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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (3): 535-540. doi: 10.19723/j.issn.1671-167X.2020.03.021

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Occurrence pattern of musculoskeletal disorders and its influencing factors among manufacturing workers

Fu-jiang WANG1,Xu JIN1,MAMAT Nazakat1,Yi-dan DONG1,Shi-juan WANG1,2,Zhong-bin ZHANG3,Shan-fa YU4,Li-yun YANG5,6,Li-hua HE1,△()   

  1. 1. Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
    2. Qiandongnan Vocational & Technical College for Nationalities, Kaili 556000, Guizhou, China
    3. National Center of Occupational Safety and Health, National Health Commission, Beijing 102308, China
    4. Henan Medical College, Zhengzhou 451191, China
  • Received:2020-01-13 Online:2020-06-18 Published:2020-06-30
  • Contact: Li-hua HE E-mail:alihe2009@126.com
  • Supported by:
    National Key Technologies Research & Development Program of the People’s Republic of China(2016YFC0801700)

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Abstract:

Objective: To explore the occurrence pattern and its influencing factors of multi-site work-related musculoskeletal disorders (WMSDs) of the main affected body sites among manufacturing workers.Methods: Musculoskeletal disorders questionnaire was adopted to investigate the prevalence of WMSDs and the influencing factors among workers from four manufacturing factories in China. The case of WMSDs was defined as the one who had symptoms such as pain, numbness, discomfort, or limitation of activities in one or more of the nine body sites, including neck, shoulder, elbow, wrist/hand, upper back, lower back, hip/thigh, knee and ankle/foot during the last year, which lasted for more than 24 hours and did not completely relieve after rest. Besides, trauma, disability, other acute injuries or sequelae were excluded. The correlation of WMSDs between different body sites was estimated by the prevalence ratio (PR) calculated by log-binominal model. The influencing factors of multi-site WMSDs of the main affected body sites were analyzed by multinomial logistic regression model.Results: The overall prevalence rate of WMSDs was 79.7% among the manufacturing workers. The main affected body sites were lower back, neck, shoulder and upper back, of which the prevalence rates were 62.3%, 55.7%, 45.6%, and 38.7%, respectively. The PR values of WMSDs among these sites were relatively high. The prevalence of multi-site WMSDs involving these four sites at the same time was 25.2%, and that of three to four sites was 41.4%. Multinomial Logistic regression analysis suggested that influencing factors of multi-site WMSDs in 3-4 sites of neck, shoulder, upper back and lower back involved several aspects. Among these factors, females (OR=2.86, 95%CI 2.38-3.33) and individuals with job tenure of 15-19 years (OR=1.87, 95%CI 1.49-2.34) might have higher risk of disease. Biomechanical factors, such as often bending neck forward or holding neck in a forward position for long periods (OR=2.15, 95%CI 1.86-2.48), often twisting neck or holding neck in a twisted position for long periods (OR=1.64, 95%CI 1.40-1.92) and often twisting trunk heavily (OR=1.40, 95%CI 1.20-1.64) might be risk factors. In the aspect of work organization, doing the same work every day (OR=1.73, 95%CI 1.44-2.08), shortage of workers (OR=1.50, 95%CI 1.31-1.71) and often working overtime (OR=1.38, 95%CI 1.20-1.60) might increase the risk of disease. Factors, such as often standing for long periods at work (OR=0.77, 95%CI 0.65-0.91) and feeling breaks sufficient (OR=0.51, 95%CI 0.44-0.59) were suggested to be protective factors with OR<1.Conclusion: The pre-valence rates of WMSDs in neck, shoulder, upper back, and lower back were high among manufacturing workers in this study. The correlation of WMSDs of these four sites was close in this study, and the comorbidity rate of 3-4 sites of these sites was relatively high, suggesting that there might be a multi-site occurrence pattern of WMSDs in “neck-shoulder-upper back-lower back” among manufacturing workers. The main influencing factors of this pattern included individual factors, biomechanical factors and work organization factors.

Key words: Manufacturing industry, Musculoskeletal disorders, Risk factors

CLC Number: 

  • R13

Table 1

Demographic characters of the study participants (n=8 021)"

Items n Constituent ratio/%
Gender
Male 6 170 76.9
Female 1 804 22.5
Age
18 years old- 1 048 13.1
26 years old- 2 862 35.7
36 years old- 2 906 36.2
46 years old- 1 205 15.0
Education level
≤Middle school 1 356 16.9
High school 4 531 56.5
≥College/University 2 134 26.6
BMI
<18.5 kg/m2 459 5.7
18.5 kg/m2- 5 107 63.7
24 kg/m2- 2 113 26.3
28 kg/m2- 342 4.3
Job tenure
<5 years old 2 042 25.5
5 years old- 1 581 19.7
10 years old- 1 337 16.7
15 years old- 1 058 13.2
20 years old- 1 763 22.0
Factory
A 1 752 21.8
B 3 876 48.3
C 1 723 21.5
D 670 8.4

Table 2

Correlations of the WMSDs of different body sites (PR value)"

Affected sites
of WMSDsa		 Affected sites of WMSDsb
Neck Shoulder Upper back Elbow Wrist/Hand Lower back Hip/Thigh Knee Ankle/Foot
Neck 1.91* 1.22* 1.00 1.04* 1.51* 1.05* 1.03* 1.00
Shoulder 2.05* 1.58* 1.14* 1.13* 1.14* 1.05* 1.09* 0.98
Upper back 1.78* 2.25* 1.17* 1.09* 1.87* 1.15* 1.07* 1.04*
Elbow 1.13 1.82* 1.70* 2.67* 1.29* 1.81* 1.70* 1.35*
Wrist/Hand 1.26* 1.36* 1.13* 1.53* 1.76* 1.12* 1.14* 1.39*
Lower back 1.57* 1.06* 1.23* 1.00 1.09* 1.02* 1.13* 1.03*
Hip/Thigh 1.47* 1.30* 1.67* 1.90* 1.47* 1.87* 1.81* 1.97*
Knee 1.25* 1.26* 1.20* 1.29* 1.20* 2.09* 1.29* 1.69*
Ankle/Foot 1.16* 0.98 1.15* 1.27* 1.76* 1.57* 1.65* 2.02*

Table 3

Prevalence of multi-site WMSDs in “neck-shoulder-upper back-lower back”"

Numbers of affected site Workers, n Constituent ratio/%
0 1 918 23.9
1 1 309 16.3
2 1 479 18.4
3 1 297 16.2
4 2 018 25.2
Total 8 021 100.0

Table 4

Multinomial Logistic regression analysis of influencing factors of multi-site WMSDs in “neck-should-upper back-lower back”"

Variables OR (95%CI)
1-2 site(s) with WMSDs 3-4 sites with WMSDs
Gender
Male 1.00 1.00
Female 1.41 (1.19, 1.69)# 2.86 (2.38, 3.33) #
Education level
≤Middle school 1.00 1.00
High school 1.27 (1.07, 1.50)# 1.26 (1.06, 1.50) *
≥College/University 1.39 (1.14, 1.70) # 1.47 (1.19, 1.80) #
Job tenure
<5 years 1.00 1.00
5 years- 1.18 (0.98, 1.41) 1.45 (1.20, 1.74) #
10 years- 1.36 (1.12, 1.66) # 1.71 (1.39, 2.09) #
15 years- 1.55 (1.24, 1.93) # 1.87 (1.49, 2.34)#
20 years- 1.38 (1.14, 1.67) # 1.80 (1.48, 2.19)#
Factory
A 1.00 1.00
B 0.65 (0.55, 0.78)# 0.70 (0.58, 0.84) #
C 0.64 (0.53, 0.78)# 0.71 (0.58, 0.87) #
D 0.77 (0.58, 1.02) 0.91 (0.68, 1.21)
Often lifting in uncomfortable position 0.89 (0.76, 1.04) 1.34 (1.14, 1.57) #
Exerting great force with arms or hands 1.33 (1.14, 1.55)# 1.31 (1.12, 1.54) #
Often bending neck forward or holding neck forward for long periods 1.23 (1.08, 1.41)# 2.15 (1.86, 2.48) #
Often twisting neck or holding neck in twisted position for long periods 1.25 (1.07, 1.47) # 1.64 (1.40, 1.92)#
Often twisting slightly with trunk 0.78 (0.69, 0.90) # 0.83 (0.72, 0.96) #
Often twisting heavily with trunk 1.14 (0.98, 1.33) 1.40 (1.20, 1.64) #
Often standing for long periods at work 0.99 (0.84, 1.15) 0.77 (0.65, 0.91) #
Often working overtime 1.26 (1.10, 1.45) # 1.38 (1.20, 1.60) #
Doing the same work almost everyday 1.30 (1.10, 1.53) # 1.73 (1.44, 2.08)#
Having sufficient breaks 0.77 (0.67, 0.88)# 0.51 (0.44, 0.59) #
Can choose the moment of a break 1.00 (0.87, 1.16) 0.81 (0.69, 0.94) #
Short of workers 1.27 (1.14, 1.45) # 1.50 (1.31, 1.71) #
Sometimes slipping or falling during work 1.15 (0.99, 1.33) 1.40 (1.21, 1.63) #
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