); except for upper back (p > 0.05). Education and working in multiple facilities simultaneously (public and private clinics) correlated significantly to sustaining injuries in the upper back (V = 0.14, p = 0.049 and V = 0.178, p = 0.002, respectively) and neck (V = 0.16, p = .019 and V = 0.142, p = 0.020, respectively). WMSDs were not associated with therapists’ experience or specialty (p > 0.05).

Conclusion

WMSDs injuries in PTs are prevalent in Egypt, especially in females, therapists with lower academic education, and those working in multiple facilities simultaneously.

Mechanical properties of a thoracic spine mannequin with variable stiffness control

OBJECTIVE

To test the posterior-to-anterior stiffness (PAS) of a new thoracic spine training simulator under different conditions of "fixation."

METHODS

We constructed a thoracic spine model using plastic bones and ribs mounted in a wooden box, with skin and soft tissue simulated by layers of silicone and foam. The spine segment could be stiffened with tension applied to cords running through the vertebrae and ribs. We tested PAS at 2 tension levels using a custom-built device to apply repetitive loads at the T6 spinous process (SP) and over adjacent soft tissue (TP) while measuring load and displacement. Stiffness was the slope of the force-displacement curve from 55 to 75 N.

RESULTS

Stiffness in the unconstrained (zero tension) condition over the SP averaged 11.98 N/mm and 6.72 N/mm over the TP. With tension applied, SP stiffness increased to 14.56 N/mm, and TP decreased to 6.15 N/mm.

CONCLUSION

Thoracic model compliance was similar to that reported for humans. The tension control system increased stiffness by 21.3% only over the SP. Stiffness over the TP was dominated by the lower stiffness of the thicker foam layer and did not change. The mannequin with these properties may be suitable for use in manual training of adjusting or PAS testing skills.

Reported 1-year prevalence of occupational musculoskeletal disorders in Ontario chiropractors

Background

Chiropractors are a particular subset of health care professionals that reportedly suffer occupational musculoskeletal disorders (MSDs), yet they have received minimal attention to date regarding mitigating risks of occupational injury. Our study determined the prevalence of occupationally-related MSDs in the preceding year, their bodily distribution, severity, and practice-related changes in practicing chiropractors in the province of Ontario.

Methods

We conducted a cross-sectional survey of chiropractors who were members of the Ontario Chiropractic Association (OCA) from January to March 2019. A three-part online survey was developed to ask chiropractors about specific details of MSDs they experienced in the past year and any practice-related changes they made as a result. Responses from participants provided both quantitative and qualitative data. Prevalence estimates were derived for quantitative data. Qualitative data were stratified by themes that were further divided into categories and subcategories. Demographic variables of the respondents and OCA membership were compared to determine representativeness.

Results

From the 432 responses (11.8% response rate), 59.1% reported experiencing an occupationally-related MSD in the past year. Survey respondents were demographically representative of the OCA membership. MSDs were most commonly reported for the lower back (38.3%), wrists/hands (38.1%) and neck (37.4%). Positioning/performing manipulation was the most common occupational activity for MSD of the upper extremity (53.1%) and lower back (34.8%). Chiropractors largely reported their MSDs did not prevent them from doing their normal work (77.4%), despite the fact that 43.2% reported experiencing their MSDs for more than 30 days in the previous year. Common reported work modifications were grouped under themes of practice and physical changes. Practice changes included reducing patient volume, hiring personnel and scheduling. Physical changes included using different office equipment, selecting different techniques requiring lower force and altering their hand contacts or body position when treating patients.

Conclusions

One-year prevalence of occupational MSDs from this study are comparable to previously reported estimates in chiropractors. These data suggest that chiropractors continue with their regular workload despite their MSDs, thereby increasing their chances of presenteeism. Chiropractors changing technique or technique parameters due to their MSDs provides direction for future research to reduce exposure to occupational MSD risk factors.

The relationship between individual, physical and psychosocial risk factors with musculoskeletal disorders and related disabilities in flight security personnel

Purpose. The purpose of this study was to investigate the relationship between individual, physical and psychosocial risk factors with musculoskeletal disorders and related disability in flight security personnel. Methods. The study was conducted among 316 employees in Iran flight security. To study the prevalence of musculoskeletal disorders, lifestyle, occupational stress, mental workload and disability, the Cornell questionnaire, Walker lifestyle questionnaire, job content questionnaire, NASA task load index and pain disability questionnaire were used, respectively. Data were analyzed using independent-sample t test, one-way analysis of variance, χ² test and multiple logistic regression. Results. A total 68.35% of participants had musculoskeletal disorders in at least one of their body parts. There was a significant relationship between the parameters of increased age, higher work experience, high body mass index, gender and educational level and the prevalence of musculoskeletal disorders. Also, some components related to healthy lifestyle, occupational stress and mental workload had significant association with mentioned disorders (p  < 0.05). Conclusion. The parameters of lifestyle, occupational stress and mental workload are among the most important risk factors for the prevalence of work-related musculoskeletal disorders and related disabilities in flight security personnel. Therefore, corrective measures through controlling individual, physical and psychosocial risk factors are necessary.