Work-Related Musculoskeletal Pain of The Neck, Shoulders And Back Among Dentists At The Dental Hospital of The University Of Barcelona: A Cross-Sectional Study

doi:10.21203/rs.3.rs-1253094/v1

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Research Article

Work-Related Musculoskeletal Pain of The Neck, Shoulders And Back Among Dentists At The Dental Hospital of The University Of Barcelona: A Cross-Sectional Study

https://doi.org/10.21203/rs.3.rs-1253094/v1

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Version 1

posted 07 Feb, 2022

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Background: Musculoskeletal pain and disorders represents one of the greatest problems of dental professionals. The present study aimed to make an assessment of the work-related musculoskeletal pain (WRMP) of the neck, shoulders and back of the professors at the Dental Hospital of the University of Barcelona (DHUB) during the last 12 months.

Methods: A cross-sectional study was performed. WRMP were assessed using validated questionnaires. Descriptive and bivariate analysis of the data were performed.

Results: 165 teachers received the survey, 70 responded and 43 fulfilled the inclusion criteria. 86.05% of respondents reported WRMP during the last 12 months, with shoulders being the most common location. 83.78% of the dentists had gradual pain of moderate intensity. Nearly one-third of these periods of pain had negative consequences. Extreme cervical torsions and flexions during work have been found to be associated with WRMP in the shoulders. In addition, Body Mass Index (BMI) was related to lower back WRMP.

Conclusions: Excessive cervical twists and flexions are predictors of shoulders’. A high BMI can be considered a trigger factor of lower back WRMP. Several strategies could reduce the impact of factors associated with WRMP. Further research is needed to prevent WRMP in dentists.

Work-related musculoskeletal pain

Dentists

Back pain

Neck pain

Shoulders pain.

Musculoskeletal conditions have a growing impact worldwide [1]. The Center for Disease Control and Prevention in the USA defines musculoskeletal disorders as “injuries or disorders of the muscles, nerves, tendons, joints, cartilages, and spinal discs” [2]. Once established, these afflictions can cause musculoskeletal pain in the neck, shoulders, arms, wrists, hands, upper and lower back, hips, knees, and feet, and can worsen or become chronic due to work conditions [3, 4].

Several studies have shown that musculoskeletal problems are produced or aggravated because of repetitive and prolonged movements, awkward postures or body movements [5–9]. However, other covariates such as Body Mass Index (BMI), age or sex [7, 10–17] have been also related to these conditions. Despite the numerous technical advances of recent years, there is evidence that dentists are usually included among the professionals with a high incidence of work-related musculoskeletal pain (WRMP), [5, 18, 19] being the neck, shoulders and back the most affected body regions [20–22].

Actually many studies pointed out that WRMP represents one of the greatest problems of dental professionals [23–25]. The prevalence of musculoskeletal symptoms among dentists in a one-year period ranged from 50-93% [23]. Moreover, WRMP might effect on the physical, psychological and social aspects of the practitioner. This can contribute on an important reduction of quality of life and productivity [5, 18, 19].

According to the need for prevention of these disorders, it has been considered necessary to carry out another research on WRMP among dental professionals. Therefore, the main objective of the present study was to evaluate the prevalence, characteristics and the risk factors of WRMP of the neck, shoulders and back among the professors of the Dental Hospital of the University of Barcelona (DHUB) during the last 12 months. Secondarily, the investigation also tried to determine how work-related musculoskeletal disorders (WRMDs) affect their work and activities of daily living; and to assess and address the problem through preventive interventions.

Design

A cross-sectional study was conducted with a sampling of dentistry professors at the University of Barcelona. Moreover, this study was designed according to “Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) statement guidelines for reporting cross-sectional studies [26]. The participants were selected from the Directory of the Faculty of Medicine and Health Sciences (Department of Dentistry) of the University of Barcelona between February and April of 2020.

Participants

In terms of the inclusion criteria, DHUB professors who agreed to participate were included in this cross-sectional study. The exclusion criteria were:

Congenital musculoskeletal pathology or malformations of the neck
Shoulders and/or back
Previous surgery or traumas that cause musculoskeletal pain in the aforementioned regions that cannot be attributed to occupational pathology (p.e. traffic accidents, sports accidents, congenital disorders, etc.).
Professors who do not work as a dentist at the DHUB at the time of the survey (i.e. management jobs exclusively), neither in private dental clinics nor in primary care centers or in the DHUB during the last 12-months were also excluded.

The researcher (B-B.) explained the nature, aim and the study method to all the participants of the present study. Any question about this study was also answered to the any participant. The included professors signed an informed consent form before the study.

Questionnaire and study variables

In this study, a form was sent to the professors who appears in the web Directory of the Faculty of Medicine and Health Sciences (Department of Dentistry) of the University of Barcelona between February and April of 2020, to evaluate the prevalence characteristics and associated factors of WRMP of the neck, shoulders and back during the 12 months before the day of the survey.

The survey was conducted by using an anonymous 26-questions survey, based on previous related research (CITES). Al-Mohrej et al. [10], Alghadir et al. [13], Meisha et al. [14] and that of Vijay et al. [10,13,14,27]. The participants had to fill out the following questionnaire with 4 different sections: baseline and demographic data; ergonomic features and work habits; characteristics of the WRMP; and its consequences in daily work and private life. Hence, prevalence of WRMP might be related not only with ergonomic features and work habits but with demographic variables, specialty, weight or heigh and even with the regular exercise practice. Moreover, how all these factors will contribute on the quality of life of the dentist.

The study variables were divided into 4 sections:

1. Baseline data from study participants:

Gender
- Female
- Male
Age (years)
Years of work experience (years)
- <25
- ≥25
Worked hours in a week (hours)
Specialty
- General practitioner
- Prosthodontics
- Pediatric dentistry
- Endodontic dentistry
- Orthodontics
- Periodontics
- Maxillofacial surgery
Weight (Kg)
Hight (cm)
Physical exercise practice
- Yes
- No

2. Ergonomic features:

Performing extreme cervical twists or flexions to gain better access to and visibility of the cavity.
- Yes
- No
Performing extreme twists or bends of the back during dental practice.
- Yes
- No
Performing prolonged static postures.
- Yes
- No

3. Characteristics of WRMP of the neck, shoulders, lower back and upper back during the 12 months before the study:

Prevalence and location
- Neck
  - Yes
  - No
- Shoulders
  - Yes
  - No
- Lower back
  - Yes
  - No
- Upper back
  - Yes
  - No
Duration
- <1 day
- 1-7 days
- 8-30 days
- >30 days
Intensity (Numeric Rating Scale).
- Neck

0-1-2-3-4-5-6-7-8-9-10

Shoulders

0-1-2-3-4-5-6-7-8-9-10

Lower back

0-1-2-3-4-5-6-7-8-9-10

Upper back

0-1-2-3-4-5-6-7-8-9-10

Onset of WRMP
- Sudden
- Gradual

4. Affection of the WRMP:

Consequences in their daily activities.
- Yes
- No

5. Outcome of WRMP:

Sick leave
Compensation
Reduction of non-work activities
Reduction of hours worked
Changes in work settings
Others

Data management and statistical analyses

All data were recorded in a Microsoft Excel® spreadsheet (Microsoft Corp., Redmond, Washington, USA) and statistical analysis was carried out with Stata 14 (StataCorp®, College Station, USA.). Logic, range, and consistency tests of the results were used to debug the data. Additionally, the distribution of unknown values and study variables was obtained.

Categorical outcomes were presented as absolute and relative frequencies. The normality of scale variables was explored using the Shapiro-Wilk test (P> .10) and visual analysis of normal P-P graphs and box diagrams. When normality was rejected a descriptive analysis was performed based on orders -median and interquartile range-. In the presence of a normal distribution a time-based descriptive analysis -mean and standard deviation- was performed.

Univariate logistic regression analyses were performed to identify potential risk factors of WRMP among dentists. The odds ratio (OR) with 95% confidence interval (95% CI) was calculated for each covariate. In all cases, the level of significance was set at P< .05.

Baseline data from study participants

Of the 165 professors of the DHUB that received the survey, 70 (42.42%) responded and 43 (26.06%) followed the inclusion criteria (Figure 1). 22 (51.16%) of the participants were male and 21 (48.84%) were female. The mean age was 48.80 ±9.81 years. They had an average of 23.28 (±8.14) years of experience working as dentists and they worked an average of 37.76 (±8.37) hours every week. The predominant specialty in the sample was orthodontics (23.26%). The mean BMI of the professors was 24.68 (±3.53) and 7 (16.28%) of the participants did not do physical exercise. Table 1 summarizes the baseline data form the participants of the study.

Table 1

Baseline data from the participants and ergonomic features
Variable	N (%)
Gender Female Male	21 (48.84) 22 (51.16)
Age, years (mean ±SD)	48.80 ±9.81
Hours worked per week	37.76 ±8.37
Experience, years (mean ±SD) <25 years ≥25 years	23.28 ±8.14 19 (44.19) 24 (55.81)
Specialty General practitioner Prosthodontics Pediatric dentistry Endodontic dentistry Orthodontics Periodontics Maxillofacial surgery	8 (18.60) 9 (20.93) 0 (0.00) 4 (9.30) 10 (23.26) 5 (11.63) 7 (16.28)
BMI (mean ±SD)	24.46 ±3.53
Physical exercise practice Yes No	36 (83.72) 7 (16.28)
Performing extreme cervical twists or flexions to gain better access to and visibility of the cavity	28 (56.12)
Performing extreme twists or bends of the back during dental practice.	24 (55.81)
Performing prolonged static postures	35 (81.40)
BMI, body mass index; SD, Standard Deviation

Ergonomic features

A total of 28 (56.12%) of the dentists performed extreme cervical twists or flexions to gain better access to and visibility of the oral cavity, 24 (55.81%) reported that they performed extreme twists or bends of the back during dental practice and 35 (81.40%) declare working in the same position for long periods of time (Table 1).

An 86.05% (n=37) of the respondents reported WRMP during the last 12 months, where of 51.35% (n=19) were female. The onset was gradual in the 83.78% (n=31) of cases and suddenly only in 16.22% (n=6) of them. Pain episodes used to be at last between 1 and 7 days in most participants with pain (59.46%).

Shoulder pain had the highest prevalence and was experienced by 69.77% (n=30). However, the prevalence of pain in the neck was 65.12% (n=28), 55,81% (n=24) in the lower back and 39.53% (n=17) experienced pain in the upper back.

A 16.28% (n=7) of the participant reported pain in a single location and 69.77% (n=30) had pain in two or more locations.

The severity of WRMP varied among the localization. The highest mean of pain intensity was in the lower back region, with a score of 5.17 on the Numeric Rating Scale (1-10). Between males it was 5.09 mean, while among females 5.25 mean. In all the studied locations moderate pain (4-7) predominated.

Table 2 summarizes the characteristics of WRMP during the 12 months before the study. Otherwise, Table 3 is composed of the WRMP intensity and location.

Table 2

Characteristics and affection of WRMP during the previous 12 months
Variable	Total N (%)	Female N (%)	Male N (%)
Prevalence of WRMP	37 (86.05)	19 (51.35)	18 (48.65)
Onset of WRMP Sudden Gradual	6 (16.22) 31 (83.78)	1 (16.67) 18 (58.06)	5 (83.33) 13 (41.94)
Average duration of WRMP <1 day 1-7 days 8-30 days >30 days	10 (27.03) 22 (59.46) 2 (5.41) 3 (8.11)	4 (40.00) 12 (54.55) 1 (50.00) 2 (66.67)	6 (60.00) 10 (45.45) 1 (50.00) 1 (33.33)
Effect of WRMP on daily activities Yes No	15 (40.54) 22 (59.46)	9 (60.00) 10 (45.45)	6 (40.00) 12 (54.55)
Outcome of WRMP Yes Sick leave Compensation Reduced non work activities Reduced working hours Changes of work settings Others No	12 (32.43) 0 (0.00) 0 (0.00) 2 (5.41) 4 (10.81) 5 (13.51) 3 (8.11) 25 (67.57)	6 (50.00) 0 (0.00) 0 (0.00) 2 (100.00) 1(25.00) 3(60.00) 1(33.33) 13 (52.00)	6 (50.00) 0 (0.00) 0 (0.00) 0 (0.00) 3(75.00) 2(40.00) 2(66.67) 12 (48.00)
WRMP, work related musculoskeletal pain

Table 3

WRMP location and intensity
Location	Gender	WRMP N (%)		Mean intensity of WRMP (1-10)		Mild (1-3) N (%)		Moderate (4-7) N (%)		Severe (8-10) N (%)
Neck	Female	28 (65.12)	15 (53.57)	5	5.40	9 (32.14)	3 (33.33)	16 (57.14)	10 (62.50)	3 (10.71)	2 (66.67)
Neck	Male	28 (65.12)	13 (46.43)	5	4.54	9 (32.14)	6 (66.67)	16 (57.14)	6 (37.50)	3 (10.71)	1 (33.33)
Shoulders	Female	30 (69.77)	16 (53.33)	4.93	5.31	9 (30.00)	4 (44.44)	18 (60.00)	9 (50.00)	3 (10.00)	3 (100.00)
Shoulders	Male	30 (69.77)	14 (46.67)	4.93	4.50	9 (30.00)	5 (55.56)	18 (60.00)	9 (50.00)	3 (10.00)	0 (0.00)
Upper back	Female	17 (39.53)	8 (47.06)	4.41	4.62	7 (41.18)	3 (42.86)	9 (52.94)	5 (55.56)	1 (5.88)	0 (0.0)
Upper back	Male	17 (39.53)	9 (52.94)	4.41	4.22	7 (41.18)	4 (57.14)	9 (52.94)	4 (44.44)	1 (5.88)	1 (100.0)
Lower back	Female	24 (55.81)	12 (50.00)	5.17	5.25	5 (21.74)	1 (20.00)	14 (60.87)	9 (64.29)	4 (17.39)	2 (50.00)
Lower back	Male	24 (55.81)	12 (50.00)	5.17	5.09	5 (21.74)	4 (80.00)	14 (60.87)	5 (35.71)	4 (17.39)	2 (50.00)
WRMP, work related musculoskeletal pain

Affection of the WRMP

As Table 2 describes, WRMP produced a negative impact on daily activities in 40.54% (n=15) of the dentists who had pain during the previous year and a 32.43% (n=12) with WRMP during the year before the study, reported consequences because of the pain. The most common were changes in work settings (13.51%).

Univariate logistic regression analysis of the predictors of WRMP

Performing extreme cervical twists or flexions to gain better access and visibility of the oral cavity is a shoulders WRMP predictor (OR = 9.00; 95%CI = 2.05 to 39.50; p= .004). However, a statistically significant association was found between elevated BMI and lumbar WRMP (OR = 1.38: 95%CI = 1.08–1.78; p= .011). Table 4 summarizes the univariate logistic regression analysis of the predictors of WRMP.

Table 4

Univariate logistic regression analysis of the predictors of WRMP
Variable	Neck WRMP OR (95%IC)	Shoulders WRMP OR (95%IC)	Upper back WRMP OR (95%IC)	Lower back WRMP OR (95%IC)
Age, years P value	1.01 (0.95-1.08) .728	1.02 (0.95-1.09) .563	1.02 (0.95-1.08) .589	1.03 (0.97-1.10) .366
Gender Female Male P value	1.73 (0.48-6.18) 1 .398	1.83 (0.48-6.90) 1 .373	0.89 (0.26-3.02) 1 .850	1.11 (0.33-3.71) 1 .864
BMI P value	1.18 (0.95-1.46) .140	1.04 (0.86-1.27) .669	1.10 (0.91-1.30) .339	1.38 (1.08-1.78) .011*
Experience, years ≥25 <25 P value	1.77 (0.50-6.27) 1 .379	1.75 (0.47-6.50) 1 .403	1.22 (0.35-4.21) 1 .748	1.85 (0.54-6.29) 1 .323
Hours worked per week >40 20-40 P value	1.30 (0.32-5.24) 1 .710	0.96 (0.23-3.96) 1 .960	0.58 (0.14-2.31) 1 .441	2.25 (0.57-8.93) 1 .249
Specialty Prosthodontics Endodontic dentistry Orthodontics Periodontics Maxillofacial surgery General practitioner P value	2.10 (0.25-17.59) 0.60 (0.05-6.80) 0.90 (0.13-6.08) 0.90 (0.09-8.90) 1.50 (0.17-13.22) 1 .8582	0.67 (0.08-5.54) 1.00 (0.06-15.99) 0.50 (0.06-3.84) 0.50 (0.04-5.51) 2.00 (0.14-28.41) 1 .7893	5.83 (0.70-48.87) 0.56 (0.34-8.08) 1.11 (0.16-7.50) - 0.67 (0.07-5.88) 1 .1802	1.25 (0.18-8.44) 3.00 (0.21-42.62) 1.00 (0.15-6.42) 1.50 (0.16- 14.42) 1.33 (0.17-10.25) 1 .9335
Physical exercise practice Yes No P value	-	-	0.42 (0.08-2.19) 1 .306	1.87 (0.36-9.59) 1 .455
Performing extreme cervical twists or flexions to gain better access to and visibility of the cavity Yes No P value	3.43 (0.91-12.92) 1 .069	9.00 (2.05-39.50) 1 .004*	1.50 (0.40-5.55) 1 .544	0.77 (0.21- 2.74) 1 .686
Performing extreme twists or bends of the back during dental practice Yes No P value	0.83 (0.23-3.03) 1 .782	0.93 (0.24-3.54) 1 .911	3.05 (0.84-11.07) 1 .089	1.55 (0.44-5.47) 1 .498
Performing prolonged static postures Yes No P value	1.15 (0.23-5.65) 1 .863	1.50 (0.30-7.50) 1 .621	1.11 (0.23-5.41) 1 .896	1.33 (0.29-6.21) 1 .714
BMI, body mass index; WRMP, work related musculoskeletal pain; *, Statistically significant association; OR, Odds Ratio; 95% CI, 95% confidence interval.

The prevalence of WRMP between dentists is high and there are associated factors. Despite the limitations that self-administered questionnaires could show, they are useful for assessing characteristics, prevalence’s and associations between variables.

The prevalence of WRMP during the previous 12 months among the dental professionals that responded the survey was 86.05%. Similar results were obtained in studies conducted in other countries such as Australia or Brazil [11, 28]. However, it was higher than some reported results done in Thailand, Greece, or United Arab Emirates [15, 22, 29, 30] and lower than what was found in Saudi Arabia, Czech Republic or USA [10, 18, 20].

The location where the highest prevalence of WRMP was found in our study was the shoulders (69.77%), however, in a study conducted in Malaysia, this location was the higher prevalence (92.7%) [21]. On the other hand, other authors found the neck as the most common location, such as the study of Pope-Ford et al. [18] (93%) or Hodacova et al. (78.1%) [20] or the lower back (7,22). In our study, 69.77% of participants had WRMP in two or more locations during the previous 12 months, which is comparable to other reported results [20–22, 32].

Respect to the intensity, moderate pain predominated in the neck WRMP in 57.14% of the participants, 60.00% in the shoulders, 52.94% in the upper back and 60.87% of the lower back. In a study conducted in Brazil for Garbin et al. [28], the intensity of moderate pain was also predominant (47.6%), followed by mild pain (26.5%), absence of pain (19.9%) and finally severe pain (6%). Al-Mohrej et al. [10] found that 28.3% of the participants reported having mild pain, while 7.4% have moderate intensity and 64.3% severe. However, there are findings where most of these locations showed absence of pain or mild pain, such as Hodacova et al. [18] and by Harutunian et al. reports [28].

In the present study the onset of pain was mostly gradual (83.78%) and only in 16.22% of the cases it appeared suddenly. In a sample of Saudi Arabian dentists, the prevalence of gradual pain was also higher than that sudden pain (70% and 30%, respectively) [13]. On the other hand, pain used to last between 1 and 7 days in most participants with pain in the present study (59.46%). Alghadir et al. [13] showed that 64% of the pain lasted <2 weeks and in the Al-Mohrej et al. [10] study it was mostly <4 weeks (86.5%).

In our study, WRMP caused an impact on daily activities in a 40.54% of dentist surveyed, however other studies showed an impact on work activities and daily life ranging from 41–79.9% [10–13]. Moreover, WRMP had other important consequences, especially changes in work settings (13.51%), which was more prevalent in the results of the Alghadir et al. [13] study.

Several studies show that there are dentists who have had to take sick leave, medical attention or even change the profession due to work-related musculoskeletal problems [10, 11, 15, 17, 18, 20]. Therefore, the health of the dentist is especially important for a successful dental practice.

The high prevalence of WRMP in dentists is largely due to awkward postures. The results of this study suggest that many dentists do not work in the correct ergonomic posture, especially, excessive torsions and cervical flexions, are predictors of shoulder WRMP (p= .004).

Al-Mohrej et al. [10] also found these associations, but in addition, they also observed an important relation between excessive torsions and cervical flexions with pain in the lumbar area (<.001). However, Al-Ali et al. demonstrate an association between the high prevalence of neck and shoulders WRMP with repetitive movements, flexed neck and raised arms [30]. However, a study in Malaysia found that upper and lower back pain was significantly related to awkward postures [21].

An 81.40% of the participants in our study performed declare prolonged static postures during the workday. According to the evidence-based literature, they are considered one of the main causes of work-related musculoskeletal problems [6, 33, 34]. On the contrary, no significant association was found between prolonged static postures and WRMP in the present study.

Some authors argue that the use of magnifying glasses may be favorable for a more upright posture and to decrease chronic back and neck pain [35]. It has also been shown that the correct setting of the dental equipment, good lighting and having the instruments upper hand are ergonomic practices that decrease the probability of occurrence of work-related musculoskeletal problems [9, 14].

In the present study it was found a non-statistically difference according to gender in which women were 21.1% more likely to suffer WRMP than men (p= .420). These results correspond to the reported by Aljanakh et al. [22] and Al-Mohrej et al. [10]. In both studies a similar trend was found with a higher prevalence in women than men but with no statistically significant differences (p= .754 and p= .606 respectively). On the other hand, multiple previous studies observed statistically significant associations between the female gender and WRMP (13,14,18,19,30–32). No statistically significant associations between gender and pain location were found either. However, Hodacova et al. [18] women had more neck and shoulder pain. Nonetheless, Rafeemanesh et al. [27] only found that women are more likely to develop shoulder pain (p <.05). On the other hand, there are studies that shows that men often have pain in the lower back, neck and shoulders, and women usually have pain in these regions but also in the hands and knees [13].

There has been controversy in the scientific literature about the influence of years of experience and age on work-related musculoskeletal problems. Some authors report that for each additional year of age, the probability of neck pain increases 1%, a 3% in the lumbar area and a 4% in the shoulders [18]. In addition, for each year of experience it also increases the probability of neck pain in 1%, 3% in the lumbar area and 3% in the shoulders [10, 13, 18]. Rafeemanesh et al. [31] also found a significant association on back pain and age (p <.05).

On the contrary, other studies found that young and unexperienced dentists were more likely to suffer neck, upper back, and shoulders pain (p <.05) [11, 36], and these dentists might have a higher intensity of pain [11, 27, 29]. It has been suggested that experienced dentists have developed technical skills and adopted their work posture in order to minimize the impact of WRMD’s [23].

No significant association was obtained between hours worked per week and WRMP. These results are also comparable to previous research [14, 36].

No consistent association between specialty and WRMP was observed in the present study (p= .950). However, it has been observed that orthodontists, followed by prosthodontists, are more likely to develop WRMP. Al-Mohrej et al. [10] obtained similar results, but they were statistically significant (p= .010). In addition, they also found that periodontists and pediatric dentists were more likely to develop WRMP, while general practitioners and oral surgeons were the group with the least pain. Kazancioglu et al. [37] reported that oral and maxillofacial surgeons did not have a higher risk to develop work-related musculoskeletal diseases than other specialties. In contrast, some authors showed that the most vulnerable specialties of having work-related musculoskeletal problems were oral surgeons and prosthodontists [7, 32, 38].

No significant associations were found in our study between the specialty and the location of the pain. However, neck and upper back pain were more common between prosthodontists. Shoulder pain was predominant in maxillofacial surgeons and lower back pain in endodontists. According to Alexopolous et al. [15], general practitioners were the most affected professionals by shoulder pain.

It is shown that high BMI contributes significantly to the development of WRMP in the lower back (p= .011), which was also observed by Rafeemanesh et al. [31] (p= .03). Other authors found a statistical significative association between BMI and symptoms in the upper back [21]. However, no significant relationship between BMI and WRMP was found in studies conducted in Israel and Saudi Arabia [7, 10].

Concerning to physical exercise, 16.28% of participants did never practice. Other studies showed that physical activity decreases the likelihood of reporting WRMP [10, 14, 16, 27]. They found that shoulder and lower back pain is more common in dentists who do not do exercise regularly. However, the current study does not show a significant correlation between physical exercise of any kind of WRMP.

WRMP is a common problem for dentists. An 86.05% of the dentists’ sample, reported WRMP during the 12 months before the study, and is slightly predominant in females.
The apparition was gradual in the 83.78%.
Pain episodes used to be at last between 1 and 7 days in most participants.
WRM can have a several negative impact on the professional careers of dentists and their daily lives, such as: reduced non-work activities, reduced hours worked, or changes in work settings.
Inadequate ergonomic positions, especially excessive torsions and cervical flexions are predictors of shoulder WRMP.
A high BMI contributes significantly to the development of WRMP in the lower back.
Preventive health promotion programs could be conducted in the degree of Dentistry during clinical practices, to acquire good working habits in the future. Workshops could also be provided to professionals already practicing. Leaflets on the prevention of WRMP could also be distributed.

WRMP: Work-related musculoskeletal pain
DHUB: Dental Hospital of the University of Barcelona
BMI: Body Mass Index
WRMDs: Work-related musculoskeletal disorders
STROBE: Strengthening the Reporting of Observational Studies in Epidemiology

Ethics approval and consent to participate

The participation in the study was voluntary and conditioned by the consent of the dentists. The informed consent was obtained from all dentists. Each participant could withdraw the study at any time and was able to contact with one of the researchers to ask any question related to the investigation. The survey was accompanied by a cover letter explaining the purpose of the study and reassuring respondents of the confidentiality of the survey. The privacy of the participant will be safeguarded as well as the protection of their data, in accordance with Organic Law 3/2018, of 5 December on the Protection of Personal Data and the Guarantee of Digital Rights in Spain. The recollection of the information was completely anonymous with the digital tool Google Drive / Forms / Quiz. The protocol complied with the Helsinki declaration guidelines and ethics approval was obtained from the DHUB Drug Research Ethics Committee (register 2019-40).

Consent for publication

Not applicable

Availability of data and materials

The datasets generated and/or analyzed during the current study are available in a supplementary file.

Competing interests

The authors declare that they have no competing interests.

Funding

This research did not reveive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors’ contributions

AEBB performed the survey and write the manuscript. MASG designed the method and revised the manuscript. OCF and BTG performed the statistical analysis and revised the manuscript. All the authors have read and approved the final version of the manuscript.

Acknowledgements

The material used in this study was provided by the Dentistry department of the University of Barcelona.

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No competing interests reported.

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Work-Related Musculoskeletal Pain of The Neck, Shoulders And Back Among Dentists At The Dental Hospital of The University Of Barcelona: A Cross-Sectional Study

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Abstract

Figures

Background

Material And Methods

Results

Baseline data from study participants

Ergonomic features

Affection of the WRMP

Univariate logistic regression analysis of the predictors of WRMP

Discussion

Conclusions

List Of Abbreviations

Declarations

References

Competing Interests

Supplementary Files

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