Epidemiological study of low back pain and occupational risk factors among taxi drivers

Evaluation of low back pain status and affecting factors in drivers in Turkey: A cross-sectional study1

BACKGROUND

Low back pain (LBP) is a common public health problem resulting in workforce loss.

OBJECTIVE

This study aims to evaluate the LBP status and its affecting factors among drivers in a city in southeast Turkey.

METHODS

This cross-sectional questionnaire survey study was conducted among 323 drivers. The chi-square test and logistic regression analysis were used to analyze the data.

RESULTS

The mean age of the drivers was 41.7±11.5 years (min: 19, max: 70), and 83.9% were married, and all were men. LBP was found in 59.4% of drivers. It was significantly higher in drivers with poor socioeconomic status, dissatisfied with their life, having a chronic illness, physically inactive, having sleep disorders, exposed to bad road conditions, prolonged vibration, high physical- psychological workload, and a family history of LBP (p <  0.05). There was no significant association between age, education level, and BMI with LBP (p >  0.05).

CONCLUSION

There is limited study on this subject in Turkey. Further studies can raise awareness about this issue and create an educational plan.

Prevalence of low back pain in professional drivers: a meta-analysis

OBJECTIVE

This meta-review aimed to investigate the prevalence of low back pain (LBP) in professional drivers.

STUDY DESIGN

This study is a meta-analysis.

METHODS

PubMed, Scopus, Embase, and Web of Science were searched for cross-sectional studies on the prevalence of LBP in professional drivers up to August 2023. The Agency for Healthcare Research and Quality was utilized for cross-sectional analytical studies. Statistical analysis of the included outcome indicators was conducted using Stata 16.0. The prevalence of LBP among professional drivers was measured using the random effects model, and heterogeneity was evaluated utilizing subgroup analysis. This meta-analysis review was registered with PROSPERO on April 28, 2023, under the registration number CRD42023422205.

RESULTS

In total, 1, 558 results met the inclusion and exclusion criteria, and 53 studies were included. The meta-analysis results indicated that professional drivers had a LBP prevalence of 35.0%, 95%CI (0.266, 0.433) for one week, 33.80%, 95%CI (0.233, 0.443) for one month, and 55.30%, 95%CI (0.503,0.603) for one year. In the global population of professional drivers, the prevalence of LBP was 56.0%, 95%CI (0.472, 0.648) and 54.5%, 95%CI (0.488, 0.602) without and with a history and high risk of LBP, respectively.

CONCLUSIONS

LBP remains prevalent among international drivers and has multiple contributing factors, highlighting the urgent need for increased awareness and prevention strategies.

Aberrant driving behaviors as mediators in the relationship between driving anger patterns and crashes among taxi drivers: An investigation in a complex cultural context

OBJECTIVE

Taxis have become an integrated component of Qatar's urban transportation network due to their convenience, comfort, and flexibility. Qatar has seen an uptick in the demand for professional taxi drivers. Most Qatari taxi drivers come from developing countries with poor awareness of road safety; therefore, they regularly engage in aberrant driving behavior, leading to traffic violations and crashes. For taxi rides to be safer, it is essential to determine the association between driving aberration and road traffic crashes (RTCs), with an emphasis on the underlying factors that trigger these behaviors.

METHODS

To this end, we collected the data from taxi drivers relying on standard questionnaires, namely the Driving Anger Scale (DAS) and the Driver Behavior Questionnaire (DBQ), together with the real crash data of the same taxi drivers obtained from the police department. We relied on factor analysis to identify the main factors of these tools and then structural equation modeling to predict their causal relationship with RTCs.

RESULTS

The results indicated that the component of DAS, namely "illegal driving", triggered all dimensions of aberrant driving behaviors, whereas hostile gestures had a positive correlation with lapses. In addition, the factor "error" was identified as a significant direct predictor, while the factor "illegal driving" was identified as a significant indirect predictor for RTCs. Regarding demographic characteristics, professional driving experience was found to be negatively associated with RTCs.

CONCLUSION

Driving aberration mediated the impact of driving anger on RTCs. The findings from this study could help road safety practitioners and researchers better understand these relations. In addition, these results could also be very helpful for driving instructors to train taxi drivers in a way to cope with provoking situations.

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.

Lumbar spinal loads and lumbar muscle forces evaluation with various lumbar supports and backrest inclination angles in driving posture

PURPOSE

The low back pain of professional drivers could be linked to excessive lumbar load. This study aims at developing a musculoskeletal model to study the lumbar spinal loads and lumbar muscle forces of the human body in driving posture, so as to contribute to a better understanding of low back pain and to improve the design of vehicle seats.

METHODS

A standing musculoskeletal model, including limbs, head and neck, that can reflect several activities of daily living was established based on the Christophy spine model. The model was then validated by comparing the calculated lumbar loads and muscle forces to the experimental data in the previous studies. Referring to radiology studies, the musculoskeletal model was adjusted into different driving postures with several different lumbar supports (0, 2 and 4 cm) and inclinations of the backrest (from 23° to 33°, by 2° intervals). The lumbar biomechanical load with various lumbar supports and backrest inclination angles was calculated.

RESULTS

The results showed that the overall lumbar spinal load and lumbar muscle force with 4 cm lumbar support were reduced by 11.30 and 26.24%. The lumbar spinal loads and lumbar muscle forces increased first and then decreased with the increase in backrest inclination angles from 23° to 33°. The lumbar biomechanical load varied slightly with the backrest inclination angles from 29° to 33°.

CONCLUSIONS

There are two findings: (i) the lumbar spinal loads at the L3-L4, L4-L5 and L5-S1, and lumbar muscle forces decreased obviously with the 4 cm lumbar support, while the seat cushion inclination angle was set to 10°. (ii) The recommended backrest inclination angles are 29° to 33° with a 10° seat cushion to the horizontal, which can keep a low level of the lumbar spinal loads and lumbar muscle forces. This study could be used to explain the association between drivers' sitting posture and the lumbar load change, and provide a reference for the prevention of low back pain.

Causal Relationship Between the Risk Factors and Work-Related Musculoskeletal Disorders Among Professional Drivers: A Systematic Review

OBJECTIVE

This review evaluates the evidence on the strength of causal relationship between categories of risk factors (RFs) and work-related musculoskeletal disorders (WRMSDs) among professional drivers.

BACKGROUND

A compilation of evidence on the causal relationship between RFs and WRMSDs among professional drivers is lacking.

METHODS

A systematic search of the literature was conducted in major electronic data bases that include Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, and Web of Science. The methodological quality of the studies was assessed and scored. A descriptive analysis on the categories of RFs associated with WRMSDs was conducted. The Bradford-Hill causation criteria and evidence interpretation tool were used to evaluate the causal relationship between RFs and WRMSDs in professional drivers.

RESULTS

Among the 54 studies reviewed, a strong evidence suggests a causal relationship between RFs such as whole-body vibration, awkward postures, lifting tasks, manual material handling, job stress, job demand, and previous pain episodes with WRMSDs. Moderate evidence was observed on RFs such as uncomfortable seat and low job satisfaction. The evidence on causal relationship between RFs such as years of professional driving, driving duration, and individual characteristics such as age and body mass index was inconclusive.

CONCLUSION

There is strong to moderate evidence on the causal relationship between the physical and psychosocial RFs and WRMSDs among professional drivers.

APPLICATION

Potential application of this review highlights evidence to occupational health practitioners, policy makers, and stakeholders on the strength of causal relationship between RFs and WRMSDs among professional drivers.

Research gaps and needs for preventing worker fatigue in the transportation and utilities industries

BACKGROUND

The transportation and utilities industries include establishments engaged in the movement of passengers and freight, or the provision of public power, water, and other services. Along with the warehousing industry, they make up the US National Occupational Research Agenda's Transportation, Warehousing and Utilities (TWU) industry sector. In 2018 the sector composed 5% of the US workforce, with approximately 8 million workers. TWU workers experienced 19% of all fatalities among U.S. workers in 2018 and 7% of total occupational injuries and illnesses.

METHODS

Around-the-clock operations, heavy workloads, long and irregular shifts, complicated schedules, and time pressures characterize work across the US TWU sector. However, there are considerable differences in worker priorities and concerns between TWU industries. Major areas of concern within the sector include disparities in work schedules; required training for employee fatigue awareness and prevention; physical and mental job demands; and safety culture.

RESULTS

Strategies for fatigue mitigation are critical to reduce the prevalence of injuries, safety-critical events, and crashes in TWU workers. Further research on the incidence and characterization of fatigue among TWU workers will guide the development of effective mitigation strategies. The influence of work scheduling on missed sleep opportunities and disrupted circadian rhythms should be determined. Evaluation of fatigue mitigation strategies can lead to the adoption of the most effective ones for each TWU industry.

CONCLUSION

Implementation of effective strategies is critical for the health, safety, wellbeing, and productivity of workers in the TWU sector.

Low back pain and risk factors among Taxi drivers in Turkey: a cross-sectional study

BACKGROUND

Taxi drivers have an increased risk of low back pain due to both physical and occupational conditions. This study aims to determine the prevalence of low back pain and occupational risk factors among taxi drivers working in İzmir, Turkey.

METHODS

This study was conducted with 447 taxi drivers at randomly selected taxi stands between April and September 2021. The questionnaire included demographic, individual, and work-related questions; the Nordic Musculoskeletal Questionnaire; and the Back Pain Functional Scale (BPFS).

RESULTS

The prevalence of low back pain in the last year was 49.7%. In multivariate logistic regression analyses, the risk factors for low back pain included having a body mass index of 25-29.9 kg/m2 (OR= 1.67, 95% CI 1.01-2.76) or ≥30 kg/m2 (OR= 2.15, %95 CI 1.19-3.87), no physical activity (OR= 1.66, 95% CI 1.06-2.62), years of work >10 (OR= 3.23, 95% CI 1.89-5.53), no weekly rest period (OR= 3.11, 95% CI 1.42-6.81), having no lumbar support on the driver's seat (OR:1.67, 95% CI:1.05-2.66), or undecisive job satisfaction (OR= 2.07, 95% CI 1.17-3.66). Being undecided about job satisfaction (OR= 2.34, 95% CI 1.15-4.92) and not having physical activity (OR= 2.10 CI 1.08-4.08) were found to be risk factors for reduced BPFS scores.

CONCLUSION

A strong correlation was found between the frequency of low back pain and the BPFS score and occupational factors. Early detection and management of low back pain are critical to avoid increased low back pain and related injuries among taxi drivers.

Occupational status and self-reported low back pain by gender: a nation-wide cross-sectional study among the general population in Japan

Background

We aimed to examine the cross-sectional association between occupational class and self-reported low back pain (LBP) in a representative sample of the Japanese general population.

Methods

We used anonymized data from a nationwide survey (31,443 men and 35,870 women aged ≥ 20). Occupational class variables included working status, occupation, employment status, and company size (number of employees). Covariates included age, socio-economic status, lifestyle, and comorbidities. Poisson regression models stratified by gender were used to estimate adjusted prevalence ratio (APR) and 95% confidence interval (CI) for self-reported LBP.

Results

The prevalence of self-reported LBP was 11.7% in men and 14.2% in women. After adjustment for covariates and mutual adjustment for all occupational class variables, among both genders, agricultural/forestry/fishery workers and non-workers had a significantly higher prevalence of self-reported LBP: APR (95% CI) of agricultural/forestry/fishery was 1.36 (1.08–1.70) in men and 1.59 (1.30–1.93) in women; that of non-workers was 1.42 (1.18–1.70) in men and 1.23 (1.08–1.40) in women. Among men, non-regular employees were more likely to have self-reported LBP than regular employees: APR (95% CI) was 1.25 (1.07–1.46) in part-timers and casual staff and 1.18 (1.03–1.35) in other types of non-regular employees. Moreover, compared to men working at companies with ≥ 100 employees, men working at companies with 30–99 employees had a significantly higher prevalence of self-reported LBP (APR 1.17; 95% CI, 1.03–1.34). Among women, professionals and technicians (1.26; 1.11–1.43) and sales workers (1.22; 1.04–1.43) had a significantly higher prevalence of self-reported LBP than clerks. Neither employment status nor company size was associated with self-reported LBP in women. After stratified analyses by age group, similar patterns were observed in participants aged 20–64, but not in those aged ≥ 65.

Conclusion

Our results suggest that self-reported LBP is highly prevalent among agricultural/forestry/fishery workers and the unemployed, regardless of gender, and that there are also gender differences in the association of occupational class factors with self-reported LBP. It is necessary, therefore, to take preventive measures against LBP based on gender and occupational class factors in Japan.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-021-01031-2.

A data mining approach to deriving safety policy implications for taxi drivers

INTRODUCTION

Traffic safety issues associated with taxis are important because the frequency of taxi crashes is significantly higher than that of other vehicle types. The purpose of this study is to derive safety implications to be used for developing policies to enhance taxi safety based on analyzing intrinsic characteristics underlying the cause of traffic accidents.

METHOD

An in-depth questionnaire survey was conducted to collect a set of useful data representing the intrinsic characteristics. A total of 781 corporate taxi drivers participated in the survey in Korea. The proposed analysis methodology consists of two-stage data mining techniques, including a random forest method, with data that represents the working condition and welfare environment of taxi drivers. In the first stage, the drivers' intrinsic characteristics were derived to classify four types of taxi drivers: unspecified normal, work-life balanced, overstressed, and work-oriented. Next, priority was determined for classifying high-risk taxi drivers based on factors derived from the first analysis.

RESULTS

The derived policies can be categorized into three groups: 'the development of new policies,' 'the improvement of existing policies,' and 'the elimination of negative factors.' Establishing a driving capability evaluation system for elderly drivers, developing mental health management programs for taxi drivers, and inspecting the taxi's internal conditions were proposed as new policies. Improving the driver's wage system, supporting the improvement of rest facilities, and supporting the installation of security devices for protecting taxi drivers are methods for improving existing policies to reinforce the traffic safety of taxi drivers. Last, restricting overtime work for taxi drivers was proposed as a policy to eliminate negative factors for improving taxi traffic safety. Practical Applications: It is expected that by devising effective policies using the policy implications suggested in this study, taxi traffic accidents can be prevented and the quality of life of taxi drivers can be improved.

Prevalence of musculoskeletal pain among professional drivers: A systematic review

OBJECTIVES

Professional drivers are at high risk of developing musculoskeletal pain (MSP) due to risk factors such as prolonged sitting, whole body vibration, awkward posture, and repetitive actions. This review investigates the reported prevalence of MSP among professional drivers.

METHODS

An electronic search of Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, PubMed, and Web of Science from 1990 to July 2019 was performed. Methodological quality of studies was assessed using three quality assessment tools for cross-sectional, case-control, and prospective cohort studies. The prevalence of MSP was reported using descriptive analysis.

RESULTS

A total of 56 studies conducted in 23 different countries across a total of 14 types of occupational transport were reviewed. Data of a total pooled population of 18 882 professional drivers were analyzed for MSP. The prevalence of MSP ranged between 43.1% and 93%. The low back was the most frequently reported body region for MSP with a meta-prevalence rate of 53% (N = 9998). Neck, shoulder, and upper back were the other common regions with high prevalence.

CONCLUSION

There is a high prevalence of MSP in professional drivers and low back was the most frequently reported body region, followed by neck, upper back, shoulder, knee, hip/thigh, wrist, ankle, and elbow. MSP is complicated in nature and therefore in-depth exploration of causal relationships between MSP and risk factors is necessary so that appropriate healthcare programs can be initiated to prevent and treat MSP effectively.

Magnitude and Contributing Factors of Low Back Pain among Long Distance Truck Drivers at Modjo Dry Port, Ethiopia: A Cross-Sectional Study

Background

Low back pain (LBP) is well known as the most common musculoskeletal disorder with the lifetime prevalence of eighty percent. Worldwide, 37% of low back pain was attributable to occupational risk factors. Truck driving is one among the jobs causing occupational LBP. Even though these drivers in Ethiopia run the high risk of occupational injuries and illnesses like drivers elsewhere, the evidence that shows the magnitude and factors that contribute to LBP is a significant shortcoming.

Objective

To assess the magnitude and contributing factors of low back pain among long-distance truck drivers at Modjo Dry Port, Ethiopia, 2018.

Methods

A cross-sectional study was conducted among systematically selected 422 long-distance truck drivers at Modjo Dry Port, Ethiopia, from February to March 2018. Data were collected through face-to-face individual interview using a structured questionnaire adapted from the standardized Nordic questionnaire for the analysis of musculoskeletal symptoms. The data were entered using EPI-DATA version 4.2.0.0 and cleaned and analyzed using SPSS version 20 statistical software for windows. Binary logistic regression was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a P value less than 0.05 in the multivariable logistic regression model were considered as significant.

Results

Of 400 truck drivers interviewed, the prevalence of LBP was found to be 65%. The study also found smoking cigarette (AOR = 2.24, 95% CI (1.25–4.01), and P=0.007), physical inactivity (AOR = 2.12, 95% CI (1.28–3.51), and P=0.003), chronic diseases other than LBP (AOR = 2.18, 95% CI (1.32–3.61), and P=0.002), frequent lifting or carrying heavy objects (AOR = 3.02, 95% CI (1.75–5.22), and P ≤ 0.001), perceived improper sitting posture while driving (AOR = 2.20, 95% CI (1.35–3.60), and P=0.002), and perceived job stress (AOR = 2.07, 95% CI (1.20–3.57), and P=0.009) were contributing factors of low back pain.

Conclusion

This finding shows the public health importance of low back pain among long-distance truck drivers in Ethiopia. Individual factors largely accounted for the development of low back pain; hence, orientation on these modifiable risk factors and regular follow-up on safety procedures should be considered to mitigate the problem.

Factors Associated with Untreated Decayed Teeth in Male Sales Workers: An Internet Survey

The purpose of this study was to identify factors associated with untreated decayed teeth (DT) in male sales workers. The participants were recruited by screening a pool of Japanese registrants in an online database for eligibility for inclusion in the study. Between 20 February 2015 and 11 March 2015, those deemed eligible were asked to complete a questionnaire on the status of their oral health. Responses from a total of 142 male sales workers aged between 30 and 49 years were analyzed. Of these, 40 reported DT and 102 no untreated decayed teeth (NDT). The percentage of participants with DT was higher than that with NDT among night shift workers (p<0.001). A higher percentage of participants with DT reported pain when eating or drinking something cold (p=0.041), pain in the teeth or gingiva (p<0.001), or frequent stomatitis (p=0.030). A higher percentage of participants with DT reported eating between meals (p=0.027) and a lower percentage visiting a dental clinic in the past 6 months (p=0.017) compared with among participants with NDT. Those with NDT were more likely to report an inability to visit a dental clinic when they wanted to (p=0.033), but those with DT were more likely to report that their reasons for not visiting a dental clinic were that multiple visits were required for treatment (p=0.012) or that they did not like the treatment (p=0.005). Working the night shift (Odds Ratio [OR], 3.492; 95% Confidence Interval [CI], 1.347-8.725) and visiting a dental clinic in the past 6 months (OR, 0.084; 95%CI, 0.010-0.733) were identified as independent variables correlated with leaving DT untreated. Requiring oral health education and dental checkups at least once every 6 months may have a positive effect on oral health among male sales workers, especially those doing night shifts.

Individual, business-related, and work environment factors associated with driving tired among taxi drivers in two metropolitan U.S. cities

INTRODUCTION

Violence-related events and roadway incidents are the leading causes of injury among taxi drivers. Fatigue is under-recognized and prevalent in this workforce and is associated with both injury outcomes. We describe the association of individual, business-related, and work environment factors with driving tired among taxi drivers in two very different cities.

METHOD

We developed a comprehensive survey for licensed taxi drivers. We trained surveyors to administer the 30-min survey using systematic sampling among taxi drivers waiting for fares in two large U.S. cities: the Southwest (City 1) and the West (City 2). A driving tired scale of the Occupational Driver Behavior Questionnaire was the outcome. Multivariate logistic models described driving tired behavior in city-specific models using adjusted Odds Ratios (ORadj).

RESULTS

City 1 and City 2 had 496 and 500 participants, respectively. Each driving tired behavior was significantly more prevalent in City 2 than City 1 (p < .05). There were more variables and a greater diversity of variables in the models describing drowsy driving in City 1 than City 2. In City 1, variables describing negative safety climate (ORadj = 1.15), socio-demographic groups (identifying as Asian, educational attainment), passenger-related violence (ORadj = 1.79), and company tenure (ORadj =1.15) were associated with driving tired. In City 2, high perceived safety training usefulness (ORadj = 0.48) was associated with driving tired. A risk factor for driving tired that was common to both cities was job demands (ORadj = 1.21 in City 1; 1.43 in City 2).

CONCLUSIONS

These findings represent two diverse taxi populations driving in two geographically distinct regions that differ in safety regulation. It is important that safety measures that include fatigue awareness training are reaching all drivers. Fatigue management training should be integrated into driver safety programs regardless of location. Practical applications: Fatigue management strategies that recognize individual factors, business-related characteristics, and work environment are an important component of road safety and are particularly relevant for occupational drivers.

Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation

Objective:

To determine the effects of repetitive ipsilateral rotation on low back pain among the taxi drivers of right and left hand drive.

Methods:

A total of 1200 (600 Iran+600 Pakistan) male taxi drivers, aged between 20-60 years with work experience of more than one year were randomly selected and interviewed in Tehran (Iran) & Lahore (Pakistan) to fill self-administered questionnaires in Persian and Urdu languages which contained socio-demographic, work related and LBP characteristics. Chi-square test and multiple logistic regression models were employed for statistical analyses.

Results:

Point, one week, one year and lifetime prevalence of LBP among right hand drive taxi drivers was 26.7%, 35.5%, 49.8% and 77.7% respectively. Point, one week, one year and lifetime prevalence of LBP among left hand drive taxi drivers was 37%, 42.7%, 53.5% and 72.3% respectively. Mean Numeric Pain rating scale (NPRS) score was 4.15 (SD=1.42) in Pakistan, while in Iran it was 4(SD=1.57). There was no significant difference regarding pain intensity (p=0.123) between drivers from both countries. Mean Roland-Morris Questionnaire (RMQ) score among drivers in Pakistan with LBP was 7.76(SD= 2.50), while in Iranian drivers who had LBP, mean RMQ score was 7.71(SD=2.99).

Conclusion:

Static or less dynamic muscles are more prone to LBP due to lower endurance. Lack of exercising habit, work as a driver for more number of years, driving within city, more driving hours in a day, forward bending, lifting, no seat comfort, lack of awareness regarding ergonomics and lower satisfaction level of job were the main reasons of LBP.

[Prevalence and factors associated with low back pain among motorcycle drivers in Porto-Novo (Benin)]

INTRODUCTION

low back pain is a major health problem in the workplace. Some populations of workers appear to be much more exposed than others. The aim of this study is to determine the prevalence and the factors associated with the occurrence of low back pain among motorcycle drivers in Porto-Novo.

METHODS

we conducted a cross-sectional descriptive and analytical study of 270 consenting motorcycle drivers with at least one year of seniority. Patients were asked to complete the Nordic Questionnaire adapted to our context and physical examination of the spine was performed. Data were analyzed using Epidata 3.1. Software and STATA/IC 11.0. The threshold significance level was 5% and the confidence intervals were 95%.

RESULTS

the prevalence of low back pain was 68.89%. The average age of motorcycle drivers was 42.43 ±11.25 [25-64]years. The majority of them had been driving for more than 5 years (93.33%). Drivers spent an average of more than 8 hours (93.34%) driving per day and 68.52% of them drove over 160km per day. Low back pain was mechanical in 91.39% of cases. It was characterized by sudden onset in 81.73% of cases. Pain was moderate in 55.91% of drivers, evolving in acute pain in 46.24% of drivers and without radiation in 62.36% of cases. Age, education level, stress, posture, condition of motorcycle shock absorbers were associated with low back pain in these motorcycle drivers (p < 0.001). By contrast, distance travelled, job duration, seniority and road conditions were not associated with the occurrence of low back pain.

CONCLUSION

low back pain is a serious public health problem in particular among motorcycle drivers in our country where riding a motorcycle is becoming more and more a work to bring assistance to the population facing growing unemployment. Hence the need to address factors associated with effective prevention.

A Cross-Sectional Study of Prevalence of Depression, Anxiety and Stress among Professional Cab Drivers in New Delhi

Background

The profession of drivers is one of the occupational groups exposed to very poor working conditions. This study aimed to establish the prevalence of depression, anxiety and stress among cab drivers.

Materials and Methods

This cross-sectional study included 134 cab drivers. Their mental health status was assessed with the help of a screening tool - Depression Anxiety Stress Scale (DASS-21). Their demographic details, working conditions, lifestyle factors and use of habit-forming substances were also assessed with the help of a semi-structured questionnaire.

Results

It was revealed that all cab drivers were male and between 20 to 64 years of age. Eighty two (62%) drivers said they are sometimes irritated at work, 29 (21.5%) said they feel irritated daily and rest 23 (17.2%) said that they were never irritated at work. When screened for depression, anxiety and stress, it was found out that 81 (60.5%) were suffering from depression, 63 (47%) from anxiety and 49 (36.5%) had variable degree of stress.

Conclusion

Cab drivers are at high risk of acquiring mental health diseases, yet the mental health of this large workforce is ignored.

Clutch Pedal Sensorization and Evaluation of the Main Parameters Related to Driver Posture

An improper decision for the design, selection and adjustment of the components needed to control a vehicle could generate negative effects and discomfort to the driver, where pedals play a very important role. The aim of the study is to provide a first approach to develop an embedded monitoring device in order to evaluate the posture of the driver, the influence of the clutch pedal and to advise about the possible risk. With that purpose in mind, a testbed was designed and two different sets of tests were carried out. The first test collected information about the volunteers who were part of the experiment, like the applied force on the clutch pedal or the body measurements. The second test was carried out to provide new insight into this matter. One of the more significant findings to emerge from this study is that the force applied on the clutch pedal provides enough information to determine correct driver posture. For this reason, a system composed of a pedal force sensor and an acquisition/processing system can fulfil the requirements to create a healthcare system focused on driver posture.

The relationship between low back pain and professional driving in young military recruits

Background

Episodes of low back pain (LBP) are very common among workers. A number of occupational risk factors have been shown to increase the risk for LBP. One of these risk factors is exposure to whole body vibration, which is a known characteristic in driving professions. The aim of this study was to assess the impact of driving on LBP amongst young professional drivers.

Methods

This is an historical-prospective cohort study based on the Israel Defense Forces (IDF) database of male soldiers drafted between the years 1997–2006. Subjects’ medical history with specific reference to LBP medical history, clinical and radiographic findings were taken as part of the recruitment process to the IDF. The study group included subjects (n = 80,599) from three occupational groups: administrative units (AU), car drivers (CD) and truck drivers (TD) that were followed for 3 years. The incidence and recrudescence rates of LBP were calculated based on standardized LBP severity tiers.

Results

The total incidence rate for LBP was 0.65%, 0.7% and 0.34% for AU, CD and TD respectively. In a comparison between subjects without a history of LBP (category 1) to subjects with a history of LBP without clinical findings (category 2) and subjects with a history of LBP with mild clinical / radiographic findings (category 3), the relative risk (RR) for severe LBP exacerbation was 1.4 (p < 0.001) and 3.8 (p < 0.01), respectively. The LBP exacerbation rates within different severity tiers yielded a similar trend amongst all profession groups.

Conclusions

This study included 80,000 soldiers who represent a population of driving and administrative occupations aged 18–21. The significant risk factors for developing LBP were a previous history of LBP and presence of LBP symptoms at the start of work. A correlation was identified between severity of LBP at the initial examination and further exacerbation of LBP in all examined occupations. Driving as a profession in our (young) age-group was not identified as a risk factor for LBP.

German taxi drivers' experiences and expressions of driving anger: Are the driving anger scale and the driving anger expression inventory valid measures?

OBJECTIVE

The objective of this article was 2-fold: firstly, we wanted to examine whether the original Driving Anger Scale (DAS) and the original Driving Anger Expression Inventory (DAX) apply to German professional taxi drivers because these scales have previously been given to professional and particularly to nonprofessional drivers in different countries. Secondly, we wanted to examine possible differences in driving anger experience and expression between professional German taxi drivers and nonprofessional German drivers.

METHODS

We applied German versions of the DAS, the DAX, and the State-Trait Anger Expression Inventory (STAXI) to a sample of 138 professional German taxi drivers. We then compared their ratings to the ratings of a sample of 1,136 nonprofessional German drivers (Oehl and Brandenburg n.d. ).

RESULTS

Regarding our first objective, confirmatory factor analysis shows that the model fit of the DAS is better for nonprofessional drivers than for professional drivers. The DAX applies neither to professional nor to nonprofessional German drivers properly. Consequently, we suggest modified shorter versions of both scales for professional drivers. The STAXI applies to both professional and nonprofessional drivers. With respect to our second objective, we show that professional drivers experience significantly less driving anger than nonprofessional drivers, but they express more driving anger.

CONCLUSIONS

We conclude that the STAXI can be applied to professional German taxi drivers. In contrast, for the DAS and the DAX we found particular shorter versions for professional taxi drivers. Especially for the DAX, most statements were too strong for German drivers to agree to. They do not show behaviors related to driving anger expression as they are described in the DAX. These problems with the original American DAX items are in line with several other studies in different countries. Future investigations should examine whether (professional) drivers from further countries express their anger as proposed by the DAX. In addition, professional drivers experience less driving anger (DAS) and less general trait anger (STAXI) than nonprofessional drivers, but they report more driving anger expression (DAX) and more current general state anger (STAXI). Subsequent studies should therefore focus on different types of anger within the group of professional drivers.

Influence of seat tilt motion on discomfort perception during a simulated driving activity

BACKGROUND

Discomfort perceived in activities where there is a prolonged sitting posture are normally compensated in a natural way by means of macro-repositioning movements in the seat. Nevertheless, evidence shows that such movements are not able to palliate discomfort due to lumbar pain.

OBJECTIVE

This study involves research performed to demonstrate whether induced postural changes are able to mitigate this type of discomfort during a simulated driving activity.

METHODS

Twenty-four subjects with lumbar pain (LBP) and without lumbar pain (WLBP) underwent 90 min of simulated driving activities while periodic variations of seat tilt (Tt) were implemented.

RESULTS

Discomfort perception due to lumbar pain significantly decreased in the case of Tt compared with the case of WTt (without seat tilt), and significant differences were found (p = 0.02). However, treatments with Tt indicated that no substantial differences exist between LBP and WLBP subjects when considering discomfort perception due to lumbar pain and the erector spinae activity.

CONCLUSIONS

This study revealed that periodic variations on seat tilt can help to reduce discomfort perception due to lumbar pain during driving activities, regardless of the health condition of the subject.

Psychosocial work factors and low back pain in taxi drivers

INTRODUCTION

Taxi drivers are at high risk for low back pain (LBP).

AIM

Identify the association between psychosocial-work factors (Job strain, Iso-strain, effort-reward imbalance [ERI], unfairness, and mental exertion) and LBP in taxi drivers.

METHODS

A cross-sectional study was done with 129 taxi drivers.

RESULTS

Approximately 63% reported LBP in the prior 12 months. Chi square or t-test analyses identified the associations between demographic, work, health, and psychosocial work factors, and self-report of LBP in the prior 12 months. Depression, perceived physical exertion, dispatcher and manager support, unfair treatment at work, and unfair treatment due to nationality were significantly associated with LBP in bivariate analyses. Multivariate logistic regression was done to identify the predictors of LBP. High dispatcher support remained the sole significant predictor for lower prevalence of LBP (OR = 0.66, P = 0.017).

CONCLUSION

Greater understanding of psychosocial work factors may aid in developing interventions to prevent LBP in taxi drivers.

Assessment and Determinants of Spinal Pain in the Course of Disc Disorders Treated Surgically

Background

Intervertebral disc disease is defined as a complex of structural changes in the aftermath of disorders of mutual elements, the structure of which form the discus intervertebralis and the spinal canal. The present work assessed pain in patients who were surgically treated due to spinal discopathy and analyzed factors that determine the condition.

Material/Methods

The research was carried on a group of 187 patients diagnosed with discopathy of the lumbosacral and cervical segment. The data are discussed in the context of medical records and the Visual Analogue Scale used for pain assessment. We used a prospective study plan with a 3-time assessment.

Results

The pain level observed among patients prior to the procedure (M=6.52) was higher than after 7 days (M=3.15) and 6 months from the operation (M= 3.45). The highest level of pain (M=6.88), with a relatively high consistency among the patients (SD=2.25), was observed in the case of left-side hernia (H=7.31; p=0.023). The influence of the analyzed factors on pain experience markedly increased by the third assessment (R2=0.14), and was strongly associated with the type of work performed by the patient.

Conclusions

Surgical operation significantly reduces pain in patients with disc disorders. The level of pain is predominantly affected by the location of the hernia and the type of work performed by the patient.

Comparison of risk factors for tooth loss between professional drivers and white-collar workers: an internet survey

This cross-sectional study was conducted to examine tooth loss and associated factors among professional drivers and white-collar workers. The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. The participants were asked to complete a self-reported questionnaire. A total of 592 professional drivers and 328 white-collar workers (male, aged 30 to 69 years) were analyzed. A multiple logistic regression analysis was performed to identify differences between professional drivers and white-collar workers. The results showed that professional drivers had fewer teeth than white-collar workers (odds ratio [OR], 1.74; 95% confidence interval [95% CI], 1.150-2.625). Moreover, a second multiple logistic regression analysis revealed that several factors were associated with the number of teeth among professional drivers: diabetes mellitus (OR, 2.68; 95% CI, 1.388-5.173), duration of brushing teeth (OR, 1.66; 95% CI, 1.066-2.572), frequency of eating breakfast (OR, 2.23; 95% CI, 1.416-3.513), frequency of eating out (OR, 1.70; 95% CI, 1.086-2.671) and smoking status (OR, 2.88; 95% CI, 1.388-5.964). These findings suggest that the lifestyles of professional drivers could be related to not only their general health status, but also tooth loss.

Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka

BACKGROUND

Approximately 5% of all households in Sri Lanka operate a three-wheeler as their primary source of income. However, very little is known about the occupational health risks associated with driving these vehicles.

OBJECTIVES

The aim of this study was to assess occupational risk factors, including the number of hours worked associated with the 4-week prevalence of low back pain (LBP) among drivers of three-wheelers.

METHODS

Questionnaires were administered to 200 full-time drivers of three-wheelers from the Galle District in Sri Lanka. Occupational, psychological, socio-demographic, lifestyle, and anthropometric variables were collected. Univariate and multivariate analysis were used to investigate the correlation between occupational risk factors of the prevalence of LBP.

RESULTS

15·5% of respondents reported experiencing LBP in the previous 4 months. Univariate analysis revealed that the number of hours worked per week, feeling pressure to compete with other drivers, and perceived stress scale scores were significantly associated with the 4-week prevalence of LBP. Multivariate analysis found that the number of hours worked per week and engine type were significantly associated with LBP.

CONCLUSIONS

LBP is common among drivers of three-wheelers in Sri Lanka. Long work hours and two-stroke engines were significantly associated with LBP. Results from this study point towards a role for educational, behavioral health, and policy interventions to help prevent and reduce LBP among these drivers.

Prevalence and Risk Factors for Low Back Pain Among Professional Drivers in Kano, Nigeria

This study investigated the prevalence, risk factors, and impact of low back pain (LBP) among professional drivers in Nigeria. Two hundred male drivers aged 19-64 years were recruited in the study. Data regarding prevalence, individual risk factors, and impact of LBP were obtained. The prevalence rate of LBP was 73.5%, and LBP have affected the driving performance of up to 74% drivers. After adjustment for age, LBP prevalence was associated with driving for >15 hours/day (odds ratio [OR]; 95% confidence interval [CI]): (0.04; 0.01, 0.20), driving car (5.52; 1.55, 19.64), and driving bus (10.49; 2.63, 41.82). No association was found between LBP prevalence and years spent driving. The study found that high prevalence of LBP affected the performance of a substantial percentage of the participants.

Sintomas osteomusculares em taxistas de Rio Branco, Acre: prevalência e fatores associados

OBJETIVO: Analisar a prevalência e fatores associados dos sintomas osteomusculares em taxistas de Rio Branco, Acre.MÉTODOS: Estudo transversal de base populacional com 321 taxistas. Utilizou-se um questionário fechado sobre sintomas osteomusculares e variáveis associadas.RESULTADOS: A prevalência de sintomas nos últimos 12 meses foi de 72,0%. As partes do corpo com maiores prevalências foram: lombar (49,5%) e cervical (29,9%). A autoavaliação insatisfatória de saúde mostrou-se associada aos sintomas osteomusculares em todas as regiões corporais. A situação de morar com mais de 4 pessoas na casa esteve associado aos sintomas nas regiões do tronco superior, membros superiores e inferiores. Conviver com companheira apresentou associação com sintomas em tronco superior e inferior. Foi evidenciado tendência linear de aumento do IMC com os sintomas no tronco superior e membros inferiores. A condição de ter 5 anos ou menos de estudo e ter 2 ou mais filhos mostraram associação com os sintomas nos tronco inferior e membros superiores, respectivamente.CONCLUSÕES: As alarmantes prevalências de sintomas osteomusculares em taxistas sugerem a necessidade de programas voltados à saúde ocupacional destes trabalhadores.

Short-term exposure with vibration and its effect on attention

BACKGROUND

About 20 to 50 percent of accidents are due to some forms of carelessness and mindedness. Studies suggested that vibration is one of the most important physical factors in human performance when traveling on any sort of vehicles. The aim of this study was to investigate the effect of vehicles vibration on cognitive performance (attention and concentration).

METHODS

The sample consists of 25 male students who undergone 4 experimental phases: acceleration low vibration (0.53 m/s(2)), medium vibration (0.81 m/s(2)), high vibration (1.12 m/s(2)) and non- exposure to vibration (control phase) according to ISO 2631-1 standard and with fixed frequency between 3 to 7 Hz. Students paired T test was applied to analysis the data, using SPSS software ver. 19.

RESULTS

The mean number of correct answers obtained from selective attention test under vibration levels of 0.53 m/s(2) and 0.81 m/s(2) were significantly lower than the condition without vibration. The mean reaction time of divided attention test in three vibration levels was significantly lower than the condition without vibration. Exposing to vibration reduces number of correct answers, selective attention and reaction time.

CONCLUSION

In this study, it was found that vibration may disrupt the ability of the participants for sustainability attention. It also changes the precision and speed of humans' information processing systems.

Occupational and Personal Determinants of Musculoskeletal Disorders among Urban Taxi Drivers in Ghana

Background. There is a lack of epidemiological data on musculoskeletal disorders (MSDs) among occupational drivers in Ghana. The present study seeks to estimate the prevalence, body distribution, and occupational and personal determinants of MSDs in a sample of taxi drivers in the Accra Metropolis of Ghana. Methods. A total of 210 participants were enrolled in this cross-sectional study. All the participants were evaluated by using a semistructured questionnaire and the standardized Nordic Musculoskeletal Disorder Questionnaire. Results. The estimated prevalence of MSDs was 70.5%. The prevalence of the various MSD domains was as follows: lower back pain (34.3%), upper back pain (16.7%), neck pain (15.2%), shoulder pain (11.0%), knee pain (10.0%), hip/thigh pain (2.9%), elbow pain (4.8%), ankle/feet pain (2.4%), and wrist/hand pain (1.9%). Multiple logistic regression analysis of the data showed that participants who were employee drivers, drove taxi more than 12 hours per day or at least 5 days per week, perceived their job as stressful, and were dissatisfied with their job were at a greater risk of developing MSDs. Conclusions. These findings call for preventive strategies and safety guidelines in order to reduce the incidence of MSDs among urban taxi drivers in Ghana.

Study the epidemiological profile of taxi drivers in the background of occupational environment, stress and personality characteristics

Background:

Work hazards have been a major cause of concern in driving industry especially in taxi drivers. This study integrates the various factors that influence physical and emotional well-being of taxi drivers into the theoretical model that shows that the work environment, stress and personality characteristics directly influence taxi drivers’ health.

Objective:

The aim of the following study is to study the relative and combined influence of work environment, personality characteristics and stress on the health of taxi drivers.

Meterials and Methods:

The present study is cross-sectional (descriptive) study taxi drivers in Mumbai. They are selected using multistage random sampling method. Calculated sample size is 508. Data produced after the survey is analyzed using IBM SPSS 16.0 software.

Results:

Nearly 65% of taxi drivers belonged to middle-age group of 21-40 years of age. Majority (59%) of taxi drivers belonged to the lower upper socio-economic class. 70% of taxi drivers worked for more than 8 h daily. 63% gave the history of one or more addictions. 52% taxi drivers had type B1 personality, only 6% had stress prone and aggressive type A1 personality. Traffic congestion (67.1%) was reported as the leading stressor followed by narrow bottle neck roads (43%), too many speed breakers (41%), rude gestures and behavior by other drivers (42%) and bad weather (36%). Nearly 86% taxi drivers had one or more symptoms of morbidities. Gastrointestinal symptoms predominated followed by musculoskeletal symptoms and depression.

Conclusion:

Socio-demographic attributes, work environment, stress and personality significantly influence physical and psychological morbidities in taxi drivers.

Occupational driving as a risk factor for low back pain in active-duty military service members

BACKGROUND CONTEXT

Although occupational driving has been associated with low back pain, little has been reported on the incidence rates for this disorder.

PURPOSE

To determine the incidence rate and demographic risk factors of low back pain in an ethnically diverse and physically active population of US military vehicle operators.

STUDY DESIGN/SETTING

Retrospective database analysis.

PATIENT SAMPLE

All active-duty military service members between 1998 and 2006.

OUTCOME MEASURES

Low back pain requiring visit to a health-care provider.

METHODS

A query was performed using the US Defense Medical Epidemiology Database for the International Classification of Diseases, Ninth Revision, Clinical Modification code for low back pain (724.20). Multivariate Poisson regression analysis was used to estimate the rate of low back pain among military vehicle operators and control subjects per 1,000 person-years, while controlling for sex, race, rank, service, age, and marital status.

RESULTS

A total of 8,447,167 person-years of data were investigated. The overall unadjusted low back pain incidence rate for military members whose occupation is vehicle operator was 54.2 per 1,000 person-years. Compared with service members with other occupations, motor vehicle operators had a significantly increased adjusted incidence rate ratio (IRR) for low back pain of 1.15 (95% confidence interval [CI] 1.13-1.17). Female motor vehicle operators, compared with males, had a significantly increased adjusted IRR for low back pain of 1.45 (95% CI 1.39-1.52). With senior enlisted as the referent category, the junior enlisted rank group of motor vehicle operators had a significantly increased adjusted IRR for low back pain: 1.60 (95% CI 1.52-1.70). Compared with Marine service members, those motor vehicle operators in both the Army, 2.74 (95% CI 2.60-2.89), and the Air Force, 1.98 (95% CI 1.84-2.14), had a significantly increased adjusted IRR for low back pain. The adjusted IRRs for the less than 20-year and more than 40-year age groups, compared with the 30- to 39-year age group, were 1.24 (1.15-1.36) and 1.23 (1.10-1.38), respectively.

CONCLUSIONS

Motor vehicle operators have a small but statistically significantly increased rate of low back pain compared with matched control population.

Driving to better health: cancer and cardiovascular risk assessment among taxi cab operators in Chicago

While a number of investigations of the health of taxi cab drivers have been conducted in Europe, Asia, and Africa, virtually none have been conducted in the United States. We undertook a survey of taxi cab operators in the Chicago area to understand better their health status and health promotion practices. The survey was completed by a convenience sample of 751 Chicago taxi drivers. Taxi drivers had low rates of insurance coverage, fruit and vegetable consumption, and physical activity compared with the general Chicago population. Participation in cancer screening tests was also lower for this group. A high proportion of taxi drivers are immigrants. They tend to be highly educated and report a readiness to engage in more health-promoting behaviors. Further research is needed to develop a targeted intervention for this population.

Health and safety strategies of urban taxi drivers

This study describes health and safety concerns and self-care strategies of San Francisco taxi drivers. Focus groups and a written cross-sectional survey were done in a convenience sample of taxi drivers working in San Francisco. Sessions were audiotaped, transcribed in English, and independently coded to identify major health and safety themes, using thematic content analysis. Strategies to manage health and safety issues are the focus of this analysis. Five focus groups were held in 2009 with 36 participants. Major health and safety themes included stress, body pain, danger, vulnerable employment status, and concerns related to unhealthy working conditions. Self-care strategies included diffusion/decompression to manage stress, maintaining a positive attitude, maintaining power and control, and practicing proactive self-care. Creative self-care strategies were described by taxi drivers to keep healthy and safe at work. These data will inform future self-care interventions to reduce health and safety risks of taxi driving.

Występowanie dolegliwości bólowych dolnego odcinka kręgosłupa i nawyków ruchowych u osób prowadzących siedzący tryb życia

Obecnie dolegliwości bólowe kręgosłupa lędźwiowo-krzyżowego stanowią istotny problem zdrowotny, społeczny i ekonomiczny. Celem pracy była ocena dolegliwości bólowych dolnego odcinka kręgosłupa i nawyków ruchowych u osób prowadzących siedzący tryb życia, wynikający z charakteru wykonywanej pracy zawodowej.

Badania przeprowadzono w okresie od listopada 2010 do lutego 2011. Materiał badawczy stanowiły 2 grupy osób: 57 pracowników biurowych (w tym 40 kobiet i 17 mężczyzn) oraz 43 kierowców autobusów i taksówkarzy (wyłącznie mężczyźni). W pierwszej grupie prze- dział wiekowy mieścił się w granicach od 21 do 60 lat, a w drugiej między 21, a 63 lat. Narzędzie badawcze stanowiła autorska ankieta składająca się z czterech części. Pierwsza i druga część zawierała pytania dotyczące danych osobowych oraz informacji na temat wykonywanej pracy. W trzeciej zapytano o ewentualne dolegliwości bólowe dolnego odcinka kręgosłupa, natomiast w czwartej o nawyki ruchowe, znajomość profilaktyki i sposób spędzania czasu wolnego.

Uzyskane wyniki świadczą o częstszym występowaniu dolegliwości bólowych dolnego odcinka kręgosłupa wśród kierowców (62,8%). Problem ten dotyczy również częściej osób z wysokim nieprawidłowym BMI (25 i powyżej). Więcej nieprawidłowości w postawie ciała pojawiało się w grupie pracowników biurowych niż wśród kierowców.

Prevalence of low back pain and motor habits in individuals leading a sedentary lifestyle

Prevalence and correlates of regional pain and associated disability in Japanese workers

OBJECTIVES

To assess the prevalence and correlates of regional pain and associated disability in four groups of Japanese workers.

METHODS

As part of a large international survey of musculoskeletal symptoms (the CUPID study), nurses, office workers, sales/marketing personnel and transportation operatives in Japan completed a self-administered questionnaire (response rate 83%) covering experience of pain in six anatomical regions, associated disability and sickness absence, and various possible occupational and psychosocial risk factors for these outcomes. Associations with risk factors were assessed by logistic regression.

RESULTS

Analysis was based on 2290 subjects. Rates of regional pain were generally less than in the UK, with a particularly low prevalence of wrist/hand pain among office workers (6% in past month). The strongest and most consistent risk factor for regional pain in the past month was tendency to somatise (ORs (95% CIs) for report of ≥ 2 versus 0 distressing somatic symptoms 3.1 (2.4 to 4.0) for low back pain, 2.8 (2.1 to 3.8) for shoulder pain, and 2.5 (1.6 to 4.1) for wrist/hand pain). Sickness absence for regional pain complaints in the past year was reported by 5% of participants, the major risk factor for this outcome being absence during the same period for other medical reasons (OR 3.7, 95% CI 2.4 to 5.8).

CONCLUSIONS

Japanese office workers have markedly lower rates of wrist/hand pain than their UK counterparts. In Japan, as in Western Europe, somatising tendency is a major risk factor for regional pain. Sickness absence attributed to regional pain complaints appears to be much less common in Japan than in the UK, and to be driven principally by a general propensity to take sickness absence.

The association between obesity and low back pain: a meta-analysis

This meta-analysis assessed the association between overweight/obesity and low back pain. The authors systematically searched the Medline (National Library of Medicine, Bethesda, Maryland) and Embase (Elsevier, Amsterdam, the Netherlands) databases until May 2009. Ninety-five studies were reviewed and 33 included in the meta-analyses. In cross-sectional studies, obesity was associated with increased prevalence of low back pain in the past 12 months (pooled odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14, 1.54), seeking care for low back pain (OR = 1.56, 95% CI: 1.46, 1.67), and chronic low back pain (OR = 1.43, 95% CI: 1.28, 1.60). Compared with non-overweight people, overweight people had a higher prevalence of low back pain but a lower prevalence of low back pain compared with obese people. In cohort studies, only obesity was associated with increased incidence of low back pain for > or =1 day in the past 12 months (OR = 1.53, 95% CI: 1.22, 1.92). Results remained consistent after adjusting for publication bias and limiting the analyses to studies that controlled for potential confounders. Findings indicate that overweight and obesity increase the risk of low back pain. Overweight and obesity have the strongest association with seeking care for low back pain and chronic low back pain.

The association between smoking and low back pain: a meta-analysis

OBJECTIVE

To assess the association between smoking and low back pain with meta-analysis.

METHODS

We conducted a systematic search of the MEDLINE and EMBASE databases until February 2009. Eighty-one studies were reviewed and 40 (27 cross-sectional and 13 cohort) studies were included in the meta-analyses.

RESULTS

In cross-sectional studies, current smoking was associated with increased prevalence of low back pain in the past month (pooled odds ratio [OR] 1.30, 95% confidence interval [CI], 1.16-1.45), low back pain in the past 12 months (OR 1.33, 95% CI, 1.26-1.41), seeking care for low back pain (OR 1.49, 95% CI, 1.38-1.60), chronic low back pain (OR 1.79, 95% CI, 1.27-2.50) and disabling low back pain (OR 2.14, 95% CI, 1.11-4.13). Former smokers had a higher prevalence of low back pain compared with never smokers, but a lower prevalence of low back pain than current smokers. In cohort studies, both former (OR 1.32, 95% CI, 0.99-1.77) and current (OR 1.31, 95% CI, 1.11-1.55) smokers had an increased incidence of low back pain compared with never smokers. The association between current smoking and the incidence of low back pain was stronger in adolescents (OR 1.82, 95% CI, 1.42-2.33) than in adults (OR 1.16, 95% CI, 1.02-1.32).

CONCLUSIONS

Our findings indicate that both current and former smokers have a higher prevalence and incidence of low back pain than never smokers, but the association is fairly modest. The association between current smoking and the incidence of low back pain is stronger in adolescents than in adults.

Subjective musculoskeletal symptoms in winter and summer among indoor working construction electricians

To evaluate the effects of cold exposure on the musculoskeletal system, two surveys on the subjective musculoskeletal symptoms among male electricians working in the buildings under construction were performed in winter (N=74) and summer seasons (N=83). A self-administered questionnaire was used to collect information on age, occupational career, working habit, present illness, and subjective musculoskeletal symptoms. Mean age, occupational career and daily smoking of the supervisors were significantly higher than those of the other subjects. In general, prevalence rates of stiffness, numbness, pain and Raynaud's phenomenon in the fingers, finger cold sensation, dull movement of the fingers, pain in the wrist, knee joint pain, pain and numbness in the foot and foot cold sensation in winter were significantly higher than those in summer. These results were marked especially in the workers except supervisors. In winter, there were no significant differences in the prevalence rates of subjective musculoskeletal complaints between the supervisors and the other workers. On the other hand, in summer, prevalence of stiffness and pain in the shoulder, stiffness and pain in the neck, dullness and pain in the arm, finger cold sensation, low back dullness and low back pain in the supervisors were significantly higher than those in the other workers. These results suggest that effects of cold on the musculoskeletal symptoms markedly appeared in the workers except supervisors.

Menstrual disorders and their influence on low back pain among Japanese nurses

An increasing body of evidence now suggests that menstrual disorders may influence the development of Low Back Pain (LBP) among women of reproductive age. To investigate this issue in Japan, we conducted a large cross-sectional survey of female nurses from a university teaching hospital during 2008. Nurses reported a wide range of symptoms both prior to and during menstruation, including breast tenderness, stomach pain, light headedness and fatigue. Around three-quarters had experienced at least one episode of LBP in the previous 12-months, with most symptoms lasting one week or less. Increasing body weight was correlated with an increased risk of LBP affecting their daily activities (OR: 12.94, 95%CI: 1.54-116.56). Having three or more children was correlated with a reduced risk of experiencing LBP (OR: 0.13, 95%CI: 0.01-0.97). Nurses who reported breast tenderness prior to menstruation were twice as likely to suffer LBP (OR: 2.09, 95%CI: 1.20-3.73), while those who reported breast tenderness during menstruation were almost twice as likely to suffer LBP that interfered with their daily activities (OR: 1.85, 95%CI: 1.06-3.32). Overall, our study suggests that reproductive symptoms and menstrual disorders may influence the development of LBP among Japanese nurses, although the magnitude of this effect appears to be less than that reported in some previous research.