WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG THE MANUAL CONSTRUCTION WORKERS IN BANGLADESH (1).pptx

Thesis on WRM

1. THESIS DEFENSE (Spring-2024) UNIVERSITY OF INFORMATION TECHNOLOGY & SCIENCES (UITS) Department of Civil Engineering

2. Title of The Thesis Topic WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG THE MANUAL CONSTRUCTION WORKERS IN BANGLADESH

3. Thesis Supervisor Md. Mohiuddin Ahmed Assistant Professor & Course Coordinator, Department of Civil Engineering University of Information Technology & Sciences (UITS) Aeysha Siddika (ID: 2043459034) Md Abubakor Siddique (ID: 2043459007) Shamsur Rahman Rezowan (ID: 1943259038) Manjurul islam (ID: 1943259050)

4. OUTLINES OF THE STUDY Introduction Objectives of the Present Study Literature Review Methodology of the Present Study Results and Discussion Conclusion & Recommendations References

5. Introduction

6. INTRODUCTION Work-related musculoskeletal disorders (WRMSDs) are an increasing problem across the globe in Construction workers. The construction industry in Bangladesh employs a significant portion of the workforce, contributing to the country’s economic growth . Construction occupations in Bangladesh encompass a wide range of tasks, including masonry, carpentry, steel fixing, electrical work, plumbing, and heavy equipment operation and these jobs often require repetitive motions, heavy lifting, awkward postures, and exposure to vibration, leading to a higher risk of WRMSDs.

7. INTRODUCTION The construction work varies with a working condition like a residential, commercial, working at multiple sites, geographical location, work under different employers, weather condition etc. This variability in construction work makes it impossible to find the relation between work, working situation and WRMSD. The factors which play role in finding relation is poor working condition, lack of proper training, prolong working, poor working posture, poor health condition, improper break, timely completion of the task, and monotonous work. WRMSDs are the main problem facing construction workers which starts at an early age .

8. INTRODUCTION In the construction industry, common WMSDs include lower back pain, shoulder injuries, tendonitis, carpal tunnel syndrome, neck strain and also injuries other soft tissues. Factors contributing to WRMSDs among Bangladeshi construction workers include inadequate ergonomic design of tools and equipment , lack of training on proper lifting techniques, long working hours, poor workplace conditions, and limited access to healthcare services. Addressing these issues through proper training , ergonomic interventions, and workplace safety measures is crucial to improving the health and well-being of construction workers in Bangladesh.

9. Objectives of the Present Study

10. To assess the pattern of pain in different body parts , pain at different time zone, working in awkward postures, working with pace, doing pervasive jobs, meet with traumatic incidents, and consumption of alcohol/tobacco/smoke which leads to the development of work-related musculoskeletal disorders among the manual construction workers . Another objective is to find which age group and which type of construction occupation has more impact of WRMSD.

11. Literature Review

12. As a developing country, the construction industries and high-rise buildings in Bangladesh are increasing day by day. According to the construction workers Union and Real Estate and Housing Association of Bangladesh (REHAB), about 3.5 million people work in the construction industry of Bangladesh. As reported by the International Labor Organization (ILO) about 24,500 workers died each year in Bangladesh due to work-related diseases in all sectors. It is also estimated that approximately 8 million workers faced work-related injuries.

13. Among them construction workers are more than 40% . Work related Musculoskeletal Disorders (WMSDs) are one of the most common occupational diseases which mainly affects the lower back , neck and upper and lower extremities . These problems are known as injuries or pain in the various body parts like tendons, muscles, ligaments, blood vessels, nerves, body limb, back, neck, etc. The main causes of Musculoskeletal Disorders are working in awkward and static postures , repetitively body movement , exposure to forces and vibration .

14. Human Body Parts

15. Heavy loads handling also causes to Musculoskeletal Disorders (MSDs). Musculoskeletal Disorders (MSDs) have a long-term impact on both workers and management and also (MSDs) harm the workers both physically and financially . WRMSDs not only substantially deteriorate physical and emotional health and productivity of the industrial work force but also the most expensive form of work disability. Most of the construction activities in Bangladesh are handled by manual labors .

16. Methodology of The Present Study

17. A questionnaire form was prepared by reviewing research papers and after that questionnaire forms were given to construction workers to get necessary data consisting of general questions which are to be responded in 'Yes' or 'No' . During discussion symptoms and exposure conditions respect to their work recorded by research team members. Three hundred and eighty six male and eleven female construction workers doing various manual construction work were randomly observed , interviewed and video recorded at various construction sites.

18. Sample Questionnaire Forms

19. To fulfill the objectives of this study, the cross-sectional study was conducted among 397 employees (Male: 386; Female:11 ; age: >15yrs) from construction workers at Basundhara residential area , East Rampura , Keranigonj & Azimpur in Dhaka Division and South Matlab , Chandpur Zilla in Chattogram Division . The study was conducted during January to March 2024 . The cross-sectional study is a study in which a group of people is observed , or certain information is collected , at a single point in time or over a short period of time .

20. The workers participated in this survey was above 17 years and grouped in four age group such as 15-30, 31-40, 41-50 And > 50 years . Prior consent was taken from project owners , contractors and individual workers to carry out the research. In many workplaces, it is found that workers typically work for 7-8 hours per day , and at times, they may even work a full week without any breaks or holidays . Some workers are known as seasonal workers who used to work in some certain period or season in Bangladesh like winter & summer .

21. Data Collection by Research Team Members

22. Data Collection by Research Team Members

23. Data Collection by Research Team Members

24. Results & Discussion

25. Table 1: Demographic and other characteristics of construction workers (n=397)       (Mean ± SD) Parameter No. of worker Percentage Age Height Weight BMI Experience Age Wise 15-30 257 64.74 24.24 ± 4.22 5.34 ± 0.29 55.90 ± 7.49 21.32 ± 6.00 3.90 ± 3.11 31-40 94 23.68 35.36 ± 2.54 5.35 ± 0.22 61.44 ± 7.53 23.04 ± 2.40 10.08 ± 4.43 41-50 25 6.30 44 ± 1.90 5.38 ± 0.25 65.24 ± 7.24 24.26 ± 2.55 14.76 ± 7.21 ≥ 51 21 5.29 54.40 ± 8.51 5.29 ± 0.19 60.33 ± 8.17 23.15±3.02 21.02 ± 11.96 Gender Wise Male 386 97.23 29.71 ± 9.44 5.34 ± 0.27 58.04 ± 8.09 22.02 ± 5.21 6.96 ± 6.63 Female 11 2.77 28.63 ± 4.80 5.05 ± 0.08 51.45 ± 3.47 21.70 ± 1.19 3.95 ± 1.87 From Table 1, it can be observed that there are total 397 workers where 386 is male and 11 is female . Age wise 15-30 age group has maximum percentage and above 51 is lowest in percentage.

26. Types of work Excavation work 26 6.55 26.12 ± 9.52 9.33 ± 0.29 56.93 ± 8.22 22.40 ± 2.49 7.07 ± 3.86 Labour work 107 26.95 30.06 ± 9.50 5.34 ± 0.27 58.11 ± 8.22 21.37±2.45 7.07 ± 6.74 Form work 32 8.06 29.78 ± 9.44 5.34 ± 0.27 58.05 ± 8.09 22.66 ± 2.25 6.64 ± 6.03 Rebar work 47 11.84 26.43±8.73 5.35±0.28 56.31±7.97 21.16 ± 2.44 6.25±6.07 Masonry work 47 11.84 29.61±9.32 5.34 ±0.27 58.05 ±8.08 21.84 ± 2.45 6.97 ±6.59 Electrical work 33 8.31 28.55±9.54 5.35 ± 0.28 58.01±8.31 25.36 ± 15.38 6.17±6.79 Plumbing work 25 6.30 32.36±7.24 5.36±0.22 57.49±8.85 22.11 ± 3.75 8.23±5.23 Flooring/Tiling work 40 10.08 27.91±9.54 5.37±0.27 56.87±8.26 21.21 ± 2.90 6.41±4.79 Carpentry work 17 4.28 29.29±7.90 5.48 ± 0.22 61.17±8.84 21.91 ± 1.96 9.12±6.02 Painting / Fall-ceiling work 23 5.79 31.04 ± 6.98 4.46±0.28 61.91±8.23 13.48 ± 4.71 7.51±4.76 From the above table, it is seen that labour worker are maximum in number which is 107 and carpentry workers are found minimum which is only 17 .

27. Working experience 00 - 10 308 77.78 26.56 ± 9.44 5.33 ± 0.27 56.50 ± 8.08 21.57 ± 5.59 4.12 ± 6.63 11 - 20 74 18.69 38.64 ± 9.44 5.37 ± 0.27 63.35 ± 8.31 23.61± 2.70 14.54 ± 6.76 21 - 30 10 2.53 50.35 ± 7.25 5.48 ± 0.21 65.5 ± 7.46 23.49 ± 1.95 25.2 ± 11.2 ≥ 30 4 1.01 57 ± 3.17 5.27 ± 0.28 56.25 ± 6.23 22.22 ± 2.59 40 ± 10.73 BMI ≤ 18 23 5.79 32.09 ± 10.20 5.35 ± 0.29 58.1± 8.78 16.80 ± 0.83 21.57 ± 5.95 18 - 25 345 86.90 29.72 ± 9.44 5.35 ± 0.27 58.04 ± 8.09 22.01 ± 5.14 21.59 ± 5.59 ≥ 25 28 7.05 29.51 ± 8.21 5.35 ± 0.28 58.18 ± 8.45 22.05 ± 5.50 21.57 ± 6.03 From the above table, it is also seen that having working experience below 10 is maximum which is 77.78% and working experience greater than 30 is minimum which is found only 1.01%.

28. Table-2 shows number of workers experiencing pain in body part. Amongst age 100% workers belonging 50 or more than 50 ages feels pain in different body parts and at different time followed by 21-30 age group workers (87.16%). The 96.81% and 92.00% workers feel pain that is belongings to the age group 31-40 and 41-50. All female workers (100%) that interviewed and observed complaints about pain while 90.16% male workers complaints about pain. Table 2: Number of Workers Feeling Pain Parameter Total number of workers No. of workers feel pain Percentage of workers feel pain Age Wise 15-30 257 224 87.16 31-40 94 91 96.81 41-50 25 23 92.00 ≥ 51 21 21 100.00 Gender Wise Male 386 348 90.16 Female 11 11 100.00 Types of Work Excavation work 26 26 100.00 Labour work 107 84 78.50 Form work 32 32 100.00 Rebar work 47 46 97.87 Masonry work 47 46 97.87 Electrical work 33 33 100.00 Plumbing work 25 20 80.00 Flooring/Tiling work 40 36 90.00 Carpentry work 17 17 100.00 Painting /Fall-ceiling 23 20 86.96 Working Experience 00 - 10 308 271 68.43 11 - 20 74 74 18.69 21 - 30 10 10 2.53 ≥ 30 4 4 1.01 BMI ≤ 18 23 18 78.26 18 - 25 325 292 89.85 ≥ 25 49 49 100.00

29. Table-2 also shows that Among the occupation, workers engaged in Excavation work, Form work, Electrical work & Carpentry work 100% each , 78.50% Labour workers, 97.87% both rebar workers & Masonry workers, 80% Plumbing Workers, 90% Tiling Workers & 86.96% Painters complained pain in body parts. 100% workers having experience in between 11-30 years complaint pain in body parts and 87.99% workers having experience between 00-10 years . Table 2: Number of Workers Feeling Pain Parameter Total number of workers No. of workers feel pain Percentage of workers feel pain Age 15-30 257 224 87.16 31-40 94 91 96.81 41-50 25 23 92.00 ≥ 51 21 21 100.00 Gender Male 386 348 90.16 Female 11 11 100.00 Types of Work Excavation work 26 26 100.00 Labour work 107 84 78.50 Form work 32 32 100.00 Rebar work 47 46 97.87 Masonry work 47 46 97.87 Electrical work 33 33 100.00 Plumbing work 25 20 80.00 Flooring/Tiling work 40 36 90.00 Carpentry work 17 17 100.00 Painting /Fall-ceiling 23 20 86.96 Working Experience 00 - 10 308 271 87.99 11 - 20 74 74 100 21 - 30 10 10 100 ≥ 30 4 4 100 BMI ≤ 18 23 18 78.26 18 - 25 325 292 89.85 ≥ 25 49 49 100.00

30. Above Table-3 shows the total numbers of workers belongs to different age group in different occupational group of construction work. Table 3: Total number of workers in different construction occupation at different age group   Age:15-30 (n=257) (male= 250) (female=07) Age:31-40 (n=94) (male= 90) (female=04) Age:41-50 (n=25) (male= 25) (female=00) Age≥51 (n=21) (male= 21) (female=0)   n % n % n % n % Excavation work 23 8.95 3 3.19 0.00 0.00 Labour work 73 28.40 16 17.02 5 20.00 13 61.90 Form work 18 7.00 12 12.77 0.00 2 9.52 Rebar work 37 14.40 8 8.51 2 8.00 0.00 Masonry work 25 9.73 10 10.64 6 24.00 6 28.57 Electrical work 17 6.61 13 13.83 3 12.00 0.00 Plumbing work 12 4.67 11 11.70 2 8.00 0.00 Flooring/Tiling work 26 10.12 13 13.83 1 4.00 0.00 Carpentry work 11 4.28 5 5.32 1 4.00 0.00 Painting /Fall-ceiling work 15 5.84 3 3.19 5 20.00 0.00

31. Table 3 and Table 4 shows total number of workers and number of workers feeling pain in different age group at different construction occupations. Labour and Masonry Workers are highest in number for different age groups and they also feel pain in highest percentage comparing to other workers. Table 4: Number of workers feeling pain in different construction occupation at different age group   Age:15-30 (n=257) (male= 250) (female=07) Age:31-40 (n=94) (male= 90) (female=04) Age:41-50 (n=25) (male= 25) (female=00) Age≥51 (n=21) (male= 21) (female=0)   n Percentage of workers between age 15-30 n Percentage of workers between age 31-40 n Percentage of workers between age 41-50 n Percentage of workers age above 50 Excavation work 23 8.95 3 3.19 0.00 0.00 Labour work 54 21.01 14 14.89 3 12.00 13 61.90 Form work 18 7.00 12 12.77 2 8.00 0.00 Rebar work 36 14.01 7 7.45 2 8.00 0.00 Masonry work 24 9.34 10 10.64 6 24.00 6 28.57 Electrical work 17 6.61 13 13.83 3 12.00 0.00 Plumbing work 7 2.72 11 11.70 2 8.00 0.00 Flooring/Tiling 22 8.56 13 13.83 1 4.00 0.00 Carpentry work 11 4.28 5 5.32 1 4.00 0.00 Painting /Fall- ceiling work 12 4.67 3 3.19 5 20.00 0.00

32. From Table 5 (a), it is found that maximum 47.86% workers feel pain in lower back, the 2 nd maximum is 42.82% in arms/hands . 33.75% workers feel pain in Shoulders. Only 2.77% workers feel pain in wrists . Table 5 (a): Feeling Pain in different body parts by all workers Body Parts Total Percentage Head 63 15.87 Neck 31 7.81 Shoulders 134 33.75 Chest 36 9.07 Elbow 16 4.03 Arms/Hands 170 42.82 Wrists 11 2.77 Fingers/Thumbs 30 7.56 Upper back 19 4.79 Lower back 190 47.86 Thigh/ hip/ buttocks 40 10.08 Legs 65 16.37 Knees 30 7.56 Ankle/ feet/toe 21 5.29

33. Table 5(c): Details of pain while working in awkward postures, doing work with pace, doing pervasive jobs, after traumatic incidents and when consume alcohol/ chewing tobacco/smoke by all workers Parameters Total Percentage Working in Awkward Posture 46 11.59 Pace of work 79 19.90 Pervasive jobs 170 42.82 Traumatic Incidents 2 0.50 Addiction to Alcohol/chewing tobacco/smoke 92 23.17 Table 5 (b) reveals that 46.85% workers complaint about pain after working while 26.95% , 24.18% and 14.86% during working , during sleeping and in the morning respectively. From Table 5 (c), it is found that 42.82% workers carry out pervasive jobs , 23.17% workers addicted to alcohol/tobacco/smoke , working in awkward postures 11.59% , 19.90% workers do work in pace and only 0.50 % workers experience traumatic incidences . Table 5(b): Pain at different time zone by all workers Time zones Total % During working 107 26.95 After working 186 46.85 During Sleeping 96 24.18 In the morning 59 14.86

34. From Table 6 (a), It is found that lower back pain, arms/hands and shoulders are the top most body parts where workers feel pain. Lower back remains in top for 15-40 age group. On the other hand, age group 41-50 and above 51 arms/hands stands top. Feel pain in wrist is minimum. Table 6(a): Percentage of construction worker feel pain in different body parts of different age group Body part and other parameters Age:15-30 (n=257) (male= 250) (female=07) Age:31-40 (n=94) (male= 90) (female=04) Age:41-50 (n=25) (male= 25) (female=00) Age≥51 (n=21) (male= 21) (female=0)   n % n % n % n % Head 30 11.67 20 21.28 4 16.00 9 42.86 Neck 23 8.95 7 7.45 0.00 1 4.76 Shoulders 84 32.68 26 27.66 12 48.00 12 57.14 Chest 22 8.56 10 10.64 3 12.00 1 4.76 Elbow 13 5.06 2 2.13 0.00 1 4.76 Arms/Hands 99 38.52 40 42.55 15 60.00 16 76.19 Wrists 8 3.11 3 3.19 0.00 0.00 Fingers/Thumbs 16 6.23 10 10.64 4 16.00 0.00 Upper back 16 6.23 3 3.19 0.00 0.00 Lower back 110 42.80 51 54.26 14 56.00 15 71.43 Thigh/ hip/ buttocks 23 8.95 11 11.70 4 16.00 2 9.52 Legs 35 13.62 16 17.02 4 16.00 10 47.62 Knees 18 7.00 5 5.32 3 12.00 4 19.05 Ankle/ feet/toe 12 4.67 7 7.45 0.00 2 9.52

35. Table 6(c): Percentage of construction workers working in awkward posture, work with pace, doing pervasive jobs, meet with traumatic incidents and consume alcohol Parameters Age:15-30 (n=257) (male= 250) (female=07) Age:31-40 (n=94) (male= 90) (female=04) Age:41-50 (n=25) (male= 25) (female=00) Age≥51 (n=21) (male= 21) (female=0)   n % n % n % n % Working in Awkward 28 10.89 13 13.83 6 24.00 0.00 Pace of work 64 24.90 17 18.09 4 16.00 0.00 Pervasive jobs 99 38.52 46 48.94 10 40.00 15 71.43 Traumatic Incidents 1 0.39 1 1.06 0.00 0.00 Addiction to Alcohol 63 24.51 15 15.96 2 8.00 3 14.29 From Table 6(b), it is found that maximum number of workers complaints about pain after working belongs to all age group. During working time zone shows the 2 nd maximum . Table 6 (c) shows that all aged group workers are involved in pervasive jobs and the percentage is maximum in age group >51 yrs . Table 6(b): Percentage of worker feel pain at different time zone by different age group construction workers Time zones Age:15-30 (n=257) (male= 250) (female=07) Age:31-40 (n=94) (male= 90) (female=04) Age:41-50 (n=25) (male= 25) (female=00) Age≥51 (n=21) (male= 21) (female=0)   n % n % n % n % During working 60 23.35 34 36.17 6 24.00 7 33.33 After working 116 45.14 46 48.94 10 40.00 14 66.67 During Sleeping 70 27.24 16 17.02 6 24.00 4 19.05 In the morning 43 16.73 11 11.70 3 12.00 2 9.52

36. Conclusion

37. Several cases were responsible for the work-related musculoskeletal disorders among construction workers. Physical risk factor, psychosocial risk factor and individual risk factors as well as working in an awkward posture, prolong working time, inadequate break time, repetition of motions with high frequency, lift heavy materials are responsible of WRMSD. From the study, it can be concluded that the construction workers always works in unacceptable , unavoidable , uncomfortable and uncooperative conditions. The more incidence found in the lower back (47.86%) , arms/hands (42.82%) & shoulder (33.75%) .

38. Almost all age group workers are suffering from some sort of pain. From all age group workers feels pain after working. Among the occupation, 100 % workers engaged in Excavation work , Form work , Electrical work & Carpentry work feels pain in different body parts during different time zones. Only 11 woman workers were found during the study period on site and 100% woman feel pain in lower back and they all involved in labour work . Pain in the lower back has been experiencing by all age group workers.

39. Maximum number of workers were found in 15-30 age group & the number is 257 . Minimum workers were found 21 and all of them are above 51 yrs . age The workers doing labour work has been found the highest number followed by workers doing rebar work and masonry work . The symptoms of the work-related musculoskeletal disorders start at an early age . This disorders in construction workers will lead them to the disability in future . From the study it has found that the pervasive jobs is main responsible factor for the workers body parts pain.

40. Recommendation

41. The efforts are needed to be taken to reduce severity of work-related musculoskeletal disorders in construction work by introducing some training programs , prevention from working in an awkward posture, minimizing repetitive movements, avoiding lifting heavy materials, providing material handling devices, proper tools and medical facilities.

42. References

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