OBJECTIVES: To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors.
METHODS: This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP.
RESULTS: The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99).
CONCLUSIONS: Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.
OBJECTIVES: To assess the effects of physical, cognitive and organisational ergonomic interventions, or combinations of those interventions for the prevention of work-related upper limb and neck MSDs among office workers.
SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, Web of Science (Science Citation Index), SPORTDiscus, Embase, the US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and the World Health Organization's International Clinical Trials Registry Platform, to 10 October 2018.
SELECTION CRITERIA: We included randomised controlled trials (RCTs) of ergonomic interventions for preventing work-related upper limb or neck MSDs (or both) among office workers. We only included studies where the baseline prevalence of MSDs of the upper limb or neck, or both, was less than 25%.
DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the interventions and outcomes in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach.
MAIN RESULTS: We included 15 RCTs (2165 workers). We judged one study to have a low risk of bias and the remaining 14 studies to have a high risk of bias due to small numbers of participants and the potential for selection bias.Physical ergonomic interventionsThere is inconsistent evidence for arm supports and alternative computer mouse designs. There is moderate-quality evidence that an arm support with an alternative computer mouse (two studies) reduced the incidence of neck or shoulder MSDs (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99), but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck or shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There is moderate-quality evidence that the incidence of neck or shoulder and right upper limb disorders were not considerably reduced when comparing an alternative computer mouse and a conventional mouse (two studies; neck or shoulder: RR 0.62; 95% CI 0.19 to 2.00; right upper limb: RR 0.91; 95% CI 0.48 to 1.72), and also when comparing an arm support with a conventional mouse and a conventional mouse alone (two studies) (neck or shoulder: RR 0.91; 95% CI 0.12 to 6.98; right upper limb: RR 1.07; 95% CI 0.58 to 1.96).Workstation adjustment (one study) and sit-stand desks (one study) did not have an effect on upper limb pain or discomfort, compared to no intervention.Organisational ergonomic interventionsThere is very low-quality evidence that supplementary breaks (two studies) reduce discomfort of the neck (MD -0.25; 95% CI -0.40 to -0.11), right shoulder or upper arm (MD -0.33; 95% CI -0.46 to -0.19), and right forearm or wrist or hand (MD -0.18; 95% CI -0.29 to -0.08) among data entry workers.Training in ergonomic interventionsThere is low to very low-quality evidence in five studies that participatory and active training interventions may or may not prevent work-related MSDs of the upper limb or neck or both.Multifaceted ergonomic interventionsFor multifaceted interventions there is one study (very low-quality evidence) that showed no effect on any of the six upper limb pain outcomes measured in that study.
AUTHORS' CONCLUSIONS: We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs. For other physical ergonomic interventions there is no evidence of an effect. For organisational interventions, in the form of supplementary breaks, there is very low-quality evidence of an effect on upper limb discomfort. For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort. Further high-quality studies are needed to determine the effectiveness of these interventions among office workers.
METHODS: Data for the years 2016 through 2018 were gathered retrospectively from several sources. These were existing Ministry of Health (MOH) influenza sentinel sites data, two teaching hospitals, and two private medical institutions in the Klang Valley, Malaysia. Expert consensus determined the final estimates of burden for laboratory-confirmed influenza-like illness (ILI) and severe acute respiratory infection (SARI). Economic burden was estimated separately using secondary data supplemented by MOH casemix costing.
RESULTS: Altogether, data for 11,652 cases of ILI and 5,764 cases of SARI were extracted. The influenza B subtype was found to be predominant in 2016, while influenza A was more prevalent in 2017 and 2018. The distribution timeline revealed that the highest frequency of cases occurred in March and April of all three years. The costs of influenza amounted to MYR 310.9 million over the full three-year period.
CONCLUSIONS: The study provides valuable insights into the dynamic landscape of influenza in Malaysia. The findings reveal a consistent year-round presence of influenza with irregular seasonal peaks, including a notable influenza A epidemic in 2017 and consistent surges in influenza B incidence during March across three years. These findings underscore the significance of continuous monitoring influenza subtypes for informed healthcare strategies as well as advocate for the integration of influenza vaccination into Malaysia's national immunization program, enhancing overall pandemic preparedness.