Predictors of Musculoskeletal Pain among Primary School Students Using Smartphones in Nakhon Si Thammarat, Thailand.

School-age children increasingly use smartphones to conduct their learning activities; increasing reports of disorders related to smartphone use exist, including visual-related symptoms, stress, and musculoskeletal pain. This study aimed to examine risk factors for musculoskeletal pain among primary school students using smartphones. A cross-sectional study was conducted with 233 school-aged children in Nakhon Si Thammarat, Thailand. Data collection used a questionnaire for musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire with ISO 11,226:2000. Through Chi-square, t-test, and logistic regression analysis, factors independently associated with musculoskeletal pain were determined. An important factor in the development of musculoskeletal pain was the prolonged use of smartphones for longer than 60 min, particularly among children aged 6-9 years old. In regards to musculoskeletal pain, almost 53% of the students used their smartphones while lying down. Posing in a prone position while using a smartphone was 7.37 times more dangerous than sitting. The laying position tilts numerous organs at varying angles, especially the upper arm. The risk of musculoskeletal complaints must be reduced by educating parents, children, and the relevant government organizations about safe smartphone usage. The mentioned factors may be used to anticipate the onset of musculoskeletal pain caused by smartphone use in young children.

The effect of laying down posture while using smartphone among school children in Nakhon Si Thammarat, Thailand.

Background: Lots of children use the smartphone in lying down posture that is unappreciated posture. The postures of children while using a smartphone affect their musculoskeletal pain and can enhance Musculoskeletal Disorders (MSDs). Objective: To study the effect of lying down posture while using smartphone among school children in Nakhon Si Thammarat, Thailand. Materials and methods: This survey study employed a Descriptive Cross-Sectional Design. The population was Grade 1-6 students studying in a primary school in Nakhon Si Thammarat. There were 122 samples selected based on the Volunteer Sampling Technique under the written consent of the students' guardians. The research instruments employed in this study were: 1) Questionnaire adapted from Nordic Musculoskeletal Questionnaire asking musculoskeletal symptoms, 2) Posture Assessment using Kinovea Software to measure the angles of the muscle and postures during photo and video shooting of the smartphone users. The data were analyzed using descriptive statistics while Chi-square and Mann-Whitney U tests were used to test the mean differences. Results: There is a significant difference at p<0.05 level in mean angles of the neck, trunk, shoulder, and lower arms when using smartphones in supine and prone postures. The correlation between smartphone usage postures and musculoskeletal symptoms at the head/neck, trunk, and upper arm are found significantly different at p<0.05 level. The statistically significant difference at p<0.05 level is also found in the differences of age, length of smartphone ownership, position when using smartphone, and length of a smartphone usage in lying down positions. Conclusion: Smartphone usage in lying down positions of the participants can cause musculoskeletal pain especially in prone posture. It is recommended that guardians or relevant sectors have greater attention to smartphone usage among children to prevent their long-term musculoskeletal problems.

Associations of Occupational, Socio-Demographic and Lifestyle Factors with Lung Functions in Malaysian Traffic Policemen.

Background: Apart from being exposed to various hazards, there are several other factors that contribute to the deterioration of traffic police health. Objectives: A cross-sectional study was carried out to explore the association of occupational, socio-demographic, and lifestyle factors with lung functions in traffic policemen in Kuala Lumpur (KL) and Johor Bahru (JB). Methods: A spirometer was used to measure lung function of subjects, whereas a self-administered questionnaire was used to obtain their information on background data, lifestyle, and occupational factors. The statistical test used was Spearman rho's test and chi-square test; then, the factors were further tested using Logistic regressions. Findings: 134 male subjects were selected as respondents in this study with 83% response rate. Among all the factors tested, age (FVC: χ = 8.42(3), p = 0.04), (FEV: χ = 8.26(3), p = 0.04), rank (FVC: χ = 8.52(3), p = 0.04), (FEV: χ = 8.05(3), p = 0.04), duration of services (FVC: χ = 11.0(1), p = 0.04), (FEV: χ = 6.53(1), p = 0.01), and average working hours (with the Measured FVC (litre), r = -3.97, p < 0.001; Measured FEV1 (litre), r = -3.70, p < 0.001; Predicted FVC, r = -0.49, p < 0.001; Predicted FEV1, r = -0.47, p < 0.001; and %Ratio FEV1/FV, r = -0.47, p < 0.001) were significantly related to lung function among traffic police. Conclusions: Occupational factors play a crucial role, and hence, the authorities should take action in generating flexible working hours and the duration of services accordingly. The data from this study can help by serving as a reference to the top management of traffic police officers to develop occupational safety and health guideline for police officers to comply with the Occupational Safety and Health Act (OSHA, Act 514 1994).

Borg CR-10 scale as a new approach to monitoring office exercise training.

BACKGROUND: There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist. OBJECTIVE: The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training. METHODS: The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined. RESULTS: Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P < 0.01). CONCLUSIONS: This study found the Borg CR-10 scale to be a reliable and valid tool for monitoring the perceived exertion of office exercise training and may potentially be useful for occupational therapists to measure physical activity intensity levels.

Knowledge, attitude, and perception of risk management of steam boilers among workers in palm oil mills.

BACKGROUND: People who work with the steam boilers in palm oil mills are vulnerable to accidents, notably to explosions, whenever failures of any kind occur during their operation. OBJECTIVE: This cross-sectional study was conducted in palm oil mills to determine the knowledge, attitude, and perception (KAP) concerning the risk management of steam boilers among workers in palm oil mills. METHODS: A total of 50 workers who were working with steam boilers and/or involved in managing the operation of steam boilers with at least three years of working experience in the palm oil industry were purposively sampled. A self-administrated questionnaire consisting of four main parts - socio-demographic and occupational information, knowledge, attitude, and perception of the risk management of steam boilers was distributed. The knowledge, attitude, and perception were calculated based on a Likert-type scale. RESULTS: This study found that 56% of boiler workers had a good level of knowledge (mean score = 77.22±19.6), 72% had a good attitude toward risk (mean score = 83.17±5.85), and 64% had a good perception of risk (mean score = 79.50±11.22). The prevalence of accidents was 16%, and, for near misses, it was 24%. The cause of the reported accidents was largely attributed to carelessness, specifically at 80%. Apart from that, there was a positive association (χ2 = 6.56; p = 0.010) between attitude and accidents. CONCLUSION: This study found that the workers had good KAP levels of risk management of steam boilers in palm oil mills. However, there is a need for the employers to revise the training of workers and ensure its effectiveness in heightening the awareness of risks and accidents despite the high level of KAP.

Prevalence, source and severity of work-related injuries among "foreign" construction workers in a large Malaysian organisation: a cross-sectional study.

Malaysian construction sector is regarded as critical in the field of health because of the high rates of accidents and fatalities. This research aimed to determine the prevalence, sources and severity of injuries and its association with commitment to safety among foreign construction workers. A cross-sectional study was conducted among 323 foreign construction workers from six construction projects of a large organization in Malaysia, using a simple random sampling method. Data was collected using a structured questionnaire to assess work-related injuries and safety commitment. The collected data was analysed by SPSS 22.0 using descriptive statistics and χ2 test. The prevalence of work-related injuries in a one year period was 22.6%, where most of the injuries were of moderate severity (39.7%) and falls from heights represented the main source (31.5%). The majority of the foreign construction workers had perceived between moderate and high safety commitment, which was significantly associated with work-related injuries. The results also showed a significant association of work-related injuries with the company's interest in Safety and Health, Safety and Health training, and safety equipment. Thus, the implementation of new procedures and providing relevant trainings and safety equipment; will lead to a decrease in injury rates in construction sites.

Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain. METHODS: Participants (N=142) in this randomized controlled trial were office workers aged 20-50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention. RESULTS: There was significant differences in pain scores for neck (MD -10.55; 95%CI -14.36 to -6.74), right shoulder (MD -12.17; 95%CI -16.87 to -7.47), left shoulder (MD -11.1; 95%CI -15.1 to -7.09) and lower back (MD -7.8; 95%CI -11.08 to -4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD -9.99; 95%CI -13.63 to -6.36), right shoulder (MD -11.12; 95%CI -15.59 to -6.65), left shoulder (MD -10.67; 95%CI -14.49 to -6.85) and lower back (MD -6.87; 95%CI -10 to -3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p<0.05). CONCLUSION: To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification. CLINICAL TRIAL ID: NCT02874950 - https://www.clinicaltrials.gov/ct2/show/NCT02874950.

Comparative reliability of different instruments used to measure the severity of musculoskeletal disorders in office workers.

BACKGROUND: The accuracy of instruments such as questionnaires and the goniometer are critical for measuring the severity of musculoskeletal disorders among office workers. OBJECTIVE: To determine the reliability of the Cornell questionnaire, goniometer and Borg questionnaire, which are commonly used instruments to assess the severity of musculoskeletal disorders in office workers. METHODS: One hundred twenty healthy office workers, body mass: 87.1 ± 10.3 (kg), age: 27 ± 5.1 (years), height: 1.78 ± 0.16 (m), (mean ± SD), who had at least 1 year of experience in office working, were chosen randomly. A plastic goniometer (30" height) was used three times to measure the range of motion in the neck, hip, knee and shoulder area, with a period of one hour between measurements to evaluate the test-retest accuracy. The Cornell questionnaire was used to measure the severity of musculoskeletal disorders and the Borg scale was used to measure perceived exertion. The questionnaires were filled out twice with a gap of 2 weeks between measurements. RESULTS: The Inter-class Correlation Co-efficient (ICC) indicated that all instrument sub-scales showed high levels of repeatability. The ICC coefficient was (0.805-0.954, p <0.001) for the Borg scale, (0.785-0.978, p <0.001) for the goniometer and (0.883-0.975, p <0.001) for the Cornell questionnaire. CONCLUSIONS: The Cornell questionnaire, goniometer and Borg questionnaire all exhibit high reliability when used for the evaluation of the severity of musculoskeletal disorders in office workers.

The Bahasa Melayu version of Cornell Musculoskeletal Discomfort Questionnaire (CMDQ): Reliability and validity study in Malaysia.

BACKGROUND: The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was developed to assess the level of musculoskeletal discomfort among office workers related to their ergonomic situation. OBJECTIVE: The primary objective of this initial study is to analyze the validity and dependability of the Malay translation of the Cornell Musculoskeletal Discomfort Questionnaire. METHODS: The questionnaire was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. The study involved 115 participants. RESULTS: The range of Cronbach Alpha coefficient showed a considerable consistency of the items for each sub-scale (Cronbach's a > 0.95). The range of Kappa coefficients was between (ICC = 0.690-0.949, p < 0.001), (ICC = 0.801-0.979, p < 0.001) and (ICC = 0.778-0.944, p < 0.001) for frequency, severity and interference scales. CONCLUSIONS: This research, introduced the Malay-language version of the CMDQ (CMDQ-M) as the first formal validation of the CMDQ, and confirmed a high reliability and validity for the evaluation of musculoskeletal discomfort among the study population.

Characterization of risk factors for DNA damage among paddy farm worker exposed to mixtures of organophosphates.

This is a cross-sectional study conducted among paddy farmers to characterize potential risk factors that influence levels of DNA damage from exposure to mixtures of organophosphates. Comet assay was used to determine the level of DNA damage by measuring the comet tail length from the exfoliated buccal mucosa. The result suggests that farmers who chronically exposure to a mixture of organophosphates has at least 2-fold significant increase of DNA damage as compared with control group. Factor analysis and linear regression both suggest that DNA damage reported by farmers may influence individual, occupational, and residential factors and are reported as significant predictor factors, whereas this effect is mainly caused by individual factors among the control group. The findings of the present study suggest that either farmer or control group bear certain extent of genotoxic burden contributed by different risk factors.

The prevalence of musculoskeletal disorder and association with productivity loss: a preliminary study among labour intensive manual harvesting activities in oil palm plantation.

Production agriculture such as harvesting in oil palm plantation has been frequently associated with MSD and significant loss of productivities. This study tends to evaluate from the viewpoint of health, the association between self-reported prevalence of musculoskeletal disorders and productivities; the impact of musculoskeletal disorders on productivity. A cross-sectional study was conducted among 143 harvesters in oil palm plantation. A general questionnaire was used to collect socio-demographic background data while Nordic Musculoskeletal Questionnaire was used to determine the prevalence of MSD. Expressed in 4 different indicators; daily harvesting quantity, efficiency score, sick leave and presenteeism, the productivity data were analysed for association. There is significant association between reported acute prevalence of MSD (within 7 d) and productivity loss in terms of presenteeism (χ(2)=5.088; p<0.05) as well as quantity of daily harvest (χ(2)=7.406; p<0.01). Logistic regression adjusted for age, BMI and smoking indicate that harvesters with MSD (past seven days) were more likely to be engaged in presenteeism (OR=2.87 95% CI=1.34, 6.14) and had lower daily productivity (OR=2.09 95% CI=1.02, 4.29) compared to harvesters without MSD (past 7 d). This study reveals that oil palm harvesters suffering acute MSD (for the past week) were likely to be still present to work and produce half lesser than their healthy counterparts. Thus, further study with comprehensive surveillance strategy is essential in order to determine the urgency or need of appropriate intervention.

The characteristics of vibrotactile perception threshold among shipyard workers in a tropical environment.

The objectives of this study are to determine the prevalence of hand-arm vibration syndrome (HAVS) and the characteristics of the vibrotactile perception threshold (VPT) among users of hand-held vibrating tools working in a tropical environment. A cross sectional study was done among 47 shipyard workers using instruments and a questionnaire to determine HAVS related symptoms. The vibration acceleration magnitude was determined using a Human Vibration Meter (Maestro). A P8 Pallesthesiometer (EMSON-MAT, Poland) was used to determine the VPT of index and little finger at frequencies of 31.5 Hz and 125 Hz. The mean reference threshold shift was determined from the reference threshold shift derived from the VPT value. The results show a moderate prevalence of HAVS (49%) among the shipyard workers. They were exposed to the same high intensity level of HAVS (mean = 4.19 ± 1.94 m/s(2)) from the use of vibrating hand-held tools. The VPT values were found to be higher for both fingers and both frequencies (index, 31.5 Hz = 110.91 ± 7.36 dB, 125 Hz = 117.0 ± 10.25 dB; little, 31.5 Hz = 110.70 ± 6.75 dB, 125 Hz = 117.71 ± 10.25 dB) compared to the normal healthy population with a mean threshold shift of between 9.20 to 10.61 decibels. The frequency of 31.5 Hz had a higher percentage of positive mean reference threshold shift (index finger=93.6%, little finger=100%) compared to 125 Hz (index finger=85.1%, little finger=78.7%). In conclusion, the prevalence of HAVS was lower than those working in a cold environment; however, all workers had a higher mean VPT value compared to the normal population with all those reported as having HAVS showing a positive mean reference threshold shift of VPT value.

Anthropometry of Malaysian young adults.

This paper presents the results of an anthropometric data collected from polytechnic students in Malaysia. A total of 1032 (595 males and 437 females) students participated in the study. Their ages ranged from 18 to 24 years. A total of 34 anthropometric dimensions were measured. Descriptive statistics such as mean, standard deviation, standard error of mean, coefficient of variation, minimum, maximum and percentile for each parameter were estimated. In addition, the comparison between Malaysia anthropometric data and Thailand (South) anthropometric data were also presented. The results show that there is a total of 12 and 11 (of dimensions parameters) significant differences (p < 0.05) between the male and female adults respectively.

The Association between risk factors and low back pain among commercial vehicle drivers in peninsular Malaysia: a preliminary result.

To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.