Prevalence of low back pain and associated occupational factors among Chinese coal miners

Risk factors for low back pain in the Chinese population: a systematic review and meta-analysis

BACKGROUND

In China, the world's largest developing country, low back pain (LBP) is a common public health issue affecting workability. This meta-analysis aimed to systematically assess the risk factors of LBP in the Chinese population.

METHODS

Four English language and four Chinese databases were searched, and cross-sectional studies on the risk factors for LBP in Chinese populations were identified and collected. The search timeframe covered the period from the establishment of the database to November 2023. Two researchers independently reviewed the literature, extracted the data, and evaluated the risk of bias. Begg's and Egger's tests were used to evaluate publication bias.

RESULTS

Fifteen cross-sectional studies involving 86,575 people were included. Seven risk factors for LBP were identified. Six risk factors were statistically significant: Cigarette smoking (odds ratio [OR] = 1.55; 95% confidence interval [CI]: 1.15, 2.08, P = 0.004, I2 = 72%), body mass index (BMI) ≥ 28 kg/m² (OR = 4.51; 95% CI: 3.36, 6.07, P < 0.00001, I2 = 8%), female sex (OR = 1.54; 95% CI: 1.25, 1.90, P < 0.0001, I2 = 63%), vibration exposure at work (OR = 1.65; 95% CI: 1.16, 2.34, P = 0.006, I2 = 84%), working overtime (OR = 2.57; 95% CI: 1.12, 5.91, P = 0.03, I2 = 85%), and lack of exercise (OR = 2.48; 95% CI: 1.62, 3.78, P < 0.0001, I2 = 0%). One risk factor that was not statistically significant was standing for long periods (OR = 1.02; 95% CI: 0.82, 1.26, P = 0.88, I2 = 73%).

CONCLUSIONS

This study found that smoking, a BMI ≥ 28 kg/m², female sex, vibration exposure at work, working overtime, and lack of exercise may be risk factors for LBP in the Chinese population. Because the included studies were cross-sectional and the certainty of the evidence was very low, the results need to be interpreted cautiously. Multicentre, high-quality studies should be conducted in the future. To reduce the prevalence of LBP, the Chinese government and hospitals must develop early screening programs and implement effective preventive and interventional measures.

TRIAL REGISTRATION

This study is registered in the PROSPERO database (No. CRD42023447857).

Longer working hours and musculoskeletal pain: a meta-analysis

Objectives. Musculoskeletal pain is the most common health problem in the workplace, and one of the most important risk factors for this pain is longer working hours. This study aimed to investigate the association between long working hours and musculoskeletal pain. Methods. Based on the keywords, two scientific sources - PubMed and Embase - were reviewed. The time limit search included articles that were published until May 2020 and only studies published in English were eligible. The results of the studies were combined based on random effects and pooled odds ratio (OR) reported. The degree of heterogeneity in all analyses was investigated and reported based on χ² and I² tests. Publishing bias was also measured using statistical tests. Results. Longer working hours are associated with increased musculoskeletal pain with OR = 1.11 and 95% confidence interval (CI) [1.08, 1.14]. The result was OR = 1.52 and 95% CI [1.14, 2.03] in men and OR = 1.11 and 95% CI [1.00, 1.24] in women. Conclusion. Long working hours are an important and threatening factor for musculoskeletal health. Therefore, this issue should be considered in health policy as well as treatment and prevention.

Assessing the impact of job demands and hazardous workload activities on musculoskeletal symptoms in stone, sand, and gravel mining operations

BACKGROUND

Musculoskeletal disorders (MSDs) and associated musculoskeletal symptoms (MSS) are problematic in stone, sand, and gravel mining. Research is needed to explore relationships between job demands, work-related hazards and MSS.

OBJECTIVE

An exploratory study was conducted in Indiana during 2019-2020 to examine associations between job demands, work-related hazards and MSS.

METHODS

Through convenience sampling, cross-sectional survey data from 459 workers were collected and analyzed using logistic multiple and binary logistic regression methods. Outcome variables were MSS to the low back, neck/shoulder, and wrist/hand. Predictor variables and MSS measures are based on the Dutch Musculoskeletal Questionnaire.

RESULTS

Increased odds of low back MSS were related to dynamic loads (OR = 2.14), pushing/pulling heavy loads (OR = 1.56), torso bending or twisting (OR = 2.36), bent, stooped, or twisted posture (OR = 2.04), uncomfortable postures (OR = 2.07), repetition (OR = 1.67) and vibrating tools (OR = 1.81). Increased odds of neck/shoulder MSS were related to dynamic loads (OR = 1.83), static loads (OR = 1.24), heavy lifting (OR = 1.50), pushing/pulling heavy loads (OR = 1.68), bending or twisting of the neck (OR = 1.82), twisted neck posture (OR = 1.77) and uncomfortable postures (OR = 1.81). Increased odds of wrist/hand MSS were related to dynamic loads (OR = 2.06), static loads (OR = 1.45), bending or twisting of the wrists/hands (OR = 10.52), extended reaching (OR = 3.05), repetition (OR = 5.25), awkward postures (OR = 4.47), working above shoulder level (OR = 2.47), and vibrating tools (OR = 1.78).

CONCLUSION

Hazards that increased the likelihood of MSS were identified. These hazards should be abated or controlled to prevent MSDs in stone, sand, and gravel mining. More applied research, including ergonomic assessments to further identify hazards that can be controlled or abated, is warranted.

Diseases-attributable disability-adjusted life years in copper and molybdenum ore workers in Mongolia: 1999-2019

Most illnesses and deaths in industry workers are associated with occupational diseases (ODs). In recent years, mining has grown rapidly into a major driver of the Mongolian economy. In this study, the organization-based registry data on OD incidence and mortality from the archival data of the 'Erdenet' Copper and Molybdenum Concentrator Plant in Mongolia were used. We estimated the ODs burden in disability-adjusted life years (DALYs) loss between 1999 and 2019. A total of 72,802 DALYs were lost over 20 years, of which 97.5% were due to years lived with disability and 2.5% for years of life lost. The disease burden was high in men, accounting for 76.8% of total DALY. In terms of age groups, among people aged 46-55, DALY accounted for the largest percentage of losses. We found that workplace dust, noise, ergonomics, and vibration were the main factors attributed to the DALYs during the past two decades.

Modeling and Validation of Fatigue and Recovery of Muscles for Manual Demolition Tasks

Manual demolition tasks are heavy, physically demanding tasks that could cause muscle fatigue accumulation and lead to work-related musculoskeletal disorders (WMSDs). Fatigue and recovery models of muscles are essential in understanding the accumulation and the reduction in muscle fatigue for forceful exertion tasks. This study aims to explore the onset of muscle fatigue under different work/rest arrangements during manual demolition tasks and the offset of fatigue over time after the tasks were performed. An experiment, including a muscle fatigue test and a muscle fatigue recovery test, was performed. Seventeen male adults without experience in demolition hammer operation were recruited as human participants. Two demolition hammers (large and small) were adopted. The push force was either 20 or 40 N. The posture mimicked that of a demolition task on a wall. In the muscle fatigue test, the muscle strength (MS) before and after the demolition task, maximum endurance time (MET), and the Borg category-ratio-10 (CR-10) ratings of perceived exertion after the demolition task were measured. In the muscle fatigue recovery test, MS and CR-10 at times 1, 2, 3, 4, 5, and 6 min were recorded. Statistical analyses were performed to explore the influence of push force and the weight of the tool on MS, MET, and CR-10. Both muscle fatigue models and muscle fatigue recovery models were established and validated. The results showed that push force affected MET significantly (p < 0.05). The weight of the tool was significant (p < 0.05) only on the CR-10 rating after the first pull. During the muscle fatigue recovery test, the MS increase and the CR-10 decrease were both significant (p < 0.05) after one or more breaks. Models of MET and MS prediction were established to assess muscle fatigue recovery, respectively. The absolute (AD) and relative (RD) deviations of the MET model were 1.83 (±1.94) min and 34.80 (±31.48)%, respectively. The AD and RD of the MS model were 1.39 (±0.81) N and 1.9 (±1.2)%, respectively. These models are capable of predicting the progress and recovery of muscle fatigue, respectively, and may be adopted in work/rest arrangements for novice workers performing demolition tasks.

The Prevalence of Musculoskeletal Disorders among Miners around the World: A Systematic Review and Meta-Analysis

Background

Musculoskeletal disorders are responsible for significant problem for workers' health. The present study aimed to investigate the prevalence of musculoskeletal disorders among mining workers.

Methods

This systematic review and meta-analysis study were designed in 2020 (from Jan to Mar). The researchers searched five international databases Medline/PubMed, ProQuest, Scopus, Embase and Web of Science. All analyzes were performed using STATA statistical software.

Results

The search results were 447 articles and after screening stage finally 50 studies were included in review. The highest number of studies (26 studies) reported the prevalence of musculoskeletal disorders of upper back and 4 studies reported the prevalence of musculoskeletal disorders of the arms and ankles & feet. The results of meta-analysis based on prevalence in different organs showed that the highest prevalence of musculoskeletal disorders was in the upper back and the lowest in the knees with a prevalence of 50.39% (CI 95%: 31.23-54.73%) and 16.03% (CI 95%: 11.78-20.28%), respectively.

Conclusion

The prevalence of musculoskeletal disorders among miners is relatively high. Therefore, supervisors and mine managers should pay more attention to reducing musculoskeletal disorders and increasing the ergonomic level of mines in order to increase workers' health.

Factors associated with musculoskeletal pain in the past 12 months amongst female miners in a South African goldmine

BACKGROUND

Mineworkers, including females, are prone to work-related musculoskeletal disorders and these disorders are not well reported amongst female mineworkers in South Africa.

OBJECTIVE

This study aimed to identify the factors associated with the presence of musculoskeletal pain over a 12-month period amongst female mineworkers (n = 225) in a South African goldmine.

METHOD

Female mineworkers' responses to the presence of musculoskeletal pain over the previous 12-month period and their exposure to physical and psychological factors were elicited using a standardised questionnaire. Descriptive and multivariable analytical statistics were conducted to test for associations between physical and psychological factors and the presence of musculoskeletal pain over the previous 12 months.

RESULTS

The median age of participants was 40 years, with 50.22% of participants reporting the presence of musculoskeletal pain over the previous 12 months. On multivariable analysis, education level and good to excellent health status were protective against the existence of pain during the previous 12 months. Participants' perceived ratings of experiencing moderate-to-high pain intensities were significantly associated with reports of pain over the past 12 months.

CONCLUSION

These findings may raise awareness amongst physiotherapists and occupational medicine physicians about the factors associated with musculoskeletal pain amongst female mineworkers, which they can then use in managing and developing interventions aimed at improving the physical health of female mineworkers.

CLINICAL IMPLICATIONS

Our study highlights the need for medical surveillance of musculoskeletal pain in female mineworkers. A cohort study in a larger study population and across several mines will build on the existing cross-sectional information and help inform workplace interventions for female mineworkers.

A Comprehensive Review of Work-Related Musculoskeletal Disorders in the Mining Sector and Scope for Ergonomics Design Interventions

OCCUPATIONAL APPLICATIONS Work-related Musculoskeletal Disorders (WMSDs) are prevalent in many industries worldwide, including the large and labor-intensive mining sector. A systematic review was carried out to understand problems in the mining sector issues from three broad perspectives: 1) the prevalence of WMSDs among miners; 2) the association of occupational, psychosocial, environmental, and other risk factors with WMSDs causation; and 3) ergonomics interventions already proposed or implemented, and scope for design interventions. Our review revealed that automation, job aids, and displays are methods suitable for ergonomic design interventions. Ergonomic intervention strategies at various hierarchical levels, and the successive way forward as proposed in our review, could act as a catalyst in formulating problem-specific solution strategies by the participation of diverse stakeholders to implement a more human-centric workplace.

Prevalence of neck/shoulder pain among public hospital workers in China and its associated factors: a cross-sectional study

Studies have reported that neck and/or shoulder pain (NSP) was prevalent and a non-ignorable occupational health problem in healthcare providers. Considering data deficiency on NSP, we aimed to investigate the prevalence and sick leave absence of NSP among public hospital workers in Shandong, China and to explore the associated factors for chronic NSP. A self-administered questionnaire including the Dutch Musculoskeletal Questionnaire and Modified Nordic Musculoskeletal Questionnaire was filled in by 30,520 hospital workers in 37 hospitals selected randomly from among all public hospitals of Shandong, China. The 12-month prevalence of NSP lasting for at least 3 months and sick leave absence due to NSP among 29,547 public hospital workers was 15.6% and 11.4%, respectively, most frequently reported in tertiary hospital workers (27.4% and 18.9%) and clinicians (19.1% and 15.2%). Log-binomial regression analysis revealed that chronic NSP was significantly associated with hospital level, employment position, contract/temporary employment status (vs. permanent), workload (long work hours per week), ergonomic factors (bending the neck forward for long periods of time, twisting the neck for long periods of time) and computer-related factors (prolonged computer-using time daily, the keyboard too close to the edge of the desk).

Risk Factors Associated with the Prevalence of Upper and Lower Back Pain in Male Underground Coal Miners in Punjab, Pakistan

There is not enough data available on occupational health and safety issues of underground coal miners in Pakistan. This study focuses on spinal disorders in association with personal and occupational factors. The Nordic Musculoskeletal Questionnaire was used for a cross-sectional study of 260 workers of 20 mines located in four districts of Punjab, Pakistan. Regression models were created for upper back pain and lower back pain of workers whose mean age is 19.8 years (±SD 1.47). Results identify the coal cutting as the most harmful work with odds ratios (ORs) 13.06 (95% confidence interval (CI) 13.7-21.5) for lower back pain and 11.2 (95% CI 3.5-19.4) for upper back pain in participants. Those with greater years of work experience had higher odds of upper back pain (2.4, 95% CI 1.4-3.5) and lower back pain (3.3, 95% CI 1.1-4.4). Number of repetitions (mean value 25.85/minute with ±SD 9.48) are also significant for spinal disorder with ORs of 4.3 (95% CI 3.2-7.4) for lower back and 1.3 (95% CI 1.0-2.4) for upper back. Many other occupational and personal factors are positively associated with the back pain in underground coal mines workers, requiring immediate ergonomic intervention.

Musculoskeletal Symptoms among Stone, Sand and Gravel Mine Workers and Associations with Sociodemographic and Job-Related Factors

Stone, sand and gravel mining (SSGM) constitutes the vast majority of mining operations in the United States. Despite musculoskeletal disorders being one of the most common occupational health problems across several industries, limited research has examined the extent of reported musculoskeletal symptoms or disorders among actively employed SSGM workers. To address this knowledge gap, cross sectional data were collected from 459 SSGM workers in the Midwestern United States to determine the prevalence of musculoskeletal symptoms. Sociodemographic and job-related factors were examined to identify possible risk factors in SSGM. Musculoskeletal symptoms of the low back (57%), neck (38%), shoulder (38%) and knee (39%) were highly prevalent among SSGM employees. The results, among other findings, showed that working more than 60 h a week increased the likelihood of musculoskeletal symptoms at the low back (OR: 4.7 95% CI: 1.9–11.5), neck (OR: 5.1, 95% CI: 2.2–11.8) and knee (OR: 4.5, 95% CI: 2.0–10.3). Working as a mechanic/maintenance worker increased the likelihood of low back (OR: 2.1, 95% CI: 1.1–4.2) and knee (OR: 2.2, 95% CI: 1.1–4.6) musculoskeletal symptoms. Intervention measures aimed at improving ergonomic hazard identification for various job tasks as well as administrative controls limiting hours worked may help reduce the burden of musculoskeletal problems in the SSGM industry.

A Cross-Sectional Survey of Low Back Pain in Nurses Working in Orthopedic Departments

The study aimed to gain knowledge about low back pain (LBP) in nurses working in the orthopedic departments of tertiary hospitals in Sichuan province, China. We used a cross-sectional survey to examine the prevalence of LBP among 797 inpatient nurses who had worked for 1 year in an orthopedic department in one of 29 hospitals (Grade 3A) in Sichuan province. The survey included a questionnaire to determine the prevalence of LBP and factors related to LBP, a screening graph of LBP symptoms, the Roland Morris Disability Questionnaire (RMDQ), and the Fear Avoidance Beliefs Questionnaire (FABQ) for LBP. The 1-year period prevalence of LBP in the nursing population was 66.8% and the point prevalence was 51.3%. Among the 523 nurses who had experienced LBP, the mean total number of days that LBP had been experienced during the past year was 20.2 ± 16.3 days (range = 1-90 days). The annual number of episodes of LBP was 5.7 ± 4.5 times/year (range = 1-20 times/year). More than half the orthopedic nurses (51.1%) planned to quit, and 5.8% thought of leaving their job due to LBP. These study findings indicate that nurses in this region experience a burden of LBP similar to those in other regions in the world.

The Status of Musculoskeletal Disorders and Its Influence on the Working Ability of Oil Workers in Xinjiang, China

The purpose of this study was to investigate the status of musculoskeletal disorders (MSDs) and its influence on the working ability of oil workers, and to provide a theoretical basis for helping lessen the burden of MSDs and improve the man-machine environment of oil workers. The cluster sampling method was used to study 2000 workers who had been employed for more than 1 year in this field. We investigated the prevalence rate and the work ability index (WAI). A total of 1935 valid questionnaires were collected, a response rate of 96.75%. There were 1639 people who had suffered from MSDs in the past year, a prevalence rate of 84.7%. The damage detection rate in female oil workers was higher than in males, and the damage detection rate in workers aged 30 to 45 years was higher than that in the other two age groups. The detection rate in less highly-educated oil workers was higher than that in more highly-educated workers. The detection rate in divorced workers was higher than that in other groups. The detection rate in workers between the number of working years of 18 to 25 years was higher than in the other two groups. The detection rate in workers with a high professional title was significantly higher than that in lower-titled workers (p < 0.05). The results showed that the WAI scores of the subjects with MSDs were significantly lower than for subjects without MSDs (p < 0.05). In a logistic regression analysis, sex, number of working years and WAI index all had an impact on MSDs. We concluded that due to the demands of their role, the oil workers had serious MSDs that influenced their working ability.

A Survey on Low Back Pain Risk Factors in Steel Industry Workers in 2015

Study Design

This was a cross-sectional study.

Purpose

The aim of this study was to determine the prevalence of low back pain (LBP) and its association with individual factors and current job status among steel industry workers in Mashhad, Iran.

Overview of Literature

Several studies have been conducted on LBP and its related risk factors, some of which emphasized oc-cupational factors as the main etiology of LBP. Meanwhile, individual risk factors have been emphasized in other studies. Despite several published articles, there are still many unresolved, basic issues about developing LBP.

Methods

For this study, 358 male workers were selected by a random sampling method and divided into two groups: production workers (n=201) and administrative personnel (n=157). Data were collected using modified Nordic questionnaire and physical examination. Statistical analysis was performed to identify the correlation between individual factors and current job status with LBP.

Results

Despite the young age of participants and their short employment duration, the overall prevalence of LBP was high (32.4%) in this industry. The prevalence of non-specific LBP in production workers and administrative personnel was 26.8% and 21.0%, respectively. Disk herniation was observed in 10.4% of production workers and 6.3% of administrative personnel. Age, employment duration, body mass index and smoking status were similar in the two groups. There was no significant relationship between LBP and current job status; however, a significant relationship was found between prevalence of LBP with age, duration of employment, and leisure time physical activity (p<0.05).

Conclusions

We have not found any relationship between LBP and current occupational status suggesting that the effects of general health-related factors such as weight, age, leisure time physical activity, and duration of employment are more important than occupational factors in developing LBP.

Lower back pain and level of disability amongst construction workers

Abstract Introduction: Lower back pain is a symptom that significantly affects people's lives, especially workers whose professional achievements can be limited by this pain. Objective: Estimate prevalence of lower back pain and describe the levels of disability amongst construction workers. Methods: 84 construction workers participated in this study. Each of them was given three questionnaires. The first questionnaire was aimed at identifying sociodemographic variables such as work and lifestyle habits. The second questionnaire was created by Monnerat and Pereira to measure the intensity of lower back pain. The last questionnaire was created by Roland-Morris to measure functional incapacity. The SPSS 18.0 program was used for data analysis. Lower back pain was described with the Mann Whitney U test using the variables of both labor and time. Furthermore, a correlation between lower back pain intensity and functional incapacity was found by Spearman. Results: A higher prevalence of lower back pain was found (71.4%) amongst the construction workers especially during laborious activity. Time worked did not affect the prevalence of lower back pain nor did it lead to functional incapacity in workers. Conclusion: Based on all observed data, it was concluded that strenuous labor activity amongst the populace drove lower back pain prevalence.

A Subtle Threat to Urban Populations in Developing Countries: Low Back Pain and its Related Risk Factors

STUDY DESIGN

A cross-sectional, population-based survey.

OBJECTIVE

The aim of this study was to estimate the prevalence, and biological and psychological correlates of low back pain (LBP) in large, populated urban areas.

SUMMARY OF BACKGROUND DATA

LBP is a common and costly medical problem all around the world. Currently, there are limited data available on prevalence as well as biological and psychological correlates of LBP in large urban populations in developing countries.

METHODS

Here, in a cross-sectional, population-based survey, we analyzed data obtained from 22,952 subjects living in Tehran.

RESULTS

Chronic, 1-year, and point prevalence of LBP among subjects were 12.2%, 42.1%, and 36.2%, respectively. LBP was more prevalent among older population, women, housewives, and obese people after adjustment for confounding factors using logistic regression models. In addition, persons with a general health questionnaire (GHQ-28) score ≥6 were about 2 times more likely to experience LBP in comparison with others. Both subjects with higher educational levels and those who were never married reported significantly less LBP. Furthermore, we could not find any significant correlation between smoking and physical activity level with LBP.

CONCLUSION

LBP is prevalent among the general population of Tehran. Our findings can help health care providers regarding logical assignment of limited resources, in order to create multidimensional prevention plans according to potentially modifiable associated factors.

LEVEL OF EVIDENCE

3.

Identification of Work-Related Musculoskeletal Disorders in Mining

Work-related musculoskeletal disorder (WMSD) prevention measures have been studied in great depth throughout various industries. While the nature and causes of these disorders have been characterized in many industries, WMSDs occurring in the U.S. mining sector have not been characterized for several years. In this report, MSHA accident/injury/illness data from 2009 to 2013 were characterized to determine the most frequently reported WMSDs in the U.S. mining sector. WMSDs were most frequently reported in workers with less than 5 years or more than 20 years of mining experience. The number of days lost from work was the highest for shoulder and knee injuries and was found to increase with worker age. Underground and surface coal, surface stone and stone processing plants experienced the greatest number of WMSDs over the period studied. WMSDs were most commonly caused by an employee suffering from an overexertion, falls or being struck by an object while performing materials handling, maintenance and repair tasks, getting on or off equipment or machines, and walking or running. The injury trends presented should be used to help determine the focus of future WMSD prevention research in mining.

Associations of psychological capital, demographic and occupational factors with cigarette smoking among Chinese underground coal miners

Background

As a specific male occupational group, underground coal miners have been commonly found to have a high prevalence of cigarette smoking. It is of urgent need to explore some factors that could be intervened to reduce smoking from personal or internal perspective. The purpose of the present study was to examine the associations of psychological capital (PsyCap), demographic and occupational factors with smoking among Chinese underground coal miners.

Methods

A cross-sectional survey was conducted in a coal-mining population in northeast China. Twenty-five hundreds of male underground miners were sampled from six coal mines. Self-administered questionnaires involving current smoking status, specific scales to measure the levels of PsyCap, effort-reward imbalance (ERI) and perceived physical environment (PPE), and some demographic and occupational factors were completed anonymously after a day shift. Complete responses were obtained from 1,956 participants (response rate: 78.2%). Multivariate logistic regression analysis was used to estimate the factors in relation to current smoking.

Results

The overall smoking prevalence was 52.4%. After controlling for demographic and occupational variables, PsyCap was not associated with smoking. Compared with the miners in the lowest tertile of resilience, the odds ratios (ORs) of smoking for the miners in the intermediate tertile and highest tertile were 1.30 (95% confidence intervals (CI): 0.99–1.70) and 1.58 (95% CI: 1.13–2.20), respectively. Compared with the miners in the lowest tertile of optimism, the ORs of smoking for the miners in the intermediate tertile and highest tertile were 0.79 (95% CI: 0.61–1.03) and 0.69 (95% CI: 0.51–0.92), respectively. Low education and high PPE were the risk factors of smoking, whereas ERI had no association with smoking.

Conclusions

More than half of the underground coal miners were current smokers, which indicated that cigarette smoking might be a common health risk behavior in this occupational population. High resilience and PPE, together with low education were the risk factors of smoking, whereas high optimism was a protective factor. Consequently, PsyCap had mixed effects on cigarette smoking. Investment in resilience and optimism should be given more attention for the purposes of the prevention and reduction of smoking among occupational populations.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1349-6) contains supplementary material, which is available to authorized users.

Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil

OBJECTIVE

To analyze the factors associated with back pain in adults who live in quilombola territories.

METHODS

A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750) was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression).

RESULTS

The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain.

CONCLUSIONS

The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems.

A review of pharmacotherapy for chronic low back pain with considerations for sports medicine

Up to 30% of athletes experience low back pain (LBP) depending on sport type, sex, training intensity and frequency, and technique. United States clinical guidelines define back pain as chronic if it persists for ≥ 12 weeks, and subacute if it persists 4 to < 12 weeks. Certain sports injuries are likely to lead to chronic pain. Persistent or chronic symptoms are frequently associated with degenerative lumbar disc disease or spondylolytic stress lesions. Exercise therapy is widely used and is the most conservative form of treatment for chronic LBP (cLBP). Pharmacotherapies for cLBP include acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids. Acetaminophen is a well-tolerated first-line pharmacotherapy, but high-dose, long-term use is associated with hepatic toxicity. Nonsteroidal anti-inflammatory drugs can be an effective second-line option if acetaminophen proves inadequate but they have well-known risks of gastrointestinal, cardiovascular, and other systemic adverse effects that increase with patient age, dose amount, and duration of use. The serotonin-norepinephrine reuptake inhibitor, duloxetine, has demonstrated modest efficacy and is associated with systematic adverse events, including serotonin syndrome, which can be dose related or result from interaction with other analgesics. Opioids may be an effective choice for moderate to severe pain but also have significant risks of adverse events and carry a substantial risk of addiction and abuse. Because the course of cLBP may be protracted, patients may require treatment over years or decades, and it is critical that the risk/benefit profiles of pharmacotherapies are closely evaluated to ensure that short- and long-term treatments are optimized for each patient. This article reviews the clinical evidence and the guideline recommendations for pharmacotherapy of cLBP.