Equity in Whom Gets Studied: A Systematic Review Examining Geographical Region, Gender, Commodity, and Employment Context in Research of Low Back Disorders in Farmers

Toxic External Exposure Leading to Ocular Surface Injury

The surface of the eye is directly exposed to the external environment, protected only by a thin tear film, and may therefore be damaged by contact with ambient particulate matter, liquids, aerosols, or vapors. In the workplace or home, the eye is subject to accidental or incidental exposure to cleaning products and pesticides. Organic matter may enter the eye and cause infection. Ocular surface damage can trigger a range of symptoms such as itch, discharge, hyperemia, photophobia, blurred vision, and foreign body sensation. Toxin exposure can be assessed clinically in multiple ways, including via measurement of tear production, slit-lamp examination, corneal staining, and conjunctival staining. At the cellular level, environmental toxins can cause oxidative damage, apoptosis of corneal and conjunctival cells, cell senescence, and impaired motility. Outcomes range from transient and reversible with complete healing to severe and sight-compromising structural changes. Classically, evaluation of tolerance and safety was carried out using live animal testing; however, new in vitro and computer-based, in silico modes are superseding the gold standard Draize test. This review examines how environmental features such as pollutants, temperature, and seasonality affect the ocular surface. Chemical burns to the eye are considered, and approaches to protect the ocular surface are detailed.

The Health of Migrant Agricultural Workers in Europe: A Scoping Review

Agriculture is a niche market for migrant workers, and one of the sectors with the highest rates of accidents, deaths and work-related health problems. To review and synthesize existing literature on the health conditions of international migrant agricultural workers in Europe. A scoping review of scientific literature published until March 2021 was conducted in PubMed, Scopus, WoS and OpenGrey, following Arksey & O'Malley's theoretical framework where 5894 references were retrieved and screened. Nineteen articles were selected, reviewed and synthetized. The country with the highest number of studies published (n = 9) was Spain. The design of the studies was mainly cross-sectional (n = 13). The main health problems identified were: lower back pain and other musculoskeletal problems, dermatitis, gastrointestinal and respiratory infections, anxiety, stress, depression and barriers to access healthcare services. Migrant agricultural workers are a neglected population with conditions of vulnerability and precariousness, physical and mental health problems and poor working conditions. Interventions to reduce or eliminate language, cultural and administrative barriers to ensure access to healthcare services are needed, as well as designing a common European framework to protect the rights of migrant agricultural workers and their families.

Effect of non-surgical interventions on pain relief and symptom improvement in farmers with diseases of the musculoskeletal system or connective tissue: an exploratory systematic review based on randomized controlled trials

Objective: There are many observational and clinical studies on pain treatment in farmers; however, little is known about the effects of interventions based only on randomized controlled trials (RCTs) on diseases of the musculoskeletal system or connective tissue (D-MSCT). This review aimed to summarize evidence on the effects of non-surgical interventions for pain relief and symptom improvement in farmers with D-MSCT.

Materials and Methods: We searched seven databases, including MEDLINE, and three clinical trial registries, including the International Clinical Trials Registry Platform, from inception up to February 15, 2021, to identify studies that included at least one treatment group wherein nonsurgical interventions were applied. We focused on 1) pain relief and symptom improvement and 2) quality of life and improvement in physical fitness.

Results: Four studies (three on low back pain and one on knee osteoarthritis) met all the inclusion criteria. Overall, the risk of bias was high, and meta-analysis could not be performed due to heterogeneity. However, a participatory ergonomic approach, exercise centered on strength training with a transtheoretical model, and/or a combination of both could be included in effective educational programs, at least in the short term, to prevent and/or reduce exacerbation of D-MSCT in farmers. Based on internal and external validity, we could postulate a future research agenda and a conceptual education model to prevent D-MSCT in farmers.

Conclusion: Participatory ergonomic intervention, exercise centered on strength training, and/or a combination of both could be included for effective educational programs to prevent and reduce exacerbation of D-MSCT in farmers. High-quality RCTs with a less risk of bias will be implemented for many agricultural work types in various parts worldwide (especially developing countries and regions) during the COVID-19 pandemic.

A Review on Ergonomics in Agriculture. Part I: Manual Operations

Background: Agriculture involves several harmful diseases. Among the non-fatal ones, musculoskeletal disorders (MSDs) are the most prevalent, as they have reached epidemic proportions. The main aim of this investigation is to systematically review the major risk factors regarding MSDs as well as evaluate the existing ergonomic interventions. Methods: The search engines of Google Scholar, PubMed, Scopus, and ScienceDirect were used to identify relevant articles during the last decade. The imposed exclusive criteria assured the accuracy and current progress in this field. Results: It was concluded that MSDs affect both developed and developing countries, thus justifying the existing global concern. Overall, the most commonly studied task was harvesting, followed by load carrying, pruning, planting, and other ordinary manual operations. Repetitive movements in awkward postures, such as stooping and kneeling; individual characteristics; as well as improper tool design were observed to contribute to the pathogenesis of MSDs. Furthermore, low back disorders were reported as the main disorder. Conclusions: The present ergonomic interventions seem to attenuate the MSDs to a great extent. However, international reprioritization of the safety and health measures is required in agriculture along with increase of the awareness of the risk factors related to MSDs.

Prevalence and risk factors of low back disorders among waste collection workers: A systematic review

BACKGROUND

Waste management is a growing industry worldwide. Working conditions may entail risk factors for musculoskeletal disorders, and especially low back disorders (LBD).

OBJECTIVE

The purpose of this study was to perform a systematic review on: (i) the prevalence of LBD; and (ii) risk factors for LBD among waste collection workers.

METHOD

A search was conducted in three electronic databases: Ovid Medline, EMBASE, and Global Health ePublications. Data were extracted on study design, sampling strategy, geographical region, LBD prevalence, and risk factors. Data were reported narratively.

RESULTS

Thirteen full-text articles met the study criteria. Using a range of definitions for LBD, the included articles reported a 12-month prevalence of 'LBD' between 16 to 74%, although none of the included studies quantified relationships between risk factors and LBD. None of the studies met all 9 risk of bias criteria. No articles investigated the association of risk factors and LBD, but even in absence this evidence authors of included studies suggested physical risk factors for LBD among waste workers: awkward posture, repetitive motion, and work duration.

CONCLUSION

In light of these risks and future growth in this industry, the lack of high quality studies and investigation of risk factors highlight the need for more research in this sector which will support future LBD prevention efforts.

The association between awkward working posture and low back disorders in farmers: a systematic review

BACKGROUND

Low back disorders (LBD) are the most common musculoskeletal problem among farmers, with higher prevalence than other occupations. Although studies of the general population have shown an association between LBD and awkward working posture, farmers have unique work context and exposures that may modify this relationship. This review aimed to 1) identify published research studies investigating posture as a risk factor for LBD in farmers/agricultural workers, and 2) determine the strength of the relationship between postural exposure and LBD risk of bias assessment.

METHOD

Comprehensive electronic searches of Medline, Web of Science, CINAHL, SCOPUS, PubMed, and EMBASE were carried out with combined conceptual groups of search terms for 'farming' and 'LBD.' After screening, data were extracted to summarize the study design, sample characteristics, exposure assessment methods, LBD risk factors, demographic information, data collection methods, farm commodities, job context, and sampling strategy. Data were synthesized to determine the weight of evidence for awkward working posture as a risk factor for LBD among farmers.

RESULTS

Nine studies were included in this review. All studies used self-report; there were no field-based studies including direct measurement of awkward posture. There was diversity in exposure definition, exposure assessment, LBD definition, worker characteristics, and analytical approaches. There was evidence to support association between awkward working posture and LBD among farmers.

CONCLUSION

Despite the diversity, the weight of evidence supported a relationship between awkward posture and LBD. Well-designed epidemiological studies with quantitative physical workload assessments, consistent and valid LBD definitions, and longitudinal designs are recommended to clarify the relationship between awkward posture and LBD.

Association Between Whole-Body Vibration and Low-Back Disorders in Farmers: A Scoping Review

INTRODUCTION

Low-back disorders (LBDs) are the most common musculoskeletal problem among farmers, with higher prevalence rates than in other occupations. Farmers who operate tractors and other types of machinery can have substantial exposure to whole-body vibration (WBV). Although there appears to be an association between LBDs and WBV, the causal relationship is not clear.

OBJECTIVE

This scoping review investigates the association between WBV and LBDs specifically among farmers.

METHODS

Nine databases were searched using groups of terms for two concepts: 'farming' and 'low back disorder'. Screening, data extraction, and quality assessment were performed by two reviewers independently. Included studies met the following criteria: focused on adult farmers/agricultural workers; assessed exposure to operating farm machinery such tractor, combine, or all-terrain vehicle; assessed LBDs as an outcome; and reported an inferential test to assess the relationship between WBV and LBD.

RESULTS

After 276 full texts screened, 11 articles were found to analyze WBV as a risk factor for LBDs. Three were case-control, five cross-sectional, and three retrospective cohorts. Four studies showed no association between WBV and LBDs, four a positive association, and three results were mixed depending on the exposure/outcome measure.

CONCLUSION

A firm conclusion is difficult due to heterogeneity in, LBDs definition, type of farm commodity, study design, and statistical strategy. Direct comparisons and synthesis were not possible. Although retrospective cohort studies tended to show a relationship, future studies with a prospective cohort design could help clarify this association further.

Effects of a Worksite Supervised Adapted Physical Activity Program on Trunk Muscle Endurance, Flexibility, and Pain Sensitivity Among Vineyard Workers

OBJECTIVES

In viticulture, the prevalence of low back pain is particularly high among vineyard workers exposed to sustained and awkward postures. One promising setting for low back pain prevention resides in the implementation of workplace physical activity.

METHODS

This nonrandomized pilot study aims at evaluating the effects of a worksite supervised adapted physical activity program among 17 vineyard workers volunteered to enter either an intervention group (n = 10) or a control group (n = 7).The intervention group followed a physical activity program for 8 weeks involving (1) 15 minutes of warm-up every working day and (2) two weekly 1-hour adapted physical activity sessions targeting trunk muscle endurance and flexibility. The control group was advised to continue normal physical activity. Evaluations were carried out at weeks 0, 4, 8, and 12. Physical capacity was assessed using flexibility tests for the trunk, along with trunk muscle flexor and extensor endurance tests. Finally, pain sensitivity was evaluated by assessing pressure pain thresholds over 14 anatomical locations in the low back region.

RESULTS

For the intervention group, the endurance of the trunk extensor and flexor significantly increased from baseline to week 8 as well as the pressure pain thresholds. No change was observed for the control group over the same period.

CONCLUSIONS

These encouraging results in combination with the high adherence rate set interesting foundations for the promotion of worksite supervised adapted physical activity and, most likely, offer a new promising approach to prevent low back pain among vineyard workers.