The prevalence of low back pain and its associated factors in Thai rubber farmers

Musculoskeletal disorders and pain in agricultural workers in Low- and Middle-Income Countries: a systematic review and meta-analysis

Agricultural workers constitute two-thirds of the population of Low- and Middle-Income Countries (LMIC) and are at increased risk of developing musculoskeletal disorders (MSD) due to high-risk activities. This systematic review and meta-analysis aim to synthesise the prevalence, predictors, and outcomes of musculoskeletal pain amongst agricultural workers to identify priority areas for prevention and development of early interventions. This systematic review and meta-analysis included Studies published from the inception of global electronic databases until 30 September 2022 were included. Prevalence estimates for MSDs among agricultural workers aged over 18 years in LMIC were extracted. Narrative synthesis summarized study findings and pooled estimates for 12-month pain prevalence were calculated. 7502 potential studies were identified. 64 studies (68,684 participants from 23 countries) were included in the systematic review; 33 studies were included in the meta-analysis. Low back pain was the most widely investigated symptom. The 12-month pooled prevalence of low back pain was highest in Africa [61.96% (45.69-76.22)] compared to Asia [54.16% (47.76-60.50)] and South/Central America [28.52%(10.91-50.33)]. Narrative synthesis found associations between MSDs, particular activities including heavy lifting and repetitive movements, and outcomes including reduced productivity. MSDs are common in agriculture workers in LMIC. Global prevalence of low back pain in farmers, particularly in Africa, is greater than in previously reported global prevalence in the general population. This may be attributed to environmental factors and high-risk activities which could be targeted for prevention and early intervention strategies to support individuals, prevent disability, and reduce loss of productivity.

Effect of MSDs and scope of ergonomic interventions among rubber processing workers: a systematic review

BACKGROUND

The rubber processing workers experience various types of musculoskeletal disorders (MSDs) due to awkward postures, repetitive movements, and manual loads etc. Research on MSDs and ergonomic interventions in this area is limited. Therefore, the present systematic review aims to (i) identify various operations done by rubber processing workers and their associated MSDs, (ii) explore the ergonomic intervention and post-intervention study and its impact among the workers, (iii) identify the research gaps in MSDs and ergonomic interventions through bibliometric analysis.

METHODS

Comprehensive electronic searches were conducted in Web of Science, ScienceDirect and PubMed for the search term "Ergonomics" or "Musculoskeletal disorder" and "Rubber" for the article published before 2020. Eleven papers were identified for the review of MSDs and ergonomic interventions; data were extracted to summarize sample size, data collection methods, analyzing tools, various operations, MSDs, and ergonomic interventions.

RESULTS

The reviewed article is classified according to various operations such as rubber tapping, latex collection, rubber sheeting and sheet pressing. The review reveals that most of the workers experience lower back pain, which involved a traditional way of operating. Every author is trying to recommend some interventions, but post-intervention studies are limited.

CONCLUSIONS

Due to the limited post-intervention study, there is a scope of ergonomic interventions in every operation. So, the implementation of a proper ergonomic tool with adequate awareness improves the MSDs among the rubber processing workers. The review will help to identify the various intervention gaps in different operations associated with rubber farming.

Prevalence and Factors Associated with Musculoskeletal Disorders among Thai Burley Tobacco Farmers

This cross-sectional analysis study aimed to identify the prevalence and factors associated with musculoskeletal disorders (MSDs) among Thai Burley tobacco farmers. Subjects included 603 burley tobacco farmers from Sukhothai province. Farmers were interviewed twice, (during planting and harvesting seasons), with a questionnaire consisting of demographic and health characteristics, musculoskeletal symptoms, and ergonomic exposure questions. The subjects average age was 49.5 years, more were female (58.5%), most had only a primary education (74.3%), 38% were overweight or obese. Farmers had a significantly higher prevalence of MSDs in the lower back (37.1%), knee (28.7%), shoulder (22.9%), wrist (19.9%), and hip (8.3%) during the harvesting season than in the planting season (p < 0.05). Models found that factors influencing MSDs prevalence during planting included long work hours in seedling, tasks such as topping tobacco plants, and using machine tools, after controlling for age, gender, and body mass index (BMI). While in the harvesting season, models found tasks conducted as a group had lower MSDs prevalence than individual work when carrying fresh tobacco to the barn, piercing/threading and curing the leaves, baling the bundles, and transporting the finished goods. We recommended working in groups to reduce workload and MSDs, especially during harvesting, in burley tobacco farming.

The Prevalence of and Risk Factors Associated with Musculoskeletal Disorders in Thai Oil Palm Harvesting Workers: A Cross-Sectional Study

Musculoskeletal disorders (MSDs) are common in various occupations. However, there is still limited research about the prevalence of, and risk factors associated with, MSDs among oil palm harvesting workers in Thailand. To investigate the prevalence of MSDs and risk factors associated with MSDs in Thai oil palm harvesting workers, face-to-face interviews were conducted with Thai oil palm harvesting workers in Krabi Province, Thailand, using a questionnaire. The questionnaire consisted of four sections which included information on demographic characteristics, work-related characteristics, job stress, and MSDs. A total of 334 oil palm harvesting workers participated in the current study. The prevalence of MSDs during the past 12 months was 88.0%. Lower back MSDs had the highest (59.0%) 12-month prevalence among oil palm harvesting workers, followed by shoulder (37.1%) and neck (27.2%). Factors associated with lower back MSDs included type of task, heavy lifting, and job stress. Moreover, type of task, repetitive movement, and job stress were associated with shoulder and neck MSDs. The cutters had a higher risk of having shoulder and neck MSDs, primarily due to the fact that their work involved cutting the fresh fruit bunches from high up in the trees. The collectors had more back issues due to the heavy lifting. These findings showed the need to raise awareness, and to design guidelines and interventions to prevent MSDs in oil palm harvesting workers.

Faculty Service-Learning Students as Home-Visitors: Outcomes of a Lifestyle Modification Program for Vulnerable Families With Residents in Rural Indonesian Communities

Background: Risks attributed to chronic diseases, cancer, musculoskeletal discomfort, and infectious diseases among Indonesians were found to be associated with lifestyle behaviors, particularly in rural areas. The aim of this study was to examine the outcomes of a home-visiting lifestyle modification program on improving health risk behaviors among Indonesians living in rural areas. Methods: A total of 160 Indonesians living in rural hamlets in the Yogyakarta Region of Indonesia participated in the program in the period of June 21 to July 21, 2019. In the pre-intervention home interview, learning needs of diet, exercise, hand hygiene, and substance use were identified by using structured assessment tools. In the next home visit, the visitors provided health education and facilitated lifestyle planning based on the related affective and cognitive domains of learning. Subsequent follow-up interviews were conducted 3 weeks after intervention. Results: The results showed that the self-reported intake of vegetables, fruits, meat and salt, cooking with less oil, hand hygiene before eating, number of cigarettes smoked, and symptoms of muscle stiffness significantly improved after the intervention. The lifestyle modification program consisted of the affective and cognitive domains of learning, and could lead to the target behavioral changes in self-reported and observable measures over 1 month. Conclusions: The findings contributed to the framework of community-based health education for health risk reduction and behavioral modification in developing rural communities where health care resources were limited. Further studies with control groups and vigorous objective measures were recommended to elucidate its long-term impacts. The factors leading to its sustainability concerning collaborative care partnerships between community residents and faculty resources are worthy of continued exploration.

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.

Can We Trust the Literature on Risk Factors and Triggers for Low Back Pain? A Systematic Review of a Sample of Contemporary Literature

Background

Risk factors (RFs) for the "disease" of low back pain (LBP) are probably different from the triggers of new episodes of LBP. Investigating RFs for the onset of the "disease" and the triggers of LBP is problematic if researchers fail to discern the different types of pain-free status of participants at and before baseline. There is a difference between never having had LBP and having been pain-free for a certain period only. In this review, we assessed the dependability of contemporary literature on RFs and triggers of LBP, in relation to the "disease" and the episodes, respectively.

Methods

A literature search from 2010 until 2017 was performed. Information on the definitions of LBP, potential RFs/triggers, and study design was extracted. Studies were reclassified based on the type of LBP concerning the "disease," episode, or mixed/unclear/chronic. RFs and triggers were grouped into major domains, and positive associations listed, respectively, for the "disease" and episodes.

Results

In 42 of the included 47 articles, it was not clear if the authors investigated RFs for the "disease" of LBP or triggers of new episodes. Only one study properly reported RFs for the onset of the "disease" of LBP, and four studies were deemed suitable to investigate triggers for a new episode of LBP. No study reproduced the results of other included studies.

Conclusion

Trustworthy information regarding RFs and triggers of LBP is rare in the current literature. Future research needs to use precise definitions of LBP (onset of the "disease" vs. episodes) and nominate the timing of the associated factors in relation to the types of LBP as these are two critical factors when studying causes of LBP.

Predictors for Nonspecific Low Back Pain in Rubber Farmers: A 1-Year Prospective Cohort Study

High prevalence of low back pain (LBP) has been reported among farmers. A number of contributing factors have been associated with LBP. However, predictors for LBP in this population are unknown. This longitudinally designed study aimed to identify the predictors of LBP in a sample of rubber farmers whose work involves heavy manual labor. Three hundred and twenty-seven rubber farmers, aged 18 to 70 years who reported no LBP in the previous year, were face-to-face interviewed and examined physically. The incidence of LBP was assessed monthly. The 12-month incidence of LBP in the cohort was 35%. Having a history of LBP (hazard ratio = 1.55, 95% confidence interval = 1.05-2.30) and an active job (hazard ratio = 1.98, 95% confidence interval = 1.16-3.40) were the predictors for the new onset of LBP in this sample. These 2 factors could therefore potentially be targeted to prevent or reduce the incidence of LBP in rubber farmers.

Simplified Chinese Version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: Agreement, Responsiveness, and Minimal Important Change for Patients With Chronic Low Back Pain

STUDY DESIGN

Psychometric test of the cross-cultural adaptation the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) in low back pain (LBP) patients.

OBJECTIVE

To investigate the agreement, responsiveness, and minimal important change (MIC) of the simplified Chinese version of the JOABPEQ in LBP patients.

SUMMARY OF BACKGROUND DATA

The factor structure, internal consistency, test-retest reliability, validity, floor and ceiling effect of simplified Chinese JOABPEQ have been tested, while the agreement, responsiveness, and MIC were required.

METHODS

The agreement, responsiveness, and MIC of the simplified Chinese version were assessed by completing the Chinese JOABPEQ twice. Agreement was tested with Bland-Altman plot. Responsiveness was operationalized using receiver operating characteristic analyses. The anchor-based method was used to calculate MIC.

RESULTS

One hundred sixty-two of 184 patients returned to finish the booklet twice were available for analysis (response rate: 88.0%). While the responsiveness, the area under the curves of each subscale were ranged from 0.746 to 0.875, which meant a good responsiveness. While the MIC (MIC%) of simplified Chinese JOABPEQ was 19.28 (44.98%) for Q1 Low back pain, 15.20 (24.13%) for Q2 Lumbar function, 15.79 (22.76%) for Q3 Walking ability, 9.58 (19.86%) for Q4 Social life function, 7.33 (17.28%) for Q5 Mental health. While compared with the MIC, only the Q3 Walking ability had a positive rating for agreement in the Bland-Altman plot.

CONCLUSION

The simplified Chinese JOABPEQ has positive agreement of Q3 Walk ability and acceptable to excellent responsiveness of all the subscales. The MICs for subscales of the simplified Chinese JOABPEQ ranged from 7.33 to 19.28 points.

LEVEL OF EVIDENCE

3.

A Cross-sectional Study of Musculoskeletal Symptoms and Risk Factors in Cambodian Fruit Farm Workers in Eastern Region, Thailand

Background

Work-related musculoskeletal disorders are accumulative disorders that are most frequently found in agricultural farmers. The purpose of this study was to investigate factors that affect symptoms resulting from work-related musculoskeletal disorders among Cambodian farm workers working in fruit plantations in the eastern region of Thailand.

Methods

The Nordic Musculoskeletal Questionnaire, Rapid Upper Limb Assessment, and Hazard Zone Jobs Checklist techniques were used to interview 861 farmers who participated in the study.

Results

The data showed that men who had been working for >10 years were more at risk of neck pain than those working for <1 year with adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) (1.90, 14.5). Among women those who had been working for >10 years experienced lower back pain with aOR 8.13, 95% CI (1.04, 63.74), compared with those who had been working for <1 year. Men whose tasks required raising the arms above shoulder height had a risk factor contributing to neck pain of aOR 1.68, 95% CI (1.08, 2.61) when compared with those who did not work with this posture, and women had aOR 1.82, 95% CI (1.07, 3.12) when compared with those who did not work with this posture.

Conclusion

Based on the results of this study, it is recommended that work-related health conditions are monitored in migrant plantation workers to reduce the risks of musculoskeletal disorders.