Table shows the basic characteristics of the study population. The subjects consisted predominantly of blue collars with two or three year secondary school of technical expertise (60.3%). Only among white collar employees females were present (n = 56). In total, 25.2% of study population had never smoked, while another 15.5% were ex smokers. Smoking was associated with educational level and it was significantly more prevalent among blue collar jobs such as welders, sandblasters, and painters.
Individual characteristics and self-reported determinants for musculoskeletal disorders among shipyard employees (n = 853)
As expected, the self-reported physical workload and perceived exertion differed markedly between white and blue-collar employees. Although job control did not differ significantly between white and blue collar workers, it is worth mentioning that lower skill discretion was reported by white-collar workers and lower decision authority by blue-collar workers. White-collar workers reported higher job demands and a worse perceived general health compared with blue collars (Table ).
The self-reported physical and psychosocial factors at work were partly determined by personal characteristics. Inverted trends of physical determinants, perceived exertion, and job control with age were present. A higher exposure to physical factors, perceived exertion, lower decision authority, and higher job demands were all associated with a higher need for recovery. A bad/moderate perceived general health was strongly associated with female gender, higher need for recovery and higher job demands.
Table present the 12-month prevalences of musculoskeletal complaints and the occurrence of sickness absence and health care use. Low-back pain (LBP) was the most prevalent musculoskeletal complaint, reported by 36.8% of the subjects. Among workers with low back pain chronic pain (at least one month presence of complaint) was reported by 16.1% among blue-collar workers and 25.6% among white-collar workers (p = 0.052). White-collar workers also reported more complaints of shoulder/neck (SNP). Within the blue-collar workers hand/wrist complaints (HWP) were more prevalent in metal workers, while shoulder/neck and low back complaints were reported more often in welders, even though these differences did not reach statistical level of significance. Musculoskeletal co-morbidity was high. In the total population, one out of five reported at least two musculoskeletal complaints. Subjects with back pain more often reported shoulder/neck pain (34.4%) and hand/wrist pain (23.9%) than those without back pain (14.1% and 9.5%, respectively). Co-morbidity and chronicity of complaints were highly related. From those who reported at least two musculoskeletal complaints, chronicity of one or more complaints was reported by 28.7% and 19.1%, respectively.
Prevalence of symptoms and consequences of musculoskeletal disorders in the past 12 months among shipyard employees (n = 853)
Low-back pain resulted in higher absenteeism and health utilization than other musculoskeletal complaints (Table ). Among workers with LBP, absenteeism was reported by 37.8% and 43.3% of white and blue collar workers, respectively. Among workers with SNP higher absenteeism was reported again by blue-collar workers (26.7%), mainly welders (41.2%). The same observation was made for absenteeism due to HWP with the highest proportion among metal workers (26.7%). Data from the accounting department showed that the total employment time reached 355000 working days in 2004 (1450 employees), while 2.75% was lost due to sickness absence. About 56% of the employees took at least period of one sick leave and MSDs accounted for 22.3% of total sick leaves and for 24% of total work days lost.
About 51% of workers with LBP went to physicians or other care givers. One out of three had visited more than one care giver and approximately four out of five of care seekers due to low back pain took a sick leave during last year. Care seeking and sick leave were less associated for shoulder/neck and hand/wrist complaints, especially among white collar workers.
In tables to the multivariate analyses for occurrence and consequences of low back, shoulder/neck, and hand/wrist complaints in the past 12 months are summarized. Ageing was associated with a higher occurrence of MSD complaints but older workers were less likely to take sick leave for low back and hand/wrist complaints. Females reported more complaints of shoulder/neck and hand/wrist, but among those women with these complaints care seeking and absenteeism was less compared with of men with the same complaints. Among those with complaints, blue collar workers and lower educated employees reported higher care seeking and absenteeism due to any complaint.
Determinants for the occurrence of low back pain, sick leave and health care use in the past 12 months among shipyard employees
determinants for the occurrence of shoulder neck pain, sick leave and health care use in the past 12 months among shipyard employees
A high exposure to physical factors was associated mainly with the occurrence of complaints, and less with sickness absence and health care use. Psychosocial factors showed inconsistent associations with the outcomes under study. Low job control was related to more care-seeking due to hand/wrist complaints whereas high job demands was associated with fewer absences due to shoulder/neck pain.
A poor/moderate perceived health (i.e. non musculoskeletal co-morbidity) was strongly associated with the occurrence of MSD complaints, while a high need for recovery was associated only with LBP. Musculoskeletal co-morbidity was associated with more care seeking and higher absenteeism due to low back pain. Chronicity of complaints was the most important determinant of both health care utilization and absenteeism for any MSD complaint.