Kwaku Essien Samuel, Trask Catherine, Khan Muhammad, Boden Catherine, Bath Brenna
a School of Public Health , University of Saskatchewan , Saskatoon , Saskatchewan , Canada.
b Canadian Centre for Health and Safety in Agriculture , University of Saskatchewan , Saskatoon , Saskatchewan , Canada.
J Agromedicine. 2018;23(1):105-120. doi: 10.1080/1059924X.2017.1383333.
Low-back disorders (LBDs) are the most common musculoskeletal problem among farmers, with higher prevalence rates than in other occupations. Farmers who operate tractors and other types of machinery can have substantial exposure to whole-body vibration (WBV). Although there appears to be an association between LBDs and WBV, the causal relationship is not clear.
This scoping review investigates the association between WBV and LBDs specifically among farmers.
Nine databases were searched using groups of terms for two concepts: 'farming' and 'low back disorder'. Screening, data extraction, and quality assessment were performed by two reviewers independently. Included studies met the following criteria: focused on adult farmers/agricultural workers; assessed exposure to operating farm machinery such tractor, combine, or all-terrain vehicle; assessed LBDs as an outcome; and reported an inferential test to assess the relationship between WBV and LBD.
After 276 full texts screened, 11 articles were found to analyze WBV as a risk factor for LBDs. Three were case-control, five cross-sectional, and three retrospective cohorts. Four studies showed no association between WBV and LBDs, four a positive association, and three results were mixed depending on the exposure/outcome measure.
A firm conclusion is difficult due to heterogeneity in, LBDs definition, type of farm commodity, study design, and statistical strategy. Direct comparisons and synthesis were not possible. Although retrospective cohort studies tended to show a relationship, future studies with a prospective cohort design could help clarify this association further.
下背部疾病(LBDs)是农民中最常见的肌肉骨骼问题,其患病率高于其他职业。操作拖拉机和其他类型机械的农民可能会大量接触全身振动(WBV)。尽管LBDs与WBV之间似乎存在关联,但因果关系尚不清楚。
本范围综述专门调查农民中WBV与LBDs之间的关联。
使用两组术语在九个数据库中进行搜索,这两组术语涉及两个概念:“农业”和“下背部疾病”。由两名评审员独立进行筛选、数据提取和质量评估。纳入的研究符合以下标准:关注成年农民/农业工人;评估接触农场机械(如拖拉机、联合收割机或全地形车)的情况;将LBDs作为结果进行评估;并报告用于评估WBV与LBD之间关系的推断性检验。
在筛选了276篇全文后,发现有11篇文章将WBV分析为LBDs的危险因素。其中三项为病例对照研究,五项为横断面研究,三项为回顾性队列研究。四项研究表明WBV与LBDs之间无关联,四项表明存在正相关,三项结果因暴露/结果测量方法而异。
由于LBDs定义、农产品类型、研究设计和统计策略的异质性,难以得出确凿结论。无法进行直接比较和综合分析。尽管回顾性队列研究往往显示出一种关系,但未来采用前瞻性队列设计的研究可能有助于进一步阐明这种关联。