Goal of the Study?

This article 1 is a systematic review that aims to summarize the prevalence rates of working related musculoskeletal disorders (WRMSDs) and measure the associations between various physical or psychosocial risk factors and WRMSDs among construction workers in different trades.

 Why are they doing this study?

The prevalence of WRMSDs is very high among construction workers globally, with rates as high as 76% in Malaysia and 77% in American construction workers. Not only does this lead to physical pain for individuals, but there is also an incredible financial burden related to work disability and absenteeism. It has been estimated that workers’ compensation for WRMSDs is more than the US $400 million annually in the American construction industry. While some strategies to prevent WRMSDs in the construction industry have been implemented, the authors argue that there is a need to identify trade-specific risk factors. 

What was done?

For this systematic review, two independent reviewers searched five electronic databases for relevant studies published between January 1, 2000, and September 30, 2020. Twenty studies were included with a mix of cross-sectional and observational, as well as a longitudinal survey. In total, these included approximately 194,863 participants from 11 different countries. Participants ranged in age from 16 – 66, were almost exclusively male and represented a range of construction backgrounds such as scaffolders, cement workers, carpenters, roofers and more.

What did they find?

While the authors had intended to summarize the evidence regarding trade-specific risks, most of the studies used in this review mixed up workers in multiple trades together; therefore, this review could only report the risk factors for WRMSDs in construction as a whole. 

Overall, the authors found the 12-month prevalence rates of WRMSDs in construction workers were high, ranging from 25% – 96%. There was strong evidence to support the relationships between awkward postures (twisting, bending or cramping positions), manual material handling, prolonged works, high job demands or mental stress and WRMSDs in construction workers. They found moderate evidence for associations between overhead works, vibration or low job satisfaction and WRMSDs in construction workers. Finally, there was limited evidence for the associations between repetitive work, low job control, high job insecurity, and WRMSDs in construction workers. 

Additionally, the review found specific tasks that were related to different types of pain. For example, they found that prolonged works, overhead work with elevated arms, lifting heavy objects frequently, working in an awkward posture, frequent bending activities and squatting for long periods of time are related to increased risk of developing lower back pain (LBP).  Similarly, for knee pain, they found tasks such as working in the same position for long periods, working in an awkward position were the major factors contributing to knee pain. 

While the authors found many physical and psychosocial factors were related to WRMSDs, the causal relationship between these and WRMSDs is unclear. 

Why do these findings matter?

With the prevalence of WRMSDs in the construction industry, prevention is critical. However, with current research, it is difficult to determine the necessary changes to specific industries. Therefore, future research must examine trade-specific risk factors to develop prevention practices. 

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