Musculoskeletal Disorders in Farm Women

Musculoskeletal disorders in farm

women and

Ergonomics for farm workers

Submitted to Dr. Suman SinghSr. Scientist AICRP

Submitted byNidhi SutharPhD Scholar FRM

Introduction

Agriculture has been rated as one of the most dangerous occupation (Mazza 1997)

Occupational risk factors include - static positioning- forward bending- heavy lifting and carrying- kneeling - vibration

The NRCIM (2001) defines work related illness as being caused by, aggravated, accelerated or exacerbated by workplace exposures, which result in impaired work capacity.

Work environment ,performance of work , personal characteristics, environmental and sociocultural factors contribute to the cause or aggravation of the disorder (WHO 1985).

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The term musculoskeletal disorders (MSDs) will be used to describe conditions affecting the musculoskeletal system (including peripheral nerves and vascular system)

Certain jobs and certain risk factors are associated with increased risk of developing MSD (NIOSH, 1997a; NRC/IOM, 2001).

• More than 1 million workers annually sustain injuries severe enough to result in lost time from work due to overexertion or repetitive motion (BLS, 1999).

• The main groups are back pain and injuries, and Work Related Upper Limb Disorders, commonly known as “repetitive strain injuries” (RSI).

Conti…..

Women's participation in Agriculture

Women constitute 50 percent of the agriculture work force in India, giving India the highest degree of female participation in agriculture (Mononmani, 2004).

About one third of women population is actively engaged in agricultural activities like care of cattle, dusting, cleaning of grains, treatment of grains and poultry keeping, pre and post harvesting activities.


A journal, Intensive Agriculture (2004) quoted that

UNDP development report results that 78 percent of the women in country side remain engaged in agricultural activities. They put in 12 or more hours of daily labour than the male counterparts.


Women perform all the activities like --–preparation of land, –sowing,– transplanting, –watering, –weeding, – fertilizer application, –pesticide spraying, –harvesting, – threshing processing, –storage and marketing


Slathia et al. (2004) conducted,

Women play an active role in storage of grains followed by about 89 percent performing hoeing and weeding operations, whereas 80 percent respondents had major play in harvesting operations.

Similarly in threshing 75%, tillage and sowing 54%, manure and fertilizer application 25%, plant protection measures 22% and irrigation 12%.


There is hardly any agricultural activity except ploughing where women are not involved (Swaminathan, 1993).

Pipy (2000) acknowledged and documented the role of farm women in agriculture production.


Average time spent of women on the farm activities varied farm 30-240 min/day (AICRP, FRM, 1998).

During peak period women work everyday for about 8-9 hours in agriculture (Bhople and Patki, 1998)

Long hours of work, continuous attention, precision, variety in work, extreme postures, poor nutrition and health apparently indicate that the farm women are under serious physical stress.

MSDs and women in agriculture

Farming is the occupation most often associated with disability in females and the second most often in males.

Musculoskeletal disorder that are referred to a group of injuries or health problems, are caused by over use or misuse of muscles, bones and nerves.


Left unaddressed, musculoskeletal disorders can result in life long pain and permanent disability.

MSDs affect the soft tissue of the body, such as the muscles, the tendons that connect muscles to bones, ligaments that connect bone to bone, nerves and blood vessels.

These disorders have also been referred to as: cumulative trauma disorders (CTDs), repetitive strain injuries (RSIs) and overuse injuries.


Examples of musculoskeletal disorders include:

• Carpal tunnel syndrome (the compression of the median nerve in the wrist).

• Epicondylitis (swelling of the tendon at the elbow). • Rotator cuff syndrome (swelling and tearing of the

tendons around the shoulder). • Sciatic pain (pain radiating from the lower back to

below the knee).


Apart from their impact on health the symptoms of Musculoskeletal disorders may affect the productivity of those sufferers. Musculoskeletal injuries/diseases, and disability due to these injuries/diseases incurred by agriculture workers are likely to affect the production by work force more frequently than any other safety and health problem during their working years of life.

(Larry chapman, James Meyers 2001).


HSE uses the term ULDs instead of "repetitive strain injury" (RSI)

ULD is used as an umbrella term for a range of disorders of the hand, wrist, arm, shoulder and neck. It covers those conditions, with specific medical diagnoses (e.g. frozen shoulder, carpal tunnel syndrome), and other conditions (often called RSI) where there is pain without specific symptoms.

Upper limb disorders in agriculture


Symptoms may include pain, swelling and difficulty moving.

WMSDs are described as inflammatory and degenerative disease and disorders that result in pain and functional inflammatory and may effect the neck, shoulders, elbows, forearms, wrists and hands (Buckle and Denereux, 2002).

Farming has been considered a high risk occupation for musculoskeletal disorders.

Upper limb disorders in agriculture

Back pain in agriculture In great Britain Musculoskeletal disorders affect 1.1

million people a year.

According to HSE in 2003/04 an estimated 4.9 million working days (full day equivalent) were lost due to back pain caused or made worse by work

Bending and twisting, static posture and whole body vibrations are associated with the prevalence of low back pain in people’s in republic of China in the agricultural activities Jin et al. (1999).

Back pain in agriculture

In Indian conditions also the farm women use bending twisting and static posture for long duration. Activities like weeding cutting/uprooting, picking / diffing, transplanting, removing of stalk and stubble, threshing were found to be maximum drudgery involved agricultural activities performed by women (Obroi and Singh, 2001).

Back pain in agricultureSimilarly, Gupta et al. (2002)

found that weeding was the maximum drudgery prone activity with a scale value of 2.01 followed by harvesting transplanting, cleaning and leveling field as perceived by women. Weeding is performed for a maximum number of 70-90 days/year and is identified as a maximum drudgery ridden farm activity in the nine states of India.

Back pain in agriculture

Kirkhorn et al. (2003) agricultural workers are at increased risk for developing osteoarthritis of the hips and knee.

Back pain, joint injury and orthopedic injury account for another 38 percent. The ability to perform agriculture job duties is significantly affected by arthritis and lack of access of health care.

MSDs due to Manual handling in agriculture

Manual handling covers a wide variety of tasks including lifting, lowering, pushing, pulling and carrying.

Manual handling injuries can occur almost anywhere, when people are at work or at home.

Lifting head loads is a demanding requirement of household work, agriculture and allied works, which causes degenerative changes in women.


In a study, Jumah and Nyame (1994)

found that cervical spondylosis is not exclusively an aging phenomenon but that regular heavy load (15 kg or more over a period 10-15 years or more) carrying on the head plays an etiological role. In another study researchers have found that the spinal load is influenced by load lifting velocity.


Jager et al. (1997) performed a case control study with 35

individuals who had carried load on their head (carriers) and 35 person who had never carried loads on their head (non-carriers). In 31 (88.6%) of the carrier, degenerative change was found in cervical spine but it was found in only 8 (22.9%) of the non carriers.


Hoozermans et al. (1998)

studied spinal stress for different working posture in various work load situations. They studied on stress value at the lumbosacral joint of a person holding, lifting or lowering a load with two hands. The results showed that more the trunk inclined forward the higher were the stress values at lumboscaral joint resulting in work related musculoskeletal disorders i.e. low back pain or disorders of upper extremities.


More trunk inclined forward, the higher were the stress values at the lumbosacral joint resulting in work related disorders related with activities which require manual material handling. (Marras and Davis 1998).

All the agricultural activities involve a very frequent use of these non-neutral posture, and increase the proneness of women to problems related to lumbosacral joints.

Causes of musculoskeletal disorders

A range of agricultural tasks can expose workers to the risk of developing these disorders, including:

heavy manual handling - lifting, lowering, pushing, pulling or carrying, that may be found when moving items such as hay or straw bales, or handling larger farm animals,

adopting awkward, static postures - when stooping or kneeling to do weeding by hand,

high force applications - when digging and shovelling,

Causes of musculoskeletal disorders

working with the arms extended above head level such as when picking fruit by hand,

frequently repeated motion patterns such as when using shears in nursery propagation or tree and vine pruning,

driving tractors and other farm vehicles that expose the body to vibration and impose shock impacts when used on rough ground,

using chain saws and other equipment that exposes the hand and arm to vibration

Simple Solutions: Ergonomics for Farm Workers

What Is Ergonomics?the physical capabilities of the human body

the limitations of the human body

a person’s work tasks tools used

the job environment

Simple Solutions

Work-related musculoskeletal disorders (WMSDs) are:

The leading cause of disability for people in their working years

Caused by chronic exposure to these physical stresses • forceful gripping - kneeling • lifting - squatting • bending - vibrating equipment

The best way to reduce WMSDs is:redesign the tools and redesign how the using the

principles of ergonomics work process is done

»»using the principles of ergonomics

Simple Solutions

Ergonomics for Farm Workers

Strains and sprains are caused by excessive reaching, bending, lifting, gripping, squatting, or twisting of hands, shoulders, or body.

Guidelines for Hand ToolsGuidelines for LiftingDeal with Back pain Deal with Manual handling How to tackle MSDs?

Remember: You may not be able to

implement all the changes recommended here. But even partial changes or small changes can reduce injuries.

Guidelines for Hand Tools


Handle diameter range 1-3/8"

For small hands

2-1/8" For large hands, with

an average of

1-3/4". Handle diameter is large enough for small overlap of thumb and fingers.


Well-designed tool: Handles are long. Spring return keeps tool open. Handles are covered with rubber or plastic grip.


Poorly-designed tool: Handle presses into base of palm and requires user to open after each cut (no spring).

Guidelines for Lifting


Lifting from a good height, between waist and shoulder level.


Poorly-designed load: No handles, and load must be carried too far from the body.


Better-designed load: Handles are provided and the load is closer to the body

Deal with Back pain

Deal with Back painwhat you may feel if you have a hurt back:

PainTingling Numbness

Weakness Stiffness

Deal with Back pain

To keep your back healthy, try to avoided these :

Lift with your legs not from back

Carry smaller loads than doubling

Get close to the fruit reduce distance

Deal with Back pain

Medical evidence from the Royal College of General Practitioners and the Faculty of Occupational Medicine focuses on three key messages to deal with back pain:-

• Stay active • Try simple pain relief • If you need it seek advice

Deal with Manual handling

Deal with Manual handling

Heavy manual labour, awkward postures and previous or existing injury can increase the risk.

It is impossible to say if one particular load is safe to lift or to set general weight limits for manual handling. Things like:

individual capability; the nature of the load; environmental conditions; training; work organisation; and other factors; all have an effect on the risk.

Deal with Manual handling If manual lifting is the only option there are a number of

things that can be done to reduce the risk including:

making the load smaller or easier to lift; reduce carrying distances, twisting movements,

or lifting things from floor level or above shoulder height;

improving the environment - eg better lighting, flooring, or air temperature can sometimes make manual handling easier and safer;

ensuring the person doing the lifting been trained to lift as safely as possible.

How to tackle MSDs?

How to tackle MSDs?An integrated management approach is necessary to tackle MSDs.

Box 1: Tackling MSDs: the European approach (1)

To prevent MSDs (2):• • Avoid MSD risks• • Evaluate the risks which cannot be avoided• • Tackle the risks at source• • Adapt the work to the individual• • Adapt to changing technology

How to tackle MSDs?

Replace what is dangerous with what is safe or less dangerous

Develop a coherent overall prevention policy, addressing the whole load on the body

Give collective protective measures priority over individual protective measures

Give appropriate instruction to workers Keep workers with MSDs at work:

Provide rehabilitationReintegrate workers that suffer or have suffered

from MSDs back into work

work organization

Musculoskeletal Disorders can handled by organization of work that refers to the way of work progresses are structured and managed.

work organization refers to the way work processes are structured and managed and it deals with subjects such as the following the schedule of work viz., work rest schedules, hours of work and shift work.

Documents

Musculoskeletal Disorders in Farm Women