PREVALENCE OF MUSCULOSKELETAL DISCOMFORT IN FARMARS OF KANPUR

Dr. Garima Gupta (PT)HOD, Assistant professorDepartment of Physiotherapy,Saaii College of Medical Science & TechnologyKanpur, India.Prevalence of Musculoskeletal Disorders in Farmers of Kanpur-Rural,India

Introduction2Musculoskeletal discomforts (MSDs) are the most common cause of sever long term pain and disability, and millions of people around the world are affected by it.MSDs are defined as a group of disorders that affect the musculoskeletal system including the nerves, tendons, muscles, and supporting structures such as intervertebral discs.

____________________________________________________Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. BullWorld Health Organ 81: 646-656. Osborne A, Blake C, McNamara J, Meredith D, Phelan J, et al. (2010) Musculoskeletal disorders among Irish farmers. Occup Med (Lond) 60: 598-603. Allison TR, Symmons DP, Brammah T, Haynes P, Rogers A, et al. (2002) Musculoskeletal pain is more generalized among people from ethnic minorities than among white people in Greater Manchester. Ann Rheum Dis 61: 151-156.

Introduction3MSDs are associated with physical disability, and severely affect the health-related quality of life.When MSDs become chronic it takes serious dimensions, literature suggests that nearly 25 percent of the affected adults are identified as having chronic MSD. Chronic MSD is equally prevalent in both developed as well as developing countries.Work-related musculoskeletal disorders (WMSD) are the fastest growing cause of work-related disability._________________________________________________________Bihari V, Kesavachandran C, Pangtey BS, Srivastava AK, Mathur N (2011) Musculoskeletal pain and its associated risk factors in residents of National Capital Region. Indian J Occup Environ Med 15: 59-63.Kar SK, Dhara PC (2007) An evaluation of musculoskeletal disorder and socioeconomic status of farmers in West Bangal, India. Nepal Med Coll J 9: 245-249.Yassi, (2000) Work-related musculoskeletal disorders. Current Opinion in Rheumatology 12 (2): 124-130.

Introduction4Farming is generally perceived as a healthy outdoor occupation however number of studies have classified farming as a risky and hazardous job. In 1990, the national safety council of the United States acknowledged agriculture was one of the three most hazardous sectors in the working world. Studies conducted in Ireland and the eastern Mediterranean region of Europe have also confirmed the fact that MSDs are the most commonly reported work-related health problems among agricultural farmers and dairy farm workers.

________________________________________________________________________________________Osborne A, Blake C, McNamara J, Meredith D, Phelan J, et al. (2010)Musculoskeletal disorders among Irish farmers. Occup Med (Lond) 60: 598-603.Holmberg S, Stiernstrom EL, Thelin A, Svardsudd K (2002) Musculoskeletal symptoms among farmers and non-farmers: a population-based study. Int JOccup Environ Health 8: 339-345.Batawi MAE (2003) Health of workers in agriculture. WHO regional publication, Eastern Mediterranean, Series 25.

Introduction5The farming occupation has its own unique characteristics. It is an unorganized sector It is subjected to various uncertainties like changing weather conditions, viruses associated with weather, new forms of chemical fertilizers, insecticides and various ergonomics stress.

________________________________________________________________________________________Osborne A, Blake C, McNamara J, Meredith D, Phelan J, et al. (2010)Musculoskeletal disorders among Irish farmers. Occup Med (Lond) 60: 598-603.Kolstrup CL (2012) Work-related musculoskeletal discomfort of dairy farmers and employed workers. J Occup Med Toxicol 7: 23.

Introduction6India is primarily an agrarian economy, as farming is one of the most important occupations in the country.In Indian agriculture human workforce contributes substantially for crop production. Environmental and lifestyle factors for disease prevalence among farmers are likely to vary between countries.The prevalence of MSDs among Indian farm workers is not well documented. This study is an attempt to evaluate the prevalence of musculoskeletal discomfort in farmers in Kanpur rural, India.

___________________________________________________Cha ES, Kong KA, Moon EK, Lee WJ (2009) Prevalence and changes in chronic diseases among South Korean farmers: 1998 to 2005. BMC Public Health 9: 268.

Objectives of the Study7To establish the prevalence of Musculoskeletal discomfort in farmers of Kanpur rural, India.

To identify the most commonly affected body regions.

Methodology8Study design: Epidemiological survey Sample: 301 full time farmersSampling: Quota sampling Variables:Nordic musculoskeletal questionnaire

Methodology9Methodology10Methodology11Results 12Results 1314

Results 15

Results Discussion16India has traditionally been an agricultural country.

About 58% of working population is employed in this sector.

While working farmers are exposed to various potentially dangerous situations like excessive bending, twisting, kneeling, squatting, carrying load, extremes of temperature, vibration from transport and equipments, exposure to dust, static and awkward stoop postures, repetitive and monotonous work, etc.

Discussion17The risk of slipping, tripping and fall on uneven fields are also associated with farming and these could also lead to development of musculoskeletal discomfort in farmers.

_________________________________________________________________________________________________Saiyed HN, Tiwari RR (2004) Occupational health research in India. Ind Health 42: 141-148.Batawi MAE (2003) Health of workers in agriculture. WHO regional publication, Eastern Mediterranean, Series 25. Kolstrup CL (2012) Work-related musculoskeletal discomfort of dairy farmers and employed workers. J Occup Med Toxicol 7: 23.Holmberg S, Thelin A, Stiernstrm EL, Svrdsudd K (2005) Low back pain comorbidity among male farmers and rural referents: a population-based study. Ann Agric Environ Med 12: 261-268.Discussion18The present study was conducted in a region where the farmers were involved in multiple crop farming throughout the year, mainly cultivated crops were potato, wheat, rice and watermelon.We observed that the farmers who were mainly involved in potato cultivation reported more of knee pain, farmers of wheat and rice crop reported more of lower back pain and farmers of watermelon reported relatively more pain in neck and shoulder region.The possible reason of this variation in discomfort region could be as per nature of crop. It can be explained by the difference in the type of posture adapted or repetitive movement done by the farmers.

18Prolonged squatting posture19

Prolonged squatting and twisting movements20

Repeated shoulder movements and forward bending 21

Discussion22Modern machinery like tractors, harvesters etc. may overtly seem to ease the work but in fact they only reduce the workforce while putting the farmer to additional disadvantages like excessive whole body vibration.

Farmers in the study area showed tendency to develop chronic musculoskeletal disorder in various body regions.

_________________________________________________________________________________________Walker-Bone K, Palmer KT (2002) Musculoskeletal disorders in farmers and farm workers. Occup Med (Lond) 52: 441-450.Batawi MAE (2003) Health of workers in agriculture. WHO regional publication, Eastern Mediterranean, Series 25.Mechanization of agriculture through the introduction of propelled machines and tractors and power-driven tools has resulted in worker exposure to non-acoustic vibration. Vibration is transmitted to the body by contact with moving surfaces. For occupational health purposes, vibration can be classified as whole-body vibration (acting on the body of sitting or standing workers through supporting surfaces) and segmental or localized vibration (transmitted mainly through the hands and arms).The overall frequency range of vibration of occupational interest ranges from 0 1000 c/s. Vibration can be described in respect to dimension, rotation, acceleration, velocity and displacement [4]. Several factors influence the extent to which vibration is transmitted to the body and include body size, posture and tension. The effects of vibration depend on the frequency, amplitude, duration of exposure, direction of vibration and clothing.Sources of whole-body vibration exposure are encountered frequently in agricultural work, e.g. two-wheel walk-behind tractors, tractors and tractor-towed agricultural equipment, harvesters, threshers and combines. Power-driven tools, especially chain saws and branch cutters, are major sources of segmental vibration. Long-term worker exposure to whole-body vibration is associated with various types of histological, histochemical and biochemical alterations leading to dystrophic changes. The most common effect is lower back pain, which is caused by various actions of vibration on the musculoskeletal system. In particular, whole-body vibration results in degeneration of the invertebral discs and damage to tissues and nerves. Discs can also be affected by long periods of sitting aggravated by vibration.22Discussion 23Future studies are recommended to study the effect of educational level and other socio-psychological factors on MSDs.The impact of health education and adherence to ergonomic measures and postural correction in farmers must be studied.Larger and random sample would give us detailed knowledge about the prevalence of MSD in farmers. Conclusion 24The findings of the present study suggests that nearly 60% of farmers are affected by LBP which emerged as most prevalent body region to be affected. It is followed by MSD affecting knee, shoulder and neck region.Observations made during the study suggest that poor postures and lack of ergonomic awareness in the farmers are the causative factors contributing to the development of MSDs.These results provides a backdrop for future health care planning and policy making in the agricultural field. Healthcare system should give emphasis on providing the necessary support services for the prevention of MSDs in Indian farmers.

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