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Musculoskeletal disorders in hotel restaurant workers

Article  in  Occupational Medicine · February 2004

DOI: 10.1093/occmed/kqg108 · Source: PubMed

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 Occupational Medicine 2004;54:55–57
DOI: 10.1093/occmed/kqg108

SHORT REPORT

Musculoskeletal disorders in hotel restaurant

workers
Jong-Yu Adol Chyuan1, Chung-Li Du2,Wen-Yu Yeh3 and Chung-Yi Li4

Background A variety of occupational groups have been shown to experience elevated risks of
work-related musculoskeletal disorders (WMSD). Little information on WMSD is
available in hotel restaurant workers.
Objective To document the profile of WMSD in a sample of hotel restaurant workers in
Taiwan.
Methods A self-administered questionnaire was used to gather information regarding body
site specific WMSD, pain intensity and strategies for pain relief amongst a sample of
hotel restaurant workers.

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Results Among 905 restaurant workers, 785 (84%) reported experience of WMSD in the
previous month, with the highest prevalence rate found for the shoulder (58%). The
highest mean score for perceived pain intensity was found for the lower back/waist
(2.50 points). Despite a high prevalence rate, only a small portion of those reporting
WMSD (12%) considered their work capacity or activities of daily living to be
affected by WMSD, and only <5% of workers with WMSD sought medical
treatment.
Conclusion WMSD related pain is common among hotel restaurant workers in Taiwan, but it
does not appear to interfere with job performance or daily living. Self-treatment and
alternative therapies that have not been evaluated for effectiveness are commonly
employed by hotel restaurant workers.
Key words Epidemiology; prevalence rate; work-related musculoskeletal disorders.
Received 29 May 2002
Revised 27 November 2002
Accepted 16 June 2003

Work-related musculoskeletal disorders (WMSD) can
affect almost all parts of the body especially the back,
neck and upper limbs, depending upon the physical
movement characteristics, and the ergonomic and
mechanical design of work tasks [1,2]. Using statistics for
1
Department of Restaurant, Hotel and Institutional Management, College of
Human Ecology, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan.
2
Division of Occupational Medicine, Institute of Occupational Safety and
Health, Council of Labor Affairs, Executive Yuen, Taiwan.
3
Division of Occupational Hygiene, Institute of Occupational Safety and
Health, Council of Labor Affairs, Executive Yuen, Taiwan.
4
Department of Public Health, College of Medicine, Fu-Jen Catholic
University, Hsinchuang, Taipei Hsien, Taiwan.
Correspondence to: Chung-Yi Li, Department of Public Health, College of
Medicine, Fu Jen Catholic University, 510, Chung Cheng Road, Hsinchuang,
Taipei Hsien, 24205 Taiwan. e-mail: chungyi@mails.fju.edu.tw
2000 from the Tourism Bureau of Taiwan, we identified a
total of 30 five-star hotels in Taiwan, 24 of which agreed
to participate in a cross-sectional survey. Between April
and July 2001, a total of 905 out of 910 restaurant
workers from the 24 hotels completed the survey.
Because of workers’ possible sick leave or scheduled time
off, we visited each of the hotels several times during the
study period in order to maximize the response rate. We
also provided a gift as an incentive for the workers to
respond to our request.
We used an adapted Nordic Musculoskeletal Question-
naire to inquire about musculoskeletal symptoms over the
month prior to the survey [3]. A 3 week test–retest
evaluation period for the reliability of the questionnaire
was administered to 15 restaurant workers at a campus
restaurant. It revealed a Spearman’s ρ coefficient of 0.92.

Occupational Medicine, Vol. 54 No. 1

© Society of Occupational Medicine 2004; all rights reserved 55
56 OCCUPATIONAL MEDICINE

Table 1. Body-site-specific prevalence rate, severity and copying strategies for musculoskeletal pain or discomfort (n = 905)

Site of pain n Prevalence (%)a Severity score Coping strategies (%)

(mean)a,b
Ignore Self-managec Alternative Medical
medicined treatmentse

Neck 491 54.3 2.32 35.2 41.1 19.3 4.3

Shoulder 524 57.9 2.36 38.9 37.4 22.3 3.8
Upper arm 292 32.3 2.33 25.1 36.6 18.2 3.1
Lower arm 247 27.3 2.27 20.6 38.9 16.6 3.6
Finger/wrist 421 46.5 2.41 27.1 39.4 24.7 4.3
Upper back 296 32.7 2.41 22.0 36.8 23.6 3.0
Lower back/waist 477 52.7 2.50 33.0 35.2 25.6 5.2
Upper leg 202 22.3 2.26 17.5 41.6 14.9 1.0
Knee joint 307 33.9 2.38 21.2 41.7 18.9 5.5
Lower leg 304 33.6 2.29 22.0 50.3 11.5 2.6
Ankle/foot 387 42.8 2.39 27.5 44.4 17.8 2.8
Overallf 758 83.8

a
The Spearman ρ coefficient for the correlation between prevalence and severity score was 0.51.
b
Based on a five-point scale in which a higher score is indicative of a higher degree of pain.
c
Using ointment, ice and/or heat pack to relieve pain or simply bed rest.
d

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Massage, spinal manipulation, fixing a dislocated bone by massage, acupuncture, physical therapies and/or taking herbs.
e
Participating in a rehabilitation programme or exercise regimens, and/or taking pain-relief medicine such as non-steroidal anti-inflammatory drugs or muscle
relaxants.
f
Those who complained that at least one body part was suffering pain.

Table 2. Perceived pain—time of occurrence and influencea

A panel of four experts also evaluated the content validity. (n = 758)
The self-administered questionnaire sought information,
Prevalence
including body-site-specific perceived pain, pain intensity
score, pain frequency, influence of pain on work and n %
activities of daily living, and strategies for pain relief. For
each body part, the pain intensity was recorded on a Time of occurrenceb
Before workc 125 16.5
horizontal line showing, from left to right, the numbers During work 396 52.2
1–5, where 1 indicates the least and 5 the most painful After workc 490 64.6
condition, respectively. In sleep hours 122 16.1
The study participants were generally young, aged Frequency (days)
>3 per week 224 29.6
33.3 ± 11.3 years (mean ± SD). The average length of 2–3 per week 234 30.9
employment with current job title was 8.0 ± 8.3 years. 2–3 per month–1 per week 122 16.1
Overall, 758 (84%) participants reported experience of <2–3 per month 178 23.5
Influence on work/moderate activities of daily livingd
WMSD related pain. The highest prevalence rate of
Not at all 379 49.9
perceived pain was found for the shoulder (58%), Slight 291 38.4
followed by the neck (54%) and lower back/waist (53%). Moderate 65 8.6
The top three highest pain intensity scores were found for Strong 23 3.1
Absent from work due to pain or discomfort
the lower back/waist, upper back and finger/wrist, with a
Ever 92 12.2
mean of 2.50, 2.41 and 2.41, respectively. A majority Never 666 87.8
of the workers reporting WMSD chose to ignore or
a
self-manage the pain. Additionally, workers preferred One month period prior to the interview.
b
alternative therapies to medical treatments for pain relief Multiple choices.
c
(Table 1). Within a 2 h period.
d
We found that 65% of participants with WMSD Such as moving a chair/table, pushing a vacuum cleaner, lifting cups, bowling
or walking.
reported pain within 2 h of finishing work, 52% reported
pain during work and 16% reported pain during sleep.
Despite the high overall prevalence of WMSD among affected by pain, and only 12% of workers with WMSD
study participants, only a small proportion (12%) reported absence from work due to pain (Table 2).
considered their work capacity or activities of daily living We found a moderate (Spearman’s ρ = 0.51) cor-
 J.-Y. A. CHYUAN ET AL.: MUSCULOSKELETAL DISORDERS IN RESTAURANT WORKERS 57
relation between body-site-specific prevalence rates and
pain intensity scores, which may mean that the most
frequently reported body-site-specific WMSD may not
necessarily cause the most painful symptoms. Thus
‘frequency or prevalence’ and ‘severity’ of WMSD should
be assessed separately as they could represent two
different aspects of disorders. A previous survey of the
semiconductor industry workers in Taiwan reported neck
and shoulder pain in 38% of workers [4]. Professional
drivers and nurses were also found to experience higher
rates (51–77%) of low back pain [5,6]. Our study found
that WMSD related pain is even more prevalent among
hotel restaurant workers in Taiwan, but WMSD does not
appear to interfere with job performance and daily living,
and so does not cause inconvenience in the workers’ daily
life. Self-management strategies and alternative therapies
are commonly adopted by the study participants to gain
pain relief, but these therapies have not been system-
atically assessed for their effectiveness.
Acknowledgement
The study was supported by grants from the ROC National
Science Council, NSC-89–2511-S-030-002.
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