The main purpose of the study was to investigate the prevalence of perceived symptoms of musculoskeletal disorders (MSD) among workers on large-scale dairy and pig farms in Sweden (herd size more than 300 cows and 450 sows) and to identify potential risk factors in the development of MSD. A study based on questionnaires was carried out among 42 workers on 10 large dairy farms and among 37 workers on 10 large pig farms in Southern Sweden during the autumn of 2002. Most importantly, the study showed that 86% of the dairy workers and 78% of the pig workers reported some kind of MSD during a period of 12 months prior to the study. The most frequently reported MSD among both the dairy and the pig workers were in the "upper extremities" (52% and 62%, respectively) especially in the shoulders and in "the back" (60% and 57%, respectively) especially in the lower back. Furthermore, being of short stature, doing repetitive work, working in awkward positions and being exposed to dust were significant risk factors in having MSD among the workers in this study. Thus, working with many cows and sows on large-scale farms in Sweden can be considered as a high risk job with regard to MSD.
To explore milkers' state of health with regard to symptoms in the wrists and hands, a study of 80 female milkers was carried out 12 months after a Nordic questionnaire study of these subjects. Of these 80, 41 had reported pain and discomfort in the wrists and hands at the time of the questionnaire study, whereas the remaining 39 had had no such symptoms. To determine the sensitivity and specificity of the Nordic questionnaire, the follow-up study included examination by an unbiased clinician. The occurrence of symptoms in the wrists and hands during the preceding 12 months was found to have been rather stable-30 of the 41 milkers still reported pain, aching, and discomfort, and eight new cases were recorded. On clinical examination, symptoms including numbness, tingling, and coldness in the forearms and hands were reported by 51 of the 80 milkers, 14 of whom had clinical symptoms and signs indicating median nerve entrapment. Peritendinitis was diagnosed in four subjects and a ganglion cyst in one. The findings in the remaining group did not meet diagnostic criteria. All subjects with wrist and hand symptoms were still at work a year after the initial study. The sensitivity of the Nordic questionnaire when it came to identifying subjects with clinical findings was found to be unsatisfactory. The actual incidence of wrist and hand disorders may be underestimated if the Nordic questionnaire is used as the only instrument in epidemiologic screenings.
The prevalence of and the impact of selected factors on self-reported musculoskeletal complaints in Swedish female milkers with special reference to symptoms in the upper extremities were investigated using on data from mail-in surveys. An agricultural study group was formed of three subgroups: 161 active milkers, 108 non-milkers and 62 ex-milkers, women who had been milkers earlier but were no longer doing that kind of work. In the course of the analysis these subgroups were compared with each other and also, separately or in combinations, with a non-agricultural population consisting of 166 nursing assistants. Problems in the upper extremities were significantly more common in the agricultural group than in the non-agricultural group. Milkers had a higher risk of developing symptoms in the wrists and hands than non-milking women. Symptoms like numbness, coldness in the wrists and white fingers were more common in all agricultural subgroups than in the non-agricultural group. Numbness and white fingers were related to vibration exposure in the ex-milking and the non-milking groups but not in the milking group. Psychosocial factors such as occupational well being were not related to the occurrence of symptoms. Milking in modernised barn gave fewer problems in the elbows than milking in a traditional barn. Milkers who had received ergonomic instruction on how to work in order to reduce muscle stress had fewer problems in the elbow region than those who had not.
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