THE RELATIONSHIPS BETWEEN MUSCULOSKELETAL DISORDERS AND ANTHROPOMETRIC INDICES IN PUBLIC VEHICLE DRIVERS

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1 1173 THE RELATIONSHIPS BETWEEN MUSCULOSKELETAL DISORDERS AND ANTHROPOMETRIC INDICES IN PUBLIC VEHICLE DRIVERS Nasin Sadeghi 1, Ehsanollah Habibi 2, Seyed Ali Sajjadi 1 * 1 Faculty of Health, Gonabad Univesity of Medical Sciences, Gonabad, IR Ian. 2 Faculty of Health, Isfahan Univesity of Medical Sciences, Isfahan, IR Ian. * Coesonding Autho: Faculty of Health, Gonabad Univesity of Medical Sciences, Gonabad, IR Ian. sa_1344@hotmail.com, Tel: , Fax: ABSTRACT Intoduction: Musculoskeletal disodes (MSDs) ae vey common amongst dives. Accoding to the evious studies, MSDs and back ain ae two main causes of ca accidents. Objective: This study investigated the elationshi between body dimensions of dives and the fom of this tye of disodes. Method: The samle included 95 bus dives selected andomly. As instucted, the dives descibed the levels of discomfot in diffeent ats of thei bodies, based on the BDC chat. In the meantime the dimensions of thei bodies' wee measued. Then, using the Seaman test, the associations between anthoometic dimensions and MSDs wee investigated. Result: The esults showed that MSDs ae elated to the height, weight and age of dives. In othe wods, the moe weight and age, the moe obability of MSDs; while the height of dives showed the evese association. Conclusion: In conclusion, when ecuiting, the younge, talle and healthy eole should be selected to minimize the MSDs; and theefoe, ca cashes and accidents. Keywods: Anthoometic Indices, Musculoskeletal Disodes, Dives

2 1174 Intoduction MSDs0F1 ae fomed gadually in eole who have inaoiate osition when woking. These tye disodes may cause muscula ains and skeleton damages in diffeent ats of body such as waist, shouldes, ams and hands. MSDs also incease the ossibility of disc henia [1]. Public vehicle dives showed to have a highe evalence of MSDs, comaed to othe caees [2]. In view of the fact that the dives send long times behind wheels, MSDs ae ogessively fomed ove time; which may have consideable imacts on thei esonal and social life [1]. The evidence showed that the eole diving at least half of woking hous each day suffe thee times moe than othe wokes [3]. High evalence of sinal disodes obseved among ofessional dives, esecially back and neck ain, usually lead to constant suffeing and disease and obably e-etiement. [4]. A eview aticle claimed that these discomfots ae due to hysical, sychological and egonomics stessos [5]. Anothe study in Jaan that examined the isk factos of back ain eoted that the evalence of back ain among 285 taxi dives was 45.8% which is consistent with othe studies. [6] Miyamoto and his colleagues in an eidemiological study evealed that the evalence of back ain among 153 tuck dives was 50.3%. The esults also showed that the back ain was significantly associated with the fittingness of dive s seat, the diven distance, the oughness of oad which elated to the amount of vibations and wok-elated stess, as well as, thei woking histoy. [7]. In anothe study in the noth of India, Kuma and his colleagues found that the evalence of occuational back ain among tacto-diving fames was about 40% highe than the othe fames who did not dive tactos [8]. A eviewed study on moto vehicle dives and heavy equiment oeatos found that diving as a job could cause back disodes since thei tasks need the cetain ostues and involve activities such as lifting; which ae elated to those disodes. [9]. Rehn in his Ph.D. thesis studied MSDs among dives of foesty machiney and snow loughequied. He discoveed that the symtoms of MSDs in neck and ue limbs could be associated with long exosue to ovewhelming vibations and inaoiate ostue duing diving. [10] The elative isk of disc henia among tuck dives aeaed to be fou times highe than the othe dives, accoding to a study in Finland. This study evealed that thee was a significant obability fo moto vehicle dives to be admitted in hositals due to otusion of nucleus ulous [11]. Medical eots stated that, in geneal, MSDs contibute 78% of all diseases, 14% of all docto calls, and 15% of total hosital admissions. Moeove, health statistics evealed that aoximately 62% of atients with MSDs ae suffeing fom mobility limitations. Futhemoe, the total cost of MSDs in Canadian dives in the eiod of showed that this caee was in the thid lace of claiming the indemnification fo MSDs; so that, the insuance comanies had to deal with 4337 cases. [12]. 1 Musculoskeletal Disodes

3 1175 Mateial and Method In this study, the extent and evalence of MSDs, as well as, the levels of discomfots among dives wee investigated. In addition, the elationshi between the dimensions of dive's body and the extent of discomfots was studied. This analytical, coss sectional study includes two ats in which 95 bus dives wee andomly selected as samles. To event eetition, systemic coding was used fo both buses and dives. At fist, the cases got the equied instuction; then anthoomety was comleted and the dives filled in the BDC 2, as instucted Anthoomety Anthoomety o the measuement of body's dimensions is a subcategoy of hysical anthoology and it is elated to the diffeent ats of body's dimensions, body's movements and the stength of muscles [13]. Regading the study objectives, we selected secific dimensions. These dimensions included height, weight, and the length of ue limbs, the length of hands, ams, thighs and knees. Weight was measued by Kilogam, and scale of the othe aametes was centimete. Anthoomety was comleted though measuing the bodies dimensions, using, stadiomete, weighing scale and stadiomete seat. Then, the dives' BMI 3 was calculated. Finally, the outcomes categoized and defined as below: BMI: lowe than 19.8: unde weight, BMI: : nomal, BMI: 26-29: oveweight, BMI: highe than 29: obese [14] Body discomfot Chat We investigated MSDs using Body Discomfot Chat. BDC is a technique which assesses the degee of subjective discomfot that individuals exeience.[15] BDC consists of two ats; the fist at coves demogahic and backgound infomation, In the second at, dives wee asked to define thei discomfots accoding to the following categoies: Without discomfot, Mild discomfot, Modeate discomfot, Sevee discomfot. This chat includes discomfots in neck, shoulde, am, elbow, hand, foeam, finges, thigh, knee, leg, ankle, Ue back, and Lowe back. We categoize these discomfots as follows: Mild discomfot is beaable. Modeate discomfot needs medications. Sevee discomfot causes lack of ability in daily tasks. Afte collecting, data wee analyzed alying SPSS softwae. Descitive statistics including aveage, standad deviation and ange wee comuted fo data seies. Then, the elationshis between MSDs and anthoometic dimensions wee investigated, emloying Seaman coefficient coelation test. 2 Body Discomfot Chat 3 Body Mass Index

4 1176 Results The deive s age anged between yeas old with standad deviation of about The descitive anthoometic esults ae esented in Table1. Table1 goes hee. The BMI findings evealed that 4.21% of dives wee undeweight. BMI of 49.47% of dives was nomal % of dives wee oveweight; and 28.42% of dives wee almost obese. The esults of discomfot fo each at of body odeed by seveity ae shown in Figues 1-3. Figues 1-3 go hee Moeove, 6.3% of dives had one accident; the same ootion of dives had musculoskeletal sugey while 18.4% of dives had a vetebal disc sugey. 1.1% of dives wee alcoholic and 38.9% of dives smoked. 20% had digestive discomfots wheeas 50.5% had chonic back ain. 42.1% of dives claimed they had egula execises. The caee histoy showed that 96.5% of dives had had the same job. 52.6% of dives wee woking with heavy vehicle. 13.7% of dives woked moe than half of day each day. The esults of the elationshi between anthoometic dimensions and MSDs ae shown in Table 2. These esults wee deived fom Seaman coefficient of coelation in test. Table 2 goes hee. If is ositive, it means that the elationshi is diect; and if is negative, then the elationshi is evese. e.g.: The elationshi between the vaiables of age and neck ain is staight. (P-value <0.05, =0.176) We investigated the associations between MSDs and the elated factos such as evious job, woking hous, egula execise, and back ain, sugey and accident histoy. Those dives who woked moe than half of day had disodes in thei hands, wists and foeam. (P-value<0.05) Those who didn't execise egulaly had moe disodes in thei hands, finges, knees, legs, and wists (P-value <0.05) The dives who had chonic back ain, felt discomfots in neck, low back, knees and ankles. Those dives who had a vetebal disc sugey comlained about discomfots in thei elvis. The dives who had at least one accident in thei diving histoy had discomfots in thei thigh. The elationshis between body s dimensions and MSDs ae shown in Table 3. Table 3 goes hee. Discussion A simila study in Sabzeva found elationshis between that weight and scoliosis amongst tuck dives. [16] The autho also eoted associations between osition of diving seat and disodes

5 1177 in elvis and back ain. Ou findings wee consistent esults with the esults of this study; in addition, we found that these disodes also wee associated to anthoometic aametes.. Reviewing some simila studies evealed inconsistent esults. Fo instance, Kause and colleagues [17] did not eot links between age, weight and back and neck ain; whee as, in anothe study, thee was a significant elationshi between weight and back ain. [18]. Bigos and colleagues [19] did not find elationshis between weight and back ain. Similaly, Andeson [20] did not eot elationshis between age and back ain. Simila to othe studies which eoted elationshis between length of woking and neck and back, ou study found that some disodes wee statistically associated with woking hous.. This study also found links between MSDs and othe elated factos such as evious caee, the woking duation, egula execise, back ain, sinal sugey and accident. Futhemoe, we discoveed that the evalence of discomfots of knee was elatively high among dives whose evious job was not diving. What is moe, woking hous aeaed to be associated with the discomfots in foeam, wist, hand and finges, aticulaly among dives who woked longe than a half day.. Those dives who did not execise egulaly had discomfots in thei hands, finges, knees, legs and ankles. Those who had chonic back ain suffeed fom neck ain and disodes in knees, ankles and thighs. The dives, who had MSDs sugey, had ain in thei elvis. Those dives, who had a sinal sugey, had disodes in thei foeams. The dives, who had an accident in the ast, suffeed fom disodes in thei thigh. Individual lifestyle and woking and disease histoy elated to MSDs ae shown in Table 4. Table 4 goes hee. The findings of this study suggested the following consideations fo hiing new dives: They should be young, tall and fit and healthy. This aoach would be an effective way which deceases MSDs among ublic vehicle dives. We suggest that dives avoid long woking hous, esecially, those who had a sinal sugey o back ain. Dives should execise egulaly. We can also event MSDs and back ain by following techniques: coect ostues duing diving, eviving and eiodical beak, egula execise, even a shot walk, and getting in shae by losing weight fo oveweight eole. We also ecommend extending anthoomety fo all dives. By that we will be able to design moe suitable seats, so the dives can dive coectly and not suffeing fom inaoiate ostues in diving. Conclusion This study showed that dives' MSDs ae elated to thei height, weight and age. In othe wods, the high weight and age inceases the obability of MSDs; while the height of dives aeaed to be negatively associated. It seems eaching the steeing wheel esults in back and neck ain; theefoe, talle individuals send lowe enegy in thei body fo eaching to steeing wheel. Finally, it is bette; we select those who ae tall, young, fit and healthy fo diving jobs.

6 1178 Acknowledgements This was a at of an MSc Poject suoted by Isfahan Univesity of Medical Science. Conflict of Inteest: The authos declae that thee is no conflict of inteests Refeences 1. G.H. Sadi, A modal of bus dive s disease: isk factos and bus accidents, IJMS, Vol.27, No.1, Mach Sadi GH. Risk factos of musculoskeletal disease in bus dives, Ach Ianian Med 2003; 6(3): Bovenzi M., Zadini A., Self eoted low back symtoms in uban bus dives exosed to whole body vibation, Alied Egonomics,1994;25(4): Olanewaju O. Okunibido, Maianne Magnusson and Malcolm Poe, Delivey dives and low back ain: A study of the exosues to ostue demands, manual mateials handling and whole-body vibation, Intenational jounal of Industial Egonomics, volume 36, Issue 3, Mach 2006, ages Lenka Gallaisa and Micheal j. Giffin, a, Low back ain in ca dives:a eview of studies ublished 1975 to 2005, jounal of sound and vibation volume 298, Issue 3, 12 Decembe 2006, ages Funakoshi M. Tamua A. Taodo K. Tsujimua H. Mishiyama K. Risk factos fo low back ain among taxi dives in jaan, San Ei shi 2003; 45(6): Miyamoto M. Shiai Y. Nakayama Y. Gembung Y. Kaneda K. An Eidemiologic study of occuational low back ain in tuck dives, jounal of Nion Medical School, vol.67 No.3, age: , Kuma A. Vaghese M. Mohan D. Mahajan. Gulati P. Kale S. Effect of whole body vibation on the low back ain. A study of tacto - diving fames in noth India, Sine 1999; 24(23)2506_ Teschke K. Nicole A.M. Davies H. Ju S. Whole body vibation and back disodes among moto-vehicle dives and heavy equiment oeatos, a eview of the scientific evidence, Ail 14, Rehn B., Nilsson T., Javholm B. Neuo Musculoskeletal disodes among dives of allteain vehicles- a case seies. BMC musculoskeletal disodes 2004, 5: Aghilinejad M., Fashad A.A., Ghafai M., Occuational medicine and occuational disease, second Vol.fist edition.119, age. Ajmand ublication, Albeta Injuy statistics and costs, woklace health and safety, Albeta injuy statistics and costs. Woklace health and safty htt://www3.gov.ab.ca/he/whs/ublications/df/eg017.df. 13. Moudi M.A., Anthoometic engineeing, Mazandean Body at discomfot scale, fi/include/ htm. 15. Katheleenl. Mahan, Escotts. stum, Kauses food, nutition. Diet theay, 11th, saundes 2004.

7 Hekmatshooa R., Lahmi M.A., The amount of Musculoskeletal Disodes (sine) evalence in dives, Sabzeva, egonomy j. 2003(31-35). 17. Kause, N. Ragland, D.R., Geine, B.A., Fishe, 1997, Physical wokload and egonomic factos associated with evalence of back and neck ain in uban tansit oeatos. Sain 22(18), Kelsey, J.L. Golden, A.L.1998, Occuational and woklace factos associated with low back ain, Occu Med: State At Rev.3 (1), Bigos, S.J, Slenge, D.M, Matin, N.A Back injuies in industy: a etosective study. Emloyee-elated factos. Sine11, Andeson, R., The back ain of bus dives, Pevalence in an uban aea of Califonia, Sine 17(12), (15).

8 1180 Table1: Anthoometic Statistics Vaiable Minimum Maximum Aveage (standad deviation) Height (6.3471) weight ( ) Ue limb length (3.7640) Am length (5.4972) Politeal length (3.6275) Politeal height (1.9649) knee length (3.4666) knee height (2.7536) Body Mass Index (4.0172) Table 2: The elationshis between anthoometic dimensions and age with MSDs (Seamen test esults) Anthoometic Paametes Discomfots in: Height weight Ue limb length Politeal length Knee length BMI Age Neck **0.245 **0.248 * Shouldes *o.170 * Ue back * Am * * * Elbow * ** *

9 1181 Low back * * Buttock * Thigh **0.291 ** Knee * Leg *0.173 * * Ankle * Table 3: The associations between body dimensions and MSDs Anthoometic indices Weight BMI Knee height Height Politeal length Sitting height Disode inceasing Neck, Shoulde, Buttock, Thigh, Leg Neck, Ue am, Elbow, Thigh, Leg, Ankle Shoulde Ue am, Elbow Ue / Low back, Knee, Leg Ue am, Elbow

10 1182 Table 4: The associations between esonal backgounds & habits on MSDs Agent: Dives who have woking histoy in diving dive moe than half of day don't execise egulaly have had back ain have had a sinal column sugey have had an accident Age and woking histoy Effect: Discomfots in knee wist, hand and finges hand, finges, knee, leg, ankle neck and sinal column elvis and foeam thigh neck and lowe back 30 The ecentage of disodes neck shoulde ue back ue am elbow lowe back lowe am wist hand, finges buttock femo knee foeleg ankle Figue 1: Distibution of Mild MSDs among dives

11 The ecentage of disodes neck shoulde ue back ue am elbow low back lowe am wist 0 Figue 2: Distibution of Modeate MSDs among dives hand, finges buttock femo knee foeleg ankle

12 The ecentage of disodes neck shoulde ue back ue am elbow low back low e am w is t hand, finges buttock fem o knee foeleg ankle Figue 3: Distibution of Sevee MSDs among dives