It is reported that work-related musculo skeletal complaints (WMSCs) make up 42-58% of all occupational diseases ( 1 ). More than 25% of working population in Europe have musculoskeletal symptoms ( 2 ). It is also repor-ted that WMCs constitute 40% of the injuries for which work compensation paid in USA ( 3 ). The studies show that age and gender as socio-demographic factors and as vocational factors, repetitive movements, static physical posture, daily time spent using computer, heavy workload and poor working conditions are risk factors for WMCs ( 1 , 4 , 5 ).Employees in the banking sectors are subject to long hours of static work, bad posture and activities of repetitive computer use. Therefore, the duties of bank employees make them prone to WMSCs ( 6 , 7 ). Working in the same posture for long periods of time, repetitive movements and agronomical inadequacies in work environments bring about several health problems, in particular,musculoskeletal complaints. These health problems result in serious loss of time, economic value and workforce, and increase the importance of the subject. The purpose of this study is to determine upper extremity musculoskeletal complaints of bank employees working with computer and to evaluate its relationship with psychosocial factors in the work environment and other risk factors.

This cross-sectional and observational study was carried out in the Center of Aydın Province between July and September 2013. Study workgroup covers bank employees working with thecomputer (WWCs) in Aydın Provincial Center, who agreed to attend the study.

Distribution of bank employees, who participated in the study, in terms ofcertain sociodemographical attributes is given in Table-1. It is reported that 56.1% of bank employees are male,65.6% married,81.1% university graduate and 50.2% of the participants do not have children. Bank employees report that 38.9% of them smoke while 19.9% do physical exercise. According to evaluation of body mass index, 61.5% of participants are of medium weight. 93.2% of the participants have not had any training related to office ergonomics.The existence of a symptom in any part of the participating bank employees is 61.1%, and the average for the body is 1.8±2.8; the highest existence is in the left neck region with 66.5% and in the left shoulder region with 28.5%. The lowest existence of symptom is in left elbow region with 13.1%. The general rate of symptom existence is 47.5% for the left side of body and 49.3% for right part of body (Table-2). Four different types of scores are obtained for psychosocial elements: work-load, control over the work score, social support score and work stress score (Table-3).

When MSC preventive behaviors are evaluated, the average score for doing exercise is found as 2.3±1.52.3 while these numbers are 3.1±1.7and2.6±1.5 for the frequency of giving short breaks and for paying attention to posture. Distribution of the symptoms according to certain attributes of the participants are shown in table-4.

The existence of the symptoms is observed to be more in women, older people, married people, people with kids and people working longer hours. When the existence of upper body musculoskeletal symptoms and psycho-social elements are considered together, there exists a meaningful relationship between skill scores and scores for control over the work (Table-5).

Prevalence of upper body musculoskeletal symptoms for bank employees working with computer and risk factors affecting this situation are determined. In this study, therate of symptom existence in any part of theupper body is found to be 61.1%. This result is in line with previous research by which the prevalence is reported between 27% and 63% ( 13 ). In a study carried by Abledu et al., the density of upper body area symptoms within last 12 months is found to be 83.5% ( 14 , 15 ), while Bhanderi reported frequency as 72.2% ( 6 , 14 ). As a result of a study over the density of upper body region symptoms within last 12 months, it is observed that neck and shoulder symptoms are more prevalent. It is understood that symptom prevalence is higher in the left region of the body than in the right region and that the lowest prevalence is observed in the left elbow region. UE-WMSC prevalence in elbow region is found to be lower than what is repor-ted in previous studies, between 6.0%- 30% ( 16 ). This situation could be explained by the joint structure of elbows, by use of handarm support and by the fact that degenerative diseases are less observed in this region.In a cross-sectional study carried out in Kuwait to determine existence of UE-WMSC for bank employees, prevalence of MSC is found to be 80% while the most affected parts of the body are neck (53.5%), waists (51,1%), shoulders (49.2%) and back (38.4%) ( 17 ). In Balcı’s dis- sertation study covering the bank employees in Gaziantep Province, the prevalence of musculoskeletal complaints is determined as 58.5%, while the most common complaints are reported as waist pains (29.0%), back pain (28,8%) and neck pain (27.9%)( 18 ). Jensen et al. showed that the most common symptoms for women working in call centers are observed in neck (53%), which is followed by shoulders (42%) and hand-wrist area (30%) ( 19 ). In his study Wood reports that participants had musculoskeletal complaints at least once in a year; 56% of the participants experienced musculoskeletal disorders within last week, and 20% of the participants experienced musculoskeletal disorders that had hindered working ( 20 ). Çalık et al. found out that white-collar workers have most common musculoskeletal complaints in theback of the body (69.9%), in the waist (68%), neck (67.1%) and 50.6% in right shoulder ( 21 ).In a study carried out by Klussmann et al., it is shown that the symptoms of last one year are reported in theneck (55%), shoulders (38%), hand-wrist (21%) and elbow and forearm (15%) ( 22 ). In this study, it is found out that individual factors such as age, thenumber of children, working time and scores of psychosocial factors such as skill and control over the work are related with UE- WMSC. Viikari et al. determined that the risk of WMSC in the neck and upper extremity increases with advancing age ( 23 ).

In some studies, it is reported that complaints in arms, wrist and hand increase after theage of 40 ( 24 , 25 ). Torqvist et al. reported that neck and shoulder symptoms slightly increase between ages of 40 and 48 while after the age of 50, an increase in shoulder symptoms are observed ( 26 ). Holmström et al. studied the relationship between age and musculoskeletal complaints and observed that they increase with advancing age ( 27 ).

Mostly in literature it is reported that MSC is more common for women than men ( 7 , 21 , 25 , 28 – 30 ). The possibility of development of a musculoskeletal problem is higher for women working in thebank compared to men. Being a woman is reported as a risk factor for the progress of MSC ( 31 ). However, no statistical significance is determined (p>0.05). In some studies, it is reported that women had more symptoms given their domestic workload and child care ( 30 , 31 ).

In this study, no significant statistical relationship is found out between working with the computer (WWC) and musculoskeletal complaints (p<0.11). In a similar way, in some studies carried out, no relationship is observed between WWC and UE-WMSC ( 33 , 34 ). Viester et al. in a study carried out in Holland, found out the relationship between musculoskeletal complaints and body-mass index ( 35 ). In this study, no relationship was found between UE-WMSC and smoking, regular sports and stretching exercises. However, physical activity has many positive effects such as protection of muscular force, protection of body shape and posture, reducing fatigue, protection against muscle contraction, maintenance of bone mineral density, body protection against injuries and accidents, etc.( 36 ). In this study, a relationship was observed between working time and existence of musculoskeletal symptoms. In a similar study, (statistical) significance was observed between working time and UE-WMSC ( 22 , 37 ). In many studies, smoking is evaluated as an individual risk factor affecting the development of musculoskeletal diseases. However, no relationship has been reported in this study. No relationship has been established between musculoskeletal symptom development and the frequency of having short breaks and controlling body posture.

In previous epidemiologic studies, it was reported that short resting breaks have positive effects ( 7 , 37 , 38 ). Use of screen is diminished together with short breaks, muscle load due to poor ergonomic conditions is decreased. Short breaks provide muscular relief and recovery (4, 39,45). In this study, statistical significance is determined between UE-WMSC and control over the work. Especially imbalance between the workload and control for the employees results in work stress. Bot et al. found out that sickness absenteeism increases for employees with high workload and low work control ( 40 ). In previous studies, psychosocial factors are evaluated as determinant factors for WMSC (22,39,4142,43,44).

It is found out that frequency of neck and shoulder musculoskeletal symptoms are most commonly observed in bank employees working with acomputer. The presence of upper body musculoskeletal symptoms are observed more with advancing age, for women, married, people with children, people with more working hours. It is also understood that skill and control over the work are among the workplace psychosocial elements that constitute risk factors for upper body musculoskeletal symptoms. It is necessary that preventive programs for musculoskeletal symptoms of bank employees should concentrate primarily on neck and shoulder disorders. It is also important to get rid of psychosocial factors that are negatively affecting the health of bank employees.