The Silent Strain: Grip Strength, and Wrist/Hand Musculoskeletal Disorders among Meat Cutters
Main Article Content
Keywords
Grip strength, Meat cutters , Musculoskeletal symptoms
Abstract
Background: Meat cutters are a working group engaged in awkward posture, repetitive motion, and forceful exertion in wrists/hands. This study was conducted a) to examine the prevalence of musculoskeletal symptoms among Iranian meat cutters, b) to assess the wrist musculoskeletal disorders risk assessment and hand grip strength. Methods: Ninety-five male meat cutters in Iran (≥ 1 year tenure) completed a demographic/occupational questionnaire, the Nordic Musculoskeletal Questionnaire (NMQ), and the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Ergonomic risk was assessed via the ACGIH-TLV hand activity method, and maximum hand-grip force was measured. Results: With 69.5% reporting point prevalence and 70.5% reporting period prevalence of wrist/hand musculoskeletal symptoms, the study indicated that meat cutters had a significant prevalence of these symptoms. Most participants demonstrated mild to moderate severity in self-reported wrist symptoms while retaining asymptomatic functional status. The ACGIH-HAL assessment indicated most participants operated at or above the action level (AL), suggesting potential ergonomic risks. Moreover, The ACGIH-HAL ratio had a weak negative association with hand grip strength (β = − 0.0071, p = 0.12). Conclusions: These findings highlight the ergonomic challenges associated with meat-cutting tasks.
References
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16. Johansson B, Rask K, Stenberg M. Piece rates and their effects on health and safety - a literature review. Appl Ergon. 2010;41(4):607-14. doi: 10.1016/j.apergo.2009.12.020
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19. Harris C, Eisen EA, Goldberg R, Krause N, Rempel D. 1st place, PREMUS best paper competition: workplace and individual factors in wrist tendinosis among blue-collar workers--the San Francisco study. Scand J Work Environ Health. 2011;37(2):85-98. doi: 10.5271/sjweh.3147
20. Nordander C, Ohlsson K, Akesson I, Arvidsson I, Balogh I, Hansson GÅ, Strömberg U, Rittner R, Skerfving S. Exposure-response relationships in work-related musculoskeletal disorders in elbows and hands - A synthesis of group-level data on exposure and response obtained using uniform methods of data collection. Appl Ergon. 2013;44(2):241-53. doi: 10.1016/j.apergo.2012.07.009
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22. Kurppa K, Viikari-Juntura E, Kuosma E, Huuskonen M, Kivi P. Incidence of tenosynovitis or peritendinitis and epicondylitis in a meat-processing factory. Scand J Work Environ Health. 1991;17(1):32-7. doi: 10.5271/sjweh.1737
23. Viikari-Juntura E, Kurppa K, Kuosma E, Huuskonen M, Kuorinka I, Ketola R, Könni U. Prevalence of epicondylitis and elbow pain in the meat-processing industry. Scand J Work Environ Health. 1991;17(1):38-45. doi: 10.5271/sjweh.1736
24. Yassi A, Sprout J, Tate R. Upper limb repetitive strain injuries in Manitoba. Am J Ind Med. 1996;30(4):461-72. doi: 10.1002/(SICI)1097-0274(199610)30:4<461::AID-AJIM12>3.0.CO;2-2
25. Magnusson M, Ortengren R, Andersson GB, Petersén I, Sabel B. An ergonomic study of work methods and physical disorders among professional butchers. Appl Ergon. 1987;18(1):43-50. doi: 10.1016/0003-6870(87)90069-x
26. Vogel K, Karltun J, Eklund J, Engkvist IL. Improving meat cutters' work: changes and effects following an intervention. Appl Ergon. 2013;44(6):996-1003. doi: 10.1016/j.apergo.2013.03.016
27. Hansson GA, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Åkesson I, Unge J, Rittner R, Strömberg U, Skerfving S. Physical workload in various types of work: Part I. Wrist and forearm. Int J Ind Ergon.2009;39(1):221–233. doi:10.1016/j.ergon.2008.04.003
28. Hansson GA, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Åkesson I, Unge J, Rittner R, Strömberg U, Skerfving S. Physical workload in various types of work: Part II. Neck, shoulder and upper arm. Int J Ind Ergon.2010;40(3):267–281. doi:10.1016/j.ergon.2009.11.002
29. Fogleman MT, Freivalds A, Goldberg JH. An ergonomic evaluation of knives for two poultry cutting tasks. Int J Ind Ergon. 1993;11(3)257–265. doi:10.1016/0169-8141(93)90114-S
30. Szabo RL, Radwin RG, Henderson CJ. The influence of knife dullness on poultry processing operator exertions and the effectiveness of periodic knife steeling. AIHAJ. 2001;62(4):428-33. doi: 10.1080/15298660108984644
31. Gay RE, Amadio PC, Johnson JC. Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release. J Hand Surg Am. 2003;28(2):250-4. doi: 10.1053/jhsu.2003.50043
32. Tirloni AS, Dos Reis DC, Tirloni SF, Moro ARP. Exertion Perception When Performing Cutting Tasks in Poultry Slaughterhouses: Risk Assessment of Developing Musculoskeletal Disorders. Int J Environ Res Public Health. 2020;17(24):9534. doi: 10.3390/ijerph17249534
33. Dias NF, Tirloni AS, dos Reis DC, Moro ARP. Risk of slaughterhouse workers developing work-related musculoskeletal disorders in different organizational working conditions. Int J Ind Ergon. 2020;76:102929. doi: 10.1016/j.ergon.2020.102929
34. Pérez E, Rodríguez Y, Salazar MC, Trujillo MA. Improving Working Conditions Using the Ergonomic Checkpoints Tool: Application in a Colombian Meat Processing Plant. IISE Trans Occup Ergon Hum Factors. 2021;9(2):72-77. doi: 10.1080/24725838.2021.1962622
35. Tirloni, A.S.; Dos Reis, D.C.; Dias, N.F.; Moro, A.R.P. The Use of Personal Protective Equipment: Finger Temperatures and Thermal Sensation of Workers’ Exposure to Cold Environment. Int. J. Environ. Res. Public Health. 2018; 15(11):2583. doi: 10.3390/ijerph15112583
36. Szabo RL, Radwin RG, Henderson CJ.The influence of knife sharpness on poultry processing operator exertions and the effectiveness of re-sharpening. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. SAGE Publications. Los Angeles, CA. 1998.
37. Hesam G, Motamedzade M, Khakbaz G, Moradpour Z. Ergonomic intervention in poultry slaughter industry and evaluation of effectiveness by key indicators method (KIM). Journal of Ergonomics.2014;2(2):9–19.
38. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. doi: 10.1001/jama.2013.281053
39. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-7. doi: 10.1016/0003-6870(87)90010-x
40. Choobineh A, Dortaj E, Razeghi M, Ghaem H, Daneshmandi H. Assessment of Load Manual Lifting among Shelf-Stoking Workers in Chain Stores: A Cross-Sectional Study. Appl Bionics Biomech. 2024;2024:2324416. doi: 10.1155/2024/2324416
41. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585-92. doi: 10.2106/00004623-199311000-00002
42. Rezazadeh A, Bakhtiary A H, Moghimi J, Samaei A. Validity and reliability of the Persian Boston questionnaire in Iranian patients with carpal tunnel syndrome. Koomesh.2014;15(2):e152626.
43. American Conference of Governmental Industrial Hygienists, Threshold limit values for chemical substances and physical agents and biological exposure indices. ACGIH. Cincinnati, OH. 1995.
44. Saleem Z, Waqas S, Ahmad M, Javaid A. Frequency of work-related musculoskeletal problems among butchers. J Riphah Coll Rehabili Sci.2020;8(2):61–63.
45. Kalair MFI, Khattak Z, Saeed A, Asif S. Assessment of lateral epicondylitis in butchers in Islamabad. Journal of Health Rehabilitation Research. 2024;4(3):1–5.
46. Anwar I, Ameer A, Azam S, Khalid M, Asim H. Hand Function among Patients with Carpal Tunnel Syndrome. Open Journal of Therapy and Rehabilitation. 2019;7:170-177. doi: 10.4236/ojtr.2019.74012
47. Pelletier R, Bourbonnais D, Higgins J, Mireault M, Harris PG, Danino MA. Pain interference may be an important link between pain severity, impairment, and self-reported disability in participants with wrist/hand pain. J Hand Ther. 2020;33(4):562-570.e1. doi: 10.1016/j.jht.2019.06.001
48. Kozak A, Schedlbauer G, Wirth T, Euler U, Westermann C, Nienhaus A. Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research. BMC Musculoskelet Disord. 2015;16:231. doi: 10.1186/s12891-015-0685-0
49. Pageaux B, Lepers R. Fatigue Induced by Physical and Mental Exertion Increases Perception of Effort and Impairs Subsequent Endurance Performance. Front Physiol. 2016;7:587. doi:10.3389/fphys.2016.00587
50. Mukhopadhyay P, Khan A. The evaluation of ergonomic risk factors among meat cutters working in Jabalpur, India. Int J Occup Environ Health. 2015;21(3):192-8. doi: 10.1179/2049396714Y.0000000064
51. Vogel K, Karltun J, Eklund J, Engkvist IL. Improving meat cutters' work: changes and effects following an intervention. Appl Ergon. 2013;44(6):996-1003. doi: 10.1016/j.apergo.2013.03.016
52. Van Eerd D, Cole D, Irvin E, Mahood Q, Keown K, Theberge N, Village J, St. Vincent M, Cullen K. Process and implementation of participatory ergonomic interventions: a systematic review. Ergon. 2010;53(10):1153-66. doi: 10.1080/00140139.2010.513452
2. Kaka B, Idowu OA, Fawole HO, Adeniyi AF, Ogwumike OO, Toryila MT. An Analysis of Work-Related Musculoskeletal Disorders Among Butchers in Kano Metropolis, Nigeria. Saf Health Work. 2016;7(3):218-24. doi: 10.1016/j.shaw.2016.01.001
3. Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol. 2004;14(1):13-23. doi: 10.1016/j.jelekin.2003.09.015
4. Barcenilla A, March LM, Chen JS, Sambrook PN. Carpal tunnel syndrome and its relationship to occupation: a meta-analysis. Rheumatology (Oxford). 2012;51(2):250-61. doi: 10.1093/rheumatology/ker108
5. National Research Council. Work-related musculoskeletal disorders: a review of the evidence. National Academies Press. Washington, DC. 1998.
6. Idowu PA, Adedoyin RA, Adagunodo RE. Computer‑related repetitive strain injuries. J Nig Soc Physiother. 2005;15(1):13–18.
7. Grant KA, Habes DJ. An electromyographic study of strength and upper extremity muscle activity in simulated meat cutting tasks. Appl Ergon. 1997;28(2):129-37. doi: 10.1016/s0003-6870(96)00049-x
8. Dempsey PG, McGorry RW. Investigation of a pork shoulder deboning operation. J Occup Environ Hyg. 2004;1(3):167-72. doi: 10.1080/15459620490424465
9. McGorry RW, Dowd PC, Dempsey PG. The effect of blade finish and blade edge angle on forces used in meat cutting operations. Appl Ergon. 2005;36(1):71-7. doi: 10.1016/j.apergo.2004.08.002
10. Arvidsson I, Balogh I, Hansson GÅ, Ohlsson K, Akesson I, Nordander C. Rationalization in meat cutting - consequences on physical workload. Appl Ergon. 2012;43(6):1026-32. doi: 10.1016/j.apergo.2012.03.001
11. Christensen H, Søgaard K, Pilegaard M, Olsen HB. The importance of the work/rest pattern as a risk factor in repetitive monotonous work. Int J Ind Ergon. 2000;25(4):367–373. doi:10.1016/S0169-8141(99)00025-6
12. Caso MA, Ravaioli M, Veneri L. Esposizione a sovraccarico biomeccanico degli arti superiori: la valutazione del rischio lavorativo nei macelli avicoli. Prevenzione Oggi. 2007;3(4):9–21.
13. Botti L, Mora C, Regattieri A. Improving ergonomics in the meat industry: a case study of an Italian ham processing company. IFAC-PapersOnLine. 2015;48(3):598–603.
14. Omokhodion FO, Adebayo A. Occupational hazards and self-reported health problems of butchers in Ibadan, southwest Nigeria. J Public Health. 2013;21(2):131–134.
15. Corbin M, McLean D, Mannetje A', Dryson E, Walls C, McKenzie F, Maule M, Cheng S, Cunningham C, Kromhout H, Blair A, Pearce N. Lung cancer and occupation: A New Zealand cancer registry-based case-control study. Am J Ind Med. 2011;54(2):89-101. doi: 10.1002/ajim.20906
16. Johansson B, Rask K, Stenberg M. Piece rates and their effects on health and safety - a literature review. Appl Ergon. 2010;41(4):607-14. doi: 10.1016/j.apergo.2009.12.020
17. Karsh BT, Moro FB, Smith MJ. The efficacy of workplace ergonomic interventions to control musculoskeletal disorders: a critical analysis of the peer-reviewed literature. Theor Issues Ergon Sci. 2001;2(1)23–96. doi:10.1080/14639220152644533
18. Tappin DC, Bentley TA, Vitalis A. The role of contextual factors for musculoskeletal disorders in the New Zealand meat processing industry. Ergonomics. 2008;51(10):1576-93. doi: 10.1080/00140130802238630
19. Harris C, Eisen EA, Goldberg R, Krause N, Rempel D. 1st place, PREMUS best paper competition: workplace and individual factors in wrist tendinosis among blue-collar workers--the San Francisco study. Scand J Work Environ Health. 2011;37(2):85-98. doi: 10.5271/sjweh.3147
20. Nordander C, Ohlsson K, Akesson I, Arvidsson I, Balogh I, Hansson GÅ, Strömberg U, Rittner R, Skerfving S. Exposure-response relationships in work-related musculoskeletal disorders in elbows and hands - A synthesis of group-level data on exposure and response obtained using uniform methods of data collection. Appl Ergon. 2013;44(2):241-53. doi: 10.1016/j.apergo.2012.07.009
21. Gorsche RG, Wiley JP, Renger RF, Brant RF, Gemer TY, Sasyniuk TM. Prevalence and incidence of carpal tunnel syndrome in a meat packing plant. Occup Environ Med. 1999;56(6):417-22. doi: 10.1136/oem.56.6.417
22. Kurppa K, Viikari-Juntura E, Kuosma E, Huuskonen M, Kivi P. Incidence of tenosynovitis or peritendinitis and epicondylitis in a meat-processing factory. Scand J Work Environ Health. 1991;17(1):32-7. doi: 10.5271/sjweh.1737
23. Viikari-Juntura E, Kurppa K, Kuosma E, Huuskonen M, Kuorinka I, Ketola R, Könni U. Prevalence of epicondylitis and elbow pain in the meat-processing industry. Scand J Work Environ Health. 1991;17(1):38-45. doi: 10.5271/sjweh.1736
24. Yassi A, Sprout J, Tate R. Upper limb repetitive strain injuries in Manitoba. Am J Ind Med. 1996;30(4):461-72. doi: 10.1002/(SICI)1097-0274(199610)30:4<461::AID-AJIM12>3.0.CO;2-2
25. Magnusson M, Ortengren R, Andersson GB, Petersén I, Sabel B. An ergonomic study of work methods and physical disorders among professional butchers. Appl Ergon. 1987;18(1):43-50. doi: 10.1016/0003-6870(87)90069-x
26. Vogel K, Karltun J, Eklund J, Engkvist IL. Improving meat cutters' work: changes and effects following an intervention. Appl Ergon. 2013;44(6):996-1003. doi: 10.1016/j.apergo.2013.03.016
27. Hansson GA, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Åkesson I, Unge J, Rittner R, Strömberg U, Skerfving S. Physical workload in various types of work: Part I. Wrist and forearm. Int J Ind Ergon.2009;39(1):221–233. doi:10.1016/j.ergon.2008.04.003
28. Hansson GA, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Åkesson I, Unge J, Rittner R, Strömberg U, Skerfving S. Physical workload in various types of work: Part II. Neck, shoulder and upper arm. Int J Ind Ergon.2010;40(3):267–281. doi:10.1016/j.ergon.2009.11.002
29. Fogleman MT, Freivalds A, Goldberg JH. An ergonomic evaluation of knives for two poultry cutting tasks. Int J Ind Ergon. 1993;11(3)257–265. doi:10.1016/0169-8141(93)90114-S
30. Szabo RL, Radwin RG, Henderson CJ. The influence of knife dullness on poultry processing operator exertions and the effectiveness of periodic knife steeling. AIHAJ. 2001;62(4):428-33. doi: 10.1080/15298660108984644
31. Gay RE, Amadio PC, Johnson JC. Comparative responsiveness of the disabilities of the arm, shoulder, and hand, the carpal tunnel questionnaire, and the SF-36 to clinical change after carpal tunnel release. J Hand Surg Am. 2003;28(2):250-4. doi: 10.1053/jhsu.2003.50043
32. Tirloni AS, Dos Reis DC, Tirloni SF, Moro ARP. Exertion Perception When Performing Cutting Tasks in Poultry Slaughterhouses: Risk Assessment of Developing Musculoskeletal Disorders. Int J Environ Res Public Health. 2020;17(24):9534. doi: 10.3390/ijerph17249534
33. Dias NF, Tirloni AS, dos Reis DC, Moro ARP. Risk of slaughterhouse workers developing work-related musculoskeletal disorders in different organizational working conditions. Int J Ind Ergon. 2020;76:102929. doi: 10.1016/j.ergon.2020.102929
34. Pérez E, Rodríguez Y, Salazar MC, Trujillo MA. Improving Working Conditions Using the Ergonomic Checkpoints Tool: Application in a Colombian Meat Processing Plant. IISE Trans Occup Ergon Hum Factors. 2021;9(2):72-77. doi: 10.1080/24725838.2021.1962622
35. Tirloni, A.S.; Dos Reis, D.C.; Dias, N.F.; Moro, A.R.P. The Use of Personal Protective Equipment: Finger Temperatures and Thermal Sensation of Workers’ Exposure to Cold Environment. Int. J. Environ. Res. Public Health. 2018; 15(11):2583. doi: 10.3390/ijerph15112583
36. Szabo RL, Radwin RG, Henderson CJ.The influence of knife sharpness on poultry processing operator exertions and the effectiveness of re-sharpening. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. SAGE Publications. Los Angeles, CA. 1998.
37. Hesam G, Motamedzade M, Khakbaz G, Moradpour Z. Ergonomic intervention in poultry slaughter industry and evaluation of effectiveness by key indicators method (KIM). Journal of Ergonomics.2014;2(2):9–19.
38. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. doi: 10.1001/jama.2013.281053
39. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-7. doi: 10.1016/0003-6870(87)90010-x
40. Choobineh A, Dortaj E, Razeghi M, Ghaem H, Daneshmandi H. Assessment of Load Manual Lifting among Shelf-Stoking Workers in Chain Stores: A Cross-Sectional Study. Appl Bionics Biomech. 2024;2024:2324416. doi: 10.1155/2024/2324416
41. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585-92. doi: 10.2106/00004623-199311000-00002
42. Rezazadeh A, Bakhtiary A H, Moghimi J, Samaei A. Validity and reliability of the Persian Boston questionnaire in Iranian patients with carpal tunnel syndrome. Koomesh.2014;15(2):e152626.
43. American Conference of Governmental Industrial Hygienists, Threshold limit values for chemical substances and physical agents and biological exposure indices. ACGIH. Cincinnati, OH. 1995.
44. Saleem Z, Waqas S, Ahmad M, Javaid A. Frequency of work-related musculoskeletal problems among butchers. J Riphah Coll Rehabili Sci.2020;8(2):61–63.
45. Kalair MFI, Khattak Z, Saeed A, Asif S. Assessment of lateral epicondylitis in butchers in Islamabad. Journal of Health Rehabilitation Research. 2024;4(3):1–5.
46. Anwar I, Ameer A, Azam S, Khalid M, Asim H. Hand Function among Patients with Carpal Tunnel Syndrome. Open Journal of Therapy and Rehabilitation. 2019;7:170-177. doi: 10.4236/ojtr.2019.74012
47. Pelletier R, Bourbonnais D, Higgins J, Mireault M, Harris PG, Danino MA. Pain interference may be an important link between pain severity, impairment, and self-reported disability in participants with wrist/hand pain. J Hand Ther. 2020;33(4):562-570.e1. doi: 10.1016/j.jht.2019.06.001
48. Kozak A, Schedlbauer G, Wirth T, Euler U, Westermann C, Nienhaus A. Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research. BMC Musculoskelet Disord. 2015;16:231. doi: 10.1186/s12891-015-0685-0
49. Pageaux B, Lepers R. Fatigue Induced by Physical and Mental Exertion Increases Perception of Effort and Impairs Subsequent Endurance Performance. Front Physiol. 2016;7:587. doi:10.3389/fphys.2016.00587
50. Mukhopadhyay P, Khan A. The evaluation of ergonomic risk factors among meat cutters working in Jabalpur, India. Int J Occup Environ Health. 2015;21(3):192-8. doi: 10.1179/2049396714Y.0000000064
51. Vogel K, Karltun J, Eklund J, Engkvist IL. Improving meat cutters' work: changes and effects following an intervention. Appl Ergon. 2013;44(6):996-1003. doi: 10.1016/j.apergo.2013.03.016
52. Van Eerd D, Cole D, Irvin E, Mahood Q, Keown K, Theberge N, Village J, St. Vincent M, Cullen K. Process and implementation of participatory ergonomic interventions: a systematic review. Ergon. 2010;53(10):1153-66. doi: 10.1080/00140139.2010.513452
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Jahangiri H, Ghasemi F, Zoaktafi M, Salmani Nodooshan H, Vali M, Daneshmandi H. The Silent Strain: Grip Strength, and Wrist/Hand Musculoskeletal Disorders among Meat Cutters. Med Lav. 2026;117(1):17299. doi:10.23749/mdl.2026.17299
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How to Cite
1.
Jahangiri H, Ghasemi F, Zoaktafi M, Salmani Nodooshan H, Vali M, Daneshmandi H. The Silent Strain: Grip Strength, and Wrist/Hand Musculoskeletal Disorders among Meat Cutters. Med Lav. 2026;117(1):17299. doi:10.23749/mdl.2026.17299
