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The purpose of this study was to determine the prevalence of and risk factors for neck pain in dentists of Tehran province and to analyze the association of neck pain with individual and occupational characteristics. Following ethical approval, a cross sectional study was conducted on 300 randomly selected dentists at Tehran city. Different questionnaires were used to collect personal and occupational characteristics as well as the prevalence and risk factors of neck pain. The Iranian validated version of visual analogue scale and neck disability questionnaires were also used to assess the pain intensity and functional disability of neck, respectively. Point, last month, last year and lifetime prevalence of neck pain were 19.3%, 27.3%, 29.9% and 34.7%, respectively. The prevalence of neck pain was significantly correlated with regular exercise, general health condition and having an assistant (P< 0.05 in all instances) and was not significantly correlated with body mass index, age and gender. Prolonged sitting, awkward postures and repeated movements were the most significant aggravating factors. Results indicated that the prevalence of neck pain in dentists appears to be high. Therefore, further studies on different preventive strategies in dentists' population seem necessary.
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Journal of Back and Musculoskeletal Rehabilitation 26 (2013) 9–15 9
DOI 10.3233/BMR-2012-0343
IOS Press
Work related neck pain in Iranian dentists:
An epidemiological study
Nahid Rahmani
a
, Mohsen Amiri
b,
, Mohammad Ali Mohseni-Bandpei
c
, Holakoo Mohsenifar
b
and
Mohammad Reza Pourahmadi
d
a
Student Research Committee, The University of Social Welfare and Rehabilitation Sciences, Evin, Tehran, Iran
b
Department of Physiotherapy, The University of Social Welfare and Rehabilitation Sciences, E vin, Te hran, Iran
c
Pediatric Neurorehabilitation Research Center, The University of Social Welfare and Rehabilitation Sciences,
Evin, Tehran, Iran
d
Department of Physiotherapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Abstract.
OBJECTIVE: The purpose of this study was to determine the prevalence of and risk factors for neck pain in dentists of Tehran
province and to analyze the association of neck pain with individual and occupational characteristics.
DESIGN: Following ethical approval, a cross sectional study was conducted on 300 randomly selected dentists at Tehran city.
Different questionnaires were used to collect personal and occupational characteristics as well as the prevalence and risk factors
of neck pain. The Iranian validated version of visual analogue scale and neck disability questionnaires were also used to assess
the pain intensity and functional disability of neck, respectively.
RESULTS: Point, last month, last year and lifetime prevalence of neck pain were 19.3%, 27.3%, 29.9% and 34.7%, respectively.
The prevalence of neck pain was signicantly correlated with regular exercise, general health condition and having an assistant
(P<0.05 in all instances) and was not signicantly correlated with body mass index, age and gender. Prolonged sitting, awkward
postures and repeated movements were the most signicant aggravating factors.
CONCLUSIONS: Results indicated that the pre valence of neck pain in dentists appears to be high. Therefore, further studies
on different prev entive strategies in dentists’ population seem necessary.
Keywords: Dentists, neck pain, prevalence, risk factors
1. Introduction
Musculoskeletal disorders (MSDs) are relatively
common conditio n and determined as injuries to the
human support system such as muscles, tendons, liga-
ments, joints, peripheral nerves, and supporting blood
vessels. Individuals with musculoskeletal pain often
report multiple pain sites including pain in the neck,
shoulders, arms, wrists, hands, upper and lower back,
hips, knees and feet [1–4]. MSDs are known to be the
most important occupational health issues in healthcare
workers with substantial costs and impact on quality of
life [5–9].
Corresponding author: Dr. Mohsen Amiri, Department of Phys-
iotherapy, The University of Social Welfare and Rehabilitation Sci-
ences, Evin, Tehran, P.O. Box, 1985713834, Iran. Tel.: +98 21
22180039; Fax: +98 19 85713834; E-mail: m.amiri@uswr.ac.ir.
Different research demonstrated that neck pain is a
common musculoskeletal problem in both the devel-
oped and developing countries [10–16]. Studies suggest
that the annual p revalence of neck pain varied across
occupations, ranged from 10.2% in France to 27.1%
in Norway to 33.7% in the UK and to 47.8% in Que-
bec, Canada [17–20]. The one week prevalence of neck
pain was variably reported from 7.3% in ofce workers
to 53% in female plant workers exposed to repetitive
work [2,21, 22]. Among healthcare workers, dentists
and nurses seem to be more affected by neck disorders
with high annual prevalence rates ranging from 17%
to 66% [23]. The socioeconomic cost of neck pain is
considerable, resulting in substantial consumption of
healthcare resources, absenteeism from work, disabil-
ity and compensation payments. In The Netherlands,
a 1 -year cost of MSDs reported to be US$ 686 mil-
ISSN 1053-8127/13/$27.50 2013 IOS Press and the authors. All rights reserved
AUTHOR COPY
10 N. Rahmani et al. / Work related neck pain in Iranian dentists: An epidemiological study
lion, representing 1% of total healthcare expenditure
and 0.1% of Gross Domestic Product [12].
Dentists are at high risk fo r developing many work-
related disorders particularly neck and back pain. Neck
pain was reported as the most prevalent musculoskeletal
complaint at 57.5% in Queensland, Australia [16]. In a
cross-sectional study carried out on 227 randomly se-
lected dental students to evaluate the presence of work-
related MSDs in Brazil, 76.2% reported pain during or
after clinical work [24]. T hey have also reported sig-
nicant difference between gender and the occurrence
of pain. In a recent study conducted on 220 dentists in
Poland, over 92% of dentists experienced MSDs, espe-
cially in the neck (47%) and lower back (35%). Statis-
tically signicant association was also found between
the years of pr actice and the prevalence of MSDs [25].
A number of work-related factors have been es-
tablished as predisposing factors for MSDs [26, 27].
Among different identied predisposing factors, years
of practice, overstrained and awkward back pos-
tures, repetitiveness, health behaviors and psychosocial
stresses were commonly reported [23,26, 27]. Female
dentists were reported to have more musculoskeletal
complaints than their male colleagues [10,28]. Previ-
ous research also demonstrated that the incidence of
neck pain increases with age. It appeared that older
worker were more likely to develop neck pain com-
pared with younger workers [23,26].
Most of the differences in prevalence rate of neck
pain may be due mainly to different methodologies
used, variations in denition of neck pain, pr evalence
periods (such as point versus lifetime), less restrictive
denition of neck p a in (any pain in the neck versus neck
pain accompanied with shoulder pain), heterogeneity
of study populations, follow up periods and different
sample size. Every effort was made in the present study
to address the gaps in prev ious research by providing a
clear denition f or neck pain specically, a dened in-
clusion and exclusion criteria, and a dened prevalence
period. A cross sectional study was designed, target-
ing dentists currently workin g in Tehran city of Iran to
investigate the prevalence of and risk factors for neck
pain in dentists, and to assess how individual and occu-
pational characteristics contribute to the risk of injuries
in dentists.
2. Materials and methods
2.1. Study design and data collection
This cross-sectional study was given ethical approval
from the Medical Ethics Board at the University of So-
cial Welfare and Rehabilitation Sciences. Three hun-
dred and fty dentists were randomly selected from
Tehran city and were sent the questionnaires. Dentists
were included if they were qualied to work as a den-
tist, had at least 1 year of work experience in the current
position and were willing to participate in the present
study. The exclusion criteria were: spinal deformi-
ties (e.g. scoliosis), malignancy, osteoporosis, multiple
sclerosis, any fracture, trauma or disorders in the head
or the neck, and any inammatory conditions.
Dentists were identied and invited to par ticipate by
an invitation letter. All dentists were given oral and
written information about the aims of the study by a
research coordinator allocated in each region. Partic-
ipants were asked to sign a consent form if they were
willing to take p art. All participants who gave their
consent were informed that they were free to withdraw
from the study at any time. In order to maximize like-
ly response returns, a decision was made to allocate
a research coordinator to each region. The study was
carried out from July to October 2011.
Different questionnaires were used to collect person-
al and occupational characteristics as well as the preva-
lence of and risk factors for neck pain and d isability.
The questionnaires involved information on individu-
al and occupational characteristics and physical load
at work, general health status [29], and prevalence of
neck pain. Individual characteristics and work history
included certain questions such as age, anthropome-
try, gender, marital status, level of education, years of
experience, and working hours per day. Questions on
physical work load and clinical data concerned repeti-
tive movements, various types of treatments provided
each day (surgery, root canal, and lling or tooth ex-
traction), awkward working postures, prolonged sitting
or standing, and use of vibrating tools, medical history,
location and nature of symptoms. Dentists were also
asked to report if they had any pain at the time of com-
pleting questionnaire, within last month, last year and
any pain during lifetime.
For this study mechanical neck pain was dened as
generalized neck symptoms provoked by maintain neck
posture, neck movements or manual muscle palpation.
Pain intensity was measured on Visual Analogue Scale
(VAS). The scale used was the typical 100 mm horizon-
tal line, with 0 mm indicating “No pain” and 100 mm in-
dicating “Unbearable pain”. VAS is a common, quick,
reliable and valid means to measure pain intensity in
a variety of clinical contexts [30]. Neck disability in-
d
ex (NDI) was also used to assess functional disability
of neck [31]. All questionnaires used in this study had
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N. Rahmani et al. / Work related neck pain in Iranian dentists: An epidemiological study 11
Table 1
Sample characteristics
Variables Mean (SD) Range
Age (years) 41.30 (8.43) 28–70
Height (cm) 175.83 (8.77) 156–196
Weight (kg) 73.56 (12.68) 49–102
BMI 27.85 (3.67) 18.90–39.01
Years of practice 12.83 (7.46) 1–42
Working hours per day 7.25 (2.43) 2–16
BMI, Body mass index.
Table 2
Neck pain prev alence for dentists
Period of prevalence Total pre valence rate
Point prevalence 19.3%
Last month prevalence 27.3%
Annual prevalence 29.9%
Lifetime prevalence 34.7%
previously been translated into Persian and the relia-
bility and validity of Iranian versions had been test-
ed and approved [29,32]. The participants were also
asked if they received any treatments. Their responses
were categorized into different groups, those being rest,
medication, physiotherapy and exercise, and surgery
groups.
2.2. Statistical analysis
Categorical and numerical variables were analyzed
using cross-tabulation, and Chi-Square analysis was
used to examine the relationship between two or more
variables. Pearson Correlation Coefcient was applied
to assess the existence of linear relationships between
variables. Data were analyzed with calculation of odds
ratio (ORs) and their 95% condence intervals (CIs)
by univariate and multivariate logistic regression for
neck pain in relation to different variables. The level
of statistical signicance was set up at 0.05. Statistical
analysis was performed using SPSS (Version 16).
3. Results
A response rate of 86% (n = 300) was obtained from
the original eligible sample (n = 350). Two hundred
and fteen (71.7%) of the dentists were male and 85
(28.3%) were female. The sample characteristics and
the epidemiological data collected from dentists are
summarized in Tables 1 and 2, respectively. Table 3
demonstrates the management of neck pain received by
dentists. Table 4 presents frequencies and adjusted ORs
and CIs for predictive factors of point prevalence of
Table 3
Management of neck pain for those dentists who received treatment
Procedure/Treatment No (Percent)
Rest 10 (9.2%)
Medication 38 (36.2%)
Physiotherapy and Exercise 53 (51.3%)
Surgery 3 (3.3%)
neck pain using a logistic regression model. Point, last
month, last year and lifetime prevalence of neck pain
were 19.3%, 27.3%, 29.9% and 34.7%, respectively.
The mean and standard deviation of pain intensity on
VAS was 44.48 ± 20.13 mm (range 5 mm to 92 mm)
for those who suffered from neck pain. The mean and
standard deviation of function disability on NDI for
those with neck pain was 40.14% ± 20.11% (range
4% to 86%) which was signicantly correlated with
pain intensity as assessed using Pearson Correlation
Coefcient analysis (r = 0.56, P = 0.019).
As demonstrated in Table 3, 104 (34.7%) of partic-
ipants had sought treatment and had received different
management for their pain. Of these, 38 (36.2%) den-
tists had medication only, including analgesics, mus-
cle relaxants and non steroid anti inammatory drugs
(NSAIDs); 53 (51.3%) dentists received physiotherapy
and exercise; 10 (9.2%) dentists had rest; and 3 (3.3%)
dentists received surgical treatment in addition to med-
ication, physiotherapy and exercise (Table 3). Approx-
imately, 27% had taken off work due to neck pain rang-
ing from 2 days to 3 months with an average duration
of 21.5 days.
Female dentists appeared to be more affected than
men but this did not reach statistical signicance (P =
0.359). The results also indicated that the o lder dentists
(> 50 years old) seemed to be more at risk of devel-
oping neck pain (Table 4) compared with younger den-
tists although this did not reach statistical signicance
(P = 0.719). Similarly the results of body mass index
(BMI) indicated no statistically signicant correlation
between BMI and prevalence of neck pain (P = 0.083).
The prevalence of neck pain was also associated with
working history in dentists. Whilst dentists who had a
work experience longer than 20 years were more likely
to report neck pain, this did not reach statistical sig-
nicance (P = 0.078). There was also a signicant
correlation between perceived g eneral health and the
prevalence of neck pain using Pearson Correlation Co-
efcient analysis (r = 0.79, P = 0.003). Participants
who had not considered themselves healthy on gener-
al health questionnaire were more likely to experience
neck pain compared with those who reported healthy
condition (P<0.001).
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12 N. Rahmani et al. / Work related neck pain in Iranian dentists: An epidemiological study
Table 4
Adjusted odds ratio and 95% condence interva ls for predictive factors of point prevalence of neck pain using logistic regression model
Variables Frequency Frequency Chi-square Odds ratio 95% P-value
(%) of (%) affected condence
total sample by neck pain intervals
Gender
Male 215 (71.7) 71 (33) 0.71 1.03 0.89–1.38 0.359
Female 85 (28.3) 33 (38.8)
Age (y)
< 40 125 (41.7) 42 (33.6) 0.23 0.91 0.83–1.42 0.719
41–50 83 (27.6) 31 (37.3)
51–60 57 (19) 23 (40.3)
> 60 35 (11.7) 8 (22.8)
BMI
< 20 17 (6) 6 (35.2) 2.67 1.19 0.87–2.01 0.083
20–25 97 (32) 27 (27)
25–30 156 (52) 62 (40.3)
> 30 30 (10) 8 (26.6)
General health
Reported healthy 211 (70.3) 48 (22.7) 37.13 8.03 4.11–19.76 0.000
Reported unhealthy 89 (29.7) 56 (62.9)
Years of practice
< 10 103 (34.3) 32 (31.1) 2.83 0.98 0.67–1.21 0.078
10–20 129 (43) 43 (33.3)
> 20 68 (22.7) 29 (42.6)
Exercise
Not exercising 204 (68) 91 (44.6) 1.39 0.73 0.41–1.09 0.114
Exercising 96 (32) 37 (38.5)
Preventive strategies (PS)
Without PS 108 (36) 55 (50.9) 6.14 2.93 1.57–4.08 0.013
With PS 192 (64) 75 (39.5)
Assistant
Without assistant 183 (61) 89 (48.6) 4.18 2.03 1.07–3.96 0.036
With assistant 117 (39) 37 (31.6)
J ob satisfaction
No 11 (3.6) 2 (18.2) 3.06 1.13 0.49–1.28 0.071
Low 63 (21) 26 (41.2)
Moderate 191 (63.7) 71 (37.1)
High 35 (11.7) 5 (14.2)
Ninety six dentists (32%) in this study reported that
they were doing exercise on regular basis. Although
those dentists who were not exercising were more likely
to report neck pain compared with those who were
exercising on regular basis, this did not reach statistical
signicance (P = 0.114). According to the data on
a structured questionnaire, prolonged sitting, repeated
movements and bad postures were reported to be the
most signicant aggravating factors, respectively.
4. Discussion
The results of this cross-sectional study demonstrate
that neck pain is a common complaint in studied den-
tists. A correlation was found between the prevalence
of neck pain and certain factors, those being general
health condition, years of practice, using preventive
strategies, having an assistant at work and job satis-
faction. It seems that the physical load amongst d en-
tists put them at risk for the occurrence of neck pain.
Available epidemiological studies on occupational in-
juries demonstrate that the prevalence of neck pain in
different profession s in healthcare setting is relatively
high [27]. The point and life time prevalence of neck
pain in the present study was 19.3% and 34.7% which
are consistent with most previously reported prevalence
rates fo r neck pain in healthcare setting [23,26].
A number of studies have investigated the effects of
certain personal and professional factors such as gen-
der, age, BMI, general health condition, years of prac-
tice, job satisfaction, etc. on prevalence of MSDs. Al-
though there is conicting results on gender differences
in MSDs, being a female is frequently reported to be
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N. Rahmani et al. / Work related neck pain in Iranian dentists: An epidemiological study 13
a risk factor for MSDs [10,24,33]. Cote et al. [23] in
a systematic review reported that women experience
more neck pain than men. It was also suggested that
female gender is positively correlated with severity of
musculoskeletal pain. The results of the study conduct-
ed on Australian dentists indicated that those dentists
who rate their pain severity at the highest rank were
more likely to be female [10]. Although no signicant
correlation was found between gender and the preva-
lence o f neck pain in the current study, further large
scale studies are n ecessary to investigate the association
between gender and prevalence of neck pain.
Despite the extensive research, there is still no gener-
al consensus on the effect of age and the prevalence of
neck pain. Some studies reported a positive association
between age and the prevalence of n eck pain (e.g. [17,
34]), some suggested negative association (e.g. [33,
35]) and some found no correlation (e.g. [37]). It was
reported that the incidence of neck pain increases with
age and older workers were more likely to develop neck
pain than younger workers [17,34]. Although no sig-
nicant relationship was found between age and preva-
lence of neck pain in the current study, but the results
is in agreemen t with those studies in wh ich the peak
effect of age was reported to be in the fourth and fth
decade of life.
Data from the present study suggest that the longer
the year of practice, the greater the risk of suffering
neck pain. Some studies reported positive correlation
between years of practice and the preva lence of MSDs
in dentists [25,37]. These results were consistent with
the ndings of Szymanska [37] and Kierlo et al. [25].
They reported that symptoms of MSDs increased with
the number of years of practice [25]. It was also report-
ed that dentists who did not report symptoms had less
than ve years of practice [37]. Conversely some stud-
ies reported that musculo skeletal pain is negatively as-
sociated with years of practice [10,16,38]. Chowanadi-
sai et al. [28] found Thai dentists to have a lesser chance
of experiencing MSDs in the previous 12 months if
they had more years of clinical experience. It appears
that long term exposure to different physical and psy-
chological demands in dentistry makes dentists more
vulnerable to MSDs. However, the results of the cur-
rent study give support to the notion that the longer
the years of practice, the higher the prevalence rate of
MSDs.
Dentists who had not considered themselves healthy
on general health questionnaire were more likely to ex-
perience neck pain compared with those who reported
healthy condition and this was strongly associated with
prevalence of neck pain. It seems that regular practice
of exercise is an effective strategy to prevent MSDs,
as those people who took part in any kind of athletic
activity or physical conditioning demonstrated lower
levels of severe symptoms than those who did not. It
was reported that the risk of neck pain increased by
15% to 22% among workers with low to moderate static
endurance of neck muscles [39]. In contrast, reported
that general health status was not associated with neck
pain recurrence [40]. However, the result of the cur-
rent stu dy is in agreement with those studies in which
physical capacity was found to be associated with neck
pain.
The results of previous studies on the association be-
tween job satisfaction and prevalence of neck pain are
conicting. Korhonen et al. [41] demonstrated no rela-
tionship between job satisfaction and local or radiating
neck pain. Some studies suggested that workers with
low level of satisfaction had higher rates of neck pain
compared with those who were more satised (e.g. [36,
42]). Whilst dentists with low level of satisfaction were
more likely to report neck pain compared with those
who reported m oderate and high level of satisfaction,
job satisfaction was not found to be associated with the
prevalence of neck pain in the present study.
Work related MSDs particu larly low back pain and
neck pain are common and costly among other health-
care workers who are in direct contact with patients [5–
9,43]. It was reported that a large number of physiother-
apists, nurses, surgeons, etc. are suffering from work
related MSDs. Previous studies demonstrated that some
work related activities such as lifting patients and heavy
equipments, transferring patients,maintaining the same
posture for a long period of time, manual therapy prac-
tices, repeated movements and awkward posture, and
prolonged sitting and standing were the most common
mechanisms lead to injury in healthcare professionals.
These wide ranges of injuries have major impact on
society, workers, employers, and the insurance com-
panies due to work absenteeism, long term disability
and delay in returning to work, decreased productivi-
ty, and psychological effects on employees. Therefore,
developing preventive strategies to minimize work re-
lated injuries and to improve working conditions have
signicant potential social and economic benets.
5. Conclusions
The ndings of the present study revealed that the
prevalence of neck pain amongst d entists appears to be
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14 N. Rahmani et al. / Work related neck pain in Iranian dentists: An epidemiological study
high and highlights a major health concern. The as-
sociations of certain risk factors such as BMI, general
health condition, years of practice, having an assistant
at work, preventive strategies used, and job satisfaction
were addressed in the current study. The results also
highlight the need to allocate more resources in order
to control the identied predisposing factors and to re-
duce the incidence of neck pain in dentists population.
Further research should focus on evaluating the effect
of different preventive strategies to reduce the impact
of such a major health issue.
Acknowledgements
This paper is taken from a research project funded
by the Student Research Committee at the University
of Social Welfare and Rehabilitation Sciences. The
authors acknowledge the University of Social Welfare
and Rehabilitation Sciences for nancial support of this
study. The authors would like to thank all dentists for
their contribution to the present study and all research
coordinators for their kind cooperation and support.
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... Prolonged static postures (PSPs) are often unavoidable in daily dental operations [4,6]. Forward-head postures which involve holding the neck and head in an unbalanced forward position to gain better visibility during treatment are common among dentists [4,6]. ...
... Prolonged static postures (PSPs) are often unavoidable in daily dental operations [4,6]. Forward-head postures which involve holding the neck and head in an unbalanced forward position to gain better visibility during treatment are common among dentists [4,6]. Sustained contraction of the cervical muscles due to the PSPs may cause the weakening of spinal discs, which in turn increases the risk of disc degeneration of herniation [4]. ...
... The possible reason may be the PSPs of the orthopedists during the operations [3]. There were many studies reported that neck pain were very common and troublesome for their careers in the dentists [6][7][8]. Rahmani et al. reported that point, last month, last year and lifetime prevalence of neck pain were 19.3, 27.3, 29.9 and 34.7%, respectively [6]. Shaik et al. reported that 70% of dental surgeons experienced neck pain [7]. ...
Article
Full-text available
Background Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap. Methods We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age- and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011. Results Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9–1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9–4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8–1.1). Conclusion Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.
... 24 Although factors such as physical demand and requirements are considered as workrelated risk factors to musculoskeletal system. 41 , 19 Our recent survey of self-reported musculoskeletal symptoms in all body region in an administrative oil refinery office official work showed a high proportion of experienced musculoskeletal symptoms in the past 12 months with a prevalence of 50% in the neck, 42.5% in the knee, 38.5% in the shoulder, 37% in the upper back. 26 Research studies have been also conducted in Iran in order to obtain an estimate of the incidence of MSDs and their related factors in different jobs, university medical science 23 Iranian nurses, 43 bank office, 29 and poultry slaughter workers. ...
... The author's previous study was the prevalence study of oil refinery administrative office of their MSDs. 26 There were a few previous studies investigating musculoskeletal symptoms in other occupations, such as U.S. agricultural sectors, 18 dairy factory, 38 nursing personnel, 3 Osborne et al. 36 These studies also reported a high prevalence of musculoskeletal symptoms among the targeted workers. ...
Article
Musculoskeletal symptoms are the most frequent occupational health problems and accounts for a large number of losses in working days and disability for workers in modern industrialization. The aim of this paper was to investigate the relationship between the self-reported prevalence of musculoskeletal symptoms in the head/neck, upper back and lower back and certain individual, work- related physical, psychological and general health factors. A cross-sectional study was conducted using a descriptive questionnaire which was distributed to 350 oil refinery workers in Iran and collected between April to December 2016. A total of 282 workers returned completed questionnaire, yielding a response rate of 81%. For the head/neck region, working at the long periods in uncomfortable posture (adjusted [Formula: see text], 95% [Formula: see text]–2.58) and doing repetitive activity (adjusted [Formula: see text], 95% [Formula: see text]–2.67) increased the risk experiencing head/neck symptoms. For the upper back region, lifting and transferring during work increased the risk of experiencing upper back symptoms (adjusted [Formula: see text], 95% [Formula: see text]–2.79). For the lower back region, working for more than 8[Formula: see text]h a week shows the strongly significant association for the risk of lower back symptoms. Lower back pain was associated with symptoms of anxiety and dysfunction in social functioning. Some physical and psychological factors were associated with the prevalence of musculoskeletal symptoms in the spine among oil refinery workers. These data emphasize the need to develop and implement preventive measures that reduce the prevalence of musculoskeletal symptoms among workers.
... Seventeen of the included articles involved predictive, correlational, or comparative statistical analyses of potential preventive or protective techniques within a cross-sectional survey or observational study design (Table 1). 10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The investigators evaluated 3 primary topics across these 17 studies, with investigators in some articles evaluating multiple topics, which included physical activity (n ¼ 13), ergonomic training (n ¼ 6), and equipment modification (n ¼ 4). We assessed the quality of presentation of these data by using the STROBE checklist. ...
... Retrospective, observational, or cross-sectional survey studies in which the investigators correlated or predicted the relationship of preventive or protective interventions or activities to musculoskeletal outcome measures in dental professionals (N ¼ 17 In most of the studies that focused on physical activity interventions, the investigators concluded that implementing regular physical activity reduced the frequency of musculoskeletal pain. [20][21][22]25,26,28 Investigators in 1 study found a significant decrease in pain with 6 to 8 hours of physical activity per week. 21 Investigators in another survey study found that physical activity and massage were the most effective preventive measures for musculoskeletal pain. ...
Article
Background: The authors’ objective in this systematic review was to describe the evidence for preventive and rehabilitative interventions for musculoskeletal disorders in oral health care. Types of Studies Reviewed: The authors conducted systematic search, screening, and eligibility processes to identify experimental, quasiexperimental, observational, and survey research studies in which the investigators either directly evaluated or predicted the effects of preventive or rehabilitative interventions on the reduction of musculoskeletal symptoms in oral health care professionals. Results: The authors identified and screened 3,571 unique abstracts, assessed 256 full-text articles for eligibility, and included 34 articles in the review. Investigators in 17 experimental studies described the results of preventive or rehabilitation interventions and in 17 survey research studies predicted or correlated preventive or protective techniques to a reduction in musculoskeletal symptoms. The primary techniques evaluated in the studies included equipment modification, ergonomic training, and physical exercise. Conclusions and Practical Implications: The evidence suggests that magnification loupes and indirect-vision techniques have a positive effect on the reduction of musculoskeletal symptoms. In terms of evaluating intervention efficacy, other techniques have mixed evidence or are limited by low-level study design.
... They reported dentists were at a higher prevalence of MSDs among healthcare professions. (18) Arsalan Humayun (2021) "Physical & Postural Determinants of Musculoskeletal Disorders among Dental Healthcare Professionals" This cross-sectional study was done among 132 dentists of hydrabad.87% of participants had compliant of suffering musculoskeletal pain in which 65.8%had neck pain. skills, sociodemographic data, awkward working posture, work pressure are considered as factors that cause MSDs. ...
Article
Full-text available
Introduction: Musculoskeletal Disorders (MSDs) refers to complications related to bone, muscle, tendon, and nerve. According to WHO MSDs refers to complication related to bone, muscle, tendon, cartilage, and the nerve gets affected. Healthcare professionals are more prone to have MSDs. This study is done to find the neck pain, ergonomic, and MSDs in healthcare professionals. Methodology: An online search was done on the basics of neck pain, musculoskeletal disorder, and ergonomic factors. Articles included in this study belonged to health care professionals only. Result: This study reported that dentists, nurses, physiotherapy, surgeon, was at the highest risk of having neck ergonomic complaints. The factors that was responsible for having awkward movement, non-ergonomic environment, repeated body stress, patient handling. Conclusion: Healthcare workers are exposed to have MSDs. WRMSDs silently develop, due to ergonomic, physical, psychosocial factors. Physiotherapists, nurses, dentists, surgeons were affected by MSDs. Positioning, change in work style, decrease work pressure, educating ergonomics and intermittent exercise, stretching, stabilizing, ergonomic principal, knowledge improvement, awareness, training, modified work environment, postural training, regular exercise, alter work tools, change in work technique and change in unhealthy habit are some evident to prevent from health hazards.
... M u s c u l o s k e l e t a l c o m p l i c a t i o n s a r e w e l l documented among dentists like other healthcare 1 professionals. Dentists are at high risk of developing many work-related complications, 2,3 especially back and neck pain. Various studies have shown that neck pain is a common problem [4][5][6][7] among health-care workers. ...
Article
Objective: To determine the prevalence of neck pain and the association between neck pain and responsible factors among dentists working in different hospitals of Lahore, Pakistan. Methodology: This cross-sectional survey with non-probability purposive sampling was conducted among 200 dentists working at different hospitals of Lahore, from February to August 2019. We used demographic questionnaire and modified Nordic questionnaire. Chi-square test was used to determine the association between variables and neck pain. Results: Out of 200 participants, 116 (58%) were female and 84 (42%) male. The age of ranged from 22 to 55 years (mean 30.30). The prevalence of neck pain was 66% (n=132). There was a statistically significant (p<0.05) association between neck pain and years of work experience 2 2 (χ =11.22, p=.004), working hours (χ =7.435, 2 p=.007) and posture (χ =12.56, p=.002). Conclusion: The prevalence of neck pain among dentists seems to be relatively high. The significant risk factors associated with neck pain were poor posture, increased working hours, and years of experience. (Rawal Med J 202;46:364-367)
... Literature demonstrated factors like age, length of employment, job satisfaction level, static head down postures and prolonged working hours with computers linked with neck pain. A positive association was found between age and the prevalence of NP [20,21,27,14]. ...
Article
Full-text available
Developing countries like ours where the growth in the education sector is almost in a geometrical progression while the requisite infrastructure to cater to this tremendous growth is not developed. Teacher is back bone of education system. Teacher role encompasses teaching but not limited to teaching, various other administrative duties are part of routine. Development of work related musculoskeletal disorder (WRMSDs) in this population may have substantial impact on education system. To the best of our knowledge, no studies have explored the occurrence of different musculoskeletal complaints in college teachers. Therefore the aim of this study was to evaluate the frequency of WRMSDs in college teacher population. A cross-sectional design was adopted; The Nordic musculoskeletal questionnaire was used to assess self reported musculoskeletal complaints. College teachers (n=42) attending short term course on yoga for healthy mind and body by UGC human resource development centre and department of physical education University of Mumbai formed the population of this study. Quantitative data were analyzed in percentage form. We concluded from study neck pain is most common WRMSDs in college teacher population. Offering health promotion awareness programs may be suitable solutions. However, further studies are required to assess the relationship between WRMSDs and specific workload-related factors.
... 16,17 Many studies have showed that dentists reported more pain in their neck and shoulders. 18 Lower back was the second site of musculoskeletal disorder. ...
Article
Full-text available
Objective Low back pain (LBP) is one of the most common and prevalent work-related conditions. The aim of this study was to estimate the prevalence and risk factors associated with LBP in dentists and to analyze the association between individual and occupational characteristics and LBP. Methods Following ethical approval, 300 dentists from Tehran Iran have voluntarily participated. Different questionnaires were completed to collect personal, occupational characteristics and the prevalence and risk factors of LBP. Visual analogue scale and Oswestry disability questionnaires were used to determine pain intensity and level of functional disability. Results The results indicated that point, last month, last six month, last year and lifetime prevalence of LBP were 24.6%, 24.9%, 27.7%, 28.1% and 31.4%, respectively. A significant correlation was found between the prevalence of LBP and preventive strategies, general health condition, having an assistant and job satisfaction. Body mass index, age and gender were not significantly correlated with the prevalence of Low back pain Conclusions The prevalence of Low back pain in dentists appears to be high. Further studies focusing on the effectiveness of different preventive strategies are recommended.
... Most available studies demonstrated that age is a risk factor for NP and a positive association was found between age and the prevalence of NP (Darwish and Al-Zuhair, 2013;Korkmaz et al., 2011;Rahmani et al., 2013;Yue et al., 2012). These studies showed that teachers older than 40 years of age were more likely to develop NP, while a number of other studies demonstrated that younger teachers are more at risk for developing NP (Chiu and Lam, 2007). ...
Article
Neck pain (NP) is a common occupational health problem associated with a number of professions. Many studies indicate that NP is common among teachers, yet no published study was found to address the prevalence and risk factors of NP in Iranian school teachers. The purpose of the current study was to assess the prevalence and risk factors for NP among school teachers in Iran. A cross-sectional study was conducted on 586 randomly selected primary and high schools teachers from 22 schools in Tehran, Iran. Point, last month, last 6 months, annual, and lifetime prevalence rates of NP were 24%, 29%, 33%, 37%, and 43%, respectively. There was a significant association and increased prevalence of NP with a number of risk factors such as; being female, age, general health, length of employment, regular exercise and job satisfaction (P < 0.05 in all instances). Therefore, some individual and occupational factors may make conditions relevant for the development of NP among teachers.
Article
Objective This study systematically reviewed the literature investigating the relationship between participation in exercise intended to improve fitness or sport and the prevalence of non-specific neck pain in adults. A secondary objective evaluated if exercise characteristics (frequency, and total duration of weekly exercise) impacted any observed relationship between this form of exercise and neck pain prevalence. Design Narrative systematic review. Literature Search Six databases including Pubmed/Medline, Scopus, EMBASE, SPORTDiscus, CINAHL, and the Cochrane Library were searched from their inception up to April 2021. Study Selection Criteria Studies were deemed eligible if they investigated the relationship between exercise participation and prevalence of non-specific neck pain. Only full-text, cross-sectional and longitudinal studies in an adult population were included. Data Synthesis Due to heterogeneity of characteristics in the included studies, a meta-analysis was not deemed feasible. Data were synthesised using narrative synthesis with subgroup analysis of exercise themes including frequency, and total weekly duration. Results Fair to good quality evidence from eight studies indicated that regular participation in exercise intended for fitness or sport was associated with a reduced prevalence of neck pain in adults. Three cross-sectional studies reported a positive relationship between greater weekly exercise duration and reduced neck pain prevalence. Conclusion The results of this review provide preliminary evidence of a potential protective effect of participation in exercise intended for fitness or sport on the prevalence of non-specific neck pain in the community. This protective relationship appeared to be stronger when exercise was undertaken for a greater total weekly duration.
Article
Background: Cervical radiculopathy is an increasing musculoskeletal disorder, with high prevalence in the office workers. In recent years, ultrasonography (US) is reported to be a valid, non-expensive and non-invasive technique for the objective evaluation of the morphology of muscles. However, measuring deep cervical paraspinal muscle dimensions using US in patients with cervical radiculopathy has not yet been demonstrated. Objective: To evaluate the intra-session and inter-session reliability of US to measure the dimensions of deep cervical muscles at rest in patients with chronic cervical radiculopathy and healthy controls. Design: Reliability study SETTING: Outpatients who came for treatment to an outpatient university physiotherapy clinic. Participants: Fifteen patients with cervical radiculopathy and 15 healthy controls participated in this study. Interventions: Ultrasound measurements MAIN OUTCOME MEASURES: Dimension of the cervical multifidus (MF) and longus colli (LC) muscles were measured on separate occasions. Methods: Two measurements were taken on the same day with an hour interval and the third measurement was taken five days later. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were used to evaluate the relative and absolute reliability. Results: The ultrasound imaging was shown to be highly reliable method in measuring the MF and LC muscle dimensions both in the patients and healthy subjects. The highest reliability score were found for the anterior-posterior dimension (APD) measurement of the MF muscle (ICC= 0.92) and the lateral dimension (LD) measurement of the LC muscle (ICC= 0.97) in healthy subjects. Conclusions: The results demonstrated that US appears to be a highly reliable method of measuring deep cervical muscle dimensions when measurements are taken in patients with cervical radiculopathy and healthy controls, by the same investigator.
Article
Full-text available
Study DesignBest-evidence synthesis. ObjectiveTo perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in workers. Summary of Background DataKnowledge of the course of neck pain in workers guides expectations for recovery. Identifying prognostic factors assists in planning effective workplace policies, formulating interventions and promoting lifestyle changes to decrease the frequency and burden of neck pain in the workplace. MethodsThe Bone and Joint Decade 2000−2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis. ResultsWe found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 14 of these studies related to course and prognostic factors in working populations. Between 60% and 80% of workers with neck pain reported neck pain1year later. Few workplace or physical job demands were identified as being linked to recovery from neck pain. However, workers with little influence on their own work situation had a slightly poorer prognosis, and white-collar workers had a better prognosis than blue-collar workers. General exercise was associated with better prognosis; prior neck pain and prior sick leave were associated with poorer prognosis. ConclusionThe Neck Pain Task Force presents a report of current best evidence on course and prognosis for neck pain. Few modifiable prognostic factors were identified; however, having some influence over one's own job and being physically active seem to hold promise as prognostic factors.
Article
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Dentists at work are susceptible to the development of health disorders. Bad working habits, repetitive tasks and uncomfortable posture contribute to musculoskeletal disorders (MSDs), stress and loss of production. The paper deals with the assessment of health status among dentists in Poland regarding the symptoms of musculoskeletal pain. The survey was conducted among 220 dentists. The questionnaire was concerned with demographic details, work duration and acquired specialization, organization and methods of work in the surgery, and also disorders connected with the musculoskeletal system and physical prophylactic activity. It was found that over 92% of the surveyed dentists experienced MSDs, especially in the neck (47%) and lower back (35%). More than 29% of the dentists experienced trouble with fingers, 23% with hip, whereas 20% demonstrated problems in the midback, and also in the shoulders (20%). Pain in the wrists was reported by 18.3%, and pain in the knees, feet or elbows by 15-16% of respondents. Statistical dependence was shown between the years of practice and the period of time when disorders occurred. Moreover, significance relationships were found between MSDs and both standing work position and non-use of rest breaks. It was concluded that limited ergonomics in the work environment of dentists results in MSDs, and its prevalence is very high. The symptoms of MSDs increased with the number of years of practice.
Article
Full-text available
To evaluate the intensity and location of musculoskeletal pain suffered by students and professors from different postgraduate programs of the School of Dentistry of the University of Barcelona (Spain), to identify the variables related to the occurrence of musculoskeletal symptoms and signs, and to establish possible preventive measures for such disorders. A cross-sectional study was made among students and faculty members from different postgraduate courses of the School of Dentistry at the University of Barcelona between May and June 2007. A total of 74 dentists (54 postgraduate students and 20 faculty members) completed an anonymous questionnaire containing 19 questions. The variables were divided into three main groups: sociodemographic information, ergonomic features and musculoskeletal pain arising from professional practice. Most of the dentists (79.8%) had experienced some kind of musculoskeletal pain in the last 6 months. On comparing the different locations of pain (lumbar, cervical, dorsal, wrist, shoulder and others), the neck was found to be the most commonly affected location (58% of all subjects), and only 34% of the respondents took some preventive measures against musculoskeletal disorders. Women showed a higher frequency of intense pain involving the cervical, lumbar, dorsal and wrist areas (p<0.05). A higher incidence of wrist pain was recorded in professionals exclusively dedicated to oral surgery (p<0.05). No statistically significant correlation was found between the workload (hours) and pain in the different anatomical locations (p>0.05). An important incidence of pain symptoms secondary to musculoskeletal disorders was observed, particularly in the cervical region. Females and younger dentists showed a higher frequency of such symptoms. The implementation of preventive measures is necessary, in view of the high incidence of these disorders.
Article
Objective: To assess the prevalence of musculoskeletal symptoms among the major ethnic minority populations of Greater Manchester. Method: The study group was a community sample of 2117 adults from the Indian, Pakistani, Bangladeshi, and African Caribbean communities. Questionnaires administered by post and by an interviewer were used to assess the presence of any musculoskeletal pain, pain in specific joints, and the level of physical function. Ethnicity was self assigned. The results were compared with those from a recent study in the local white population using the same methodology. Results: Overall response rate was 75% among the south Asian (Indian, Pakistani, and Bangladeshi community and 47% among the African Caribbean community. The profile of musculoskeletal pain among the ethnic minority groups differed from that in the white population. Although musculoskeletal symptoms were slightly more prevalent among people from ethnic minority groups than among the white population, pain in multiple sites was considerably more common among ethnic minorities. Conclusions: The finding that musculoskeletal pain is more widespread among ethnic minority communities in the UK has not previously been reported. This may reflect social, cultural, and psychological differences. The cause of the differences in the profile of pain and the health needs that follow need further investigation.
Article
This article reviews the use of the visual analogue scale as a method of assessing pain in the everyday clinical situation. The advantages and disadvantages of this method of assessment are examined, and some practical issues regarding its use are considered.
Article
Study Design. Best evidence synthesis. Objective. To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions. Summary of Background Data. Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research. Methods. A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980–2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis. Results. The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females. Conclusion. WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk, and better consideration of confounding factors, are needed.
Article
This study describes the prevalence and distribution of symptoms of musculoskeletal disorders occurring in New South Wales dentists and investigates the relationship between these symptoms and work practices.Four hundred and forty two members of the Australian Dental Association (New South Wales Branch), were randomly selected and sent questionnaires. Eighty per cent (n=355) responded. No significant differences in reported symptoms were found when considering age, experience, handedness, operating position or period of working without a break.Eighty-two per cent of the respondents reported experiencing one or more musculoskeletal symptoms during the previous month. Sixty-four per cent of the sample reported suffering pain (the majority reported back pain) and 58 per cent headaches. Most severe symptoms reported were pain (39%) and headaches (25%). Those in the youngest age category of less than 35 years (26%), were significantly more likely to have headaches (X2 4df p<0.05). Female dentists were more likely to rate the severity of their most severe symptom higher (X2 1df p<0.05), and to report more frequent pain (X2 2df p<0.05) and headaches (X2 2df p<0.05).Those practising four-handed dentistry were significantly more likely to be in the 35–44 age range (X2 4df p<0.01), to work for longer periods before taking a 10-minute break (X2 5df p<0.05) and to report frequent pain (X2 2df p<0.05).The results support the findings of previous studies conducted overseas but additional information about musculoskeletal symptoms in this occuptional group has been identified.
Article
Low back pain (LBP) is a common and costly occupational injury among health care professionals. The purpose of this study was to investigate the prevalence and risk factors of LBP in surgeons and to analyze how individual and occupational characteristics contribute to the risk of LBP. A cross sectional study was conducted on 250 randomly selected surgeons including 112 general surgeons, 95 gynecologists and 43 orthopedists from 21 hospitals at northern Iran. A structured questionnaire including demographic, lifestyle, occupational characteristics as well as prevalence and risk factors of LBP was used. Visual analogue scale and Oswestry low back disability questionnaires were also used to assess the pain intensity and functional disability, respectively. Point, last month, last six months, last year and lifetime prevalence of LBP was 39.9%, 50.2%, 62.3%, 71.7% and 84.8%, respectively. The highest point prevalence was related to the gynecologists with 44.9%, and the lowest for general surgeons (31.7%). Age, body mass index, smoking, general health, having an assistant, job satisfaction, using preventive strategies and years of practice were found to be correlated with the prevalence of LBP (P < .05 in all instances except for age and job satisfaction). Prolonged standing, repeated movements and awkward postures were the most prevalent aggravating factors (85.2%, 50.2% and 48.4%, respectively). Rest was found to be the most relieving factor (89.5%). The results of this study demonstrate that the prevalence of LBP amongst surgeons appears to be high and highlights a major health concern. Further large scale studies, including other specialties and health professions such as physical therapy, chiropractic, and general medicine, should be performed.
Article
Musculoskeletal problems have become a significant issue for the profession of dentistry and dental hygiene. This review provides a detailed examination and discussion regarding the prevalence of musculoskeletal disorders (MSD) in dental personnel and possible causative factors. All research studies or literature reviews, which have reported on the prevalence of musculoskeletal symptoms and/or potential risk factors for this problem in dentists, dental hygienists and dental students, were selected for inclusion. Our literature suggests that the prevalence of general musculoskeletal pain ranges between 64% and 93%. The most prevalent regions for pain in dentists have been shown to be the back (36.3-60.1%) and neck (19.8-85%), while the hand and wrist regions were the most prevalent regions for dental hygienists (60-69.5%). Interestingly, we found that studies on MSDs among dental and dental hygiene students are quite limited. Many risk factors have been identified, including static and awkward posture and work practices. Overall, the review suggests that musculoskeletal problems represent a significant burden for the dental profession. More research in the form of larger studies is urgently required, to help more clearly elucidate the development of this important issue for dental hygienists and dental hygiene students.