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Cultural differences in musculoskeletal symptoms and disability

Cultural differences in musculoskeletal symptoms and disability
Cultural differences in musculoskeletal symptoms and disability
Objectives To test the hypothesis that cultural factors such as health beliefs and expectations have an important influence on common musculoskeletal symptoms and associated disability, we compared prevalence rates in groups of workers carrying out similar physical activities in different cultural settings.

Methods We conducted a cross-sectional survey at factories and offices in Mumbai, India and in the UK. A questionnaire about symptoms, disability and risk factors was administered at interview to six occupational groups: three groups of office workers who regularly used computer keyboards (165 Indian, 67 UK of Indian subcontinental origin and 172 UK white), and three groups of workers carrying out repetitive manual tasks with the hands or arms (178 Indian, 73 UK of Indian subcontinental origin and 159 UK white). Modified Cox regression was used to calculate hazard ratios (HRs) for the prevalence of symptoms and disability by occupational group, adjusted for differences in sex, age, mental health and job satisfaction.

Results Reported occupational activities were similar in the three groups of office workers (frequent use of keyboards) and in the three groups of manual workers (frequent movements of the wrist or fingers, bending of the elbow, work with the hands above shoulder height and work with the neck twisted). In comparison with the Indian manual workers, the prevalence of back, neck and arm pain was substantially higher in all of the other five occupational groups. The difference was greatest for arm pain lasting >30 days in the past year in UK white manual workers (HR 17.8, 95% CI 5.4–59.1) and UK manual workers of Indian subcontinental origin (HR 20.5, 95% CI 5.7–73.1). Office workers in India had lower rates of pain in the wrist and hand than office workers in the UK. Only 1% of the Indian manual workers and 16% of the Indian office workers had ever heard of ‘RSI’ or similar terms, as compared with 80% of the UK workers.

Conclusions Our findings support the hypothesized impact of cultural factors on common musculoskeletal complaints. Current controls on hazardous physical activities in the workplace may not have the benefits that would be predicted from observational epidemiology.
0300-5771
1181-1189
Madan, Ira
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Reading, Isabel
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Palmer, Keith T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Madan, Ira
c6fd0de4-6d73-47eb-9e97-79a2941c8767
Reading, Isabel
6f832276-87b7-4a76-a9ed-b4b3df0a3f66
Palmer, Keith T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3

Madan, Ira, Reading, Isabel, Palmer, Keith T. and Coggon, David (2008) Cultural differences in musculoskeletal symptoms and disability. International Journal of Epidemiology, 37 (5), 1181-1189. (doi:10.1093/ije/dyn085).

Record type: Article

Abstract

Objectives To test the hypothesis that cultural factors such as health beliefs and expectations have an important influence on common musculoskeletal symptoms and associated disability, we compared prevalence rates in groups of workers carrying out similar physical activities in different cultural settings.

Methods We conducted a cross-sectional survey at factories and offices in Mumbai, India and in the UK. A questionnaire about symptoms, disability and risk factors was administered at interview to six occupational groups: three groups of office workers who regularly used computer keyboards (165 Indian, 67 UK of Indian subcontinental origin and 172 UK white), and three groups of workers carrying out repetitive manual tasks with the hands or arms (178 Indian, 73 UK of Indian subcontinental origin and 159 UK white). Modified Cox regression was used to calculate hazard ratios (HRs) for the prevalence of symptoms and disability by occupational group, adjusted for differences in sex, age, mental health and job satisfaction.

Results Reported occupational activities were similar in the three groups of office workers (frequent use of keyboards) and in the three groups of manual workers (frequent movements of the wrist or fingers, bending of the elbow, work with the hands above shoulder height and work with the neck twisted). In comparison with the Indian manual workers, the prevalence of back, neck and arm pain was substantially higher in all of the other five occupational groups. The difference was greatest for arm pain lasting >30 days in the past year in UK white manual workers (HR 17.8, 95% CI 5.4–59.1) and UK manual workers of Indian subcontinental origin (HR 20.5, 95% CI 5.7–73.1). Office workers in India had lower rates of pain in the wrist and hand than office workers in the UK. Only 1% of the Indian manual workers and 16% of the Indian office workers had ever heard of ‘RSI’ or similar terms, as compared with 80% of the UK workers.

Conclusions Our findings support the hypothesized impact of cultural factors on common musculoskeletal complaints. Current controls on hazardous physical activities in the workplace may not have the benefits that would be predicted from observational epidemiology.

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More information

Published date: October 2008

Identifiers

Local EPrints ID: 72550
URI: http://eprints.soton.ac.uk/id/eprint/72550
ISSN: 0300-5771
PURE UUID: b819b834-c6f2-4ada-8d4a-d1183e288862
ORCID for Isabel Reading: ORCID iD orcid.org/0000-0002-1457-6532
ORCID for David Coggon: ORCID iD orcid.org/0000-0003-1930-3987

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Date deposited: 18 Feb 2010
Last modified: 14 Mar 2024 02:42

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Contributors

Author: Ira Madan
Author: Isabel Reading ORCID iD
Author: Keith T. Palmer
Author: David Coggon ORCID iD

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