Musculoskeletal symptoms due to technical preconditions in long cycle time work in an automobile assembly plant: a study of prevalence and relation to psychosocial factors and physical exposure.

The aim was to evaluate the prevailing ergonomic conditions in a parallelized flow, long cycle time, assembly system. The evaluation focused on physical exposure, psychosocial factors and work-related musculoskeletal symptoms. A random sample of 67 assembly operators was included in a cross-sectional study mainly based on questionnaires. Hand/wrist symptoms were common and related to work exposure with hand-held powered tools. In general, the self-reported physical exposure showed only a few significant associations with musculoskeletal symptoms. This may in part be explained by the ergonomic conditions generally being good, with a relatively low duration of 'combined' extreme work postures. Significant associations were found between the psychosocial work environment and musculoskeletal symptoms.     

Cross-sectional study of risk factors for symptoms in the neck and shoulder area

Abstract

This study was performed in order to evaluate how individual characteristics, as well as ergonomic, organizational and psychosocial factors in the work situation are associated with early symptoms in the neck and shoulder area. Nine hundred randomly drawn subjects of the working population in a semi-rural community in Sweden were mailed a questionnaire comprising the Nordic questionnaire on musculoskeletal symptoms, questions on ergonomic, organizational and psychosocial work conditions, life style factors, and background factors. The total response rate was 73% ( n = 637). Questions on ergonomic work conditions and on organizational and psychosocial work conditions provided the measures of exposure. Prevalence ratios (PR) were calculated for symptoms in the neck and shoulder area as reported by 303 subjects. Significant determinants for early symptoms were being a female and being an immigrant, as were repetitive movements demanding precision. High work pace, low work content and work role ambiguity were significant organizational risk factors while life style characteristics did not appear as risk factors. The results suggest that symptoms are signals not only of ergonomic deficiencies in the work situation, but in particular of work organizational conditions. Special attention should be given to the work conditions of women and immigrants in preventive interventions.     

Ergonomics interventions to reduce musculoskeletal risk factors in a truck manufacturing plant

Ergonomic interventions may potentially reduce MSDs, but the context of industries (barriers, ever-changing situations, dialogue processes) might play a significant role in the success of interventions. This study evaluates the effectiveness of ergonomic interventions including engineering/technical and organizational interventions, and the involvement of the stakeholders in reducing musculoskeletal risk factors/symptoms. A pre-post-test experimental study in non-randomized groups was performed over three years in a sector of a truck assembly plant. The mean age of the operators in the sector for the initial and second assessment time was 42.0 (±7.6) years and 39.0 (±8.7), respectively. The mean length of work experience in the current job was 15.2 (±7.2) years and 13.9 (±7.3) for the initial and second assessment times, respectively. Five engineering ergonomic solutions and organizational interventions were implemented after a comprehensive ergonomic analysis. The organizational interventions consisted mostly of transferring and redistributing the tasks, i.e., ergonomically balancing and redesigning of the workstations. Before performing the interventions, the findings of the ergonomic study were presented at several meetings to encourage the involvement of the stakeholders (including managers, engineers, and operators) in the interventions. This study showed that a combination of ergonomic measures—engineering and organizational interventions—could reduce physical workloads. Musculoskeletal symptoms decreased after interventions although the difference was not significant.     

Computer-telephone interactive tasks: predictors of musculoskeletal disorders according to work analysis and workers' perception

Sixty-two workers engaged in computer-telephone interactive tasks in an active telemarketing center and a telephone call center of an international bank subsidiary in S?o Paulo. Brazil, were assessed by means of a work analysis and a self-administered questionnaire aiming to determine the statistical relationship of ergonomic, organizational and psychosocial characteristics of their jobs with the report of symptoms in neck-shoulder and hand-wrist for more than 7 consecutive days and any time away from work during the current job due to musculoskeletal disorders (MSD). According to chi-square univariate tests and multiple logistic regression models, active telemarketing operations, duration in the job and the low level of satisfaction with the physical arrangement of the workstation emerged as the factors most related to neck-shoulder and hand-wrist MSD and MSD-induced time away from work. This study emphasizes the role of psychosocial factors and duration in the job in MSD occurrence and induced absenteeism among workers engaged in computer-telephone interactive tasks.     

Multifactor association of job,individual and psychosocial factors in prevalence of distal upper extremity disorders and quantification of job physical exposure

The objective of this study was to develop a multifactor model of job, individual and psychosocial factors in prevalence of distal upper extremity musculoskeletal disorders (DUE MSDs); and quantify job physical exposure to establish safe exposure limits. The study sample comprised of 525 workers who were part of a large prospective cohort study and represented a broad array of industrial practices and a wide range of job physical exposure. Only baseline data was considered for the analysis in the study. Workers underwent laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current DUE MSDs. All workers' jobs were individually measured for job physical exposure factors and videotaped. Binomial logistic regression was used to develop and test the multifactor association and quantification of job physical exposure for safe exposure limits. Results indicated that work-related DUE MSDs are multifactor in nature and are significantly affected by specific factors of (1) job physical exposure - percentage duration of exertion (PDOE), workers' subjective ratings of perceived effort or intensity of exertion (IOE) (using Borg CR-10), hand activity level measured by the American conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL), and presence of 2-point pinch grasps; (2) individual factors - female gender, diabetes, higher body mass index (BMI), and past and current smokers; (3) psychosocial factors - neither likely/unlikely or very unlikely to take up the current job again, divorced/separated, and presence of family problems. Quantification of job physical exposure indicated that prevalence of work-related DUE MSDs significantly increases with efforts per minute (Eff/min) >8 (OR = 1.69, p = 0.006) and woker's perceived effort based on Borg rating for IOE at the end of the shift >3 (OR = 2.46, p < 0.001). Further studies should be conducted to validate these safe exposure limit criteria.     

Visually deficient working conditions and reduced work performance in office workers: Is it mediated by visual discomfort?

IntroductionThe main purpose of this cross-sectional study was to investigate whether visual discomfort acts as a mediating factor between perceived visual ergonomic working conditions and self-rated visual performance among office workers who carry out administrative tasks and computer-based work at the Swedish Tax Agency.MethodsA questionnaire was sent to 94 office workers addressing: 1) perceived visual quality of the visual display units; 2) prevalence of eye symptoms; and 3) self-rated visual performance. Eighty-six persons (54 women (63%), 31 men (36%), and 1 of unspecified sex) answered the questionnaire. Multiple regression analysis investigated the association between visual ergonomic working conditions and visual performance, both with and without visual discomfort as a mediator.ResultsThe group mean of the Indexed survey questions indicated a reasonably good quality of visual ergonomic working conditions, a relative absence of eye symptoms, and acceptable self-rated visual performance. Results from multiple regression analysis showed a significant association between perceived visual ergonomic working conditions and self-rated visual performance (r² = 0.30, β = 0.327, p < 0.01). When visual discomfort was used as a mediator, the association between perceived visual ergonomic working conditions and self-rated visual performance remained the same (r² = 0.32, β = 0.315, p < 0.01).DiscussionIt was remarkable to discover that self-rated visual performance was independent of visual discomfort. Possible explanations include exposure factors not included in the current study, such as dry air and sensory irritation in the eyes, psychosocial stress, time spent performing near work activities, or time exposed to visually deficient working conditions.Relevance to industryThe strong connection between satisfaction with visual ergonomic working conditions and productivity in this study has implications for workplace profitability and staff satisfaction. If productivity is enhanced by better visual ergonomic working conditions, then managers of workplaces may be able to improve work outcomes by optimizing the physical work environment.     

Musculoskeletal disorder prevalence and psychosocial risk exposures by age and gender in a cohort of office based employees in two academic institutions

This study presents data on self-reported prevalence of Musculo-Skeletal Disorder (MSD) symptoms and psychosocial risk exposures by age and gender among a group of office based University workers who use their computers for at least 25% of their workday. Employees in two academic organisations received an invitation to participate in an on-line questionnaire. A total of n = 852 office workers participated in this study; yet respondents who were employed for greater than 12 months were only included in the study cohort. Furthermore, participants were only considered for further analysis if they spent 50% or more of their workday in their office, and of this time at least 50% was spent on computer work (n = 569). The study indicates that self-reported symptoms of MSDs for these workers were highest in the neck, shoulder and lower back. Neck, shoulder and back MSDs were higher for females than males, yet age differences within genders were not evident for these symptoms. For neck disorders, symptomatic individuals reported significantly higher levels of office work (p < 0.05) and PC usage (p < 0.005), and significantly lower levels of job content (p < 0.01), job demands (p < 0.05), and work environment (p < 0.05) compared to asymptomatic participants. For the shoulder, symptomatic individuals exposure levels were significantly higher for office work (p < 0.05) and PC usage (p < 0.05) and significantly lower for job content (p < 0.05) compared to asymptomatic individuals. There was evidence of important differences in the psychosocial exposures between age and genders, but associations between these differences and MSD symptoms were not present.Relevance to industryThis study presents prevalence data on age and gender differences in self-reported symptoms of MSDs and psychosocial risk exposures in a group of sedentary workers.     

Occupational stress factors in visual display terminal (VDT) operation: a review of empirical research

A review of the literature involving empirical research (experimental and field investigations) on stressful aspects of visual display terminal (VDT) operation is presented. Studies reviewed included assessment of visual fatigue and/or performance, musculoskeletal symptoms and operator attitudes towards job demands and quality of working life. In addition, some investigation included discussions and evaluations of the physical attributes of VDT workplaces; including ergonomic factors (task lighting, glare conditions, anthropometric configuration of VDT and accompanying furniture), environmental factors (temperature, humidity, radiation) and psychosocial factors (job demand, work content, work-rest schedules).

The literature reveals that levels of visual and musculoskeletal complaints among VDT operators are high. Moreover, ergonomic field assessment of VDT workplaces indicate that the majority of those examined were suboptimal with respect to existing recommendations regarding lighting, glare control and anthropometric dimensions of screen, keyboard, desk and chair. Nevertheless, evidence of causal linkages between specific ergonomic attributes of the workplace and specific patterns of symptomatology are lacking.

Finally, work demand and task structure attributes to the VDT operation were demonstrated to have strong effects on incidences of reports of visual and postural symptoms as well as on psychosocial attitudinal indicators. Hence, it is argued that approaches toward stress reduction must include job content as well as ergonomic factors.     

Work routinization and implications for ergonomic exposure assessment

Jobs in many modern settings, including manufacturing, service, agriculture and construction, are variable in their content and timing. This prompts the need for exposure assessment methods that do not assume regular work cycles. A scheme is presented for classifying levels of routinization to inform development of an appropriate exposure assessment strategy for a given occupational setting. Five levels of routinization have been defined based on the tasks of which the job is composed: 1) a single scheduled task with a regular work cycle; 2) multiple cyclical tasks; 3) a mix of cyclical and non-cyclical tasks; 4) one non-cyclical task; 5) multiple non-cyclical tasks. This classification, based primarily on job observation, is illustrated through data from a study of automobile manufacturing workers (n = 1200), from which self-assessed exposures to physical and psychosocial stressors were also obtained. In this cohort, decision latitude was greater with higher routinization level (p < 0.0001), and the least routinized jobs showed the lowest self-reported exposure to physical ergonomic stressors. The job analysis checklist developed for non-routinized jobs is presented, and limitations of the task analysis method utilized in the study are discussed. A work sampling approach to job analysis is recommended as the most efficient way to obtain a comparable unbiased exposure estimate across all routinization levels.     

Interaction between physical and psychosocial risk factors on the presence of neck/shoulder symptoms and its consequences

This study aimed to quantify the interaction between physical and psychosocial factors on the presence of neck/shoulder symptoms (NSS) and its consequences (reduced activities and absenteeism) among 1294 coal mining workers in Indonesia. A self-administered questionnaire was used to obtain information on current workplace exposure and NSS and its consequences. Participants were grouped into one of four combination exposure groups: low physical and low psychosocial (as the reference group); low physical and high psychosocial; high physical and low psychosocial, and high physical and high psychosocial (HPhyHPsy). The attributable proportion (AP) due to interaction between both factors was examined. Individuals in the HPhyHPsy group were most likely to report NSS [odds ratio (OR) 4.83, 95% confidence interval (CI) 2.43–9.58], reduced activities (OR 3.90, 95% CI 2.36–6.43), and absenteeism (OR 3.91, 95% CI 2.11–7.25). This study has shown an interaction between physical and psychosocial factors that increases the OR of NSS (AP 0.49, 95% CI 0.08–0.89).

Practitioner Summary: Although physical and psychosocial factors are known to be predictors for NSS, little is known about their interaction. Self-reported questionnaire was used to obtain information about physical and psychosocial factors at work. This study found an interaction between the physical and psychosocial risk factors that increases the odds ratio of NSS.     

Neck/shoulder and low-back disorders in the forestry industry: relationship to work tasks and perceived psychosocial job stress

In a national cross-sectional study, the prevalence of neck/shoulder and low-back disorders and their relationship to work tasks and perceived psychosocial job stress was studied among forestry employees. The data were collected by occupational health service staff using Karasek's demand/control questionnaire for the psychosocial measures and the Standardized Nordic questionnaire for the analysis of musculoskeletal disorders. Based on data about past and present work tasks, the study population was classified into three groups: 645 manual workers, 66 machine operators and 124 administrative workers. Low-back disorders were more common among the manual workers than among the administrative workers \[odds ratio (OR) = 1.98]. For the machine operators and manual workers, an increasing level of psychological demands was significantly associated with an increased prevalence of low-back disorders. The prevalence of neck/ shoulder disorders was significantly higher among the machine operators (OR = 3.37) and manual workers (OR = 2.34) than among the administrative workers. An increasing level of psychological demands combined with a decreasing level of intellectual discretion was associated with an increased prevalence of neck/shoulder disorders. Authority over decisions was not associated with musculoskeletal disorders. In conclusion, musculoskeletal disorders were associated with both physical and psychosocial work factors. The modest strength of the associations between each individual independent variable and the outcome measure shows, however, that a substantial reduction in the prevalence of musculoskeletal disorders may be difficult to achieve. Nevertheless, the study clearly suggests that in the forestry industry attention should be paid to psychosocial work factors in future organizational changes and preventive programmes.     

Paddling upstream: a contextual analysis of implementation of a workplace ergonomic policy at a large newspaper

Efforts to implement workplace ergonomic programs aimed at reducing the burden of work-related musculoskeletal disorders (WMSD) have to address multiple physical and psychosocial aspects of work environments yet often contextual factors limit their success. We describe the processes involved in an ergonomic program to reduce neck and upper limb WMSDs at a large Canadian newspaper. Using qualitative data collection and analysis methods, we illustrate the impact of key contextual characteristics of: (1) the program (management commitment, union involvement, experience and skill of program leaders, and researcher involvement); (2) the organization (drive for productivity, management control, organizational culture); and (3) the broader social context (economic climate, nature of newspaper work, technology and nature of WMSD). We argue for increased attention to identification and response to the contextual factors affecting program implementation in order to more successfully address upstream determinants of WMSD.     

Ergonomic analysis of the effects of a telehandler's active suspended cab on whole body vibration level and operator comfort

IntroductionExposure to whole body vibration (WBV) is one of the most important risks for musculoskeletal disorders (MSDs). The objective of the study was to investigate whether an active cab suspension system fitted on a telehandler was effective in reducing WBV and in improving comfort.MethodSixteen male healthy professional operators drove a telehandler on a 100 m ISO 5008 smooth track at two different speeds (5 and 12 kph) with activated and deactivated cab suspension system. Adopting an ergonomic approach, different aspects of the human-machine interaction were analyzed: 1) vibration transmissibility, 2) subjective ratings of general comfort and local body discomfort, and 3) anthropometric characteristics of the users.ResultsA series of ANCOVAs showed that the suspension system was effective in reducing WBV at both speeds but did not affect the perception of comfort by the operators. Moreover, individuals with higher Body Mass Index (BMI) experienced more comfort. Some neck/shoulder and lumbar complaints and perceived hard jolts seemed to remain even when the system was activated. No correlations were found between objective and subjective measures.Practical applicationsResults suggest that the operators, given their wide range of physical variability, may need more adjustable or customizable WBV reduction systems.     

Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work

The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men. PRACTITIONER SUMMARY: The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.     

Relationships between ergonomics and quality in assembly work

Several studies indicate a relationship between ergonomic work conditions and the quality of the work. The purpose of this study was to evaluate relationships between a number of ergonomic conditions and product quality in car assembly. The most physically demanding tasks, the tasks with the most difficult parts to assemble, and the most psychologically demanding tasks, were identified by interviews with experienced assembly workers. Information on quality deficiencies was obtained from the internal quality statistics of the company and from interviews with quality control personnel. The results showed that the quality deficiencies were three times as common for the work tasks with ergonomics problems, compared with the other tasks. An increased risk of quality deficiencies was seen for all three categories of ergonomics problems investigated. Direct causes of quality deficiencies were identified, such as discomfort from strained parts of the body, organizational factors and time pressure. The analyses pointed to certain types of task that were more likely than others to cause quality problems. The results also showed that an important factor for job satisfaction was the possibility for the workers to perform their tasks with high quality. The study therefore confirms close relationships between ergonomics and quality, and thereby points to the possibility of conducting integrated change programmes aimed at improving work quality and work conditions simultaneously.     

An ergonomic expert system for risk assessment of work-related musculo-skeletal disorders

A computer-based expert system (SONEX) was developed to identify ergonomic risks for work-related musculoskeletal disorders (WRMSDs) in a wide variety of jobs and provide expert prevention advice. SONEX uses a rule base and 6 knowledge base modules: WRMSD risk factors are grouped into two main knowledge base modules (symptoms, engaged body part) with four supplementary knowledge base modules (work environment, work chair, work tools, organization factors). SONEX uses a menu-based interface and a series of simple questions that lead a user through each of the two main modules. Based on user responses it then recommends other knowledge base modules that are relevant for a detailed analysis of work risks. The SONEX rule base has over 140 questions, the knowledge base includes over 200 risk factors, and around 500 possible answers can be generated. SONEX relates ergonomic shortcomings in the job with worker's subjective symptoms; it predicts possible WRMSDs; and it offers preventive suggestions for ergonomic improvements to the job to prevent WRMSDs. It has been tested in a variety of work places with known ergonomic problems and with known employee WRMSDs by comparing its performance with conventional analytical methods and results show that it accurately predicts possible WRMSD risks and identifies ergonomic shortcomings. The advantages of SONEX are that it is much faster than other ergonomic analysis methods and it can be used by ergonomists and other professionals and also by workers themselves.     

Dutch Musculoskeletal Questionnaire: description and basic qualities.

A questionnaire ('Dutch Musculoskeletal Questionnaire', DMQ) for the analysis of musculoskeletal workload and associated potential hazardous working conditions as well as musculoskeletal symptoms in worker populations is described and its qualities are explored using a database of 1575 workers in various occupations who completed the questionnaire. The 63 questions on musculoskeletal workload and associated potentially hazardous working conditions can be categorized into seven indices (force, dynamic and static load, repetitive load, climatic factors, vibration and ergonomic environmental factors). Together with four separate questions on standing, sitting, walking and uncomfortable postures, the indices constitute a brief overview of the main findings on musculoskeletal workload and associated potentially hazardous working conditions. Homogeneity of the indices is satisfactory. The divergent validity of the indices is fair when compared with an index of psychosocial working conditions and discomfort during exposure to physical loads. Worker groups with contrasting musculoskeletal loads can be differentiated on the basis of the indices and other factors. With respect to the concurrent validity, it appears that most indices and factors show significant associations with low back and/or neck-shoulder symptoms. This questionnaire can be used as a simple and quick inventory for occupational health services to identify worker groups in which a more thorough ergonomic analysis is indicated.     

Long-duration assessment of upper arm posture and motion and their association with perceived symptoms among bakery workers

Awkward shoulder postures have been suggested to be a cause of shoulder discomfort among bakery workers. This study aimed at long-duration assessment of upper arms posture and motion and their association with perceived symptoms among bakery workers. Among workers in three types of bread systems, fifty-seven bakers were randomly selected. The self-reported rates for the perceived severity and frequency of shoulder discomfort were collected through questionnaires. Working postures and movements of the shoulders during work were continuously recorded with inclinometry measurements for three hours. Percentage of time spent with the upper arm right elevated more than 60° was significantly correlated with the perceived discomfort rate in the right shoulder for all bakery workers (r = 0.48 to 0.63, p ≤ 0.05). A significant correlation was found between angular velocity with the perceived discomfort intensity for right upper arm.(r = 0.60 to 0.87, ≤0.005) of all workers in the three baking systems. Physical exposure in bakers was characterized by significantly more awkward postures and the percentage of time spent with the upper arms elevated more than 60°. The current findings can facilitate more informed decisions with respect to both engineering (e.g.ergonomic workstation and tool design) and administration (e.g. work organization) control strategies.     

Assembly failures and action cost in relation to complexity level and assembly ergonomics in manual assembly (part 2)

Earlier studies have demonstrated strong relationships between manual assembly at high physical load levels and increased amounts of quality defects compared to assembly at low physical load levels. A recent Swedish interview study of engineers in design and manufacturing engineering indicated that assembly complexity factors are of additional importance for the assembly quality. The objective of this study was therefore to examine the significance of high and low complexity criteria and the relationships between assembly ergonomics and assembly complexity and quality failures by analyzing manual assembly tasks in car manufacturing. In total, 47 000 cars were analyzed and the results showed several significant correlations between assembly ergonomics and assembly complexity, assembly time, failures and action costs. The action costs for high complexity tasks were 22.4 times increased per task per car compared to low complexity tasks.     

Physical discomfort and psychosocial job stress among male and female operators at telecommunication call centers in Taiwan

The prevalence of job stress, distributions of major job stressors, and associations between perceived job stress levels and multiple physical discomforts are assessed via a cross-sectional study of 1023 male and female operators at telecommunication call centers in Taiwan. Cases of discomfort are identified via questionnaire surveys requiring respondents to self-reported symptoms of discomfort. Information is obtained on demographics, health status, perceived job stress levels, major job stressors and psychosocial job characteristics. Multivariate logistic regression models are developed to predict physical discomfort in nine body areas. ‘Eye strain’, ‘hoarse or painful throat’ and ‘musculoskeletal discomfort’ are the most pronounced and prevalent complaints after prolonged work time at call centers. Female operators had higher prevalence of physical discomfort than male operators for all body areas. ‘Encountering difficult customers’ ranked as the most important job stress factor among both male and female operators. Working in a call center for more than 4 years is strongly associated with discomfort in all body areas (odds ratio ranges from 1.65 to 2.15). Analysis of risk factors vs. physical discomfort reveals that operators who perceive higher job stress have significantly increased risk of several health complaints, including eye strain, tinnitus, hoarse or painful throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, frequent urination and musculoskeletal discomfort.