Understanding Neck Pain Among Construction Workers in Nigeria

Neck Pain is a common issue affecting many people around the world. It often prevents individuals from doing normal activities and can lead to difficulties in daily life. According to research, neck pain is the second leading cause of Disability related to musculoskeletal problems, second only to lower back pain. The impact of neck pain is significant not just on the individuals affected but also on society as a whole, leading to high costs and loss of productivity.

The range of people who experience neck pain varies widely, with some studies showing rates as low as 0.4% and others reporting up to 86.8%, with an average prevalence of about 23.1%. Point prevalence looks at who has the pain at a specific time, while yearly prevalence considers who experiences it over a full year. For the whole of 2019, the prevalence of neck pain was about 27 per 1,000 people.

Neck pain is particularly worrying in low and middle-income countries. Various factors in these regions contribute to increasing rates of neck pain, such as an older population, high levels of poverty, and a mix of health challenges. In certain areas, like sub-Saharan Africa, the situation is even more concerning due to a lack of resources and support systems for health care.

In countries like Nigeria, research has focused on neck pain among specific groups, including students and farmers, with reported prevalence rates varying significantly. Construction workers are particularly at risk for neck pain-related injuries, but not much research has examined the specific causes behind this issue, especially in collaboration with psychosocial elements.

Studies in rural Nigeria have pointed out that Psychosocial Factors, which include things like stress and work pressure, play a significant role in the experience of chronic lower back pain. However, it's also noted that the physical aspects related to a person's job (like the type of work they do) did not show strong associations with disability. This reflects a need to look deeper into how these factors interact, especially among different worker groups.

#Study Purpose and Design

This study aims to investigate the relationship between physical and psychosocial factors related to neck pain among construction workers in urban Nigeria. It focuses on how these factors contribute to neck pain intensity, disability caused by neck pain, and the amount of Sick Leave taken due to neck pain.

Approval for the study was obtained from the relevant ethics committee, and informed consent was collected from all participants.

The approach taken was a cross-sectional study, which looks at data from a specific point in time. The location was in one of the major cities in Nigeria, focusing on construction sites. Recruitment aimed to include a diverse range of workers from numerous construction sites.

The expected sample size for the study was calculated to be around 189 participants, with a precautionary increase to 201 to account for potential dropouts or incomplete data. Eligible participants were required to be over 18 years old and engaged in construction work that typically involved carrying loads.

#Data Collection

Participants in the study underwent a screening process to ensure they met all requirements. They were asked about their background, including age, sex, and education. Different tools were used to measure the outcomes:

1. Pain Intensity: This was measured using a simple scale where participants rated their pain from 0 (no pain) to 10 (worst pain imaginable).
2. Neck Disability: The Neck Disability Index (NDI) was used to measure how neck pain affected daily activities. This included a series of questions about personal care, lifting, and recreation.
3. Psychosocial Factors: Job-related stressors and work conditions were assessed through specific questions about work pressure and control over tasks.
4. Biomechanical Factors: A questionnaire asked about the physical demands of the job, including how heavy the loads were and how long they had to carry them.

Data were collected in a straightforward manner. Participants either self-completed the questionnaires or answered questions through a researcher if they had trouble reading.

#Overview of Participants

Most participants in this study were men, reflecting the typical gender makeup of construction work in Nigeria. Education levels varied, but many had completed secondary school. On average, workers carried loads weighing about 39 kilograms for roughly nine hours a day and six days a week, often with their necks in twisted positions.

The measures of pain intensity revealed a median pain score of 6, indicating a moderate level of pain among participants. The results indicated that many workers experienced moderate disability due to neck pain, with sick leave reported only on average one day in the past four weeks.

#Findings

#Relationships Between Factors and Neck Pain

When looking at the interactions between different factors, it was found that psychosocial elements like work pressure and the ability to take breaks were linked to increased pain intensity. Specifically, being unable to control the pace of work was strongly connected to neck pain. These factors explained a significant portion of the pain intensity experienced by the workers.

The biomechanical factors also played a role. The weight that participants were required to carry and the duration they spent carrying these loads were correlated with neck pain severity and disability. However, psychosocial factors seemed to have a greater influence on pain intensity compared to biomechanical factors.

#Neck Disability and Sick Leave

In terms of neck disability, weight carried and duration of load carriage were identified as significant factors. Workers who carried heavier loads for longer periods reported greater levels of disability. Interestingly, when taking pain intensity into account, it was found that pain played a crucial role in explaining neck disability as well.

When examining sick leave, only a small portion of workers reported taking days off work. This was surprising, given the levels of pain and disability reported. The minimal sick leave could be attributed to the economic conditions where workers felt compelled to work despite pain, reflecting the challenges faced in low-income job markets.

#Discussion

The findings point toward a complex relationship between work conditions, psychosocial factors, and neck pain. The construction workers' experiences reveal that both mental and physical aspects of their work contribute to the pain they experience.

The significant impact of psychosocial factors suggests that improving job conditions, such as providing better control over work tasks and reducing stress, could help mitigate neck pain among workers. While biomechanical factors remain important, specifically regarding load carriage, enhancing the work environment and support available to workers could be equally beneficial.

The low levels of reported sick leave highlight an important issue: the reality of working in an environment with no safety net or social benefits. This emphasizes the need for better occupational health measures and regulations that address both the physical and mental health of workers.

#Implications for Practice

There is a clear need for better workplace policies that prioritize worker health. Employers should consider limiting the weight of loads and ensuring that workers have the opportunity for proper breaks. Furthermore, developing programs that address stress management and provide workers with greater control over their tasks could lead to better outcomes regarding neck pain.

Implementing training for workers on proper lifting techniques and ergonomics can also help reduce the physical burden on workers. Overall, a holistic approach that considers both psychosocial and physical aspects of work is crucial for promoting worker health and well-being.

#Future Research Directions

Future studies should take a longitudinal approach, tracking changes in neck pain and related factors over time. This can offer deeper insights into cause-and-effect relationships and help identify effective interventions.

Additionally, expanding research to encompass more diverse populations and job types can provide a broader understanding of these issues. Employing more refined methods to measure sick leave and other outcomes, along with adapting interventions for different contexts, will also be essential moving forward.

#Conclusion

The findings from this study reveal critical insights into neck pain among construction workers in Nigeria. Both psychosocial and biomechanical factors are important contributors to neck pain severity and disability. Addressing these factors through enhanced workplace practices and policies could significantly improve the health and quality of life for workers facing these challenges.