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 Table of Contents  
Year : 2022  |  Volume : 7  |  Issue : 1  |  Page : 41-44

Work-related musculoskeletal disorders in tyre factory workers – An observational study

Department of Orthopaedic Manual Therapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India

Date of Submission09-Jun-2021
Date of Decision17-Nov-2021
Date of Acceptance19-Nov-2021
Date of Web Publication27-Jun-2022

Correspondence Address:
Dr. Anand Heggannavar
Department of Orthopaedic Manual Therapy, KAHER Institute of Physiotherapy, Belagavi - 590 010, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjhs.bjhs_58_21

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CONTEXT: Work-related musculoskeletal disorders (WRMSDs) are considered major public health problems and the leading cause of occupational injury. Activities such as prolonged standing, repetitive task, awkward sitting posture, heavy lifting, pulling, and pushing may result in functional impairment and pain due to poor working conditions and absence of work injury prevention programs.
AIM: This study aimed to determine the prevalence of WRMSDs in factory workers.
SETTINGS AND DESIGN: An observational study was carried out in a tyre factory in India.
SUBJECTS AND METHODS: Two hundred and fifty-two (n = 252) male workers aged 21–59 years with at least 1 year of job tenure were included in this observational study. The assessment was done using the Nordic Musculoskeletal Questionnaire and Rapid Entire Body Assessment (REBA) tool.
STATISTICAL ANALYSIS USED: Data analysis was done using Chi-square test to calculate the prevalence of musculoskeletal disorders.
RESULTS: The most commonly affected body regions of factory workers in 12 months were neck and lower back with P = 0.001and P = 0.146, and problems faced in the past 7 days were more common in the lower back and neck with P = 0.004 and 0.001, respectively. This study reported the highest prevalence in the neck (62.7%) and lower back (54.8%). The REBA tool revealed a majority of the workers emerged under the category of high risk.
CONCLUSIONS: The study concluded that neck and lower back regions were found to be more commonly affected, and a majority of workers emerged into high-risk category.

Keywords: Nordic Musculoskeletal Questionnaire, Rapid Entire Body Assessment tool, work-related musculoskeletal disorders

How to cite this article:
Heggannavar A, Naik S. Work-related musculoskeletal disorders in tyre factory workers – An observational study. BLDE Univ J Health Sci 2022;7:41-4

How to cite this URL:
Heggannavar A, Naik S. Work-related musculoskeletal disorders in tyre factory workers – An observational study. BLDE Univ J Health Sci [serial online] 2022 [cited 2022 Aug 15];7:41-4. Available from: https://www.bldeujournalhs.in/text.asp?2022/7/1/41/348275

Work-related musculoskeletal disorders are considered as major public health problems and the leading cause of occupational injury. It is described as a wide range of degenerative and inflammatory conditions. These conditions may result in functional impairment and pain due to poor working conditions.[1],[2],[3],[4]

One of the most commonly used tools in the evaluation of musculoskeletal disorders (MSDS) is the Nordic Musculoskeletal Questionnaire which allows comparisons of general complaints of lower back, neck, and shoulder.[5],[6]Postural analysis techniques in the working environment are important to rule out the risk of musculoskeletal injuries associated with work. Rapid Entire Body Assessment (REBA) tool evaluates whole-body postural MSD and risks associated with job tasks in which a single worksheet is used for evaluation.[7]

There is a paucity of literature on the health status of employees working in tyre factories in India. Hence, the main aim of the study was to determine the prevalence of MSD'S in tyre factory workers using Nordic Musculoskeletal Questionnaire and to assess whole body for postural MSD'S and risks associated with job tasks using REBA tool.

  Subjects and Methods Top

The current observational study was carried out in a tyre manufacturing facility. The study included 256 male workers ranging in age from 21 to 59 years old. Workers with at least 1 year on the job[8] were included in this study, but those with any underlying diagnosed pathological conditions or occupational or nonoccupational injuries affecting the musculoskeletal system were excluded.[9]

Outcome measures

The Nordic Musculoskeletal Questionnaire is a simple questionnaire recognized and validated internationally for detecting symptoms in the neck, back, shoulders, and extremities. It consists of 28 multiple-choice questions, divided into two parts. The first part focuses on symptoms in nine body parts that is the neck, shoulders, elbows, wrists/hands, upper back, lower back, hip/thighs, knees, and ankles/feet during the last 12 months or 7 days. The second part refers to symptoms in specific three parts of the body that is neck, shoulders, and lower back throughout the subject's working life/7 days beforehand.[5],[6],[10] REBA divides the body into segments to be coded individually; regarding movement planes, it provides a scoring based on muscle activity caused by dynamic, static, quick-changing, or unpredictable postures, considering that coupling is important in the handling of loads but may not always be with the hands. It is a subjective method that requires minimal equipment that is pen and paper.[7],[11],[12]

Ethical approval for the present study was obtained from the Institutional Ethical Committee (SI. No. 486). The study's goal was explained, and all participants signed a written informed consent form. Prior to their enrolment in the trial, all subjects were evaluated for inclusion and exclusion criteria. All demographic data were recorded on the data collection sheet, and each participant was assigned a unique serial number. A brief history of the professional career was noted after the demographic data were recorded. The Nordic Musculoskeletal Questionnaire was used for assessment, which was delivered as a structured interview, and postural analysis was done by observation using the REBA worksheet. The prevalence of musculoskeletal problems was calculated using the Chi-square test, and the findings were obtained.

  Results Top

[Table 1] displays the demographic characteristics of the patients. Male workers aged between 21 and 59 years were included in the study, the mean age was found to be 39.19 ± 10.22 years. The mean height was 170.58 ± 7.35 cms. The mean weight was found to be 73.18 ± 10.04 kgs and BMI of the workers ranged from16.70 to 36.10 with a mean 25.33 ± 3.32 kg/m2.
Table 1: Demographic profile

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[Table 2] represents trouble in different body regions in the last 12 months, 7 days, and prevention from doing work for 12 months.
Table 2: Trouble in different body regions in last 12 months, 7 days, and prevention from doing work for 12 months using Nordic Questionnaire

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According to the results obtained

Trouble in last 12 months

The Nordic Questionnaire identified symptoms in which neck and lower back were most affected regions with a prevalence of 62.7% and 54.8%, followed by knees (15.9%), shoulders (11.5%), wrist and hands (11.5%), upper back (11.1%), and ankle (0.4%).

Trouble for last 7 days

Most affected region was the lower back with a prevalence of 47.62%, followed by neck (8.33%), shoulders (7.94%), knees (7.54%), and ankle (0.4%).

Prevented from doing work for 12 months

Neck, shoulders, and knees were most significant in preventing from doing work with P = 0.001, followed by lower back and ankle (P = 0.001), while the other components were not affected.

[Table 3] represents the musculoskeletal risks in various tasks, which were done using the REBA tool.
Table 3: Level of musculoskeletal risk using Rapid Entire Body Assessment Scale

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In this table, majority of the workers emerge under the category of high risk that is 54%, which indicates there should be a change in the working methods to reduce musculoskeletal risks.

  Discussion Top

According to the Nordic Questionnaire, the prevalence of MSD'S was common among tyre factory workers and showed that the workers had experienced some form of musculoskeletal problems during the last few months. The results of REBA scale helped to identify the risk relating to musculoskeletal injuries, and majority of the workers emerged in the high-risk category. This indicates that the tyre factory should be considered as a high-risk industry for developing MSD'S which possesses a great deal on changing the working methods.

Musculoskeletal injuries in the tyre factory are common and need proper attention. Comparison of the results with previous studies conducted by Choobineh A et al. in 2007 indicated that lower back and neck symptoms were found to be more common in the present study.[2] Neck pain could be attributable to awkward postures which was mainly seen in desktop workers who worked on computers for more than 5 h and spent most of their time in the seated position. The lower back pain prevalence was 54.8% among industrial workers, which might be due to the heavy physical work done in a prolonged standing position, manual handling of materials, frequent bending, twisting to lift tyres, and forceful movements, which might be relevant risk factors for the onset of LBP which was observed in all working units but mainly in production and manual material handling. Shoulder, wrist, and hand symptoms were seen in 11.5% of the workers who were mainly exposed to manual handling, pushing, and pulling of heavy objects in the production unit. Only 11.1% of workers had upper back pain and was seen in workers who worked in accounts and human resources units who worked on computers for long duration. Usage of heavy footwear by workers while walking and constant standing might have led to the symptoms in the ankle, which accounted for 0.4%. Moreover, when compared to the other study, which was conducted by Rita de Cassia Pereira Fernandes Rde et al., the highest prevalence was noted in women than men where the symptoms were more in distal extremities in a woman as compared to men, which was 34.6% and 11.6%, but this study reported 16% prevalence in the distal extremities. The current study was conducted in a factory that had only male workers and showed the prevalence more in the neck and lower back.[4],[13]

Job duties in tyre factories can be considered occupations with a risk of developing injuries in different body parts producing MSD'S. Thus, general corrective measures can be recommended for reducing exposure level and risk.

Work-related musculoskeletal risk assessment in a variety of tasks using REBA tool reported that the majority of the workers were working with inappropriate postures. Results of postural analysis reported that 54% of the workers were working at a high-level risk which might lead to work-related injuries if they continued to work in the same posture. Forty percent of those working in medium-level risks can be reduced by providing necessary information and corrective measures. Education regarding ergonomics and ergonomic programs will help workers in reducing musculoskeletal injuries at work and will maintain a safe and healthy working environment.[14],[15],[16]


This study concluded that neck and lower back regions were found to be more commonly affected, and a majority of workers emerged into the high-risk category. Providing necessary information and corrective postural measures through ergonomic programs seemed essential in reducing the musculoskeletal injury risk level.


We are grateful to the head of the institution for granting us permission to conduct the study. We are thankful to the statistician for helping us with the data analysis. We also thank the factory workers for participating in the study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Korhan O, Memon AA. Introductory chapter: work-related musculoskeletal disorders. InWork-related musculoskeletal disorders 2019 Mar 29. IntechOpen, London UK.  Back to cited text no. 1
Choobineh A, Tabatabaei SH, Mokhtarzadeh A, Salehi M. Musculoskeletal problems among workers of an Iranian rubber factory. J Occup Health 2007;49:418-23.  Back to cited text no. 2
Choobineh A, Tabatabaee SH, Behzadi M. Musculoskeletal problems among workers of an Iranian sugar-producing factory. Int J Occup Saf Ergon 2009;15:419-24.  Back to cited text no. 3
Fernandes Rde C, Carvalho FM, Assunção AÁ. Prevalence of musculoskeletal disorders among plastics industry workers. Cad Saude Publica 2011;27:78-86.  Back to cited text no. 4
Crawford JO. The nordic musculoskeletal questionnaire. Occup Med 2007;57:300-1.  Back to cited text no. 5
López-Aragón L, López-Liria R, Callejón-Ferre ÁJ, Gómez-Galán M. Applications of the standardized Nordic questionnaire: A review. Sustainability 2017;9:1514.  Back to cited text no. 6
Hignett S, McAtamney L. Rapid Entire Body Assessment (REBA). Appl Ergon 2000;31:201-5.  Back to cited text no. 7
Bena A, Giraudo M, Leombruni R, Costa G. Job tenure and work injuries: A multivariate analysis of the relation with previous experience and differences by age. BMC Public Health 2013;13:869.  Back to cited text no. 8
Leigh J, Macaskill P, Kuosma E, Mandryk J. Global burden of disease and injury due to occupational factors. Epidemiology 1999;10:626-31.  Back to cited text no. 9
Dawson AP, Steele EJ, Hodges PW, Stewart S. Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): A screening instrument for musculoskeletal pain. J Pain 2009;10:517-26.  Back to cited text no. 10
Lamarão AM, Costa LC, Comper ML, Padula RS. Translation, cross-cultural adaptation to Brazilian – Portuguese and reliability analysis of the instrument Rapid Entire Body Assessment-REBA. Braz J Phys Ther 2014;18:211-7.  Back to cited text no. 11
Plus E. A Step-by-Step Guide: Rapid Entire Body Assessment (REBA). Available from: https://www.ergo-plus.com. [Last accessed on 2021 Mar 03].  Back to cited text no. 12
Andersen JH, Haahr JP, Frost P. Risk factors for more severe regional musculoskeletal symptoms: A two-year prospective study of a general working population. Arthritis Rheum 2007;56:1355-64.  Back to cited text no. 13
Hoe VC, Urquhart DM, Kelsall HL, Sim MR. Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Cochrane Database of Systematic Reviews. 2012(8).  Back to cited text no. 14
Govaerts R, Tassignon B, Ghillebert J, Serrien B, De Bock S, Ampe T, et al. Prevalence and incidence of work-related musculoskeletal disorders in secondary industries of 21st century Europe: A systematic review and meta-analysis. BMC Musculoskelet Disord 2021;22:751.  Back to cited text no. 15
Harcombe H, McBride D, Derrett S, Gray A. Physical and psychosocial risk factors for musculoskeletal disorders in New Zealand nurses, postal workers and office workers. Inj Prev 2010;16:96-100.  Back to cited text no. 16


  [Table 1], [Table 2], [Table 3]


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