Silvia Tamez-González

Computer use increases the risk of musculoskeletal disorders among newspaper office workers

BACKGROUND Our objectives were to estimate prevalence of musculoskeletal disorders among office workers at a newspaper in Mexico City, analyze the relationship between musculoskeletal disorders and use of the personal computer (PC) and associated ergonomic factors in the aforementioned population, and to analyze the modifying effect that psychosocial factors have on the relationship between ergonomic factors and musculoskeletal disorders and extant jobs at the newspaper. METHODS A total of 73% (218 of 298) of office workers at a newspaper were studied. Information was collected by a questionnaire completed by participants. Cases for work-related musculoskeletal disorder in hands (WMSD-H), upper extremity (WMSD-UE), and back (WMSD-B) were established. Working conditions, computer use, and ergonomic and psychosocial factors were studied as independent variables. To study the relationship between musculoskeletal disorders and independent variables, prevalence ratios adjusted for potential confounders (sex, age, educational level, and marital status) were estimated. RESULTS Risk of musculoskeletal disorders was greater among workers at the newspaper who used computers, those involved in editing work, and those who adopted uncomfortable positions. The modifying effect of psychosocial factors was observed only in the relationship between ergonomic factors and WMSD-B because among workers with control over work, WMSD-B risk was reduced by the greater number of work breaks. Among workers without social support, increase in number of postures and rotation/inclination of the neck was associated with substantial risk increase, while amid workers under psychological demand number of PC tasks and number of rest pauses were associated with increase in WMSD-B risk. CONCLUSIONS The findings of our study showed that PC use increased risk of developing musculoskeletal disorders (WMSD-H and WMSD-UE). Such an increase is mediated by ergonomic factors such as mouse use, remaining seated for prolonged periods, adoption of inadequate or uncomfortable postures, performing certain PC tasks, and psychosocial factors.

Adaptación del modelo de Andersen al contexto mexicano: acceso a la atención prenatal

Tamez-Gonzalez S, Valle-Arcos RI, Eibenschutz-Hartman C, Mendez-Ramirez I. Adjustment of the Andersens model to the Mexican context: access to prenatal care. Salud Publica Mex 2006;48:418-429. Abstract The aim of this work was to propose an adjustment to the Model of Andersen who answers better to the social ine- quality of the population in the Mexico City and allows to evaluate the effect of socioeconomic factors in the access to the prenatal care of a sample stratified according to de- gree of marginalization. Material and Methods. The data come from a study of 663 women, randomly selected from a framework sample of 21 421 homes in Mexico City. This work collects information about factors that affect utiliza- tion of health services, as well as predisposing factors (age and socioeconomic level), as enabling factors (education, social support, entitlement, pay out of pocket and opinion of health services), and need factors. The sample was ranked according to exclusion variables into three stratums. The data were analyzed through the technique of path analysis. Results. results indicate that socioeconomic level takes part like predisposed variable for utilization of prenatal care services into three stratums. Otherwise, education and so- cial support were the most important enabling variables for utilization of prenatal care services in the same three groups. In regard to low stratum, the most important en- abling variables were education and entitlement. For high stratum the principal enabling variables were pay out of pocket and social support. The medium stratum shows atyp- ical behavior which it was difficult to explain and under- Tamez-Gonzalez S, Valle-Arcos RI, Eibenschutz-Hartman C, Mendez-Ramirez I. Adaptacion del modelo de Andersen al contexto mexicano: acceso a la atencion prenatal. Salud Publica Mex 2006;48:418-429.