Modeling the Impact of Ergonomic Interventions and Occupational Factors on Work-Related Musculoskeletal Disorders in the Neck of Office Workers with Machine Learning Methods.

BACKGROUND: Modeling with methods based on machine learning (ML) and artificial intelligence can help understand the complex relationships between ergonomic risk factors and employee health. The aim of this study was to use ML methods to estimate the effect of individual factors, ergonomic interventions, quality of work life (QWL), and productivity on work-related musculoskeletal disorders (WMSDs) in the neck area of office workers. Study Design: A quasi-randomized control trial. METHODS: To measure the impact of interventions, modeling with the ML method was performed on the data of a quasi-randomized control trial. The data included the information of 311 office workers (aged 32.04±5.34). Method neighborhood component analysis (NCA) was used to measure the effect of factors affecting WMSDs, and then support vector machines (SVMs) and decision tree algorithms were utilized to classify the decrease or increase of disorders. RESULTS: Three classified models were designed according to the follow-up times of the field study, with accuracies of 86.5%, 80.3%, and 69%, respectively. These models could estimate most influencer factors with acceptable sensitivity. The main factors included age, body mass index, interventions, QWL, some subscales, and several psychological factors. Models predicted that relative absenteeism and presenteeism were not related to the outputs. CONCLUSION: In this study, the focus was on disorders in the neck, and the obtained models revealed that individual and management interventions can be the main factors in reducing WMSDs in the neck. Modeling with ML methods can create a new understanding of the relationships between variables affecting WMSDs.

The differences between normal and obese patient handling: re- structural analysis of two questionnaires.

BACKGROUND: Precise causes of musculoskeletal complaints among nurses are not known well, but many studies have pointed to manual patient handling tasks. Subjective judgment and decision-making process for patient lifting is crucial for gathering data regards patient handling. The aim of this study was to consider reliability and validity and re-structure of two special tools for patient handling's tasks. METHODS: In this cross- sectional study 249 nurses were fully participated. As recommended by literature for cultural adaptation of instruments, forward/backward translation method was applied. Reliability of the translated version was assessed by Cronbach's alpha coefficient. Validity testing for the two scales was based on content validity index/ratio analysis and also Exploratory Factor Analysis was run to extract latent factors. RESULTS: Reliability estimated by internal consistency reached a Cronbach's Alpha of above 0.7 for all subscales of two questionnaires. After testing the validity, the final version of questionnaires was remained by 14 and 15 questions respectively. CONCLUSIONS: These instruments evaluated for manual handling of normal and obese patients had acceptable validity and reliability in Iranian Nursing context. So, these tools can be used in further studies with the same cultures.

The Protective Effects of High-Intensity Interval Training Combined with Q10 Supplementation on Learning and Memory Impairments in Male Rats with Amyloid-ß-Induced Alzheimer's Disease.

BACKGROUND: Oxidative stress plays a major role in the progression of Alzheimer's disease (AD)-related cognitive deficits. OBJECTIVE: This study was done to determine the protective effects of coenzyme Q10 (CoQ10) and high-intensity interval training (HIIT) alone and in combination for eight continuous weeks, on oxidative status, cognitive functions, and histological changes in the hippocampus in amyloid-ß (Aß)-induced AD rats. METHODS: Ninety male Wistar rats were randomly assigned to the sham, control, Q10 (50 mg/kg of CoQ10; P.O.), HIIT (high intensity: 4 min running at 85-90% VO2max, low intensity: 3 min running at 50-60% VO2max), Q10 + HIIT, AD, AD+Q10, AD+HIIT, and AD+Q10 + HIIT groups. RESULTS: The results showed that Aß injection reduced cognitive functions in the Morris water maze (MWM) test and recognition memory in the novel object recognition test (NORT), which was accompanied by a decrease in total thiol groups, catalase, and glutathione peroxidase activities, an increase in malondialdehyde levels, and neuronal loss in the hippocampus. Interestingly, pretreatment with CoQ10, HIIT, or both, could markedly improve the oxidative status and cognitive decline in the MWM and NOR tests, and hinder neuronal loss in the hippocampus of Aß-induced AD rats. CONCLUSION: Therefore, a combination of CoQ10 and HIIT can improve Aß-related cognitive deficits, probably through an amelioration in hippocampal oxidative status and prevention of neuronal loss.

A comparative study of electronic and pen-paper safety inspections: A mixed method study design for assessing ergonomic parameters.

BACKGROUND: Workplace inspections are applied to facilitate the adherence to the occupational health and safety regulations. The Iranian Ministry of Health introduced a new software system for tablets to inspect workplaces. OBJECTIVES: The aim of this study was to take measurements of the usability, mental workload, and mood of inspectors. METHODS: Inspectors used both pen-and-paper and tablet methods to inspect the automotive industry in a mixed-method procedure. The NASA-TLX score, QUIS score, I-PANAS (SF) situation, inspection time, and number of errors were collected throughout the procedure. The differences were investigated using a paired sample and the Wilcoxon signed ranks test. RESULTS: In terms of efficacy, using the tablet resulted in lower error rates, but it took longer to complete the inspection task (P < 0.001). Participants perceived a lower workload when inspecting with a tablet rather than the traditional method. (Mental Demand: p < 0.002, Performance: p < 0.009, Effort: p < 0.012, TLX: p < 0.002 based on various subcomponents of NASA-TLX). The newly introduced system's usability was insufficient. CONCLUSION: Although the use of tablets has improved safety inspections, ergonomic redesign of the system and consideration of a user-centered approach, as well as inspector training, can make the system more likely to succeed.

Analysis of body heat tolerance of workers in a simulated warm environment based on linear mixed model.

Workers' heat tolerance plays a crucial role in maintaining their health and performance in hot environments. This study aimed to empirically analyze the body heat tolerance of workers under a simulated warm environment. Twenty healthy male workers from the typical light metal industry (age: 23.15±2.45 years) were participated in the experimental study. Workers were exposed to two thermal environments (Ta = 22°C, RH = 35%, and Ta = 35°C, RH = 35%) in a simulated moderate workload in a climate-controlled room. The maximal aerobic capacity (VO2 max) and body fat mass of workers were determined. The heat tolerance indicators were determined based on heart rate (HR) and ear temperature (ET) before and after each experiment. A linear mixed model was employed to analyze body heat tolerance indicators using the SPSS statistical package. All physiological responses significantly increased in the warm air condition compared to the thermoneutral condition. The HR and ET increased by an average of 14 bpm and 0.75°C, respectively (p<0.05). The mixed model could accurately predict heat tolerance indicators (r = 0.95 and r = 0.97) so that the VO2 max and body fat mass were identified as the main individual influential factors. The VO2 max showed significant correlation with urinary specific gravity (r = -0.55, p<0.05), HR (r = -0.59, p<0.05), and ET (r = -0.57, p<0.05) in warm environment. The model confirmed that physical fitness is critical in increasing heat tolerance in warm environments. It can be a helpful screening tool for properly selecting workers in occupational medical examinations for working in warm air conditions. It is proposed that workers' regular exercise and lifestyle modifications can strengthen their heat tolerance.

Burnout and Mental Health of COVID-19 Frontline Healthcare Workers: Results from an Online Survey.

Objective: The COVID-19 pandemic has been prolonged and healthcare workers have become exhausted. The purpose of this study was to investigate burnout and its relationship with mental health in COVID-19 frontline healthcare workers. Method : This cross-sectional study was carried out in all hospitals where patients with COVID-19 were admitted in Hamedan, Iran. With the census method and considering the inclusion criteria, 924 COVID-19 frontline healthcare workers participated in this study. Data were collected using a web-based survey consisting of demographic characteristics, GHQ-28, and Maslach Burnout Inventory. Statistical analysis was performed using Stata 14. Results: The results showed that the main cause of concern and stress in employees was that it was not clear how long this situation would continue. The results regarding burnout and mental health showed that 29.33% of participants were high in emotional exhaustion (EE), 10.93% were high in depersonalization (DP), 34.31% were low in personal accomplishment (PA), 50.4% had physical symptoms, 50.2% had anxiety and insomnia symptoms, 62.2% had social dysfunction and 17.5% had depression symptoms. The results of the multivariate logistic regression showed that EE had the greatest role in reducing mental health of employees with OR = 6.92 for moderate EE and OR = 39.42 for high EE (P < 0.001). Conclusion: COVID-19 frontline healthcare workers are at risk for burnout and poor mental health. Health policies should be implemented to help reduce burnout in healthcare workers. Also, person-directed and organizational-directed interventions to rejuvenate these employees seem necessary.

Effect of Convalescent Plasma Therapy on Clinical Improvement of COVID-19 Patients: A Randomized Clinical Trial.

Background: Due to the critical condition of COVID-19, it is necessary to evaluate the efficacy of administrating convalescent plasma to COVID-19 patients. Therefore, we decided to design a clinical trial to investigate the effect of convalescent plasma of patients recovered from COVID-19 on the treatment outcome of COVID-19-infected patients. Materials and Methods: In this parallel randomized controlled clinical trial, patients in the intervention group received standard treatment plus convalescent plasma of patients recovered from COVID-19. We allocated 60 patients to each treatment group through balanced block randomization. Then, COVID-19 outcomes, vital signs, and biochemical parameters were compared between the two treatment groups by the independent t test and ANCOVA. Results: The mean age (SD) of the patients in the intervention and standard treatment groups was 52.84 (15.77) and 55.15 (14.34) years, respectively. Although patients in the intervention group reported more hospitalization days (11.45±5.86 vs. 10.42±6.79), death rates (26.67% vs. 18.13%), ICU admission (45 vs. 41.67%), and ARDS (11.67% vs. 3.33%), these differences were not statistically significant (P>0.05). Moreover, the two groups were homogenous in vital signs and biochemical parameters before and after treatment (P>0.05). Conclusion: The present study indicated that convalescent plasma therapy has no significant effect on the survival, hospitalization, and ICU admission of COVID-19 patients.

Incidence of Neurotoxic Symptoms in Iranian Anesthesiology Staff: Psychometric Properties of Persian Version of the Euroquest Questionnaire.

BACKGROUND: With the increase in the number of people exposed to anesthetic gases, there is a critical need to examine the prevalence of neurotoxic symptoms in these individuals using reliable tools. The aim of this study was to evaluate the psychometric characteristics of EUROQUEST questionnaire and to measure the rate of neurotoxic symptoms in the anesthesiology personnel. METHODS: This research was a cross-sectional study. This study was a cross-sectional one. Participants included 404 personnel of the operating room in western Iran. EUROQUEST questionnaire was translated into Persian and used to measure the rate of neurotoxic symptoms. Reliability of the questionnaire was examined by Cronbach's alpha, while face and construct validities were evaluated using SPSS 16 (SPSS Inc., Chicago, IL, USA) and AMOS 18 (IBM, Chicago, IL, USA) software. RESULTS: The results indicated that EUROQUEST questionnaire had acceptable reliability and validity. The most prevalent symptoms were observed in memory and concentration, fatigue, and sleepiness. The prevalence of fatigue was higher than other dimensions, with 28% of participants in the third and fourth quartiles. Also, there was no relationship between symptoms and work experience. CONCLUSIONS: EUROQUEST questionnaire can be applied in studies of the neurotoxic symptoms. The study of the prevalence of symptoms also indicated that most participants complained about memory and concentration, fatigue, and sleepiness, and these symptoms were observed in all individuals regardless of their work experience.

Insights into the relationship between usability and willingness to use a robot in the future workplaces: Studying the mediating role of trust and the moderating roles of age and STARA.

BACKGROUND AND AIM: Human-robot collaboration is the key component of the fourth industrial revolution concept. Workers' willingness to collaborate with industrial robots is a basic requirement for an efficient and effective interaction. The roles of human-robot trust and technology affinity as mediators in the relationship between robot usability and worker willingness were analyzed in this study. As other critical variables, the mediator roles of Age and STARA were also calculated. MATERIALS AND METHODS: This study included 400 workers from a car company who interacted with industrial robots in their daily work activities. After examining the questionnaires' validity and reliability, the main variables were determined to be willingness to use robots and robot usability. AMOS software also considered human-robot trust and worker technology affinity as mediators. The bootstrapping method was used to evaluate indirect relationships. A set of goodness-of-fit indices were presented to determine the adequacy of the goodness of fit between the proposed model and the data. RESULTS: Based on model fit indices, an overall satisfactory model fit was obtained for the direct/indirect relationship between robot usability and worker willingness to use it (with mediating role of human-robot trust). Workers' age and fear of Smart Technology, Artificial Intelligence, Robotics, and Algorithms (STARA) were identified as moderators in the relationship between usability and willingness. CONCLUSION: Attention to the robot usability and the role of workers' trust in robots appears to be required to ensure workers' willingness to use robots and the success of human-robot collaboration in future workplaces. As the workers age and their fear of robots grows, usability can play a larger role in increasing their willingness to put robots to work.

Investigation of hand muscle fatigue and its influential factors in manual tasks.

Muscle fatigue (MF) can lead to musculoskeletal disorders (MSDs) in the long term; however, it can be managed if the causes are well known. This study aimed to examine the grip force (GF) and grip fatigue (GFa) of employees with light, moderate and heavy manual tasks using a dynamometer and find their possible relationship with other factors. The nature of heavy manual tasks led to more experience of GFa and GF of the right hand. Moreover, the equal need for both hands in occupations with light and moderate manual tasks is the reason for more GFa in the left hand. In this primary study, the height, weight and age of subjects and their exposure to vibration had a decisive effect on GF. In order to determine the accurate effects of the aforementioned risk factors on MF, it is recommended for future studies to be performed on larger populations.

What do the different ergonomic interventions accomplish in the workplace? A systematic review.

Introduction. Improving well-being and overall system performance are the ultimate goals of ergonomics, which are achieved through ergonomic interventions. This systematic review aimed to answer the question of what different ergonomic interventions accomplish in the workplace. Method. The systematic review followed PRISMA guidelines. Ergonomic interventions in workplaces focusing on any ergonomics health outcomes or productivity were identified in electronic databases up to June 1, 2019. Results. The 1635 articles collected from the literature screening stage were screened for their relevance to this study by the authors independently. The full-text review identified 22 papers qualified for inclusion in this systematic review. Most of the interventions implemented in the analyzed articles were ergonomic training programs, participatory ergonomics and workstation designs. The highlight results showed that interventions such as feedback, participatory ergonomics in short-term follow-ups and job rotation along with ergonomic guidelines did not significantly affect the risk of psychosocial factors. A significant reduction of musculoskeletal disorders in the upper limbs was reported with workplace improvements. Conclusion. There was no specific study method or intervention approach found to influence ergonomic outcomes. A multicomponent intervention program can be used to improve the impact of interventions on employees' health and system productivity.

Development of a mobile application to screen and manage fall risks in older people.

OBJECTIVE: Falls and related injuries are known to be the major health problem leading to disability and mortality among older adults. Identification and management of fall risks aimed to prevent falling is considered to be essential. The aim of this study was to develop a mobile application for screening and management of fall risks based for older adults. METHOD AND MATERIALS: First, we determined product features based on literature reviews. Then we asked 10 experts to assess the importance of capabilities. The application was designed in Android environment based on the STEADI toolkit. Finally, the usability and satisfaction of the application were assessed among 30 older adults by means of a usability questionnaire, and the final version was modified. RESULTS: The experts rated the majority of feasibility features to be important. The application consisted of falls risk self-assessment, and the Timed Up and Go (TUG) test to measure individual fall risks, fall prevention education, and suggestions for training based on the individuals' level of fall risk among older adults. The results of the usability assessment showed that the users were satisfied with the application, 8.83 out of 10. CONCLUSION: The mobile application can be used to screen and manage fall risks in older adults. It may help health providers to identify older adults at low, moderate, and high risks of falls provide education and training to minimise falls and fall-related injuries.Implications for rehabilitationFalls are a major health problem in older people. A great proportion of falls and falls related injuries are preventable.Given the availability and accessibility of various mobile health application and the increasing mobile device usage among older adults, mobile application can be used as a platform for delivering fall prevention programmes such as education and exercise training.The mobile application may be a valuable tool in the fall prevention and their consequences either in old adult.

Household Secondary Attack Rate of COVID-19 among Healthcare Workers and Related Factors.

Background: The risk for transmission of COVID-19 to people in close contact with infected people, especially healthcare workers, has not been well estimated. Therefore the present study was conducted to assess the household secondary attack rate (SAR) of COVID-19 among healthcare workers and related factors. Materials and Methods: The present prospective case-ascertained study was conducted on 202 healthcare workers with confirmed COVID-19 in Hamadan, diagnosed from March 1, 2020, to August 20, 2020. For households with close contact with the index case, RT-PCR was performed regardless of symptoms. We defined SAR as the proportion of secondary cases from the total contacts that live in the index case household. SAR was reported as a percentage and 95% confidence interval (CI). Multiple logistic regression was performed to explore the predictors of COVID-19 transmission of index cases to their households. Results: We found 36 secondary cases out of 391 household contacts with laboratory confirmation (RT-PCR), representing a household SAR of 9.2% (95% CI: 6.3, 12.1). Among factors related to the family member, female gender (OR: 2.9, 95% CI: 1.2, 6.9), being the patient's spouse (OR: 2.2, 95% CI: 1.0, 4.6), and living in the apartment (OR: 2.78, 95% CI: 1.24, 6.23), and among factors related to index cases, hospitalization (OR: 5.9, 95% CI: 1.3, 26.9) and caught (OR: 2.4, 95% CI: 1.1, 5.2) were the significant predictors of disease transmission to other family members (P<0.05). Conclusion: The findings of this study suggest that the SAR is remarkable in household contacts of infected healthcare workers. Some characteristics of family members of the index case, including female gender, being the patient's spouse, and living in the apartment, and some characteristics of the index case, including hospitalization and caught, were associated with the increased SAR.

Effects of Biopsychosocial Interventions on Non-specific Chronic Low Back Pain and Its Related Disabilities among Students.

BACKGROUND: This study aimed to investigate the effects of biopsychosocial interventions on non-specific chronic low back pain (NSCLBP) and disabilities caused by it among Students. STUDY DESIGN: A two-group pretest-posttest randomized clinical trial. METHODS: The statistical population of the study was female students enrolled at the first-stage secondary school in Hamadan, Iran. A total of 200 students were selected through cluster sampling and randomized into two groups of intervention and control. The primary evaluation was performed by the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), the Health-Related Quality of Life (SF-36), the International Physical Activity Questionnaire-Short Form (IPAQ-S), the World Health Organization Disability Assessment Schedule (WHODAS), and the visual analogue scale (VAS). Upon developing and implementing the biopsychosocial model-based interventions for ten weekly two-hour sessions, the secondary evaluation was fulfilled, and the extracted data were analyzed using the IBM SPSS version 21. RESULTS: The independent-group t-test results revealed that the mean scores of quality of life (QOL) and physical activity significantly elevated in the intervention group, compared to the control. In addition, the mean value of disabilities, the amount of disorder in the lumbar region, and the VAS scores in the intervention group substantially declined compared to the control group. CONCLUSION: The significant variations in the biopsychosocial factors demonstrated that the development of some interventions based on the bio-psychosocial model (BPSM) could help manage the NSCLBP and its ensuing disabilities. Therefore, the BPSM-based interventions could be exploited to minimize musculoskeletal disorders (MSDs) in students.

Predictors of death in patients with COVID-19: A cross-sectional study in West of Iran.

Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. The purpose of this study was to evaluate the predictors of COVID-19 mortality in Hamadan province in western Iran. Methods: In this study, we included all laboratory-confirmed COVID-19 cases with known treatment outcomes in Hamadan province, Iran, between 20, 2020, to May 10, 2020. Demographic, clinical, laboratory data, and treatment outcomes were obtained from computerized medical records and compared between survived cases and patients with death outcomes. Univariable and multivariable logistic regression models were used to determine the predictors of death. Results: From 749 investigated patients, 77 patients (10.28%) died during the treatment. The Mean age of patients was 53.97±19.04 years. Multivariable logistic regression showed that males had 2.07 (95% CI: 1.73, 2.54) fold higher odds of death. Those with 60 years old and more had 6.49 (95% CI: 4.53, 7.93) fold higher odds of death. Patients with an underlying disease had 7.14 (95% CI: 6.94, 7.38) fold higher odds of death, and patients who were hospitalized in the ICU ward had 2.24 (95% CI: 1.75, 2.90) times higher odds of COVID-19 related mortality. Conclusion: The potential predictors of death in COVID-19 cases, including the male gender, older age, and having an underlying disease could help physicians to identify patients with poor prognoses at an early stage and better management of them.

Assessment of mask-wearing adherence and social distancing compliance in public places in Hamadan, Iran, during the COVID-19 pandemic.

BACKGROUND: The determination of the rate of social distancing compliance and mask-wearing adherence is essential to address the health aspects of COVID-19. The present study aimed to estimate the adherence to mask-wearing and maintaining the social distancing in public places in Hamadan, western Iran, during the COVID-19 pandemic. STUDY DESIGN: The present study was conducted based on a cross-sectional design. METHODS: The current study included 72 images from 12 areas in Hamadan as clusters in January 2021. The images were extracted from the traffic control center of Hamadan Municipality. The mean of social distancing and percentage of mask-wearing in all clusters were obtained based on cluster sampling. RESULTS: In this research, the majority of people(68%) of people in public places were men and 32% women. The mean±SD of social distancing in all public places in Hamadan was obtained at 65.27 ±73.37 cm (95% CI: 38.48-92.08). The percentage of men who wore masks correctly was higher than that of women (57% vs. 51%). Moreover, mask-wearing adherence was not recognizable in about 34% of people in the images (28% of men versus 48% of women). Among the people whose images were recognizable, all the women were wearing masks, while about 13% of men were not (P<0.05). CONCLUSION: As evidenced by the obtained results, the mean social distance in Hamadan was much lower than the standard value (1.5-2 meters) even at the time of restrictions. Although more than half of people wore masks in public places, it was much less than that in developed countries. Therefore, people should pay more attention to health advice regarding mask-wearing and maintaining social distance.

Ergonomics 4.0: A bibliometric review of Human Factors research in Industrial Revolution 4.0 (IR 4.0).

BACKGROUND: The scientometric study is a visualization method used to collect big data from databases, to explore the relationships between citing and co-cited documents and then visualize the results. Unlike the new term Ergonomics 4.0, bibliometric analysis has been studied in various related fields of Ergonomics. OBJECTIVE: The aim of this study was to create a bibliometric analysis in related field of Ergonomics and Fourth Industrial Revolution. This analysis can shed light on the new developed research field in both sides of the present study, occupational ergonomics and industry 4.0. METHODS: After selecting related keywords, Advance search was done in Scopus and Web of Science. Bibliometric results were presented by these databases' analyzer and by exported data to VOS viewer software. No time or language restriction was applied. RESULTS: Retrieved Articles were 104 and 285 for Web of Science and Scopus respectively. The frequent co-occurrences for keywords were seen between "industry 4.0" and "Human Factors". The USA and Germany were also the most productive countries in this field. Well-known Ergonomics journals had low participation in the Evolution of Ergonomics and Fourth Industrial Revolution topics. CONCLUSION: Due to more participation of industry 4.0-related researchers in this topic, it is recommended that ergonomists from around the world, and especially Eastern countries, attempt to conduct research in this field. Furthermore, devoting some forth-coming special issues in this field is recommended to top ergonomics journals.

Identification of factors related to behaviors associated with musculoskeletal pain among elementary students.

BACKGROUND: Musculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models. METHODS: In this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018. RESULTS: The findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, ß = 0.219), perceived severity (p < 0.05, ß = 0.166), perceived barriers (p < 0.05, ß = - 0.191), perceived self-efficacy (p < 0.05, ß = 0.188) and also enabling factors (p < 0.05, ß = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, ß = 0.198), perceived barriers (p < 0.05, ß = - 0.258), perceived self-efficacy (p < 0.05, ß = 0.185) and reinforcing factors (p < 0.05, ß = 0.208). CONCLUSIONS: It seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.