Effects of driving on low back pain

Self-Reported Work-Related Musculoskeletal Problems and Associated Risk Factors Among Three-Wheel Car Drivers in Ethiopia: A Cross-Sectional Community-Based Study

Background

Globally, the demand for mobility is increasing. Three-wheel cars are one of the best options for meeting this demand and creating new job opportunities in most developing countries, including Ethiopia. Drivers are highly susceptible to developing musculoskeletal disorders (MSDs). Even though several studies on other groups of drivers have been conducted, little is done in Ethiopia among three-wheel car drivers.

Objective

This study investigated the prevalence of MSDs and identified their associated risk factors among three-wheel car drivers in Ethiopia.

Methods

A community-based cross-sectional research was conducted among drivers of three-wheel cars from August 05 to October 07, 2022. A stratified sampling followed by a simple random sampling technique was used to select 422 respondents. Structured and pretested questionnaires adapted from the Nordic Musculoskeletal Questionnaire were used to collect the data. Epi-data version 4.2.0.0 and SPSS version 20 were used to enter and analyze the collected data, respectively.

Results

In the previous 12 months, 62.45% of three-wheel car drivers had musculoskeletal disorders in any body region (95% CI: 58.36, 66.14). The back pain was the most frequently reported site of pain in this study. This study showed that the habit of doing physical exercise, work experience, site of service, taking rest breaks while driving, and having comfortable sitting posture was risk factor for musculoskeletal pain.

Conclusion

In this study, the overall 12-month prevalence of musculoskeletal problems among three-wheel car drivers was high. Periodic health checkups for drivers, lifestyle changes, delivering training, and creating awareness are important to address this high-burden occupation-related problem.

Lumbar Flexion During Driving: Establishing a Methodology for Characterising Real-Time Posture Data Collected by Innovative Technology

OBJECTIVE

To determine a methodology for the analysis of real-time driving posture data in the low back pain population.

BACKGROUND

The strength of the relationship between driving posture and low back pain is yet to be defined due to the lack of studies in the field using validated and repeatable posture measurement tools. Reliable and validated real-time measurement tools are now available, yet reliable methods of analysis of these data are yet to be established.

METHOD

Ten occupational drivers completed a typical work shift while wearing an inertial motion sensor system (dorsaVi ViMove). Real-time lumbar flexion data were extracted, with test-retest reliability of mean lumbar flexion, peak lumbar flexion, and standard deviation of lumbar flexion analysed at different times across a work shift, and in different sections within a drive.

RESULTS

Mean lumbar flexion was highly repeatable over numerous drives in one day, with greater test-retest reliability if the first five minutes of driving data were excluded. Peak lumbar flexion had acceptable test-retest reliability over numerous drives in one day, while standard deviation of lumbar flexion was not a repeatable measure.

CONCLUSION

Mean lumbar flexion was a reliable outcome for characterising driving posture in drivers with low back pain. Peak lumbar flexion may be used if appropriate to the individual study. Standard deviation of lumbar flexion is not a reliable posture outcome.

APPLICATION

This paper provides a reliable methodology for analysis of real-time driving posture data in occupational drivers with low back pain.

Sitting Posture During Occupational Driving Causes Low Back Pain; Evidence-Based Position or Dogma? A Systematic Review

OBJECTIVE

In this review, we determine if there is evidence to demonstrate a relationship between occupational driving posture and low back pain.

BACKGROUND

The burden of low back pain is increasing. An understanding of this relationship is required to enable the development of recommendations for clinicians and policy-makers for the driving industry.

METHOD

Five databases were searched up to March 12, 2018. Study quality was assessed using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, followed by a GRADE analysis to consider the evidence as a whole. A narrative, critical synthesis was completed that considered the methods by which driving posture and low back pain were measured and analyzed.

RESULTS

There were 653 articles identified, with seven eligible for review. Four articles identified an association between occupational driving posture and low back pain, yet this was based on the use of measurement tools lacking validity. Although a relationship may exist, the specific driving postures associated with low back pain and the strength of this relationship have not been confirmed.

CONCLUSION

Future research needs to employ validated and reliable, real-time qualitative methods for measuring occupational driving posture to advance our understanding of this relationship.

APPLICATION

Clinical and policy recommendations regarding driving posture and low back pain should be used with caution, as they are guided by evidence incorporating bias. Future studies are required to confirm the specific postures assumed while occupational driving and their relationship with low back pain, before recommendations can be made.

Health-related quality of life and depression among medical sales representatives in Pakistan

Pharmaceutical companies have been known to pose stress and mental harassment on medical sales representatives (MSRs) in-order to increase pharmaceutical sales. This cross sectional descriptive study, conducted during November and December 2014 in the Lahore and Bahawalpur districts of Punjab, Pakistan, evaluates the Health-Related Quality of Life (HRQoL) and extent of depression among MSRs in Pakistan. The significant predictors of HRQoL and depression among the MSRs were also determined. Using a convenience sampling technique, all consenting MSRs (N = 318) of pharmaceutical companies were asked to self-complete the Short Form-36 (SF-36v2) Health Survey and Stanford Personal Health Questionnaire (PHQ-8). The standard scoring scheme for the SF36v2 and PHQ-8 questionnaires was used. The PHQ-8 scores showed that 16.4 % (n = 52) and 2.5 % of respondents were suffering from major depression and severe major depression, respectively. Being depressed and having difficulty in achieving sales targets were the factors independently associated with lower physical health. Similarly, depression, insufficient time for the family and monthly income less than 36,000 Pakistan Rupees were significant predictors of lower mental health. The factors associated with depression included insufficient time for the family and unsatisfactory behavior of the managers. Compromised mental health and the prevalence of depression among the MSRs suggest pharmaceutical companies need to devise health management strategies and interventions to ensure effective prevention and management of mental health problems among Pakistani MSRs.

Participatory ergonomics: co-developing interventions to reduce the risk of musculoskeletal symptoms in business drivers

The participatory process within four case study organisations with a target population of high mileage business drivers is described. The aim was to work with drivers and their managers to co-develop intervention activities to raise awareness of musculoskeletal health in drivers, including use of the car as a mobile office and manual handling from the car. Train-the-trainer sessions were delivered in each organisation, along with the co-production of training materials. The effectiveness of these activities were evaluated using three sources of data: post-intervention questionnaires, interviews with organisation 'champions' and observations from the research team's diaries. The approach raised management awareness of the risks to drivers and was successful in affecting change, and as such, participatory research should consider the early stages of a project as part of any intervention activities. The research team also reflect on conducting applied longitudinal research in the field.

PRACTITIONER SUMMARY

Raising awareness of the risks of musculoskeletal disorders in drivers who work from their vehicle is important. This paper reflects on research in the field and provides guidance on the participatory process and evaluating intervention activities. The participatory process was successful in affecting change at management level.

Stakeholder perspectives on managing the occupational health of UK business drivers: a qualitative approach

Musculoskeletal disorders are one of the leading causes of work related ill health and sickness absence. Those who drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using 'Template Analysis'. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision.