Low back pain in health care: Study among 300 health care workers of two University Hospitals in the center of Tunisia.
Dr Salma KAMOUNa, Dr Irtyah ALLAGUIb, Dr Lamia BOUZGARROUb, Dr Iness RASSASb, Dr Amira OMRANEb, Prof Charefeddine AMRIb, Prof Mohamed Adnène HENCHIb, Prof Mohamed AKROUTb, Prof Neila CHAARIb
a Laboratoire de Médecine de Travail & d’Ergonomie – Faculté de Médecine de Monastir-Université de Monastir, b Département de Médecine du Travail et d’Ergonomie- Faculté de Médecine de Monastir-Université de Monastir
Objectives: The aims of this study is to evaluate Low back pain (LBP) prevalence among caregivers and to investigate socio-occupational risk factors associated with this pathology.
Materials and Methods: A cross-sectional study, conducted over a period of 14 months (October 2012-December 2011), with a representative sample of the health staff of two University Hospitals of Monastir and Mahdia in the center of Tunisia. The survey was based on the analysis of socio-professional characteristics, the evaluation of the working capacity index (WAI), the Nordic Questionnaire musculoskeletal disorders (MSDs), and some tests of joint suppleness and of the spine flexibility (distance finger-ground, sit-stand maneuver, equilibrium test..).
Results: Among the sample of the study, sex ratio was 1.06 and the mean age was42.64±11.65 years, with 42.66% of workers aged under 45 years and 47.10% of them are working on alternating schedules. The fifth nurses had a BMI> 30 and more than the half (51.9%) did not practice any regular physical activity. The perceived physical workload was considered heavy by 41.6% interviewed health care workers. According to the work ability index (WAI), 3/4 of the caregivers had good to excellent working capacity. During the previous 12 months of investigation, 2/3 of health care workers complained of LBP with pain rated as "severe" or "extremely severe" in 54.4% of cases. Higher LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p<10-3).The mean distance finger-ground was 7.10±7.5cm and the increase was statistically associated with the presence of low back pain (p = 0.05), with the increasing age (p <10-3), seniority (p <10-3) and a BMI ≥ 25 (p = 0.001). Others spine flexibility tests were statistically underperformed among LBP suffering workers (sit-stand maneuver (p = 0.03) ; equilibrium test (p = 0.01)).
Conclusion: Low back pain is still a health problem among caregivers with heavy professional and social impact. Prevention of LBP based on the improvement of working conditions and multidisciplinary management with collaboration between rehabilitation and occupational physician may ensure the reduction of the prevalence and the impact of this disabling disease.
Keywords : Low back pain , Health sector , Joint flexibility , Risk factors , Prevention