The effects of physical and psychosocial factors and ergonomic conditions on the prevalence of musculoskeletal disorders among dentists in Malaysia

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021

Introduction

Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021.

Methods

This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes.

Results

A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

Prevalence of musculoskeletal disorders among dental healthcare providers: A systematic review and meta-analysis

Background: Work-related musculoskeletal disorders (MSD) are common in dentistry due to the prolonged static work involved during patient care, making dental health care personnel vulnerable to musculoskeletal complaints. We aimed to pool the prevalence estimates of MSD among various dental healthcare providers, including dentists, dental students, dental hygienists, and auxiliaries. Methods: A systematic search of five databases was performed (Scopus, Embase, CINAHL, Web of Science, Dentistry & Oral Sciences Source). The studies that reported the prevalence of MSD among dental healthcare workers and those written in English were selected. Screening and data extraction were performed by two review authors independently. Discrepencies were resolved by another review author. Risk of bias assessment was done using a nine-item questionnaire developed by Hoy et al. Pooled estimates were calculated using meta-analysis of proportions (random effects model). Results: Among the 3090 publications screened, 234 publications were included for full-text screening. Meta-analysis was performed for 89 estimates from 88 publications. Females showed significantly higher prevalence [OR = 1.42 (95% CI = 1.09-1.84); I ² = 66.02; N = 32]. The analysis yielded a pooled estimate of 78.4% (95% CI = 74.8-82). The meta-regression showed similar prevalence over the years (Coefficient: 0.001; P-value: 0.762). Conclusions: A high prevalence of MSD was noted among dental healthcare providers, with about seven out of ten having experienced MSD in the past. This emphasizes the need for awareness and adoption of appropriate ergonomic postures by dental healthcare providers from early in their careers to minimize work-related MSD.

Occupational ergonomics and related musculoskeletal disorders among dentists: A systematic review

BACKGROUND

There is an increasing concern about musculoskeletal disorders (MSD), resulting from occupational health hazards among dentists. Dentists who are susceptible to occupational health hazards could develop cumulative trauma disorders, lead to absenteeism from work, loss of productivity and performance or even long-term disability.

OBJECTIVE

This study aims to determine the prevalence of musculoskeletal disorders among dentists, explore the risk factors and identify the ergonomic preventive measures for dental professionals.

METHODS

Articles published between 2008-2020 were searched in scientific databases (MEDLINE, PubMed, Scopus and Cochrane Library). The Critical Appraisal Skills Programme Systematic Review Checklist was used to assess the quality of the studies.

RESULTS

Eighteen studies were found to be suitable in the final review. Relevant data was extracted and summarized from the included studies. The annual prevalence of musculoskeletal disorders in any body site ranged between 68% and 100%. The most predominant regions for musculoskeletal disorders among dental professionals were identified to be the lower back (29% to 94.6%), shoulder (25% to 92.7%), and neck (26% to 92%). The most frequently reported risk factors of MSDs were the individual characteristic female gender (57.1%), followed by awkward working postures (50%), long working experience (50%) and being dental specialists (42.9%). Several preventive measures were identified as the most effective ways in preventing MSDs, the use of magnification (40%) and regular physical activity (40%).

CONCLUSIONS

This review reported a high prevalence of musculoskeletal disorders (MSD) among dentists. It critically updates and adds the latest evidence on occupational ergonomics among dentists.

Prevalence of musculoskeletal disorders among dental healthcare providers: A systematic review and meta-analysis

Background: Work-related musculoskeletal disorders (MSD) are common in dentistry due to the prolonged static work involved during patient care, making dental health care personnel vulnerable to musculoskeletal complaints. We aimed to pool the prevalence estimates of MSD among various dental healthcare providers, including dentists, dental students, dental hygienists, and auxiliaries. Methods: A systematic search of five databases was performed (Scopus, Embase, CINAHL, Web of Science, Dentistry & Oral Sciences Source). The studies that reported the prevalence of MSD among dental healthcare workers and those written in English were selected. Screening and data extraction were performed by two review authors independently. Discrepencies were resolved by another review author. Risk of bias assessment was done using a nine-item questionnaire developed by Hoy et al. Pooled estimates were calculated using meta-analysis of proportions (random effects model). Results: Among the 3090 publications screened, 234 publications were included for full-text screening. Meta-analysis was performed for 89 estimates from 88 publications. Females showed significantly higher prevalence [OR = 1.42 (95% CI = 1.09-1.84); I ² = 66.02; N = 32]. The analysis yielded a pooled estimate of 78.4% (95% CI = 74.8-82). The meta-regression showed similar prevalence over the years (Coefficient: 0.001; P-value: 0.762). Conclusions: A high prevalence of MSD was noted among dental healthcare providers, with about seven out of ten having experienced MSD in the past. This emphasizes the need for awareness and adoption of appropriate ergonomic postures by dental healthcare providers from early in their careers to minimize work-related MSD.

Effectiveness of participatory ergonomic interventions on musculoskeletal disorders and work ability among young dental professionals: A cluster-randomized controlled trail

Objectives

This study is to evaluate the efficacy of participatory ergonomic (PE) intervention on musculoskeletal disorders (MSDs) and work ability among young dental professionals in China.

Methods

A cluster randomized controlled trail was conducted during 2015–2016. Twenty‐nine departments from five hospitals in the South of China were randomized into intervention (14 departments) and control (15 departments), with individuals of 125 and 138 dental professionals, respectively. Main participatory ergonomic interventions involved work posture, repetitive motions, tool usage, work break relaxation and work time re‐arrangement with total 235 ergonomic changes in the trail. Individual ergonomic risk exposure was assessed by investigator's observation using quick exposure check (QEC). Work ability index (WAI) and MSDs were collected by questionnaires at baseline, and every 3 months during the 1‐year follow‐up.

Results

Follow‐up rate was 91% and 96% for the intervention and control group, respectively. Significant reductions in ergonomic risk exposure and MSD prevalence on six anatomic sites were found in the PE group during the different follow‐up stages. WAI scores improved by 1.1 (95% CI 0.43, 1.89) after the 9‐month intervention. Compared to the control, the PE participants significantly reduced MSDs on neck (OR = 2.93, 95% CI: 1.25, 4.03) and wrists/hands (OR = 2.33, 95% CI: 1.08, 4.21), marginally increased WAI scores by 0.53 (95% CI: −0.02, 1.56) due to the interventions.

Conclusion

PE intervention is effective in reducing ergonomic risk exposure and MSDs on neck and wrists/hands among young dental professionals. PE ought to be offered in the early dental career for preventing MSDs.

The Most Important Risk Factors Affecting the Physical Health of Orthodontists: A Pilot Study

The purpose of this study is to evaluate the most frequent problems in the physical health of orthodontists and to determine which factors in the working environment of dental specialists have the most important influence on the physical health of orthodontic practitioners. This survey was conducted using a questionnaire that was distributed among orthodontists and dental specialists. The questionnaire consisted of 42 questions: 36 closed-ended questions with 1 or multiple possible answer choices, and 6 open-ended questions. The survey was carried out online and responses were collected anonymously. The study included 266 questionnaires completed by orthodontists and dental practitioners with a mean age of 34.5 ± 10.1 years. The results showed that 71% of orthodontists and 90% of dental practitioners experienced different types of pain during their workday and after work. The most common health problems among orthodontists were shoulder and neck pain. Orthodontists’ health status was better than dentists’. Usually, orthodontists experience shoulder and neck pain. The factors that helped orthodontists avoid health disorders were: the use of individually adjustable backrests and saddle-type chairs, assuming a neutral sitting position, keeping work equipment as close as possible, and breaks in between patients during work.

Risk factors for work-related musculoskeletal disorders of dentists in Kuwait and the impact on health and economic status

BACKGROUND

Work-related musculoskeletal disorders have become a great health issue among dentists. However, it is never been examined among dentists in the State of Kuwait.

OBJECTIVES

The purposes of this study were to define the prevalence of work-related musculoskeletal disorders (WMSD) among dentists in the State of Kuwait, to identify risk factors for WMSD, and to explore relationships between WMSD and absenteeism/productivity.

METHODS

A descriptive cross-sectional design was used in this study. A self-administered questionnaire was distributed to dentists at government, private, and academic dental clinics.

RESULTS

A total of 186 questionnaires were returned (80% response rate). The results showed that 88 (47%) of responding dentists experienced WMSDs. Dentists self-reporting WMSD were older (36.4 (10.3) years vs. 32.6 (9.33); P = 0.01), in practice longer (11.7 (10.4) years vs. 8.2 (8.4); P = 0.013), and worked longer hours (34.9 (10.6) hours vs. 30.4 (11.5); P = 0.08) than dentists not reporting WMSD. A significant association was found between rating of pain and lost days from work (x2 (10, n = 85) = 20.96, ρ = 0.021).

CONCLUSIONS

Dentists' occupational procedures expose their bodies to prolonged and awkward postures, thereby subjecting the dentists to unnatural forces and stresses on crucial movement and functioning joints. Cumulative exposures to such postures lead to WMSDs. Generally, WMSD has a considerable impact on the health and economic status of the individual, family, and workplace. WMSD increases absenteeism and reduces productivity.

Interaction between occupational physical burdens and low job control on musculoskeletal pain: Analysis of the 5th Korean Working Environment Survey

OBJECTIVE

This study aimed to investigate the interactive impacts between occupational physical burdens and psychological job demand or control on musculoskeletal pain (MSP) using nationally representative data for Korean workers.

METHODS

Using 5th Korean Working Conditions Survey (KWCS), we explored the interaction between occupational physical burdens and levels of psychological job demand or control on risk of MSP in 49 572 eligible participants. For quantitative evaluation of the interaction, relative excess risk due to interaction (RERI) was calculated.

RESULTS

In a group with low job control and at least one occupational physical burden, odds ratio (OR) for neck and upper extremity pain was 2.44 (95% CI, 2.24-2.66) compared with a group with high job control and no physical burden (a reference group: lowest risk), which was the highest value among the four groups, and the RERI was 0.35 (95% CI, 0.19-0.51). Similarly, OR for lower extremity pain was 2.15 (95% CI, 1.95-2.37) and RERI was 0.26 (95% CI, 0.07-0.45). However, the RERI was not significant in the case of psychological job demand.

CONCLUSION

This study revealed significant interactions between occupational physical burdens and low job control on MSP.

The effectiveness of ergonomics interventions in reducing upper limb work-related musculoskeletal pain and dysfunction in sonographers, surgeons and dentists: a systematic review

The aim of this systematic review was to summarise the effects of ergonomics interventions on work-related upper limb musculoskeletal pain and dysfunction, and on productivity in sonographers, surgeons and dentists. A total of 31 studies were included. All studies reported effects on upper limb pain. Nine studies reported effects on dysfunction and only two studies reported effects on productivity. Moderately strong evidence in reducing upper limb pain was found for instigation of microbreaks into long duration surgical procedures, and the use of wider, lighter handles in dental instruments. Moderate evidence was also found for use of prismatic glasses and favourable positioning in reducing upper limb pain. Weak, inconsistent or no evidence was found for all other ergonomics interventions in reducing upper limb pain and dysfunction and increasing productivity. The lack of high quality research, particularly in sonographers and in the outcome of productivity, should be addressed. Practitioner summary: This systematic review investigates the effectiveness of ergonomics interventions on upper limb pain, dysfunction and productivity in sonographers, dentists and surgeons. Instigation of microbreaks during long duration procedures and the use of wider, lighter instrument handles were most effective in reducing upper limb work-related pain. Abbreviations: ANOVA: analysis of variance; CLS: conventional laparoscopic surgery; DMAIC: define, measure, analyze, improve and control; GRADE: grading of recommendations, assessment, development and evaluations; HD: high definition; PRISMA: preferred reporting items for systematic reviews and meta-analyses; PROSPERO: The International Prospective Register of Systematic Reviews; RCT: randomised control trial; SILS: single incision laparoscopic surgery; VITOM: video telescopic operative microscope; WNSWLHD: Western New South Wales Local Health District; WMSD: work related musculoskeletal disorder.

Prevalence of self-reported musculoskeletal disorders of the hand and associated conducted therapy approaches among dentists and dental assistants in Germany

Background

Dental professionals are subjected to higher risks for musculoskeletal disorders (MSDs) than other professional groups, especially the hand region. This study aims to investigate the prevalence of hand complaints among dentists (Ds) and dental assistants (DAs) and examines applied therapies.

Methods

For this purpose, an online questionnaire analysed 389 Ds (240female/149male) and 406 DAs (401female/5male) working in Germany. The self-reported data of the two occupational groups were compared with regard to the topics examined. The questionnaire was based on the Nordic Questionnaire (self-reported lifetime, 12-month and 7-day MSDs prevalence of the hand, the conducted therapy and its success), additional occupational and sociodemographic questions as well as questions about specific medical conditions.

Results

30.8% of Ds affirmed MSDs in the hand at any time in their lives, 20.3% in the last twelve months and 9.5% in the last seven days. Among DAs, 42.6% reported a prevalence of MSDs in the hand at any time in their lives, 31.8% in the last 12 months and 15.3% in the last seven days. 37.5% of the Ds and 28.3% of the DAs stated that they had certain treatments. For both, Ds and DAs, physiotherapy was the most frequently chosen form of therapy. 89.7% of Ds and 63.3% of DAs who received therapy reported an improvement of MSDs.

Conclusion

Although the prevalence of MSDs on the hand is higher among DAs than among Ds, the use of therapeutic options and the success of therapy is lower for DAs compared to Ds.

Ergonomic risk exposure and work ability among young dental professionals in China: A cross-sectional study

BACKGROUND

Exposure to high ergonomic risk resulted in an increasing prevalence of musculoskeletal disorders among dental professional. However, little is known about the high exposure risk impact on work ability among dental professionals.

OBJECTIVE

We conducted a cross-sectional study to examine the association between ergonomic risk exposure and work ability among young dental professionals in their early careers.

METHODS

A total of 230 dental professionals including dentists, dental assistants, and nurses were clustered sampled from three hospitals in Guangzhou, south of China. We used the Quick Ergonomic Check (QEC) to assess participants' ergonomic risk exposure and Work Ability Index (WAI) to evaluate their work ability. Demographics and other factors related with WAI were also included in the data collection. Multiple linear regression was applied to analyze the association between ergonomic exposure scores and WAI.

RESULTS

A total of 218 participants (94.8%) had valid data and consent forms. The participants' average WAI was 39.6, of which the poor and moderate WAI composed 31%. High and very high ergonomic risk exposure level was 45.9% for the neck and 21.1% for the wrist/hand. In general, WAI decreased with higher ergonomic exposure level. With adjustment of other potential risk factors, the ergonomic scores for wrist/hand and total scores for the whole body were significantly associated with the decreased WAI.

CONCLUSION

High ergonomic risk exposure might risk in reducing work ability among young dental professionals. Intervention measures toward ergonomic risk should be taken to prevent WAI from decreasing in their early careers.

Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep

Purpose

Work ability can be measured by the work ability index (WAI), and work-related questions measuring productivity loss in terms of quality and quantity of work. Dentists have high occupational risk of musculoskeletal pain and the exposure of ergonomic strain is already high during dental education. The aim was to evaluate work ability and productivity among dentists, and to identify gender differences and associations with sleep, stress, and reported frequent pain.

Methods

The study population comprised 187 dentists (123 women and 64 men) who had been working as dentists between 5 and 12 years. Participants completed a questionnaire regarding sleep, stress, presence of pain at different sites, work ability assessed by WAI, and productivity in terms of quality and quantity of work.

Results

Poor sleep quality and high level of stress were reported by 31% and 48.1% of participants, respectively, with no gender differences and no association with age. The prevalence of frequent pain ranged 6.4–46.5% with shoulders being the most prevalent site. Thirty-three percent reported reduced work ability. Poor sleep, high amount of stress, and multi-site pain were associated with decreased work ability.

Conclusions

A high prevalence of pain was shown among dentists. Decreased work ability in terms of productivity loss was associated with poor sleep quality, high amount of stress, and multi-site pain. Preventive actions at the workplace should promote good musculoskeletal health, and measures taken, both individual and organizational, to minimize the risk of high, persistent stress and work-related pain.