Sociodemographic Data and Work-Related Musculoskeletal Symptoms in the Metal Polishing Industry: A Case Study in Central Portugal
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsSociodemographic Data and Work-Related Musculoskeletal Symptoms in the Metal Polishing Industry: A Case Study in Central Portugal
The research accessed the anthropometric characteristics and work-related musculoskeletal symptoms in an industrial environment. It gave a good knowledge of worked related physical attributes, health status, and musculoskeletal symptoms, including age, gender, BMI, body parts related to work discomfort, etc.
Introduction. Introduction should give a good understanding of the state of art of the topic. The introduction is a little short and can be improved with researches of others to better elaborate the topic.
Methods. 1. Workers from the same sector with tasks typically performed while seated were chosen as the subjects. Thus, the work related musculoskeletal symptoms were focused on the upper body. The lower body were not analyzed, which was a limitation of the study.
2. The questionnaire related to the musculoskeletal professionals can be given more clearly.
Results. Musculoskeletal symptoms of the upper body, the neck, the shoulder, the hands were revealed. How about the work shift and the rest between these manual works. Work shift and rest between work times may relieve the musculoskeletal symptoms.
Discussion. Figure 3 and Figure 5. The colors of the bar charts are very similar, which is difficult to distinguish.
Limitations. As aforementioned, the study focused on work related with upper body in the polishing industry, so the musculoskeletal symptoms of the lower body, for instance, work with long time standing, etc., were not studied.
Author Response
Reviewer 1/ Comment 1: The research accessed the anthropometric characteristics and work-related musculoskeletal symptoms in an industrial environment. It gave a good knowledge of worked related physical attributes, health status, and musculoskeletal symptoms, including age, gender, BMI, body parts related to work discomfort, etc.
Answer: The authors would like to thank Reviewer 1 for taking time to review our paper. We will take all comments injuries and about participatory ergonomics and worker inclusion and involvement to support the use of the research questionnaire in lines 46and suggestions for improvement into consideration for the publication of the article and the alterations are marked in blue throughout the text.
Reviewer 1/ Comment 2: Introduction. Introduction should give a good understanding of the state of art of the topic. The introduction is a little short and can be improved with researches of others to better elaborate the topic.
Answer: The authors of the article thank you for this comment. We added more information about the ageing workforce and its prevalence of musculoskeletal -55: “In addition, there is an increasing diversity in the workforce in terms of both age and gender, that is, the rise of an ageing workforce and the increase and balance of the female gender in the workplace. Despite this, the prevalence of musculoskeletal symptoms is higher in older workers than in younger workers [11]. Studies reveal that older workers have a higher prevalence of more severe or fatal injuries when compared to younger operators, where less severe injuries predominate [12]. Ageing workers with a high prevalence of WRMSDs incur significant costs for companies and contribute to job losses and early retirements [11]. Therefore, equipment and work systems must adapt to workers to reduce musculoskeletal risks and promote health, well-being, and job satisfaction, especially for those who have extended their active working life [11].”, and in lines 66-73: “Thus, by administering questionnaires to workers, their participation and involvement in the appropriate application of participatory ergonomic interventions can be enhanced, thereby promoting and raising awareness among the groups involved, which is often neglected [15]. Studies show that through worker participation, effective and sustainable transformations of workplace interventions have been achieved. Notably, this includes prioritising workers' needs, engaging management in occupational safety and health, and fostering a positive and motivating work environment that builds trust among workers [16].”.
Reviewer 1/ Comment 3: Methods. 1. Workers from the same sector with tasks typically performed while seated were chosen as the subjects. Thus, the work related musculoskeletal symptoms were focused on the upper body. The lower body were not analyzed, which was a limitation of the study.
Answer: The authors of the paper thank you for this comment. We understand your comment, and yes, it could be a limitation of the study because the work is mostly performed sitting down. However, the application of the Nordic musculoskeletal questionnaire is designed to assess symptoms throughout the entire body. That said, even though most of the work is done sitting down, the assessment of the perception of the symptoms of work-related musculoskeletal injuries was carried out on the whole body, and a higher prevalence was found for the upper body, as expected. This will be a limitation for future work, particularly when it comes to carrying out an ergonomic assessment, in which it may be necessary to choose a detailed ergonomic analysis for the upper body according to the work done by these operators. We introduce this information in limitations section (lines 590-595): “On the other hand, a more detailed ergonomic assessment will be necessary to prove and/or determine the reasons for the high prevalence of musculoskeletal symptoms more precisely. However, it will have to be assessed in the workplace if the best option is to conduct a complete assessment of the entire human body or if it would be better to choose an assessment of the upper body since this is where the highest prevalence of symptoms was detected, and the work is mostly done sitting down.”.
Reviewer 1/ Comment 4: Methods. 2. The questionnaire related to the musculoskeletal professionals can be given more clearly.
Answer: The authors of the paper thank you for this comment. We understand that it may not have been clear and explicit, so we have added the following information about the Portuguese version of the NMQ (lines 122-130): “The Portuguese Version of the NMQ comprises of 27 binary choice questions, i.e. the response is yes or no. The questionnaire is grouped in three questions that correlate to nine anatomic regions that complete the entire human body, from the neck, shoulders, writs/hands, upper back, lower back, hips/thighs, knees, to ankles/feet [14]. The first question is the existence and prevalence of fatigue, discomfort, pain, and/or musculoskeletal injuries related to work in the last 12 months, the second one is the existence and prevalence of fatigue, discomfort, pain, and/or musculoskeletal injuries related to work in the last 7 days, and the last one, is the hindrance in performing normal work tasks in the last 12 months [13].”.
Reviewer 1/ Comment 5: Results. Musculoskeletal symptoms of the upper body, the neck, the shoulder, the hands were revealed. How about the work shift and the rest between these manual works. Work shift and rest between work times may relieve the musculoskeletal symptoms.
Answer: The authors of the paper thank you for this comment. As mentioned in lines 515-516 in limitations, most of the workers in the study work the normal shift and do not work shifts. Of the few who do, the work is done in two shifts, morning or afternoon. As the work performed is not clearly explained, an explanation has been added on lines 92-96, describing the role of the workers in the company and how the task/activity is carried out. “The operators involved in the study are exclusively dedicated to manually polishing pieces work tasks, without any leadership responsibilities or labour ascendancy over other workers. So, the operators' work activities during their working hours are to polish small pieces of luxury jewellery by hand using polishing equipment, successively.” As a result, rest time between manual labour is reduced and, as a result, symptom relief is difficult. Only at the end of the working day can workers fully recover. To clarify this issue, it was added the next information in discussion: “As the operators work consecutively polishing small metal pieces by hand, using the polishing equipment, the rest time between job tasks is reduced and, as a result, it is difficult to relieve the operators’ symptoms. Only at the end of the working day can workers fully recover.” (lines 443-446).
Reviewer 1/ Comment 6: Discussion. Figure 3 and Figure 5. The colors of the bar charts are very similar, which is difficult to distinguish.
Answer: The authors of the paper thank you for this comment. Thanks for the advice and the colors have been changed for better visualization and distinction.
Reviewer 1/ Comment 7: Limitations. As aforementioned, the study focused on work related with upper body in the polishing industry, so the musculoskeletal symptoms of the lower body, for instance, work with long time standing, etc., were not studied.
Answer: The authors of the paper thank you for this comment. We understand what you're referring to, so in line with comment 3 above, we've added this limitation to the text: “On the other hand, a more detailed ergonomic assessment will be necessary to prove and/or determine the reasons for the high prevalence of musculoskeletal symptoms more precisely. However, it will have to be assessed in the workplace if the best option is to conduct a complete assessment of the entire human body or if it would be better to choose an assessment of the upper body since this is where the highest prevalence of symptoms was detected, and the work is mostly done sitting down.” (lines 590-595).
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThis manuscript provided a case study that conducted in a real industrial environment in a metallurgical industry specializing in high-quality and precision crafting of metal items, to find the prevalence of work-related musculoskeletal disorders.
There is only one comment, as the real industrial environment is a specific one, Why doesn't the title of the article just use the name of the company?
Author Response
Reviewer 2/ Comment 1: This manuscript provided a case study that conducted in a real industrial environment in a metallurgical industry specializing in high-quality and precision crafting of metal items, to find the prevalence of work-related musculoskeletal disorders.
Answer: The authors would like to thank Reviewer 2 for taking time to review our paper.
Reviewer 2/ Comment 2: There is only one comment, as the real industrial environment is a specific one, Why doesn't the title of the article just use the name of the company?
Answer: The authors of the article thank you for this comment. Unfortunately, due to confidentiality protocols, it is not possible to give details about the company, namely the name.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsThank you for the opportunity to be among the first to read your article titled "Sociodemographic Data and Work-Related Musculoskeletal Symptoms in the Metal Polishing Industry: A Case Study in Central Portugal."
I hope my comments will help you present an interesting and scientific sound piece of work.
Given the article's focus on analyzing demographic characteristics, it is essential to develop a more comprehensive methodology. This should not only collect demographic data but also provide a detailed understanding of the activities, job roles, and organizational aspects. The results should then emphasize musculoskeletal issues, as these are crucial for drawing meaningful conclusions. A detailed analysis of the independent (demographic) variables, while informative, should be used in conjunction with activity variables to interpret musculoskeletal symptoms.
For scientific purposes, it is irrelevant what kind of experience or complaints the workers in an unnamed plant with unspecified activities have.
The information about handedness in lines 173-174 is interesting because it suggests that with experience, hand dominance might decrease, allowing workers to perform tasks efficiently with both hands.
In addition to describing the activities in detail, I recommend including an ergonomic risk assessment of the workplaces. This could be done, for example, using the REBA method. Such an assessment would provide a more comprehensive understanding of the factors contributing to work-related musculoskeletal symptoms in the metal polishing industry.
The presentation of results and discussion stop at descriptive statistical analysis, merely indicating that there are work and workplace design issues in the factory. The manuscript should only be reconsidered for publication if the further analyses mentioned in lines 527-530 are conducted.
The gap between the survey presented in the manuscript and Industry 5.0 does not support the conclusions drawn in the paper.
Comments on the Quality of English LanguageThe text contains phrases that confuse the interpretation, which must be revised for clarity.
Author Response
Reviewer 3/ Comment 1: Thank you for the opportunity to be among the first to read your article titled "Sociodemographic Data and Work-Related Musculoskeletal Symptoms in the Metal Polishing Industry: A Case Study in Central Portugal." I hope my comments will help you present an interesting and scientific sound piece of work.
Answer: The authors would like to thank Reviewer 3 for taking time to review our paper. Your insights were fundamental to improve the content of the paper. The manuscript has been revised according to your comments and suggestions and marked in blue.
Reviewer 3/ Comment 2: Given the article's focus on analyzing demographic characteristics, it is essential to develop a more comprehensive methodology. This should not only collect demographic data but also provide a detailed understanding of the activities, job roles, and organizational aspects. The results should then emphasize musculoskeletal issues, as these are crucial for drawing meaningful conclusions. A detailed analysis of the independent (demographic) variables, while informative, should be used in conjunction with activity variables to interpret musculoskeletal symptoms.
Answer: The authors of the paper thank you for this comment. Unfortunately, with the non-disclosure agreement established with the company to carry out the work makes it impossible to use its data, namely the organizational aspects. For this reason, it was only possible to collect personal data from the operators after they had given their consent, thus allowing us to obtain data to analyse the sociodemographic characteristics in the polishing activity. The operators involved in the study and asked to complete the questionnaire are exclusively dedicated to polishing luxury jewellery pieces. Still, it can be said that they are individual operators carrying out work tasks manually, without any leadership responsibilities or labour ascendancy over other workers. This information was added in lines 92-96: “The operators involved in the study are exclusively dedicated to manually polishing pieces work tasks, without any leadership responsibilities or labour ascendancy over other workers. So, the operators' work activities during their working hours are to polish small pieces of luxury jewellery by hand using polishing equipment, successively.”.
Reviewer 3/ Comment 3: For scientific purposes, it is irrelevant what kind of experience or complaints the workers in an unnamed plant with unspecified activities have.
Answer: The authors of the paper thank you for this comment. As previously stated, due to confidentiality protocol, it is not possible to give more details about the company or describe its processes. However, in our opinion, the thoughts and ideas of the operators are a key point for the centralisation of human beings in production processes, as they are the ones who carry out the work tasks consecutively and can come up with ideas through their experience. This is also in line with the ideas and concepts of participatory ergonomics and an organisational strategy to achieve a more sustainable Industry 5.0 focused on operator well-being and health. However, to clarify this matter, it was added new information in lines 92-96: “The operators involved in the study are exclusively dedicated to manually polishing pieces work tasks, without any leadership responsibilities or labour ascendancy over other workers. So, the operators' work activities during their working hours are to polish small pieces of luxury jewellery by hand using polishing equipment, successively.”, and in the discussion (lines 443-446): “As the operators work consecutively polishing small metal pieces by hand, using the polishing equipment, the rest time between job tasks is reduced and, as a result, it is difficult to relieve the operators’ symptoms. Only at the end of the working day can workers fully recover.”.
Reviewer 3/ Comment 4: The information about handedness in lines 173-174 is interesting because it suggests that with experience, hand dominance might decrease, allowing workers to perform tasks efficiently with both hands.
Answer: The authors of the paper thank you for this comment. We understood what you were suggesting, but in fact the data showed no such trend. In this case, hand dominance is not related to the experience of the workers. Since the work is manual and depends on the operators, both right- and left-hand dominance are similar for all seniorities in the company, so we can't draw that conclusion. To clarify this subject with add this information in lines 225-228:” This could suggest that with increased experience of the workers, i.e. higher seniority in the company, there could be an influence on hand dominance. However, such conclusions cannot be drawn, since for both cases of hand dominance, the workers' seniority in the company is similar.”.
Reviewer 2/ Comment 5: In addition to describing the activities in detail, I recommend including an ergonomic risk assessment of the workplaces. This could be done, for example, using the REBA method. Such an assessment would provide a more comprehensive understanding of the factors contributing to work-related musculoskeletal symptoms in the metal polishing industry.
Answer: The authors of the paper thank you for this comment. We agree with your opinion and think that with the data presented, we can raise the company's awareness and in the future be given the opportunity to carry out a more detailed ergonomic assessment of these workers.
Reviewer 3/ Comment 6: The presentation of results and discussion stop at descriptive statistical analysis, merely indicating that there are work and workplace design issues in the factory. The manuscript should only be reconsidered for publication if the further analyses mentioned in lines 527-530 are conducted.
Answer: The authors of the paper thank you for this comment. The aim of the work, as mentioned in the article, is to characterise the sample under study sociodemographically and to obtain their perception of work-related musculoskeletal symptoms using the Nordic musculoskeletal questionnaire. As described in the article, since the work is demanding and manual, results were obtained in this regard, proving the need for action. In addition, this analysis was carried out by gender and with a special focus on age clusters due to the problematic of an ageing workforce. With the data collected in the questionnaire, it was not possible to carry out correlation studies to make them statistically reliable and worthy of scientific coherence and accuracy, and this has therefore been a limitation to the study and proposals for future work.
Reviewer 3/ Comment 7: The gap between the survey presented in the manuscript and Industry 5.0 does not support the conclusions drawn in the paper.
Answer: The authors of the paper thank you for this comment. When applied, the Nordic musculoskeletal questionnaire provides an insight into the symptoms of work-related musculoskeletal injuries reported by operators. As previously stated, the involvement of operators in the industrial environments of the future involves their participation so that their jobs and workplaces can be adapted and/or adapted to them, with the objective of improving their working conditions, well-being and health. This information was added/adjusted in conclusion: “In summary, by applying the Portuguese version of the Nordic Musculoskeletal Questionnaire, an insight into the symptomatology of work-related musculoskeletal complains reported by operators was obtained. This enhances their involvement and participation in the development of future industrial environments so that workplaces can be adjusted and/or adapted to them, with the aim of improving their working conditions, well-being, and health, highlighting the importance of adapting working conditions to ensure the health and well-being of workers, especially for the ageing workforce in the context of transitioning to Industry 5.0.”(lines 618-625).
Reviewer 3/ Comment 8: The text contains phrases that confuse the interpretation, which must be revised for clarity.
Answer: The authors of the paper thank you for this comment. We proofread and make changes throughout the text.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThe authors has made great improvement on the article according to the reviewer's comments. It can be accepted.
Author Response
Reviewer 1/ Comment 1: The authors has made great improvement on the article according to the reviewer's comments. It can be accepted.
Answer: The authors would like to thank Reviewer 1 for taking time to review our revised version of the paper. Your comments and suggestions have helped to clarify and improve the article. Thanks again.
Reviewer 3 Report
Comments and Suggestions for AuthorsDear Authors,
Thank you for resubmitting an improved version of your paper.
Unfortunately, the novelty you introduced didn't answer all my concerns in my first review.
Comments on the Quality of English LanguageNo real improvement and no comments.
Author Response
Reviewer 3/ Comment 1: Dear Authors, Thank you for resubmitting an improved version of your paper. Unfortunately, the novelty you introduced didn't answer all my concerns in my first review.
Answer: The authors would like to thank Reviewer 3 for taking time to review our revised paper. We think we have answered all the questions you have raised, and we have amended the text accordingly. To further improve and clarify the research work novelty, its limitations and the future research agenda, we have added some explanations marked in blue in the manuscript.
Round 3
Reviewer 3 Report
Comments and Suggestions for AuthorsDear Authors, Thank you for allowing me to reconsider your submission.
Unfortunately, I can't see the added value of science in your paper. I understand you assessed a factory; however, this is part of the daily OSH activity.
The demographic analysis itself has no value because it reflects the employment/recruitment activity of the company.
Author Response
The work is part of a larger study that is under development. We hope that the explanation added about the present limitations clarifies the questions raised.
