Pushing and pulling in relation to musculoskeletal disorders: a review of risk factors

Abstract

The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on cross-sectional data, that pushing and pulling is associated with low back pain. Evidence with respect to complaints of other parts of the musculoskeletal system is lacking. Risk factors have been found to influence the maximum (acceptable) push or pull forces as well as the physiological and mechanical strain on the human body. The risk factors have been divided into: (a) work situation, such as distance, frequency, handle height, and cart weight, (b) actual working method and posture/movement/exerted forces, such as foot distance and velocity, and (c) worker's characteristics, such as body weight. Longitudinal epidemiological studies are needed to relate pushing and pulling to musculoskeletal disorders.

Lower Back Problems and Work-Related Risks in a South African Manganese Factory

“…Although velocities of motion and other biomechanical variables were not taken in consideration in this study, the self-reported perceived exposure to occupational risks of pushing and pulling activities is verified by the finding of a high prevalence of LBP in the cell house labourers. Hoozemans and co-workers [15], in their review on pushing and pulling concluded that epidemiological studies provide evidence that pushing and pulling are associated with low back pain when factors such as the load, distance, frequency, handling height, working method and worker characteristics are considered. Looking at the literature, the risk of pushing and pulling has not been studied as well as lifting and carrying, and generally epidemiological data available to answer the question of whether pushing and pulling is related to musculoskeletal complaints is inconclusive [12,57,58].…”

“…Psychosocial factors have also been associated with both work-and nonwork-related back disorders [9][10][11]. The most frequently reported occupational risk factors are heavy physical work; frequent bending, twisting, lifting, pulling, and pushing; repetitive work; forceful movements; static postures like prolonged sitting, awkward postures and whole-body vibrations [12][13][14][15][16][17][18][19][20][21][22][23]. While the focus of this manuscript is on physical occupational risks, work related psychosocial risk factors that have been identified include anxiety, depression, job dissatisfaction, and mental stress [24,25].…”

Low-back and shoulder complaints among workers with pushing and pulling tasks

“…Lifting loads has been extensively studied and was found to be consistently related to low-back complaints (6). The risk of musculoskeletal complaints related to pushing and pulling is less well documented (7). Of all back strain and pain, 9-18% was found to be associated with pushing and pulling (8,9).…”

A Survey of Ergonomic Parameters of Shoppers

“…Khaled W. Al-Eisawi et al recommended that hand forces in pushing and pulling carts are affected by cart load and handle height and also found for heavier cart loads, lower forces are applied at higher handle heights 4 . Marco J. M. Hoozemans suggested that in pushing the (hand) force is directed away from the body and in pulling the force is directed toward the body 11 .…”