Prevalence of musculoskeletal pain in primary care dentists

Silva, Rayssa Nogueira de Sousa; Silva, Jose Mario Nunes da

doi:10.5935/1806-0013.20170106

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ORIGINAL ARTICLES • Rev. dor 18 (3) • Jul-Sep 2017 • https://doi.org/10.5935/1806-0013.20170106 copy

Prevalence of musculoskeletal pain in primary care dentists

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Dentistry is among the occupational categories that most inflicts its practitioners to a series of risk factors to develop musculoskeletal disorders, especially the maintenance of static postures, repetitive activities, long work days, poorly designed work environment, stress and handling of chemical and biological materials. The objective of this study was to analyze the prevalence of work-related musculoskeletal pain in primary care dentists.

METHODS:

The sample consisted of 167 primary care dentists, who answered questionnaires relating to musculoskeletal pain, social-demographic data, lifestyle, occupational characteristics, fatigue and ability to work.

RESULTS:

The prevalence of musculoskeletal pain was high for upper limbs (38.3%), lower limbs (34.7%) and on the back (27.5%). The was a statistical association in the three body segments, with family income, associated morbidities, daily and weekly working time, the perception of fatigue, and ability to work.

CONCLUSION:

The studied sample showed a high prevalence of musculoskeletal pain, which serves as a warning flag to the adoption of public policies to improve the working conditions of the dentists surveyed.

Keywords:
Dentists; Musculoskeletal pain; Occupational health; Working conditions

Sociodemographic variables	n	%	Average	SD
Gender
Male	72	43.1
Female	95	56.9
Age group (years)			40.3	10.7
23├ 40	96	57.5
≥40	71	42.5
Marital status
Not married	66	39.5
Married/domestic partnership	101	60.5
Family income (MW)
4├ 5	11	6.6
5-10	77	46.1
≥10	79	47.3
Lifestyle
Physical activity
Yes	117	70.1
No	50	29.9
Smoking
Yes	04	2.4
No	163	97.6
Alcohol consumption
Yes	48	28.7
No	119	71.3
Nutritional status (BMI kg/m ²)			24.0	3.0
Eutrophic	117	70.1
Overweight	50	29.9
Occupational
Workplace
Public service only (Primary Care Service)	62	37.1
Public service (Primary Care) and private	105	62.9
Tenure (Primary Care) (years)			18.9	9.0
Up to 10	114	68.3
≥10	53	31.7
Daily work (hours)			7.8	2.4
4├ 8	45	26.9
8-10	105	62.9
≥10	17	10.2
Health aspects^* * Adapted12
Satisfaction with sleep
Very dissatisfied	11	6.6
Dissatisfied	40	24.0
Neither dissatisfied / nor satisfied	42	25.1
Satisfied	67	40.1
Very satisfied	07	4.2
Self-reported stress
Always	04	2.4
Often	25	15.0
Sometimes	98	58.6
Rarely	00	0.0
Never	40	24.0
Health state
Very bad	00	0.0
Bad	00	0.0
Regular	30	18.0
Good	113	67.6
Very good	24	14.4
Fatigue perception^ Fatigue perception questionnaire13;
Low	123	73.7
High	44	26.3
Capacity to work^* ***** Capacity to work index14.
Adequate	89	53.3
Inadequate	78	46.7

Variables^* * Adapted12.	Always or very frequent		Little frequent		Very little frequent or never
Variables^* * Adapted12.	n	%	n	%	n	%
Proper cleaning	74	44.3	52	31.1	41	24.6
Satisfactory lighting	86	51.5	51	30.5	30	18.0
Proper cooling system	57	34.1	61	36.6	49	29.3
Humid environment	18	10.8	52	31.1	97	58.1
A lot of noise in the work environment	58	34.7	54	32.3	55	33.0
Work environment with unpleasant odor	23	13.8	60	35.9	84	50.3
Organized environment	71	42.5	63	37.7	33	19.8
Materials required for carrying out the procedures are sufficient	26	15.6	76	45.5	65	38.9
Equipment used are appropriate to the procedures	46	27.6	53	31.7	68	40.7
Excessive work pace	21	12.6	84	50.3	62	37.1
Sufficient number of oral health assistants	140	83.8	14	8.4	13	7.8
Repetitive and monotonous tasks	68	40.8	52	31.1	47	28.1
Difficult communication between the leadership and the team	33	19.8	62	37.1	72	43.1
Leadership supports professional growth	41	24.6	52	31.1	74	44.3
Autonomy to make decisions	72	43.1	60	35.9	35	21.0

	Upper limbs		Lower limbs		Back
	%	PR (CI95%)	%	PR (CI95%)	%	PR (CI95%)
Gender
Male	37.9	1	34.7	1	27.8	1
Female	38.9	1.01 (0.87 -1.17)	34.9	1.01 (0.88 -1.17)	27.4	0.96 (0.84 -1.10)
Age group (years)
23├ 40	37.5	1	23.9	1	22.9	1
≥40	39.4	1.04 (0.75 -1.28)	42.7	1.27 (1.09-1.49) ^ p≤0.01;	33.8	1.04 (0.88 -1.24)
Marital status
Not married	37.9	1	27.3	1	21.2	1
Married/domestic partnership	38.6	1.03 (0.87 -1.21)	39.6	1.04 (0.89 -1.22)	31.7	1.09 (0.96 -1.26)
Family Income (MW)
4├ 5	27.1	1	18.2	1	23.4	1
5├ 10	36.4	1.16 (1.04 -1.34) ^ p≤0.01;	27.3	1.09 (1.02-1.29) ^ p≤0.01;	29.1	1.01 (0.88 -1.17)
<10	49,4	1.36 (1.22 -1.54) ^ p≤0.01;	44,3	1.24 (1.18 -1.46) ^ p≤0.01;	45.5	1.27 (1.09-1.48) ^ p≤0.01;
Physical activity
Yes	37.6	1	33.3	1	24.8	1
No	40.0	1.03 (0.88 -1.20)	38.0	1.02 (0.88 -1.18)	34.0	1.09 (0.94 -1.25)
Smoking
Yes	38.7	1	50.0	1.38 (1.15 -1.66) ^ p≤0.01;	25.0	1
No	25.0	1.05 (0.70 -1.56)	34.4	1	27.6	1.08 (0.94 -1.25)
Alcohol consumption
Yes	45.8	1	41.7	1.13 (0.96 -1.32)	27.1	1
No	35.3	0.92 (0.77 -1.09)	31.9	1	27.7	1.01 (0.76 -1.35)
Nutritional status
Eutrophic	38.0	1	34.2	1	26.5	1
Overweight	38.5	0.93 (0.79 -1.09)	36.0	1.02 (0.87 -1.19)	30.0	1.03 (0.89 -1.20)
Associated morbidities
None	31.0	1	8.8	1	19.5	1
1-4 diseases	32.4	1.02 (0.88 -1.17)	34.5	1.33 (1.16-1.54) ^* ***** p≤0.001.	23.5	1.09 (0.94 -1.26)
5 or more	56.5	1.25 (1.01-1.55) ^ p≤0.01;	54.3	1.67 (1.40-1.98) ^* ***** p≤0.001.	45.7	1.21 (1.01-1.39) ^ p≤0.01;

	Upper limbs		Lower limbs		Back
	%	PR (CI95%)	%	PR (CI95%)	%	PR (CI95%)
Workplace
Public service only (Primary Care Service)	36,2	1	25.8	1	25.7	1
Public service (Primary Care) and private	41,9	1.12 (0.96 -1.32)	40.0	1.08 (0.94 -1.26)	30.6	1.12 (0.96 -1.30)
Tenure (Primary Care) (years)
<10	32,1	1	34.0	1	20.2	1
≥10	41,2	1.22 (1.04 -1.47) ^ p<;0.01,	35.0	1.09 (0.92 -1.30)	43.4	1.27 (1.05 -1.45) ^* ***** p<;0.001.
Daily work (hours)
4├ 8	31,1	1	26.7	1	26.7	1
8├10	39,0	1.04 (0.93 -1.32)	29.4	1.05 (0.97 -1.15)	25.7	0.98 (0.86 -1.46)
<10	52,9	1.55 (1.12 -1.71) ^* ***** p<;0.001.	39.0	1.59 (1.35-1.86) ^* ***** p<;0.001.	35.3	1.37 (1.10 -1.76) ^ p<;0.01,
Furniture is adequate
Yes	32,4	1	34.6	1	18.9	1
No	40,0	1.10 (0.95 -1.29)	35.1	0.99 (0.85 -1.15)	30.0	1.10 (0.96 -1.27)
Too much noise
Yes	39,7	1.02 (0.87 -1.18)	43.1	1.08 (0.92 -1.27)	32.8	1.02 (0.89 -1.16)
No	37,6	1	30.0	1	24.8	1
Excessive work pace
Yes	57,1	1.19 (0.95 -1.50)	47.6	1.07 (0.88 -1.30)	47.6	1.21 (1.01-1.46) ^* * p<;0.05;
No	35,6	1	32.9	1	24.7	1
Repetitive and monotonous tasks
Yes	52,9	1.19 (1.02-1.39) ^* * p<;0.05;	44.1	1.07 (0.92 -1.26)	30.9	1.05 (1.01-1.38) ^* * p<;0.05;
No	28,3	1	28.3	1	25.3	1
Fatigue
Low	35,8	1	26.8	1	18.7	1
High	45,5	1.08 (1.01-1.29) ^* * p<;0.05;	56.8	1.18 (1.07 -1.43) ^ p<;0.01,	52.3	1.32 (1.10 -1.58) ^ p<;0.01,
Capacity to work
Adequate	28,1	1	22.5	1	18.0	1
Inadequate	50,0	1.24 (1.04 -1.47) ^* * p<;0.05;	48.7	1.17 (1.03-1.39) ^ p<;0.01,	38.5	1.21 (1.01-1.46) ^* * p<;0.05;

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