Prevalence of neck and upper limb musculoskeletal disorders in artisan fisherwomen/shellfish gatherers in saubara, Bahia, Brazil

Falcão, Ila Rocha; Couto, Maria Carolina Barreto Moreira; Lima, Verônica Maria Cadena; Pena, Paulo Gilvane Lopes; Andrade, Lílian Lessa; Müller, Juliana dos Santos; Alves, Ivone Batista; Viana, Wendel da Silva; Rêgo, Rita de Cássia Franco

doi:10.1590/1413-81232015208.17272014

Ila Rocha Falcão

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Maria Carolina Barreto Moreira Couto

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Verônica Maria Cadena Lima

Departamento de Estatística, Instituto de Matemática, UFBA.

Paulo Gilvane Lopes Pena

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Lílian Lessa Andrade

Escola de Nutrição, UFBA

Juliana dos Santos Müller

Instituto Federal de Educação, Ciência e Tecnologia da Bahia

Ivone Batista Alves

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Wendel da Silva Viana

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Rita de Cássia Franco Rêgo

Programa de Pós-Graduação em Saúde, Ambiente e Trabalho (PPGSAT), Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal da Bahia (UFBA). Largo do Terreiro de Jesus s/n, Centro Histórico. 40026-010

Collaborations

IR Falcão, RCF Rêgo, PGL Pena, JS Müller, LLA Lino, MCBM Couto and WS Viana contributed to the literature review. IR Falcão, RCF Rêgo, IB Alves, JS Müller, LLA Lino, MCBM Couto and WS Viana contributed to the study design and collection. IR Falcão, RCF Rêgo, IB Alves and VMC Lima contributed in statistical analysis. All authors contributed to the interpretation and writing. All authors had access to all the data and have the responsibility in the final manuscript.

Continuous variables			média	Desvio Padrão (DP)
Age in years			39.6	11.5
Monthly income from shellfish			137.1	104.7
gathering
Age at start of work			12.8	7.2
Years of work			26.8	12.9
Daily working hours as a			8.7	3.1
shellfish gatherer
		Categorical variables	n	%
Birthplace:
Saubara			106	50.7
Santo Amaro			42	20.1
Salvador			23	11.1
Cachoeira			9	4.3
Other locations			29	13.8
Age
	≥ 38 years		106	50.7
	< 38 years		103	49.3
Ethnicity
	Black		125	59.8
	Brown		76	36.4
	White		8	3.8
Marital status
	Married/Cohabiting /Live-in		135	64.6
	partner
	Single/Separated/Widow		74	35.4
Education^* * 4.8% (n = 10) were illiterate, and 18.2% (n = 38) only studied up to primary school.
	< Incomplete High School		156	74.6
	≥ Incomplete High School		53	25.4
Children
	Yes		192	91.9
	No		17	8.1
Age of children
	≤ 2 years		21	10.1
	> 2 years		171	81.8
Years of work
	> 26 years		106	50.7
	≤ 26 years		103	49.3
Daily working hours as a shellfish gatherer
	> 11 h
	≤ 11 h		37	18
Weekly hours of housework			169	82
	> 7 h
	≤ 7 h		160	76.6
Current job			49	23.4
	Yes
	No		61	29.2
Previous job			148	70.8
	Yes
	No		120	57.4
Smoking habit			89	42.6
	Yes
	No		11	5.3
Alcohol consumption			198	94.7
	≤ Once a week
	< Once a week		165	78.9
Physical activity practiced during leisure			44	21.1
time
	Yes		141	67.5
	No		68	32.5
Waist circumference (WC)
	≤80		156	74.6
	<80		53	25.4
Body mass index (BMI)
	≤ 24.9		62	29.7
	25 \|–\| 29.9		79	37.8
	≥ 30		68	32.5
Comorbidities
	Diabetes mellitus
		Yes	14	6.7
		No	195	93.3
	Rheumatoid arthritis
		Yes	22	10,5
		No	187	89.5

Body part	Pain in the last twelve months		msD
	n	%	n	%
In any body part (upper limbs, lower limbs or back)	204	97.6	198	94.7
Neck or shoulder	165	78.9	149	71.3
Wrist or hand	149	71.3	120	60.9
Forearm or elbow	99	47.4	81	40.1
Distal upper limbs (wrist or hand or forearm or elbow)	187	89.5	147	70.3

Physical demand variables		Gathering	Transport	Processing
Physical demand variables		Mean; ± SD	Média; ± DP	Média; ± DP
Postures
	Sitting	1.58; 1.73	0.92; 1.36	4.55; 0.99
	Standing	1.81; 1.77	3.22; 2.00	0.99; 1.35
	Walking	2.84; 1.59	4.44; 1.13	0.68; 1.35
	Crouching	3.53; 1.73	0.53; 1.19	1.00; 1.71
	Bending over at the waist	3.94; 1.51	0.92; 1.54	2.46; 2.15
	Twisting the torso	2.29; 1.96	0.59; 1.16	1.45; 1.16
	Holding the arms aloft	0.71; 1.34	3.54; 1.78	0.50; 1.14
	Repetitive hand movements	4.55; 1.07	1.33; 1.74	4.54; 1.06
	Precise and very fne movements	2.98; 2.04	1.44; 1.87	3.70; 1.81
Muscle strength
	Arm or hand muscle strength	4.05; 1.14	3.81; 1.42	2.55; 1.82
	Physical pressure with hands on a work tool	3.92; 1.29	2.76; 1.96	2.48; 1.88
Load handling
	Lifting	3.35; 1.67	3.60; 1.46	2.01; 1.85
	Pulling	2.53; 2.01	1.07; 1.72	1.59; 1.87
	Pushing	1.40; 1.88	0.87; 1.55	1.05; 1.61

Psychosocial demands and job satisfaction variables	n	%
High psychosocial demand	106	50.7
Low psychosocial demand	103	49.3
High job satisfaction (satisfaction ≤ 0.40)	92	44.0
Low job satisfaction (satisfaction > 0.40)	117	56.0

Country; Workers; Type of study; Authors (year)	Females (%)	Number of study subjects	Musculoskeletal symptom rating	Prevalence per body part and groups of workers (1), females (2) or total (3)	(%)
Denmark; Workers of service sectors (S1. administrative assistants, S2. nurses, S3. nursing assistants, S4. cleaning and cooking staff and S5. technical staff) and different types of industries (P1. administrative work, P2. skilled workers and P3. unskilled workers); Prospective Cohort; ^{Andersen et al. (2007)}33. Andersen JH, Haahr JP, Frost P. Risk Factors for More Severe Regional Musculoskeletal Symptoms. Arthritis Rheum 2007; 56(4):1355-1364..	Data not shown in the article	4006^* * Only results and number of baseline subjects.	Pain in the last 12 months, per functional unit, considering the severity higher than or equal to 4 on a scale with 7categories ranging from no pain to extreme pain.	Neck or shoulder (1, 3)	S1: 43.0 S2: 29.0 S3: 44.0 S4: 46.0 S5: 32.0 P1: 32.0 P2: 22.0 P3: 38.0 Total: 37.0
	Data not shown in the article	4006^* * Only results and number of baseline subjects.		Distal upper limbs (1, 3)	S1: 17.0 S2: 11.0 S3: 21.0 S4: 28.0 S5: 13.0 P1: 12.0 P2: 17.0 P3: 22.0 Total: 18.0
Greece; Inhabitants of the island of Crete who perform rural work and sought one of the three rural Primary Care Centers (PCCs); Case-control; ^{Antonopoulou et al. (2007)}24. Antonopoulou M, Antonakis N, Hadjipavlou A, Lionis C. Patterns of pain and consulting behaviour in patients with musculoskeletal disorders in rural Crete, Greece. Fam Pract 2007; 24(3):209-216..	57.2	455	Pain or discomfort in the last 12 months and affecting the daily activities at work or at home.	Neck(2) Shoulder (2) Elbow (2) Wristor hand (2)	43.8 35.0 15.0 25.8
Reino Unido; Motoristas de entrega, trabalhadores de atendimento ao cliente, de informática e pessoal de escritório em geral; Estudo Transversal; ^{Devereux et al. (2002)}30. Devereux JJ, Vlachonikolis IG, Buckle PW. Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb. Occup Environ Med 2002; 59(4):269-277.	20.2^* ***** Percentage of women in the total number of individuals rated according to exposure (n = 564)	720	Pain or discomfort during the 7 days preceding the completion of the questionnaire.	Neck (3) Shoulder (3) Elbow (3) Wrist our hand (3) Upper limbs (3)	34.0 35.0 17.0 35.0 55.0
Estados Unidos (EUA); Pescadores comerciais licenciados de 13 municípios da costa da Carolina do Norte; Coorte Prospectiva; ^{Lipscomb et al. (2004)}21. Lipscomb HJ, Loomis D, McDonald MA, Kucera K, Marshall S, Li L. Musculoskeletal symptoms among commercial fishers in North Carolina. Applied Ergonomics 2004; 35(5):417-426..	11.6	215	Pain or discomfort in the last 12 months, seeking medical assistance related to the problem and affecting work.	Neck (3) Shoulder (3) Elbow or forearm (3) Wrist or hand (3)	6.0 15.0 14.0 15.0
India; Female workers from eight fish processing units; Case-control; ^{Nag et al. (2012)}23. Nag A, Vyas H, Shah P, Nag PK. Risk Factors and Musculoskeletal Disorders Among Women Workers Performing Fish Processing. Am J Ind Med 2012; 55(9):833843..	100.0	450	MSD prevalence in the last 12 months.	Neck (2) Shoulder (2) Hand (2) Some body area (2)	170 27.0 17.0 71.0
Spain; Shellfish gatherers from the Autonomous Region of Galicia; Cross-sectional Study; Rodriguez-Romero et al. (2012).	98.7	929	Musculoskeletal pain on the day of the interview, considering the pain intensity assessed from a verbal numeric scale ranging from 0 (no pain) to 10 (worst pain imaginable).	Neck or shoulder or upper back (3) Distal upper limbs (without the forearm) (3)	82.0 51.0
USA; Sewing machine operators from 13 clothing industries in Los Angeles, California; Cross-sectional Study; ^{Wang et al. (2007)}34. Wang PC, Rempel DM, Harrison RJ, Chan J, Ritz BR. Work-organizational and personal factors associated with upper body musculoskeletal disorders among sewing machine operators. Occup Environ Med 2007; 64(12):806-813..	64.4	520	Self-report of musculoskeletal symptoms in the last month, according to the minimum frequency of 1 day a week with pain intensity higher than or equal to 3 on a scale from 0 (no pain) to 5 (much pain) with anchors at the ends.	Neck or shoulder (3) Distal upper limbs (3)	24.0 15.8
China; Fish processing workers from eight small- to medium-sized factories on the outskirts of the Kaohsiung port in Taiwan. The sample was divided into 3 groups: G1. Low repeatability and low use of strength (managers, office personnel and specialists); G2. High repeatability and high use of strength (semiskilled workers working on conveyor belts, fish processing and packers); G3. High repeatability and strength (workers who cut, separated and rated the fish or seafood); Cross-sectional Study; ^{Chiang et al. (1993)}22. Chiang HC, Ko YC, Chen SS, Yu HS, Wu TN, Chang PY. Prevalence of shoulder and upper-limb disorders among workers in the fish-processing industry. Scand J Work Environ Health 1993; 19(2):126-131..	G1. 47.5 G2. 75.4 G3. 78.6	207	Self-reported symptoms and clinical diagnosis during the last month^ Only data regarding symptoms are shown in the table. .	Neck (1)s	G1: 6.6 G2: 13.6 G3: 21.4
				Shoulder (1)	G1: 14.8 G2: 44.1 G3: 50.0
				Elbow (1)	G1: 18.0 G2: 19.5 G3: 35.7
				Wrist (1)	G1: 8.2 G2: 17.8 G3: 25.0
				Hand (1)	G1: 13.1 G2: 21.2 G3: 32.1

[1] Collaborations

IR Falcão, RCF Rêgo, PGL Pena, JS Müller, LLA Lino, MCBM Couto and WS Viana contributed to the literature review. IR Falcão, RCF Rêgo, IB Alves, JS Müller, LLA Lino, MCBM Couto and WS Viana contributed to the study design and collection. IR Falcão, RCF Rêgo, IB Alves and VMC Lima contributed in statistical analysis. All authors contributed to the interpretation and writing. All authors had access to all the data and have the responsibility in the final manuscript.

Brasil

Brasil

Prevalence of neck and upper limb musculoskeletal disorders in artisan fisherwomen/shellfish gatherers in saubara, Bahia, Brazil

Abstract