FACTORS RELATED TO THE COMPLAINTS OF MUSCULOSKELETAL DISORDERS AT PT. DETPAK INDONESIA WORKERS IN 2021
1Marsya Balkhies Alfaatihah, 2Suherman, 3Dihartawan, 4Dadang Herdiansyah
1-4Public Health Study Program, Faculty of Public Health, Universitas Muhammadiyah Jakarta KH. Ahmad Dahlan St., Cirendeu, Ciputat, South Jakarta, Banten 15419
Email: suherpru@gmail.com ABSTRAK
Musculoskeletal Disorders (MSDs) adalah sekelompok kondisi abnormal yang mempengaruhi dari fungsi jaringan tubuh. MSDs terjadi disebabkan faktor pekerjaan (beban kerja, postur kerja, durasi kerja, dan gerakan berulang) faktor individu (usia, jenis kelamin, masa kerja, kebiasaan merokok, lama kerja, kesegaran jasmani dan IMT), dan faktor lingkungan (suhu, getaran dan pencahayaan) dan faktor psikososial. World Health Organization dan data dari Global Burden of Disease sekitar 1,71 milyar orang didunia memiliki gangguan musculoskeletal. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan keluhan musculoskeletal disorders pada pekerja PT.Detpak Indonesia tahun 2021. Desain studi cross sectional, data primer yang disebar melalui angket, jumlah responden 97 karyawan teknik pengambilan sampel accidental sampling. Analisis data ini menggunakan uji statistik chi-square (α = 0,05). Variabel yang berhubungan dengan keluhan musculoskeletal disorders yaitu kesegaran jasmani (p value = 0,021 dan OR = 7,238), masa kerja (p value = 0,019 dan OR = 3,947), lama kerja (p value = 0,001 dan OR = 6,979) dan postur kerja (p value
= 0,011 dan OR = 4,340) sedangkan variabel yang tidak berhubungan adalah jenis kelamin (p value = 0,147 dan OR = 2,514). Dari penelitian ini bahwa ada hubungan kesegaran jasmani, masa kerja, lama kerja dan postur kerja dengan keluhan musculoskeletal disorders pada pekerja. Penelitian ini menyarankan kepada pekerja agar melakukan peregangan sebelum dan setelah bekerja, bekerja diselingi istirahat jika pekerja merasa lelah dan lebih memperhatikan posisi kerja saat melakukan pekerjaan.
Kata Kunci : Musculoskeletal Disorders, Penyakit Akibat Kerja, Tubuh ABSTRACT
Musculoskeletal Disorders (MSDs) are a group of abnormal conditions that affect the functioning of body tissues. MSDs occur due to work factors (workload, work posture, work duration, and repetitive movements), individual factors (age, gender, years of service, smoking habits, length of work, physical fitness, and BMI), and environmental factors (temperature, vibration, and lighting) and psychosocial factors. According to the World Health Organization and data from the Global Burden of Disease, about 1.71 billion people worldwide have musculoskeletal disorders. The purpose of this research is to find out the factors related to complaints of musculoskeletal disorders in PT. Detpak Indonesia workers in 2021. Cross-sectional study design, primary data was distributed through questionnaires, and the number of respondents was 97 employees of the accidental sampling technique. This data analysis used the chi-square statistical test (α = 0.05). Variables related to complaints of musculoskeletal disorders are physical fitness (p value = 0.021 and OR = 7.238), years of service (p value = 0.019 and OR = 3.947), length of work (p value = 0.001 and OR = 6.979) and work posture ( p value = 0.011 and OR
= 4.340) while the unrelated variable is gender (p value = 0.147 and OR = 2.514). From this study that there is a relationship between physical fitness, working period, length of work, and work posture with complaints of musculoskeletal disorders in workers. This study suggests that workers stretch before and after work, work interspersed with breaks if workers feel tired, and more pay attention to work position when doing work.
Keywords: Musculoskeletal Disorders, Occupational Illness, Body
INTRODUCTION
The development of the current era is also followed by the development of science and technology (IPTEK) in various fields increasingly advanced (Septiani, 2017). This technology also requires human labor to operate it (manual handling). That way, the risk of workers getting accidents and even occupational diseases can still occur (Zulhijjah, 2021).
Musculoskeletal disorders (MSDs) are health problems workers face, such as injuries to muscles, ligaments, the nervous system, bones, and blood vessels. This disease is caused by improper work posture, static, constantly moving of the body repeatedly, and the weight of the load being lifted (Rahman, 2019).
Around 1.71 billion people worldwide have musculoskeletal disorders, with a prevalence of 568 million people experiencing low back pain. Southeast Asia has as many as 369 million people who share musculoskeletal disorders (World Health Organization, 2021).
In international cases, of all occupational diseases, 42%-58% of workers experience Musculoskeletal Disorders; in America, there are 6 million similar cases in a year, or 300-400 cases per 100,000 workers (Sekaaram & Ani, 2017). According to statistical data from the Health and Safety Executive (HSE), in the UK, in 2020, 1.6 million workers were suffering from work-related diseases, and 480,000 had musculoskeletal disorders (Health and Safety Executive, 2020).
In Indonesia, 9482 workers from 12 districts/cities are experiencing health problems as much as 40.5%, while among them are workers who have musculoskeletal disorders as much as 16% and nervous disorders as much as 5% (Kementerian Kesehatan RI, 2018). The highest prevalence of Musculoskeletal Disorders by occupation is fisherman, farmer, and laborer, which is 31.2% (Zulhijjah, 2021).
A study on musculoskeletal disorders conducted by Riana and Hendra in 2013 showed that complaints of musculoskeletal disorders in manual handling workers in Cikarang often experienced complaints in the waist as much as 58% and complaints in the upper shoulder by 52.9% (Laksana &
Srisantyorini, 2020).
Factors that can affect the occurrence of Musculoskeletal Disorders (MSDs) are categorized into four categories, namely work factors (workload, work posture, work duration, and repetitive movements) and individual factors (age, gender, years of service, smoking habits, length of work, freshness). Physical and BMI), environmental factors (temperature, vibration, and lighting), and psychosocial factors (Anisa Fahmiawati et al., 2021).
There is no research conducted at PT. Detpak Indonesia, regarding factors related to complaints of musculoskeletal disorders, made researchers interested in researching factors related to the complaints of musculoskeletal disorders at PT. Detpak Indonesia workers in 2021."
METHOD
This research is quantitative, with the method used being observational analytic with a cross- sectional design. This study uses the accidental sampling method, which is an accidental sampling technique by taking cases or respondents who happen to exist or are available in a place according to the research context. The sample in this study amounted to 97 respondents.
Data was obtained through observation, interviews, and questionnaires. The researcher observed workers' body positions obtained during the work on MSDs complaints. The measuring instrument used to measure body posture is the Repaid Entire Body Assessment (REBA) survey sheet.
Then proceed with filling out the Nordic Body Map (NBM) sheet to find out which body part is experiencing complaints and the level of complaints felt by each individual. The analysis carried out in this study was univariate analysis to see prevalence and bivariate chi-square analysis (α = 0.05) and the calculation of Odds Ratio (OR).
RESULTS AND DISCUSSION
Based on table 1, is known as that from 97 workers, there are 79 (81.4%) respondents who have complaints of musculoskeletal disorders. While 18 (18.6%) respondents did not have complaints of musculoskeletal disorders, it is known that most workers experienced complaints on the waist, right lower arm, right hand, right shoulder, wrist, upper neck, and left hand.
Table 1. Distribution of Respondents Experiencing Complaints of Musculoskeletal Disorders at PT.
Detpak Indonesia in 2021
Based on table 2, it can be seen that more respondents were male, as many as 59 (61%) respondents. While the female sex, as many as 38 (39%) respondents.
Table 2. Distribution of Respondents by Gender in Workers of PT. Detpak Indonesia in 2021
Table 3 shows that as many as 90 (93%) respondents have less physical fitness; in other words, only 7 (7%) have good physical fitness.
Musculoskeletal Disorders Complaints n %
Complaints 79 81.4%
No Complaints 18 18.6%
Total 97 100%
Gender n %
Male 50 51.5%
Female 47 48.5%
Total 97 100%
Table 3. Distribution of Respondents Based on Physical Fitness in Workers of PT. Detpak Indonesia in 2021
Physical Fitness n %
Less physical fitness 90 92.8%
Sufficient physical fitness 7 7.2%
Total 97 100%
Table 4 shows that for the most working years, those with a risk tenure of ≥ 9 years are 49 (50.5%) respondents. Meanwhile, the respondents had no risk of working period < 9 years, 48 (49.5%).
Table 4. Distribution of Respondents Based on Years of Service at PT. Detpak Indonesia in 2021
Based on table 5, we can see that as many as 75 (77.3%) respondents work > 8 hours, while as many as 22 (22.77%) respondents work < 8 hours.
Table 5. Distribution of Respondents Based on Length of Work at PT. Detpak Indonesia in 2021
Length of Work n %
>8 hours 75 77,3%
<8 hours 22 22,7%
Total 97 100%
Table 6 shows that as many as 65 (67%) respondents work with non-ergonomic work postures, while as many as 32 (33%) work with ergonomic body positions.
Table 6. Distribution of Respondents Based on Work Posture Employees of PT. Detpak Indonesia in 2021
Work Posture n %
Non-ergonomic 65 67%
Ergonomic 32 33%
Total 97 100%
From the analysis of the relationship between sex and complaints of musculoskeletal disorders, p-value = 0.147, it can be concluded that there is no significant relationship between gender and the occurrence of complaints of musculoskeletal disorders. The analysis results obtained an OR value of 2.514, which shows that male workers have a 2.514 times greater risk of experiencing complaints of musculoskeletal disorders than female workers.
Years of Service n %
≥9 Years at risk 49 50,5%
Risk Of Working Period < 9 Years 48 49,5%
Total 97 100%
Table 7. Relationship between Independent Variables and Complaints of Musculoskeletal Disorders (MSDs) in PT. Detpak Indonesia in 2021
Variable Musculoskeletal Disorders Complaints OR (95% CI) P-Value Complaints No Complaints Total
n % n % n %
Gender
Male 44 88% 6 12% 50 100% 2.514
(0.85 - 7.37)
0.147
Female 36 74.5% 12 25.5% 47 100%
Physical Fitness
less physical fitness 76 84.4% 14 15.6% 90 100% 7.238 (1.4 - 35.9)
0.021 sufficient physical fitness 3 42.9% 4 57.1% 7 100%
Years of Service
≥9 Years 49 91.8% 4 8.2% 49 100% 4.632
(1.39-15.3)
0.016
< 9 Years 34 70.8% 14 29.2% 48 100%
Length of Work
>8 hours 67 89.3% 8 10.7% 75 100% 6.979
(2.29-21.2)
0.001
≤8 hours 12 54.5% 10 45.5% 22 100%
Work Posture
Non-Ergonomic 58 89.2% 7 10.8% 65 100% 4.340
(1.48– 12.6)
0.011
Ergonomic 21 65.6% 11 34.4% 32 100%
Based on the results of the relationship between physical fitness and complaints of musculoskeletal disorders, knew that the statistical results of the chi-square test obtained a value of p = 0.021 from these data, it can conclude that there is a significant relationship between physical fitness and complaints of musculoskeletal disorders and an OR value of 7.238 which indicates that the respondent has less physical fitness. have a 7.239 times greater chance of experiencing complaints of musculoskeletal disorders compared to respondents who have good physical fitness.
The analysis of the relationship between the length of service and fatigue with musculoskeletal disorders showed that the statistical results of the chi-square test obtained a p-value = 0.016, so it can conclude that there is a significant relationship between tenure and complaints of musculoskeletal disorders. From the analysis results, the value of OR = 4,632 (95% CI =1,39-15.3), meaning that the service period of 9 years has a 3,947 times greater chance of experiencing complaints of musculoskeletal disorders compared to the working period of < 9 years.
The analysis of the relationship between the length of work and complaints of musculoskeletal disorders showed a value of p = 0.001 which means that there is a relationship between the length of labor and complaints of musculoskeletal disorders. From the analysis results, the OR = 6.979 (95% CI
= 2.290-21.270) means that working hours > 8 hours have a 6.979 times greater chance of experiencing complaints of musculoskeletal disorders compared to working hours of 8 hours.
The relationship between work posture and complaints of musculoskeletal disorders showed that respondents who had musculoskeletal disorders obtained a p-value = 0.011. So it can be interpreted that there is a significant relationship between work posture and complaints of musculoskeletal disorders. The OR = 4.340 (95% CI = 1.487-12.667) means that respondents with non-ergonomic work
postures have a 4.340 times higher chance of experiencing musculoskeletal disorders complaints compared to those with ergonomic work postures.
Men's muscle strength is greater than that of women. Physiologically, someone with lower physical strength when doing work requiring more exertion will be susceptible to musculoskeletal risk (Lubis, 2018). The muscle ability of women is two-thirds of that of men, and the difference in muscle complaints between men and women is 1 to 3. Men and women have different hormonal influences (Helmina et al., 2019).
This is in line with other studies which state that there is no significant relationship between gender and complaints of musculoskeletal disorders conducted by Anisa Fahmiawati et al. (2021), as evidenced by the p-value = 1,000. But it is not in line with research conducted by Rossa et al. (2017) that there is a significant relationship between gender and complaints of musculoskeletal disorders with a p-value=0.002.
The risk of musculoskeletal disorders, especially muscle complaints, is influenced by the freshness of the body. A muscle elasticity lock causes musculoskeletal disorders complaints due to excessive physical activity without sufficient physical fitness (Viswanatha & Adiatmika, 2020). Regular exercise can help increase blood flow to muscles, tendons, and ligaments to increase nutrition for cells.
Someone who works with great energy and does not get enough rest will be more at risk of experiencing muscle complaints. A low level of physical fitness will increase the risk of complaints of musculoskeletal disorders (Mulyadi, 2015).
This is in line with research (Widitia et al., 2020) with the results of p-value = 0.041 that there is a significant relationship between physical fitness and musculoskeletal complaints. Another study by Marcilin and Situngkir (2020) found a significant association between physical fitness and musculoskeletal complaints.
A person's working period is a supporting factor influencing the occurrence of musculoskeletal disorders complaints. A person's physical endurance is related to the length of time a person has to work (Butar-Butar, 2018). Complaints felt by workers can be influenced by years of service; the higher the period of service, the more complaints handled will be even more significant because the work period is an accumulation of one's work activities carried out over a long time. And activities carried out continuously will result in disturbances in the body (Komarliawati et al., 2019).
According to Kattang, Kawatu, and Tucuan (2018), this is in line with research that there is a significant relationship between tenure and complaints of musculoskeletal disorders, the p-value = 0.017. Meanwhile, according to a study conducted by Icsal, Sabilu, and Pratiwi (2016), it is inversely proportional, which states that there is no significant relationship between tenure and complaints of musculoskeletal disorders, obtained p-value=0.672
Constitution No. 13 of 2003 concerning Manpower explains that the length of time a person
possibility of undesirable things such as occupational diseases or work accidents (President of the Republic of Indonesia, 2003).
A person's working time determines health related to his work's efficiency, effectiveness, and productivity. The most important aspect of working time includes the length of time a person can do a good job (Rovendra & Meilinda, 2021). The length of work can affect energy availability, so it needs to be balanced with adequate rest in a day. Good rest will restore the energy lost during work.
The results of this study are in line with research conducted by Wafiq et al. (2021), which states that there is a significant relationship between the length of work and complaints of musculoskeletal disorders with a p-value = 0.020, research conducted by Santosa and Ariska, (2018) states that there is a significant relationship between the length of work and complaints of
Posture is the measured position of the body part at work and is determined by body size, work environment design, and the size of objects/other equipment used at work. Posture and movement play an important role in ergonomics. One of the main causes of skeletal muscle disorders is awkward posture (Awkward posture) (Sulaiman & Purnama Sari, 2016). Improper work posture will add risk because it requires maintenance of muscle strength. If this situation is repeated for a long time, the likelihood of MSDs is three times that of workers who do it for a shorter time (Prahastuti et al., 2021).
This study is in line with research conducted by Fauziah (2018) that there is a significant relationship between body posture and complaints of musculoskeletal disorders as evidenced by the p- value = 0.006 and in line with research conducted by Pratiwi (2020), obtained p-value = 0.006 which means that there is a significant relationship between work posture and complaints of musculoskeletal disorders.
CONCLUSIONS AND SUGGESTIONS
In conclusion, the variables with a significant relationship with musculoskeletal disorders are physical fitness, service length of work, and work posture, with a p-value of 0.05. Suggestions from this research are:
a. It is expected to be input in taking action to anticipate the occurrence of complaints of musculoskeletal disorders in employees
b. Provide training to employees about the dangers of musculoskeletal disorders and how to overcome them
c. Modify the height of the seat and footing so that it is possible for employees to work in a safe position or not bend too much.
d. Workers use the best possible rest time outside of working hours and do stretching to stretch tense muscles.
Doing physical activity outside of work time to maintain physical fitness
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