Curriculum Development Cell
CONFIRMATION FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
Registration No. / :Name of the Candidate / : Ms. SNEHAL NANDARGI
Address / : SDM COLLEGE OF PHYSIOTHERAPY, DHARWAD
Name of the Institution / : SDM College of Physiotherapy, Dharwad
Course of Study and Subject / : MPT (Physiotherapy in Musculoskeletal and Sports Injuries)
Date of Admission to Course / : 17/07/2013
Title of the Topic /
: “Evaluation of Workstyle Risk Factors on Work
related Musculoskeletal Disorders in Either
Gender Among Information Technology
Professionals”
Brief resume of the intended work / : AttachedSignature of the Student / :
Guide Name / : Dr. PRASHANT MUKKANNAVAR
Remarks of the Guide / : Recommended for registration
Signature of the Guide / :
Co-Guide Name / : -
Signature of the Co-Guide / :
HOD Name / : Dr. RAVI SAVADATTI
Signature of the HOD / :
Principal Name / : Dr. RAVI SAVADATTI
Principal Mobile No. / : 9845051209
Principal E-mail ID / :
Remarks of the Principal / :Recommended for registration
Principal Signature / :
A) /
BRIEF RESUME OF THE STUDY
IntroductionIn the twenty-first century, computers have become almost as the humble pen and paper in many peoples' daily life, approximately 6 computers/1000 population with an installation of 18 million personal computers (PCs) and their number is increasing all the time.1,2 The computer is a vital tool in every dimension. Nearly every educational, research and medical field; business and industry uses some type of computer system. However, majority of people actually do not pay much attention to the medical consequences that can cause while working with computers, such as damaged eyesight, bad posture, overuse injuries of the hands and wrists, arthritis in fingers1-3 and computer stress injuries4 that can be caused by sitting in one position for a prolonged period of time as most people do.
‘Workstyle’ has been described as a mechanism by which ergonomic and psychosocial risk factors interact to affect the development, exacerbation and/or maintenance of upper limb pain and functional limitations5,6 which is mostly associated with the increase in the work demand. As work demand increases, according to the characteristic of workstyle, risk of the development of musculoskeletal disorders also increase.7 Adverse workstyles associated with computer based work, also referred to as ‘‘maladaptive coping behaviours’’.8
The work related musculoskeletal disorders (WRMSDs) describe a wide range of inflammatory and degenerative disease conditions that result in pain and functional impairment affecting the neck, shoulders, elbows, wrists, and hands.9,10 A disorder is work-related when work procedures, equipment, or environment contribute significantly to the cause of the disorder.
Some of the important studies11-19 explained how workstyle act as the link between ergonomic in relation to job demands and psychosocial factors in work-related upper-extremity (WRUE) symptoms/ disorders resulting in limiting functional activities which also have negative impact on activities of daily living.
According to previous studies8,20 the prevalence of self-reported musculoskeletal symptoms were higher in women than in men performing the same type of work tasks. These studies also assessed the occupational risk factors and concluded that risk factors for physical disorders were age, female gender, overtime work, negative working atmosphere, awkward posture, vibrations & noise and chemical pollutants. Risk factors for mental disorders were female gender, inadequate breaks, negative working atmosphere, and awkward posture.21 Moreover, few studies8,21,22 evaluated musculoskeletal disorders (MSD) among male and female workers having same environmental conditions. However, studies9,23,24 show that workstation/ergonomic modification along with job stress management intervention help to reduce upper extremity (UE) pain symptoms and functional limitations.
In a cross-sectional survey25 which evaluated work related musculoskeletal disorders prevalence and associated risk factors among quarry workers in a South Eastern Nigerian Community. Survey reported that 83.3%, 78.9% prevalence of work related injury and low back pain respectively. Furthermore, it was reported that higher demanding jobs and task repetition were associated with injury by workers. Carayonet.al.4 showed that there was direct relationship between work organization and job stress that represent relation between physical ergonomic risk factors and WRMSDs.
In some studies18,19,27 samples from various regions across India and Malaysia were collected and concluded that there is a significant relationship between psychosocial work factors and job organization (workload, social support), which further influenced biomechanical demands of workers resulted in adverse workstyle.
The Workstyle Short Form (WSF) reflects dimensions of workstyle and develops a self- report workstyle measure.6 It is used to obtained measures of job stress, ergonomic risk, upper extremity symptoms and functional limitations of the worker.5-7 It is a reliable and valid version of the workstyle measure6 of 32 items containing ten subscales. Internal consistency of these sub-scales varies from 0.61 to 0.91, n = 282 while the test–retest (3 weeks) reliability for the various subscales ranged from r = 0.68 to 0.89, n = 143.
The Nordic Musculoskeletal Questionnaire (NMQ) is widely used with the aim to develop and test a standardized questionnaire methodology allowing comparison of low back, neck, shoulder and general complaints for use in epidemiological studies.28-31 It consists of structured, forced, multiple-choice questions and can be used as a self- administered questionnaire.19,28,31 The questionnaire is designed to answer the following question “Do musculoskeletal troubles occur in a given population and if so in what parts of the body are they localized?” Respondents are asked if they had any musculoskeletal trouble in the last 12 months and last 7 days which has been prevented normal activity. NMQ is accepted as a screening tool.29 NMQ is repeatable and sensitive and is likely to have a high utility in screening and surveillance.18,25,30.
NEED OF THE STUDY
Studies1,10,34 which were done in the past shows that 93% of subjects had one or more than one computer related health problems which has a high computer related morbidity. The difference in prevalence rates in these studies mostly associated with or depends upon factors like workstation, environment, degree of immobilization, level of constrained postures, social awareness level, and practices of workers regarding computer operations.1,18,24
One survey32 shows that not only computer users are increasing, but exposure to computer related risk factors are also increasing. Therefore, computer related morbidity had become an important occupational health problem and it is a matter of great concern.1 With the increase in frequency, intensity and popularity of computer use inside and outside of work and at home, the incidence of work related illness and injuries are also increasing.
Most of the studies regarding work style and other ergonomic risk factors are being done in western developed countries8,12-16,20,21 but very few studies are obtainable in developing countries.2,3,17-19,24 As the direct employment in the Indian information technology (IT) sector is also expected to reach nearly 2.8 million32 in near future and as seen that MSD are more in women than in men working in the same environment21,22 and hence more research work is essential to be carried out.
Though men and women perform the same type of work tasks, may have the same job title none of the studies explored the workstyle risk factors among IT professionals. In view of this, in the present study an attempt has been made to find out the workstyle risk factors and work related musculoskeletal disorders in IT professionals with special reference to find out gender difference in relation to workstyle factors.
RESEARCH HYPOTHESIS
Null Hypothesis (H0): There will not be a relation between workstyle risk factors in terms of work related musculoskeletal disorders in either gender among IT professionals.
Alternate Hypothesis (H1): There will be a relation between workstyle risk factors in terms of work related musculoskeletal disorders in either gender among IT professionals.
REVIEW OF LITERATURE
Sharma et.al.1 examined 200 IT engineers in Delhi and found almost same results showing that females experienced significantly more musculoskeletal problems, while stress perceived was significantly more by males. The visual problem and stress was significantly more common in subjects working in software development, while musculoskeletal problem was more prevalent among data entry/processing operators.
Shrivasta and Bobhate2 made a cross sectional study regarding prevalence of various health problems and its association with their environmental conditions in about 200 software professional in Mumbai working for 6 months continuously for 4 hours daily. Standardized Nordic questionnaire was used to assess musculoskeletal problems. The results showed that 89% occurrence of more than one type of discomfort among professional computer users. Participants who were using soft key pads had lower frequency (66%) of musculoskeletal complaints in contrast to nonusers (70%).
Talwar et.al.3 made a study of visual and musculoskeletal health disorders among 200 Computer Professionals in NCR Delhi which included software developers, call centre workers, and data entry workers found that found that there was a gradual increase in visual complaints as the number of hours spent working on computers daily increased and the same relation was found to be true for musculoskeletal problems as well.
Griffith et.al.8 reviewed papers published in 1980 to 2007 related to impact of an increasingly computerized workplace on the physical and psychological wellbeing of professional occupations. The survey concluded that in response to workload, deadline and performance monitoring pressures, many professional workers are often encouraged to perform long hours of computer work with high mental demands resulting in extreme muscle tension and forces. These factors were identified in this review as risk factors for work related musculoskeletal disorders.
Nicholas et.al.13 made study to recognize the work related upper extremity symptoms (WRUESDs) that can be influenced by a number of factors on 282 computer users between ages 21-60 years and working at least for 3-4 hours/day from Washington using workstyle questionnaire and logistic regression model. The results indicated that both ergonomic exposures and workplace demands affect independently on either gender and generate a response of negative cognitions, behavioral responses, and physiologic reactions. This in turn, increases the risk that an individual will work in a way such that further exposure to risk factors can occur and thus contribute to increases in pain and functional limitations.
While performing a longitudinal study in an office building of a Dutch governmental institute, Meijer et.al.14 studied whether workstyle is a mediating factor for upper extremity pain in a changing work environment of office workers working for 4hrs/day and who reported UE Symptoms at baseline using workstyle short form (WSF) questionnaire. The results showed that an adverse workstyle is a mediating factor for pain in the upper extremity in office workers in the 12 months. Office workers with an adverse workstyle have a three times higher risk of pain after 12 months compared to office workers with a good workstyle.
Harrington et.al.15 in their study tried to determine whether a brief measure of a patient’s perception of how they respond to perceived increases in demands at work predicts pain levels and work status in the age group of 18 to 65 years using Visual Analogue Scale (VAS) and work restrictions based on patient’s history, physical examination, and relevant diagnostic testing.
Harrington et.al.16 by using a mixed-model experimental design tested the hypothesis that workstyle will differentiate asymptomatic workers and their responses to high and low work demands in relation to keyboard force, postural change, cognitive reactivity, physiological arousal, and work output. They considered about 80 asymptomatic office workers from Washington D.C. varying in workstyle. Asymptomatic office workers with higher workstyle scores using WSF have higher levels of keyboard force, awkward arm posture, negative mood, negative work-related cognitions, and increased work performance on increased work demands, as compared to a group of office workers not reporting these workstyle characteristics.
Sharan and Sasidharan17 studied the association between ergonomics risk factors, workstyle and WRMSD in about 200 IT professionals in India working for 7 to 9 hours using WSF questionnaire. Result revealed that most prevalent body regions were lower back (20%), Upper back (16%) and shoulder (14%). He found that there is a positive association between workstyle score with musculoskeletal pain. They concluded that ergonomic intervention is less effective when the intervention which include both ergonomics and job stress management or workstyle management.
Bhanderi et.al.18 made a cross sectional study on 419 young participant between 16-20 yrs. who work on computer for varying period of time (21 to 40 hrs/week), to understand the relationship between various psychosocial workplace factors and occurrence of MSD problems. The study revealed that 315 out of 419 subjects reported any of the symptoms like tiredness, neck and shoulder stiffness, neck and shoulder pain, tingling/numbness in hands or fingers during or after work or at night perhaps interrupting sleep, hand or wrist pain, backache, headache, leg cramps, leg stiffness, numbness in ankles and feet, reduction in strength of hand and difficulty in grasping objects.
Mehta and Parijat19 assessed about 77 IT professionals from Bangalore, India in the age group of 22 to 32 years to know the contributions of prevalent psychosocial factors on perceived WMSD outcomes using Job Content Questionnaire (JCQ), the Subjective Workload Assessment Technique (SWAT) questionnaire, and pain/discomfort scales (Borg CR10 scale).Their findings suggested that prevalence of existing pain (shoulder/neck and low back) is in more than one-fourth of the respondents. Psychological stress was strongly correlated to all JCQ scales (except decision authority). The results suggested a greater association between psychosocial risk factors and WMSD outcomes than physical demands.
Eltayeb et.al.20 examined prevalence of complaints of arm, neck and shoulder (CANS) among computer office workers and psychometric evaluation of a risk factor. Their result showed that the one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%).
Blagojevic et.al.21 investigated the occupational risk factors that may lead to computer-related health disorders and to evaluate health conditions of computer operators employed in the biggest Serbian telephone company, Telecom Serbia, by using a self-administered questionnaire. The study revealed that although there was no difference between the mean age of male and female workers; male workers had longer job tenure and longer duration of exposed employment than females, the number of females with health complaints was greater than the number of males. Female gender has emerged as an independent risk factor for developing both physical and mental health disorders.