Relationship of Healthy Building Determinants With Back and Neck Pain: A Systematic Review

Trends in chronic neck and low back pain prevalence in Spain (2006-2020): differences by sex, age, and social class

PURPOSE

To analyze the evolution of chronic neck and low back pain prevalence in the general Spanish population (≥ 15 years) from 2006 to 2020, examining differences by sex, age, social class, and the potential influence of the COVID-19 pandemic.

METHODS

A repeated cross-sectional observational study was conducted based on data from six health surveys conducted in Spain between 2006 and 2020, with samples ranging from 21,007 to 29,478 subjects per survey, reported by the European Statistical System and the National Statistical Institute. Overall and specific prevalence rates were calculated, and linear trends were assessed over time. The potential influence of the COVID-19 pandemic was evaluated using the Mann-Kendall test, along with prevalence forecasts up to 2020, derived from S-curve models.

RESULTS

Between 2006 and 2020, the prevalence of chronic neck pain ranged from 23.64 to 12.3%, while chronic low back pain ranged from 24.01 to 14.73%. A decreasing trend was observed in both conditions, slightly more pronounced for neck pain. This trend persisted even when excluding 2020 data, which was potentially influenced by the COVID-19 pandemic, and was independent of health surveys. Forecasts indicated that the actual 2020 prevalence rates were lower (by 3.1-4.4%) than predicted. The prevalence was consistently higher among women, older individuals, and lower social classes, though all subgroups showed similar decreasing trends.

CONCLUSION

The prevalence of chronic neck and low back pain in the Spanish population declined between 2006 and 2020. Subgroup analyses revealed consistent decreases across sex, age, and social class. The COVID-19 pandemic may have impacted the 2020 prevalence rates.

Living successfully with chronic pain: Identifying the pivotal conditions needed to make it happen

Chronic pain is associated with many negative consequences for individuals and society. Given the burden it represents, many studies have focused on the risk factors involved, but very few have aimed to explain why some people live well with chronic pain, beyond the psychological realm. Thus, this study collected and analyzed different individual experiences to identify the pivotal conditions that help some individuals achieve quality of life despite chronic pain, with an emphasis on social considerations. We conducted a qualitative study using a narrative inquiry approach to unpack the participants' stories on these pivotal conditions. We carried out 25 individual interviews with persons who considered they had been living well with their pain for a minimum of 6 months. Data were analyzed using the inductive narrative method. Most participants were women (64%), White (88%), with a high level of education, and having low back or generalized pain (56%). Three main themes were identified: 1) a care partnership, 2) a nurturing environment, and 3) breaking free from previous life to move forward. These themes were then divided into 11 sub-themes, providing an in-depth understanding of the pivotal conditions needed to live well with chronic pain. The data collected suggest that to enable people to have a favorable evolution in the presence of chronic pain, a socio-ecological approach could be necessary to counteract painogenic environments. However, these results need to be validated and adapted to different populations. Perspective This study highlights the importance of a socio-ecological approach to living well with chronic pain, emphasizing that care partnerships, a nurturing environment and the ability to break with the past are essential to improve the quality of life of those affected.

Pilot study of musculoskeletal discomfort in Indonesian pregnant workers during COVID-19 pandemic era

Objective

This pilot study aims to analyze the factors influencing musculoskeletal discomfort in pregnant workers in Indonesia from occupational aspects, especially during the pandemic, to recommend further interventions and policies for a safer and healthier workplace.

Methods

This study was a cross-sectional study. It used an online questionnaire to collect data on individual, occupational, and work environmental factors and musculoskeletal discomfort. We used Chi-square and logistic regression analysis to determine associations between the risk factors and the musculoskeletal discomfort.

Results

A total of 126 women from multiple employment sectors participated. About 59% of respondents reported discomfort, with the majority having pain in the lower back (62.2%). Chi-square analysis revealed that age, history of injury, subjective agility and speed, length of working days in a week, and subjective temperature conformity were associated with the prevalence of musculoskeletal discomfort. Logistic regression revealed that age (p = 0.018 and OR = 2.218) and temperature conformity (p = 0.049 and OR = 2.157) were the most significant independent predictors of musculoskeletal discomfort.

Conclusion

This study shows that temperature conformity is a predictor of musculoskeletal discomfort. Employers should consider this when determining whether their workplace is suitable for pregnant women. The treatment of younger workers needs attention, especially during pregnancy, they may need extra accommodation during pregnancy.

Impact of Environment on Pain among the Working Poor: Making Use of Random Forest-Based Stratification Tool to Study the Socioecology of Pain Interference

Pain interferes with one's work and social life and, at a personal level, daily activities, mood, and sleep quality. However, little research has been conducted on pain interference and its socioecological determinants among the working poor. Noting the clinical/policy decision needs and the technical challenges of isolating the intricately interrelated socioecological factors' unique contributions to pain interference and quantifying the relative contributions of each factor in an interpretable manner to inform clinical and policy decision-making, we deployed a novel random forest algorithm to model and quantify the unique contribution of a diverse ensemble of environmental, sociodemographic, and clinical factors to pain interference. Our analyses revealed that features representing the internal built environment of the working poor, such as the size of the living space, air quality, access to light, architectural design conducive to social connection, and age of the building, were assigned greater statistical importance than other more commonly examined predisposing factors for pain interference, such as age, occupation, the severity and locations of pain, BMI, serum blood sugar, and blood pressure. The findings were discussed in the context of their benefit in informing community pain screening to target residential areas whose built environment contributed most to pain interference and informing the design of intervention programs to minimize pain interference among those who suffered from chronic pain and showed specific characteristics. The findings support the call for good architecture to provide the spirit and value of buildings in city development.

Impact of Indoor Air Quality and Breathing on Back and Neck Pain: A Systematic Review

Back pain and neck pain are important public health concerns and are among the most common and disabling conditions globally. However, the relationships among indoor air quality (IAQ), breathing parameters (pulmonary function, respiratory disorders), and back pain and neck pain have not been adequately assessed. The purpose of this study was to systematically review the literature about the impact of IAQ and breathing parameters on back pain and neck pain (PROSPERO ID: CRD42022380515). CINAHL, EMBASE, PEDRo, and PubMed databases were searched through January 19, 2023. Inclusion criteria for study eligibility were observational studies (except case reports) or randomized controlled trials (RCTs), published in peer-reviewed journals in the English language, human research, original research, examined the relationships between IAQ, or breathing parameters with back pain or neck pain. Review procedures were conducted and reported according to PRISMA recommendations. Empirical evidence statements were developed for observational studies, and grades of evidence statements were developed for RCTs. Sixty-seven eligible studies were found (54 observational studies and 13 RCTs) that enrolled 345,832 participants. None of the studies assessed the combined impact of IAQ and breathing parameters on back pain or neck pain. No level 1 studies were found, which precludes making strong statements about causality and strong recommendations about the efficacy of IAQ and breathing exercise interventions for reducing pain and disability related to back pain and neck pain. Evidence indicates that poor IAQ and respiratory disorders are related to an increased risk of back pain and neck pain. Conflicting evidence exists about the association between pulmonary function with back pain and neck pain. Evidence for breathing exercise interventions was mixed with numerous limitations. This review provides preliminary evidence on the relationships of IAQ and breathing parameters with back pain and neck pain, which can be used to guide future research and clinical implementation efforts. Assuming positive findings in subsequent research, a wide range of stakeholders involved with this complex human-building-environment interface can be equipped to address IAQ and breathing parameters, along with other established risk factors to help those suffering from back pain and neck pain.

Relationship of Healthy Building Determinants With Musculoskeletal Disorders of the Extremities: A Systematic Review

Musculoskeletal disorders (MSDs) are a substantial societal burden and various factors affect their causation, recovery, and prognosis. Management of MSDs is complex and requires multifaceted interventions. Given the challenges of MSDs and their continued burden, it is possible that additional elements could impact these disorders that have not been fully researched, for example, indoor environmental quality. Our previous review provided preliminary evidence that healthy building determinants (HBDs) are associated with the risk of back and neck pain. However, the relationship of HBDs with extremity MSDs and general MSDs (i.e., MSDs involving multiple body regions or in which body regions were unspecified in the original reports) has not been formally studied. The purpose of this review was to conduct a systematic literature review to assess the relationship of HBDs with extremity and general MSDs (PROSPERO ID: CRD42022314832). PubMed, CINAHL, Embase, and PEDRo databases were searched through April 2022. Inclusion criteria for study eligibility were as follows: humans of ages ≥18 years, reported on one or more of eight HBDs (1. air quality and ventilation, 2. dust and pests, 3. lighting and views, 4. moisture, 5. noise, 6. safety and security, 7. thermal health, 8. water quality), and compared these HBDs with extremity MSDs or general MSDs, original research, English. Exclusion criteria were as follows: articles not published in peer-reviewed journals, full-text articles unavailable. Review procedures were conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Empirical evidence statements were developed for 33 pairwise comparisons of HBDs with MSDs. The search uncovered 53 eligible studies with 178,532 participants. A total of 74.6% (39/53) of the studies were cross-sectional and 81.1% (43/53) were fair quality. Overall, the majority of uncovered evidence indicates that HBDs are related to risk of extremity and general MSDs. Nineteen comparisons support that as HBDs worsen, the risk of MSDs increases. Six comparisons had conflicting evidence. Three comparisons support that poor HBDs are not related to increased risk of extremity and general MSDs. Five comparisons had no evidence. This systematic review builds upon previous work to provide useful starting points to enhance awareness about the HBD-MSD relationship. These findings can help inform research and public health efforts aimed at addressing suboptimal HBDs through appropriate interventions to improve the lives of those suffering from MSDs.