Abstract: Objective: To determine the ratio of work related

Abstract:

Objective:

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To determine the ratio of work
related musculoskeletal disorders among bankers community in Hayatabad
Peshawar, Pakistan.

Method:

A cross-sectional study was
conducted in the banking community of Hayatabad Peshawar, with a minimum experience
of one year. A total of 120 questionnaires were distributed amongst the participants.
Questionnaires were given to different employers of banks eg manger,
operational manager, cashier, etc. among all of them positive response was  71.8% and negative was 28.2% ,respectively.
Questionnaire consists of two sections, mainly containing demographic
characteristics and modified Nordic method. IBM SPSS version 20 was used for
data analysis.

Result:

The prevalence of WRMDs was more common among
bankers with the prevalence rate of , with the highest rate in .

conclusion:

MSD’s are of various forms, and
relating to various risk factors including, repetitive tasks, working in
abnormal position, same posture or position for longer period of time, continue
to work despite of injury, short rest timing during work and also having less
or no physical training.  Relation of
MSD’s to BMI and gender is seen during the study. Ration of MSD’s is going
higher and higher and need proper attention of physical therapist and medical
Practitioners in addition to prevention, in order to minimize the problem.

 

Keywords:

Musculoskeletal disorders,
bankers,

Introduction:

High rates
of musculoskeletal disorders (MDs) have been increasingly associated with work
conditions in several organizations1. WMSDs
comprise numerous groups of diagnoses which include  different clinical sets of disorders,
these  include disorders of the tendons,
tendon sheaths and muscles, joint disorders, neurovascular disorders and nerve
entrapment syndromes2. Commonly
these symptoms occur in different parts of human body which   includes upper limbs (hands, wrists, elbows
and shoulder), neck, lower limbs (legs, hips, ankles, and feet) and back. Pain
,fatigue and Discomfort are the most frequently occurring early symptoms of the
work-related musculoskeletal symptoms3

The
most important Work related musculoskeletal disorder  risks  are physical characteristics of actions,
implied in performing  different work
tasks4.
Dangerous physical task characteristics confine movement characteristics (joint
angles and postures (duration; how extreme or awkward), body part compression
(frequency, magnitude) high

frequencies,
velocities, accelerations, durations), exertion of force (high frequencies,
magnitudes), and exposure to whole body or  part of body to  vibration .These physical task factors damage
body tissue and increases the prevalence 
of work related musculoskeletal disorders4.

Among bank staff operators at Yazd the prevalence of back
symptoms was 18.6% and of wrist/hand was 0.9%.5 A study from Kuwait shows of 750 employees, 80% of the employees had
suffered a minimum of  1 episode of MSD
during the previous year and 42% suffered at least 1 disabling(leading to
permanent injury) episode’6. A study conducted in Hong Kong shows the
prevalence of problems in different body parts shows: neck—31.4%, back 30.6%,
shoulder—16.5%, hand and wrist—14.9% and arm—6.6%7.
Another study  conducted at Brazil shows prevalence rates of 56% for  upper limbs symptoms and 30% for ‘repetitive
strain injury-like condition’8. Also in Korea the roughly calculated prevalence of clinically
confirmed cases of Repetitive strain injury was 22%.and  found prevalence rates of 56% for upper limb
symptoms and 30% for ‘RSI-like condition’9.

No such studies were identified
regarding the prevalence of WMSDs in Bankers in Peshawar, KPK. This study is
aimed to estimate the prevalence of the WMSDS in the Bankers, in order to
identify and categorize the extent and types of WMSDs and compare region wise
that which body part is more prone to WRMSDs.

 

METHODS:

After the approval of research proposal by
the supervisor, the required data through questionnaires was collected from the
bankers in Hayatabad banks, who fulfilled the inclusion criteria. Before data
collection, permission was taken from the manager of the bank and information
sheet was provided to the participants. Consent was taken from the subjects who
were willing to participate in the study.

 

INCLUSION
CRITERIA OF STUDY:

Bank workers apart from office
boys, and security guards, who have more than one year of experience at any
bank private or public, and minimum 5 days of working with at least 8 hours per
day, meet the inclusion criteria including both male and female bankers. Apart
from that the will of all the participant was priority during the study.

EXCLUSION
CRITERIA OF STUDY:

Bankers who have some
congenital, hereditary, and systemic disorders, have history of other than
occupational injuries and lastly participants who do not fulfil the inclusion
criteria were excluded from the study.

EXPLANATION
OF METHODOLOGY:

Questionnaire was taken from
the past reliable study conducted on bankers in Kuwait and Hong Kong. Nordic
method questionnaire was used, which is reliable and valid, which include MSD’s
related different parameters. Questionnaires in hard forms were distributed and
English language with most easily understanding words was used. Questionnaire
had two sections; demographic characteristics and modified Nordic
questionnaire.

An information sheet, consent form and Nordic
questionnaire was given to 120 bankers, in 24 banks, including both male and
female of different age and designation, having minimum of one year experience,
Hayatabad Peshawar, Khyber Pakhtunkhwa, Pakistan, in November to December 2017.Positive
responses were 79 and negative responses were 31 respectively. Because of
systemic issues and incompletely filled questionnaire 3 of 10 were rejected.
From the remaining 7 responses from different bankers were eliminated randomly
to compose the final sample of 110 in study. Data was analyzed through SPSS
version 20 after collection .The collected data were presented with tables, bar
graphs and pie charts. The collected data and result shows real image about the
demographic characteristics and the predisposing risk factors about the work
related musculoskeletal disorders among bankers working in Hayatabad Peshawar.
The obtained results were then calculated in frequencies and percentages while
descriptive were shown.

 

 

RESULTS:

Data analysis represent that n=79,(71.8%)
subjects out of 110 subjects have some form of WRMDs. Comparing different job
positions showed that; manager operation n=16,(14.5%), Teller n=16,(14.5%), manager
n=13,(11.8%),cashier n=9(8.2%),officer grade1 n=9,(8.2%)and others n=47(42.7%) have
some form of WRMDs.(Figure; IV)

 

Data
showed that of all the participants n=93 were male while n=17 were female.
Analysis also demonstrate that in male n=69, (62%) out of 93 were suffered from
WRMDs while in female n=10, (58%) subjects out of 17 have some form of WRMDs.
Outcomes show that male are more prone to MSD as compared to female. Data
analysis regarding mean age of the respondents is 35 with standard deviation of
8.

 

Male, Female Bankers WRMD’s Percentage

Figure:
I;   shows the ratio of effected and unaffected male
and female bankers with work related musculoskeletal disorders at Hayatabad
Peshawar.

Data
analysis showed that most common musculoskeletal disorder in overall bankers
were low back n=15, (18.5%) problem followed by neck n= 12(14.8%), shoulders n=
10 (12.13%). Upper back n=4 and Wrist/hands n=4 is followed by 4.9%. Whereas
Hip, thighs, buttocks, and knees is about 3% and elbow, ankle/feet is 2.5%. Regarding
area of pain and symptoms n=53(67%) have symptoms in at least one area of body
while n=26, (33%) have symptoms in multiple area of the body. Out of n=110
participants n=79 participants that   experienced WRMD problems in different body
region consisting of n=13 manager operation, n=12 manager, n=10 teller, n=6
officer grade 1, cashier n=3 and others n=35.

 

Percentage Of Effected And Non Effected
Bankers.

Figure:
II;   shows
the ratio between effected and unaffected participants of same designation in
bankers, by work related musculoskeletal disorders, at Hayatabad Peshawar.

 

 

Relating different body parts with banker
positions showed that in teller  neck
pain(20%) was more common followed by wrist/hand(20%), upper back
(10%).shoulder (10%), . Similarly in managers neck pain (16%) were more common
followed by knees (15%). While in officer grade 1 low back (33.3%) followed by
neck (16.7%) and elbows (16.7%).

 

 

Percentages   Of
Effected Areas In Body Among Bankers

 

Neck                       .

Shoulders            .

Upper Back        .

Elbows             .

Low back        .

Wrists/ Hands

Hips/ Thighs/
Buttocks

Knees          .

Ankles/       Feet

Manager

15.40%

0.00%

0.00%

0.00%

7.70%

0.00%

7.70%

15.40%

7.70%

Teller

20.00%

10.00%

10.00%

0.00%

0.00%

20.00%

0.00%

0.00%

0.00%

Manager
Operation

15.40%

30.80%

15.40%

0.00%

7.70%

7.70%

15.40%

0.00%

0.00%

Cashier

0.00%

33.30%

0.00%

0.00%

33.30%

0.00%

0.00%

0.00%

0.00%

Officer
grade one

16.70%

0.00%

0.00%

16.70%

33.30%

0.00%

0.00%

0.00%

0.00%

Others

13.90%

11.10%

2.80%

2.80%

27.80%

2.80%

0.00%

2.80%

2.80%

 

Figure: III; Table shows percentages of different body areas effected by work
related musculoskeletal disorders among different bankers at Hayatabad,
Peshawar.

 

Outcome showed that of all n=110
participants the most common risk factor stated for WRMDs was performing the
same task over and over (21%), awkward or cramped positions (19.1%%) followed
by working in the same position for long periods (15.5%), continuing to work
despite of injury or pain (6.4%), not enough rest breaks during the day (5.5%),
and repetitive movements of upper limb (5%). So stressful positions in all
bankers leading to injuries are performing the same task over and over, working
in awkward or cramped positions, working in the same position for long periods.

Figure:
IV; shows percentage of different
possible causes of work related musculoskeletal disorders among bankers at
Hayatabad, Peshawar.

 

Comparing
different types of treatment data shows that out of n=38 participants using
medications n=13, (34.2%) participants were improved while n=25, (65.8%)
participants remain unchanged. Of all the n=16 participants using physiotherapy
n=11, (68.8%) participants were improved, n=5, (31.2%) participants were
unchanged. While surgery and others taken as a treatment option has no effect.

 

 

DISCUSSION:

WRMSDs is one of the major health issue among
bankers community, who work in continues static and awkward posture with doing same
task again and again for longer period of time There is limited literature present
about the prevalence of MSDs in bankers Hayatabad Peshawar KP. The result  of our study shows that n=79(79.8%) bankers have
experienced some form of musculoskeletal disorders which is comparable to a
study conducted in Kuwait where the prevalence was 80%.The prevalence of low
back pain in our study is 18.5% ,this  finding  is comparable to the results of a cross
sectional study conducted  Among bank staff operators at Yazd where  the prevalence of back symptoms was 18.6%. and
of wrist/hand was 0.9% which is very similar to the outcome for wrist and hand
in our study. The prevalence of shoulder pain among bankers in our study is
12.13% and  a similar study conducted in Hong Kong, shows the prevalence of problems in different body parts shows:
neck—31.4%, back 30.6%, shoulder—16.5%.

Similarly
another study conducted at Brazil shows
prevalence rates of 56% for upper limbs symptoms and 30% for ‘repetitive strain
injury-like condition. Where as in our study separate conditioned are discussed
as for hand, wrist, elbow and shoulder joint, but not as whole upper limb and
combining all the values of the above areas we have 19.53% prevalence is
measured.  Also in Korea the roughly
calculated prevalence of clinically confirmed cases of Repetitive strain injury
was 22%.and  found prevalence rates of
56% for upper limb symptoms and 30% for ‘RSI-like condition, the study reveal
the above percentage of another study in brazil, but in our case the prevalence
is less than both of them.

In above articles some of the areas have higher prevalence
results where as some are closed or less than the values measured in our study,
the main reason is that, in some of the above studies the population, gender, working
hours and days are different from our study, that’s why the resultant
prevalence did not exactly match their percentages in certain areas.

 The paper
reviews workstation, chair, and keyboard design, and makes recommendations to
improve user comfort. Also discussed is worker selection, training, posture,
conditioning, and rest breaks10. On the basis of this article we can say that improper biomechanics and
also prolong sitting and repetitive tasks can cause WRMSD’s among bankers. Fixed postures and prolonged seating are also risk
factors. . Any prolonged posture will lead to static loading of the soft
tissues and cause discomfort.11 This study is also in support of prolong, static, and
awkward posture, which can cause the proper pain in back, neck and other areas
of the body.

Also in the study we have seen
that the male are more prone and have WRMSD’s as compared to female, mainly due
to less sample size, and also disease is related to BMI and gender. Obesity,
underweight and overweight are also causes of MND’s among the bankers community
all over the world.

Babatunde in (2008) showed in study that risk
factors leading to WRMDS is, more working duration in one day, working in same
position for long time, bending or twisting position in awkward cramp position,
not enough rest break, same task over and over, and continuing work with
ignorance of injuries. No significant statistical correlation has been found
between MSDs and risk factors, but it is shown that WRMDs are multidimensional
and all these factors can lead to MSDs.,,

 

CONCLUSION:

Prevalence of Work related musculoskeletal
disorders (WRMD) are high among bankers. Which is related to different risk
factors. There is highest prevalence of WRMDs in that manager operation
n=16, (14.5%), Teller n=16, (14.5%), manager n=13, (11.8%), cashier n=9(8.2%),
officer grade1 n=9, (8.2%) and others n=47(42.7%).The most frequently affected area is neck,
lower back and shoulder. There is significant relation of MSDs with BMI and
gender of participants. Males have greater prevalence of WRMDs than females
while MSDs are more common in underweight, over weight and obese participants.
In summary WRMDs shows significant burden for health professional’s therefore
proper attention and preventive measures should be taken to minimize this
burden.

 

BIBLIOGRAPHY:

In Vancouver style.

 

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