Agriculture and musculoskeletal disorders in low- and middle-income countries

ABSTRACT

Objectives: To systematically explore and summarize the risk factors of work-related musculoskeletal disorders (WMSDs) among the agricultural workers in low- and middle-income countries (LMIC). In addition, to identify and analyze the methodological flaws in the reviewed studies.

Methods: A comprehensive electronic literature search was conducted using PubMed, Medline, SCOPUS, CINAHL, Science Direct, Embase, Wiley Online Library, Google Scholar, and Web of Science databases. Three-phased screening process was undertaken to eliminate irrelevant publications. Assessment of methodological quality was done using a standardized assessment tool.

Results: Eighteen cross-sectional studies were included in the narrative synthesis. Based on the median score of 38%, nine publications were classified as having higher methodological quality. Eight countries were represented in this review, mainly the South East Asia countries. Majority of the participants were rice farmers. Most common risk factors associated with WMSDs were physical factors (n = 10), followed by individual (n = 6) and psychosocial (n = 5) risk factors. A majority of the studies investigated the risk factors for spinal region. Several methodological weaknesses were noticed in the studies concerning outcome definition, assessment of potential confounders, generalizability, selection bias, information bias, and statistical analysis. Extensive heterogeneity across the studies prevented statistical pooling.

Conclusions: The common anatomical region evaluated was the spine and the most reported risk factors were physical risk factors. Future researches in the LMIC should focus on conducting longitudinal studies that could infer temporality. Researchers should give more attention in defining the study population, evaluating the exposure and outcome in an unbiased way, and in executing reliable statistical analysis.

KEYWORDS:

• Agricultural-related musculoskeletal disorders
• agricultural risk factors
• agricultural workers
• low- and middle-income countries
• work-related musculoskeletal disorders

Acknowledgments

The principal author would like to express heartfelt thanks to the Swedish Institute, for granting the SI scholarship and giving the opportunity to execute this research during the final year of Master’s Programme in Public Health at Lund University. The authors would like to thank Jan Jensen, librarian at Clinical Research Centre Malmo, for his assistance in electronic literature search.

Disclosure statement

This research was not supported by any research grant.

Additional information

Funding

This research was conducted as part of thesis project during the final year of Master’s Programme in Public Health at Lund University.