Health effects associated with working in the wind power generation industry: a comprehensive systematic review
Authors: Cooper Kay , Kirkpatrick Pamela , Stewart Arthur 
Published: December 2014

Executive Summary

Background
The onshore wind power generation sector is set to expand its workforce dramatically in the next decade. As the industry matures, it will be increasingly important to understand the potential health effects of the work carried out by wind technicians who are required to ascend and descend wind turbines, often taking equipment with them, several times daily. Whilst most risks are mitigated via fall-arrest and other equipment, together with safe working systems, there are still some risks, especially the potential for musculoskeletal disorders from chronic exposure to ladder climbing and cramped work spaces.

Objectives
To identify the known and/or potential musculoskeletal risks of working in the wind power generation industry, specifically relating to vertical ladder climbing and working in confined spaces.

Inclusion criteria

Participants

Adult onshore wind technicians, and in the absence of studies pertaining to these professionals, participants from telecommunications, offshore, construction, fire-fighting, military and other occupations.

Phenomena of interest

The musculoskeletal and other physical health risks to onshore wind technicians and others associated with the repeated climbing of vertical ladders and working in confined spaces.

Types of studies

Any relevant quantitative or qualitative study or text-based opinion article.

Types of outcomes

Prevalence; incidence; type and severity of musculoskeletal and related physical disorders.

Data collection and synthesis
Three thousand two hundred and thirty-three studies in English were identified following the searching of 24 databases. Seventeen were critically appraised by two independent reviewers and findings from ten were extracted using Joanna Briggs Institute critical appraisal and data extraction tools. There was a high degree of heterogeneity between the ten quantitative studies included, rendering meta-analysis inappropriate; therefore results are presented in narrative form.

Results
Despite finding no published evidence on wind technicians as an occupational group, evidence from similar professions informed the study objective. Ladder-related injuries are common, and amongst different types of ladder injury, falls are most likely to be associated with fracture. Rest breaks may protect workers by preserving conditions in which a fall is less likely, and thus delaying a time-point, however unlikely, of a fall occurring within a shift. by delaying the possibility of falls occurring during a shift. In professions similar to wind technicians, musculoskeletal disorders are widespread and account for 47% of work-related injuries in Norwegian offshore workers. Adopting stooping and kneeling postures has a dose-response relationship with severe low back pain. There is limited evidence on its association with knee osteoarthritis, but in regards to its association with hip osteoarthritis, no evidence was found. However, those in manual occupations in general are associated with roughly a two-fold increase in odds of developing knee osteoarthritis, and there is clear evidence of a link between the risk of knee osteoarthritis and a high Body Mass Index.

Conclusions
Ladder climbing is associated with an increased risk of musculoskeletal disorder, low back pain and knee osteoarthritis, and this may be exacerbated by workers adopting prolonged kneeling or stooping postures, and having a high Body Mass Index.