Knee pain and driving duration: a secondary analysis of the Taxi Drivers' Health Study

Musculoskeletal disorders among taxi drivers: a systematic review and meta-analysis

INTRODUCTION

Taxi drivers, as professional drivers, encounter numerous ergonomic risk factors related to musculoskeletal disorders (MSDs) because of the demands of their jobs. This study conducted as a systematic review and meta-analysis aimed to explore the prevalence of MSDs among taxi drivers.

MATERIALS AND METHODS

The present study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and its protocol was registered in the international prospective register of systematic review (PROSPERO) under the code CRD42024509258. Searches were carried out using various databases, such as PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, with no time restrictions until February 7th, 2024. A random effects model was utilized for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Lastly, data analysis was conducted using STATA software (version 14).

RESULTS

After the initial search, 1606 articles were extracted from the reviewed sources. Following screening, study selection, and quality evaluation, a total of 11 studies were chosen for meta-analysis, involving 5277 taxi drivers. Based on the results of the meta-analysis, the highest prevalence of MSDs among taxi drivers was related to the lower back region (53.87% (95% CI:40.89-66.84, I2= 98.7%, P < 0.001)). Additionally, the prevalence rates of MSDs in different body regions, such as the neck (38.15%), shoulder (34.97%), upper back (18.30%), and knee (14.10%), were also reported.

CONCLUSION

Based on the findings of this study, the prevalence of MSDs among taxi drivers is relatively high, and specific risk factors may contribute to the development of these disorders. Therefore, to prevent the occurrence of MSDs among taxi drivers, it is advisable to implement essential measures concerning the development of training programs, ergonomic interventions, and evaluation of the work environment.

Prevalence of work-related musculoskeletal disorders (WRMSDs) and its association with modifiable risk factors in metropolitan bus transit drivers: A cross-sectional comparison

Background

Bus drivers are one of the top three occupations with the highest prevalence of work-related musculoskeletal disorders (WRMSDs). The present study aimed to determine the pattern and prevalence of WRMSD among metropolitan bus transit drivers, whose job profiles differ from traditional long-distance bus drivers, and to explore the effect of modifiable lifestyle-related risk factors.

Materials and Methods

In this cross-sectional study, consenting 254 metropolitan transit bus drivers (with at least five years of job duration) and 73 age-matched indoor desk job workers (administration staff of the same department) as a comparison group enrolled. Sociodemographic and occupational profile were collected on a semi-closed questionnaire. A modified Nordic questionnaire was used to determine musculoskeletal problems. Anthropometric measurement and haematocrit estimation were performed with standard techniques. All statistical analyses including logistic regression were performed with SPSS 26.0.

Results

The prevalence of WRMSDs among bus drivers was twice higher than administration staff (49.2% v/s 28.8%). Drivers experienced significantly higher pain for the lower back (36.6% v/s 11%), knee (29.5% v/s 15.1%), and hip (7.5% v/s 1.4%) in comparison with administration staff. Study reported age, tobacco usage, body mass index (BMI) and job profile of drivers (compared to administration staff) as significant predictors of WRMSDs.

Conclusion

WRMSDs were significantly higher among metropolitan bus transit drivers in comparison with administrative staff. Furthermore, WRMSDs are strongly associated with tobacco use and BMI. These modifiable risk factors may be the targets for preventive strategies to reduce the burden of WRMSDs among bus drivers.

Causal Relationship Between the Risk Factors and Work-Related Musculoskeletal Disorders Among Professional Drivers: A Systematic Review

OBJECTIVE

This review evaluates the evidence on the strength of causal relationship between categories of risk factors (RFs) and work-related musculoskeletal disorders (WRMSDs) among professional drivers.

BACKGROUND

A compilation of evidence on the causal relationship between RFs and WRMSDs among professional drivers is lacking.

METHODS

A systematic search of the literature was conducted in major electronic data bases that include Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, and Web of Science. The methodological quality of the studies was assessed and scored. A descriptive analysis on the categories of RFs associated with WRMSDs was conducted. The Bradford-Hill causation criteria and evidence interpretation tool were used to evaluate the causal relationship between RFs and WRMSDs in professional drivers.

RESULTS

Among the 54 studies reviewed, a strong evidence suggests a causal relationship between RFs such as whole-body vibration, awkward postures, lifting tasks, manual material handling, job stress, job demand, and previous pain episodes with WRMSDs. Moderate evidence was observed on RFs such as uncomfortable seat and low job satisfaction. The evidence on causal relationship between RFs such as years of professional driving, driving duration, and individual characteristics such as age and body mass index was inconclusive.

CONCLUSION

There is strong to moderate evidence on the causal relationship between the physical and psychosocial RFs and WRMSDs among professional drivers.

APPLICATION

Potential application of this review highlights evidence to occupational health practitioners, policy makers, and stakeholders on the strength of causal relationship between RFs and WRMSDs among professional drivers.

Aches and Pains: How Do They Affect Transitions From Driving?

Background and Objectives

Chronic pain, which affects more than 1 in 4 middle-aged and older adults, can have profound implications for everyday behaviors like driving. The literature examining it, however, is relatively small and is limited by its reliance on patient populations and its lack of attention to some driving-related behaviors and self-assessments that may signal the start of a transition from driving.

Research Design and Methods

We address these issues using data from an online survey of Floridians aged 50 and older that was conducted between December 2020 and April 2021 and funded by the Florida Department of Transportation (n = 3,832). We ran multivariate regression analyses to examine the association between pain's interference with driving and 5 driving-related outcomes: self-rated driving ability, driving frequency, self-regulated driving, perceived nearness of driving retirement, and planning for driving retirement.

Results

Results indicate that experiencing more pain that interferes with driving is associated with worse self-rated driving ability, more frequent self-regulated driving, and greater planning for driving retirement. It is not associated with driving frequency or with anticipating that driving retirement will occur in the next 5 years.

Discussion and Implications

These findings indicate that greater pain may hasten the transition from driving, along with planning for it. These patterns suggest that pain may increase people's risk of isolation and other negative outcomes that can follow driving retirement; however, pain's effect on planning may reduce these risks. By focusing on transitioning from driving, our study reveals a largely overlooked benefit of reducing pain-It could extend people's years behind the wheel.

Prevalence of musculoskeletal disorders among taxi drivers in Yaoundé, Cameroon: preventive effect of physical activity

Background

Musculoskeletal Disorders (MSDs) are very common conditions in the workplace. Among professional drivers, there would be an increased risk of developing these disorders. Identifying the associated factors would allow us to better devise effective prevention strategies. Our objective was to determine the prevalence of MSDs among taxi drivers in the city of Yaoundé and to search for associated factors, mainly the level of physical activity.

Methods

We conducted an analytical cross-sectional study of 151 adult male professional taxi drivers. We used a non-probabilistic consecutive and non-exhaustive sampling method. Sociodemographic, anthropometric and occupational data were collected. MSDs over the past 12 months were assessed using the Nordic Questionnaire and physical activity level was determined by the World Health Organization (WHO) Global Physical Activity Questionnaire (GPAQ). Univariate logistic regression models, followed by a multivariate logistic regression, were used to determine factors associated with the presence of MSDs.

Results

The overall prevalence of MSDs was 86.8% (95% CI 80.8 – 91.4); the most affected areas were mainly the lower back (72.8%) the neck (42.4%), and the knees (29.1%). Job dissatisfaction was associated with MSDs (OR = 2.1 95%CI = 1.1–3.9). Most taxi drivers (62.9%) had a low physical activity level and no association was found between the physical activity level and MSDs.

Conclusions

MSDs are common ailments among taxi drivers in Yaoundé (Cameroon). There is a need to think about how to address job dissatisfaction and better identify other associated factors in order to define good prevention strategies.

Self-Reported Musculoskeletal Disorder Symptoms among Bus Drivers in the Taipei Metropolitan Area

Bus driving is considered a highly stressful and unhealthy occupation, even among sedentary jobs, because of the particular task characteristics. This study used the Nordic Musculoskeletal Questionnaire (NMQ) to interview bus drivers and determine the risk factors for musculoskeletal discomfort. The NMQ was distributed to 152 bus drivers in the Taipei metropolitan area (Taiwan) and the valid data of 145 respondents were analyzed. The survey revealed that the overall prevalence of musculoskeletal disorder symptoms in any body part during the preceding year was 78.3%, and the body parts for which with the prevalence of discomfort was highest were the neck (46.9%), right shoulder (40.0%), lower back (37.2%), and left shoulder (33.8%). Stress and an uncomfortable seat may contribute to neck, shoulder, and lower back discomfort. Stretching between trips may help to reduce neck and shoulder discomfort. When comparing our results with those of similar studies, we discovered that the prevalence of symptoms and detailed risk factors vary by country and region. On this basis, we believe that local investigations emphasizing specific task arrangements and characteristics are needed to address the problem of musculoskeletal disorders in bus drivers.

Assessment of semen quality of taxi drivers exposed to whole body vibration

Whole body vibration (WBV) is a recognized occupational hazard for many workers such as drivers and operators of heavy and light machinery and exposure to it is accompanied by physical and mental repercussions. Only the limited studies have been done on the effects of vibration exposure on reproductive indices, however vibration exposure has been indicated as being a hazardous agents with the potential of being able to directly affect the reproductive system. Considering the importance of infertility, the present study was conducted with the aim of investigating semen quality among taxi drivers in Tehran and determine the effect of exposure to WBV on sperm parameters. The study population consisted of 70 taxi drivers and 70 office employee who attended infertility clinics for diagnostic purposes in the past year. The participants had to meet the entry criteria of the study while also being willing to recruit. Data was collected in the form of demographic questionnaires and general health questionnaires as well as sperm analysis conducted in an infertility clinic according to standard laboratory guidelines. The 8-hour time-weighted average (TWA) exposure to of WBV in automobile was measured as per ISO 2631-1. The TWA exposure to WBV among the taxi drivers and office employees were 0.697 ± 0.13 m/s2 and 0.068 ± 0.09 m/s2 respectively (P < 0.05). A statistically significant difference in total sperm count, progressive motility, non-progressive motility and total motility was observed between the taxi drivers and the office employees (P < 0.05). According to the univariate analysis of variance, exposure to WBV had negative effect on sperm concentration, progressive motility and normal morphology (P > 0.05); moreover exposure to WBV resulted in the larger effect size (B) on sperm parameters than the demographic variables (P > 0.05). Being taxi drivers increase the chance of the decreased semen quality (P > 0.05). It is difficult to draw definitive conclusions regarding the effects of WBV while intervening factors exist, such as psychological stressors, quality of sleep, background issues as well as environmental factors such as chemical pollutants (heavy metals) or ergonomic factors (body posture and working while sitting down).

Factors Affecting the Deterioration of the Physical Health Status of Taxi Drivers by Age Group

With the rapidly aging population, taxi drivers are aging at a fast pace, and competition in the taxi industry is intensifying due to the emergence of various transportation platforms. A descriptive secondary data study was conducted (on a total of 936 subjects) to determine the factors affecting the deterioration of taxi drivers’ physical health status (PHS) according to their age group. The increased incidence of chronic diseases and cognitive decline among taxi drivers aged 55−64 years had the greatest influence on the deterioration of their PHS. Driver obesity was more likely to be related to deterioration of the PHS in the drivers aged 55−64 years (OR: 2.459, <0.001) and 35−54 years (OR: 2.133, <0.001). Among the financial factors, a driver’s income and their number of dependent family members were correlated with the deterioration of the PHS for drivers aged 55 years or over. Therefore, chronic diseases, obesity and cognitive decline were related with deterioration of the physical health status. This suggests that attention should be paid to healthcare policies not only for the elderly aged over 65 years but also those aged 50 to 64 years, i.e., middle-aged people at the beginning of the transition to old age.

Osteomuscular symptoms on motorcycles in the city of Rio Branco, Acre, Brazil, West Amazon

ABSTRACT

Musculoskeletal disorders gradually affect workers in different parts of the world, compromising their occupational health and quality of life. Professionals exposed to these symptoms include the motorcycle taxi driver, whose pain is due to the overuse of the musculoskeletal system and little time to recover it.To identify the prevalence of musculoskeletal symptoms in motorcycle taxi drivers in the city of Rio Branco, Acre, Brazil, West Amazon.Cross-sectional study, involving 296 motorcycle taxi drivers in the city of Rio Branco-Acre, Brazil, male, from December 2016 to February 2017. The Nordic Musculoskeletal Questionnaire was used to collect information related to symptoms (pain, discomfort, or numbness) in the last 7 days of work. For the exclusion criteria were, being female; not reside outside the city of Rio Branco, Acre; having less than 3 months of work activity; not be carrying out their work activities at the time of application of the protocol; be limited by clinical or physical issues at the time of application of the protocol. The data obtained in the questionnaire were entered into the Epidata program (Epidata Association, Odense, Denmark) and then transferred to the STATA 10 statistical program (Stata Corp., College Station), for categorization and statistical analysis.The study population is over 36 years old; most reported having a partner and a higher education level. The average daily working hours of the participants were 12 hours, with the majority working over 12 hours daily. Most of the epidemiological variables factors were associated with musculoskeletal pain when the prevalence and prevalence ratio analyzes were performed. Higher prevalence of musculoskeletal symptoms in the lumbar region is with 17.9%. In the lower limbs, the most affected joint was the ankle (5.7%), followed by the hip (5.07%) and knee (5.07%), respectively. Insomnia was present in 55.35% and self-reported headache in 49.4% of participants.The musculoskeletal disorders generated by the daily service of motorcycle taxi drivers are directly affecting the quality of life of these professionals.

Health problems among Swedish ambulance personnel: long-term risks compared to other professions in Sweden - a longitudinal register study

Objectives. This study aimed to investigate whether Swedish ambulance personnel differ in the extent of suffering from health problems compared to other occupational groups. Methods. Two cohorts of ambulance personnel from 2001 and 2008, with 1778 and 2753 individuals, respectively, were followed regarding assignment of diagnostic coding (International Classification of Diseases codes) until 2016. These two cohorts represent all who were employed as ambulance personnel by public employers during these years. Two comparison groups were added: other healthcare workers and other professions. All data were retrieved from national registers. The χ² test was were used for statistical calculation. Results. Swedish ambulance personnel are at a significantly higher risk of being affected by 'Paroxysmal tachycardia, atrial fibrillation and flutter, other cardiac arrhythmias', by 'Other intervertebral disc disorders' and by 'Arthropathies', when compared to both comparison groups in both cohorts. Almost similar results were seen for 'Gonarthrosis' and for 'Dorsopathies'. Conclusions. Swedish ambulance personnel run the risk of being affected by certain diseases and injuries to a greater extent compared to other professions.

Taxi drivers and modifiable health behaviors: Is stress associated?

BACKGROUND

Taxi drivers, an immigrant male population, may exhibit poor health behaviors and increased health risks.

OBJECTIVE

The current study examined stress and demographics as predictors of physical activity (PA), nutrition, sleep, and smoking, and the co-occurrence of these behaviors among taxi drivers.

METHODS

A cross-sectional needs assessment was conducted in New York City. The sample (n = 252) was comprised of male taxi drivers, 98%of whom were born outside of the U.S., with the majority from South Asian countries (62%), and 45 years old on average (SD = 11).

RESULTS

We found low rates of fruit/vegetable consumption and PA. Rates of stress, PA, and smoking varied by demographic factors. Stress was positively associated with sleep disturbances and negatively associated with smoking. Aside from a relationship between sugar consumption and smoking, other health behaviors were not associated.

CONCLUSIONS

While stress appears to impact some indicators of modifiable health behaviors, its lack of relationship with others points to more persistent health issues. Demographic differences found for PA and smoking also point to groups that may especially benefit from interventions. These findings suggest the need for targeted health interventions for taxi drivers in large metropolitan cities.

Predictors of Health Insurance, Life Insurance, and Retirement Savings Among NYC's Immigrant Taxi and For-Hire Vehicle Drivers

Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19's devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers' health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits, < 50% understood how to use them. Drivers felt primary care coverage to be most important followed by other health-related coverage, retirement benefits, and life insurance. Results reveal compelling addressable gaps in insurance and benefits coverage and the need to implement accessible financial literacy with navigation and advising services and programs.

The impact of working conditions on the health of taxi drivers in an urban metropolis

Purpose

This descriptive qualitative study explores how working conditions impact the health of taxi drivers in Toronto, Canada.

Design/methodology/approach

Drivers were recruited between September 2016 and March 2017. A total of 14 semi-structured qualitative interviews and one focus group (n = 11) were conducted. Transcripts were analyzed inductively through a socioecological lens.

Findings

The findings of this study are as follows: drivers acknowledged that job precariousness (represented by unstable employment, long hours and low wages) and challenging workplace conditions (sitting all day and limited breaks) contribute to poor physical/mental health. Also, these conditions undermine opportunities to engage in health-protective behaviors (healthy eating, regularly exercising and taking breaks). Drivers do not receive health-enabling reinforcements from religious/cultural networks, colleagues or their taxi brokerage. Drivers do seek support from their primary care providers and family for their physical health but remain discreet about their mental health.

Research limitations/implications

As this study relied on a convenience sample, the sample did not represent all Toronto taxi drivers. All interviews were completed in English and all drivers were male, thus limiting commentary on other experiences and any gender differences in health management approaches among drivers.

Practical implications

Given the global ubiquity of taxi driving and an evolving workplace environment characterized by growing competition, findings are generalizable across settings and may resonate with other precarious professions, including long-haul truck operators and Uber/Lyft drivers. Findings also expose areas for targeted intervention outside the workplace setting.

Originality/value

Health management among taxi drivers is understudied. A fulsome, socioecological understanding of how working conditions (both within and outside the workplace) impact their health is essential in developing targeted interventions to improve health outcomes.

Discrimination as a social determinant of stress and health among New York City taxi drivers

Discrimination is associated with poorer mental and physical health outcomes. Taxi drivers have a higher risk of exposure to discrimination and higher rates of chronic conditions. A cross-sectional needs assessment was conducted with a multilingual group of 535 male taxi drivers in New York City. Drivers reporting higher discrimination were more likely to have higher perceived stress and were more likely to have anxiety/depression and chronic pain, adjusting for confounders. Workplace-based interventions designed to help drivers cope with discrimination, stress, and chronic health conditions, interventions to educate the taxi-riding public, and greater attention to these issues from administrative agencies are warranted.

Need of the Hour

Belonging to Millennial generation, Generation Z and Generation Alpha we have lot of changes in livelihood and lifestyle. From an orthopaedic surgeons perspective, we notice a change in diseases and disorders specific to this millennial generation. Lot of changes in lifestyle of people in past 20 years have caused newer challenges in the way doctors have been treating their patients. I hereby present a sneak peek into some of the generation specific diseases and disorders due to rampant explosion of technology in past twenty-five years. From usage of mobile phones to computers and the way we commute every day. The way we sit, the way we sleep and the way some of the young generation earns livelihood has many disorders related to posture, stress, overuse and work environment.

Prevalence of musculoskeletal pain among professional drivers: A systematic review

OBJECTIVES

Professional drivers are at high risk of developing musculoskeletal pain (MSP) due to risk factors such as prolonged sitting, whole body vibration, awkward posture, and repetitive actions. This review investigates the reported prevalence of MSP among professional drivers.

METHODS

An electronic search of Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, PubMed, and Web of Science from 1990 to July 2019 was performed. Methodological quality of studies was assessed using three quality assessment tools for cross-sectional, case-control, and prospective cohort studies. The prevalence of MSP was reported using descriptive analysis.

RESULTS

A total of 56 studies conducted in 23 different countries across a total of 14 types of occupational transport were reviewed. Data of a total pooled population of 18 882 professional drivers were analyzed for MSP. The prevalence of MSP ranged between 43.1% and 93%. The low back was the most frequently reported body region for MSP with a meta-prevalence rate of 53% (N = 9998). Neck, shoulder, and upper back were the other common regions with high prevalence.

CONCLUSION

There is a high prevalence of MSP in professional drivers and low back was the most frequently reported body region, followed by neck, upper back, shoulder, knee, hip/thigh, wrist, ankle, and elbow. MSP is complicated in nature and therefore in-depth exploration of causal relationships between MSP and risk factors is necessary so that appropriate healthcare programs can be initiated to prevent and treat MSP effectively.

Occupational health risks and intervention strategies for US taxi drivers

Research has shown that taxi drivers are at risk for numerous health concerns, such as low back and leg pain, linked to their highly sedentary occupation, long work hours and stressors related to the job (e.g. low income, safety threats). The goal of this study was to explore occupational health risks and opportunities for health interventions with taxi drivers using community-based participatory research (CBPR) methods. A mixed methods approach included first a convenience sample of 19 East African taxi drivers participating in focus group discussions. Second, a convenience sample of 75 current taxi drivers (M age = 45.7 years) and 25 non-driver comparison participants (M age = 40.3 years) were recruited to complete a structured self-reported questionnaire and objective measures of health. Health education was provided alongside the research to address common health concerns and to ensure mutual benefit and an action orientation. The focus groups described numerous health concerns that drivers attributed to their occupation, including chronic pain, sleep deprivation, cardiovascular disease, diabetes, kidney disease and eye problems, as the most common. Participants offered ideas for health interventions that include workplace reform and driver education. Quantitative data indicate that 44% of drivers reported their health as 'fair' or 'poor'. Drivers were more likely to report musculoskeletal pain, less sleep, more fatigue and less physical activity as compared to non-drivers. The majority of drivers reported financial and job dissatisfaction. The research provides data to inform targeted health interventions that support the health and safety of taxi drivers.

Knee pain in nursing home workers after implementation of a safe resident handling program

PURPOSE

Approximately 25-30% of nursing personnel experience knee pain (KP). We sought to identify physical and psychosocial work exposures, and personal factors related to prevalent, incident, and persistent KP 5-8 years after safe resident handing program (SRHP) implementation in nursing homes.

METHODS

Health and exposure information was obtained from worker surveys 5-6 years ("F5") and 7-8 years ("F6") post-SRHP implementation. Prevalent KP correlates were examined at F5; persistent and incident KP predictors were analyzed at F6, utilizing robust Poisson multivariable regression.

RESULTS

F5 KP prevalence (19.7%) was associated with combined physical exposures, and with either high job strain or low social support, in separate models. Two-year persistent KP was similarly associated with these psychosocial exposures. Being overweight was associated with KP in all analyses.

CONCLUSIONS

The SRHP program did not eliminate knee physical loading, which should be reduced to prevent nursing home worker KP. Workplace psychosocial exposures (high job strain, low social support) also appeared germane.

Discrimination and Health Among Taxi Drivers in New York and Toronto

Immigrant taxi drivers in metropolitan cities are exposed to experiences of discrimination and occupation-based health risks. Given the structural differences in health care systems in the United States and Canada, we investigated the differences in reports of discrimination, health conditions and concern about health conditions between taxi drivers in New York City and Toronto, Ontario. Participants were recruited for a taxi driver Needs Assessment Survey as part of a Taxi Network needs assessment project using a street side convenience sampling technique in New York City and Toronto. The matched sample contained 33 drivers from Toronto and 33 drivers from NYC. All Toronto drivers in our sample reported having health insurance while over a quarter of NYC drivers did not have health insurance. Toronto drivers reported greater everyday and workplace discrimination. Drivers in both cities experienced higher rates than average, and reported concern about, major health conditions. We also found preliminary evidence suggesting a relationship between experiencing discrimination and reporting chronic pain. Our findings suggest the need for future research to more closely examine the associations between discrimination and health among the taxi driver population.

Sintomas osteomusculares em taxistas de Rio Branco, Acre: prevalência e fatores associados

OBJETIVO: Analisar a prevalência e fatores associados dos sintomas osteomusculares em taxistas de Rio Branco, Acre.MÉTODOS: Estudo transversal de base populacional com 321 taxistas. Utilizou-se um questionário fechado sobre sintomas osteomusculares e variáveis associadas.RESULTADOS: A prevalência de sintomas nos últimos 12 meses foi de 72,0%. As partes do corpo com maiores prevalências foram: lombar (49,5%) e cervical (29,9%). A autoavaliação insatisfatória de saúde mostrou-se associada aos sintomas osteomusculares em todas as regiões corporais. A situação de morar com mais de 4 pessoas na casa esteve associado aos sintomas nas regiões do tronco superior, membros superiores e inferiores. Conviver com companheira apresentou associação com sintomas em tronco superior e inferior. Foi evidenciado tendência linear de aumento do IMC com os sintomas no tronco superior e membros inferiores. A condição de ter 5 anos ou menos de estudo e ter 2 ou mais filhos mostraram associação com os sintomas nos tronco inferior e membros superiores, respectivamente.CONCLUSÕES: As alarmantes prevalências de sintomas osteomusculares em taxistas sugerem a necessidade de programas voltados à saúde ocupacional destes trabalhadores.

Predictors of Work-Related Musculoskeletal Disorders among Commercial Minibus Drivers in Accra Metropolis, Ghana

Background. The objective of this study is to determine the prevalence and predictors of work-related musculoskeletal disorders (WMSDs) among a sample of commercial minibus drivers in the Accra Metropolis of Ghana. Methods. The participating drivers (n=148) were recruited from various lorry terminals and assessed by using a semistructured questionnaire that included the Nordic Musculoskeletal Questionnaire (NMQ). Results. Of the 148 drivers, 116 (78.4%) reported having WMSDs during the previous 12 months. The prevalence of the various WMSD domains was low back pain (58.8%), neck pain (25%), upper back pain (22.3%), shoulder pain (18.2%), knee pain (14.9%), ankle pain (9.5%), wrist pain (7.4%), elbow pain (4.7%), and hip/thigh pain (2.7%). Multiple logistic regression analysis adjusted for possible confounders showed that less physical activity (OR = 4.9; 95% CI = 1.5–16.5; P=0.010), driving more than 12 hours per day (OR = 2.9; 95% CI = 1.1–7.8; P=0.037), and driving at least 5 days per week (OR = 3.7; 95% CI = 1.4–9.4; P=0.007) were significantly associated with WMSDs among this cohort of drivers. Conclusion. These modifiable factors may be targets for preventive strategies to reduce the incidence of WMSDs among occupational minibus drivers in Ghana.

Occupational and Personal Determinants of Musculoskeletal Disorders among Urban Taxi Drivers in Ghana

Background. There is a lack of epidemiological data on musculoskeletal disorders (MSDs) among occupational drivers in Ghana. The present study seeks to estimate the prevalence, body distribution, and occupational and personal determinants of MSDs in a sample of taxi drivers in the Accra Metropolis of Ghana. Methods. A total of 210 participants were enrolled in this cross-sectional study. All the participants were evaluated by using a semistructured questionnaire and the standardized Nordic Musculoskeletal Disorder Questionnaire. Results. The estimated prevalence of MSDs was 70.5%. The prevalence of the various MSD domains was as follows: lower back pain (34.3%), upper back pain (16.7%), neck pain (15.2%), shoulder pain (11.0%), knee pain (10.0%), hip/thigh pain (2.9%), elbow pain (4.8%), ankle/feet pain (2.4%), and wrist/hand pain (1.9%). Multiple logistic regression analysis of the data showed that participants who were employee drivers, drove taxi more than 12 hours per day or at least 5 days per week, perceived their job as stressful, and were dissatisfied with their job were at a greater risk of developing MSDs. Conclusions. These findings call for preventive strategies and safety guidelines in order to reduce the incidence of MSDs among urban taxi drivers in Ghana.

Study the epidemiological profile of taxi drivers in the background of occupational environment, stress and personality characteristics

Background:

Work hazards have been a major cause of concern in driving industry especially in taxi drivers. This study integrates the various factors that influence physical and emotional well-being of taxi drivers into the theoretical model that shows that the work environment, stress and personality characteristics directly influence taxi drivers’ health.

Objective:

The aim of the following study is to study the relative and combined influence of work environment, personality characteristics and stress on the health of taxi drivers.

Meterials and Methods:

The present study is cross-sectional (descriptive) study taxi drivers in Mumbai. They are selected using multistage random sampling method. Calculated sample size is 508. Data produced after the survey is analyzed using IBM SPSS 16.0 software.

Results:

Nearly 65% of taxi drivers belonged to middle-age group of 21-40 years of age. Majority (59%) of taxi drivers belonged to the lower upper socio-economic class. 70% of taxi drivers worked for more than 8 h daily. 63% gave the history of one or more addictions. 52% taxi drivers had type B1 personality, only 6% had stress prone and aggressive type A1 personality. Traffic congestion (67.1%) was reported as the leading stressor followed by narrow bottle neck roads (43%), too many speed breakers (41%), rude gestures and behavior by other drivers (42%) and bad weather (36%). Nearly 86% taxi drivers had one or more symptoms of morbidities. Gastrointestinal symptoms predominated followed by musculoskeletal symptoms and depression.

Conclusion:

Socio-demographic attributes, work environment, stress and personality significantly influence physical and psychological morbidities in taxi drivers.

Driving to better health: cancer and cardiovascular risk assessment among taxi cab operators in Chicago

While a number of investigations of the health of taxi cab drivers have been conducted in Europe, Asia, and Africa, virtually none have been conducted in the United States. We undertook a survey of taxi cab operators in the Chicago area to understand better their health status and health promotion practices. The survey was completed by a convenience sample of 751 Chicago taxi drivers. Taxi drivers had low rates of insurance coverage, fruit and vegetable consumption, and physical activity compared with the general Chicago population. Participation in cancer screening tests was also lower for this group. A high proportion of taxi drivers are immigrants. They tend to be highly educated and report a readiness to engage in more health-promoting behaviors. Further research is needed to develop a targeted intervention for this population.

Health and safety strategies of urban taxi drivers

This study describes health and safety concerns and self-care strategies of San Francisco taxi drivers. Focus groups and a written cross-sectional survey were done in a convenience sample of taxi drivers working in San Francisco. Sessions were audiotaped, transcribed in English, and independently coded to identify major health and safety themes, using thematic content analysis. Strategies to manage health and safety issues are the focus of this analysis. Five focus groups were held in 2009 with 36 participants. Major health and safety themes included stress, body pain, danger, vulnerable employment status, and concerns related to unhealthy working conditions. Self-care strategies included diffusion/decompression to manage stress, maintaining a positive attitude, maintaining power and control, and practicing proactive self-care. Creative self-care strategies were described by taxi drivers to keep healthy and safe at work. These data will inform future self-care interventions to reduce health and safety risks of taxi driving.

Burden of work-related knee disorders in Washington State, 1999 to 2007

OBJECTIVE

To describe the burden of knee work-related musculoskeletal disorders (WMSDs).

METHODS

Knee WMSDs were identified using Washington State Fund workers' compensation data from 1999 to 2007 and analyzed by cost, industry, occupation, and claims incidence rates.

RESULTS

Knee WMSDs accounted for 7% of WMSD claims and 10% of WMSD costs. The rate of decline in claims incidence rates for knee WMSDs was similar to the rate of decline for all other WMSDs. Industries at highest risk for knee WMSDs included construction and building contractors. Occupations of concern included carpenters and truck drivers in men and nursing aides and housekeepers in women.

CONCLUSIONS

Between 1999 and 2007, Washington State Fund knee WMSDs were widespread and associated with a large cost. Identification of specific occupational knee WMSD risk factors in high-risk industries is needed to guide prevention efforts.

Elevated serum liver enzymes and fatty liver changes associated with long driving among taxi drivers

BACKGROUND

Previous studies suggested increased morbidities and mortalities of liver diseases in drivers.

METHODS

To examine whether driving (monthly driving distance; tenure) is associated with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), or chronic fatty liver (FL) changes, we performed a cross-sectional, secondary analysis of the Taxi Drivers' Health Study (n = 1,355), adjusting for clinical, demographic, and lifestyle factors.

RESULTS

Prevalence of elevated ALT, elevated AST, and fatty liver changes were 22.0%, 5.1%, and 9.3%, respectively. Driving distance had a positive association with elevated ALT with a prevalence ratio of 1.35 (95% CI: 0.98, 1.89) comparing the highest versus lowest driving quartile. This association differed by alcohol use, with a corresponding prevalence ratio of 2.08 (95% CI: 1.30, 3.33) among "past/current" drinkers but no association among "never" drinkers. Similar patterns were found for AST, but estimates were less stable. We found a curvilinear response pattern for fatty liver changes; prevalence first increased with years as a taxi driver and then receded in the highest ranges of driving tenure, regardless of the alcohol history.

CONCLUSIONS

Our results provide evidence that long driving is associated with both short-term and chronic liver insults, although alcohol use appears to modify this putative effect.

A review of occupational knee disorders

INTRODUCTION

Lower extremity knee disorders, like other cumulative disorders of the body, build up over time through cumulative exposures. 2006 data from the U.S. Bureau of Labor Statistics reveal that cumulative knee disorders account for 65% of lower extremity musculoskeletal disorders and 5% of total body musculoskeletal disorders.

METHODS

The objective of the literature review was to find papers on work-related musculoskeletal disorders (WMSDs) common to the knee region. From these, symptoms of the disorders, affected industries, and potential risk factors were assessed.

RESULTS

A review of the literature divulges that knee disorders primarily consist of bursitis, meniscal lesions or tears, and osteoarthritis. Though kneeling and squatting are considered to be two of the primary risk factors correlated to these knee disorders, 12 other risk factors should also be contemplated. These 14 contributing risk factors include both occupational (extrinsic) and personal (intrinsic) variables that affect the labor industries. Example industries include mining, construction, manufacturing, and custodial services where knee bending postural activities exist as a commonality.

CONCLUSION

The understanding of the types of knee disorders, the affected occupations, and the job related risk factors will allow ergonomic practitioners and researchers to create and adjust work environments for the detection and lessening of knee work-related musculoskeletal risk. Further studies need to be conducted to (1) justify the presence of risk from certain risk factors and (2) enhance the understanding of risk factor dose-response levels and their temporal development.

Working conditions and musculoskeletal pain among Brazilian pottery workers

In the municipality of Pedreira in São Paulo State, Brazil, a large number of workers from the ceramic industry have left their jobs because of work related musculoskeletal disorders. The objectives of this study were to describe the work conditions pertaining to the ceramic industry, to determine the prevalence of musculoskeletal pain and to identify the associations between symptoms and organizational, biomechanical, psychosocial and individual variables. Nine ceramic manufacturers participated. The activities of 18 individuals were analyzed through direct observation. All workers answered a questionnaire about work and health (n = 235). The results found that the general working conditions in the pottery manufacturers were poor. A 38.5% prevalence of musculoskeletal pain was found. Repetition, tool use, lack of control over decisions, worries regarding work demands, relationship issues, work dissatisfaction and the wish to move on to another function were all associated with pain. We concluded that musculoskeletal pain is one of the outcomes of elevated human requirements resulting from working conditions and organization in the ceramic industry.

Diagnosis and management of a patient with knee pain using the movement system impairment classification system

STUDY DESIGN

Case report.

BACKGROUND

Selecting the most effective conservative treatment for knee pain continues to be a challenge. An understanding of the underlying movement system impairment that is thought to contribute to the knee pain may assist in determining the most effective treatment. Our case report describes the treatment and outcomes of a patient with the proposed movement system impairment (MSI) diagnosis of tibiofemoral rotation.

CASE DESCRIPTION

The patient was a 50-year-old female with a 3-month history of left anteromedial knee pain. Her knee pain was aggravated with sitting, standing, and descending stairs. A standardized clinical examination was performed and the MSI diagnosis of tibiofemoral rotation was determined. The patient consistently reported an increase in pain with activities that produced abnormal motions or alignments of the lower extremity in the frontal and transverse planes. The patient was educated to modify symptom-provoking functional activities by restricting the abnormal motions and alignments of the lower extremity. Exercises were prescribed to address impairments of muscle length, muscle strength, and motor control proposed to contribute to the tibiofemoral rotation. Tape also was applied to the knee in an attempt to restrict tibiofemoral rotation.

OUTCOMES

The patient reported a cessation of pain and an improvement in her functional activities that occurred with correction of her knee alignment and movement pattern. Pain intensity was 2/10 at 1 week. At 10 weeks, pain intensity was 0/10 and the patient reported no limitations in sitting, standing, or descending stairs. The patient's score on the activities of daily living scale increased from 73% at the initial visit to 86% at 10 weeks and 96% at 1 year after therapy was discontinued.

DISCUSSION

This case report presented a patient with knee pain and an MSI diagnosis of tibiofemoral rotation. Diagnosis-specific treatment resulted in a cessation of the patient's pain and an improved ability to perform functional activities.

Fatores de risco físicos e organizacionais associados a distúrbios osteomusculares relacionados ao trabalho na indústria têxtil

Distúrbios osteomusculares relacionados ao trabalho (DORT) atingem trabalhadores de diversas ocupações e constituem um dos maiores problemas de saúde em muitos países. Este estudo foi realizado em dois setores de fiação de uma mesma indústria têxtil, sendo um deles tecnologicamente mais moderno. Os objetivos foram identificar os fatores de risco físicos e organizacionais associados aos DORT nos dois setores e determinar a prevalência de sintomas de dor entre esses trabalhadores. Tendo como referencial a análise ergonômica, foram observadas as atividades de trabalho de 12 indivíduos; e 50 trabalhadores responderam a um questionário. Os fatores de risco físico identificados foram os seguintes: posturas inadequadas de ombro, trabalho na posição em pé, repetitividade de movimentos e aspectos ambientais desfavoráveis. Os fatores organizacionais identificados foram: ritmo intenso de trabalho, fragmentação e invariabilidade das tarefas, inexistência de pausas e impossibilidade de comunicação com os colegas. Foi encontrada prevalência de 60% e 76% de dor nos dois setores estudados, respectivamente. As conclusões mostram que investimentos em tecnologia que não acompanham mudanças na organização e nas condições de trabalho resultam na manutenção ou no agravamento das situações de risco reconhecidamente associadas aos DORT.

Gonalgia entre trabalhadores e fatores ocupacionais associados: uma revisão sistemática

Com o objetivo de reunir informações sobre gonalgia entre trabalhadores e fatores ocupacionais associados, foi realizada uma revisão sistemática nas bases de dados MEDLINE, LILACS, SciELO, Free Medical Journals, entre outros, referentes ao período 1990-2006, usando-se os descritores gonalgia, knee, knee pain, knee joint, knee dislocation, knee injuries, work, workplace, workload, employment, occupations, industry, occupational, workers, arthrosis, osteoarthritis e seus equivalentes em português e espanhol. Dos 2.263 estudos inicialmente encontrados, somente 26 cumpriram os critérios necessários para permanecer na revisão. As prevalências de gonalgia nos últimos 12 meses variaram entre 11,2% e 60,9%, e os principais fatores associados foram: sexo feminino, idade avançada, índice de massa corporal elevado, trabalhar ajoelhado e carregar peso no trabalho.

Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers

AIMS

To examine the association between driving time and changes in haematological markers of increased risks for cardiovascular diseases (CVD).

METHODS

The authors conducted a cross sectional analysis of baseline data from the Taxi Drivers' Health Study cohort in Taipei, Taiwan. They retrieved information on comorbidity, laboratory tests, age, and anthropometric measures from medical records of 1157 subjects (mean age 44.6 (SD 8.6) years). Whole blood cell (WBC) count was used as the primary haematological marker for increased CVD risk, and platelet count and haematocrit as the secondary markers. Standardised questionnaires were implemented to collect information on demographics, lifestyle, work related physical and psychosocial factors, and driving time profiles. Multiple regression was used to estimate the adjusted effects of driving time on three haematological markers.

RESULTS

The mean measured hematological marker was 6656 (SD 1656) cells x10(6)/l for WBC, 47.2 (SD 3.5) % for hematocrit, and 243 (SD 52) cells x10(9)/l for platelets. The driving time was 264 (SD 76) hours/month. Compared with drivers who drove < or =208 hours/month (1st quartile cut off), drivers who drove >208 hours/month had a higher WBC count (by 317 x10(6)/l; 95% CI 99 to 535), haematocrit (by 0.8%; 95% CI 0.3 to 1.2), and platelets (7.9 x10(9)/l; 95% CI 1.0 to 14.8). After adjusting for conventional CVD risk factors (age, sex, smoking, hypertension, diabetes, and hypercholesterolaemia), obesity, alcohol drinking, regular exercise, and sociodemographics (education, marital status, income, and so on), long driving time was still associated with significant increases in WBC and platelets, whereas the effect on haematocrit was diminished and became statistically non-significant. Additional controls for physical workload, self-perceived job stress, and job dissatisfaction did not alter the associations with increased WBC and platelets.

CONCLUSIONS

Longitudinal studies are needed to confirm the observed cross sectional association and to further examine the specific occupational exposures accountable for the association between driving time and haematological markers of systemic inflammation and haemostatic alteration.

Occupational factors associated with low back pain in urban taxi drivers

BACKGROUND

Urban taxi drivers differ from other professional drivers in their exposures to physical and psychosocial hazards in the work environment. Epidemiological data on low back pain (LBP) of this occupational group are very scarce.

AIMS

To examine LBP in taxi drivers and its association with prolonged driving and other occupational factors.

METHODS

We analyzed the cross-sectional data from the Taxi Drivers' Health Study. Standardized instruments were used to collect information on personal factors, work-related physical and psychosocial factors and driving time profiles. LBP prevalence was assessed using the modified Nordic Musculoskeletal Questionnaire. Multiple logistic regression models were employed for statistical analyses.

RESULTS

Of 1242 drivers, 51% reported LBP in the past 12 months, significantly (P < 0.001) higher than other professional drivers (33%) in Taiwan. After adjusting for the effects of demographic characteristics, lifestyle factors, anthropometric measures and socioeconomic positions, we found that driving time >4 h/day [prevalence odds ratio (POR) 1.78; 95% CI 1.02-3.10], frequent bending/twisting activities while driving (adjusted OR 1.86; 95% CI 1.15-2.99), self-perceived job stress (POR 1.75; 95% CI 1.20-2.55), job dissatisfaction (POR 1.44; 95% CI 1.05-1.98) and registration type were the major occupational factors significantly associated with higher LBP prevalence in taxi drivers.

CONCLUSIONS

We have identified that long driving time and several physical and psychosocial factors are associated with high prevalence of LBP in taxi drivers. This should be further investigated in prospective studies. Future studies are needed to examine the potential adverse effects of prolonged exposure to low levels of whole-body vibration.

Sintomas de distúrbios osteomusculares em bancários de Pelotas e região: prevalência e fatores associados

Este estudo objetivou conhecer a prevalência de sintomas de distúrbios osteomusculares em bancários de Pelotas e região e investigar fatores associados. O estudo foi transversal e os dados foram coletados através de questionário auto-aplicado no local de trabalho. O desfecho foi relato de dor osteomuscular com freqüência em três ou mais de dez regiões anatômicas (Questionário Nórdico de Sintomas Osteomusculares - QNSO). De 502 bancários estudados, 60% da amostra mencionaram dor músculo-esquelética no último ano, 43% referiram nos últimos sete dias, 19% tiveram que evitar o trabalho devido às dores e 40% relacionaram esta dor com a atividade que realiza no seu trabalho. Dor com freqüência foi relatada por 39% dos bancários. Maiores prevalências foram observadas em mulheres, pessoas que não praticavam atividade física, usuários de terminal on-line e máquinas autenticadoras, aqueles que referiram seu ritmo de trabalho como "acelerado", aqueles que trabalhavam na maior parte do tempo sentados e aqueles que classificaram seu ambiente de trabalho como "inadequado".

Review of epidemiologic studies on occupational factors and lower extremity musculoskeletal and vascular disorders and symptoms

The epidemiologic literature on lower extremity musculoskeletal disorders (MSDs), vascular disorders, and occupational mechanical factors is relatively sparse, compared to the low back and upper extremities. The present literature review aims to summarize and evaluate the current literature on lower extremity vascular disorders, MSDs, and symptoms, and to update previous literature reviews. A search was conducted in PubMed. Articles were included if they had a lower extremity musculoskeletal outcome, and a workplace factor(s). They were evaluated based upon their generalizability, exposure, and outcome assessments, study design, and controlling of confounders. Most of the literature has focused on osteoarthritis of the hip and knee, whereas not much research has been done examining the feet/ankles and lower legs. Overall, better exposure assessment is needed to examine the causal pathway between occupational factors and MSDs.