title: Helping women but hurting ourselves? Neck and upper back musculoskeletal symptoms in a cohort of Australian Midwives.
abstract: OBJECTIVE
  To determine the prevalence of neck and upper back musculoskeletal symptoms in a group of Australian midwives and explore individual characteristics and workplace exposures associated with these symptoms.
  
  
  METHODS
  cross-sectional, using data from the Nurses and Midwives e-Cohort Study, a longitudinal, electronic survey of midwives and nurses in Australia, New Zealand and the United Kingdom.
  
  
  METHODS
  data were collected via an online survey in 2006-2008.
  
  
  METHODS
  qualified Australian midwives aged 23-70 years.
  
  
  RESULTS
  We undertook descriptive analysis of the sample, calculated prevalence and examined associations between individual and workplace variables and neck and upper back musculoskeletal symptoms. Variables achieving p<0.1 in bivariate analysis were entered simultaneously into logistic regression models. Overall prevalence rates were 48.8% for neck and 28.2% for upper back musculoskeletal symptoms; work-related prevalence was 40.8% (neck) and 24.5% (upper back), comparable to reported rates among nurses and physicians. Presence of symptoms in the adjacent area was associated with greater than a fourfold increased risk for neck and upper back symptoms. Participants with care responsibility for an adult dependent were 36% more likely to report neck symptoms. Current shift work and total physical activity were associated with decreased likelihood of neck and upper back symptoms, respectively. Psychological job demands were only weakly associated with upper back symptoms, possibly because the survey tool could not capture a sufficiently broad range of psychosocial exposures to present a complete picture. A striking finding was that work in awkward postures conferred an increased risk of 35% for neck and nearly 50% for upper back symptoms.
  
  
  CONCLUSIONS
  neck and upper back musculoskeletal symptoms were prevalent in this sample. Both individual and workplace factors were significantly associated with neck and/or upper back symptoms. Psychological job demands and work in awkward postures are potentially modifiable exposures that deserve further examination.
  
  
  CONCLUSIONS
  midwives who are or may become carers for adult dependents should be aware of a possible increased risk for neck symptoms. It may be prudent for midwives and those who employ/supervise them to monitor and, where possible, jointly develop strategies to mitigate psychological job demands. The potential hazard posed by work in awkward postures warrants consideration of how midwives may minimize time spent working in these postures.
authors.affiliation: School of Nursing and Midwifery, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia. maryann.long@gmail.com
authors.forename: Maryann H
authors.initials: MH
authors.lastname: Long
authors.forename: Venerina
authors.initials: V
authors.lastname: Johnston
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Bogossian
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data*; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D016272:Occupational Health / Q000706:statistics & numerical data; D009786:Occupational Health Services; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology / Q000592:standards