Musculoskeletal disorders among workers in plastic manufacturing plants

Musculoskeletal symptoms among workers of the pulp and paper industry: the contribution of age, gender, body mass index and physical activity level

Objectives. This study aimed to investigate 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry, and assess the contribution of age, gender, body mass index (BMI) and physical activity (PA). Methods. The sample comprised 904 workers. Musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. χ2 tests assessed the association between musculoskeletal symptoms and age/gender/BMI/PA, and multivariate logistic regression models predicted the 12-month occurrence of symptoms in the five most prevalent regions. Results. The five most affected body regions were the lower back, shoulders, neck, knees and wrists/hands. Older workers presented more symptoms in all body regions, except dorsal; female gender was associated with neck symptoms (p = 0.001); overweight was associated with a higher prevalence of lower back (p = 0.01), knee (p = 0.017) and ankle/foot (p = 0.037) symptoms; and a moderate PA level was associated with thigh/hip symptoms (p = 0.006). Age was a significant predictor in all five most affected regions; gender was a significant predictor for shoulders, neck and wrists/hands; and BMI was a significant predictor for lower back symptoms. Conclusion. The 12-month and 7-day prevalence of musculoskeletal symptoms among workers of the pulp and paper industry is higher in the lower back, shoulders, neck, knees and wrists/hands.

The multidimensional construct of precarious work, the future of work, and workers' health

This essay aims to discuss the flexibilization of work, which has been accentuated during the COVID-19 pandemic, leading to an expansion of precarious work. Additionally, the essay seeks to explore theoretical models and methodological challenges for the study of precarious work, its dimensions, and its effects on workers' health. The health and economic crisis has heightened the social vulnerability of workers, introduced by the global flexibilization and the Brazilian Labor Reform. The setbacks materialize in precarious work, a multidimensional construct that encompasses the characteristics of this flexibilization in its three dimensions: (1) unstable work relationships resulting from insecure hiring, temporary contracts, involuntary part-time work, and outsourcing; (2) inadequate and unstable income; and (3) insufficient rights and protection, with reduced collective representation of workers, resulting in low power to react to degrading working conditions, lack of social security, and setbacks in regulatory support for labor safety. Repercussions of precarious work on health - work accidents, musculoskeletal and mental disorders - are evidenced in epidemiological studies, highlighting the theoretical and methodological limitations that still exist. The conclusion is that if the current bases of social protection and work insertion for workers are maintained, the future will see an expansion of precarious work. Thus, highlighting the causal relationships between precarious work and health is a contemporary challenge of the research and public policy agenda that is imposed upon society, with a focus on workers' health services.

Health Risks Associated with Informal Electronic Waste Recycling in Africa: A Systematic Review

Informal electronic waste (e-waste) recycling in Africa has become a major public health concern. This review examined studies that report on the association between e-waste exposure and adverse human health outcomes in Africa. The review was conducted following the updated version of the Preferred Items for Systematic Review and Meta-analysis (PRISMA 2020) statement checklist. We included papers that were original peer-reviewed epidemiological studies and conference papers, written in English, and reported on e-waste exposure among human populations and any health-related outcome in the context of Africa. Our results from the evaluation of 17 studies found an association between informal e-waste recycling methods and musculoskeletal disease (MSD) symptoms and physical injuries such as back pains, lacerations, eye problems, skin burns, and noise-induced hearing loss (NIHL). In addition, the generation and release of particulate matter (PM) of various sizes, and toxic and essential metals such as cadmium (Cd), lead (Pb), zinc (Zn), etc., during the recycling process are associated with adverse systemic intermediate health outcomes including cardiopulmonary function and DNA damage. This systematic review concludes that the methods used by e-waste recyclers in Africa expose them to increased risk of adverse health outcomes. However, there is a need for more rigorous research that moves past single pollutant analysis.

Prevalence and Work-Related Factors Associated with Lower Back Musculoskeletal Disorders in Female Shellfish Gatherers in Saubara, Bahia-Brazil

Lower back musculoskeletal disorders (MSDs) are an important public health problem and the leading cause of disability worldwide, but with yet unknown prevalence among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia-Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04–1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95% CI: 1.08–1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95% CI: 1.01–1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.

[Measuring work-related physical demand: factorial structure and reliability of items on posture, handling of loads and repetitiveness]

This study sought to analyze the dimensionality of a set of items that measure work-related physical demand, their internal consistency and their test-retest reliability. We carried out an exploratory factorial analysis of ten physical demand items in two populations, totaling 1,070 workers from the footwear industry and from urban cleaning, using weighted least squares means and adjusted variance with Promax oblique rotation. We measure internal consistency using Cronbach's alpha. The test-retest used a subsample of 121 workers, using quadratic weighted kappa. We identified two dimensions in urban cleaning and three in the footwear industry: (1) dynamic work with anomalous postures; (2) work that requires handling material; and (3) work that demands repetitive motions. Reliability was excellent for upright work posture, good for walking, moderate for lifting loads, squatting, rotated trunk and only regular for repetitive motions and arms above shoulders. The dimensions we identified through factorial analysis are compatible with the physical demands of urban cleaning and the footwear industry and, in general, showed good internal consistency. The 10 items' reliability was compatible with the literature, showing excellent to good reliability for general posture, moderate for specific body segment posture and regular for repetitiveness. Results reveal the specificity of each occupational group, which suggests a dimensionality of physical demand items, supporting their use for measuring physical exposure.

Demandas psicológicas, baixo apoio social e repetitividade: fatores ocupacionais associados à dor musculoesquelética de trabalhadores da indústria de calçados

Resumo Introdução: os distúrbios musculoesqueléticos (DME) constituem importante problema de saúde pública, podendo promover sofrimento físico e psíquico, incapacidades para o trabalho e alto custo social. Objetivo: descrever a população de trabalhadores da indústria de calçados, estimar a prevalência e identificar os fatores associados aos DME em membros superiores e pescoço. Método: estudo de corte transversal, com amostra aleatória estratificada de 446 trabalhadores. Variáveis sociodemográficas, de estilo de vida e ocupacionais (demandas físicas e psicossociais) foram levantadas e mensuradas por meio de instrumentos validados. Conduziu-se análise fatorial das variáveis de demandas físicas e por meio da regressão logística múltipla identificaram-se os fatores associados ao desfecho. Resultados: encontrou-se prevalência de DME, nos últimos 12 meses, de 47,3% em pescoço, ombro e dorso (extremidades proximais) e 37,4% em extremidades distais. DME em extremidades proximais se associaram a alta demanda psicológica, baixo apoio social do supervisor, tempo de trabalho na empresa ≥ 8 anos, sexo feminino. Em extremidades distais se associaram a alta demanda psicológica, baixo apoio social do supervisor, demandas físicas com repetitividade e sexo feminino. Conclusão: DME em membros superiores apresentam alta prevalência na indústria de calçados, com relevante papel das demandas psicossociais na sua ocorrência, cujo controle exige intervenção sobre as condições de trabalho.

[Musculoskeletal pain among bus drivers and fare collectors in the Metropolitan Region of Belo Horizonte, Brazil]

Musculoskeletal pain among professionals in the transport sector has been linked to working conditions. The scope of this study was to assess the prevalence of cervical musculoskeletal pain and its relation to pain in other areas (arms, hands and shoulders). The association between neck pain, related to pain in other areas or otherwise, was checked against occupational factors. A cross-sectional, descriptive and analytical study was conducted with 799 bus drivers and 708 fare collectors of the Metropolitan Region of Belo Horizonte, Brazil. The outcome was characterized according to the positive answer to the question about musculoskeletal pain in the anatomical areas studied. The prevalence of neck pain in the sample was highest at 16.3%, followed by pain in the shoulders 15.4%, arms 13.3% and hands 6.3%. The factors associated with musculoskeletal pain in the sample were being female, complaints of disability, perception of threat to safety, vibration, excessive or unbearable noise and sitting in an uncomfortable posture. The results provide clues to transformation of the workplace, thereby contributing to the enhancement of occupational health.

Artisanal fisherwomen/shellfish gatherers: analyzing the impact of upper limb functioning and disability on health-related quality of life

The aim is to analyze upper limb functioning and disability, and its association with health-related quality of life among artisanal fisherwomen from Bahia, Brazil. Cross-sectional epidemiological study was conducted with a sample of 209 fisherwomen. Structured questionnaires were used for socio-demographic and comorbidity information, as well as the instruments Disabilities of the Arm, Shoulder and Hand (DASH) and Short-Form Healthy Survey (SF-36) respectively, to evaluate the upper limbs and health-related quality of life. The results demonstrated that the presence of musculoskeletal disorders in the upper limbs directly affects the values of the DASH instrument and the SF-36v01 questionnaire scores, while also generating a negative correlation between the DASH and SF-36v01. The varying functioning abilities, pain and social aspects negatively affect upper limb function, and the daily activities and work of fisherwomen. The presence of chronic disease and the absence of intervention and rehabilitation for these professionals, that could produces, in a long-term, cases of disability.

Distúrbios musculoesqueléticos em extremidades superiores distais entre homens e mulheres: resultados de estudo na indústria

Resumo Objetivo: estudar a associação entre distúrbios musculoesqueléticos em extremidades superiores distais (DMED) e a variável sexo na indústria de plástico. Método: estudo transversal com 577 trabalhadores. O DMED foi definido pela presença de dor nos últimos doze meses, com duração maior que uma semana ou frequência mensal, causando restrição ao trabalho ou busca por assistência médica, ou gravidade ≥ 3 (de 0 a 5), em pelo menos uma das regiões: dedos, punhos, mãos, antebraços e cotovelos. Covariáveis de interesse foram demandas físicas e psicossociais no trabalho, variáveis sociodemográficas e de estilo de vida, condicionamento físico e trabalho doméstico. Regressão logística múltipla analisou interação estatística e confundimento. Resultados: a ocorrência de DMED foi maior entre as mulheres, de forma independente das demandas ocupacionais e extralaborais testadas. Condicionamento físico foi variável de interação e demandas psicossociais, confundidora. Homens que referiram bom condicionamento físico apresentaram prevalência menor do que aqueles com mau condicionamento. Nas mulheres, estar bem condicionada fisicamente foi insuficiente para alterar substancialmente sua alta morbidade musculoesquelética. Conclusão: diferenças na exposição ocupacional são insuficientes para explicar a maior morbidade em mulheres. É necessário considerar a diversidade entre os sexos, seja socialmente determinada ou relativa à natureza biomecânica do corpo, com diferentes respostas frente às demandas do trabalho.

Health-Related Quality of Life among Artisanal Fisherwomen/Shellfish Gatherers: Lower than the General Population

Quality of life is an indicator of how well one perceives that he/she is functioning physically and mentally. The aim of this paper is to determine the health-related quality of life (HRQOL) of artisanal fisherwomen/shellfish gatherers from the Saubara municipality in Bahia, Brazil in comparison to the general population. A structured questionnaire was administered to a sample of 209 artisanal fisherwomen selected at random. The HRQOL questionnaire, known as the 36-Item Short-Form Health Survey version 1 (SF-36v01), was also used, having been translated and verified cross-culturally for the Brazilian population. Sociodemographic, lifestyle and comorbidity information was also collected. Chronic diseases and indicators of musculoskeletal disorders (MSDs) were self-reported. The study population consisted primarily of individuals between 30 and 45 years of age (78%), of self-classified races black or brown (96.2%), with no more than an elementary school education (77%) and married (64.6%). In all the SF-36v01 dimensions, the values in the sample were lower than in the general population of Brazil, which was used as the reference population. In the "Physical Health" domain (Physical Functioning; Physical Role Limitations; Bodily Pain; General Health Perception) a tendency toward a lower health-related quality of life was observed among those who were older, had a lower education level, and had a prevalence of MSDs, hypertension or arthritis. The interference of health conditions linked to the fisherwomen's work activities may contribute to lower HRQOL in all analyzed aspects, in comparison to the general population. In light of these findings, public health policies must consider these informal workers who contribute greatly to Brazil's economy and food system.

Perfil epidemiológico dos casos de LER/DORT entre trabalhadores da indústria no Brasil no período de 2007 a 2013

Resumo Objetivo: descrever o perfil epidemiológico dos casos de lesões por esforço repetitivo (LER/DORT) entre trabalhadores da indústria no Brasil, notificados no período de 2007 a 2013. Métodos: estudo descritivo com dados secundários do Sistema de Informação de Agravos de Notificação (Sinan). Calcularam-se as proporções dos casos de LER/DORT de acordo com as variáveis do estudo, estimou-se o coeficiente de incidência (CI) das LER/DORT, total e por sexo, e calculou-se a variação proporcional percentual (VPP) no período estudado. Resultados: entre 2007 e 2013 foram notificados 17.537 casos de LER/DORT na Indústria, com um CI total de 7,4/100 mil trabalhadores em 2007 e de 16,7/100 mil em 2013, com uma VPP no período de 126%. Os três principais diagnósticos foram: lesões no ombro (29,3%), transtornos de sinóvias e tendões (14,6%) e dorsalgias (14%). Conclusão: diante do aumento das notificações, observa-se a importância do registro e análise dos casos para o planejamento e instituição de medidas de prevenção e atenção integral à saúde dos trabalhadores de acordo com as especificidades da atividade econômica desenvolvida por eles. Também é fundamental a discussão da responsabilidade das empresas e empregadores sobre o adoecimento dos trabalhadores.

Heavy physical work and low back pain: the reality in urban cleaning

Low back pain (LBP) is a major public health issue. There is lack of research on this disorder affecting urban cleaning workers. A cross-sectional study was conducted to describe the prevalence of LBP, occupational and extra-occupational characteristics, as well as associated factors in these workers. A census was performed with 624 workers in Salvador, Brazil, using a questionnaire administered by an interviewer in 2010. Cases of LBP were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or with monthly minimum frequency, which led to restrictions at work or to seeking medical attention, or in cases when respondents had a severity score > 3 on a numerical scale from 0 to 5. Physical demands at work were measured on a numerical 6-point scale with 14 variables. Psychosocial demands were measured using the Job Content Questionnaire. Sociodemographic factors, lifestyle habits and domestic work were evaluated. Multiple logistic regression (LR) was used to identify factors associated with LBP, for which the prevalence was 37.0%. Among them, 62.8% of workers felt pain in the last 7 days. LBP was associated with longer working hours, flexion and trunk rotation, psychosocial demands, working directly in collection and low schooling. Dynamic work (walking, running) served as a protective factor. It was concluded that many workers develop their activity at the presence of pain. The results emphasize the need for preventive measures through multifactorial approach encompassing adaptations in physical environment and changes in work organization.

[How do physical fitness and heavy physical work interact in the occurrence of musculoskeletal disorders?]

A cross-sectional study investigated the association between self-reported physical fitness and musculoskeletal disorders in the neck, shoulder, or upper back among workers in 14 plastics factories in Salvador, Bahia State, Brazil. Physical fitness was assessed on a scale from 0 to 5. Cases were defined as self-reported pain in the previous 12 months, lasting more than a week or having monthly minimum frequency, with restrictions at work or seeking medical care, or where respondents' severity was greater than 2 (on a scale from 0 to 5). Logistic regression was performed to investigate statistical interaction between physical fitness and physical demands from work in the occurrence of musculoskeletal disorders. Precarious physical fitness resulted in 3.19 times greater odds of musculoskeletal disorders among workers exposed to light physical demands on the job. Among workers exposed to heavy physical demands, physical fitness failed to protect against musculoskeletal disorders. Heavy physical work was always associated with high prevalence of musculoskeletal disorders. Despite the importance of physical fitness, physical exercise programs should not be used to replace improvements in working conditions.

[Cumulative annual incidence of disabling work-related musculoskeletal disorders in an urban area of Brazil]

This study focused on the annual cumulative incidence (ACI) of disabling work-related musculoskeletal disorders affecting the neck and/or upper limbs (ULMSD) among workers covered by the National Social Insurance System in the city of Salvador, Bahia State, Brazil. Cases were workers who received disability compensation benefits when unable to work due to ULMSD, during the year 2008. The data were obtained from the administrative systems of the National Social Insurance Institute and Ministry of Labor and Employment. ACI was 15 per 10,000 workers. Increased ACI of ULMSD was associated with female gender, lower income, and work in financial activities or manufacturing. Women earning the minimum wage (US$ 64.00 per month) or less had the highest ACI of ULMSD (123 per 10,000), suggesting inequalities in the occurrence of these disorders. The study indicates the need to prioritize preventive actions focusing on ergonomics and work organization, early diagnosis, treatment, and rehabilitation.

Prevalence of musculoskeletal disorders among plastics industry workers

The prevalence of musculoskeletal disorders among workers in the plastics industry in Salvador, Bahia State, Brazil was estimated. Cases were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or having monthly minimum frequency, which had given rise to restrictions at work or to seeking medical attention, or where respondents had a severity score greater than or equal to 3 (on a numerical scale of 0 to 5). A stratified proportional random sample of 577 workers was studied. The prevalence of musculoskeletal disorders, considering of all body segments, was 50.1%. The prevalence of musculoskeletal disorders was higher among women than among men at distal upper extremities (34.6% and 11.6% respectively) and also in the region of the neck, shoulder or upper part of the back (27.4% and 17.6% respectively). There was no difference between genders for the prevalence of lower back pain (21.2% and 21.4% respectively); 65% of cases in this region had reports of pain in the previous seven days. Due to the importance and prevalence of musculoskeletal disorders, it is necessary that their measurement in epidemiological studies be done properly.