Abstract
The purpose of this study was three fold:
1. To determine the life time incidence, 6 month prevalence and point prevalence of Low Back Pain (LBP) in the work environment of ABSA Bank and compare it to the rest of the world.
2. To determine whether individual factors such as age, gender, body mass index and work environment factors like main daily position and activity could be causal factors contributing to LBP.
3. To determine whether treatment is sought, the type of care sought for LBP and the cost of sick leave due to LBP to the company.
A Review of the data indicates that LBP is a condition that 60-80% of people will suffer from at some stage in their lives. Epidemiological studies have shown that simple backache has a point prevalence and 1-month prevalence of 15-30% and 30-40% respectively. (1, 2, 3)
LBP could be caused by many disorders of the spine, but for many sufferers no causative diagnosis will be made. There are a large number of occupational causes that could lead to the development of LBP. The major causes are the following: forceful lifting of heavy objects, twisting coupled with bending of the trunk, whole body vibration and heavy manual work. (60)
There are a number of causal factors of LBP that are non work related such as personal risk factors including age, gender, fitness level, trauma to the back, cigarette use and recreational activities (60).
LBP is seen to be one of the most common ailments affecting people, but most do not seek medical attention. Those patients who do seek medical attention seem to seek the help of the following specialities: physicians, chiropractors, nurses, orthopaedic surgeons, neurosurgeons, physical therapists or alternative medical practitioners. (20)
Researchers in the USA, in 1992 found that 73.1% of LBP sufferers sought medical care, while many saw a multiple variety of health care providers. Of those people who sought medical care, 64% consulted a general practitioner, 55% consulted an orthopaedic surgeon, 29% consulted a physical therapist and 25% consulted a chiropractor. (8)
A cross sectional, systematic random sample to study the incidence and prevalence of low back pain (LBP) was conducted on 355 employees of ABSA Bank and Unibank. The data was collected by the researcher by means of a personal interview. A permission letter from ABSA Bank Health Clinic (Appendix A) was used to gain access to those who needed to be interviewed in the sample group. The data was recorded on a questionnaire (Appendix B) and a low back diagram (Appendix C) was used to define LBP so that it would be easier to understand.
The results of this study showed that the lifetime incidence of LBP was 63% (225/355), the 6 month prevalence of LBP was 41% (147/355) and the point prevalence of LBP was 9.6% (34/225).
The major daily activity that was associated with the 6 month prevalence of LBP was computer type work at 93.88% (138/147); this was followed by telephonic work at 65.31% (96/147). Physical and administrative work was only reported to have caused LBP in 4.76% (7/147) and 22.45% (33/147) of the sample population.
The major daily position that was associated with the 6 month prevalence of LBP was sitting - 97.28% (143/147). This was followed by walking - 61.64% (90/147), standing - 17.69% (26/147) and lifting-t 6.57% (9/147).
Treatment was sought by 46.94% (69/147) of the sample population that suffered from LBP in the last 6 months. Treatment was sought from the pharmacy in 21.99% (31/141) of the cases. Chiropractors were consulted in 8.51% (12/141) of the cases; medical doctors were consulted in 14.89% (21/141) of the cases, physiotherapists in 17.02% (24/141) of the cases, while acupuncture and private hospitals were used by only 0.71% (1/141) of those who suffered from LBP. Biokinetics, homeopathy and
osteopathy were three other disciplines that were on the questionnaire, but none of these disciplines were made use of by the study population.
This study showed that the lifetime incidence, six month prevalence and point prevalence of LBP in the South African workplace is similar to other countries in the world and that this condition is costing the South African economy millions of rand each year due to lost working days as a result of absenteeism.
The only individual factor that seemed to be statistically significantly associated with LBP was trauma to the lumbar spine. Other factors like age, gender and race did not seem to have statistically significant effects on the prevalence of LBP. The results regarding the individual factors that could lead to LBP seem to vary between the different studies evaluated.
Just under half of those who suffer from LBP seek treatment for the condition. When evaluating what kind of treatment is used by the study population, it was seen that the majority used drugs from the pharmacy to treat the condition.
Dr. B. Losco
Dr. M. Moodley