Low back pain and musculoskeletal symptoms among Kansas farmers

BACKGROUND: Farming continues to rank as one of the most dangerous occupations in the United States. The purpose of this study was to determine the prevalence of low back pain and other musculoskeletal disorders (MSDs) among the farmers and to examine the factors associated with occupational back pain. Farmers in a predominately corn and soybean growing region of Kansas served as the study sample. METHODS: Questionnaires were mailed out to 499 active farmers of a Farmers' Cooperative in Southeast Kansas. The self-administered questionnaire was used to determine the prevalence of self-reported symptoms of back pain and other MSDs and to determine the strength of associations between back pain and work factors. RESULTS: The participation rate was 57.2%. The low back was the anatomical area with the highest prevalence of self-reported work-related pain (37.5%), followed by the shoulders (25.9%), knees (23.6%), and neck (22.4%). Close to 60% of the farmers reported that they experienced farm work-related MSD symptoms in at least one of the nine body areas in the previous year. Nearly one quarter of the farmers reported seeing a physician for their low back symptoms, and one in five farmers had to modify their work habits due to low back symptoms during the previous year. CONCLUSIONS: Low back pain and other musculoskeletal conditions are a significant problem for Kansas farmers. This group of Kansas farmers experienced low back pain at a much higher rate than the general working population and higher than other groups of farmers previously studied.     

Interrelations of risk factors and low back pain in scaffolders

OBJECTIVES—To assess with a cross sectional study the interrelations between physical, psychosocial, and individual risk factors and different end points of low back pain.
METHODS—In total, 229 scaffolders and 59 supervisors completed a questionnaire about manual handling of materials, awkward back posture, strenuous arm position, perceived exertion, psychosocial load, need for recovery, and general health. Physical load at the worksite was also measured with many frequent observations. Interrelations between risk factors and their relation with four end points of low back pain were investigated.
RESULTS—Interrelations were strong among self reported determinants of physical load but showed an inverted trend for both age and total working experience, which could indicate the presence of a healthy worker effect. Weak relations existed between variables of psychosocial and physical load. The multivariate analyses showed a significant relation between high manual handling of materials, moderate perceived general health, high job demands, and low back pain in the past 12 months. Chronic low back pain was significantly correlated with high perceived exertion and moderate perceived general health. Severe low back pain was significantly correlated with awkward back postures, high need for recovery, and high job demands. Finally, low back pain with perceived disability was significantly related to strenuous shoulder positions and moderate perceived general health. All end points of low back pain were consistently associated with physical load whereas psychosocial aspects showed a more diverse pattern.
CONCLUSIONS—The findings of this study suggest that work related risk factors may vary according to different definitions of low back pain. Distinct patterns of risk factors might enhance different expressions of it. Scaffolders are a group at high risk of developing persistent forms of low back pain.


Keywords: interrelations; low back pain; risk factors     

Risk factors for work-related musculoskeletal disorders in an aluminum smelter

A cross-sectional study of selected jobs in an aluminum smelter was conducted to assess the prevalence of work-related musculoskeletal disorders (WMDs), and to estimate their association with physical and psychosocial characteristics of the jobs. A structured interview and physical exam were used to assess the musculoskeletal health status of the participants, and a self-administered questionnaire was used to assess the psychosocial factors. Observational job analysis was conducted to evaluate 37 potential physical risk factors. Complete data were available for 104 subjects. The prevalence of WMDs on interview and physical exam were 0.8%, 14.9%, 11.6%, 14.9%, and 17.4% for the neck, shoulder, elbow/forearm, hand/wrist, and low back regions, respectively. Unconditional multiple logistic regression was used to model the relationship between physical and psychosocial factors and health status. Years of forearm twisting were found to be a significant predictor for hand/wrist disorders on interview (OR = 17, 95% CI = 2.9–106); for elbow/foream disorders on physical exam and interview (OR = 37, 95% CI = 3.0–470); and for shoulder disorders on interview (OR = 92, 95% CI = 7.3–∞) and on interview and physical exam (OR = 46, 95% CI = 3.8–550). Low decision latitude was also found to be significant for the shoulder on interview (OR = 4.5, 95% CI = 1.3–16). High job satisfaction (OR = 5.9, 95% CI = 1.4–25) and low social support (OR = 5.3, 95% CI = 1.3–22) were associated with low back pain report on interview; only high job satisfaction (OR = 5.3, 95% CI = 1.1–26) was associated with low back pain on both interview and physical exam. Am. J. Ind. Med. 32:66-75, 1997. © 1997 Wiley-Liss, Inc.     

Risk factors for back pain among male farmers: analysis of Iowa Farm Family Health and Hazard Surveillance Study.

BACKGROUND: Back pain causes considerable morbidity, disability, and economic loss among workers. Farmers handle heavy objects, often in awkward postures. However, the prevalence of back pain among farmers and the risk factors associated with back pain are not well known. METHODS: In this study, we assess the frequency of risk factors for back pain among 287 Iowa male farmers. From 1992 to 1994, using a mail questionnaire, we collected data on potential risk factors for back pain. Eighteen months later, we surveyed occurrence of back pain as the outcome measure. RESULTS: Thirty-one percent of farmers reported having daily back pain for a week or more during the past 12 months compared to 18.5% in the general working population. Using a multiple logistic regression model, we found two factors associated with back pain: 45-59 years of age (OR = 2.13, 95% CI 1.02-4.43) and having a non-agricultural job as the major occupation (OR = 2.02, 95% CI 0.98-4.17, P = 0.055). CONCLUSIONS: Farmers had a significantly higher prevalence of back pain than the general working population. Middle-aged farmers and those with additional non-agricultural jobs had the highest risk for back pain.     

肩部肌肉骨骼疾患及危险因素

肌肉骨骼疾患(MSDs)是一类常见的工作有关疾病,发病率较高,严重影响劳动者的身心健康和工作质量。引起MSDs的危险因素众多、复杂,查阅近年来国内外文献,本文针对肩部MSDs的危险因素进行综述,探讨职业因素、社会心理因素和个体因素在MSDs的发生发展中的作用。以期从加强个人体育锻炼、定期体检、改善工作环境、合理安排劳动组织等方面加以预防。     

Understanding the ergonomic risk for musculoskeletal disorders in the United States agricultural sector

INTRODUCTION: Farming is a very large industry in the United States. Understanding the risks for injuries and more specifically musculoskeletal disorders in this industry poses a challenge for health officials. METHODS: A review was conducted of the existing peer-reviewed publications prior to December 2006 about injuries and musculoskeletal disorders for farmers and farm workers. The aim was to review existing knowledge concerning: (1) the prevalence, types, and causes of farm-related injuries, paying particular attention to musculoskeletal disorders and the special populations within the agricultural sector, and (2) interventions that have been developed to reduce risk factors associated with farm-related injuries. RESULTS: Farmers and farm workers experience high rates of low back, shoulder, and upper extremity disorders. Musculoskeletal disorders may disproportionately affect farm youth and migrant workers due to the types of farm tasks performed. There is an urgent need for improved and validated interventions to reduce exposures and to improve the health of farmers and farm workers. DISCUSSION: Future farm-related musculoskeletal disorder research should emphasize: (1) better identification of exposures for special populations, (2) development of interventions for diverse farm populations, and (3) identification of additional exposures for musculoskeletal disorders. Inadequate understanding of musculoskeletal disorders in farming impedes efforts to prevent this common and important type of occupational injuries on farms.     

A strategy for evaluating occupational risk factors of musculoskeletal disorders

There is a large and increasing incidence of work-related muscoloskeletal disorders, both upper extremity cumulative trauma disorders and low back pain. Several occupational risk factors have been linked with the development of musculoskeletal disorders. In order to identify the known occupational risk factors associated with a specific job, an analysis procedure is described to help identify ergonomic risk factors in the workplace. Job analysis should be one part of an overall ergonomics control program. Once the ergonomic risk factors have been documented, the ergonomics committee can use that information to begin developing solutions that will decrease or eliminate the identified risk factors. When placing a worker who is returning to the workforce after recovering from an injury, health care professionals can also use the information from the job analysis to assist in matching up task demands with worker capabilities and limitations.     

Individual and work-related risk factors for musculoskeletal pain among computer workers in Nigeria

We investigated the prevalence of musculoskeletal pain (MSP) and the association of 1-month prevalence with individual and work-related factors among commercial typists in Enugu. Participants responded to a questionnaire about occurrences of MSP and a 75.6% (242/320) response rate was achieved. Prevalence was summarized in frequencies and percentages while associations between MSPs and risk factors were explored using chi-square. MSP was most common in the low back (58.3%), and low back pain limited 51.7% from activities between 1 and 30 days. Advancing age was significantly associated with MSP in the low back (x² = 19.885; p = .001), neck (x² = 28.309; p < .001), shoulder (x² = 13.122; p = .011), but not wrist/hand (p = .075). Working 1–5 years in this job was associated with increasing prevalence of MSP in all body regions studied. Lesser job control was associated with increased prevalence of wrist/hand pain. Prevalence of MSDs among computer operators in Enugu, Nigeria, is high and highlights the importance of workplace intervention.     

电解铝厂工人职业性下背痛危险因素探讨

目的　探讨电解铝厂工人职业性下背痛患病情况及其危险因素。方法　采用横断面调查问卷对铝厂工人及对照组的下背痛有关危险因素逐一询问,并依据病史及症状作出下背痛的临床诊断。结果　电解铝厂工人职业性下背痛患病率４５－４ ％ ,不同车间工人患病率差异未见显著性,但均高于对照组（１６－４ ％ ） 。Ｌｏｇｉｓｔｉｃ 回归分析提示下背痛患病与性别、年龄、身高、文化程度、婚烟状况、子女数、吸烟、饮酒、工作紧张感、疲劳感、既往疾病史及劳动姿势有关。结论　提示改善作业方式及有关社会心理状况、降低工作和家庭劳动负荷以及杜绝不良生活习惯是减低下背痛患病率的重要途径。     

The association between awkward working posture and low back disorders in farmers: a systematic review

Background: Low back disorders (LBD) are the most common musculoskeletal problem among farmers, with higher prevalence than other occupations. Although studies of the general population have shown an association between LBD and awkward working posture, farmers have unique work context and exposures that may modify this relationship. This review aimed to 1) identify published research studies investigating posture as a risk factor for LBD in farmers/agricultural workers, and 2) determine the strength of the relationship between postural exposure and LBD risk of bias assessment.

Method: Comprehensive electronic searches of Medline, Web of Science, CINAHL, SCOPUS, PubMed, and EMBASE were carried out with combined conceptual groups of search terms for ‘farming’ and ‘LBD.’ After screening, data were extracted to summarize the study design, sample characteristics, exposure assessment methods, LBD risk factors, demographic information, data collection methods, farm commodities, job context, and sampling strategy. Data were synthesized to determine the weight of evidence for awkward working posture as a risk factor for LBD among farmers.

Results: Nine studies were included in this review. All studies used self-report; there were no field-based studies including direct measurement of awkward posture. There was diversity in exposure definition, exposure assessment, LBD definition, worker characteristics, and analytical approaches. There was evidence to support association between awkward working posture and LBD among farmers.

Conclusion: Despite the diversity, the weight of evidence supported a relationship between awkward posture and LBD. Well-designed epidemiological studies with quantitative physical workload assessments, consistent and valid LBD definitions, and longitudinal designs are recommended to clarify the relationship between awkward posture and LBD.     

Respiratory symptoms in Swiss farmers: an epidemiological study of risk factors

BACKGROUND: The study was undertaken to assess the prevalence and risk factors of self-reported asthma, symptoms of chronic bronchitis, hay fever, and work-related respiratory symptoms in Swiss farmers as well as to compare the prevalence rates of respiratory symptoms with the Swiss population (SAPALDIA-Study). METHODS: An epidemiological study was performed with a representative sample of 1,542 Swiss farmers using a self-administered questionnaire. To investigate the effect of the type of farming on reported symptoms, the farmers were subdivided into seven groups according to the time farmers spent in different animal confinement buildings. A multivariate analysis was performed by the methods of binary and multivariate logistic regression adjusted for age and smoking habits. RESULTS: In farmers the prevalence rate was 16.0% for chronic bronchitis, 15.4% for asthma symptoms, and 42.0% for reporting at least one work-related symptom. Using logistic regression analysis, it was established that poultry farming and pig/cattle farming was a risk factor for reporting nasal irritation at work [OR 5.33, (1.57-18.0), OR 3.37 (1.04-10.87)]. Poultry farmers experienced the highest symptom rates. In crop farmers, the prevalence for chronic bronchitis was increased [OR 2.32 (1.03-5.23)]. Over 4 hr spent per day in animal confinement buildings more than doubled the risk for reporting chronic bronchitis [OR 2.61 (1.01-6.76)] and phlegm [OR 2.3 (0.99-5.4)] independent of the type of farming. The comparison of Swiss farmers with the Swiss population showed a twofold elevated risk of reporting chronic bronchitis [OR 1.89 (1.32-2.95)] and a 4.5-fold elevated risk for bringing up phlegm regularly [OR 4.5 (3.25-6.69)] in farmers. In contrast, the risk of farmers to report nasal allergies was less than half as high [OR 0.40 (0.29-0.56)] as that of the general population. CONCLUSIONS: This study shows that agricultural work in Switzerland is associated with an elevated risk for reporting symptoms of chronic bronchitis and chronic phlegm compared with the general Swiss population. These main results most likely indicate occupational disorders as the exposure-response relationship (hours spent in animal confinements) was particularly obvious for these symptoms.     

A case-control study of risk factors for industrial low back injury: implications for primary and secondary prevention programs.

Data were collected on 228 consecutive back injuries in Boston's General Mail Facility and 228 non-injured controls drawn randomly from each case's work unit, matching on craft (clerk, mailhandler, maintenance), shift, and general supervisor. Data were collected on age, gender, duration of employment, 3 year history of injury claims, overtime work in the past 2 weeks, job change in the past 60 days, and machine vs. manual job. Risk factors for back injury were examined simultaneously in a conditional logistic regression for matched pairs. Risk factors included history of back injury claim (OR = 16.5, p less than 0.0001), younger age (OR = 3.0, p = 0.0001), shorter duration of employment (OR = 2.6, p = 0.0007), recent job change (OR = 2.5, p = 0.06), and history of non-back injury claim (OR = 2.0, p = 0.08). Among heavy lifters (vs. clerks) overtime and being female increased the risk of injury. In this setting, higher risk workers who may benefit from preventive education programs can be identified.     

大棚菜农肌肉骨骼疾患及其影响因素

目的 调查大棚菜农肌肉骨骼疾患现况并探讨危险因素.方法 采用整群抽样方法,对某大棚种植区的203名菜农和邻近村庄的127名非大棚菜农的肌肉骨骼疾患进行回顾性问卷调查.结果 大棚菜农肌肉骨骼疾患检出为70.0％,非大棚菜农为33.9％.大棚菜农前3位疾患依次是下背痛、膝和肩部疾患.年龄、大棚蔬菜种植年限、体重和卷帘机使用与大棚菜农肌肉骨骼疾患有统计学相关,调整后的OR值分别为1.17,1.82,1.08和0.07.结论 大棚菜农肌肉骨骼疾患检出率较高,主要疾患是下背痛、膝和肩部疾患.年龄、大棚蔬菜种植年限、体重和卷帘机使用为肌肉骨骼疾患的主要影响因素.     

铸造工人腰背痛流行病学特征

[目的 ]描述铸造工人腰背痛流行病学特征 ,探讨职业相关因素。 [方法 ]对 6 17名铸造工人进行背部骨科体检和疼痛测量。 [结果 ]清理和造型工种背部压痛阳性率显著高于后勤组 ,OR值分别达 6 16和 11 90 ,控制性别、年龄和工龄等混杂因素后 ,OR值更为加大 ;曾有腰背痛主诉没有差异 ,但与目前工作有关的调整腰背痛患病率仍以清理和造型高 ,与后勤比OR值在 2倍左右。造型工疼痛诱因以过度用力、重复劳动和不良姿势为主 ,共占 88 4%。腰背疼痛强度多为中等度。 [结论 ]静态弯腰作业和重体力弯腰作业与腰背痛患病率密切相关     

坐位和重体力工作人群腰背痛流行病学调查

[目的 ]探讨坐位和重体力工作人群腰背痛的患病情况及其相关危险因素。 [方法 ]对 3类工作人群 (固定体姿、重体力和教师等工种 ,以轻体力自由体姿教师组作为参比组 )采用标准问卷和体检等方法进行横断面调查 ,共调查3 5 6人 (3组分别为 81,181和 94人 )。 [结果 ]坐位、重体力和参比组的累积患病率分别为 79 0 % ,60 2 % ,45 8% ,年患病率分别为 74 1% ,46 4% ,3 7 5 % ,周患病率分别为 3 3 3 % ,13 3 % ,2 1 9% ;对偏倚进行控制后 ,坐位工人累积患病率、年患病率和周患病率与参比组比较的OR值分别为 8 2 ,8 0 ,3 1,而重体力工人则为 4 8,3 7,3 8(P值均小于 0 0 5 )。 [结论 ]固定体姿和重体力劳动都是工作相关腰背痛的重要危险因素 ,健康工人效应在重体力工人组表现明显 ,工种和工作体力要求评分可影响腰背痛的患病情况 ,主要混杂因素是年龄和工作满意度