Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2017; 8(6): 478-483
Published online Jun 18, 2017. doi: 10.5312/wjo.v8.i6.478
Upper extremity disorders in heavy industry workers in Greece
Thomaella Tsouvaltzidou, Evangelos Alexopoulos, Ioannis Fragkakis, Eleni Jelastopulu
Thomaella Tsouvaltzidou, Eleni Jelastopulu, Department of Public Health, Medical School, University of Patras, 26500 Patras, Greece
Evangelos Alexopoulos, Medical School, University of Athens, 11527 Athens, Greece
Ioannis Fragkakis, Department of Orthopaedic Surgery, General Hospital of Patras “Agios Andreas”, 26335 Patras, Greece
Author contributions: Tsouvaltzidou T and Alexopoulos E contributed equally to this work; Tsouvaltzidou T and Alexopoulos E designed the study; Tsouvaltzidou T and Fragkakis I analyzed and interpretated the data; Tsouvaltzidou T participated in the drafting and reviewing of the manuscript; Alexopoulos E acquired the data; Alexopoulos E and Jelastopulu E participated in the critical revisions of the manuscript for intellectual content; Jelastopulu E contributed in the final approval of the version of the article to be published.
Institutional review board statement: The study was reviewed and approved by the Bioethics Committee of the University of Patras.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at jelasto@upatras.gr. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eleni Jelastopulu, MD, PhD, Professor of Public Health, Department of Public Health, Medical School, University of Patras, Hippokrates Avenue, 26500 Patras, Greece. jelasto@upatras.gr
Telephone: +30-2610-969878 Fax: +30-2610-991606
Received: January 25, 2017
Peer-review started: February 3, 2017
First decision: March 28, 2017
Revised: April 30, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: June 18, 2017

To investigate the disability due to musculoskeletal disorders of the upper extremities in heavy industry workers.


The population under study consisted of 802 employees, both white- and blue-collar, working in a shipyard industry in Athens, Greece. Data were collected through the distribution of questionnaires and the recording of individual and job-related characteristics during the period 2006-2009. The questionnaires used were the Quick Disabilities of the Arm, Shoulder and Hand (QD) Outcome Measure, the Work Ability Index (WAI) and the Short-Form-36 (SF-36) Health Survey. The QD was divided into three parameters - movement restrictions in everyday activities, work and sports/music activities - and the SF-36 into two items, physical and emotional. Multiple linear regression analysis was performed by means of the SPSS v.22 for Windows Statistical Package.


The answers given by the participants for the QD did not reveal great discomfort regarding the execution of manual tasks, with the majority of the participants scoring under 5%, meaning no disability. After conducting multiple linear regression, age revealed a positive association with the parameter of restrictions in everyday activities (b = 0.64, P = 0.000). Basic education showed a statistically significant association regarding restrictions during leisure activities, with b = 2.140 (P = 0.029) for compulsory education graduates. WAI’s final score displayed negative charging in the regression analysis of all three parameters, with b = -0.142 (P = 0.0), b = -0.099 (P = 0.055) and b = -0.376 (P = 0.001) respectively, while the physical and emotional components of SF-36 associated with movement restrictions only in daily activities and work. The participants’ specialty made no statistically significant associations with any of the three parameters of the QD.


Increased musculoskeletal disorders of the upper extremity are associated with older age, lower basic education and physical and mental/emotional health and reduced working ability.

Keywords: Upper extremity disorders, Heavy industry, QuickDASH, Movement restrictions, Occupational diseases

Core tip: To our knowledge, this is the first study to use the QuickDASH questionnaire for the evaluation of the physical functionality of the upper extremities in the heavy industry sector. Furthermore, it has proved that the presence of musculoskeletal disorders is negatively associated with the reported working ability of the participants, as well as their physical and emotional health. These data will assist in taking measures for the prevention of occupational accidents and injuries in manual labor.