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Working conditions and musculoskeletal disorders in flight baggage handling
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.ORCID iD: 0000-0001-9612-3766
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Baggage handling is considered to be a heavy manual handling job including biomechanical exposures suspected of increasing the risk for musculoskeletal disorders. Aims: To document low back pain (LBP), shoulder pain (SP), and physical and psychosocial factors in baggage handlers, and to evaluate the implementation of an ergonomic intervention aiming to increase the use of loading assist devices. Methods: A questionnaire was utilized to characterize pain and psychosocial work conditions in 525 baggage handlers. The postures of 55 baggage handlers during 114 shifts were measured using inclinometry, half shift video-recordings were made for subsequent task analysis, and the number of aircraft handled was registered. Associations for psychosocial and biomechanical exposures with pain were assessed using regression analyses. An ergonomic intervention was implemented and evaluated using questionnaires and repeated interviews. Feasibility, intermediate outcomes, barriers and facilitators were assessed. Results: The prevalence rates of reported LBP and SP were 70% and 60%, respectively. Pain interfering with work (LBP - 30% and SP - 18%) and high pain intensity (LBP - 34% and SP - 28%) were associated with poor psychosocial working conditions. Extreme postures with arms elevated >60° occurred for 6.4% of the total time, and in trunk flexion >60° for 2.1% total time. In contrast, 71% of the total time was spent in a neutral trunk posture. The 90th percentile trunk forward flexion was 34.1°.  Daily shoulder pain increased in approximately one-third of all shifts and was positively associated with extreme work posture and the number of aircraft handled; this association was modified by influence and support. The intervention was delivered as planned, and dose received and satisfaction were rated as high. Motivated trainees facilitated implementation while lack of manager support, opportunities to observe and practice behaviors, follow-up activities, staff reduction, and job insecurity were barriers. Conclusion: The high prevalence rates of LBP and SP in baggage handlers were associated with psychosocial exposures, and daily shoulder pain was associated with higher biomechanical exposure. Barriers to implementation can be minimized by recruiting motivated trainees, securing strong organizational support, and carrying out follow-up activities.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. , p. 59
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1321
Keywords [en]
epidemiology, low back pain, shoulder pain, physical exposures, psychosocial exposures, inclinometry, implementation, process evaluation
National Category
Medical and Health Sciences
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:uu:diva-316468ISBN: 978-91-554-9868-9 (print)OAI: oai:DiVA.org:uu-316468DiVA, id: diva2:1084662
Public defence
2017-05-17, Frödingesalen, Ulleråkersvägen, Uppsala, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2017-04-26 Created: 2017-03-27 Last updated: 2017-05-05
List of papers
1. Psychosocial Work Factors and Musculoskeletal Pain: A Cross-Sectional Study among Swedish Flight Baggage Handlers
Open this publication in new window or tab >>Psychosocial Work Factors and Musculoskeletal Pain: A Cross-Sectional Study among Swedish Flight Baggage Handlers
2015 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 798042Article in journal (Refereed) Published
Abstract [en]

Objective. Flight baggage handlers sort and load luggage to airplanes. This study aimed at investigating associations between psychosocial exposures and low back and shoulder musculoskeletal disorders (MSDs) among Swedish flight baggage handlers. Methods. A questionnaire addressing MSDs (Standardized Nordic Questionnaire) and psychosocial factors (Copenhagen Psychosocial Questionnaire, COPSOQ) was answered by 525 baggage handlers in six Swedish airports. Results. Low back (LBP) and shoulder pain (SP) were reported by 70% and 60%, respectively. Pain was reported to interfere with work (PIW) by 30% (low back) and 18% (shoulders), and intense pain (PINT) occurred in 34% and 28% of the population. Quality of leadership was the most dissatisfying psychosocial factor, while the most positive was social community at work. Low ratings in the combined domain Work organization and job content were significantly associated with PIW in both low back and shoulders (Adjusted Hazard Ratios 3.65 (95% CI 1.67-7.99) and 2.68 (1.09-6.61)) while lower ratings in the domain Interpersonal relations and leadership were associated with PIWLBP (HR 2.18 (1.06-4.49)) and PINT LBP and SP (HRs 1.95 (1.05-3.65) and 2.11 (1.08-4.12)). Conclusion. Severity of pain among flight baggage handlers was associated with psychosocial factors at work, suggesting that they may be a relevant target for intervention in this occupation.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:uu:diva-268722 (URN)10.1155/2015/798042 (DOI)000364083100001 ()
Funder
AFA Insurance, Dnr 2010/358Forte, Swedish Research Council for Health, Working Life and Welfare, Forte Dnr. 2009-1761
Available from: 2015-12-09 Created: 2015-12-09 Last updated: 2017-12-01Bibliographically approved
2. Full-shift trunk and upper arm postures and movements among aircraft baggage handlers
Open this publication in new window or tab >>Full-shift trunk and upper arm postures and movements among aircraft baggage handlers
Show others...
2016 (English)In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-316462 (URN)
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2017-11-29
3. Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day
Open this publication in new window or tab >>Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day
2017 (English)In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 61, no 9, p. 1145-1153Article in journal (Refereed) Submitted
Abstract [en]

Objectives

This study of flight baggage handlers aimed at examining the extent to which shoulder pain developed during single work shifts, and whether a possible development was associated with biomechanical exposures and psychosocial factors during the same shift.

Methods

Data were collected during, in total, 82 work shifts in 44 workers. Right and left shoulder pain intensity was rated just before and just after the shift (VAS scale 0–100 mm). Objective data on ‘time in extreme’ and ‘time in neutral’ upper arm postures were obtained for the full shift using accelerometers, and the baggage handlers registered the number of ‘aircrafts handled’ in a diary. During half of the shift, workers were recorded on video for subsequent task analysis of baggage handling. ‘Influence’ at work and ‘support’ from colleagues were measured by use of Copenhagen Psychosocial Questionnaire (COPSOQ). Associations between exposures and the increase in pain intensity during the shift (‘daily pain’) were analysed for the right and left shoulder separately using Generalized Estimating Equations (GEE).

Results

‘Daily pain’ was observed in approximately one third of all shifts. It was significantly associated with the number of ‘aircrafts handled’ for both the right and left shoulder. In multivariate models including both biomechanical exposures and the psychosocial factors ‘influence’ at work and ‘support’ from colleagues, ‘aircrafts handled’ was still significantly associated with ‘daily pain’ in both shoulders, and so was ‘influence’ and ‘support’, however in opposite directions.

Conclusions

‘Daily pain’ was, in general, associated with biomechanical exposures during the same shift and with general ‘influence’ and ‘support’ in the job. In an effort to reduce pain among flight baggage handlers, it may therefore be justified to consider a reduction of biomechanical exposures during handling of aircrafts, combined with due attention to psychosocial factors at work.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-316463 (URN)10.1093/annweh/wxx073 (DOI)000417609300010 ()29136416 (PubMedID)
Funder
AFA Insurance, 100071Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2018-03-09Bibliographically approved
4. Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation
Open this publication in new window or tab >>Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 3, article id e0191760Article in journal (Refereed) Published
Abstract [en]

Objective

To conduct a process evaluation of the implementation of an ergonomics training program aimed at increasing the use of loading assist devices in flight baggage handling.

Methods

Feasibility related to the process items recruitment, reach, context, dose delivered (training time and content); dose received (participants’ engagement); satisfaction with training; intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods.

Results

Implementation proved successful regarding dose delivered, dose received and satisfaction. Confidence among participants in the training program in using and talking about devices, observed use of devices among colleagues, and internal feedback on work behavior increased significantly (p<0.01). Main facilitators were self-efficacy, motivation, and perceived utility of training among the trainees. Barriers included lack of peer support, opportunities to observe and practice behaviors, and follow-up activities; as well as staff reduction and job insecurity.

Conclusions

In identifying important barriers and facilitators for a successful outcome, this study can help supporting the effectiveness of future interventions. Our results suggest that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:uu:diva-316466 (URN)10.1371/journal.pone.0191760 (DOI)000426896800008 ()29513671 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1761
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2018-05-22Bibliographically approved

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