Indian Journal of Public Health

: 2021  |  Volume : 65  |  Issue : 2  |  Page : 194--197

Characteristics of musculoskeletal pain among employees of fish processing factory in Udupi City, Karnataka

Rajesh Navada V. Gundmi1, Somu Gangahanumaiah2, Arun Gundmi Maiya1, Vasudeva Guddattu3,  
1 Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 Department of Hospital Administration, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
3 Department of Biostatistics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India

Correspondence Address:
Rajesh Navada V. Gundmi
Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal - 576 104, Karnataka


Fish processing employees are exposed to various occupational risk factors that result in musculoskeletal pain (MSP). The objective of the study was to determine the characteristics of MSP among them and its association with the nature of the job and work condition. A cross-sectional study was conducted among 364 employees of five fish processing factories using standard questionnaires. Descriptive analysis and Chi-square test were performed using SPSS software version 15.0. The prevalence of MSP was 77.7% affecting more of the upper extremities (43.8%). Mild and moderate types of pain were more (37.6%) that resulted due to repeated work (30.2%) and work method (35.4%) that include extreme temperature and work posture. The mean numeric pain severity score was 3.02 ± 2.14. Global self-rated health was reported as predominantly good (57.7%). To conclude, the study revealed a higher prevalence of MSP and its various characteristics in detail which help in designing intervention programs.

How to cite this article:
Gundmi RN, Gangahanumaiah S, Maiya AG, Guddattu V. Characteristics of musculoskeletal pain among employees of fish processing factory in Udupi City, Karnataka.Indian J Public Health 2021;65:194-197

How to cite this URL:
Gundmi RN, Gangahanumaiah S, Maiya AG, Guddattu V. Characteristics of musculoskeletal pain among employees of fish processing factory in Udupi City, Karnataka. Indian J Public Health [serial online] 2021 [cited 2021 Sep 23 ];65:194-197
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Full Text

Many industrial work like fish processing is associated with a considerable risk of musculoskeletal disorders (MSDs) and their consequences have the highest morbidity rates. The nature of work, job setting, and the environment in various units of the fish processing are chief occupational etiologic factors of MSDs among their employees. They demand prolonged periods of static or awkward position of the body, high physical workloads, and repetitive movements under improper work conditions.

Musculoskeletal pain (MSP) is the most frequently reported work-related health problem[1] and considered a medical and public health issue. During the absence of physical signs, it might be necessary to depend majorly on its characteristics to tailor specific treatment to MSDs.[2] The studies are limited or confined to only a single component of MSP characteristics. Hence, the objective of the study was to determine the characteristics of MSP among fish processing employees and its association with job-related factors such as job experience. Working hours, posture, and work conditions.

The questionnaire-based, cross-sectional study was conducted at the fish processing factories located in the coastal region of Udupi city, Karnataka State, India from January to December 2018. The study protocol was approved by an institutional ethics committee (IEC: 126/2016) with CTRIregistration number (CTRI/2017/09/009854).

The study was confined to five fish processing factories out of 31 in the district depending on its locality, the existence of uniform sections, type of task, average size of the industry to make equal comparability of the participants. All the five factories were of small-sized (with employees from 50 to 100), situated at the coastal line within the city limits of Udupi city, having common sections which include repetitive and forceful action-oriented tasks.

A sample size of 384 was decided based on a 95% confidence interval, anticipated 50% prevalence, and allowable absolute error of 5%.

The employees (384) were screened randomly for eligibility to obtain basic data and trends. Of the data collected, 20 employees were excluded as they were not associated with the specified occupational category and out of criteria and consent were taken from the rest of 364 giving participation rate of 94.79%. The major percentage of their population has been covered to make the representation in each section and to minimize bias. The present study was taken up to proceed for a large sample size to incorporate all the fish processing industries in the district followed by an intervention program.

Eligibility criteria for the study population were male and female employees who were aged from 18 to 60 years with a minimum of 1 year of experience. The employees who had any neurological and orthopedic conditions and not willing to participate in the study were excluded.

A self-reported, validated questionnaire was distributed at the worksite which comprises socio-demographic variables, MSP characteristics, and work-related factors. The pain was described by presence or absence, type, onset, frequency, severity, location, description for the cause of pain, sick leave, and treatment details. Work characteristics included section, body posture (sitting, standing, nonstatic [walking, bent or rotated trunk, handling of load]), temperature, experience, and working hours. Nordic musculoskeletal questionnaire (NMQ), global health measure, and Numeric Pain Rating Scale (NPRS) were used to assess the frequency of MSP, health status, and severity of pain, respectively, after a pilot study. The employee ticks the box of “yes” or “no” for pain suffered from the past 12 months by referring to body map for easy representation of the joints in NMQ. NPRS is a 10-point scale measurement that is to be marked to classify as mild (1-3), moderate (4-6), and severe (≥7). Questions addressing the levels of health such as excellent, very good, good, fair, and poor in the last year were adapted from standard form – 36. Data were collected by a trained physiotherapist, to clear the doubts and even to help the illiterate.

Data were analyzed using SPSS software version 15.0. Descriptive statistics were used to summarize the data and the Chi-square test was used for association. The prevalence of MSP was determined, global health ratings and scores of MSP were compared between the groups with and without pain. P ≤ 0.05 was considered statistically significant.

The overall prevalence of MSP was77.7% among fish processing employees. The sociodemographic and job-related factors of the participants and their association with MSP are detailed in [Table 1] and [Table 2]. Many of the participants were <40 years (60.2%) and married (59.3%). The mean numeric pain severity score for MSP_SD was 3.02_2.14 experiencing more of dull aching (36.0%) type of pain. The pain was exacerbated after the duty hours (46.7%) compared to the working period. The employees displayed “good” as a higher score in global health rating among both the groups of pain (51.7%) and no pain (71.6%) keeping a marked gap from other scores. Repetition (30.2%) and work method (35.4%) were reported as the main cause for increased pain in which the latter holds the association with work posture and extreme temperature. The employees who adopt the sitting position (15.7%) for processing purposes were grossly affected (84.2%) compared to the standing and nonstatic posture occupants. A higher prevalence of MSP was reported among employees who work under hot and cold temperature conditions compared to those who were at room temperature (81.1% vs. 75.8%). The men employees (80.8%) in the thermal processing section were more in total strength than women (19.2%) and together complained of a greater MSP (82.7%).{Table 1}{Table 2}

The current study's report of the prevalence rate of MSP (77.7%) was greater than the earlier study.[3] The employees having a mean age of 36.74 ± 12.33, were more of young migrants aged below 30 years (39.6%). They conspicuously do not have any complaints (84.0%) and so were employed for high energetic labor. Women were affected more than men with a minor difference of only 2.6% because of biological, personal, familial, and psychosocial factors.[4] However, the total strength of women was half of that of men which cannot be ignored. The married employees (92.6%) were affected more than unmarried (56.1%) making a strong association between marital status and MSP (<0.001). This may be due to their over-time work to support their dependents financially[5] [Table 1].

A mild and moderate degree of pain ratings (37.6%) on NPRSbothered even after the duty hours, but it was only a moderate degree of pain in Nag's study.[5] The intensity of pain between 3 and 6 on NPRS was 63.1% and the highly conveyed type of pain was dull aching (36%) which gives insight into the severity of MSP. However, our study points out that their pain was more chronic, often severe, and has a foremost effect on their perceived general health. More than half of the employees marked their global health ratings as good in both the comparative groups with and without pain in an overall frequency of 57.7%.

The present study did reveal the association between MSP and job characteristics such as working hours, job experience, body posture, and extreme temperature conditions [Table 2] which were not considered extensively in earlier studies. Further, all the body parts were targeted for a higher prevalence of MSP among men, regardless of job characteristics. The employees were affected more as they work more years and the same was illustrated in an Indian study.[5] Regarding working hours, the duty of official 8 h caused the maximum occurrence of MSP (81.5%).

Repetition (30.2%) and work method (35.4%) were recorded as chief sources for increased MSP under personal and workplace factors, respectively. The findings are consistent with a study[6] and turned out to be important ergonomic stressors for the development of MSDs.[5] The prolonged standing has been observed primarily in various work methods, constructing joint overload as a potential origin for MSDs.[7] The anatomical variations affect the lower back majorly by changing the center of the pressure distribution of the body causing degeneration of the intervertebral disc and compression of the sciatic nerve. Sitting over the low-level workbenches made the employees to bend the spine throughout the working period. An extended period in sitting posture with a constant grasp and repeated movements set the maximum pain at joints of upper extremities (84.2%). In the nonstatic posture activities, it was also noticed that processing work includes frequent twisting affecting the majorly low back area. The previous study evidenced this factor by comparing it with the other tasks which seldom or never imposes a twisting posture.[8] Application of high force during manual handling activities, awkward or static posture, recurrence of same movements were some of the potential risks observed which have similarity with meat processing tasks.[9] Silverstein and co-employees defined highly repetitive jobs as those (1) cycle time of lesser than 30 s or (2) >5 of the cycle time performing the same type of work cycles.[10] Most of the tasks at the fish processing factories satisfy both conditions and also the study from Iceland[3] debated for muscular or joint pain that happened due to repetitive movements. Other than the ambient temperature situation (>40°C or <10°C), employees also face constant contact with extremely cold water, lack of protection from cold areas, and endless exposure to cold products contribute to the development of MSP.[3]

The limitation of the study is recall bias and subjective answering may be one of the problems encountered. However, the study targeted the least neglected rural and heterogeneous population of the community. The uniqueness lies in attempting to identify various characteristics of MSP with rare literature background as available evidence.

Musculoskeletal problems in the industrial sector have gained significant focus due to their ill effects. The work condition and nature of the job in fish processing factories have resulted in high MSP of different characteristics among its employees. This information could advantageously be used to plan an educational design followed by a treatment strategy to improve employees' quality of life. Ergonomic programs depending on-site design and nature of the work should also be initiated to address the neglected complaints at the workplace as a preventive measure.

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Conflicts of interest

There are no conflicts of interest.


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