Musculoskeletal ambulation disability symptom complex as a risk factor of incident bone fragility fracture

Ichiro Yoshii,Tatsumi Chijiwa,Naoya Sawada,Shohei Kokei 대한골다공증학회 2021 Osteoporosis and Sarcopenia Vol.7 No.3

Objectives: Influence of presenting musculoskeletal ambulation disability symptom complex (MADS) on occurrence of bone fragility fracture (BFF) is investigated with retrospective cohort study. Methods: A total of 931 subjects joined in the study. Subjects were selected as bone fragility risk positive in the fracture assessment tool questionnaire. Their assumed risk factors were harvested from the medical records and X-ray pictures. They were followed up at least 8 years consecutively, and occurrence of incident BFF was set as primary endpoint. Each assumed risk factor including MADS was evaluated using Cox regression analysis. Subjects were divided into 2 groups according to presence of MADS (GMADS and G-noMADS). Adjusted hazard ratios between the 2 groups was evaluated using Cox regression analysis. The statistical procedures were performed before and after propensity score matching (PSM) procedures in order to make parallel with assumed risk factors. Results: Statistically significant risk factors within 5% were prevalent vertebral body fracture, disuse, MADS, cognitive disorder, hypertension, contracture, Parkinsonism, being female sex, hyperlipidemia, insomnia, T-score in the femoral neck ≤ -2.3, chronic kidney disease ≥ stage 2, chronic obstructive pulmonary diseases, glucocorticoid steroid administrated, and osteoarthritis in order of the adjusted hazard ratios (from highest to lowest). Adjusted hazard ratios between G-MADS and G-noMADS were 2.70 and 1.83 for before and after PSM, respectively. Conclusions: MADS demonstrated as a significant risk factor of BFF occurrence. In treating osteoporosis, fall risk should be aware of as well as bone fragility risk.

소나무와 일본잎갈나무 조림지 관리를 위한 어린나무가꾸기의 작업 자세 위험도 분석

이은재 ( Eun-jai Lee ),이상태 ( Sang-tae Lee ),한상균 ( Sang-kyun Han ),조구현 ( Koo-hyun Cho ) 한국산업융합학회 2021 한국산업융합학회 논문집 Vol.24 No.3

Pinus densiflora and Larix kaempferi forests not only extended the plantation management area but also cultivated to the sustainable wood supply chain during the last 5-years. These prescriptions are primarily done by manual operation activities, particularly in young tree tending. Two types of tending activities, brashing by brush cutter(BB) and pruning by pruning shear and saw(PP), were selected for the investigate of musculoskeletal disorders’ level and postural risks using Ovako Working Posture Analysis System (OWAS). The postural risk indexes (BB and PP) ranged from 115 to 125 and 102 to 105, respectively. There is no significant difference between the species. The young tree tending operations had low postural risks. The results may be used as basic data to develop technical guideline for safe young trees.

중소규모 사업장에서 근골격계 증상의 고 위험군 선정과 운동프로그램의 효과

김보경,박정일,임현우,구정완,이강숙 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.1

목적: 중소규모사업장 근로자들의 근골격계증상을 실제적이며 효과적으로 관리하는 방안을 제시하기 위하여 중점관리대상자를 선별하고 근골격계 운동프로그램의 효과를 평가하고자 하였다. 방법: 문헌검색과 Delphi법에 의한 전문가의견을 종합하여 근골격계질환과 관련된 요인을 선정하고 785명을 대상으로 이들 요인들에 관한 설문조사(5점척도)를 실시하였으며, 증상이 있는 군(3점척도 이상)을 위험군으로, 위험군 중에서 작업특성관련요인과 일반특성관련요인이 함께 있는 군(평균이 3점척도이상)을 고 위험군으로 분류하여 중점관리대상자를 선별하였다. 저 위험군과 고 위험군을 대상으로 12주간 근골격계 운동프로그램을 실시 한후 증상 호소율의 변화를 비교, 분석하여 운동프로그램의 효과를 평가하였다. 결과: 근골격계질환 위험군은 전체대상자 785명 중, 454명(57.8%)이었으며 고 위험군은 121명 (15.4%)이었다. 저 위험군의 근골격계증상에 대한 위험요인의 다중로지스틱회귀분석 결과 유의한 위험용인은 성, 근골격계질환과 관현된 개인질병이었고, 고 위험군에서의 위험요인은 연령, 성, 근골격계질환과 관련된 개인질병 등이었다. 저 위험군을 대상을 12주간의 운동프로그램 실시한 후 대조군에서의 근골격계증상호소율은 유의한 변화가 없었으나 중재군에서는 근골격계증상 호소율이 신체부위 모두에서 유의하게 감소하였고, 고위험군을 대상으로 12주간의 운동프로그램을 실시한 결과 대조군에서 근골격계 증상호소율이 팔과 팔꿈치 부위에서 유의하게 증가한 반면 중재군에서는 허리부위에서 증상호소율이 유의하게 감소하였다. 결론: 이상의 결과를 종합하면 저 위험군에서는 운동프로그램이 근골격계증상 관리에 유의하게 기여하였으나 고 위험군에서 운동프로그램의 효과는 확인할 수 없었기 때문에 고 위험군에서의 근골격계 증상을 효과적으로 관리하기 위하여는 운동프로그램외의 다른 조치가 필요할 것으로 판단된다. Objectives: This study was conducted to provide data for the establishment of a practical and the effective exercise program for managing the musculoskeletal symptoms of workers who are employed in small and medium sized enterprises. Methods: The risk factors related to musculoskeletal disease management were chosen according to the relevant literatures, and were based on advise from experts on the Delphi method. Questionnaires on selected risk factors (with a 5-point Likert scale) were given to 785 subjects who worked in small and medium sized enterprises. The subjects were then classified in the risk group when they had the symptoms and recorded at least 3 points. From those subjects in the risk group, those who had both work-related factors and general characteristics factors (with an average of at least 3 points) were further classified as the high risk group. We performed a 12-week musculoskeletal exercise program for the low and high risk groups to analyze their changes in symptoms and complaints in order to estimate the effectiveness of the exercise program. Results: Out of 785 subjects, 454(57.8%) were in the risk group of musculoskeletal diseases and 121(15.4%) were in the high risk group. According to multiple logistic regression analysis of the factors for the musculoskeletal symptoms in the low risk group, the significant risk factors were sex and personal disease related with musculoskeletal disease, while the risk factors in the high risk group were age, sex, and personal disease related with musculoskeletal disease. After the I2-week exercise program was performed by the low risk group, the number of musculoskeletal symptom complaints in the control group did not significantly changed, whereas for the intervention group, the number of musculoskeletal symptom complaints significantly declined for all parts of the body. After the 12-week exercise program performed by the high risk group, the number of musculoskeletal symptom complaints in the control group was significantly enhanced for the arm and elbow parts. In the intervention group, the complaint rate for musculoskeletal symptoms significantly declined only for the low back. Conclusion: The musculoskeletal symptoms were significantly improved by the exercise program in the low risk group, but not in the high risk group. It is suggested that control measures on administrative and/or work related factors, in addition to the exercise program should be considered simultancously for the control of musculoskeletal symptoms in groups at high risk of musculoskeletal disease.

반도체 제조회사의 근골격계 운동치료 프로그램을 통한 체형교정 효과에 관한 연구

정예영(Ye Young Jeong),박재희(Jae Hee Park) 대한인간공학회 2021 大韓人間工學會誌 Vol.40 No.4

Objective: The aim of this study is to evaluate the cases and effects of preventive management program run by a semiconductor manufacturing company for workers suffered from musculoskeletal pain out of the scope of the current risk assessment of musculoskeletal burden works, and to propose the spread of the program to the same industry. Background: Currently, risk assessment of musculoskeletal burden works will exempt a company from all legal obligations if the company has no legal musculoskeletal burden works. However, there is still a risk of musculoskeletal disorders among workers even if there are no legal musculoskeletal burden works. Method: This study examined the correction effects of the body type by using a Back Mapper after 80 workers who complained of musculoskeletal symptoms of turtle neck, flat back, bent back, flat waist, lumbar hyperlordosis and scoliosis, from June 2019 to June 2020, received customized individual exercise therapy. Results: The individual exercise therapy significantly relived the angles of turtle neck, flat back, bent back, flat waist, and lumbar hyperlordosis (p<0.05) except for scoliosis (p=0.110). Conclusion: The legal risk assessment of musculoskeletal burden works is limited to protect workers from developing musculoskeletal disorders in advance. Therefore, to prevent the musculoskeletal disorders of workers in the blind spot of the current law, it is necessary to introduce a musculoskeletal exercise therapy program. Application: The results of this study can be used as a basis for the introduction of an exercise therapy program even at workplaces that are not obligated to investigate legal risk assessment of musculoskeletal burden works.

반도체 제조회사의 근골격계부담작업 유해요인조사 실태와 개선방안

정예영,박재희 한국안전학회 2022 한국안전학회지 Vol.37 No.1

In Korea, companies which perform work that places a burden on the musculoskeletal systems of their workers should have conducted legal risk assessments of this work every three years from 2004 onwards. However, due to problems with the legal definition of work-related musculoskeletal burdens, some companies may have been exempted from these risk assessments even though their workers still experience work-related musculoskeletal pain. For example, the manufacturing process used by a particular semiconductor manufacturing company involved a great deal of work which placed a burden on the musculoskeletal systems of its workers. However, this company eliminated the musculoskeletal burden on its workers by continuously introducing automated processes, and finally, in 2016, all work which was legally defined as placing a musculoskeletal burden on workers was removed from the company’s manufacturing process. Nevertheless, in a 2016 survey, 9.6% of the company's workers still complained of musculoskeletal pain, and in a 2019 survey this proportion actually increased to 15.7%. This incident demonstrates the limitations and problems of the current legal risk assessment of work-related musculoskeletal burdens. Therefore, this study proposes two improvements to solve these problems. Firstly, it is necessary to broaden the current legal definition of work-related musculoskeletal burdens. For example, vibration risk factors and push/pull tasks that are currently missing from the definition should be included. Secondly, it is proposed that a survey on musculoskeletal pain should be conducted for all workers, regardless of whether they are engaged in work which is currently defined as placing a musculoskeletal burden on them. The results of this study could be used to improve the legal risk assessment of work-related musculoskeletal burdens.

근골격계질환 예방을 위한 유해요인조사 결과보고 제도의 실효성 방안에 대한 연구

이신우(Shinwoo Lee),김유창(Yuchang Kim) 대한인간공학회 2020 大韓人間工學會誌 Vol.39 No.4

Objective: The purpose of this study is to understand the appropriateness and disadvantages of the result reporting system about risk factors analysis and to find out how to improve the effectiveness of the result reporting system. Background: Although the risk factors analysis for preventing musculoskeletal disorders was conducted since 2003, the implementation rate was low in Korea. Recently, as the legal effectiveness of the risk factors analysis has been lowed due to the low implementation rate, the issue of legal obligation the reporting system about risk factors analysis has been raised. In order to protect all workers from musculoskeletal disorders, it was necessary to find out how to increase the implementation rate by legally mandating the result reporting system about risk factors analysis. Method: This study was conducted a questionnaire of 126 safety/health managers, workers, and management supervisors, safety/health agency workers, and business owners in various industries. The main contents of the questionnaire are appropriateness, advantages, disadvantages, and effectiveness of the result reporting system about risk factors analysis. Results: The results showed that the reliability of risk factors analysis would be increased by the implementation of the result reporting system. The cost support system about risk factors analysis would be needed because of the cost problem on the corporation. Conclusion: It was judged that plan for enforcing the legal obligation of the reporting system would be needed to enhance the effectiveness of risk factor analysis. In order to increase the reliability of the risk factors analysis, it was necessary to report to the Minister of Employment and Labor after confirming by worker representative. Also, it was considered that a cost support system would be necessary to activate the result reporting system about risk factor analysis. Application: These results can contribute to the improvement of the risk factor analysis and the prevention of musculoskeletal disorders. It can be used as the basic data for research on the result reporting system about risk factors analysis.

근골격계부담작업의 적절성에 관한 연구

천인애(Inae Chun),김유창(Yuchang Kim) 대한인간공학회 2020 大韓人間工學會誌 Vol.39 No.5

Objective: The purpose of this study was to identify the problems and appropriateness of musculoskeletal burden work by industry, and to present the improvement direction and efficient implementation so that musculoskeletal burden work can be applied to the workplace. Background: The Ministry of Employment and Labor defined the scope of 11 musculoskeletal burden work in 2003. However, controversy continues over the appropriateness of musculoskeletal burden work. There are missing elements such as vibration, job stress, and a subjective load of workers in determining whether musculoskeletal burden work. Also, intermittent work with less than 60 days of work is not included in the musculoskeletal burden work. Method: This study was conducted a questionnaire of 127 safety manager, health manager, general worker, and administrative supervisor. Of the 127 respondents, 33.1% respondents were engaged in the manufacturing industry and 66.9% were engaged in the non-manufacturing industry. The main contents of the questionnaire are appropriateness and improvement direction of the 11 musculoskeletal burden work. Results: The results of the appropriateness of including a subjective load of workers to the evaluation method of musculoskeletal burden work were statistically significant differences by industry. The results of the appropriateness of the 11 musculoskeletal burden work were not statistically significant differences by industry except for No. 4, and 48.6% of respondents replied that the 11 musculoskeletal burden work were not appropriate. Conclusion: The 11 musculoskeletal burden work should be improved to include factors that can cause musculoskeletal disorders such as vibration and job stress. The intermittent criteria of musculoskeletal burden work need to be improved. In addition, by integrating musculoskeletal burden work No. 8 to 10 related to weight handling, it seems necessary to judge the degree of burden on a simple and clear criterion. Application: A subdivided criteria is needed so that the criteria for determining musculoskeletal burden work can be applied to various industries. The result of this study can be used as the basic data for research on the improvement of musculoskeletal burden work.

제조업의 생산직 근로자의 상지 근골격계 증상에 영향을 미치는 요인

김규상,홍창우,이동경,정병용 한국산업위생학회 2009 한국산업보건학회지 Vol.19 No.4

This study aimed to examine the general characteristics of individual workers, psychosocial working environment, and ergonomic risk factors which affect the status of musculoskeletal disorders. Self-report was carried out for musculoskeletal symptoms and ergonomic risks in working environment in 856 production workers in 16 small to medium sized manufacturing companies. Musculoskeletal symptoms were examined with a standardized questionnaire, and ergonomic risks were evaluated with a qualitative self-administered instrument for the tasks related to musculoskeletal disorders. Major findings were as follows: 1) Complaint rate for musculoskeletal symptoms was higher in female, aged, married workers with longer working hours, less leisure/hobby activity, longer household working hours and history of disease or accident. 2) Complaint rate for musculoskeletal symptoms was significantly higher in workers with dissatisfaction, difficult tasks, and no self-control at work. 3) Complaint rate for musculoskeletal symptoms was significantly higher in workers involved in tasks with major ergonomic risk factors, and handling heavy equipment. 4) Explanatory power increased the model with the musculoskeletal symptoms as dependent variable and demographic variables, psychosocial working environment and ergonomic risk factors included, and total explanatory power of 18.6% revealed the significant effect. Based on the results, we can conclude that musculoskeletal symptoms in manufacturing workers are associated with individual demographic characteristics, psychosocial working environment and ergonomic risk factors.

Case Studies of Risk Assessment in Analyzing Risks Associated with MSDS

Woo Jin Kim,Byung Yong Jeong 대한인간공학회 2013 大韓人間工學會誌 Vol.32 No.1

Objective: This study aims to suggest different approaches in analyzing risks associated with musculoskeletal disorders(MSDS) for risk assessment. Background: Upon concluding that the changes in the industrial environments have made it hard to regulate diverse risk factors, the government has implemented a policy for risk assessment. Method: This study has proposed a method, creating programs using Excel that perform qualitative or quantitative analysis, for evaluating risk factors in risk assessments and has applied this in manufacture and service industries. Results: To verify the validity of the developed program, risk assessment has been performed on restaurant chefs as an example. For quantitative evaluation, the study has suggested approaches using the results for REBA evaluation and the analysis report on the work scenes of a fitting-shop in a shipbuilding industry. Application: Constructing and adapting a system using Excel in evaluating risk factors for risk assessments as this study suggests, is expected to contribute to revitalizing risk assessments.

피부미용사의 근골격계 손상과 예방에 관한 문헌연구

채경주 한국피부과학연구원 2009 대한피부미용학회지 Vol.7 No.4

It follows today in advancement of industry and the work enviroment becomes fractionation anger with simple repetition work. This result in increase work-related musculoskeletal disorders. Work-related musculoskeletal disorders are the most serious health problems in the skin beauty artists. They are a major cause of occupational disease in the skin beauty artists. Consequently, prevention of work-related musculoskeletal disorders is important about personal quality of life as well as decrease of social resource. So, efforts must be made to detect persons at risk of work-related musculoskeletal disorders and to prevent or reduce the frequency of work-related musculoskeletal disorders. To facilitate such approaches, it is essential to review risk factor of work-related musculoskeletal disorders of the skin beauty artists. This study was aimed at designing interventions that minimiz risk work-related musculoskeletal disorders of skin beauty artists by ameliorating contributing factors. I hope that this program will promote prevention of work-related musculoskeletal disorders to the skin beauty artists 현대산업의 발달에 따라 작업환경은 단순 반복 작업으로 세분화되고 경영합리화에 따른 공장설비의 자동화, 여유시간의 축소, 다기능화로 인하여 노동 강도가 강화되는 등의 노동환경의 많은 변화를 가져오고 있다. 이러한 노동환경의 변화는 작업자에게 육체적·정신적 피로도를 증가시켜 근골격계 질환을 증가시키는 요인으로 자리 잡았다. 최근 발표된 국내외 근골격계 질환의 발생은 점점 그 비율이 증가하고 있으며, 앞으로도 지속적으로 증가할 것으로 전망되고 있기 때문에 특별관리가 절대적으로 필요한 시점이다. 따라서 근골격계 질환의 산업체 및 사회에 미치는 영향이 점점 더 증가되고 문제의 심각성이 대두되어짐에 따라 근골격계 질환을 감소시킬 수 있는 근본적인 대책마련이 시급함에도 불구하고, 아직까지 직업관련 근골격계질환에 대한 대응책과 예방에 대한 프로그램이 매우 부족한 실정이다. 미용업계종사자들은 전문직업인으로서 정신적, 심리적 부담이 가중되고 과중한 작업증가와 함께 정신적, 육체적 피로가 누적되고, 반복적인 기구사용과 작업, 팔을 어깨높이의 상태에서 장기간 기립된 상태로 고정된 시선을 유지하는 불균형적인 자세, 복잡한 장비와 도구의 사용 등으로 인하여 근골격계 자각증상 호소율이 높게 나타나고 있다. 그러나 지금까지 피부미용사들에게서 발생할 수 있는 작업관련 근골격계 손상에 대한 인식과 대책은 아직 미비한 실정이다. 이에 본 연구는 문헌고찰을 통하여 피부미용사들에게 발생할 수 있는 근골격계손상과 관련된 위험요인과 근골격계질환의 종류 및 예방에 대해 알아봄으로써 피부미용사의 직업관련 근골격계손상에 대한 치료 프로그램에 대한 기초자료를 제시하고자 하였다. 앞으로 피부미용사에 대한 객관적이고 정확한 직무분석을 통하여 위험성의 정도를 평가하는 것이 매우 중요하며, 피부미용사 직업과 관련된 인간공학적 연구가 많이 이루어져야 하겠고, 이론을 임상에서 실질적으로 적용한 임상효과에 대한 많은 연구가 필요할 것으로 사료된다.