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Master projects - Cohort 2016

Asociación entre las condiciones ergonómicas de trabajo y la prevalencia de los trastornos musculoesqueléticos (TME) en infantes de marina terrestres y fluviales de la Armada Nacional de Colombia

Arrázola Ángel RAT
2016 MSc Thesis, LMU München.


Background: The information that exists about musculoskeletal disorders (MSDs) related to military activity is considerable but there is a lack of knowledge focusing on land and river marines. This study aimed to estimate the prevalence of back pain in these marines and to identify risk factors for these MSDs in the Colombian Navy.

Methods: We invited 240 marines to participate in a questionnaire study. Of these, 227 participated, 114 land (50,2%) and 113 river marines. The questionnaire included questions on years of service and psychosocial working, ergonomic working conditions as well as the Nordic questionnaire on MSD. Back pain was defined as dorsal and lumbar pain in the last 12 months. Descriptive statistics were followed by crude and adjusted logistic regression modelling.

Results: It was found that in descriptive analyses that the age, education, heavy load, daily work repetitive and uneven ground in both groups of marines are similar but is different in years of service in river marines (1- 5 years: 41,7%) than land marines. The back pain is similar in two kinds of marines but is higher among older marines (30-49 years 70.2%) and in those with more years of service (11 to 15 years: 80.2%); is greater among carrying heavier load (27-29%). carrying heavy load (adjusted Odds Ratio 2,28; 95% Confidence Interval (1,10 – 4,74) and years of service, 11-15 years of service: 2,37 (1,16 – 4,84).

Conclusions: Back pain should be decreased by program related years of service and age. They should be given training on how to carry loads to avoid musculoskeletal symptoms that can lead to illnesses or accidents.

Key words: carrying heavy load, years of services, back pain, marines, musculoskeletal disorders (MSDs)

Effort-reward imbalance and distress in Colombian university teachers: a cross-sectional study

Ramírez Olarte CJ
2016 MSc Thesis, LMU München.


Objective: Determine the association between Effort-Reward Imbalance - ERI – and the prevalence of distress in Colombian University teachers.

Background: The teaching profession is considered a high-stress level. The model for assessing ERI is useful to determine relationship with Common Mental Disorders –CMD Methods Survey work and health conditions in Latin America, including ERI questionnaire, and the GHQ-12-General Health Questionnaire- were applied to 225 teachers. The logistic regression model was applied for confounders.

Results: The prevalence of CMD was high in teachers. Factors such as gender, working hours/week and contract hours were significantly associated with high Over commitment. ERI -ERRatio- was associated with the presence of CMD. The risk of having CMD was twice when there is a high score for ERI.

Conclusions: The teaching job is associated with a high prevalence of CMD. The risk of CMD is twice when there is an Imbalance Effort-Reward in University teachers. The Over commitment factor is associated with women, the long hours of work per week and contracts for full-time work.

Ergonomic and psychosocial risk factors for musculoskeletal disorders in Chilean meat processing industry: a cross-sectional study

Reyes González, M A
2016 MSc Thesis, LMU München.


Background: Meat processing work implies an elevated risk of work-related musculoskeletal disorders due to ergonomic and psychosocial demands, which are understudied in Chile. This study assessed associations between the ergonomic and psychosocial conditions and disabling musculoskeletal pain in the upper limbs among Chilean meat processing workers.

Methods: A cross-sectional study was performed in 288 workers (response rate 99%) in two processing plants. Socio-demographics, ergonomic and psychosocial conditions and upper limb work disabling pain during the last 12 months were studied using questionnaires. Applying logistic regression analyses, Odds Ratios were estimated using pain as outcome and age, commuting, ergonomic load handling risk, psychological demands, decisional latitude, compensation and double burden as predictors.

Results: Seventy five percent of the population were men;. Forty seven percent of the workers had ergonomic risk, 48% reported high psychological demand, 49% low decisional latitude and 52% felt double burden. The prevalence of disabling pain was 17%. Protective factors was age (adjusted Odds Ratio for

30 - 39 yrs vs. <30 yrs 0.33; 95% Confidence Interval 0.15 – 0.74. adjusted Odds Ratio for 40+ yrs vs. <30 yrs 0.34; 95% Confidence Interval 0.14 – 0.83) and high psychological demands (2.50; 1.22 – 5.13). Not statistically significantly predictors were poor decisional latitude (1.91; 95% CI 0.94 – 3.89) and extensive commuting times (31 – 80 minutes 1.90; 95% CI 0.86 - 4.21).

Conclusions: Psychosocial risks might be important predictors of musculoskeletal symptoms. Prevention strategies should be comprehensive by integrating individualities, psychosocial demands, mental health and worker’s wellness.

Keywords: Meat-Packing Industry, Abattoirs, Musculoskeletal Diseases/epidemiology, Stress, Psychological/epidemiology, Workplace/psychology, Chile

Fatores psicossociais relacionados aus acidentes de trabalho com materiais biológicos em trabalhadores de hospitais de Curitiba

Honório da Silva Oba L
2016 MSc Thesis, LMU München.


Objective: Occupational exposure to biological materials has been considered a concern to health personnel. To prevent accidents, the identification of risk factors assumes strategic role for worker safety. The aim of this study was to evaluate the relationship between psychosocial factors and the occurrence of accidents with biological material.

Methods: A case-control study of 100 workers, from 25 hospitals at Curitiba - Brazil, monitoring their accident with biological material at a reference center in 2014 to 2015. The controls at the rate of 1 case for each control were selected in hospital cases. The 100 workers of control group were matched by age, sex and occupation. The instruments used were: ISTAS21 short version; GHQ-12 and Irritation Index. Variables as sociodemographic and work conditions were included to control confounding bias. Descriptive and conditional logistic regression analyzes were performed in EpiInfo7.1®program.

Results: The temporary work was associated with no accidents (OR = 0.06, 95% CI 0.01 to 0.92) compared with other kinds of contract. Double presence related to the domestic workload and family concerns valued at ISTAS21, was also associated with reduced risk of injury (OR = 0.34, 95% CI 0.15 - 0.77). The night shift (OR = 6.86, 95% CI 1.68 to 27.98) was associated with a higher risk of accidents compared to other shifts.

Conclusions: The double presence being a protective factor, it suggests that the worker is more concerned with others, taking heed more around you or be a feature of this population. Further studies are necessary for this or other psychosocial relations, considering that other factors were relevant in the bivariate analysis.

Keywords: Health personnel; Occupational exposure; biohazards; stress disorders; psychosocial factors.

Hazardous work: a look at the safety and health at work of garbage collectors in Asunción, Paraguay, 2013-2014

Flores Rodríguez LE
2016 MSc Thesis, LMU München.


Introduction: Garbage collector is a high-risk job, with exposure to a variety of occupational and non-occupational factors. Total injury rates of occupational accidents in these groups of workers are not known in Paraguay, moreover, nothing is known about accidents in the informal garbage collection sector the aim of the study was to estimate and to compare the prevalence of accidents at work in formal and informal garbage collectors of Asunción, Paraguay.

Methods: A cross-sectional study was conducted among 186 formal and 123 informal garbage collectors (response 84.5%, 56%). The 12-months-prevalence of occupational accidents and its association with socio-demographic factors (age, gender, education), employment conditions and working conditions (duration of employment, work shifts, safety (exposure to unprotected openings and holes, ladders, slopes, a lack of cleanliness, clutter, poor lighting, signage, lack of protection of machinery and Equipment and tools in poor condition), frequency of alcohol consumption, mental health, use of personal protective equipment (PPE), manual handling of waste) were examined using a structured questionnaire. Descriptive statistics, bivariate analysis (chi square test) and adjusted logistic regression models were carried out.

Results: Formal workers were younger (57% over 40 years old), all male and better educated (82% completed the first grade), compared to the informal group (7% over 40 years old, 68% males and 30% completed the first grade). The 12-months-prevalence of occupational accidents among formal garbage collectors was 37% vs. 30% among informal garbage collectors (p=0.1). Likewise, after adjustment for potential confounders no statistically significant difference between the two groups was found (Odds Ratio for informal workers as compared to formal workers 1.8; 95% Confidence Interval 0.8-4.0).Significant risk factors for the 12-months prevalence of accidents were lack of gloves2.5; 1.2-5.1) and poor safety conditions at the workplace (2.1; 1.0-4.3).

Conclusion: Prevalence of accidents at work among garbage collector is high, and in both groups of formal and informal workers. Workplace safety measures and use of gloves decrease the risk of accidents, therefore researches and interventions on occupational health related to this activity are necessary.

Musculoskeletal symptoms in garbage collectors in Quito city – a cross-sectional study

Puente Navarro TC
2016  MSc Thesis, LMU München.


Background: Household garbage collectors and street sweepers are exposed to highly demanding working conditions potentially associated with musculoskeletal symptoms. The aim of this study was to determine ergonomic and psychosocial risk factors associated with musculoskeletal symptoms in household garbage collectors and street sweepers in Quito city.

Methods: In 2014, a cross-sectional questionnaire was conducted in 102 household garbage collectors and 99 street sweepers (response70%). Based on validated questionnaire instruments taken from previous studies, the 7-day prevalence of back pain was determined. Employment conditions, job demand, job control, and ergonomic working conditions were considered as potential predictors in bivariate (Chi²- test) and logistic regression analyses.

Results: The 7-day prevalence of back pain was lower among street sweepers (29%) than among household garbage collectors (44%; p= 0.03). This difference was confirmed in the final multiple logistic regression model (adjusted Odds Ratio for street sweepers 0.5; 95% Confidence Interval 0.3-0.9). In the same model, low to medium job security was a risk factor for back pain (2.6; 1.4-4.9).In the sensitivity analysis, high job demand was statistically significantly related to work disabling back pain (2.5; 1.0-5.8). None of the ergonomic risk factors under study was statistically significantly related to back pain.

Conclusions: Almost half of the garbage collectors in our study suffered from back pain during the week prior to the study. Even though sample size was small the results contribute to the evidence that precarious employment conditions contribute to the development of back pain.

Key words: Garbage collectors- back pain – employment conditions.

Use of personal protective equipment for the prevention of Leishmaniasis in military personnel in Colombia

González de Vodniza AM
2016 MSc Thesis, LMU München.


Military personal deployed in tropical forests in Colombia are at high risk for acquiring Leishmaniasis. Therefore, the use of anti-mosquito Personal Protective Equipment (PPE; wearing a complete uniform with long sleeves impregnated with permethrin, using caps, boots and personal insecticides) is of uppermost importance in this population. The objective of this study was to consider predictive factors for the compliance with anti-mosquito PPE.

Compliance with PPE was explored in military personal deployed to the Caguán area of Colombia during the retraining period of 2014. The population answered a self-administered questionnaire. The association between personal characteristics, knowledge about Leishmaniasis (defined as having heard about a disease called Leishmaniasis), and the use of PPE were investigated using multiple logistic regression models.

The survey was answered by 300 recruits (response 84.3 %); 23% of them reported to apply all the required PPE, and 83% had heard about Leishmaniasis. In the adjusted regression model, knowledge about Leishmaniasis (aOR = 2.9; 95% CI 1.1-7.2) and working with the army more than five years (2.2; 1.1-4.1) were positively associated to PPE use.

Knowledge showed to be an important factor for the use of preventive measures. Teaching different strategies may help to lower the likelihood of Leishmaniasis infection in this high-risk population.

Key words: Military personnel, personal protective equipment, Leishmaniasis, knowledge.

Work-disabling musculoskeletal pain in Chilean cooper miners: a cross-sectional study

Méndez Campos JI
2016 MSc Thesis, LMU München.


Background: Mining workers are exposed to ergonomic and psychosocial risks, known to be related to musculoskeletal disorders. In Chile, few studies in this area are available, urging the need to determine ergonomic and psychosocial conditions associated with neck and back pain in miners.

Methods: A cross-sectional study was conducted in 2014 in Los Andes, Chile, with 343 mining workers (response rate 99.7%), classified according to tasks into operative (n=253) and administrative workers (n=79).

The adapted survey of Working Conditions and Health in Latin America, Nordic questionnaire of musculoskeletal pain and SUSESO-ISTAS21 questionnaire of psychosocial risks were applied. The main outcome was disabling neck and/or back pain in the last 12 months, which is pain that has not allowed performing habitual tasks. Descriptive, bivariate (chi² test) and logistic regression analyses controlling for potential confounding factors were performed.

Results: From all male workers considered, 94% had complete secondary/higher education. Prevalence of disabling neck and/or back pain in the last 12 months was higher in operative than administrative workers (14.9%; p=0.01), and no difference was observed between workers from main company and subcontractors. In bivariate analysis a statistically significant association was found between the presence of pain and low/medium job security (17.8%; p=0.04) and high strain jobs (29.3%; p<0.001). In the logistic regression analysis, workers in high strain jobs (OR 3.13; 95% CI 1.20-8.18) were at increased odds of disabling back pain, compared to low strain jobs.

Conclusion: High strain jobs may be related to disabling back pain in Chilean miners.

Keywords: Work-related musculoskeletal disorders, neck pain, back pain, miners.

Work distress among Peruvian health care personnel caring for patients with infectious diseases – a cross sectional study

Cam Pimentel GM
2016 MSc Thesis, LMU München.


Background: Health care personnel caring for patients with contagious diseases are at risk of work-related mental diseases especially in high burden countries. The aim of this study was compare the prevalence of work distress among health care personnel caring for patients with contagious diseases and not caring for patients with contagious diseases.

Methods: In a cross-sectional study 230 eligible participants of two hospitals of the social security system in Callao-Peru took part (response 88%). Health care personnel were screened for psychological distress using the 12-item short version of the General Health Questionnaire (GHQ-12). Work distress was defined as a GHQ-12 ≥5. Bivariate analyses identified factors potentially related to healthcare workers’ psychological distress. Factors with a p ≤ .05 were included in the final multiple regression model.

Results: Health care personnel were mostly female 68%, worked more than 5 years at the hospital 44% and reported low job security 26%. Personnel were caring for patients with infectious diseases 45%; the prevalence of work distress was 41%. In the final logistic regression model odds of distress in personnel not caring for patients with infectious diseases was 0.10 (95% Confidence Interval 0.05-0.22).

Conclusion: Our study shows a high prevalence of work distress in Peruvian health care personnel. This distress was associated with contact to patients suffering from infectious diseases. The study supports the proposal of proactive measures to address the psychological needs.

Keywords: Psychosocial, Health care Personnel, distress, work related, contagious diseases, General Health Questionnaire.