Study of musculoskeletal disorders risk factors and discomfort in sculptors in the north of Mexico

Abstract

BACKGROUND:

The sculpting craft must adopt awkward postures that lead to musculoskeletal disorders (MSDs).

OBJECTIVE:

This study investigated the prevalence of musculoskeletal discomfort (MD) and its associations with postural risk factors, demographics, and work characteristics among sculptors. They were determined the differences between MDs during the weeks of the study.

METHODS:

A longitudinal study was conducted; MD was investigated using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Posture was assessed using the Rapid Upper Limb Assessment method (RULA). Multivariate logistic regression (MLR) models analyzed associations with different factors. ANOVA was used to test for differences in MD prevalence.

RESULTS:

The analysis included 585 responses by body region. The prevalence of MD was high in the lower and upper limbs among sculptors (67.6%), with the lower back, upper arm, neck, and knees being the four most affected regions. Gender (female) (OR = 2.15), marital status (married) (OR = 1.80), health risk (obesity), the dual of a secondary job (OR = 1.94), job stress (OR = 2.10), duration of work (OR = 2.01), and difficulty keeping up with work (OR = 2.00) were significant predictors contributing to the occurrence of MD in different body regions. Only shoulder MD prevalence showed significant differences between study weeks.

CONCLUSIONS:

Sculptors suffer from MD. Demographic and work characteristic factors influence MD prevalence. Postural training, improved adaptation of work organization, and intervention guidance on ergonomic risks may reduce the prevalence of MD and the risk of MSDs in this population.

Keywords

Musculoskeletal pain posture art ergonomics prevalence health

1 Introduction

The prevalence of musculoskeletal disorders (MSDs) in the handicraft workforce and their associated risk factors has been broadly researched [1 –5]. The associations between musculoskeletal discomfort (MD), postural risk factors, demographics, and work characteristics have been documented in the handicraft workforce [6 –12]. Sculptors are considered craftsmen [13], and sculpting is an artistic activity in which decorative objects are made by hand or using simple tools [14]. The handicraft sector includes a wide range of occupations with common characteristics such as inactive sitting, repetitive and forceful body part movements, good hand-eye coordination, and fine manual dexterity. The occupations include artisans [16], goldsmiths [17], craftsmen [18], weavers [19], stone cutters [20], handicraft workers [15, 21], home-based workers [22], pottery workers [23], workers in the footwear industry [24], female handicraft workers [25], manual workers [26], and handicraft artists [27].

MSDs are painful conditions caused by the overuse of muscles, joints, nerves, tendons, and soft tissues [28 –32]. MSDs can affect many aspects of an individual’s life, particularly physical and mental well-being [30]. As described by the Bureau of Labor Statistics in the United States, MSDs are related to illnesses and injuries, accounting for 31.8% of all of them [31]. According to the International Labour Organization (ILO), 160 million work-related complaints are reported yearly. MSDs are related to multiple factors such as non-neutral postures, repetition, handling loads, vibration, and others that may contribute to these problems in occupational tasks [31]. Moreover, psychosocial, biomechanical, organizational, individual, and environmental factors may be involved [29].

Sculptors belong to the informal work sector (workers outside the formal employment sector neither taxed nor monitored by any form of government) suffering from musculoskeletal problems [3, 33]. Some studies [5 , 28] have investigated the prevalence of musculoskeletal discomfort among these workers. In one study, handicraft workers’ tasks were reported to cause MD problems in the neck, shoulders, elbows, wrists, lower and upper back, knees, and ankles [13]. Another study found a 38.5% prevalence of MD among sculptors. The most affected body parts were the legs (35%) and back (33%), followed by the neck (9%), shoulders (9%), hands and wrists (9%), elbows (3.5%), and chest (1.5%) [23].

Since MD is one of the most frequent occupational health problems, extensive epidemiological literature demonstrates the importance of occupational ergonomic factors for its occurrence [14]. However, there needs to be more information on the prevalence of musculoskeletal disorders in the informal sector to which the sculptors belong [3]. Furthermore, the sculptor’s work is associated with MD in various parts of the body [21] and with workstations lacking ergonomic conditions, which may cause them physical harm [18 –20]. On the other hand, discomfort increases with the presence of risk factors among sculptors [3 , 33]. Additionally, exposure to certain sociodemographic and work-related elements can cause the development of MSDs [36]. The nature of risk factors can be biomechanical, organizational, and physiological [25, 26]. Therefore, identifying risk factors for MSDs is necessary to know their causes and reduce their incidence [10]. In addition, given the nature of their jobs, sculptors are not considered for occupational health or protection schemes, thus leaving them even more vulnerable [14].

The association between MD and demographic and work characteristics in the population studied is scarce, as is the evolution of MD over time.

The current study aimed to investigate the prevalence of MD among sculptors. The study objectives were to (i) assess the exposure of workers to posture risk factors, (ii) determine the association between MD prevalence, posture risks factors, demographics, and work characteristics, and (iii) Determine differences in the prevalence of MD over a period of fifteen weeks.

2 Methods

2.1 Participants

The study participants were professional sculptors from the Art Association in the north of México. The sample size calculation considered the data from an author’s pilot study of the population of interest and recommendations stated in previous study [36]. The data were as follows:

The MD prevalence standard deviation (SD) was 0.1511, with 0.05 precision error and a significance level of 0.05. The adjusted sample size was n = 39, considering a 10% of drop out. In accordance with the recommendations of the previous longitudinal study of MD [37]. The judgment sampling method was applied to conform the sample according to the following inclusion criteria:

The worker should be over 18 years of age.

The worker should have worked for at least one year in their current occupation.

The worker should have worked at least five hours daily.

The worker should not have been pregnant or be under medical treatment.

The worker should have no previous musculoskeletal injuries.

2.2 Procedure

One of the authors acted as coordinator for the study, and an e-mail invitation, including a participant information sheet, was sent to Art Association members’ mailing lists. The study was accepted according to the approval letter CE-2022-01 (Asociación Sonorense de Artistas Plásticos Ethics Committee approved January 22, 2022). The selected sculptors (n = 39) stated their agreement to participate.

A session was held by the authors to introduce the methodology and purpose of the study. After giving their written consent, briefings were given to sculptors on how answer the questionnaire. During the initial visit, the authors noticed that workers were unaware of the occupational risk factors in their workplace. Sculptors routinely started their activity from 3 : 00 to 9 : 00 p.m. from Monday to Friday. The administration of the MD questionnaire occurred during the afternoon period.

2.3 Study design

A longitudinal prospective study was conducted over fifteen consecutive weeks in 2022 using a self-reported MD questionnaire and the Rapid Upper Limb Assessment method (RULA) [39]. RULA is the preferred ergonomic assessment tool due to its simplicity, efficiency, and widespread recognition. RULA provides a systematic approach to evaluate postures, forces exerted, and muscle activity (static posture or repetitive movements) with a specific focus on upper limb tasks, which aligns within the scope of this study.

2.4 Materials

The sculptor’s weight and height were measured using a digital weighing scale (180 kg capacity and 0.05 kg resolution) and a GPM stadiometer (Rudolph Martin, range 0–2100 mm). All participants’ body mass index was calculated to determine their health risk level (Ideal weight, overweight, and obesity) [38]. A repeatability and reproducibility study of the weighing scale and the stadiometer was conducted. The acceptability of the measurement system was confirmed. The most demanding postural tasks were identified using video and digital photography resources (4K Camcorder 10X Optical Zoom Camera ORDRO Ultra HD Wi-Fi Video Camera).

2.5 Sculpture task description

The observation of the sculptor’s tasks lasted more than one week and occurred within their schedules (3 : 00 p.m. to 9 : 00 p.m.). The sculptural process starts with sifting the soil, then hydrating and pouring it in plaster of Paris piles for moisture reduction, followed by the kneading process. The prepared model and mold must be then dried to start slip casting. The final step is to remove the piece from the mold for drying, firing, painting, and curing.

2.6 Posture risk assessment

The posture analysis was performed using the RULA observational method [39]. Additionally, to prevent inter-observer variability, the same rater assessed the posture in the study population (kappa statistic, k = 0.79, 95% CI [0.70–0.88]).

Some of the affordances of observational methods are their usability and applicability to several scenarios [40]. Additionally, they are inexpensive, flexible, and do not interfere with the worker’s tasks [41]. In particular, the RULA has been widely used for posture analysis [36]. RULA consists of a single-page worksheet to assess posture, strength, and repetition. Based on the assessments, scores are entered for each body region in part A of the form for the upper arm, lower arm, and wrist, wrist twist, force/load, and in part B of the form for the neck, trunk, legs, and force/load. A score of 1 indicates the most neutral posture, and a score of 4 indicates the worst position. After the data is collected and scored for each region, a table on the form is used to compile the part A and Part B risk factor scores. Two additional scores (muscle use and force/load) are then added respectively to Part A and Part B scores, generating a final Part A and Part B scores. The combination of final Part A and Part B scores (ranging from 1 to 7+) is called grand RULA score, which represents the level of MSDs risk that is categorized into an action level associated with a conclusion depending on the urgency of the corrective action required [42].

Video and digital photography resources were used to conduct a posture assessment using the RULA method. The RULA assessment was first used to determine the task with the highest postural risk. The risk assessment was then performed on each worker’s task on the last workday of each week for the entire fifteen-week study period for the designated task.

2.7 Musculoskeletal discomfort

Pain intensity can be determined using one-dimensional pain scales such as numeric, verbal rating, visual, and analog scales [44]. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) [45] provides a seven-day longitudinal assessment of the frequency, severity, and MD interference with work in 20 body regions. The CMDQ consists of 54 questions relating to the above terms. According to the CMDQ scoring guidelines, the MD score and the MD prevalence are parameters for measuring the intensity and occurrence of MD [46]. Frequency, severity, and interference with work were calculated using Equation 1:

$F = S = I = \sum_{i = 1}^{W} n_{i} W_{i}$ (1)

Where:

F = Frequency score

S = Severity score

I = Interference with work score

n_i = Total number of participants with MD

W_i = Weighting of the importance of the MD

Frequency, severity, and interference with work were weighted according to Table 1.

Table 1

CMDQ frequency, severity, and interference with work weightage

Weight	MD Frequency	Weight	MD Severity	Weight	MD Interference with work
0.0	Never	1	Slightly uncomfortable	1	Not interfered
1.5	1-2 Times per week	2	Moderate uncomfortable	2	Slightly interfered
3.5	3-4 Times per week	3	Very uncomfortable	3	Substantially interfered
5.0	Once a day
10.0	Several times every day

The MD score refers to a specific region of a worker’s body and is calculated by multiplying the frequency, severity, and interference scores, as shown in Equation 2: $MD score = F * S * I$ (2)

The MD prevalence for each body region was estimated by using Equation 3 below: $MD Prevalence = \frac{MD score by body region}{Grand MD score}$ (3)

Grand MD score is the sum of the MD scores for each body region.

The questions on MD were adapted from the CMDQ, which was translated and revised in Spanish and whose reliability (Kappa statistic, k = 0.8, 95% CI [0.6–0.9]) and validity (Spearman correlation, ρ= 0.7, 95% CI [0.4–0.8]) were established in a previous study [45].

Since the demographic and work characteristics contributing to MD among sculptors remain to be determined, these factors were incorporated into the CMDQ. The resulting document was named the Adapted Cornell Musculoskeletal Discomfort Questionnaire (ACMDQ). The ACMDQ considered the following demographic characteristics: age, gender, weight, height, body mass index (BMI), health risk (ideal weight, overweight, and obesity), and marital status (married or single). The following work characteristics were considered: work experience (1–5 years (y), 5–10 y, 10–20 y), job stress (not at all stressful, mildly stressful, moderately stressful), holding two jobs (yes, no), difficulty to keep up with work (never, sometimes, often), and duration of continuous work without breaks (< 2 hours (h), 2–3 h, > 3 h). The ACMDQ was administered to the participants each week of the study after they had signed the written informed consent.

2.8 Statistical data analysis

The data management and statistical analysis were carried out using the IBM SPSS (v24, SPSS Inc., Chicago, USA) software suite. The participants’ demographic data were reported in ranges, means, standard deviations (SDs), frequencies, and percentages. The work characteristics were shown in percentages. The respective MD scores of the body regions and MD prevalence were measured according to Equations (2) and (3) to identify critical body regions. The association between the MD prevalence and the independent variables (RULA A and B scores, demographics, and work characteristics) was analyzed using multivariate logistic regression (MLR) models. A backward stepwise procedure was used to analyze the associations between variables. Twenty different MLR models were developed for the body regions. The p-value, odds ratios (OR), and 95% confidence intervals (CI) were obtained as a measure of association from MLR models. The model’s fitness for this study was assessed using the Hosmere-Lemeshow goodness-fit test. The MD prevalence mean, and standard deviation were calculated for each body region throughout the analysis period. In addition, a one-way ANOVA was used to test for significant differences between the MD prevalence of each body region throughout the weeks the study lasted. A significance level of 0.05 was used for both logistic regression and ANOVA.

3 Results

3.1 Demographics and work characteristics data

Participants were predominantly male (70%), aged 24 to 62 years, BMIs ranging from 23.71 to 34.31 kg/m2, and 66.67% were overweight and married, as seen in Table 2. Most participants were within the job experience group of 10–20 years (n = 39, 51.28%). Some sculptors reported that their work was mildly stressful (46.16%), and more than half held two jobs (76.92%), one as a sculptor and the other as a high school art teacher. Additionally, more than a third of the sculptors in the sample (38.46%) found it difficult to keep up with their work, and 35.89% were, at the time, working continuously for more than three hours without a break.

Table 2
Demographic and work characteristics of sculptors

Category Variables Values

Age (years)

Mean 37.23

Range 24–62

Standard deviation 11.10

Gender (%)

Male 30 (70%)

Female 9 (30%)

BMI (kg/m²)

Mean 27.83

Range 23.71–34.31

Standard deviation 3.89

Health risk (%)

Normal weight 4 (10.26%)

Overweight 26 (66.67%)

Obesity 9 (23.08%)

Marital status (%)

Married 26 (66.67%)

Single 13 (33.33%)

Job experience (years)

1–5 4 (10.26%)

5–10 15 (38.46%)

10–20 20 (51.28%)

Job stress

Not at all stressful 6 (15.38%)

Mildly stressful 18 (46.16%)

Moderately stressful 15 (38.46%)

Another job?

Yes 30 (76.92%)

No 9 (23.08%)

Difficulty keeping up

with this work? Never 13 (33.33%)

Sometimes 11 (28.21%)

Often 15 (38.46%)

Duration of

continuous work < 2 hrs. 14 (35.89%)

without breaks 2–3 hrs. 11 (28.22%)

> 3 hrs. 14 (35.89%)

Category	Variables	Values
Age (years)
	Mean	37.23
	Range	24–62
	Standard deviation	11.10
Gender (%)
	Male	30 (70%)
	Female	9 (30%)
BMI (kg/m²)
	Mean	27.83
	Range	23.71–34.31
	Standard deviation	3.89
Health risk (%)
	Normal weight	4 (10.26%)
	Overweight	26 (66.67%)
	Obesity	9 (23.08%)
Marital status (%)
	Married	26 (66.67%)
	Single	13 (33.33%)
Job experience (years)
	1–5	4 (10.26%)
	5–10	15 (38.46%)
	10–20	20 (51.28%)
Job stress
	Not at all stressful	6 (15.38%)
	Mildly stressful	18 (46.16%)
	Moderately stressful	15 (38.46%)
Another job?
	Yes	30 (76.92%)
	No	9 (23.08%)
Difficulty keeping up
with this work?	Never	13 (33.33%)
	Sometimes	11 (28.21%)
	Often	15 (38.46%)
Duration of
continuous work	< 2 hrs.	14 (35.89%)
without breaks	2–3 hrs.	11 (28.22%)
	> 3 hrs.	14 (35.89%)

3.2 Posture risk assessment

Sculpting entails various activities (sifting, hydrating, kneading, modeling, mold making, slip casting, and curing). The initial RULA risk assessment indicated that the tasks with the highest level of exposure in sculpting were sifting, kneading, and modeling. Table 3 shows the activities with their corresponding Grand RULA scores, action levels, and most affected body regions.

Table 3
Most demanding postures in sculptor’s tasks during the working day

Task Grand RULA RULA action Most affected

score level body regions

Sifting 5 3 Arms, lower back

Kneading 7 4 Lower back

Modeling 5 3 Neck, lower back

Task	Grand RULA	RULA action	Most affected
Sifting	5	3	Arms, lower back
Kneading	7	4	Lower back
Modeling	5	3	Neck, lower back

Kneading activity had the highest risk of MD, and the lower back is the most affected body region. Therefore, this activity was selected to perform the posture assessment for the weeks of study.

The RULA posture scores for each body region for the kneading activity were summarized in Table 4. The number of postures assessed (n) and their percentage in parentheses are shown in each column and indicated by n (%). In addition, the table shows the RULA scores (A and B) and the grand RULA score. According to the RULA method, the A-score comprises the assessment of the upper arm, lower arm, wrist, wrist twist, and force/load of body regions. Likewise, the B-score includes the evaluation of the neck, trunk, legs, and force/load.

Table 4

Distribution of RULA scoring in posture assessment

Posture	Upper	Lower	Wrist	Wrist	Force/	RULA A	Neck	Trunk	Leg	Force/	RULA
RULA	arm	arm	n (%)	twist	Load A	score	n (%)	n (%)	n (%)	Load B	B-score
score	n (%)	n (%)		n (%)	n (%)	n (%)				n (%)	n (%)
1					9360 (41.02)				22815 (100)	9360 (41.02)
2	585 (2.56)	5850 (25.64)		22815 (100)	12285 853.84)		1170 (5.12)			12870 (56.41)
3	13455 (58.97)	16380 (71.79)	11115 (48.71)		1170 (5.12)	585 (2.56)	9360 (41.02)	2925 (12.82)		585 (2.56)
4	7605 (13.33)	585 (2.56)	11115 (48.71)			585 (2.56)	11115 (48.71)	17550 (76.92)			585 (2.56)
5	1170 (5.12)		585 (2.26)			1755 (7.69)	1170 (5.12)	2340 (10.25)
6						9360 (33.33)					2340 (10.25)
7						2925 (12.82)					4095 (17.94)
8											4095 (17.94)
9											5850 (25.64)
10											5850 (25.64)

n = Postures assessed.

The body parts that registered the highest RULA scores were the following: the upper arms, whose score was 3 (n = 1755, 58.97%) since the sculptors’ posture requires the upper arms to be slightly abducted and flexed; the neck, whose score was 4 (n = 11115, 48.71%), thus indicating a flexion of more than 20 grades with a twist and, in other cases, a lateral flexion; the trunk, with a score of 4 (n = 17550, 76.92%) for most workers, indicating that sculptors’ trunks leaned forward more than 20 degrees, featuring a twist and lateral flexion in some postures. A total of n = 585 assessments were performed during the 15 weeks of the study, and the grand RULA score was 7 for most assessments (n = 540, 92.3%).

3.3 Prevalence of musculoskeletal discomfort

The prevalence of MD considered MD frequency, severity, and work interference factors. The frequency, severity, and interference scores were calculated. In addition, both the MD score and the MD prevalence were obtained. In Table 5, the last two columns show the MD score and the MD prevalence for all corresponding body regions. Sculptors presented a high prevalence of MD in the upper and lower body (67.6%). The MD prevalence in the upper limbs was as follows: right upper arm (8.83%), upper back (8.56%), left upper arm (7.61%), neck (7.57%), and right shoulder (7.41%); the most affected region was the lower back (10.88%). Other body regions affected were the lower limbs: the left knee (8.54%) and the right knee (8.15%). MD prevalence in the regions on the right side of the body was higher than those on the left.

Table 5
Musculoskeletal discomfort prevalence

Body regions Frequency (F) Severity (S) Interference (I) MD score MD Prevalence (%)

Neck 3097 1172 1109 4025319556 7.570770187

Shoulder Left 1265 1178 1125 1676441250 3.153029532

Right 2991 1168 1128 3940654464 7.411533151

Upper back 3434.5 1178 1125 4551571125 8.560537492

Upper arm Left 3070.5 1179 1118 4047293601 7.612098694

Right 3418 1212 1134 4697726544 8.835424759

Lower back 4086.5 1220 1160 5783214800 10.87699736

Forearm Left 1842.5 1171 1132 2442366410 4.593571901

Right 2533.5 1176 1137 3387573252 6.371304992

Wrist Left 1548 1162 1151 2070391176 3.893965578

Right 1518.5 1176 1118 1996475208 3.754945359

Hand finger Left 1513.5 937 608 862234896 1.621680504

Right 1397 942 608 800112192 1.504840907

Hip/buttocks 1477 570 608 511869120 0.962716977

Thigh Left 1280.5 960 608 747402240 1.405704694

Right 1586.5 942 613 916118079 1.723023314

Knee Left 2593.5 1326 1320 4539454920 8.537749487

Right 2484 1325 1316 4331350800 8.146349886

Lower leg Left 1458 905 721 951352290 1.789291373

Right 1579.5 941 599 890299390.5 1.674463851

Grand MD score 53169221314 100

Body regions		Frequency (F)	Severity (S)	Interference (I)	MD score	MD Prevalence (%)
Neck		3097	1172	1109	4025319556	7.570770187
Shoulder	Left	1265	1178	1125	1676441250	3.153029532
	Right	2991	1168	1128	3940654464	7.411533151
Upper back		3434.5	1178	1125	4551571125	8.560537492
Upper arm	Left	3070.5	1179	1118	4047293601	7.612098694
	Right	3418	1212	1134	4697726544	8.835424759
Lower back		4086.5	1220	1160	5783214800	10.87699736
Forearm	Left	1842.5	1171	1132	2442366410	4.593571901
	Right	2533.5	1176	1137	3387573252	6.371304992
Wrist	Left	1548	1162	1151	2070391176	3.893965578
	Right	1518.5	1176	1118	1996475208	3.754945359
Hand finger	Left	1513.5	937	608	862234896	1.621680504
	Right	1397	942	608	800112192	1.504840907
Hip/buttocks		1477	570	608	511869120	0.962716977
Thigh	Left	1280.5	960	608	747402240	1.405704694
	Right	1586.5	942	613	916118079	1.723023314
Knee	Left	2593.5	1326	1320	4539454920	8.537749487
	Right	2484	1325	1316	4331350800	8.146349886
Lower leg	Left	1458	905	721	951352290	1.789291373
	Right	1579.5	941	599	890299390.5	1.674463851
Grand MD score					53169221314	100

Figure 1–3 illustrates the participants’ responses regarding MD in terms of frequency, severity, and interference with work. According to Figure 1, the population surveyed reported experiencing MD with varying frequency. Specifically, 30% reported feeling MD 3–4 times on the last working day (Friday) of each week studied, while at least 29% reported suffering from MD 1-2 times during that same time frame. Additionally, 26% of individuals reported experiencing MD once every day.

Fig. 1

Frequency of musculoskeletal discomfort among sculptors.

Fig. 2

Severity of musculoskeletal discomfort among sculptors.

Fig. 3

Interference of musculoskeletal discomfort with work.

Regarding the severity of MD, as seen in Figure 2, most sculptors described the pain as being moderately uncomfortable. On the other hand, Figure 3 provides information about the interference of MD with work. In this regard, the participants (46%) reported a slight interference of MD with their work.

3.4 Association between MD prevalence, RULA scores, demographics, and work characteristics

Multivariate Logistic Regression (MLR) models results show the association between MD prevalence, RULA Scores, demographics, and work characteristics. The MLR model results are shown separately according to the respective body regions. Tables 6–9 show such associations.

Table 6
Associations between neck, left shoulder, right shoulder, left upper arm, right upper arm, MD prevalence, RULA scores, demographic, and work characteristics

MD prevalence by body region

Factor Category Neck Left shoulder Right shoulder Left upper arm Right upper Arm

OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)

RULA A-score 1–3 1.14 (0.59–2.20) 1.02 (0.53–1.96) 1.23 (062–2.45) 0.99 (0.51–1.90)

4–6 0.86 (0.45–1.62) 1.42 (0.74–2.73) 0.99 (0.49–1.96) 1.25 (0.66–2.36)

7–10 1 1 1 1

RULA B-score 1–3 1 0.83 (0.43–1.60) 1.01 (0.52–1.98) 1.23 (0.62–2.46) 1.33 (0.69–2.55)

4–6 2.34 (1.18–4.62) 1.14 (0.59–2.20) 1.08 (0.56–2.10) 0.99 (0.49–1.99) 1.66 (0.89–3.11)

7–10 0.79 (0.41–1.53) 1 1 1 1

Gender Male 1 1 1

Female 1.24 (0.68–2.26) 1.02 (0.57–1.82) 1 1.61 (0.64–2.10)

Health risk Normal weight 1.48 (0.63–3.44) 1.21 (0.44–3.307) 1.68 (0.65–4.34) 1.53 (0.54–4.35) 0.82 (.38–1.77)

Overweight 1 1 1 1 1

Obesity 1.22 (0.64–2.31) 1.42 (0.75–2.68) 0.78 (0.43–1.44) 1.57 (0.82–3.01) 1.24 (0.68–2.27)

Marital status Married 1.40 (0.81–2.42) 1.33 (0.74–2.40) 1.02 (0.57–1.80) 1.20 (0.693–2.08)

Single 1 1 1 1

Job experience 1–5 yrs. 0.72 (0.30–1.73) 1.58 (0.58–4.24) 1.72 (0.68–4.26) 1.95 (0.69–5.49) 1.52 (0.64–3.61)

5–10 yrs. 1 1 1 1 1

10–20 yrs. 0.72 (0.41–1.26) 1.36 (0.76–2.41) 1.46 (0.82–2.62) 1.07 (0.59–1.93) 1.32 (0.76–2.28)

Job stress Not at all 1 1 1

Moderately 0.62 (0.28–1.41) 0.41 (0.17–0.95) 0.32 (0.13–0.79) 0.40 (0.17–1.61)

Mildly 1.03 (0.45–2.33) 0.47 (0.20–1.13) 0.30 (0.12–0.73) 0.70 (0.30–1.61)

Holding a secondary job Yes 1 1

No 1.85(0.98–3.47) 1.12(0.59–2.07)

Difficult to keep up with work Never 1.04 (0.55–1.98) 1.53 (0.82–2.82) 0.76 (0.40–1.45) 0.52 (0.28–0.97)

Sometimes 1 1 1 1

Often 1.07 (0.56–2.05) 1.83 (0.92–3.50) 1.22 (062–2.42) 0.90 (0.47–1.72)

Duration of work < 2 hrs. 1.77 (0.84–3.31) 1.00 (0.52–1.91) 0.56 (0.30–1.02)

without breaks 2-3 hrs. 1 1 1

< 3 hrs. 1.30 (0.67–2.52) 1.14 (0.58–2.25) 1.15 (0.60–2.23)

		MD prevalence by body region
RULA A-score	1–3		1.14 (0.59–2.20)	1.02 (0.53–1.96)	1.23 (062–2.45)	0.99 (0.51–1.90)
	4–6		0.86 (0.45–1.62)	1.42 (0.74–2.73)	0.99 (0.49–1.96)	1.25 (0.66–2.36)
	7–10		1	1	1	1
RULA B-score	1–3	1	0.83 (0.43–1.60)	1.01 (0.52–1.98)	1.23 (0.62–2.46)	1.33 (0.69–2.55)
	4–6	2.34 (1.18–4.62)	1.14 (0.59–2.20)	1.08 (0.56–2.10)	0.99 (0.49–1.99)	1.66 (0.89–3.11)
	7–10	0.79 (0.41–1.53)	1	1	1	1
Gender	Male	1	1	1
	Female	1.24 (0.68–2.26)	1.02 (0.57–1.82)	1		1.61 (0.64–2.10)
Health risk	Normal weight	1.48 (0.63–3.44)	1.21 (0.44–3.307)	1.68 (0.65–4.34)	1.53 (0.54–4.35)	0.82 (.38–1.77)
	Overweight	1	1	1	1	1
	Obesity	1.22 (0.64–2.31)	1.42 (0.75–2.68)	0.78 (0.43–1.44)	1.57 (0.82–3.01)	1.24 (0.68–2.27)
Marital status	Married	1.40 (0.81–2.42)	1.33 (0.74–2.40)	1.02 (0.57–1.80)	1.20 (0.693–2.08)
	Single	1	1	1	1
Job experience	1–5 yrs.	0.72 (0.30–1.73)	1.58 (0.58–4.24)	1.72 (0.68–4.26)	1.95 (0.69–5.49)	1.52 (0.64–3.61)
	5–10 yrs.	1	1	1	1	1
	10–20 yrs.	0.72 (0.41–1.26)	1.36 (0.76–2.41)	1.46 (0.82–2.62)	1.07 (0.59–1.93)	1.32 (0.76–2.28)
Job stress	Not at all	1	1	1
	Moderately	0.62 (0.28–1.41)	0.41 (0.17–0.95)	0.32 (0.13–0.79)	0.40 (0.17–1.61)
	Mildly	1.03 (0.45–2.33)	0.47 (0.20–1.13)	0.30 (0.12–0.73)	0.70 (0.30–1.61)
Holding a secondary job	Yes		1	1
	No		1.85(0.98–3.47)	1.12(0.59–2.07)
Difficult to keep up with work	Never	1.04 (0.55–1.98)	1.53 (0.82–2.82)	0.76 (0.40–1.45)	0.52 (0.28–0.97)
	Sometimes	1	1	1	1
	Often	1.07 (0.56–2.05)	1.83 (0.92–3.50)	1.22 (062–2.42)	0.90 (0.47–1.72)
Duration of work	< 2 hrs.		1.77 (0.84–3.31)	1.00 (0.52–1.91)	0.56 (0.30–1.02)
without breaks	2-3 hrs.		1	1	1
	< 3 hrs.		1.30 (0.67–2.52)	1.14 (0.58–2.25)	1.15 (0.60–2.23)

p-value < 0.05 in bold. Significance level a = 0.05.

Table 7

Associations between upper back, right forearm, left forearm, right wrist, left wrist MD prevalence, RULA scores, demographic, and work characteristics

		MD prevalence by body region
Factor	Category	Upper back	Right forearm	Left Forearm	Right wrist	Left wrist
OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)
RULA A-score	1–3	1.38 (0.75–2.56)		1.32 (0.71–2.44)
	4–6	1.19 (0.61–2.31)		0.48 (0.25–0.94)
	7–10	1
RULA B-score	1–3	1.04 (0.53–2.03)	1.40 (0.71–2.79)
	4–6	0.70 (0.37–1.34)	1.98 (0.99–3.98)
	7–10	1	1
Gender	Male	1.23 (0.67–2.28)	1
	Female	1	1.60 (0.88–2.90)			1.68 (0.99–2.87)
Health risk	Normal weight	1.39 (0.61–3.148)	0.92 (0.36–2.34)	2.32 (0.92–5.88)
	Overweight	1	1	1
	Obesity	131 (0.69–2.48)	2.19 (1.14–4.19)	0.56 (0.29–1.07)
Marital status	Married			1.17 (0.67–2.03)
	Single
Job experience	1–5 yrs.	0.675 (.25–1.75)		0.45 (0.24–0.85)
	5–10 yrs.	1		0.52 (0.27–0.99)
	10–20 yrs.	1.219 (0.69–2.14)		1
Job stress	Not at all	1			0.48 (0.25–0.89)	0.82 (.43–1.54)
	Moderately	1.06 (0.47–2.39)	1.18 (0.51–2.44)		0.65 (0.35–1.18)	0.46 (0.24–0.86)
	Mildly	1.53 (0.68–3.43)	1.06 (0.50–2.23)		1
Holding a secondary Job	Yes				1.66 (1.01–2.77)
	No				1
Difficulty to keep up	Never
with work	Sometimes
	Often
Duration of work	< 2 hrs.	1.64 (.084–3.21)	1.51 (0.83–2.75)
without breaks	2-3 hrs.	1	1
	< 3 hrs.	1.45 (0.78–2.68)	2.21 (1.66–4.21)

p-value < 0.05 in bold, S. Significance level α= 0.05.

Table 8

Associations between lower back, right hand finger, left hand finger, right thigh, Left thigh, MD prevalence, RULA scores, demographic, and work characteristics

		MD prevalence by body region
Factor	Category	Lower back	Right hand finger	Left hand finger	Right thigh	Left thigh
		OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)
RULA A-score	1–3			2.04 (1.02–4.08)
	4–6			1.96 (0.97–3.95)
	7–10			1
RULA B-score	1–3
	4–6
	7–10
Gender	Male	1
	Female	1.72 (1.02–2.91)
Health risk	Normal weight				0.87 (0.42–1.62)	0.45 (0.23–.87)
	Overweight				1.631 (0.83–3.199	0.99 (.52–1.91)
	Obesity				1
Marital status	Married	1.80 (1.06–3.07)			1.77 (1.06–2.97)
	Single	1			1
Job experience	1–5 yrs.
	5–10 yrs.
	10–20 yrs.
Job stress	Not at all			2.10 (1.10–4.00)
	Moderately			1.46 (0.75–2.85)
	Mildly
Holding a secondary job	Yes		1.94 (1.14–3.31)
No	1
Difficult to keep up with work	Never	0.88 (0.46–1.67)	2.00 (1.04–3.84)	0.43 (0.22–0.84)	0.39 (0.20–.77)
	Sometimes	1	1.13 (0.59–2.16)	0.55 (0.29–1.03)	0.54 (0.30–1.08)
	Often	1.70 (0.88–3.29)	1	1	1
Duration of work	< 2 hrs.	1.82 (0.96–3.46)		2.01 (1.0–3.90)		0.83 (0.41–1.65)
without breaks	2-3 hrs.	1.37 (0.71–2.65)		1		0.50 (.025–1.01)
	< 3 hrs.	1		1		1

p-value < 0.05 in bold. Significance level α= 0.05.

Table 9

Associations between right lower leg, left lower leg, buttocks, right knee, Left knee, MD prevalence, RULA scores, demographic, and work characteristics

		MD prevalence by body region
Factor	Category	Right Lower Leg	Left Lower Leg	Buttocks	Right Knee	Left Knee
		OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)
RULA A-score	1–3				1.19 (0.63–2.23)
	4–6				1.73 (0.91–3.28)
	7–10				1
RULA B-score	1–3	0.73 (0.37–1.41)			2.02 (1.17–4.11)	1.18 (0.58–2.13)
	4–6	0.46 (0.24–0.95)			1.18 (0.63–2.21)	1.26 (0.69–2.33)
	7–10	1			1	1
Gender	Male			1	1	1
	Female			1.11 (0.60–2.04)	2.15 (1.12–4.10)	1.53 (0.83–2.80)
Health risk	Normal weight	0.38 (0.20–0.74)	1.15 (0.53–2.48)		2.15 (.87–5.29)
	Overweight	0.60 (0.30–1.20)	1		1
	Obesity	1	1.16 (0.61–2.03)		0.89 (0.46–1.72)
Marital status	Married	1.61 (0.96–2.77)		1.20 (0.69–2.08)	0.55 (0.31–0.95)
	Single	1		1	1
Job experience	1–5 yrs.		2.12 (0.88–5.07)	1.64 (0.60–4.45)
	5–10 yrs.		1	1
	10–20 yrs.		1.913 (1.10–3.36)	1.72 (0.77–3.85)
Job stress	Not at all			0.97 (0.43–2.16)	1	1
	Moderately			1.44 (0.63–3.29)	0.30 (0.12–0.76)	1.62 (0.73–3.57)
	Mildly			1	0.38 (0.1–0.72)	1.45 (0.67–3.10)
Holding a secondary job	Yes	1.24 (074–2.08)	1	1	0.740	2.088
	No	1	1.368 (0.75–2.46)	1.44 (0.79–2.60)
Difficult to keep up with work	Never			1.28 (.68–2.40)		1.59 (0.84–2.98)
	Sometimes			1		1
	Often			1.63 (0.85–3.12)		1.05 (0.55–2.00)
Duration of work	< 2 hrs.	0.83 (0.41–1.65)		1.09 (0.59–2.04)		0.97 (0.53–1.79)
without breaks	2-3 hrs.	0.50 (0.25–1.01)		1		1
	< 3 hrs.	1		1.18 (0.61–2.31)		1.03 (0.53–1.99)

p-value < 0.05 in bold. Significance level α= 0.05.

More comprehensively, the results shown in Table 6 found statistically significant associations (p < 0.05) between the neck MD prevalence and the RULA B-score (OR = 2.34; 95% CI [1.18 –4.62]), while the left shoulder MD prevalence and the work characteristic of holding a secondary job showed the strongest association (OR = 1.85; 95% CI [0.98–3.47]).

In addition, the results shown in Table 7 found a significant association (p < 0.05) between the right forearm MD prevalence and health risk (obesity) (OR = 2.19, 95% CI [1.14 –4.19]), as well as with the duration of work without breaks (> 3 hrs.) (OR = 2.21; 95% CI [1.66 –4.21]). In addition, the right wrist MD prevalence was associated with holding a secondary job (OR = 1.66; 95% CI [1.01–2.77]).

Table 8 shows the association between the lower back, hand finger (right), hand finger (left), thigh (right), and thigh (left) MD prevalence, RULA scores, demographics, and work characteristics. The lower back MD prevalence showed a significant association with gender (female) (OR = 1.72; 95% CI [1.02–2.9]), while marital status (married) (OR = 1.80; 95% CI [1.06 –3.07]) showed a significant association (p < 0.05) as well. The MD prevalence for the right-hand finger showed an association with the holding a secondary job (yes) (OR = 1.94; 95% CI [1.14 –3.31]) and difficulty keeping up with work (never) (OR = 2.00; 95% CI [1.04 –3.84]). The left-hand finger showed an association with the RULA A-score (1–3) (OR = 2.04;95% CI [1.02 –4.08]) and work characteristics such as job stress (not at all) (OR = 2.10; 95% CI [1.10 –4.00]) and the duration of work without breaks (< 2 h) (OR = 2.01;95% [1.0 –3.90]). Finally, the MD prevalence in the right thigh proved to be associated with marital status (married) (OR = 1.77;95% [1.06–2.97]).

The data in Table 9 show a definite association between lower leg (left) MD prevalence and job experience (10–20 years) (OR = 1.91; 95% CI [1.10 –3.36]), and the knee (right) MD prevalence shows an association (p < 0.05) with the RULA B-score (1–3) (OR = 2.02; 95% CI [1.17 –4.11)] as well as with gender (female) (OR = 2.15; 95% CI [1.12 –4.10]).

Finally, the fitness of the models was assessed using the Hosmere-Lemeshow goodness-of-fit test, and p < 0.05 was found statistically significant.

3.7 Musculoskeletal discomfort prevalence throughout the weeks of study

Concerning the mean MD prevalence throughout the fifteen-week duration of this study, the results in Table 10 showed no significant difference between the mean MD prevalence throughout the weeks, except for both shoulders (p > 0.05).

Table 10
Musculoskeletal discomfort prevalence throughout the weeks of study (ANOVA test)

Body Region Mean SD CI (95%) f

Neck 24.45 22.25 (0.92–22.64) 2.05

Right shoulder 23.65 20.90 (21.95–25.35) 0.803*

Left shoulder 8.00 4.32 (7.64–8.35) 1.31*

Upper back 25.05 21.22 (23.33–26.75) 2.23

Right upper arm 26.84 21.34 (25.11–28.57) 6.11

Left upper arm 21.38 16.37 (20.11–22.66) 4.45

Lower back 30.78 22.79 (28.93–32.63) 6.29

Right forearm 18.27 15.72 (16.99–19.54) 8.35

Left forearm 11.82 11.14 (10.92–12.73) 7.82

Right wrist 30.78 22.79 (28.93–32.93) 6.28

Left wrist 10.98 8.95 (10.26–11.71) 5.18

Right finger hand 4.30 2.88 (4.07–4.54) 1.77

Left finger hand 5.26 3.97 (4.93–5.58) 5.25

Hips/buttocks 3.45 3.74 (3.15–3.75) 3.41

Right thigh 4.56 3.25 (4.30–4.83) 8.22

Left thigh 4.77 3.06 (4.53–5.02) 8.93

Right knee 22.06 14.87 (20.85–23.27) 7.67

Left knee 23.55 17.28 (22.14–24.95) 12.00

Right lower leg 5.02 6.03 (4.53–5.51) 6.69

Left lower leg 4.62 3.76 (4.31–4.93) 5.49

Body Region	Mean	SD	CI (95%)	f
Neck	24.45	22.25	(0.92–22.64)	2.05
Right shoulder	23.65	20.90	(21.95–25.35)	0.803*
Left shoulder	8.00	4.32	(7.64–8.35)	1.31*
Upper back	25.05	21.22	(23.33–26.75)	2.23
Right upper arm	26.84	21.34	(25.11–28.57)	6.11
Left upper arm	21.38	16.37	(20.11–22.66)	4.45
Lower back	30.78	22.79	(28.93–32.63)	6.29
Right forearm	18.27	15.72	(16.99–19.54)	8.35
Left forearm	11.82	11.14	(10.92–12.73)	7.82
Right wrist	30.78	22.79	(28.93–32.93)	6.28
Left wrist	10.98	8.95	(10.26–11.71)	5.18
Right finger hand	4.30	2.88	(4.07–4.54)	1.77
Left finger hand	5.26	3.97	(4.93–5.58)	5.25
Hips/buttocks	3.45	3.74	(3.15–3.75)	3.41
Right thigh	4.56	3.25	(4.30–4.83)	8.22
Left thigh	4.77	3.06	(4.53–5.02)	8.93
Right knee	22.06	14.87	(20.85–23.27)	7.67
Left knee	23.55	17.28	(22.14–24.95)	12.00
Right lower leg	5.02	6.03	(4.53–5.51)	6.69
Left lower leg	4.62	3.76	(4.31–4.93)	5.49

*p > 0.05, significance level α= 0.05.

4 Discussion

Few epidemiological studies have explored the occurrence of MD and its contributing risk factors (posture, demographics, and work characteristics) among sculptors. The differences in the prevalence of MD during the study weeks were also investigated. Sculptors are vulnerable to MSDs [3]. The RULA method was used to identify sculptor tasks with higher postural risk factors for MSDs. The highest RULA grand scores (5–7) were found for sifting, kneading, and modeling tasks. Such findings confirm MSDs risk factors in the upper arms, neck, and trunk, making them a significant occupational health problem for these art workers. Due to the scarcity of MSDs sculptor studies in the literature, a meaningful comparison of the results of this study is difficult. However, the findings are consistent with previous studies of MSDs risk factors among workers engaged in similar handicraft occupations, such as stone cutters [20], craft workers [18], goldsmiths [17], and glass art ware workers [9]. The studies cited above reported that MD was associated with posture risk factors. This is unsurprising, as handicraft workers often adopt awkward postures and perform strenuous tasks.

The sculptor’s exposure to risk factors contributing to postural load and potential upper body MSDs was evaluated during the kneading task, which yielded the highest RULA grand score (7). Most sculptors performing kneading tasks exhibited the highest RULA action level. (4, 93.2%). This rate exceeds both the 44% reported in prior research [48] and the 62.7% (action levels 3 and 4) [49]. The differences can be attributed to the specific working characteristics of sculptors, as their postural load is more concentrated in their trunks. Additionally, the sculptors’ posture requires the upper arms to be abducted and flexed. Besides, the neck and trunk postures are in front flexion of more than 20 degrees. The possible basis for the discrepancies is that the sculptor works while standing, whereas the sewing machine operator works while seated.

The prevalence of MD was assessed using the ACMDQ. According to the ACMDQ, the MD score by body region, which comprises MD severity, frequency, and interference with work, was found to be highly prevalent in the back (lower and upper), knee (right, left), upper arms (right and left), neck, and shoulders. The high MD scores highlight the need for ergonomic interventions to improve the working conditions of sculptors. The prevention of MD is suggested through posture training and workplace redesign. Although the related MD studies in these populations are scarce, the studies conducted for craftsmen show similarities in the type of workers and the prolonged standing activities, including those carried out by glass art ware workers [9], gemstone polishers [7], and manual workers [26]. Other studies [46 , 50] have shown that lower limbs were affected due to prolonged standing, increasing MD.

In addition, our research found that some demographic and work factors were associated with the prevalence of MD, highlighting the multifactorial nature of MD in this population. According to one study [51], over the course of a workday, workweek, and longer, physical work-related exposure may accumulate in the body, causing tissue damage and eventually leading to MSDs. Sculptor’s tasks are typically characterized by less frequent and repetitive work but more exposure. Often, the sculptor’s activity involves successive low-to-moderate intensity tasks that result in complex and varying efforts. However, in some tasks, prolonged exposure may exceed a worker’s physical tolerance and should therefore be prevented. Some theories [52] suggest that if a person works with an incorrect posture for an extended period, more force is required to complete the same amount of work. This will eventually lead to increased muscle loading as well as an overwork injury. The body may experience a static load from an adverse posture. When a static force is applied to the musculoskeletal system, physiological or biomechanical responses can interfere with tissue regeneration, resulting in structural tissue deformation. In any case, one of the most effective strategies to alleviate MD may be to reduce postural load. A previous research study [50] advised providing postural training, routine assessment, and correcting working posture.

Posture, work characteristics and demographic factors may have a broad impact on the occurrence of MD [53] which is supported by the results in this study. According to the biopsychosocial model, stressors at work may cause specific physiological responses in an individual, such as an increase in muscle tension, and persistent muscle tension may lead to musculoskeletal injuries [54]. Besides, the significance of mechanical and physiological factors in work-related MD is highlighted by a dose-response model [55]. This model suggests that an internal dose, such as tissue load and metabolic demand, can be produced by external exposure to work demands. These internal doses are thought to cause mechanical, physiological, or psychological changes known as internal disturbances. Such internal disturbances could include alterations in the body’s cellular processes or deformation of tissues. The capacity of a worker to adjust to internal changes may be enhanced or negatively impacted by repeated or prolonged doses. Muscle, tendon, or nerve disorders may arise when the body’s ability to adjust to these changes is impaired. It is not possible for us to conclude that job stress and rest periods and their dosage directly impact MD in sculptors, as one of the limitations of our study was its sample size, with the inherent potential inability to establish causality. Therefore, additional longitudinal research is needed to clarify this matter further and corroborate our findings.

The association of posture, work characteristics, and demographic factors with MD was explored with MLR models. Statistically significant associations were found between most independent variables and the MD in at least one body region.

The duration of work performed without breaks was strongly associated with the MD in the forearm and hand fingers. Furthermore, it was found that working without enough breaks affected the prevalence of MD [14]. Although this report mentioned multiple breaks of varying lengths, it explained the importance of taking sufficient breaks from work as they provide relief from both physical and mental stress. A possible cause for this finding is that our body is not designed to remain prolonged working hours. One study suggests that prolonged working hours increase the muscular load around the facet joint, leading to joint compression, which impacts MD [57]. A study of wage workers [57] reported a strong association between hours worked and the prevalence of MD, supporting the results of the present study. In addition, dual job was a risk factor that affected the prevalence of shoulder and hand fingers MD.

Another study from Brazil [58] did not find an association between MD prevalence and engaging with dual employment. In addition, work experience was associated with lower leg MD, whereas earlier studies reported that neck and shoulder MD was associated with work experience [8, 10]. A systematic review [14] has provided evidence of a strong association between work experience and MD prevalence among different personnel.

Other demographic factors, such as gender, marital status, and health risk, were associated with MD. For example, female participants reported an association with knee and lower back MD. The impact of gender is predicted because women typically have lower muscle strength and stature than men [60]. It has been proposed that women may be more vulnerable than men due to differences in their physiology and anthropometry [61]. Because women in Mexican culture bear full responsibility for housekeeping, they may start doing various household chores even after a long day at the workshop, which could put them under additional physical strain and increase MD. The present study revealed that marital status (married) was associated with thigh and lower back MD prevalence, consistent with those shown by a standing sewing operator [10]. The health risk (obesity) factor was associated with forearm pain, confirming similar studies [8, 10]. Other research [62] found a significant association between foot MD and health risk (obesity). Finally, postural scores were associated with knee and hand finger MD; the same knee associations were found in another study [8]. These findings emphasize the significance of comprehending such connections to promote decisive organizational actions. Sculpting workstations frequently lack adjustments to accommodate sculptors’ physical limitations, leading to the adoption of non-neutral postures. This is often due to the presence of improvised work elements, outdated machinery, tools, and furniture. Similar issues have been reported the same problems among machine operators in Sri Lanka [8]. Besides, poor posture has been associated with MD. Poor posture can lead to inappropriate postures that increase MD. It is common for sculptors to have workstations that do not allow them to change postures, forcing them to perform their tasks in the same position throughout the workday. Psychosocial factors such as commitment to the workplace, psychological demands, job insecurity, and work-family conflict can be added as interesting factors in the future analysis of MD among this working population.

Regarding the variations of MD prevalence throughout the fifteen weeks of study, only the shoulders (right and left) showed a statistically significant difference. This implies that the difference between the weeks is not due to chance for the MD in this body region. No other studies were found that analyzed the MD prevalence over the weeks.

Based on the results of this study, this work suggests the following preventive measures: encourage alternating between static and dynamic tasks, provide well-designed workstations (adjustable workbench), and organize ergonomic awareness and training programs for sculptors to help them improve their work posture. Training on the effects of MSDs should be provided.

4.1 Limitations

Three main limitations were considered in this study: the first involves the presence of bias in the questionnaire, the second is related to the homogeneity of the sample, and the third limitation is the lack of consideration of hand dominance of the sculptors. Because the study was designed as a self-reported MD questionnaire, it has been suggested that there is a latent risk of selection bias that may affect the observed findings. The limitation of using the self-reported MD Cornell questionnaire has been acknowledged [43]. Designing studies of females and males separately may provide more precise and interesting findings. In contrast, this sample consisted of 70% male participants with a small sample size (n = 39). The study results are consistent with those of other studies involving different populations but where the sample was homogeneous as well, i.e., gemstone polishers [7], sewing machine operators [8], and glass art ware workers [10]. Hand dominance was not examined in this study as a factor related to the presence of upper extremity MD. No other studies were found to confirm the possible association of hand dominance with MD. However, the inclusion of this factor may have led to interesting findings.

5 Conclusions

The prevalence of MD was high among sculptors. Holding a secondary job, duration of work without breaks, job experience, and demographic factors such as gender, marital status, and health risk were significant predictors and contributed to the prevalence of MD among sculptors.

By identifying the different risk factors for the development of MSDs, our findings contribute to a better understanding of the work environment of sculptors. These factors may reflect the specific work characteristics to which professional sculptors are exposed in their respective workshops. However, studies on MD and their association with demographic factors and work characteristics have not been conducted with this population. Therefore, our research fills this gap in the literature and advances knowledge on this topic.

Consequently, identifying MSDs risk factors among sculptors may facilitate the establishment of more assertive interventions to improve the work environment and well-being of this population.

Conflict of interest

The authors declare that they have no conflict of interest.

Footnotes

Acknowledgments

The authors would like to express their gratitude to the sculptors of the Sonoran Plastic Artist Association for their participation in this study.

Funding

The authors report no funding.

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Study of musculoskeletal disorders risk factors and discomfort in sculptors in the north of Mexico

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Keywords

1 Introduction

2 Methods

2.1 Participants

2.2 Procedure

2.3 Study design

2.4 Materials

2.5 Sculpture task description

2.6 Posture risk assessment

2.7 Musculoskeletal discomfort

3 Results

3.1 Demographics and work characteristics data

Table 3 Most demanding postures in sculptor’s tasks during the working day Task Grand RULA RULA action Most affected score level body regions Sifting 5 3 Arms, lower back Kneading 7 4 Lower back Modeling 5 3 Neck, lower back

4.1 Limitations

5 Conclusions

Conflict of interest

Footnotes

Acknowledgments

Funding

References

Table 3
Most demanding postures in sculptor’s tasks during the working day

Task Grand RULA RULA action Most affected

score level body regions

Sifting 5 3 Arms, lower back

Kneading 7 4 Lower back

Modeling 5 3 Neck, lower back