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      Gender differences and site‐specific incident risks of musculoskeletal disorders among 224 506 workers in the food and beverage service industry in Taiwan: A 15‐year Nationwide Population‐Based Cohort Study

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          Abstract

          Objectives

          Occupational characteristics in the food and beverage service industry (FBSI) have been found to be associated with musculoskeletal disorders (MSDs). This study aimed to examine gender and site‐specific incident risks of MSDs among FBSI workers in Taiwan using a national population‐based database.

          Methods

          We conducted a 15‐year population‐based cohort study among 224 506 FBSI workers in Taiwan using data from five large nationwide databases to estimate direct standardized incidence ratios (SIRs) for identifying specific MSDs related to overexertion and repetitiveness during work. Overall, MSDs risks were also investigated by gender, sub‐industrial categories, and certificate types.

          Results

          We found SIRs for overall MSDs for male and female workers of 1.706 (95% CI, 1.688‐1.724) and 2.198 (95% CI, 2.177‐2.219), respectively. Our findings indicate significantly increased WMSD risk for both men and women, including median/ulnar nerve disorders (ICD‐9 354.0‐354.2); spondylosis and allied disorders (ICD‐9 721); intervertebral disc disorders (ICD‐9 722); disorders of the back (ICD‐9 724); peripheral enthesopathies and allied syndromes (ICD‐9 726); synovium, tendon, and bursa disorders (ICD‐9 727); and soft tissues of the peripheral system disorders (ICD‐9 729). Food stall workers and workers with Chinese cuisine or baking licenses were at higher risk among sub‐industrial categories and certificate types.

          Conclusion

          This large‐scale study revealed that FBSI workers were at higher risk for several MSDs than the general population. This information could help prioritize MSD problems and identify a high‐risk population. Relevant policy and ergonomic improvements and interventions could be implemented for health promotion in this industry.

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          Most cited references27

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          A simple method to calculate the confidence interval of a standardized mortality ratio (SMR)

          K Ulm (1990)
          In analyzing standardized mortality ratios (SMRs), it is of interest to calculate a confidence interval for the true SMR. The exact limits of a specific interval can be obtained by means of the Poisson distribution either within an iterative procedure or by one of the tables. The limits can be approximated in using one of various shortcut methods. In this paper, a method is described for calculating the exact limits in a simple and easy way. The method is based on the link between the chi 2 distribution and the Poisson distribution. Only a table of the chi 2 distribution is necessary.
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            Gender differences in workers with identical repetitive industrial tasks: exposure and musculoskeletal disorders.

            For unknown reasons, females run a higher risk than males of work-related musculoskeletal disorders. The aim of this study was to evaluate whether male and female workers, with identical repetitive work tasks, differ concerning risk of disorders, physical or psychosocial exposures. Employees in two industries were studied; one rubber manufacturing and one mechanical assembly plant. These industries were selected since in both, large groups of males and females worked side by side performing identical repetitive work tasks. Physical exposure was measured by technical equipment. Postures and movements were registered by inclinometry for the head and upper arms, and by electrogoniometry for the wrists. Muscular activity (muscular rest and %max) was registered by surface electromyography for m. trapezius and the forearm extensors (18 males and 19 females). Psychosocial work environment was evaluated by the demand-control-support model (85 males and 138 females). Musculoskeletal disorders were assessed (105 males and 172 females), by interview (last 7-days complaints), and by physical examination (diagnoses). Concerning physical exposure, females showed higher muscular activity related to maximal voluntary contractions [(%MVE); m. trapezius: females 18 (SD 9.2), males 12 (SD 4.3); forearm extensors: females 39 (SD 11), males 27 (SD 10), right side, 90th percentile]. Working postures and movements were similar between genders. Also, concerning psychosocial work environment, no significant gender differences were found. Females had higher prevalences of disorders [complaints: age-adjusted prevalence odds ratio (POR) 2.3 (95% CI 1.3-3.8) for neck/shoulders, 2.4 (1.4-4.0) for elbows/hands; diagnoses: neck/shoulder 1.9 (1.1-3.6), elbows/hands 4.1 (1.2-9.3)]. In 225 workers, PORs were adjusted for household work, personal recovery and exercise, which only slightly affected the risk estimates. In identical work tasks, females showed substantially higher muscular activity in relation to capacity, and higher prevalence of musculoskeletal disorders of the neck and upper extremity, than did males.
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              Prolonged standing at work and hospitalisation due to varicose veins: a 12 year prospective study of the Danish population.

              Recent studies suggest that prolonged standing at work is associated with the development of diseases of varicose veins (VV). To assess the risk of hospitalisation due to VV in the lower extremities prospectively in workers standing or walking at least 75% of their time at work. A representative random sample of 9653 working age adults was drawn from the Central Population Register of Denmark in 1991. Of these, 8664 accepted to be interviewed by telephone (response rate 90%). Respondents (2939 men and 2708 women) were 20-59 years old and employed in 1990. Risk ratios for VV were estimated by log-linear Poisson regression models separately for men and women with adjustment for smoking status, body mass index (BMI), heavy lifting, and, for females only, number of children at baseline. During 12 years of follow up, 40 hospitalisations due to VV were observed among the men and 71 among the women. For employees with jobs that require prolonged standing or walking compared to all other employees, the relative risk was 1.75 (95% CI 0.92 to 3.34) for men and 1.82 (95% CI 1.12 to 2.95) for women. The pooled estimate of the relative risk was 1.78 (95% CI 1.19 to 2.68). The aetiological fraction of prolonged standing or walking at work was estimated as 22.5% for men and 22.6% for women. This prospective study confirms that prolonged standing at work constitutes an excess risk of hospital treatment due to varicose veins and accounts for more than one fifth of all cases of working age.
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                Author and article information

                Contributors
                hsiehhm@gmail.com
                Journal
                J Occup Health
                J Occup Health
                10.1002/(ISSN)1348-9585
                JOH2
                Journal of Occupational Health
                John Wiley and Sons Inc. (Hoboken )
                1341-9145
                1348-9585
                16 March 2021
                Jan-Dec 2021
                : 63
                : 1 ( doiID: 10.1111/joh2.v63.1 )
                : e12214
                Affiliations
                [ 1 ] Department of Public Health Kaohsiung Medical University Kaohsiung Taiwan
                [ 2 ] Research Center for Environmental Medicine Kaohsiung Medical University Kaohsiung Taiwan
                [ 3 ] Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Taiwan
                [ 4 ] Department of Community Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan
                [ 5 ] Center for Big Data Research Kaohsiung Medical University Kaohsiung Taiwan
                [ 6 ] Department of Physical Therapy Kaohsiung Medical University Kaohsiung Taiwan
                [ 7 ] Department of Occupational Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan
                [ 8 ] Institute of Labor Occupational Safety and Health Ministry of Labor Taipei Taiwan
                [ 9 ] Department of Family Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
                [ 10 ] Environmental and Occupational Medicine Kaohsiung Medical University Kaohsiung Taiwan
                [ 11 ] Graduate Institute of Clinical Medicine Kaohsiung Medical University Kaohsiung Taiwan
                Author notes
                [*] [* ] Correspondence

                Hui‐Min Hsieh, 100 Shih‐Chung 1st Road, San‐Ming Dist., Kaohsiung 807, Taiwan.

                Email: hsiehhm@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-3286-7306
                https://orcid.org/0000-0001-7307-7816
                Article
                JOH212214
                10.1002/1348-9585.12214
                7966568
                33728746
                e5f1afcb-8b44-4016-a837-fd2331330c2e
                © 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 20 February 2021
                : 06 January 2021
                : 25 February 2021
                Page count
                Figures: 1, Tables: 4, Pages: 11, Words: 7664
                Funding
                Funded by: Occupational Safety and Health, Ministry of Labor
                Award ID: ILOSH‐
                Award ID: 103‐3002
                Award ID: ILOSH‐
                Award ID: 105‐0007
                Award ID: ILOSH‐
                Award ID: 106‐0012
                Funded by: Ministry of Science and Technology
                Award ID: MOST 109‐2423‐H‐037‐001‐SS3
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January/December 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.9 mode:remove_FC converted:17.03.2021

                food and beverage service industry,musculoskeletal disorders,standardized incidence ratios

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