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Grobler S.H.1, Mostert K.1, Becker P.2
1University of Pretoria, School of Health Care Sciences, Physiotherapy, Pretoria, South Africa, 2University of Pretoria, School of Health Care Sciences, Statistics, Pretoria, South Africa
Background: Suggestions to improve employee health by decreasing sitting time at work, has been made recently. However, literature lacks research-to-practice guidance on the expected impact of a postural change on musculoskeletal disorders in the work place.
Purpose: a) Determine the incidence of work-related musculoskeletal disorders when the work posture of a sewing-machine operator changes from seated work posture to stand-up work posture,
b) determine the association of personal and ergonomic risk factors with work-related musculoskeletal disorders during the implementation period of such a postural change.
b) determine the association of personal and ergonomic risk factors with work-related musculoskeletal disorders during the implementation period of such a postural change.
Methods: This study has a quantitative, retrospective, longitudinal design with a convenience sample. Postural change was managed within a work-place health programme. Data of personal and ergonomic risk factors, and work-related musculoskeletal disorders of 123 sewing-machine operators were captured, and analysed using Poisson regression over a 4.5 year period (June 2004 to January 2009).
Results: Stand-up work posture reduced the incidence for spinal disorders to 0.29 fold the incidence for seated work posture (p ˂ 0.001). Morbid obesity had significantly increased (p=0.04) incidence of upper limb disorders, 3.35 times that of normal body mass index (BMI) (regardless of work posture). Stand-up work posture was associated with an increased IRR (1.49) for lower limb disorders. Lower limb disorders were specifically associated with obesity (overweight (IRR 2.58; p=0.08), obese (IRR=2.45; p=0.09), and morbidly obese (IRR=6.24; p=0.001)).
Conclusion(s): From a musculoskeletal point of view: Implementing the stand-up work posture among overweight sewing-machine operators, proved to be protective for spinal disorders. A temporary increase in the incidence of lower limb disorders was managed with the combination of supportive footwear, silicone innersoles, compressive stockings, and exercise, and lasted for a period of two months. The responsibilities of the employer towards optimised musculoskeletal health in the work place, should include creating and maintaining a safe work environment. This includes sound ergonomic workplace design and a stand-up work posture; as well as a work-place health programme to prevent and manage work-related musculoskeletal disorders. For the employee, the responsibility is to maintain a healthy personal lifestyle with a normal BMI.
Implications: Postural implementation guidelines for South African sewing-employers, in managing a change from seated work posture to stand-up work posture, include: Not to combine the implementation phase of a stand-up work posture with working overtime; management of lower limb disorders within the work-place health programme; and to promote a reduction of high BMIs, especially in morbid obesity. From a holistical health perspective, monitoring of medical conditions, and inclusion of psychosocial risk factors may identify additional risk factors that may guide the implementation of postural change interventions.
Funding acknowledgements: None
Topic: Occupational health & ergonomics
Ethics approval: Ethics Committee of the Faculty of Health Sciences at the University of Pretoria (S157/2011).
All authors, affiliations and abstracts have been published as submitted.
