Abstract
Background:Heavy load carrying has been associated with musculoskeletal discomfort (MSD) and disability. However, there is a lack of research investigating this association in resource-constrained settings where heavy load carrying by women is common.Objective(s):We assessed the impact of heavy load carrying on musculoskeletal pain and disability among women in Shinyanga Region, Tanzania, in an exploratory cross-sectional study.Methods:Eligible participants were a convenience sample of women, at least 18 years of age, who passed a study recruitment site carrying a load. We collected information on load-carrying practices, including frequency and time spent carrying water, wood, agricultural products, coal, sand, or rocks, and measured the weight of the load carried at the time. Outcomes included self-reported MSDs, defined as experiencing pain lasting >3 days in the neck, head, back, knees, feet and/or ankles within the last 1 year, and related disability. Using multivariable logistic regression we assessed for associations between load carrying exposures and MSDs and disability.Findings:Results showed a high prevalence of MSDs across the body regions assessed and evidence to suggest a relationship of back pain and related disability with several measures of load-carrying, including duration, frequency, and weight. Multivariable analyses revealed associations of increased load carrying exposures with low back pain (LBP) and related disability, including statistically significant increases in odds of LBP with increasing weight, total duration of load carrying/week and cumulative loads/week.Conclusions:Findings indicate a substantial burden of MSDs and disability in this population of women who carry heavy loads daily. The extent of discomfort and disability increased with increasing exposure to various load-carrying measures, especially for LBP. Larger epidemiologic studies that definitively assess relationships of load carrying with MSDs and disability are warranted.
Highlights
Musculoskeletal injuries comprise as the largest burden of disease globally
We found our results to be consistent with our 12-month primary outcome models, including increased odds of severe back pain with increasing exposure to various load carrying exposures, and increased odds of low back pain (LBP) within the last month with each 1 kg increase in load weight
Load carrying is an almost-ubiquitous activity amongst women in African countries, especially in more rural regions of the African continent where reliable and cheap mechanized transportation is often scarce
Summary
Musculoskeletal injuries comprise as the largest burden of disease globally. The 1990, 2005, and 2015 Global Burden of Disease studies listed low back pain (LBP) and neck pain as the primary global contributors to years lost to disability (YLD), and in the top ten causes of YLDs in all countries [1, 2]. Heavy load carrying has been associated with musculoskeletal discomfort (MSD) and disability. Objective(s): We assessed the impact of heavy load carrying on musculoskeletal pain and disability among women in Shinyanga Region, Tanzania, in an exploratory cross-sectional study. Findings: Results showed a high prevalence of MSDs across the body regions assessed and evidence to suggest a relationship of back pain and related disability with several measures of load-carrying, including duration, frequency, and weight. Multivariable analyses revealed associations of increased load carrying exposures with low back pain (LBP) and related disability, including statistically significant increases in odds of LBP with increasing weight, total duration of load carrying/week and cumulative loads/week. Conclusions: Findings indicate a substantial burden of MSDs and disability in this population of women who carry heavy loads daily. Larger epidemiologic studies that definitively assess relationships of load carrying with MSDs and disability are warranted
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