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Start date: 2020Subject: search.filters.subject.Low back pain

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    The epidemiology of low back pain in construction workers in the eThekwini Municipality of KwaZulu-Natal
    (2024) Moodley, Verushan; Pillay, Julian David
    Background Low back pain (LBP) is a significant musculoskeletal disorder and a major occupational health concern globally. In developing countries, occupational LBP remains a major public health crisis, with high levels of LBP reported, resulting in high levels of absenteeism, disability, and a loss of productivity. Construction workers are involved in one of the most physically demanding occupations, making them exceedingly susceptible to LBP. They are also exposed to a variety of demographic, lifestyle, and occupational risk factors that may further predispose them to LBP. In South Africa, research on LBP amongst construction workers is currently lacking. The aim of this study was, therefore, to determine the epidemiology of LBP in construction workers in the eThekwini Municipality of KwaZulu-Natal. Methodology This study adopted a cross-sectional survey design. Participants were recruited from the two largest construction companies in the eThekwini Municipality. A sample size of 256 construction workers was used and questionnaires were provided to the participants at their respective companies. The questionnaire was divided into four sections, namely demographic factors, lifestyle factors, occupational factors, and LBP history. IBM SPSS version 28 was used to analyse the data. Descriptive statistics, such as mean, standard deviation and range, were used to summarise continuous data. Frequency counts and percentages were used to summarise categorical data. Risk factors for LBP were assessed for those who reported LBP. Pearson’s chi-square tests or Fisher’s exact tests were deemed as appropriate and were used to assess categorical factors, while t-tests were used to assess mean differences for continuous variables. A p-value of <0.05 was used to indicate statistical significance. Results A total of 256 construction workers in the eThekwini Municipality were investigated in this study. The mean age of the male participants was 34.2 ± 9.2 years, while the female participants were 37.5 ± 8.1 years. The mean BMI of the men was calculated as 24.1 ± 3.9 kg/m2 and for the women it was 32.0 ± 10.1 kg/m2. The females had a mean weight of 78.7 ± 18.7kg and the men had a mean weight of 69.8 ± 9.9 kg. The males had a mean height of 1.7 ± 0.1kg and the females had a mean weight of 1.6 ± 0.1 kg. The point and period prevalences were 16.8% (n=43) and 26.2% (n=67) respectively. The study reported that 54.3% of the participants experienced LBP on both sides of the lumbar spine, 43.2% experienced it daily, and 48.1% had mild pain. Factors such as height (p=0.507), weight (p=0.657), and BMI (p=0.657) were not significantly associated with LBP. It was noted that age (n=81; p=0.124) was marginally non-significantly higher in those with LBP. No association between LBP and sex was noted (p=0.517) and LBP was equally likely in men and women (31% in men and 37.5% in women). A longer duration of smoking (p=0.015), a higher number of cigarettes smoked per day (p=0.047), the presence of work-related stress (p=<0.001), personal stress, or both, were significantly associated with LBP. The general workers (43.2%; n=16), followed by the erectors (33.3%; n=6), were most likely to have LBP. The most frequently used treatment was getting advice from a general practitioner, 56.7% (n=17), followed by self-medication, 30% (n=9). Conclusion LBP continues to be a major health burden on construction workers, impacting their daily activities and causing disability. The prevalence of LBP reported in the study was similar to some of the previous studies, whilst it varied from others. Notwithstanding this, LBP in construction workers is a concern requiring urgent attention. A joint intervention strategy between health professionals and the construction industry is required. This will reduce absenteeism, stress, decreased productivity, and activity limitations.
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    The epidemiology of work related back pain in full-time restaurant waitron staff within the eThekwini Municipality
    (2020-11-30) Wolff, Alexia Michaela; Haffejee, Firoza
    Background Low back pain (LBP) is one of the leading causes of morbidity in high-, middle- and lowincome populations and is one of the most common and most expensive occupational health problems in developed and developing countries. This affects the working population as LBP has a detrimental effect on work performance, therefore it is an important clinical, social, economic, and public health problem affecting the population. Internationally, risk factors in the development of LBP in the working population include prolonged standing, awkward posture and incorrect lifting. There is limited literature on prevalence of LBP, the risk factors associated with LBP and its impact on waitrons in South Africa. This study aims to determine the prevalence, clinical presentation, risk factors and impact of work-related LBP amongst full-time restaurant waitron staff within the eThekwini Municipality. Methodology This study was a mixed methods study comprising qualitative and quantitative components. The quantitative research tool consisted of a previously validated selfadministered questionnaire whilst the qualitative component consisted of voice recorded semi-structured interviews using an interview guide to obtain information on low back pain from participants. The data collected from the questionnaires were entered into an Excel spreadsheet and thereafter analysed using SPSS. Descriptive statistics were used to describe categorical outcomes, whilst Pearson’s chi square or Fisher’s exact tests in the case of categorical variables, and t-tests for continuous variables were used to assess factors associated with LBP. The audio recordings from the qualitative interviews were transcribed verbatim and exported into a Microsoft Word document. Thereafter, thematic analysis was used to analyse the qualitative data to identify common themes and subthemes. Results Of the 340 questionnaires which were distributed, a total of 180 questionnaires were completed by waitrons in the eThekwini Municipality, resulting in a 52.9% response rate. The point, three-month period and annual prevalence was recorded at 50.0%, 62.2% and 78.2%, respectively. Within this population, LBP was associated with the ethnicity of the participants (p=0.002) where Indians had a 7.7 times increase in the odds of prevalent LBP compared with Black Africans (OR = 7.713; 95% CI = 1.273-46.718; p = 0.026) and Whites a 5.9 times increase in the odds of prevalent LBP than Black Africans (OR = 5.891; 95% CI = 1.429-24.289; p = 0.014). Low back pain was associated with the education of the participants (p = 0.002) where participants with high school education had an almost 12 times increase in the odds of prevalent LBP than those with tertiary education (OR = 11.967; 95% CI = 1.399-102.387; p = 0.023). Prolonged standing or walking during a work shift was associated with LBP (OR = 42.808; 95% CI = 2.346-780.985; p = 0.011). Onset of LBP was common during a long single shift or when working a double shift and pain sessions tended to last between one to two hours. The frequency of LBP experienced averaged two to three times a week, where pain was at its worst in the evenings. Low back pain in waitrons commenced gradually without injury and the severity of LBP was unchanged since it initially started. Low back pain resulted in moderate impact on the work of waitron staff, sometimes resulting in absenteeism and bed rest. Eight in-depth, qualitative interviews were conducted. Two main themes emerged from the data: low back pain characteristics and type of treatment. Interviewees discussed pain, onset and duration, and relieving factors as part of LBP characteristics, where they reported first experiencing LBP as young adults. Their onset of LBP was common during a long single work shift or when working a double shift. They re-iterated that prolonged standing and lifting or carrying heavy objects aggravated their LBP. Various therapies were used by interviewees to relieve the pain which included analgesics, antiinflammatories, heat therapy and topical gels. Type of treatment included chiropractic. There was good knowledge of the services offered by chiropractors and various types of chiropractic treatment available. Conclusion The prevalence of LBP amongst waitron staff within the eThekwini Municipality was high. Work-related factors were associated with the onset of LBP. These included prolonged standing, constant walking for long periods of time, carrying heavy loads and falling. Low back pain negatively impacted on their work due to absenteeism as bed rest was required. Various treatment options, including chiropractic were utilized. Participants had some knowledge of what constitutes chiropractic treatment and the types of services offered.