Please use this identifier to cite or link to this item: https://hdl.handle.net/10321/3972
Title: The epidemiology of work related back pain in full-time restaurant waitron staff within the eThekwini Municipality
Authors: Wolff, Alexia Michaela 
Keywords: Epidemiology;Low back pain;Restaurant;Waitron staff;eThekwini Municipality
Issue Date: 30-Nov-2020
Abstract: 
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.
Description: 
Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2020.
URI: https://hdl.handle.net/10321/3972
DOI: https://doi.org/10.51415/10321/3972
Appears in Collections:Theses and dissertations (Health Sciences)

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