INCIDENCE OF MUSCULOSKELETAL DISORDERS IN TRAIN COMMUTERS

Background: A Musculoskeletal disorders (MSD’s) arises not directly from an acute or instantaneous event but arising gradually and chronically. Indian railway is the world’s largest railway system; in Mumbai the daily ridership is about 7.585 million. As Mumbai is India’s commercial and financial centre therefore, the network is severely crowded during peak hours. Hence, it is the busiest railway system and has some of the worst severe crowding in the world. Repetitive movements and awkward posture are the levels of primary risk factors that have been associated with the MSD’s.

A musculoskeletal disorders (MSDs) is a "A disorders of muscle, tendon, joint, intervertebral disc, peripheral nerves and vascular systems not directly resulting from an acute or instantaneous event but arising gradually and chronically" [1].Indian railway is the world's largest railway system; in Mumbai suburban railway the daily ridership is about 7.585 million.Therefore, it is the busiest commuter rail system and has some of the worst severe overcrowding in the world [2].As Mumbai is India's commercial and financial center and one of the most densely populated cities in the world.The cities relies heavily on public transport with about 80% of all motorized trips being undertaken by the public rail .More than half of these trips is undertaken by the rail system which is the lifeline of the city.Every day some 8 million commuters use the city's suburban rail system , travelling on more Vrushali Rajesh Patil, Satish Pimpale, Ajay kumar.Incidence of Musculoskeletal Disorders in Train Commuters.

MATERIALS AND METHODS
than 2,800 trains a day.The network is severely overcrowded during peak hours when the numbers of passengers exceeds the networks carrying capacity by more than four times.Hence, Mumbai rail network will continue to be the primary mode of transportation in the cities for the year to come [3].Repetitive movements and awkward posture, and high force levels are the primary risk factors that have been associated with MSD's [4].Therefore, the problems faced by the commuters are their productive hours are decreased and results in the loss of business and personal human health.Other problems faced by the commuters in local train are stress, discomfort during journey, accidents and potential for physical injuries.[5] Need of study: To our knowledge there is very study on incidence of musculoskeletal disorders in train commuters During rush hours, many of the train commuters have to travel for their work places, Due to which there will be potential for physical injuries leading to disorders.Some of the train commuters due to overcrowding have to complete their journey by standing throughout their route.
commuters have to compromise in their health to reach their work places, which may lead to physical stress.Therefore, there is a need to estimate the incidence of musculoskeletal disorders in train commuters.
An observational study was conducted for the duration of 1year in the metropolitan city with the sample size of 500 Healthy Adult Male and Female 20-40 years of age who are train commuters.They were selected according to the selection criteria that includes commuters travelling at least for 1hour of single route per day and travelling during rush hours from 7am-10am & 6pm-9pm for 6 months; and excludes Commuters travelling in afternoon and night, work related to prolonged sitting and standing for more than 6hrs, handicapped population, recent surgery for less than 6 months, congenital condi--tions, cardiovascular and neurological conditions.Procedure: The whole study was explained to the subjects.They were screened as per the inclusion criteria.Subjects not fulfilling the inclusion criteria were excluded from the study.Subjects who were willing to participate in the survey were only considered and a written consent form was taken from them.Demographic data was recorded.A self-reporting Standardized Nordic Questionnaire based on musculoskeletal disorders that includes various parameters related to musculoskeletal disorders were given and explained on how to fill in the details in the language best understood by them.The data was collected and analyzed accordingly.Outcome Measure: Standard Nordic Questtionnaire: It is a selfadministered questionnaire.This is used for the analysis of musculoskeletal symptoms.The reliability of the questionnaire is shown to be acceptable.Please answer by putting "X" in the appropriate box-one "X" for each position.You may be in doubt as to how to answer, but please do your Best any way.Note that column I of the questionnaire is to be answered even if you have never had trouble in any part of your body; column 2 and 3 are to be answered if you answered yes in column I.

RESULT To be answered by everyone
To be answered by those who have had trouble
(based on the Nordic questionnaire (kourinka of al. 1987) Job/position:_________________________________ Gender: M F A g e : _ _ _ _ _ _ _ H e i g h t _ _ _ _ _ _ _ _ f t _ _ _ _ _ I n .Weight__________ How long you have been doing this job?____years_____months.How many hours you work each week?________How to answer the questionnaire: Vrushali Rajesh Patil, Satish Pimpale, Ajay kumar.Incidence of Musculoskeletal Disorders in Train Commuters.
Katherine Craine et al. in their study found that commuting to and from the work everyday can have a profound effect on the body biomechanics.Combination of poor posture combined with inability to stretch it out during the commute makes for quite a bit discomfort for most of the people.The factors contributing for it are: 1. Awkward posture 2. Everyday wear and tear of Ankles/Feet 3. Overuse of feet 4. Repetitive translatory movements 5. Ligaments causing microscopic tears 6. Prolonged standing in awkward posture Debarati Sen in their study found that foot pain is common in train commuters who travel for long hours, due to this it causes abnormal walk that affects the spine and you develop back and neck pain, therefore recommended to avoid weight bear on one leg at a time.The factors attributing for Low Back pain are: 1. Slouched sitting posture 2. Sitting on less surface area with awkward posture 3. Sudden jerky posture 4. Twisting Amenda Macmillan in their study found train commuters faces pain in neck, shoulders, upper back, hips, elbows and hands.The factors attributing to it are: 1. Sitting slumped for hours 2. Overuse of shoulders 3. Holding rails and continuously gripping

Table 1 :
Showing the body regions and joint pain (%).