The results of this study revealed that the surgical blacksmiths are engaged in rigorous hand intensive jobs, so naturally they suffer from various MSDs primarily affecting the upper extremity.
It can be observed from the present study that work-related incidents affect different body parts of the blacksmiths. This has also lead to a high rate of workday loss. Previously, it has been observed that unskilled blacksmiths fail to keep their commitments because of absenteeism .[16
] In the case of unskilled blacksmiths, the added disadvantage is low control over the task in an unhygienic working environment.[16
The blacksmiths perform repetitive hammering jobs[17
] that give shape to the surgical instruments. This type of job not only requires skill but is also time consuming. Hammering jobs are responsible for most of the incidents. The significant correlation between the total number of incidents and total workdays lost in a year is an indicator of the fact that frequent incidents result in lost workdays.
From the statistical analysis it is evident that there is a significant association between positive and negative responses of discomfort feeling among the skilled and unskilled blacksmith workers. This suggests that the unskilled blacksmith workers engaged in hand intensive activities have to perform strenuous tasks repeatedly throughout the day, suffered the most, where as the skilled blacksmith workers suffered less.
It is also evident from the results that the unskilled blacksmith suffered from discomfort in the upper extremities in more number than the skilled blacksmith. Most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%), neck skilled 60% and unskilled 80%), hand (skilled 50% and unskilled 64%), wrist (skilled 20% and unskilled 50%), and shoulder (skilled 30% and unskilled 36%).
It is found that the unskilled blacksmith workers had significantly higher intensity of pain feeling than the in the skilled blacksmith workers. Thus, it can be assumed that the job done by the unskilled blacksmith workers are extremely intense.
This finding can be supported further by the fact that the tasks performed by the unskilled blacksmith workers involve repetitive acceleration of hands with heavy hammer over sustained period of time. According to Silverstein et al
] an activity is said to be repetitive if 50% of the work cycle involves similar motion patterns. This criterion of repetitiveness was satisfied in this study wherein the hammering activity covers 90.7% of the work cycle of unskilled blacksmith workers and 55.2% of the work cycle of skilled blacksmith workers. Thus, high repetitiveness may be regarded as a causative factor for the development of MSD in upper limbs of the of the unskilled blacksmith workers predominantly
This type of job not only requires skill but is also time-consuming. Hammering jobs are responsible for most of the incidents. The significant correlation between the total number of incidents and total workdays lost in a year is an indicator of the fact that frequent incidents result in lost workdays. Gangopadhyay et al
] also found that there is a significant difference in the total number of injuries occurring between the skilled and unskilled surgical blacksmiths. Thus, it can be said that the unskilled blacksmiths are more affected than the skilled ones. Among them, incidents are very predominant, the unskilled ones involved in the highest number of incidents.
The handgrip strength of the workers of both groups was measured at 90° elbow flexion and 180° elbow extension. A significant difference in handgrip strength at both positions was observed between the subjects of both the groups. The skilled ones had significantly higher handgrip strength than the unskilled ones.
Therefore, all the results when aggregated together provide a fairly clear indication of the fact that the unskilled blacksmiths are more liable to suffer from MSD of the upper limb than the skilled ones.
From this study it can be concluded that the surgical blacksmiths are constantly engaged in highly repetitive hand intensive jobs and by performing such strenuous jobs for several years, they suffer from discomfort feeling at the upper extremities like the hands, wrists, fingers and shoulder region. The feeling gets aggravated with prolonged work, injuries followed by a decrease in the handgrip strength, and inability in grasping objects. The finger is the most affected portion of the body, followed by the hand, wrist, eye, face, leg and back. In both skilled and unskilled blacksmiths, the primary types of injuries are burns or scalds and scratches or abrasions. All these factors consequently may lead to the development of MSD at the upper limbs of the surgical blacksmiths.