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Int. J. Mgmt Res. & Bus. Strat. 2013 S Arun Vijay, 2013

WORK-RELATED MUSCULOSKELETAL HEALTHDISORDERS AMONG THE INFORMATION

TECHNOLOGY PROFESSIONALS IN INDIA:A PREVALENCE STUDY

S Arun Vijay1*

Objective: To study the prevalence of the Work-Related Musculoskeletal Health Disorders(WRMSDs) among the Information Technology (IT) professionals working at selected IT industriesin India. Study Design: A cross-sectional design was adopted to study the prevalence of WRMSDsamong the IT professionals in India. Materials and Methods: IT Professionals (N=300) belongingto the selected IT Industries located at four metropolitan cities in India formed the population ofthis study. A Nordic musculoskeletal questionnaire was used to capture the prevalence of self-reported musculoskeletal complaints among the samples along with their associated Annualdisability. A simple percentage technique with 95% confidence interval was adopted to study theprevalence of Musculoskeletal Health Disorders among the IT professionals. Results: 59% ofthe IT professionals reported that they had experienced some form of WRMSDs in the past 12months. Neck pain problems were the most frequently reported where 30% of the samples hadexperienced such problems in the past 12 months. Low back pain, wrists and hand pain and,the shoulder pain were the next frequently reported symptoms where the annual prevalencewas reported as 25%, 14% and 13% respectively. Conclusion: The study concluded that theWRMSDs are widely reported among the IT professionals working in the IT industries in Indiaand an appropriate prevention strategy needs to be carried out in order to enable them to workcomfortably.

Keywords: Work-related Musculoskeletal Disorders (WRMSDs), Information Technology (IT)Professionals, Information Technology Industries, India

*Corresponding Author: S Arun Vijay,[email protected]

INTRODUCTIONWork-Related Musculo-Skeletal Disorders

(WRMSDs) are common among computer

professionals. Musculoskeletal disorders are

1 KG College of Physiotherapy, KG Campus, Saravanampatti Post, Coimbatore-641035, Tamil Nadu, India.

Int. J. Mgmt Res. & Bus. Strat. 2013

ISSN 2319-345X www.ijmrbs.comVol. 2, No. 2, April 2013

© 2013 IJMRBS. All Rights Reserved

work-related when the work environment and

performance of work are significant contributors

to their development or exacerbation, but are not

the sole determinant of causation. Thus, a

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disorder is work-related when work procedures,

equipment, or environment contribute significantly

to the cause of the disorder (WHO, 1985). The

WRMSDs describe a wide range of inflammatory

and degenerative disease conditions that result

in pain and functional impairment affecting the

neck, shoulders, elbows, wrists, and hands.

Moreover, the WRMSDs are defined differently in

different studies; some investigators restrict the

case definitions based on Clinical Pathology,

some due to the presence of symptoms, and

some due to ‘object ively’ demonstrable

pathological processes, and some due to work

disability (such as lost work time status). The

most common health outcome has been the

occurrence of pain, which is assumed to be the

precursor of more severe disease (Riihimaki,

1995).

The Indian IT Industry, comprising IT and IT

enabled services has grew from USD4 bn in the

year 1998 to USD52 bn in 2008, employing over

2 million people (NASSCOM, 2010). As a

proportion of National GDP, the IT sector revenues

have grown from 1.2% in financial year 1998 to

an estimated 7.5% in the year financial 2012

(NASSCOM Strategic Review, 2012). Bureau of

Labor Statistics (BLS) estimated that 1.64 million

new IT jobs would be created within the period of

2004 to 2016 (BLS, 2007). According to this

bureau, one out of four new jobs will be IT related

(Guna Seelan Rethinam and Maimunah Ismail,

2008). In India, there were approximately six

computers per thousand populations with an

installation of 18 million personal computers and

their number is increasing all the time (Sharma

et al., 2006). India has been in the forefront in

cyber world in which the Indian IT sector is

growing rapidly with 2,236,614 working in it

(NASSCOM Fact Sheet, 2009). During the

financial year 2012, the direct employment in the

Indian IT sector is expected to reach nearly 2.8

million, an addition of 2, 30,000 employees, while

indirect job creation is estimated at 8.9 million

(NASSCOM Strategic Review, 2012). From these

data, it can be seen that not only the number of

computer users increasing, exposure to

computer-related risk factors are also increasing.

With an increase in the frequency, intensity, and

popularity of computer use inside and outside of

work and at home, the incidence of work-related

illnesses and injuries has increased.

Video Display Terminal (VDT) workers are

particularly susceptible to the development of

musculoskeletal symptoms, with prevalence as

high as 50% (Gerr and Marcus, 2002). The meta-

analysis was done by Lim et al. (1998) NIOSH-

National Institute for Occupational Safety and

Health found musculoskeletal discomfort to be

as or more prevalent than visual discomfort with

prevalence rates of 20-75% among the computer

operators. Conformance to this findings, other

studies also reported musculoskeletal disorders

prevalence rate of 20% to over 75% among the

computer users (Hsu and Wang, 2003; Ming et

al., 2004). Sharma et al. (2006) conducted a

cross-sectional study about the computer related

health problems among the IT professionals in

Delhi and reported that 93% of subjects had one

or more than one computer related problems

which is very high computer related morbidity. The

common musculoskeletal symptoms reported

were pain (55%), and stiffness (14.8%) and the

common sites affected with musculoskeletal

problem were neck (44%), low back (30.5%),

wrist/hand (19%) and shoulders (12.5%). Another

study investigated the prevalence of self-reported

musculoskeletal symptoms in all the body regions

in the general population of office workers

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(n=1428) using a self-reported questionnaire

showed the following 12 months prevalence rates:

head/neck (42%), low back (34%), upper back

(28%), wrists/hands (20%), shoulders (16%),

ankles/feet (13%), knees (12%), hips (6%) and

elbows (5%) (Janwantanakul et al., 2008).

Approximately, 76% of computer professionals

from India reported musculoskeletal discomfort

in various epidemiological studies (Richa Talwar

et al., 2009; Bhanderi et al., 2007; Sharma et al.,

2006; Bhanderi, 2003). Recently in a study done

in Mumbai, it was reported that musculoskeletal

symptoms (63%), Ocular problems (68%) and

psycho-social problems in the form of stress

(44%) were the key health problems among the

computer professionals (Saurabh R Shrivastava

and Prateek S Bobhate, 2012). Thus, the

prevalence of WRMSDs are increasing among

computer users throughout the world (Bergqvist

et al., 1992; Andersen et al., 2003; Luis, 2003).

In this article, the term ‘WRMSDs’ are limited

and lessened down to the symptoms consisting

of general ache, discomfort and pain related to

nine body segments. The term ‘IT professional’

is applied to those belongs to the programming

and software development division only. Thus, the

objective of this study is to document the

prevalence of the musculoskeletal health

disorders among the IT professionals working at

selected IT industries located in four metropolitan

cities in India.

STUDY DESIGNA cross-sectional design was adopted to study

the prevalence of musculoskeletal health

disorders among the IT professionals in India.

SUBJECTSIT employees (N=360) working in the private IT

industries located at four metropolitan cities

(Chennai, Coimbatore, Bangalore and

Hyderabad) in India formed the population of this

study. Six corporate IT industries were covered

with 60 samples were recruited from each

industry using criterion sampling methods. The

criterion for including the samples in to this

questionnaire survey includes: age (i.e., 25-35

years), duration of working hours (at least 4 h a

day or 20 h per week); working in specific IT

division (programming and software develop-

mental division); working only on day shifts and

those who are willing to participate in the study.

Further, the employees who are working in other

service domains of IT industry including support

services were excluded.

METHODOLOGYThe Nordic musculoskeletal questionnaire was

adopted in this study to assess the nature and

severity of self reported musculoskeletal

complaints with respect to nine body areas such

as neck, shoulder, elbows, wrists/hands, upper

back, lower back, hips, knees and ankles/feet.

The occurrences of these symptoms over the

past week (weekly prevalence) and over the past

year (annual prevalence) were captured. Further,

during the administration of the questionnaire tool,

subjects who had more than one symptom were

asked to mark as ‘P1’ and ‘P2’ which indicates

their primary complaints (P1) and secondary

complaints (P2) respectively. However, for the

purpose to this study, only the primary complaints

of the subjects were taken into consideration. All

the subjects were distributed with the Nordic

musculoskeletal questionnaire along with the

covering letter briefing the purpose of this study.

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Questionnaires were distributed to 360

participants covering six IT companies with 60

samples were recruited from each company

using criterion sampling methods. 300 completed

questionnaires were returned along with signed

informed concern form. The response rate was

measured as 83%.

DATA ANALYSIS AND RESULTSThe reporting of the occurrence of the WRMSDs

among the IT professionals with respect to their

pain prevalence data were analyzed using simple

percentage techniques with 95% confidence

interval. The prevalence of WRMSDs reported in

this study was based on the primary

musculoskeletal complaints recorded by the

participating IT professionals through the

questionnaire tool.

Table 1 shows the gender specific distribution

of the primary musculoskeletal health disorders

among subjects participated in this study. The

occurrence of the musculoskeletal symptoms

with respect to two different time intervals

consisting of its occurrence in the last 12 months

and the last one week along with the subsequent

annual disability were captured. From theanalysis, it was inferred that 59% of subjectsreported to have one particular symptom as their

primary musculoskeletal complaint in the last oneyear in which 45% of them are reported to havesimilar complaints of that symptom in the last oneweek. Among those reported primarymusculoskeletal symptoms, 17% reported tohave annual disability. Taking in to considerationof the gender, 53% of male and 67% of femalereported that they are experiencing a particularsymptom as their primary musculoskeletalcomplaint in the last one year and 54% of femaleand 40% of male reported that they experiencesimilar symptom in the last week. Further, 21%of female and 14% of male were reported to haveannual disabili ty due to their primarymusculoskeletal symptoms.

The distribution of work related musculoskeletalhealth disorders with respect to difference body

locations in the IT professionals were depicted in

the Table 2 (Figure 1). It can be seen that over

both time frames, Neck pain problems were the

most frequently reported. 30% of the samples had

experienced such problems in the past 12

months, and 29% during the past week. In the

present data, lower back, wrists and hands, and,

shoulder problems were the next most frequent

types of musculoskeletal symptoms with annual

prevalence of 25% for lower back problems, 13%

for Wrists and Hands and 12% for Shoulder

problems.

Occurrence of WRMSDs Occurrence of WRMSDs Annual DisabilityGender Total (N) During Last 12 Months During Last 7 Days

N % 95% CI* N % 95% CI* N % 95% CI*

Male 171 91 53.21 50, 55 69 40.35 38, 43 24 13.50 11, 16

Female 129 87 67.44 65, 70 68 53.71 52, 56 27 20.93 19, 23

Total 300 178 59.33 57, 63 136 45.33 41, 49 51 17.0 13, 21

Table 1: Magnitude of Gender Specific Distribution of WRMSDsAmong the IT Professionals

Note: *CI-Confidence Interval.

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DISCUSSION OF FINDINGSThe present study is the documentation of the

prevalence of Work related Musculoskeletal

Health Disorders among the Information

Technology professionals in India. For the

purpose of attaining wider representation of the

samples among the Indian Information

Technology Industries, the IT industries located

at four metropolitan cities in India were selected.

A criterion based sampling method was adopted

to include the samples into this study which

includes: age, working hours (at least 4 h per day)

and the employees working at the specific domain

of IT industry (i.e., programming and software

developmental division) based on the

homogeneity of the nature of job. The age group

of all the subjects recruited for this study range

from 25 to 35, in which probability of the

occurrence of degenerative changes in the joints

were uncommon. The average mean age of all

subjects in this study was 28.5 years. Previous

studies had cited 4 h per day as being a critical

time for the development of musculoskeletal

disorders in employees working with visual

display unit (Rossignol et al., 1987).

WRMSD’s are disorders of the muscles,

skeleton and related tissues which have been

empirically shown or are suspected to have been

caused by a workplace activity (particularly a

repetitive activity). A disorder is work related when

work procedures, equipment, or environment

contribute significantly to the cause of the disorder

Table 2: The Distribution of Work Related Musculoskeletal Health Disorderswith Respect to Different Body Locations Among the IT Professionals

Human Body Occurrence of WRMSDs Occurrence of WRMSDs Annual Disability Location During Last 12 Months During Last 7 Days

N % N % N %

Neck 54 30.33 39 28.68 15 29.41

Shoulder(s) 23 12.92 18 13.24 5 9.80

Elbow(s) 4 2.25 3 0.70 1 0.20

Wrists and Hand(s) 24 13.48 20 14.71 6 15.69

Upper back 6 3.37 6 4.41 1 0.20

Lower back 46 25.24 36 26.47 17 33.33

Hips and Thigh(s) 5 1.12 1 0.20 1 0.20

Knee(s) 15 8.42 9 6.62 4 7.84

Ankle and Feet(s) 1 0.56 4 2.94 1 0.20

Total (N)=300 178 59.33 136 45.33 51 17.0

Figure 1: Pie-Chart Showing the AnnualPrevalence of WRMSDs Reported Among

the IT Professionals

Note: The values are expressed in percentage.

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(WHO, 1985). Throughout this study, the term

WRMSDs was used since most of the aliments

were arising out of low load static exertions and

static postures sustained for prolonged duration

of the computer work (Jeffrey et al., 2011).

Further, for the purpose of this study the term

WRMSDs related to nine body segments were

captured. To facil itate that, the Nordic

musculoskeletal questionnaire was used and it

had been applied to a wide range of occupational

groups to evaluate musculoskeletal problems,

including computer and call center workers

(Bergqvist et al., 1995; Cook et al., 2000). The

reliability of the Nordic musculoskeletal

questionnaire as a screening tool was proved by

earlier studies using a test-retest methodology

(Kuorinka et al., 1987). Other studies also

indicated that Nordic musculoskeletal

questionnaire tool is repeatable, sensitive and can

be used for screening and surveillance purpose

(Joame, 2007).

Overall, WRMSDs were widely reported by the

participating IT professionals in this study. Thus,

59% of IT professionals reported that they had

experienced one or more musculoskeletal health

symptoms in the past 12 months; 45% reported

that they had experienced one or more symptoms

over the past seven days. Contrary to these

findings, the results of other study done by

Sharma et al. (2006) reported that over 94% of

Indian IT professionals had one or more computer

related health problems. Other studies also

indicated that musculoskeletal discomfort to be

as or more prevalent than visual discomfort with

prevalence rates of 20-75% among the computer

operators (Lim et al., 1998; Hsu and Wang, 2003;

Ming et al., 2004). The difference in the findings

may be attributed to the fact that the present study

only focused on the musculoskeletal discomfort

rather than visual discomfort whereas the

previous study focused both. Unlike the earlier

study done by Sharma et al. (2006), the present

study reported the prevalence of musculoskeletal

health disorders in IT professionals working

specifically in the programming and software

developmental division whose job description is

homogenous in nature. This may be attributed to

the difference in the prevalence rate.

The other factors contribut ing to the

differences in the prevalence rate of computer

related problems in various studies were work

station environment, degree of mobilization and

levels of constrained posture, awareness levels

and practices of workers regarding computer

ergonomics (Sharma et al., 2006). The

understanding of the risk factors leading to such

high prevalence rates among computer users

was beyond the scope of this study and further

research is warranted.

In the present study, neck pain was the most

frequently reported whereas 30% (N=54) of the

subjects had experienced such problems in the

past 12 months, and 29% during the past week.

This 12-months prevalence value for neck pain

(30%) corresponds closely to the findings of

previous studies which reported that the annual

prevalence of neck pain was measured as 34.4%

(Korhonen et al., 2003). Further the reported

prevalence rate of neck pain in the present study

was considerably lower than the 63% value found

by Sillanpaa et al. (2003) and 48% reported by

Richa Talwar et al. (2009).

Low back pain, wrists and hand, and shoulder

pain were the next frequent types of WRMSDs

with annual prevalence of 25%, 14% and 13%

respectively. Contrary to the findings of the present

study, previous studies indicated that Annual

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prevalence of 35.6% for Low back pain, 23.1%

for Wrists and Hand and 15.7% for Shoulder pain

among the Computer Professionals (Richa

Talwar et al., 2009). A comparison of prevalence

rate is difficult due to different definitions of

musculoskeletal disorders adopted by various

studies. Further, the results of the present study

found that the Neck problem was most debilitating

causing reduction in Activities of Daily Living

(ADL) in 15% of subjects. Thus, the finding of the

present study validates the previous study done

by Cote et al. (2008) who reported that office

workers and computer users experienced the

highest incidence of Neck pain of all workers with

reported incidences ranging from 36 to 57.5 per

100 worker years where neck and upper limb

symptoms were common among the computer

users.

Ironically, a significant proportion of IT

Professionals in the present study reported that

they are experiencing more than one

musculoskeletal complaint over the last 12

months. Over this time period, 15% (N=45) of

the total subjects reported musculoskeletal health

complaints in more than one body areas among

the nine body areas assessed. This may be due

to various factors such as involvement of multiple

joints in computing tasks, anatomical and

biomechanical alignment of body motions, impact

of workstation design and other workplace

physical risk factors.

The present study also established the gender

differences in the Prevalence of WRMSDs. From

the results of this study, it was found that more

women, compared to men, were exposed to

WRMSDs. 67% (N= 87) of women had

experienced such problems in the past 12

months, and 53% (N=68) during the past week

whereas, 53% (N=91) of men had annual

prevalence of musculoskeletal symptoms and 40%

(N=69) during the past week. Further, from the

results of the this study, it was also found that the

musculoskeletal symptoms were most debilitating

causing reduction in Activities of Daily Living (ADL)

in 21% (N=27) of women and 14% (N=24) of men.

The finding of this study lend support to the findings

of earlier studies that prevalence of WRMSDs was

higher among women visual display unit operators

(Lena Karlqvist et al., 2002). The reason for this

gender differences may be due to the difference

in the occupational exposure among the men and

women (Dennis et al., 2000). But, in the present

study, all the subjects were performing a similar

type of job. Further, two other studies indicated

that women were more often exposed in working

conditions related to work tasks with low task

variability and work-rest probabilities (Kilbom

et al., 1998; Harenstam et al., 2001). So, the

possible explanation would be even in the same

occupations, men and women had different work

tasks with different durations and variations that

accounts for this gender differences in the present

study.

CONCLUSIONIt is concluded that WRMSDs are widely reported

by the IT professionals working in the IT industries

in India and 59% of them reported that they had

experienced some form of musculoskeletal health

symptoms in the past 12 months. Neck pain

problems were the most frequently reported

where 30% of the IT professionals had experienced

such problems in the past 12 months. Lower

back, wrists and hands, and shoulder problems

were the next most frequent types of

musculoskeletal disorders.

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Further, this study also demonstrated that

women IT professionals are more prone to

WRMSDs than men IT professionals. Thus, the

present study provides an alarming signal to both

the IT professionals and human resource

managers to understand the health issues of the

employees working with IT Industries and an

appropriate prevention strategy needs to be

carried out in order to enable them to work

comfortably.

SCOPE FOR FURTHERRESEARCH1. The risk factors contribut ing to the

occurrences of WRMSDs in IT professionals

are not captured in the present study. Future

studies to focus on the analysis of the risk

factors on the occurrence of WRMSDs are

warranted.

2. The present study was conducted on specific

population of IT professionals who are

working in the programming and software

developmental division. Similar studies can

be conducted on other divisions of IT

profession to find out the occurrence of work

related musculoskeletal disorders.

3. Further studies could find out the relationship

between the prevalence of work related

musculoskeletal health hazards and the

employees productivity.

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35. WHO (1985), “Identification and Control of

Work-related Diseases”, Geneva,

Switzerland, World Health Organization.

WHO Technical Report Series 174.

work-related musculoskeletal health disorders among the ...

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