Martin-Marantes, Julio D.

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    A descriptive study of work-related musculoskeletal disorders and other occupational safety & health issues among agricultural workers in Puerto Rico
    (2018-05-18) Martin-Marantes, Julio D.; Pomales-García, Cristina; College of Engineering; Torres García, Wandaliz; Figueroa Sánchez, Ivys; Irizarry, Maria de los A.; Department of Industrial Engineering; Ortiz, Gloribell
    Given the diverse tasks that are performed in a farm, agricultural workers are constantly exposed to injuries, suffer discomforts, and at risk of developing musculoskeletal disorders (MSD). With an estimated population of 30,000 agricultural workers in Puerto Rico, commonly from socio-economically disadvantaged communities, it is critical to evaluate their work conditions. In the first phase of the study, medical records of 4,686 patients were analyzed to compare the presence of MSD diagnostics among agricultural and non-agricultural workers who received services at the Castañer General Hospital Out-patient (OPD) clinic. With a Bonferroni corrected α-value=0.005, a Two-Sample proportion test (Z=3.35, P-value=0.000) show that as a group, agricultural workers receive a higher number of MSD diagnostics when compared to non-agricultural workers. However, no statistical difference was found within gender variables. The median of MSD diagnostics by agricultural workers is 2.25 while for non-agricultural workers is 1.94 (H=8.22, p=0.004). No significant difference was found among average number of MSD diagnostics for gender and work category. Among agricultural workers, the three most common body areas affected by MSD conditions were low back (19.9%), neck (8%), and the right shoulder (4.7%). For non-agricultural workers, the most common body areas affected were lower back (18.4%), neck (8.7%), and the left knee (4.5%). MSD conditions were classified in four groups: a) Pain, b) Arthritis, c) Discs and nerves conditions, and d) Muscle conditions. For agricultural and non-agricultural workers, MSD conditions in the category of Pain were the most common with 67.12% and 65.08%, respectively. It was also found that agricultural workers suffered more from conditions in the category of Pain than for Muscle conditions when compared with non-agricultural workers (Z=4.95, P-value=0.000). In proportion, it was also found that agricultural workers suffered more from Arthritis related conditions than by Muscle conditions (Z=5.23, P-value=0.000). Agricultural workers were found to suffer more of Discs and Nerves conditions than by Muscle conditions when compared with non-agricultural workers (Z =4.65, P-value=0.000). The data from the OPD Clinic showed enough evidence that agricultural workers as a group are at more risk of developing MSD conditions when compared with those who are not agricultural workers. For the second phase of this study, a questionnaire was designed to gather data of demographics information, musculoskeletal discomforts, and health and safety practices at the farms. A modified version of the Standardized Nordic Questionnaire was used to determine the parts of the body in which agricultural workers suffered pain in the periods of 7 days and 12 months. A visual and numeric scale based in the “Faces Pain Scale Revised” was included to facilitate the characterization of the level of pain in the different parts of the body. The sample consisted of 95 men and 5 women agricultural workers from farms in the south and west area of Puerto Rico in which their principal crops were coffee, mango, banana, plantain, and fruit trees. In a 12-month period, 66% reported pain in the lower back area, 51% in the shoulders, and 43% in the hands/wrists. In a 7-day period, 58% of the participants reported pain in the lower back area, 51% in the hands/wrists, and 38% in the shoulders. Moderate lower back pain was also reported with the higher average level of pain among participants (Average= 6.39; SD=2.79) for the period of 12 months and 7 days (Average=6.72; SD=2.53). These results can be compared with the information from the OPD clinic as low back pain and pain in the shoulders were the most common MSD conditions among agricultural workers treated at the clinic. In fact, of those participants of the questionnaire who reported suffering from lower back pain and pain in the shoulders, 74% and 56% respectively, reported to have received some type of medical treatment to relieve the pain in these areas. The analysis of the partial plots of a Random Forest analysis concluded that the reported level of pain is mostly affected by participant’s age, the body area, years of experience, and the academic degree. Most of the participants reported a moderate discomfort in all parts of the body. The area of the ankles and the lower back are more commonly to report “strong” levels of pain. On the other side, the area of the hands/wrists, knees, and shoulders were mostly related to moderate discomfort or pain. Participants within 30 to 40 years of age were less likely to report light discomfort while participants between 30 to 60 years of age were associated to reporting strong levels of pain. Those participants with more than 10 years of experience were more likely to report strong pain levels while those with less than 5 years of experience tend to report unbearable pain. Related to academic degree, participants with Intermediate, High School, or Associate/Technical Degree were more likely to report light to moderate discomfort and less likely to report unbearable pain independently of their academic degree level. During this research it was found that: a) the proportions of agricultural workers who suffer from MSD is higher than for non-agricultural workers, b) the median of MSD diagnostics for agricultural workers is significantly higher than for non-agricultural workers, c) agricultural workers suffered more from conditions classified as Pain, Arthritis, and Discs and nerves conditions when compared with non-agricultural workers, d) lower back and the shoulders were the most affected body areas among agricultural workers, e) there is no clear understanding by this population about trainings or knowledge required to perform the tasks in a safely manner. Inherently, it can be said that agricultural workers are at more risk of injuries, body discomforts, and MSD conditions when compared with non-agricultural workers.