Browsing by Author "Peiris-John, R.J."

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Additional perspectives on chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka-lessons learned from the WHO CKDu population prevalence study
(BioMed Central, 2014) Redmon, J.H.; Elledge, M.F.; Womack, D.S.; Wickremasinghe, R.; Wanigasuriya, K.P.; Peiris-John, R.J.; Lunyera, J.; Smith, K.; Raymer, J.H.; Levine, K.E.
The recent emergence of an apparently new form of chronic kidney disease of unknown aetiology (CKDu) has become a serious public health crisis in Sri Lanka. CKDu is slowly progressive, irreversible, and asymptomatic until late stages, and is not attributable to hypertension, diabetes, or other known aetiologies. In response to the scope and severity of the emerging CKDu health crisis, the Sri Lanka Ministry of Health and the World Health Organization initiated a collaborative research project from 2009 through 2012 to investigate CKDu prevalence and aetiology. The objective of this paper is to discuss the recently published findings of this investigation and present additional considerations and recommendations that may enhance subsequent investigations designed to identify and understand CKDu risk factors in Sri Lanka or other countries.
Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause?
(Biomed Central, 2011) Wanigasuriya, K.P.; Peiris-John, R.J.; Wickremasinghe, R.
BACKGROUND: The rising prevalence of chronic kidney disease (CKD) and subsequent end stage renal failure necessitating renal replacement therapy has profound consequences for affected individuals and health care resources. This community based study was conducted to identify potential predictors of microalbuminuria in a randomly selected sample of adults from the North Central Province (NCP) of Sri Lanka, where the burden of CKD is pronounced and the underlying cause still unknown. METHODS: Exposures to possible risk factors were determined in randomly recruited subjects (425 females and 461 males) from selected areas of the NCP of Sri Lanka using an interviewer administered questionnaire. Sulphosalicylic acid and the Light Dependent Resister microalbumin gel filtration method was used for initial screening for microalbuminuria and reconfirmed by the Micral strip test. RESULTS: Microalbumnuria was detected in 6.1% of the females and 8.5% of the males. Smoking (p < 0.001), alcohol use (p = 0.003), hypertension (p < 0.001), diabetes (p < 0.001), urinary tract infection (UTI) (p = 0.034) and consumption of water from wells in the fields (p = 0.025) were associated with microalbuminuria. In the binary logistic regression analysis, hypertension, diabetes mellitus, UTI, drinking well water in the fields, smoking and pesticide spraying were found to be significant predictors of microalbuminuria. CONCLUSIONS: Hypertension, diabetes mellitus, UTI, and smoking are known risk factors for microalbuminuria. The association between microalbuminuria and consumption of well water suggests an environmental aetiology to CKD in NCP. The causative agent is yet to be identified. Investigations for cadmium as a potential causative agent needs to be initiated.
Chronic kidney disease of unknown aetiology in the North Central Province of Sri Lanka: trying to unravel the mystery
(Sri Lanka Medical Association, 2011) Wickremasinghe, A.R.; Peiris-John, R.J.; Wanigasuriya, K.P.
No Abstract Available
Classification of neck/shoulder pain in epidemiological research: a comparison of personal and occupational characteristics, disability and prognosis among 12,195 workers from 18 countries
(Elsevier-North-Holland, 2016) Sarquis, L.M.; Coggon, D.; Ntani, G.; Walker-Bone, K.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Vargas-Prada, S.; Bonzini, M,; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Kadir, M.M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Marziale, M.H.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Harris, E.C.; Serra, C.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Tiina; Freimann; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Herbison, P.; Gray, A.; Salazar Vega, E.J.
To inform case-definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9,150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The one-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs. 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs. 1.3) and poor mental health (PRR 1.3 vs. 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs. 61.7%). Our findings highlight important epidemiological distinctions between sub-categories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain which is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region.
The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample
(Public Library of Science, 2012) Coggon, D.; Ntani, G.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Serra, C.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Kadir, M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Marziale, M.H.; Sarquis, L.M.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Salazar Vega, E.J.; Harris, E.C.; Vargas-Prada, S.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Sirk, T.; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kielkowski, D.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Gray, A.
BACKGROUND: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample. METHODS/PRINCIPAL FINDINGS: A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as "repetitive strain injury" (RSI). CONCLUSIONS/SIGNIFICANCE: The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.
Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study
(Public Library of Science, 2016) Vargas-Prada, S.; Coggon, D.; Ntani, G.; Walker-Bone, K.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Kadir, M.M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Sarquis, L.M.; Marziale, M.H.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Harris, E.C.; Serra, C.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Freimann, T.; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Herbison, P.; Gray, A.; Vega, E.J.
Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
Disability studies in Sri Lanka: priorities for action
(Informa Healthcare, 2014) Peiris-John, R.J.; Attanayake, S.; Daskon, L.; Wickremasinghe, A.R.; Ameratunga, S.
ABSTRACT PURPOSE: To review the published literature relating to disability in Sri Lanka, identify research gaps and inform priorities for action. METHODS: A narrative literature review was undertaken and relevant articles extracted using electronic databases such as Medline and PubMed. The available literature was examined in relation to the nine key recommendations of the World Report on Disability. RESULTS: Over the past 30 years, published disability research in Sri Lanka has primarily focussed on mental health, visual impairment and healthcare delivery. Significant gaps were apparent in evidence relating to the status and services for people with intellectual disability, policies and their impact, provider attitudes, barriers to education and employment, health workforce training and access to healthcare. CONCLISIONS: While published studies provide insights on several dimensions of disability, there are important research gaps pointing to unmet needs that require attention to support the health and wellbeing of people living with disability in Sri Lanka. To address these gaps, it is imperative that a critical mass of multi-disciplinary researchers including people living with disabilities collaborate on a strategic program of research using effective participatory approaches that engage all sectors and communities relevant to uphold the rights of people living with disability. Implications for Rehabilitation All nine key recommendations in the World Report on Disability are highly pertinent to the needs and status of people living with disabilities in Sri Lanka. Significant gaps in research on disability-related health issues exist and warrant more focussed attention by researchers, funders and policy makers. It is imperative that national stakeholders including the Ministries of Health and Social Welfare, organisations representing people living with disability and related advocacy groups, work collaboratively to identify and implement a research strategy that would better inform disability policies and programmes that have access and equity as core principles. Implementation of a national disability survey by the Department of Census and Statistics, will help prioritize disability research in the country
Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?
(Elsevier/North-Holland., 2013) Coggon, D.; Ntani, G.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Serra, C.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Masood Kadir, M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Marziale, M.H.; Sarquis, L.M.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Salazar; Vega, E.J.; Harris, E.C.; Vargas-Prada, S.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Sirk, T.; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Herbison, P.; Gray, A.
To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed. Copyright © 2013 International Association for the Study of Pain. All rights reserved.
Effects of occupational exposure to organophosphate pesticides on nerve and neuromuscular function
(Lippincott Williams and Wilkins, 2002) Peiris-John, R.J.; Ruberu, D.K.; Wickremasinghe, A.R.; Smit, L.A.; van der Hoek, W.
This study aimed to investigate whether occupational exposure to organophosphate (OP) pesticides caused neurophysiological abnormalities. Thirty farmers who regularly spray OP pesticides and 30 fishermen (controls), living close by but not involved in pesticide spraying, were evaluated during and between cultivation seasons. The farmers had higher erythrocyte acetylcholinesterase levels than the controls during (P = 0.06) and between cultivation seasons (P = 0.09). During the cultivation season, there was a significant reduction in erythrocyte acetylcholinesterase activity in both groups (P < 0.01). Significant differences between the farmers and controls were found in sensory conduction velocity (P = 0.04) and motor conduction velocity (P = 0.04) between cultivation seasons. Sensory conduction velocity was reduced significantly in farmers (P < 0.01) and in controls (P = 0.04) during the cultivation season. Effects of OP poisoning were seen both in farmers and in controls, who had no history of spray activities. Evidence of sensory dysfunction after acute exposure and sensory and motor impairment after long-term low-level exposure to OP was seen.
Efficacy of activated charcoal in yellow oleander poisoning
(Sri Lanka Medical Association, 2008) Peiris-John, R.J.; Wickremasinghe, A.R.
No Abstract Available
Epidemiological differences between localized and nonlocalized low back pain
(Lippincott Williams & Wilkins, 2017) Coggon, D.; Ntani, G.; Walker-Bone, K.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Vargas-Prada, S.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Kadir, M.M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Sarquis, L.M.; Marziale, M.H.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Harris, E.C.; Serra, C.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Freimann, T.; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Herbison, P.; Gray, A.; Vega, E.J.
STUDY DESIGN: Cross-sectional survey with longitudinal follow-up OBJECTIVES.: To test the hypothesis that pain which is localised to the low back differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. METHODS: We analysed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability and potential risk factors, in 47 occupational groups (office workers, nurses and others) from 18 countries. RESULTS: Among 12,197 subjects at baseline, 609 (4.9%) reported localised LBP in the past month, and 3,820 (31.3%) non-localised LBP. Non-localised LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, non-localised LBP was differentially associated with risk factors, particularly female sex, older age and somatising tendency. There were also marked differences in the relative prevalence of localised and non-localised LBP by occupational group. CONCLUSIONS: Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP which occurs in association with pain at other anatomical locations.
Exposure to acetylcholinesterase-inhibiting pesticides and chronic renal failure
(Sri Lanka Medical Association, 2006) Peiris-John, R.J.; Wanigasuriya, J.K.; Wickremasinghe, A.R.; Dissanayake, W.P.; Hittarage, A.
No Abstract Available.
Low-level exposure to organophosphate pesticides leads to restrictive lung dysfunction
(Elsevier-W.B. Saunders, 2005) Peiris-John, R.J.; Ruberu, D.K.; Wickremasinghe, A.R.; van-der-Hoek, W.
Apart from symptomology, there are very few reports on lung function following exposure to low levels of organophosphate (OP) pesticides in man. Twenty-five occupationally exposed farmers and 22 environmentally exposed freshwater fishermen were evaluated between and during OP spray seasons. Forty marine fishermen living away from agricultural areas were recruited as a control group. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) were measured by spirometry. Haemoglobin corrected erythrocyte acetylcholinesterase (AChE) levels were measured during and between (baseline estimation) spray seasons using a portable WHO-approved Test-mate system (EQM Research, Ohio). FVC ratio was lower in the farmers as compared to the controls (P<0.001) between exposureseasons. In the farmers, FVC ratio decreased further during the exposure season (P=0.023). FEV(1) was lower in the farmers as compared to the controls in both periods (P<0.05). In the fishermen, the decrease in ratios of FVC and FEV(1) following exposure to pesticides was not significant. FEV(1)/FVC ratios were similar in the three groups between (P=0.988) and during (P=0.159) exposure periods. Followingexposure to OPs, AChE levels dropped 12.75% in the farmers (P<0.001) and 5.62% in the freshwater fishermen (P=0.001). Occupationalexposure to OP results in restrictive lung dysfunction, a phenomenon not observed following environmental exposure
Musculoskeletal pain in four occupational populations in Sri Lanka
(Oxford University Press, 2012) Warnakulasuriya, S.S.; Peiris-John, R.J.; Coggon, D.; Ntani, G.; Sathiakumar, N.; Wickremasinghe, A.R.
BACKGROUND: Factors influencing work-related musculoskeletal disorders might differ in developing and developed countries. AIMS: To assess the prevalence and determinants of musculoskeletal pain in four occupational populations in Sri Lanka. METHODS: As part of the international Cultural and Psychosocial Influences on Disability study, samples of postal workers, sewing machinists, nurses and computer operators were interviewed about pain at each of six anatomical sites in the past month, and about possible physical and psychosocial risk factors. Associations with prevalent pain were assessed by binomial regression. RESULTS: Analysis was based on 852 participants (86% response rate). Overall, the lower back was the most common site of pain, with 1-month prevalence ranging from 12% in computer operators to 30% in nurses. Postal workers had the highest prevalence of shoulder pain (23%), but pain in the wrist/hand was relatively uncommon in all four occupational groups (prevalence rates ranged from 8% to 9%). Low mood and tendency to somatize were consistently associated with pain at all six sites. After adjustment for psychosocial risk factors, there was a higher rate of low backpain in nurses and postal workers than in computer operators, a higher rate of shoulder pain in postal workers than in the other occupationalpopulations, and a relatively low rate of knee pain in computer operators. CONCLUSIONS: Rates of regional pain, especially at the wrist/hand, were lower than have been reported in Western countries. As elsewhere, painwas strongly associated with low mood and somatizing tendency. Differences in patterns of pain by occupation may reflect differences in physical activities.
Patterns of multisite pain and associations with risk factors
(Elsevier/North-Holland, 2013) Coggon, D.; Ntani, G.; Palmer, K.T.; Felli, V.E.; Harari, R.; Barrero, L.H.; Felknor, S.A.; Gimeno, D.; Cattrell, A.; Vargas-Prada, S.; Bonzini, M.; Solidaki, E.; Merisalu, E.; Habib, R.R.; Sadeghian, F.; Masood Kadir, M.; Warnakulasuriya, S.S.; Matsudaira, K.; Nyantumbu, B.; Sim, M.R.; Harcombe, H.; Cox, K.; Marziale, M.H.; Sarquis, L.M.; Harari, F.; Freire, R.; Harari, N.; Monroy, M.V.; Quintana, L.A.; Rojas, M.; Salazar Vega, E.J.; Harris, E.C.; Serra, C.; Martinez, J.M.; Delclos, G.; Benavides, F.G.; Carugno, M.; Ferrario, M.M.; Pesatori, A.C.; Chatzi, L.; Bitsios, P.; Kogevinas, M.; Oha, K.; Sirk, T.; Sadeghian, A.; Peiris-John, R.J.; Sathiakumar, N.; Wickremasinghe, A.R.; Yoshimura, N.; Kelsall, H.L.; Hoe, V.C.; Urquhart, D.M.; Derrett, S.; McBride, D.; Herbison, P.; Gray, A.
To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20-59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites. Copyright © 2013 International Association for the Study of Pain. All rights reserved.
Work-related musculoskeletal Disorders among mail sorting officers in Sri Lanka: a cross sectional study
(College of Community Physicians of Sri Lanka, 2012) Warnakulasuriya, S.S.P.; Peiris-John, R.J.; Sivayogan, S.; Sathiakumar, N.; Coggon, D.; Wickremasinghe, A.R.
BACKGROUND: Mail sorting requires repetitive movements of the upper limbs, target oriented tasks, long term standing or sitting, concentration and a good memory. The extent of musculoskeletal disorders (MSDs) among mail sorting officers (MSOs) is not known. This study was conducted to determine the prevalence and associated factors with work-related MSDs among MSOs in Sri Lanka. METHODS: 250 randomly selected MSOs who were attached to the Central Mail Exchange, Colombo, were administered a pre-tested questionnaire after obtaining informed written consent. Information on demographic characteristics, musculoskeletal symptoms of the different body parts, job tasks, work history, job satisfaction, sick leave, feelings of job security, and personal perceptions of musculoskeletal symptoms during the past month were obtained. Data were analyzed using SPSS (version 16). Descriptive analyses were used to describe variables and chi-square tests were used to determine associations between pain symptoms and associated variables. RESULTS: The prevalence of backache was highest (38.4%), followed by shoulder pain (27.6%), knee pain (21.2%), neck pain (16.4%), wrist and arm pain (11.2%) and elbow pain (10%). 59.6% of MSOs had experienced at least one MSDs sometime during the past 12 months. Mail sorting activities involved repetitive hand and wrist movements for more than four hours a day (n=239), repetitive bending and straightening of elbow more than one hour a day (n=239), keeping the hand above shoulder height for more than one hour a day (n=239) and climbing up and down more than 30 steps (n=218) a day. Height was significantly associated with shoulder pain (OR=1.056, 95% CI=1.069-3.577). Pain in all of the other sites was not associated with known risk factors in other studies. CONCLUSION: The predominant ergonomic problem in mail sorters in Sri Lanka are in the lower back, shoulder and neck areas. Although there is a high prevalence of some musculoskeletal symptoms in MSOs, most of the known risk factors identified in other studies such as age, right or left handedness, years of experience in current job, smoking habit and job satisfaction etc., were not significantly associated with MSDs in this population. Other physical, psychosocial and environmental factors need to be investigated.