The epidemiology of low back pain in construction workers in the eThekwini Municipality of KwaZulu-Natal

Abstract

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.