Musculoskeletal disorders in industry workers: analysis of factors related to the granting of sickness benefits and the effectiveness of ergonomic interventions for pain control
Ergonomics; Industry; Occupational Health; Social Security.
Industry workers are affected, with high frequency, by musculoskeletal diseases that can be related to work and that have pain as the main symptom. These diseases can lead to incapacity for work and absenteeism, which, in combination with the granting of social benefits, lead to an increase in public expenditure on social security and health. In this context, ergonomic interventions have been developed in the work environment in order to control the signs and symptoms of injuries that include Work-related Musculoskeletal Disorders (WMSD). For this Doctoral Thesis, two studies were carried out, whose objectives were: 1) To analyze the factors related to the granting of different types of benefits to workers impeded from working due to WMSD; 2) Investigate the effects of ergonomic interventions in the workplace to reduce the effects of pain on workers in the industry. Study 1 is a cross-sectional retrospective study with a quantitative approach. The data from the evaluation forms of the workers of the industry admitted to a Reference Center in Occupational Health because they were diagnosed with WMSD. Descriptive statistical analysis was conducted and logistic regression was used to estimate the factors related to the type of assistance granted to the worker. Were evaluated 108 medical records of industrial workers, where 56.5% received the aid for accidental illness (B-91). The majority in the sample are women (72.2%) from the industry with a light demand for work (95.4%) and the shoulder was the segment most frequently affected (85.2%). The factors related to the granting of social security sickness benefits: have undergone a dismissal exam (OR = 0.22) and previous work with exposure to chemical risk (OR = 0.21). For the granting of accidental sickness benefits: the time in the current occupation (OR = 1.01), work with flexion of the cervical spine (OR = 4.68), participation in the rehabilitation program of the National Institute of Social Security (OR = 31.27) and referral for consultation with specialists (OR = 3.10). Study 2 is a systematic review of controlled and randomized studies with meta-analysis. 15 studies involving 4,286 industry workers were included. There was a greater prevalence of the inclusion of physical exercises in the work environment that allowed moderate evidence for cervical pain control (-0.66; -1.12 to -0.20; p = 0.005) and strong evidence for control of shoulder pain (-0.84; -1.26 to -0.41; p = 0.0001) in industry workers with a light demand for work after this intervention. There was very poor evidence for cervical, lumbar and shoulder pain control for the inclusion of physical exercises in heavy industry. No positive results were finding in studies with ergonomic training, however, there were positive results in studies that modified the physical structure of the workplace. The insertion of physical exercises in the industrial work environment can reduce shoulder and neck pain in light industry workers. Is necessary to create institutional programs at industry and to implement public health and social security politics as strategy to control factors related to illness and the granting of benefits.