Prevalence of work-related musculoskeletal disorders in agriculture workers in Korea and preventative interventions

Investigation of prevalence and risk factors of musculoskeletal disorders among tea harvesting farmers - A systematic review

BACKGROUND

Tea harvesting is a common agricultural occupation, usually conducted in mountainous regions with steep slopes and high altitudes. Despite the utilization of modern technology and mechanized equipment in agriculture, a substantial portion of tea harvesting continues to be traditional and physically strenuous. This dependence on manual labor can lead to a higher likelihood of musculoskeletal disorders among tea harvesting farmers.

OBJECTIVE

The objective of this research was investigation of prevalence and risk factors of musculoskeletal disorders in tea harvesting farmers.

METHODS

In this review study, we analyzed all published articles on the prevalence and factors influencing musculoskeletal disorders in tea harvesting farmers from March 10, 2010, to November 10, 2023 (last search date). We systematically searched for articles using keywords (risk factor, risk assessment, lower limb, upper limb, musculoskeletal disorders, tea harvesting, posture, manual handling, discomfort, ergonomics, prevalence, farmers) in PubMed, Google Scholar, SID, Web of Science, Scopus, Magiran, Iran Medex, Cochrane Library, and Embase. The quality of the articles was evaluated using the Mixed Methods Appraisal Tool (MMAT), 2018 version. Unrelated articles were excluded following PRISMA statement guidelines, and only articles directly related to the study were reviewed. GraySource and BASE databases were also utilized to identify Gray sources..

RESULTS

Initially, 128 articles were found across different databases, and a total of 17 articles were selected for the final assessment. The primary areas of the body that workers are commonly exposed to musculoskeletal issues are the back, hands, wrists, shoulders, neck, and knees. The research identified four main categories of factors: personal, occupational, environmental, and psychosocial that contribute to musculoskeletal problems. Among these factors are women working in physically demanding environments, lifting heavy bags of harvested tea, time pressures during tea collection, repetitive hand motions from using harvesting tools, the height of the tea plants in the field, working in wet and slippery conditions, uneven ground surfaces, extended working hours, low pay, and lack of support from employers.

CONCLUSIONS

Ergonomic interventions such as redesigning tea harvesting tools, enhancing tea plants and workspaces, teaching ergonomic principles of body posture and manual movement, and organizing work with job rotation and adequate rest are recommended to alleviate musculoskeletal disorder symptoms.

Work-Related Musculoskeletal Disorders Among Farmers in the Southeast Asia Region: A Systematic Review

Background

Southeast Asia has many people who work in the agriculture sector. Not many stakeholders pay special attention to the health of farmers, even though they are exposed to various types of hazards. One of the most common health complaints among farmers is related to work-related musculoskeletal disorders (WMSDs). This study aims to assess the prevalence of WMSDs and factors associated with them among farmers in Southeast Asia.

Methods

A literature search on PubMed, ScienceDirect, Scopus, and EBSCO was conducted. Articles were included if they studied ergonomic problems among farmers from 11 countries in the Southeast Asia region and were published during 2015-2022. The Critical Appraisal Skills Program was used to evaluate the quality of the articles. The search process and retrieval process reflected PRISMA's recommendation.

Result

There were 14 studies found from 3 countries that had published articles in PubMed and ScienceDirect, including Thailand [8], Indonesia [4], and Malaysia [2]. The prevalence of WMSDs in Thailand, Indonesia, and Malaysia was 78,31%, 81,27%, and 88,39%, respectively. Common factors associated with WMSDs include age, sex, smoking habits, drinking alcohol habits, working period (years), type of work, awkward position, non-ergonomic equipment, repetitive movements, and lifting heavy loads.

Conclusion

The prevalence of WMSDs among farmers in Southeast Asia is considerably high. Effective intervention is essential for reducing the prevalence and protecting workers' health and well-being.

Determining the ergonomic risk factors affecting the musculoskeletal disorders of traffic enforcers in Manila City, Philippines

BACKGROUND

Traffic enforcers are vulnerable to work accidents, injuries, and illnesses because they are commonly exposed to ergonomic risk factors while performing their tasks.

OBJECTIVE

The purpose of this study is to determine the effects of environmental risk factors and postural risk factor to the prevalence of musculoskeletal disorders (MSDs) among traffic enforcers in Manila City, Philippines using binary logistic regression analysis.

METHODS

A total of 120 participants were included in the study. The Nordic Musculoskeletal Questionnaire (NMQ) and Rapid Entire Body Assessment (REBA) were utilized. In addition, several devices such as a noise dosimeter, digital air thermometer, and IAQ sensors were also utilized to measure the environmental exposure of enforcers during their work shift.

RESULTS

The prevalence of MSDs among traffic enforcers was high, with 71% of the respondents reporting symptoms of MSDs in more than one part of the body for the past 7 days. The body part that has highest prevalence was upper back, followed by lower back, and legs/ankles. Logistic regression analysis revealed that awkward work posture (OR = 4.61, 95% CI = 2.17, 9.83), noise exposure (OR = 1.42, 95% CI = 1.11, 1.82), heat exposure (OR = 0.53, 95% CI = 0.85, 1.05), and pollution exposure (OR = 0.94, 95% CI = 0.85, 1.05) were significant contributors for the prevalence of MSDs among traffic enforcers in Manila City.

CONCLUSION

The prevalence of MSDs among traffic enforcers is caused by their work posture and exposure to psychosocial factors such as noise, heat, and poor air quality. Thus, to minimize the risk of MSDs, it is suggested to provide administrative controls, such as job rotation or shifting, and introduce frequent rest breaks. It is also recommended to provide enforcers with appropriate personal protective equipment, such as cooling vests, noise-canceling earplugs and N95 facemasks. This would help in uplifting musculoskeletal health for traffic enforcers and other workers in a similar field.

Characteristics of Work-Related Musculoskeletal Disorders in Korea

This study aimed to analyze trends for work-related musculoskeletal disorders (WMSDs) from 1996 to 2020 in Korea and to investigate characteristics of WMSDs, including WMSD approval rates, distribution by WMSD names, and the effects of industry type and size, and workers’ age and gender on WMSD occurrence. The data included those obtained from the official yearbooks for industrial accidents published by the Ministry of Employment and Labor and those obtained personally from the Korea Workers’ Compensation & Welfare Service. The results showed that although the incidence of WMSDs differed by year, approximately 9500 cases of WMSDs occurred in 2019 and 2020, the incidence rate of WMSDs was approximately 5.0 per 10,000 workers, and the proportions of WMSDs among industrial accidents were almost 9%. Low back pain was the leading cause of WMSDs; WMSDs occupied 9.5−71.5% of total occupational diseases by year and occurred most frequently in the manufacturing industry, followed by construction, transportation/warehouse and communication, and mining industries, and nearly 60% of WMSDs occurred in small business with <50 workers. Among chronic WMSDs, rotator cuff syndrome in the shoulder ranked first, intervertebral disc disorders second, and rotator cuff and tendon injuries third. By body parts, the shoulder was most susceptible to chronic WMSDs, followed by the low back, leg, and elbow/lower arm. The chi-square test and logistic regression analysis showed that industry type and size and workers’ gender and age were significantly associated with WMSD approval. It can be concluded that the WMSD preventive efforts should focus on low back pain and rotator cuff syndrome by WMSD name, manufacturing by industry, small business by industry size, men by gender, and aged workers by age.

Comparing the occurrence of chronic physical disorders in self-employed individuals with that of employees: A systematic review

BACKGROUND

A stringent systematic review of population-based observational studies focusing on the physical health of self-employed individuals as a basis for the development of targeted prevention strategies is lacking.

OBJECTIVE

We aimed to systematically evaluate all the studies of good quality that compared the occurrence of chronic physical disorders in self-employed individuals with that of employees.

METHODS

We searched three major medical databases (MEDLINE, Web of Science, Embase) following the Cochrane guidelines. The quality of the studies was rated based on the slightly modified validated assessment tool that was developed by Hoy et al.RESULTS:We included 16 population-based studies of good quality, with data from 15,369,964 participants in total. The two longitudinal evaluations of Swedish national registers with the longest follow-up periods showed increased cardiovascular mortality and incidence estimates of cardiovascular disease in self-employed individuals compared with those of white-collar (i.e., nonmanual) employees but decreased risk estimates compared with those of blue-collar (i.e., manual) workers. The results of the shorter cohort studies were heterogeneous. In cross-sectional studies, prevalence estimates for musculoskeletal, respiratory and malignant diseases were higher among self-employed individuals than among employees.

CONCLUSION

The long-term cardiovascular disease risk and mortality of self-employed individuals seemed to be higher than those of white-collar employees but lower than those of blue-collar employees. As a basis for targeted prevention strategies, further longitudinal studies in different settings are required to better understand the development of physical health disorders for specific self-employment categories such as sole proprietors, small entrepreneurs, family businesses and others.

Association between the time of physical laboral activities and leisure over shoulder pain in fruitculture workers: A cross-sectional study

BACKGROUND

Fruitculture workers are exposed to shoulder pain disorders due to long working times in overhead activities.

OBJECTIVE

This study aims to analyze the association between the time of physical work and leisure activities over the perception of shoulder pain intensity in fruit growing workers.

METHODS

This is a descriptive and correlational cross-sectional study. The sample consisted of 180 fruit-growing workers. Multivariable logistic regression was used, with an estimate of the Odds Ratio (OR) and 95% confidence intervals. The dependent variable: Numeric Pain Rating Scale (NPRS) (0-10 points), was categorized as low and high, with cutoff points of NPRS > 3 and NPRS > 4, and was associated with the independent variables (level of physical activity, personal, labour and psychosocial).

RESULTS

Workers which are insufficiently active in leisure time are more likely to report high-intensity shoulder pain, NPRS > 3 (OR: 2.39; p = 0.049) and NPRS > 4 (OR: 2.85; p = 0.036). In addition, working time in overhead activities is a risk factor for high-intensity pain for NPRS > 3 and NPRS > 4 (OR = 1.01; p < 0.001). Underweight and normal-weight workers were less likely to report shoulder pain in NPRS > 3 (OR = 0.35; p = 0.020) and in NPRS > 4 (OR = 0.20; p = 0.001).

CONCLUSION

Fruit-growing workers had a high prevalence of severe shoulder pain. In addition, workers who are insufficiently active at leisure, overweight and obese are more likely to report severe pain. It was observed that overhead tasks increase the chances of reporting high-intensity shoulder pain among workers.

The barriers and opportunities to support the early career academics and professionals in human factors/ergonomics - revisiting reflections from IEA2015, IEA2018 & IEA2021

BACKGROUND: The Early-Career Community (ECC) comprises researchers, practitioners, and professionals in their “early-career” stages in the Human Factors/Ergonomics (HFE) profession. Early-career HFE professionals are essential to both current industry decision making and future growth of our profession. OBJECTIVE: This paper provides detailed insights into the barriers and suggestions to support engagement with ECC within the International Ergonomics Association (IEA) and its Federated Societies. METHODS: This report integrates key findings from the formal and informal discussions that occurred with diverse groups of stakeholders (n > 100) at IEA2015, IEA2018 and IEA2021 guided by the participatory inquiry paradigm, cooperative action-inquiry and participatory ergonomics approaches. RESULTS: Barriers to support ECC include: a lack of employment opportunities, poor general awareness and integration of HFE in existing university-courses, financial constraints, inclusivity challenges and a lack of Influence in decision-making. While some of the more systemic challenges are context-specific and cannot be overcome, ECCs suggested that: the IEA and its Federated Societies include ECC members as part of their boards; a Standing Committee for the ECCs be established as part of the IEA; make use of social-media more effectively to engage the ECC. More mentorship, networking, knowledge sharing, training and education, combined with financial-support will ensure that the ECC can participate. CONCLUSION: ECC members experience complex and dynamic challenges that affect their development and involvement in the broader HFE profession. It is therefore critical that appropriate, global, national and local strategies are developed to continue to support and develop the ECC to ensure the continued growth of and demand for HFE.

Vocal ergonomics with sports coaches: Co-devised approaches to occupational voice

BACKGROUND: Work-system participation and factors are associated with occupational vocal health for vocally reliant workers, such as sports coaches. However, there is limited use of systems approaches and worker collaboration to address occupational voice. OBJECTIVE: The current research aimed to cooperatively consider coaches’ vocally reliant systems participation, including addressing vocal ergonomic factors that can create barriers for occupational vocal health and voice use. METHODS: Collaborative action inquiries explored vocal ergonomics with coaches (n = 24) from nine professional basketball teams. Across three basketball seasons, coaches and a subject matter expert identified what influenced coaches’ voices and trialed approaches to optimize vocally reliant coaching participation. Nine action inquiry methods were used, including search conferences, ergonomic approaches to enhance systems participation, and focus groups. Multi-level analyses were also undertaken. RESULTS: Participants cooperatively generated, implemented, and evaluated different strategies. A cumulative total of 57 strategies were explored within teams (team mean = 6.33, SD = 3, range = 4–14). Cross-case analysis identified 25 different strategy types. Overall, participants appraised 31.58% (18/57) strategies as supportive (i.e., enhanced facilitators for voice), 61.40% (35/57) strategies as somewhat supportive (i.e., some enhanced facilitators and some ongoing barriers), and 7.02% (4/57) strategies as unsupportive (i.e., pervasive ongoing barriers not mitigated by strategies). Further, factors across coaches’ work-systems continued to influence coaches’ voices in dynamic and complex ways. CONCLUSIONS: Collaboration with coaches enriched vocal ergonomic approaches by providing novel, context-anchored insights. Collaboration should form ‘part’ of broader mechanisms to support coaches’ voice use and vocal health at work.

Predictors of Low Back Pain Risk among Rubber Harvesters

Low back pain (LBP) is a significant work-related musculoskeletal disorder among rubber farmers. This major occupational health problem was highly reported in the agricultural sector. While rubber farming is a profession with high risk of LBP, predictors for LBP remain unclear. This study was designed to investigate the risk predictors of LBP among rubber farmers during the harvesting process. A cross-sectional study was conducted between January and March 2021, in which an interviewer administered a pretested structured questionnaire. Bivariate and multivariate binary logistic regression analyses were performed. A total of 317 rubber farmers were recruited with a 100% response rate. The prevalence of LBP was 71.2% with 95% confidence interval (CI) of (0.716-1.900). Significant risk predictors were working experience (adjusted odds ratio (AOR): 1.743, 95% CI (1.034-2.937)), agricultural registration (AOR: 2.022, 95% CI (1.078-3.792)), work without training (AOR: 2.037, 95% CI (1.083-3.832)), heavy workload (AOR: 2.120, 95% CI (1.242-3.621)), and prolonged standing (AOR: 2.944, 95% CI (1.586-5.465)). Intriguingly, those with sufficient income had a reduced risk of LBP than those with insufficient income. This study confirmed that LBP is a major work-related musculoskeletal disorder among rubber farmers. The result here suggests that the five predictors reported above should be prioritized for further disease prevention.

Nail job and women’s health: Assessment of ergonomics and occupational hazards

BACKGROUND: The nail job is a new occupation in which the number of people who choose this job is rising. Therefore, the harmful hazards affecting the health of the practitioners should be taken into account. OBJECTIVE: The purpose of this study is to evaluate the ergonomics and occupational health hazards among nail technicians in Iranian society. METHODS: The self-administered questionnaire, the Nordic Musculoskeletal Questionnaire and Novel Ergonomic Postural Assessment (NERPA) method were used to gather data from 80 female nail technicians who participated in this study. RESULTS: More than half of the participants (67.6%) complained of coughing and eye irritation (70%) which was the most frequently reported irritation. The final score of the NERPA was at a high-risk level and the neck pain (63.8%) was the highest in comparison with other parts of the body. There was a significant relationship between activity type with disorder in the neck, elbow, hip, knee, and ankle. Lighting intensity was not significantly associated with musculoskeletal disorders. CONCLUSIONS: Concerning the low work experience, the prevalence of musculoskeletal disorders and, respiratory complaints is high. Hence, the attention of policy-makers to the safety and hygiene issues of women in this occupation is necessary by setting guidelines and considering inspections of occupational health and safety professionals.

Comparisons of working conditions and health-related problems between older male and female crop farmers

BACKGROUND

Although the number of farmers in Korea is declining, the proportion of older farmers aged ≥60 increases.

OBJECTIVE

This study aims to analyze gender differences in working conditions, exposure to risk factors, and health problems of older crop farmers aged ≥60.

METHODS

This study used data from the 5th Korean Working Conditions Survey (KWCS) data of 818 male and 985 female crop farmers aged ≥60 years.

RESULTS

This study showed that older female farmers had higher ratios of living alone (45.0% vs. 13.4%, p <  0.001), lower education levels (80.7% vs. 53.4%, p <  0.001), and lower average incomes (1.565 vs. 2.036 million KRW, p <  0.001) than that of males. Among subjective scores on the exposure of risk factors, only females' repetitive motion (4.923) and awkward posture (4.415) scores were higher than that of males' repetitive motion (4.601) (p <  0.001) and awkward posture (4.159) scores (p = 0.001). However, female's health problem rates on upper limb pain (68.3%), lower extremity pain (67.6%), backache (48.4%), overall fatigue (44.8%), and headache and eyestrain (25.0%) were higher than that of male's complaint rates on upper limb pain (48.5%) (p <  0.001), lower extremity pain (53.3%) (p <  0.001), backache (35.0%) (p <  0.001), overall fatigue (39.5%) (p = 0.024), and headache and eyestrain (19.4%) (p = 0.005). The rate of depression symptoms in females (54.6%), with a high proportion of single-person households, was higher than that of males (46.9%) (p = 0.001).

CONCLUSIONS

The musculoskeletal pains and depression symptoms of older female farmers are prevalent, and efforts and support are required to improve working conditions.

Participatory Ergonomic Interventions for Improving Agricultural Work Environment: A Case Study in a Farming Organization of Korea

Farmers are often exposed to risk factors for musculoskeletal disorders through lifting, carrying heavy loads, and sustained or repeated full-body bending. Several relevant studies on ergonomic interventions have been conducted for specific agricultural tasks, such as harvesting and pruning, by experts without involving farmers. This study introduces ergonomic interventions to mitigate risk factors in a farming organization that cultivates peaches as the main crop based on ergonomic analysis of the entire peach farming cycle; subjective and objective evaluations of the proposed interventions are also performed. The ergonomic analysis and interventions were established based on consultations provided by an ergonomist, the government, and the organization members. Engineering controls were introduced for powered carts, sorters, and stools to reduce load carrying and awkward postures; moreover, thermal or cooling vests, winter shoes and gloves, and farmer hats were provided to alleviate cold or heat stresses. Administrative controls such as education/training and adjusting work–rest cycles were also recommended after considering the characteristics of the risk factors identified. The scores of the questionnaire survey from the organization members were high (>4.1 out of 5 for five questions), and postural loads for unstable postures by RULA were significantly reduced so as to avoid fast or immediate changes for the postures or working methods assessed. The study results are expected to help promote farmers’ health and enhance farming efficiency.

Ergonomic Task Analysis for Prioritization of Work-Related Musculoskeletal Disorders among Mango-Harvesting Farmers

This paper proposes a mixed ergonomic tool analysis algorithm to prioritize work-related musculoskeletal problems. This study is a cross-sectional study assessing the prevalence of work-related musculoskeletal disorders (WMSDs) with associated risk factors among 14 male mango-harvesting farmers (all right-handed) with the mean age of 52.28 ± 7.75 years. Four tasks following mango-harvesting processes were analyzed: (1) mango harvesting, (2) mango transporting, (3) mango size sorting, and (4) mango weighing and transporting to the truck. The perceived physical exertion while working on a mango-harvesting farm was based on the Borg CR-10 with a modified Standardized Nordic Questionnaire. Physical risk level due to awkward posture was evaluated by the Rapid Upper Limb Assessment (RULA), and risk due to whole-body posture in association with the level of WMSDs risk was evaluated by the Rapid Entire Body Assessment (REBA) score sheets. The subjective feelings of fatigue and posture analysis were normalized and combined using the theorem of power superposition to establish the fatigue effective index (FEI) for determining priorities to solve ergonomics-based task problems. This study indicated clearly that WMSDs are highly prevalent in mango-harvesting farmers, whereas the highest prevalence of WMSDs was reported in the right shoulder, right upper arm and lower back. The result provided the FEI of mango-harvesting farmers, ranked as follows: (1) size-sorting task, (2) weight-lifting task, (3) harvesting task, and (4) transporting task. The authors concluded that mango size sorting should be the first task to be improved to resolve the muscle fatigue problems among male mango-harvesting farmers.

Prevalence of Low Back Pain and Associated Risk Factors among Farmers in Jeju

Background

We aimed to investigate the prevalence of low back pain (LBP) and its associated agricultural work-related, biomechanical factors among this population.

Methods

We analyzed initial survey data from the Safety for Agricultural Injury of Farmers cohort study involving adult farmers in Jeju Island. The prevalence of LBP was calculated with associated factors.

Results

In total, 1,209 participants were included in the analysis. The overall prevalence of LBP was 23.7%. Significant associations for LBP were the type of farming activity, length of farming career, prior agricultural injury within 1 year, and stress levels. Multivariate logistic regression analysis revealed three biomechanical factors significantly related to LBP: repetitive use of particular body parts; the inappropriate posture of the lower back and neck.

Conclusions

Some occupational, and biomechanical risk factors contribute to LBP. Therefore, postural education, injury prevention education, and psychological support will be needed to prevent LBP.

Action inquiry and vocal ergonomics: A pilot study with sports coaches

BACKGROUND

Coaches critically rely on voice for occupational functioning, which has associated risks to vocal health. However, vocal occupational health and safety (OHS) and vocal ergonomics are not typically considered for, by, or with coaches.

OBJECTIVE

This study piloted a participatory approach to vocal ergonomics, aiming to collaboratively (i) understand coaches' vocally reliant occupational participation, and (ii) consider vocal ergonomic factors.

METHODS

This research was undertaken at an international tournament for floorball (also known as 'Innebandy', 'Salibandy', or 'Unihockey'). Three national coaches (n = 3) and the lead researcher undertook cooperative action inquiry. This piloted a participatory vocal ergonomics programme. Action inquiry methods included fieldnotes, interviews, observations, a workshop, ergonomics approaches, and a focus group. Multi-level analyses supported the findings, including categorical aggregation, direct interpretation, and reflexive thematic analysis.

RESULTS

Participants identified vocal ergonomic factors present at the tournament; including personal, activity, physical environmental, and organisational factors. Participants developed four vocal ergonomic approaches responsive to factors. These were: (1) player consultation, (2) ongoing feedback discussions, (3) movement and postural change, and (4) specific task adaptation. Approaches 1-2 directly supported coaches' voices. Coaches posited limitations to other strategies, but made recommendations for future use. Coaches also reflected that this collaboration provided actionable voice insights and opportunities to address vocal ergonomics. They advocated for extended engagement with coaches, increased focus on vocal health, and inclusion of early career coaches in future programmes.

CONCLUSIONS

These findings support engagement of coaches, and other vocally reliant workers, in addressing voice use and vocal health at work.