92

PREVALENCE OF WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG

LABORATORY WORKERS.

Syed Murtaza Ali1 Mahak Memon2, ,Zunaira 3, Archina 4, Irum 5, Asma 6, Marish Memon7
ABSTRACT
OBJECTIVES: To determine the prevalence of Work-Related Musculoskeletal Disorders among
laboratory workers. METHODOLOGY: This cross-sectional study design was used from November
2019 to January 2020, among randomly selected laboratory workers. Data was collected using
standardized Nordic Musculoskeletal Questionnaire (SNMQ) andNumericPain Rating Scale (NPRS) to
determinethe prevalence of Work-Related Musculoskeletal Symptoms and pain intensity along with
participants’ demographic data, among laboratory workers. Data was analyzed using the Statistical
Package for the Social sciences (SPSS) version 20 and summarized by descriptive statics, which were
presented using frequency tables and expressed as percentages, mean+SD. RESULTS: In this study we
found 38% prevalence of Work Related Musculoskeletal Disorders (WRMSDs) among laboratory
workers. Moreover, ankles/feet turned out to be the most symptomatic region with prevalence of 0.7%
followed by neck and upper back being more common among male 131(87.3%), laboratory technicians
121(81.3%), with mean age of 34.65(11.82%). In our study, most of the participants (63.3%) were having
mild pain and 4% had severe pain. CONCLUSION: In conclusion, high prevalence of Work-Related
Musculoskeletal Pain, affecting one or both ankles/feet, neck, and upper back. Most of the study
participants reported having mild pain.

KEYWORDS: Standardized Nordic musculoskeletal questionnaire, Numeric pain rating scale, Statistical
package for social sciences

1. Assisstant professor, IPRS, PUMHSW, SBA.

2. Assistant Professor Dept of Biochemistry, PUMHSW, SBA.
3. House Officer, IPRS, PUMHSW, SBA.
4. House Officer, IPRS, PUMHSW, SBA.
5. House Officer, IPRS, PUMHSW, SBA.
6. House Officer, IPRS, PUMHSW, SBA.
7. Lecturer, IPRS, PUMHSW, SBA.

HOW TO CITE THIS ARTICLE: Ali SM1 Memon M2, Zunaira3, Archina4, Irum5, Asma6, Memon M7.
PREVALENCE OF WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG LABORATORY
WORKERS. JPUMHS; 2021, 11(02);92-96.
http://doi.org/10.46536/jpumhs/2021/11.02.301

CORRESPONDING AUTHOR: Marish Memon, Lecturer, IPRS , PUMHSW, SBA.

marishmemon@gmail.com

Received Dec 23, 2020, Accepted On 15 TH June 2021, Published On 30TH June 2021.
INTRODUCTION and even other joints and muscles .6 Laboratory
The technology which is used in medical labs is technicians are reported to have high level of
one of the most important health care strain in neck and shoulders owing to prolonged
branch.Technicians who are working in labs are static loading which leads to high prevalence of
exceptionalgroup of health care professionals neck pain, shoulder pain, elbow pain, hand /wrist
who are at high risk for developing pain, upper back, lower back and ankle/foot. 7-8
musculoskeletal problems and are at the most Prealence of musculoskeletal problems in those
frequent health issue faced by working using microscope for 11-15 years was found in
1
population are musculoskeletal disorders. maximum numbers, while those groups using
which are also linked with more disability than microscopes for more than 15 years reported
any other diseases.2 Musculoskeletal disorders smaller numbers.9 As indicated by Word Health
not only attack on person’s ability to work and Organization (WHO) reports, laboratory
function but also exert an financial influence on workersare prone to work related muscular
the work place health system and community.3 problems which causes high occurances in pain
Musculoskeletal disorder is describe as feeling related to neck, hand and shoulder. Neck pain is
of discomfort, difficulty or pain in the associated with poorposture. worldwide
musculoskeletal systems(joint, muscle, tendon) occurance of musculoskeletal problems occur
or soft tissue of the body due to repetitive and from 14% to 42% 10 Female are at high risk and
irregular movement or long term poor body increased working hours may further increase to
posture and also define as an extensive range the occuranceof musculoskeletal problems 11-12
4
of inflammatory conditions. Worldwide, the InIranand India, the prevalence of laboratory
musculoskeletal problems are very common. 5 lab work-related musculoskeletal disorders is
workers whichincludes pathologist, reported between 72% and 80%. Increased sites
microbiologist, biochemist and technicians are at of musculoskeletal problems in lab workers areas
high risk for developing musculoskeletal back (31%to 43%) and neck (18% to 33%) 12-13
problems like lower back and shoulder injuries laboratory workers are reported to have increased
Journal of Peoples University of Medical and Health Sciences. 2021: Volume 11; Issue 02.
 93
level of neck and shoulders strain due to constant nine areas of body. There are two types of
loading those results in increased prevalence of questionnaire general and specific questionnaire.
shoulder and neck pain. 14 In studies from The general questionnaire was used in present
America 15-16 Ethiopia 17 Sweden 18 Switzerland study which is binary response questionnaire and
11
reported that neck and back are vulnerable consistof27questions.Thepermissiontouse this
sites. The shoulder (58%to60%), upperback questionnaire from the author through mail. The
(25% to 57%) and hand/wrists (28% to 57%) third section includes Numeric Pain Rating Scale
were also recorded with increased involvement in (NPRS) which ranges from 0 to 10, 0 shows no
pipetting and microscope activities.11,15,16,18 This pain, while1-3 showsmild pain, and 4-6 shows
study aims to estimate the prevalenceof reported moderate pain, while7-10 represent severe pain.
musculoskeletal symptoms among laboratory Data was entered in Microsoft Excel Sheets and
workers with regard to theirwork- related analyzed by using Statistical Package for Social
physical factors. There is lack of literature Sciences (SPSS) version-20. Demographic data
available on the health care profession was calculated by descriptive statistics which
particularly inmedical laboratories .Laboratory includes (mean, standard deviation and
workers during their training who may be at percentages) and Nordic musculoskeletal
increased risk initially in their carrier According questionnaire to determine the prevalence of
to our knowledge only few studies have been work-related musculoskeletal disorders
conducted on prevalence of Work- Related
Musculoskeletal Disorders among laboratory RESULTS
workers. So, the results of our study will
therefore, helps to identify the occurance of The results of our research project are presented
disorders related to Musculoskeletal in literature in 3 sections. The first section includes
and to improve quality of life among laboratory Demographic information. The second section
workers of Hyderabad and Nawabshah. It includes the occuranceof Muscles related
willsupport the existing literature and can further problems in lab staff, through the Standardized
help in finding risk factors to which laboratory Nordic Musculoskeletal Questionnaire (SNMQ).
workers are exposed. The third section consists of Numeric pain rating
scale (NPRS) through which we had determined
pain.The 12 months prevalence of Work-related
MATERIAL AND METHODS Musculoskeletal disorders WMSDs was found to
be 57(38%) with pain in one orboth ankles/ feet
This research was conducted during Nov 2019 to while only 1(0.7%) had pain in leftelbow.
January 2020 at laboratories of nawabshah and
Hyderabad in Sindh province of Pakistan, and Table 4.1: Subjects information
comprised laboratory technicians and all of them
(n=150) participated voluntarily. those included VARIABLE MEAN SD
were both male and female gender. And Age 34.65 11.82
Laboratory workers e.g., Pathologist, biochemist, FREQUENCY (%)
microbiologist, technicians. Age 18 to 65 years.
Those who were not working in laboratories and Gender
known cases of Previous back pain history, Male 131 87.3%
Previous back injuries, Previous surgeries, and Female 19 12.7%
Previous disabilities were excluded. Approval Lab specialty
for the study was obtained fromthe institutional Microbiologist 10 6.7%
ethics committee (letter No/PUMHS/IPRS/ORS/ Pathologist 13 8.7%
3111/10) and consent was taken from all the
Biochemist 5 3.3%
participants. Participants filled a questionnaires,
Nordic standardized musculoskeletal Laboratory technicians 122 81.3%
questionnaire and numeric painwritingscale.
Prior to the inclusion in the study, all subjects DISCUSSION
signed an informed consent. All the participants
were given a detailed description of the study, Several occupations have increased risk of
and their anonymity and data confidentiality was muscles associated problems. Lab staff like
garranted and it took approximately 20-30 doing pipetting work reported increased
minutes. Simple structured standardized Nordic occurance of pain related to neck, shoulder,
musculoskeletal questionnaire was used for this elbow, back, and hand19. Mechanism for work-
study. Our questionnaire was divided into three related musculoskeletal disorders involves
sections: The first section was on the socio- fibrosis, tissue injury, recurrent cycle
demographic proforma of the laboratory workers ofinflammation that further lead to recurrent
like age, gender and lab specialty pain, muscle diseases, and dysfunction of
(microbiologist, pathologist, biochemist, ligament and fascia.20,21,22,23,24.
technicians). The second section includes
standardized Nordic musculoskeletal disorder
questionnaire which is used for scanning
musculoskeletal problems and epidemiologic
studies for the general complains of
shoulder/neck, upper/lower backand other body
regions. It also indicates the symptoms in these
Journal of Peoples University of Medical and Health Sciences. 2021: Volume 11; Issue 02.
 94
Table 4.2: Occurance of work- related muscular problems in Lab staff

Problems within Last 12 months n (%)

Body regions Yes No
Frequency percentage frequency Percentage
Neck 53 35.3% 97 64.7%
Shoulders 24 16% 105 70%
7 4.7%
14 9.3%
Elbows 10 6.7% 13 90.7%
1 0.7%
3 2.0%
Wrists/hands 28 18.7% 105 70%
9 6.0%
8 5.3%
Upper back 53 35.3% 97 64.7%
Lower back 50 33.3% 100 66.7%
One or both 25 16.7% 125 83.3%
Hips/thighs
One or both knees 49 32.7% 101 67.3%
One or both 57 38% 93 62%
ankles/feet
Table 4.3: Occurance of activity compromised in lab staff.

Body regions Problem Preventing daily activities N (%)

Frequency percentage frequency Percentage
Neck 16 10.7% 134 89.3%
Shoulders 9 6% 141 94%
Elbows 3 2% 147 98%
Wrists/hands 12 8% 138 92%
Upper back 17 11.3% 133 88%
Lower back 16 10.7% 134 89.3%
One or both 9 6% 141 94%
Hips/thighs
One or both knees 16 10.7% 134 89.3%
One or both 14 9.3% 136 90.7%
ankles/feet

Table 4.4: Occurance of work related muscular problems in laboratory staff

Body areas Problems within Last 7 days N (%)

Yes No
Frequency percentage frequency Percentage
Neck 25 16.7% 125 83.3%
Shoulders 17 11.3% 133 88.7%
Elbows 9 6% 141 94%
Wrists/hands 16 10.7% 134 89.3%
Upper back 27 18% 123 82%
Lower back 30 20% 120 8%
One or both 12 8% 138 92%
Hips/thighs
One or both knees 26 17.3% 124 82.7%
One or both 43 28.7% 107 71.3%
ankles/feet
Table 4.5 Prevalence of pain in laboratory workers.

CATEGORY FREQUENCY PERCENTAGE

No pain 15 10%
Mild pain 95 63.3%
Moderate pain 34 22.7%
Severe pain 6 4%

Therefore, the aim of our study was to find out present study, the overall 12 months
the prevalence of work-related prevalence of musculoskeletal disorders was
musculoskeletal disorders among laboratory 90% with highest prevalence in one or both
workers in different laboratories of ankles/feet 57(38%) followed by neck
Nawabshah, Hyderabad and Tando 53(35.5%) and upper back 53(35.5%). In
Muhammad khan through this cross- present study the results indicate the greater
sectionalstudy. According to findings of prevalence of WRMSD in laboratory
Journal of Peoples University of Medical and Health Sciences. 2021: Volume 11; Issue 02.
 95
technicians which is about (81.3%) as compare and contribute in literature to investigate this
to other laboratory workers, being more subject further. However, there are some
common in males (87.3%). These findings are limitations of this study firstly, the study
supported by previous study conducted in comprises small sample size and data was
Ethiopia where (21.7%) prevalence of collected only from Nawabshah, Hyderabad
ankle/feet pain founded in 156 laboratory staff and Tando Mohammad Khan
[25]. Another study determined the similar
prevalence of neck pain (33.3%) among CONCLUSION
pathologist (chart) and in Sweden the
prevalence of upper back pain was (25 to57 %) This study provides detailed information on
among laboratory technicians 18. So far, to the the prevalence of work-related musculoskeletal
best of our knowledge, no previously study disorders among laboratory workers. In
conducted was Pakistan that determining conclusion we found a high prevalence among
prevalence of WRMSD among laboratory laboratory workers of Nawabshah, Hyderabad
technicians. The occrance of work-related and Tando Mohammad Khan with highest
muscular disorders had been studied in frequency of muscular problems noted in one
different parts of the world. Among Indian or both ankles/ feet followed by neck and
medical labtechnicians, themajority of study upper back and lowest prevalence in elbow. As
population 66.9% had the most commonly present study we have only determined the
affectedbodyregionsamongwhichtheupper back occurancemuscular problems in lab workers
is about (11.5%), neck (18.4%) and ankle/feet and there may be other related factors like age,
(6.9%) 26. Furthermore, a study from Iran obesity, gender, biomechanical loading which
reported that the prevalence of WRMSD is can cause muscular problems. So
about between (72% and 80%) among futureresearch must consider these factors and
laboratory workers and the more prominent interactions that may occur between them.
sites of musculoskeletal problems were lower
back (31% to 43%) and neck (18% to 33%) DATA AVAILABILITY: data will be
1,13
.In previous study the global reference to available on request. ETHICS APPROVAL:
musculoskeletal symptoms in at least one The ERC gave ethical review approval .
anatomic segment was 86.7% in the last 12 CONSENT TO PARTICIPATE: written and
months and 70.2% in the last 7 days regardless verbal consent was taken from subjects and
of the activity performed by workers. 27 next of kin. FUNDING: The work was not
According to (WHO) global occurance of financially supported by any organization. The
muscular problems varies from 14%to 42% 12. entire expense was taken by the authors.
Such findings have shownthat WRMSD ACKNOWLEDGEMENTS: We would like
prevalence is high throughout the world to thank the all contributors and staff and other
leading to decreased QOL. In addition to persons for providing useful information.
lowering the quality of worker life and AUTHORS’ CONTRIBUTIONS: All
reducing productivity, WRMSDs are the most persons who meet authorship criteria are listed
expensive form of work disability, attributing as authors, and all authors certify that they
approximately 40% of all costs toward the have participated in the work to take public
treatment of work-related injuries and work- responsibility of this manuscript. All authors
related MSDs has a huge impact, emerging as read and approved the final manuscript..
an increasing problem in our modern societies. CONFLICT OF INTEREST: No competing
28
and there is very limited literature on the interest declared.
WRMSDs among laboratory workers in
Pakistan and this should be addressed in future REFRENCES
studies.A total of 150 participants are
approached rangingin age from 18 to 65 years, 1. Maulik S, De A, Iqbal R, editors. Work
with mean age of participants was 34.65yrs. related musculoskeletal disorders among
Out of 150 respondent, 131 (87.3%) were medical laboratory technicians. 2012
males, 122 (81.3%) participants were Southeast Asian Network of Ergonomics
laboratory technicians and only 5 (3.3%) were Societies Conference (SEANES); 2012:
biochemist.(Table 4.1) Seventeen (11.3%) IEEE.
participants had trouble during their work in 2. Australia SW. Statistics on work-related
past 12 months due to pain in upper back while musculoskeletal disorders. Canberra:
only 3(2%) participants had trouble due to SafeWork Australia.2016.
elbow pain Majority of our study participants 3. FritzscheFR, Ramach C, s D, Caduff R,
had trouble in one or both ankles/ feet Tinguely M, Cassoly E, et al. Occupational
43(28.7%) during their work in last 7 days health risks of pathologists-results from a
while only 9(6%) had trouble due to elbow nationwide online questionnaire in
pain. In our study most of the participants were Switzerland. BMC Public Health. 2012;
having 95(63.3%) mild pain while 6(4%) had 12:1054
severe pain. To the best of our knowledge 4. Andersen LL, Mortensen OS, Hansen JV,
there is no any study conducted in Pakistan BurrH.Aprospectivecohortstudyonsevere
before which determine the work-related pain as a risk factor for long-term sickness
musculoskeletal disorders specifically among absence in blue and white-collar workers.
laboratory workers. So, this study will support Occup Environ Med. 2011;68(8):590-2.

Journal of Peoples University of Medical and Health Sciences. 2021: Volume 11; Issue 02.
 96
5. Pollack R. Dental office ergonomics: how Hand and shoulder ailments among
to reduce stress factors and increase laboratory technicians using modern
efficiency. J Can Dent plunger-operated pipettes. Appl Ergon.
Assoc.1996;62(6):508-10 1994;25:88-94.
6. AlipourA, Ghaffari M, Jensen I, Shariati 19. David G, Buckle P. A questionnaire survey
B, Vingard E. Reliability and validity of the ergonomie problems
study of Persian modified version of associatedwith pipettes and their usage
MUSIC (musculoskeletal intervention with specific reference to workrelated
center)– Norrtalje questionnaire. BMC upper limb disorders. Appl Ergon.
MusculoskeletDisord.2007;8(1):88 1997;28(4):257-62.
7. CDC Laboratory Ergonomics. URL 20. Barbe MF, Barr AE. Inflammation and the
available from pathophysiology of work-related
http://ehs.uky.edu/docs/pdf/ohs_lab_ergon musculoskeletal disorders. Brain, behavior,
o mics_00 01.pdf. Accessed 22 November and immunity.2006;20(5):423-9.
2018. 21. Gerdle B, Hilgenfeldt U, Larsson B,
8. Björksten MG, Almby B, Jansson ES. Kristiansen J, SøgaardK, Rosendal L.
Hand and shoulder ailments among Bradykinin and kallidin levels in the
laboratory technicians using modern trapezius muscle in patients
plunger-operated pipettes. Appl withworkrelated trapezius myalgia, in
Ergon.1994;25(2):88-94. patients with whiplash associated pain, and
9. Sillanpää J, Nyberg M, Laippala P. A new in healthy controls–a microdialysis study
table for work with a microscope, of women. Pain. 2008;139(3):57887.
asolution to ergonomic problems. Appl 22. Larsson B, Rosendal L, Kristiansen J,
Ergon. 2003;34(6):621-8. Sjøgaard G, SøgaardK, Ghafouri B, et al.
10. Flavin RJ, Guerin M, O’Briain DS. Responses of algesic and metabolic
Occupational problems with microscopy in substances to 8 h of repetitive manual
the pathology laboratory. VirchowsArchiv. work in myalgic human trapezius muscle.
2010;457(4):509-11. Pain. 2008;140(3):47990.
11. Patel H, Pandya U. J Nov Physiother. 23. Millar N,Wei A,Molloy T,Bonar
2017. F,MurrellG. Cytokines and apoptosis in
12. Woolf AD, Pfleger B. Burden of major supraspinatus tendinopathy. J Bone Joint
musculoskeletal conditions. Bulletin of the surg Br. 2009;91(3):417-24.
World Health Organization.2003;81:646- 24. Yelin EH, Henke CJ, Epstein WV. Work
56. disability among persons with
13. Sadeghian F, KasaeianA, Noroozi P, musculoskeletal conditions. Arthritis &
Vatani J, Hassan Taiebi S. Psychosocial Rheumatism: Official Journal of the
and individual characteristics and American College of Rheumatology.
musculoskeletal complaints among clinical 1986;29(11):1322-33.
laboratory workers. Int J OccupSaf Ergon. 25. Penkala S, EL-Debal H, CoxonK. Work-
2014;20(2):355-61. related musculoskeletal problems related
14. KalavarSS, Hunting KL. Musculoskeletal to laboratory training in university medical
symptoms among cytotechnologists. science students: A cross sectional survey.
Laboratory Medicine.1996;27(11):765-9. BMC Public Health.2018;18:1208
15. Thompson SK, Mason E, Dukes S. 26. Maulik Sh, Iqbal R. Occupational health
Ergonomics and cytotechnologists: and musculoskeletal symptoms among
reported musculoskeletal Indian Medical Laboratory technicians.
discomfort.Diagnostic cytopathology. Journal of Occupational Health and
2003;29(6):364-7. Epidemiology 2013;2(3):82-92.
16. Yelin EH, Felts WR. A summary of the 27. Ramadan PA, FERREIRAJRM.
impact of musculoskeletal conditions in Riskfactors associated with the reporting
the United States. Arthritis & Rheumatism: of musculoskeletal symptoms in workers at
Official Journal of the American College a laboratory of clinical pathology. Ann
of Rheumatology.1990;33(5):750-5. OccupHyg.2005;50(3):297-303
17. Yelin EH, Henke CJ, Epstein WV. Work 28. Yasobant S, Rajkumar P. Work-related
disability among persons with musculoskeletal disorders among health
musculoskeletal conditions. Arthritis & care professionals: A cross-sectional
Rheumatism: Official Journal of the assessment of risk factors in a tertiary
American College of Rheumatology. hospital, India. Indian J Occup Environ
1986;29(11):1322-33. Med 2014;18:75- 81.
18. Björksten MG, Almby B, Jansson ES.

Journal of Peoples University of Medical and Health Sciences. 2021: Volume 11; Issue 02.