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Working conditions and musculoskeletal disorders in flight baggage handling
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Medical Sciences, Occupational and Environmental Medicine, Akademiska sjukhuset, Uppsala Universitet.ORCID-id: 0000-0001-9612-3766
2017 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2017. , s. 59
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1321
Nyckelord [en]
epidemiology, low back pain, shoulder pain, physical exposures, psychosocial exposures, inclinometry, implementation, process evaluation
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:hig:diva-25324OAI: oai:DiVA.org:hig-25324DiVA, id: diva2:1144284
Disputation
2017-05-17, Frödingesalen, Ulleråkersvägen, Uppsala, 09:30 (Engelska)
Opponent
Handledare
Tillgänglig från: 2017-09-27 Skapad: 2017-09-26 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
Delarbeten
1. Psychosocial work factors and musculoskeletal pain: a cross-sectional study among Swedish flight baggage handlers
Öppna denna publikation i ny flik eller fönster >>Psychosocial work factors and musculoskeletal pain: a cross-sectional study among Swedish flight baggage handlers
2015 (Engelska)Ingår i: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, artikel-id 798042Artikel i tidskrift (Refereegranskat) 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) was 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 PIW LBP (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.

Nyckelord
musculoskeletal disorders, epidemiology, low back pain, shoulder pain, work organisation, interpersonal relationships
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:hig:diva-16578 (URN)10.1155/2015/798042 (DOI)000364083100001 ()26558282 (PubMedID)2-s2.0-84947080989 (Scopus ID)
Forskningsfinansiär
AFA Försäkring, 2010/358Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1761
Tillgänglig från: 2014-04-26 Skapad: 2014-04-26 Senast uppdaterad: 2018-04-03Bibliografiskt granskad
2. Full-shift trunk and upper arm postures and movements among aircraft baggage handlers
Öppna denna publikation i ny flik eller fönster >>Full-shift trunk and upper arm postures and movements among aircraft baggage handlers
Visa övriga...
2016 (Engelska)Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 60, nr 8, s. 977-990Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: The present study assessed full shift trunk and upper arm postural exposure amplitudes, frequencies, and durations among Swedish airport baggage handlers, and aimed to determine whether exposures differ between workers at the ramp (loading and unloading aircraft) and baggage sorting areas.

Methods: Trunk and upper arm postures were measured using inclinometers during three full work shifts on each of 27, male baggage handlers working at a large Swedish airport. Sixteen of the baggage handlers worked on the ramp and 11 in the sorting area. Variables summarizing postures and movements were calculated, and mean values and variance components between subjects and within subject (between days) were estimated using restricted maximum likelihood algorithms in a one-way random effect model.

Results: In total, data from 79 full shifts (651 hours) were collected with a mean recording time of 495 minutes per shift (range 319-632). On average, baggage handlers worked with the right and left arm elevated >60° for 6.4% and 6.3% of the total workday, respectively. The 90th percentile trunk forward projection (FP) was 34.1° and the 50th percentile trunk movement velocity was 8°s-1. For most trunk (FP) and upper arm exposure variables, between-subject variability was considerable, suggesting that the flight baggage handlers were not a homogeneously exposed group. A notable between-days variability pointed to the contents of the job differing on different days. Peak exposures (>90°) were higher for ramp workers than for sorting area workers (trunk 0.6% ramp vs 0.3% sorting; right arm 1.3% ramp vs 0.7% sorting).

Conclusions: Trunk and upper arm postures and movements among flight baggage handlers measured by inclinometry were similar to those found in other jobs comprising manual material handling, known to be associated with increased risks for musculoskeletal disorders. The results showed that full-shift trunk (FP), and to some extent peak arm exposures, were higher for ramp workers compared to sorting workers.

Nyckelord
baggage handling, exposure variability; ergonomics, musculoskeletal disorders, epidemiology
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:hig:diva-20430 (URN)10.1093/annhyg/mew043 (DOI)000386017300007 ()27417186 (PubMedID)2-s2.0-84990985854 (Scopus ID)
Forskningsfinansiär
AFA Försäkring, 100071Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1761
Tillgänglig från: 2015-10-16 Skapad: 2015-10-16 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
3. Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day
Öppna denna publikation i ny flik eller fönster >>Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day
2017 (Engelska)Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 61, nr 9, s. 1145-1153Artikel i tidskrift (Refereegranskat) Published
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.

Nyckelord
biomechanical exposure, ergonomics, manual handling, musculoskeletal disorder
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:hig:diva-23214 (URN)10.1093/annweh/wxx073 (DOI)000417609300010 ()29136416 (PubMedID)2-s2.0-85044132508 (Scopus ID)
Forskningsfinansiär
AFA Försäkring, 100071Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1761
Tillgänglig från: 2017-01-04 Skapad: 2017-01-04 Senast uppdaterad: 2018-05-31Bibliografiskt granskad
4. Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation
Öppna denna publikation i ny flik eller fönster >>Implementation of an ergonomics intervention in a Swedish flight baggage handling company: a process evaluation
2018 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 3, artikel-id e0191760Artikel i tidskrift (Refereegranskat) 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 (recruitment, reach, context, dose delivered, dose received, satisfaction); intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods.

Results: Implementation proved feasible 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, our study can help supporting the effectiveness of future interventions. Our results show that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation.   

  

Nyckelord
implementation barriers, implementation facilitators, musculoskeltal disorders, loading assist devices, qualitative methods
Nationell ämneskategori
Arbetsmedicin och miljömedicin
Identifikatorer
urn:nbn:se:hig:diva-21685 (URN)10.1371/journal.pone.0191760 (DOI)000426896800008 ()29513671 (PubMedID)2-s2.0-85043373121 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-1761
Tillgänglig från: 2016-06-16 Skapad: 2016-06-16 Senast uppdaterad: 2018-12-11Bibliografiskt granskad

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