Table 5.

A non-exhaustive summary of ergonomic effects, conditions and disease relating to poultry processing.

Research Study	Main Findings	Research Information	Reference
Musculoskeletal disorders (MSD)
Taiwan: General cleaning workers	Cleaning workers at risk of: Musculoskeletal discomfort, pain reported by 90% cleaners in: Hand, wrist 42%; Shoulders 41% Low back 38%; Elbows 33%	Workers in awkward positions Associated contributing psychosocial factors: Time pressure/Speed of work Production targets	Chang, 2012 [103]
Canada: Female workers	MDS in women MSD may lead to accidents, efficiency decrease	Contributory factors:   Poor tool design/Tool use/Force exertion	Messing, 1997 [104]
U.S.: 13 Female poultry processors	Mechanical deboning: Muscular activity significantly higher during: Repetition, Extreme wrist postures, Peak acceleration Moderately reduced some peak forces Manual cut: Extreme wrist postures—more frequent in cutting	Contributing factors: Force requirements Work postures Repetitive movements Increase muscle activity during cutting the most strenuous part of manual deboning: Different muscle groups used	Juul-Kristensen, 2002 [105]
U.S.: 200 Poultry abattoir processing workers <35 years old	MSD prevalence	Female workers show higher risks than male workers Worker age < 35 years No significant absenteeism & no medical care sought	Quandt, 2006 [106]
U.S.: 319 Female poultry abattoir processing workers	Three fifths reported musculoskeletal symptoms Greater job demands shows a greater MSD prevalence & depressive symptoms Lower skill variety & lower job control shows a greater MSD & depressive symptoms prevalence	Job demands included: Heavy load, awkward posture, greater psychological demands Greater support & with management (supervisor’s authority & safety climate) fewer depressive symptoms	Arcury, 2014 [107]
U.S.: Poultry abattoir processing workers	57% diagnosed with at least one MSD or symptom 39% reported hand symptoms Prevalence: Hand/ wrist tendonitis 8% Trigger finger 4% Ganglion cysts 3% Traumatic Injuries: Nerve damage in hands 72% showed abnormal results with the presence of median mono neuropathy in hands in 79% Damage degree: Mild 25%; Moderate 60%; Severe 15% 2009–2012 Incidence higher than the U.S. average	Killing 90 birds per minute; 160,000 per day Forceful repetitive work with knife use 50% participants were obese—BMI 1 > 30 58% workers indicated the use of cutting tools 47% worked overtime on weekly basis 41% of the non-overtime workers did job rotation—lower prevalence 43% visited plant medical clinic reporting symptoms of: Pain; Burning; Tingling; Symptoms of numbness in hands & wrists 41% of workers worked at levels above the ACGIH TLV for hand activity & force At baseline study 36% and at follow up 32% were performing tasks above the ACGIH TL	Musolin, 2014 [85]
Denmark: 3123 workers across 19 industries & poultry abattoirs	Prevalence of: Hand wrist pain; Tendinitis; Extensor tendinitis	Contributing factors: Repetitive work Force	Thomsen, 2007 [108]
U.S.: 291 poultry processing females	MSD symptom differences observed between poultry processing women & controls Upper extremity and neck symptoms 2.4 times higher	Contributing factors: Rapid line speed/Repetitive work Potential magnitude of upper extremity morbidity among women in poultry	Lipscomb, 2007 [109]
U.S.: 291 Female poultry workers	Early MSD onset Continued exposure cause rapid onset among women	Highly repetitive work Psychosocial variables included: Work organisation factors, Prevalence of other medical conditions, Depressive symptoms, Children at home, Hand intensive home activities, Age, Obesity, Job insecurity Complex relationships exists between physical work & psychosocial factors	Lipscomb, 2008 [110]
New Zealand: 237 workers, union, safety personnel management at 28 meat processing sites	Knife dullness cause increase use of force Greater risk of MSD of the neck & upper limbs	Table height, knife handle guarding & use of gloves play a role during cutting Highest incidence of MSD in meat processing & poultry processing accounting for over 50% of compensation costs for the sector	Tappin, 2008 [111]
Portugal: 50 meat packers	MSD diagnosed in 42% 88% of workers had two or more conditions Higher female prevalence 39% vs. 12% in males MSD disease/syndrome incidence: CTS (9) Osteoarthritis in fingers (5) Lateral epicondylitis (4) de Quervains disease (2) Guyon canal syndrome (2) Radial tendinitis (1) Tendoperiostitis of great palmar nerve (1) Tendosynovitis—distal in upper extremity joints (1)	Vibration from hand tools Repetitive work Precision movements Nine workers contributed to 446 days off work for the year	Sarranheira, 2008 [112]
Brazil: 290 poultry abattoir processing workers	67% suffered discomfort, pain in: Shoulders 63%; Neck 43%; Spine 36%; Forearms 31%; Arms 29%; Wrists 26%; Hands 26%	88% engaged in repetitive tasks 61% used hand tools 54% workers experienced cold	Tirloni, 2012 [113]
Brazil: 6000 poultry abattoir processing workers	MSD prevalence	Associated with: Repetitive tasks/Cold exposure/Production increase/pace	Buzanello, 2012 [56]
U.S.: 403 Poultry abattoir processing workers	More than 35% workers reported: Workers suffered from back, wrist & hand symptoms lasting more than 1 day Greater pain occurrence in overtime workers	Contributing factors: Rapid work pace, repetitive motions Poultry workers reported more wrist & elbow symptoms More symptom prevalent in overtime workers	Schulz, 2012 [114]
Back and arm discomfort/pain
U.S.: 699 poultry workers	Back & arm discomfort and pain	Women were more susceptible	Stuart-Buttle, 1994 [115]
U.S.: 516 poultry workers	Low back pain in 17% (n = 89)	May negatively impact long-term	Rosenbaum, 2013 [116]
U.S.: 518 poultry abattoir processing workers	Back pain	Management commitment, awkward posture; repeated movements predicted. Low job control, high psychological demands elevated among poultry abattoir processing workers	Grzywacz, 2012 [117]
Epicondylitis
U.S.: 518 poultry abattoir processing workers	Epicondylitis	Awkward posture; repeated movements predicted Low job control, high psychological demands elevated among poultry abattoir processing workers Workers exposed to work organisation hazards that contribute to occupational health disparities	Grzywacz, 2012 [117]
U.S.: 516 poultry abattoir processing workers	Epicondylitis in 6%	Increased prevalence after age 40 May negatively impact long-term exposure	Rosenbaum, 2013 [116]
U.S.: 234 Female poultry abattoir processing workers	Epicondylitis prevalence	Awkward posture and decision latitude were associated with epicondylitis Work organization factors may affect workers health	Arcury, 2014 [118]
Rotator cuff syndrome
U.S.: 518 poultry abattoir processing workers	Management commitment, awkward posture; repeated movements predicted Rotator cuff syndrome	Low job control, high psychological demands elevated among poultry abattoir processing workers Workers exposed to work organisation hazards that contribute to occupational health disparities	Grzywacz, 2012 [117]
U.S.: 516 poultry abattoir processing workers	Rotator cuff syndrome 15% (n = 76)	Increased prevalence after age 40 May negatively impact long-term	Rosenbaum, 2013 [116]
U.S.: 234 Female poultry abattoir processing workers	Rotator cuff syndrome	Rotator cuff syndrome associated with awkward posture, psychological demand Work organisation factors affect health	Arcury, 2014 [118]
Impingement syndrome
Denmark: Poultry workers employed 1986–1993	Impingement syndrome (IS) prevalent Physical examination revealed signs of subacromial impingement in the corresponding shoulder	Contributing factors contributing: Repetition; Force; Complicated movements; Shoulder intensive work; is diagnosed if symptoms were present for 3 months with subacromial impingement signs	Frost, 1999 [119]
Carpal Tunnel Syndrome
Taiwan: 207 meat packers	CTS prevalence: Workers performing repetitive tasks 41% Workers exposed to cold & performing repetitive tasks 37%	Contributing factors: Force exertion Repetitive wrist movements Cold exposure	Chiang, 1990 [120]
U.S.: 30 male poultry abattoir processing workers	CTS from use of tools in deviated, angular wrist positions Pinch strength decrease	Strength degradation ranged from 14% to 43% Effect on maximum voluntary pinch strength: Least effect on: Natural deviation, radial deviation (smallest effect), Greatest effect on: Ulnar deviation, dorsiflexion & palmar flexion	Imrhan, 1991 [121]
U.S.: 157 poultry processors	50% workers had 3 or more of 22 conditions The average worker had 5 to 6 abnormal findings Major conditions/symptoms: Impaired pinch, decreased finger sensitivity, Hand/ finger numbness	Contributing factors: Vibration and repetitive tasks	Young, 1995 [122]
U.S.: 1591 Poultry abattoir processing workers	CTS prevalence: Deboning tasks dominant hand statistical significance:  Reference group 2%  Non-deboning abattoir workers 5%  Deboning processing workers 8%	Associated with: Repetitive deboning tasks High-force and high-velocity manual work	Frost, 1998 [123]
India: Review CTS in food workers including poultry	CTS prevalence significant in: Abattoirs; Poultry processing; Meat processing; Frozen food workers; Packaging industry	Contributing factors: Prolonged repetitive hand intensive activities; Forceful exertions; Awkward or static postures; Vibration; Cold; Localised mechanical stress	Jagga, 2011 [124]
Taiwan: General cleaning workers (non-poultry)	Wrists at extreme angles of ulnar and radial deviation increased risk of CTS development	Associated psychosocial factors: Time pressure; Pace of work; Production targets	Chiang, 2012 [103]
U.S.: 287 poultry abattoir processing workers	CTS prevalence 8.7% higher in poultry processing Lower CTS trends in: Packing, sanitation & chilling workers	Repetitive & strenuous hand movement	Cartwright, 2012 [125]
U.S.: 318 Poultry abattoir processing workers	42% workers met the CTS criteria CTS prevalence 10% 47% females; 28% males Degree of CTS: Mild 20%; Moderate 60%; Severe at 21% 15% or workers reported absenteeism	50% participants were obese—BMI > 30 The mean age of CTS sufferers was 42 years 58% workers indicated the use of cutting tools 47% worked overtime on weekly basis 41% work at levels above ACGIH TLV for hand activity & force 41% did job rotation (non-overtime workers)	Musolin, 2014 [85]
U.S.: Latino poultry abattoir slaughtering & processing workers (106 wrists)	Based on 106 wrists, the 1-year incidence of CTS was higher in poultry processing workers (20%) than non-poultry manual workers (12%)	Contributing factors: Wrist position; Repetitive & strenuous nature of poultry processing work Poultry workers has significantly higher chance for CTS development	Cartwright, 2014 [126]
U.S.: 234 Female poultry abattoir processing workers	Carpal tunnel syndrome prevalence	Awkward posture & psychological demand & decreased skill variety & job control were related to CTS Work organisation factors important for musculoskeletal & neurological injury	Arcury, 2014 [118]
Raynaud Syndrome: Finger sensitivity
France: 17 poultry abattoirs: 1474 workers	Raynaud Syndrome Finger sensitivity	More common in women Contributing factors: Cold environment Repetitive tasks; Arm exertion; Vibrating tools; Plastic gloves Aggravated by Infrequent breaks in cold areas	Kaminski, 1997 [52]
Callosities, calluses, knuckle pads
U.S.: 41 Live bird hangers	Knuckle pads were observed in 56% (23) chicken hangers	Repeated striking, knocking & sliding of knuckles against metal	Richards, 1987 [127]
Poverty
U.S. 2009: Poultry abattoir processing workers	Female poultry workers displayed a 36% PHRQoL 2& moderate to high incidence of MSD	Link between MSD & PHRQoL	Armstrong, 1982 [128]
Job stress & Strain
U.S.: Poultry inspectors Comparison of 4 groups: Full- and Part-time inspectors; Rotating relief inspectors; Supervisory group	Full-time inspectors had the highest frequency rates for 17 health symptoms Followed by Rotating relief inspectors with 9 most prevalent health complaints: Respiratory; Skin; Musculoskeletal; Gastrointestinal; Visual complaints, Job stress & strain	Full-time inspectors: Highest job stress & poorest work environment scores Supervisor social support lowest for full-time inspectors Rotating relief inspectors had least support from others at work Psychological & behavioural strain highest for full-time inspectors	Wilkes, 1981 [129]

¹ BMI—Body mass index; ² Low physical related quality of life.