Musculoskeletal disorders among manufacturing worker.
Authors
Gerr F; Merlino L
Source
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-007945, 2009 Dec; :1-76
Introduction: Musculoskeletal disorders (MSD) continue to be important occupational health problems in industry. In order to assess risk factors for upper extremity MSD, we investigated the relationship between occupational exposure to hand-intensive work among 386 household appliance manufacturing workers and (a) upper extremity musculoskeletal symptoms and (b) upper extremity musculoskeletal disorders in a prospective epidemiologic study. Methods: Participants were recruited from one large home appliance manufacturing facility. Exposure to physical risk factors was ascertained with video analysis and EMG. Time in specific tasks and selected administrative/organizational factors were ascertained with a daily task diary. Demographic factors and exposures to occupational psychosocial stressors were ascertained with validated questionnaires. Health outcomes were obtained with a weekly symptom questionnaire and a physical examination conducted by an occupational medicine physician. Descriptive statistics included prevalence and incidence of musculoskeletal symptoms and disorders. Cox proportional hazard methods were used to estimate risk while controlling for confounding. Analyses were conducted separately for hand-arm symptoms, neckshoulder symptoms, hand-arm disorders, and neck-shoulder disorders. Results: The prevalence of hand-arm symptoms was 19% and the prevalence of hand-arm disorders was 11.8% (Table 5). The most prevalent hand-arm disorder was carpal tunnel syndrome (prevalence=6.8%). The incidence of hand-arm symptoms was 58/100 person years and the incidence of hand-arm disorders was 19/100 person years. The prevalence of neck/shoulder symptoms was 16.8% and the prevalence of neck/shoulder disorders was 7.6%. The incidence of neck/shoulder symptoms was 54/100 person years and the incidence of neck/shoulder disorders was 14/100 person years. In multivariate analyses, few physical risk factors were associated with MSD outcomes. A non-statistically significant increase of 19% per unit of HAL was observed for hand-arm disorders but not for hand-arm symptoms. Associations between psychosocial risk factors and hand-arm symptoms and hand-arm disorders were relatively large and in the hypothesized direction. Weekly job stress level was statistically significantly associated with all four musculoskeletal outcomes. Job change was statistically significantly associated with hand-arm symptoms and hand-arm disorders. Conclusion: The results of this study support a large role for psychosocial and organizational factors in the development of musculoskeletal symptoms and disorders. Methodological issues, including a highly selected study sample (average job tenure was 16 years) and a high degree of job rotation may have resulted in underestimates of associations between musculoskeletal outcomes and exposure to physical risk factors.
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