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Upper Extremity Musculoskeletal Disorders In Female Machine milkers - An Epidemiological, Clinical and Ergonomic Study

Stål, Marianne LU (1999)
Abstract (Swedish)
Popular Abstract in Swedish

Inom svensk mjölkproduktion förekommer en hög frekvens av belastningsbesvär. Vid jämförelser mellan manliga och kvinnliga mjölkare har det visat sig vara stora skillnader avseende besvärsförekomst. Kvinnorna har rapporterat högre frekvens av problem i nästan alla kroppsdelar jämfört med männen. Dessutom har andelen hand- och handledsbesvär visat sig vara anmärkningsvärd hög bland kvinnliga mjölkare. Kunskap om varför dessa skador uppträder i samband med mjölkningsarbete har hittills varit begränsad. Några jämförelser har ej heller gjorts mellan kvinnor sysselsatta inom lantbruk och andra kvinnogrupper som är exponerade för tungt fysiskt arbete. Avhandlingens syfte har därför varit att bestämma... (More)
Popular Abstract in Swedish

Inom svensk mjölkproduktion förekommer en hög frekvens av belastningsbesvär. Vid jämförelser mellan manliga och kvinnliga mjölkare har det visat sig vara stora skillnader avseende besvärsförekomst. Kvinnorna har rapporterat högre frekvens av problem i nästan alla kroppsdelar jämfört med männen. Dessutom har andelen hand- och handledsbesvär visat sig vara anmärkningsvärd hög bland kvinnliga mjölkare. Kunskap om varför dessa skador uppträder i samband med mjölkningsarbete har hittills varit begränsad. Några jämförelser har ej heller gjorts mellan kvinnor sysselsatta inom lantbruk och andra kvinnogrupper som är exponerade för tungt fysiskt arbete. Avhandlingens syfte har därför varit att bestämma andelen besvär i övre extremiteterna hos kvinnor arbetande inom svensk mjölkproduktion. Målet har även varit att jämföra besvärsförekomsten mellan olika kvinnogrupper såväl inom som utanför lantbruksföretag. Avsikten har också varit att undersöka om det finns något samband mellan besvär och faktorer i den fysiska och den psykosociala miljön för att kunna identifiera eventuella riskfaktorer. Slutligen har syftet varit att studera vilken typ av skada som förekommer, skadans varaktighet, samt orsak till skadans uppkomst. Avhandlingens första del är en epidemiologisk tvärsnittsstudie omfattande 161 aktiva kvinnliga mjölkare, 108 kvinnor med annat arbete inom lantbruket, 63 f.d. mjölkerskor samt 166 undersköterskor. Resultaten visar att maskinmjölkning medför en ökad risk för symptom i form av värk, domningar och köldkänsla. Hos dessa mjölkerskor har symptomen inget samband med exponering för vibration. Vid uppföljning efter 12 månader kvarstår problemen hos flertalet av mjölkerskorna. En klinisk undersökning omfattande 80 slumpvis utvalda personer visar att symptom i handleder och händer föreligger hos 51. Fjorton av dessa har tecken på en skada på medianusnerven. I några enstaka fall förekommer även seninflammationer. En fördjupning av den kliniska analysen som sker i en studie (III) där 30 mjölkerskor med symptom från underarmar och/eller händer undersöks av handkirurg. Den tidigare misstanken på en nervskada bekräftas här. Den övervägande lokalisationen visar sig vara i armbågsnivå (pronatorsyndrom). Operation av åtta av dessa ger en signifikant förbättring avseende såväl symptom som muskelstyrka. (Less)
Abstract
The aims of the thesis were to investigate the prevalence of the upper extremity musculoskeletal disorders in female milkers in relation to other occupational groups; to clarify the relationship between disorders and work environment, psychosocial and life style factors; to compare in a prospective study, pain, ache and discomfort reported by a questionnaire with clinical symptoms and sign; to examine milkers with wrist and hand disorders with regard to type and localization of the tissue injury; to quantify the work load on forearms, wrists and hands during machine milking. An increased risk developing symptoms in wrists and hands was noted in the active milker group compared to the non-milker and the nursing assistant group. Numbness in... (More)
The aims of the thesis were to investigate the prevalence of the upper extremity musculoskeletal disorders in female milkers in relation to other occupational groups; to clarify the relationship between disorders and work environment, psychosocial and life style factors; to compare in a prospective study, pain, ache and discomfort reported by a questionnaire with clinical symptoms and sign; to examine milkers with wrist and hand disorders with regard to type and localization of the tissue injury; to quantify the work load on forearms, wrists and hands during machine milking. An increased risk developing symptoms in wrists and hands was noted in the active milker group compared to the non-milker and the nursing assistant group. Numbness in the wrist and hands was significantly more frequent in all agricultural groups than in the group of nursing assistants. The occurrence of symptoms in the upper extremities was not related to number of cows. Neither was a significant difference in experience of numbness, coldness or white fingers among milkers who were using vibration tools as compared to those who have never done so. Milkers working in a modernized dairy barn had fewer problems in the upper extremities than those who were working in a traditional barn. However only 13 of the 161 milkers had the possibility to work in a modern way. There was no relationship between symptoms and social and/or well-being factors among the milkers. A prospective study showed a persistent prevalence of wrist and hand symptoms among most of the milkers. In a clinical examination consisted of 80 randomized persons it was shown that 51 had some kind of symptoms in the wrist and hands. Fourteen of these had a clinical sign of median nerve entrapment. A further clinical study confirmed the result from the first study but the localization was most at the elbow region. A registration of the wrist positions and movements and the muscle activity in two different dairy barns showed that there exist extreme positions and movements. The results of the measurements of the muscle activity showed high peak loads which in combination with the positions and movements of the wrist might contribute to an increased risk of developing injuries. Preliminar result of an ergonomic study showed that by using a ”support arm” and a adjustable platform on the floor the work load could be reduced. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • PhD, Prof Kilbom, Åsa
organization
publishing date
type
Thesis
publication status
published
subject
keywords
biaxial eletrogoniometer, movements, wrist positions, pronator syndrome, median nerve entrapment, clinical examination, hands, wrists, upper extremity musculoskeletal disorders, agriculture, Cross-sectional study, female milkers, electromyography muscles of the forearm., Occupational health, industrial medicine, Yrkesmedicin, arbetsmiljömedicin
pages
109 pages
publisher
RPT, Box 88, 230 53 Alnarp, Sweden,
defense location
Blocket, Universitetssjukhuset, Lund
defense date
1999-04-20 13:00
external identifiers
  • other:ISRN: LUMEDPT-1011-SE
ISBN
91-628-3469-X
language
English
LU publication?
yes
id
89822363-0485-4153-a0d8-c582b6d118a0 (old id 39482)
date added to LUP
2007-07-31 12:22:51
date last changed
2016-09-19 08:45:02
@phdthesis{89822363-0485-4153-a0d8-c582b6d118a0,
  abstract     = {The aims of the thesis were to investigate the prevalence of the upper extremity musculoskeletal disorders in female milkers in relation to other occupational groups; to clarify the relationship between disorders and work environment, psychosocial and life style factors; to compare in a prospective study, pain, ache and discomfort reported by a questionnaire with clinical symptoms and sign; to examine milkers with wrist and hand disorders with regard to type and localization of the tissue injury; to quantify the work load on forearms, wrists and hands during machine milking. An increased risk developing symptoms in wrists and hands was noted in the active milker group compared to the non-milker and the nursing assistant group. Numbness in the wrist and hands was significantly more frequent in all agricultural groups than in the group of nursing assistants. The occurrence of symptoms in the upper extremities was not related to number of cows. Neither was a significant difference in experience of numbness, coldness or white fingers among milkers who were using vibration tools as compared to those who have never done so. Milkers working in a modernized dairy barn had fewer problems in the upper extremities than those who were working in a traditional barn. However only 13 of the 161 milkers had the possibility to work in a modern way. There was no relationship between symptoms and social and/or well-being factors among the milkers. A prospective study showed a persistent prevalence of wrist and hand symptoms among most of the milkers. In a clinical examination consisted of 80 randomized persons it was shown that 51 had some kind of symptoms in the wrist and hands. Fourteen of these had a clinical sign of median nerve entrapment. A further clinical study confirmed the result from the first study but the localization was most at the elbow region. A registration of the wrist positions and movements and the muscle activity in two different dairy barns showed that there exist extreme positions and movements. The results of the measurements of the muscle activity showed high peak loads which in combination with the positions and movements of the wrist might contribute to an increased risk of developing injuries. Preliminar result of an ergonomic study showed that by using a ”support arm” and a adjustable platform on the floor the work load could be reduced.},
  author       = {Stål, Marianne},
  isbn         = {91-628-3469-X},
  keyword      = {biaxial eletrogoniometer,movements,wrist positions,pronator syndrome,median nerve entrapment,clinical examination,hands,wrists,upper extremity musculoskeletal disorders,agriculture,Cross-sectional study,female milkers,electromyography muscles of the forearm.,Occupational health,industrial medicine,Yrkesmedicin,arbetsmiljömedicin},
  language     = {eng},
  pages        = {109},
  publisher    = {RPT, Box 88, 230 53 Alnarp, Sweden,},
  school       = {Lund University},
  title        = {Upper Extremity Musculoskeletal Disorders In Female Machine milkers - An Epidemiological, Clinical and Ergonomic Study},
  year         = {1999},
}