Severe back pain among farmworker high school students from Starr County, Texas: baseline results

Understanding Latinx Child Farmworkers' Reasons for Working: A Mixed Methods Approach

Agricultural labor is extremely hazardous, yet young children are legally permitted to work on farms. This paper contextualizes and describes Latinx hired child farmworkers’ stated reasons for working. We conducted a mixed-methods study using in-depth interviews ( n = 30) and survey interviews ( n = 202) with Latinx child farmworkers aged 10 to 17 in North Carolina. Our qualitative thematic analysis identified children’s salient reasons for working, including supporting family, contextual factors that lead to farm work, and occupying summer time. Statistical analysis showed that children’s primary reasons for working included buying clothes (91.1%) and school supplies (64.7%), with few differences by gender, age, or other characteristics. The findings demonstrate that most Latinx children view farm work as a necessary but temporary experience that financially supports their families. We discuss the implications for protecting Latinx child workers by reducing their structural vulnerability in order to facilitate healthy development.

Factors associated with intensity and frequent low back pain in high school students

Introduction: Low back pain is frequent among schoolchildren and the variables related to high intensity and high back frequency are important predictors for the increase of such complaints in adulthood. Objective: To determine the high intensity and high frequency of low back pain and its associated factors in high school students. Methods: This cross-sectional study included 760 students (319 boys and 441 girls) who reported low back pain. Demographic, socioeconomic, electronic devices, habitual physical activity practice, mental health, and high frequency and high intensity low back pain data were collected. Descriptive analyzes and bivariate and multivariate logistic regressions were used. Results: Of the total number of subjects with low back pain, 14.6% reported high frequency of pain, being 36.9% boys and 63.1% girls, while 42.6% reported high intensity, being 35.8% boys and 47.2% girls. The variables associated with the high frequency of low back pain were altered mental health, posture lying on the use of tablet, time of daily use of the cell phone and distance of the screen to the eyes of the computer user, while the female sex, mental health problem, posture lying on the use of cell phone and the distance of the screen to the eyes of the computer user with severe intensity of low back pain. Conclusion: The demographic factors and related to the use of electronic devices were associated with high intensity and high frequency of low back pain.

Structural Vulnerability and Occupational Injury Among Latinx Child Farmworkers in North Carolina

Children as young as ten-years-old can legally work as hired farm labor in the United States. In North Carolina, many hired children are part of the Latinx farmworker community. Agriculture is a hazardous industry, and child workers experience high rates of injury, illness, and mortality. As part of a community-based participatory research study, we draw from thirty in-depth interviews with Latinx child farmworkers aged ten to seventeen to describe their experiences of personal and observed workplace injury and close calls. Nearly all child workers had experienced or observed some form of injury, with several reporting close calls that could have resulted in severe injury or fatality. Overall, children reported a reactive approach to injury prevention and normalized pain as part of the job. Highlighting Latinx child farmworkers' structural "vulnerability, this analysis contextualizes understanding of workplace injury among this largely hidden population. We offer policy recommendations to protect and support these vulnerable workers.

Musculoskeletal injury symptoms among hired Latinx child farmworkers in North Carolina

BACKGROUND

Although children 10-17 years can be hired to work in agriculture, little research has addressed possible musculoskeletal injuries. Children may be at particular risk for these injuries because of the repetitive and load bearing nature of work tasks. Existing research relies on child workers to self-report musculoskeletal injuries.

METHODS

In 2017, 202 Latinx child farmworkers ages 10-17 employed across North Carolina completed survey interviews. In 2018, 145 of these children (94 [64.8%] current farmworkers) completed a physical examination and second interview. The examination obtained findings for upper and lower extremity as well as back injuries.

RESULTS

Positive indicators for musculoskeletal symptoms were few in either current or former child farmworkers. The knee was most common site for positive indicators with 15.4% of children having at least one. Combining all anatomical sites, 29.0% of children had at least one positive indicator, with no significant difference between current and former farmworkers. Overall, boys had significantly more indicators of knee injuries than girls (21.3% vs. 4.1%), indicators of ankle injuries were found only in the youngest workers (9.5% of children 11-13 years), and significantly fewer current farmworkers had indicators of lower back injuries than former farmworkers (6.4% vs. 17.7%).

CONCLUSIONS

Expectations of injuries come from previous studies using child farmworker self-reports, adult farmworker injury rates, and sports medicine pediatric findings. Hired child farmworkers may not perform activities as repetitious and load-bearing as children in sports training or adult farmworkers. Additional research using physical examination is needed to confirm these findings.

Work Safety Culture of Latinx Child Farmworkers in North Carolina

Background

Little research has addressed the safety environment of child farmworkers. This analysis examines the work safety culture experienced by Latinx child farmworkers in North Carolina.

Methods

Survey interviews were conducted in 2017 with 202 Latinx children aged 10 to 17 years employed on North Carolina farms. Analysis included measures of the behavioral, situational, and psychological elements of work safety culture.

Results

The work culture on North Carolina farms employing Latinx child farmworkers places limited value on safety. Behaviorally, many did not wear appropriate work clothing (e.g., 47.5% wore gloves, 37.1% wore boots). Situationally, few received safety training for tools (40.6%), machinery (24.3%), or pesticides (26.0%); about one-third (33.7%) had worked piece-rate; and many did not have field sanitation services available (e.g., 37.1% had water for washing, 19.8% had soap). Safety attitudes were mixed, and work safety climate was low, with 21.8% stating that their supervisor was only interested in doing the job fast and cheaply. Greater safety training, field sanitation services, and work safety climate were associated with working in western North Carolina, migrant workers, limited English fluency, and working in tomatoes. Wearing appropriate work clothing, not working piece-rate, fewer unsafe work attitudes were associated with working in eastern North Carolina, seasonal worker, speaking English, and working in tobacco.

Conclusions

This research makes it apparent that efforts are needed to improve safety culture wherever child farmworkers are employed. Current policy is not providing a safe environment for children working on farms in the United States.

Occupational Injuries of Latinx Child Farmworkers in North Carolina: Associations With Work Safety Culture

OBJECTIVE

This paper examines the association of occupational injuries with work safety culture among Latinx child farmworkers.

METHODS

Interviews were conducted in 2017 with 202 Latinx farmworkers aged 10 to 17 years.

RESULTS

Occupational injuries were common among the child farmworkers: for example, 66.8% reported any work injury and 45.5% reported heat-related illness. Work safety culture was inadequate; for example, most did not receive safety training, one-third reported having worked piece-rate; only a few field sanitation services were available, and perceived work safety climate was low. Work safety culture had a mixed association with occupational injuries, with safety training and a better perceived work safety climate having a direct association with occupational injuries.

CONCLUSIONS

Policy is needed to reduce child farmworker injuries. Strategies to improve the predictive value of the work safety culture model are required.

Health and Occupational Injury Experienced by Latinx Child Farmworkers in North Carolina, USA

Children as young as 10 years old are hired to work on farms in the United States (U.S.). These children are largely Latinx. Using interview data collected from 202 North Carolina Latinx child farmworkers in 2017, this analysis documents the heath characteristics and occupational injuries of Latinx child farmworkers and delineates characteristics associated with their health and occupational injuries. Latinx child farmworkers include girls (37.6%) and boys (62.4%), aged 10 to 17 years, with 17.8% being migrant farmworkers. Three-quarters reported receiving medical and dental care in the past year. Respiratory (15.8%) and vision (20.3%) problems were prevalent. Girls more than boys, and younger more than older children had greater health service utilization. Occupational injuries were common, with 26.2% reporting a traumatic injury, 44.1% a dermatological injury, 42.6% a musculoskeletal injury, and 45.5% heat-related illness in the past year. Age increased the odds of reporting work injuries and heat-related illness, and being a non-migrant reduced the odds of reporting work injuries. These results emphasize the need for greater documentation of child farmworker occupational health and safety. They underscore the need to change occupational safety policy to ensure that children working in agriculture have the same protections as those working in all other U.S. industries.

"Be careful!" Perceptions of work-safety culture among hired Latinx child farmworkers in North Carolina

BACKGROUND

Children as young as 10 years of age can be hired to work on farms. Many of these hired child farmworkers are Latinx. Although these children experience high rates of injury, little research has addressed work-safety perceptions among hired Latinx child farmworkers.

METHODS

For this qualitative study, we conducted in-depth interviews in North Carolina in 2016 with 30 Latinx child farmworkers, ages 10 to 17. Our analysis used the work-safety culture conceptual framework to delineate their perceptions of the psychological, behavioral, and situational elements of safety culture.

RESULTS

The child farmworkers describe a weak work-safety culture. Psychologically, they understand that their parents want them to be safe, but they observe that safety is important to only a fraction of their supervisors and coworkers. Behaviorally, they recognize many of the hazards they confront while working, but it is not clear how well they use this knowledge to mitigate these hazards or to change their behaviors to avoid these hazards. Situationally, several children note that the only safety training they receive is the imperative to "be careful." Most receive little formal training, much of the training they receive is informally provided by family members and coworkers rather than supervisors, and their training is geared more toward how to complete a task than how to complete the task safely.

CONCLUSIONS

Child farmworkers perceive that work-safety culture is of limited importance in agriculture. Regulations are needed that improve work-safety culture in agriculture, especially for those vulnerable due to minority age.

Hired Latinx child farm labor in North Carolina: The demand-support-control model applied to a vulnerable worker population

BACKGROUND

US government child labor policies allow children as young as age 10 to be hired as workers on farms not operated by family members. Children may face substantial health risks in an industry known for high worker morbidity and mortality rates, due to high demands for productivity, and low control and little support because of the organization of the workplace. This paper examines how child farmworkers in North Carolina experience their work situation.

METHODS

In-depth interviews conducted in 2016 with 30 Latinx child farmworkers, ages 10 to 17, were analyzed using concepts from the demand-control-support model. All had worked as either migrant or seasonal hired farmworkers within the past year.

RESULTS

Children reported planting, cultivating, and harvesting crops including fruits, vegetables, and tobacco. The crew leader supervisory system, piece-rate pay, and coworker pressure produced significant demands to work quickly and take risks including lifting heavy loads, operating mechanical equipment, and working in excessive heat. Children had little control over work to counter demands they experienced; and they labored in a state of fear of firing, wage theft, and other sanctions. Support was variable, with younger children more likely to experience family and coworker support than older children.

CONCLUSIONS

The high demands with limited control and, for some, little support, that these children experience place them at risk and show the possibility of injury and exploitation. Future research should systematically document the occupational injury and illness of hired child farmworkers, and consider whether changes in labor policy are warranted.

Potential risk factors and triggers for back pain in children and young adults. A scoping review, part II: unclear or mixed types of back pain

Background

Back pain is a global problem in terms of disability and financially, with a large burden both to the individual and to society. Back pain was previously believed to be uncommon in children. However, there is a growing body of evidence that this is not the case.

Objective

Part I of this scoping review studied risk factors of incident and episodic back pain. In this part II we aimed to identify all risk factors and triggers with unclear or mixed type back pain in young people and to identify any gaps in the literature.

Methods

A scoping review design was selected to summarise the evidence, as there are many studies on “risk factors” for back pain. The scoping review followed the PRISMSA-ScR guidelines. We considered all studies that tested potential risk factors and triggers for thoracic and/or lumbar spine pain, in children, adolescents, and young adults (≤ 24 years). PubMed and Cochrane databases were searched from inception to September 2018, to identify relevant English language articles. The results regarding potential risk factors were separated into temporal precursors and bidirectional risk factors and the studies were classified by study design.

Results

Our comprehensive search strategy identified 7356 articles, of which 83 articles were considered eligible for this review (part II). There were 53 cross-sectional studies and 30 cohort studies. Potential risk factors for back pain were: female sex, older age, later pubertal status, positive family history of back pain, increased growth, and a history of back pain, most of which are temporal precursor variables. There was limited research for the illness factors, spinal posture, and muscle endurance in the development of back pain.

Conclusion

Many of the included studies approached risk factors in similar ways and found factors that were associated with back pain but were not obvious risk factors as causality was uncertain. Future research should be more rigorous and innovative in the way that risk factors are considered. This could be through statistical approaches including cumulative exposures, or longitudinal approaches including multi-trajectory methods. Additionally, data on proposed risk factors should be collected before the onset of back pain.

Latinx child farmworkers in North Carolina: Study design and participant baseline characteristics

BACKGROUND

Although children as young as 10 years can work in agriculture, little research has addressed their occupational health. This paper describes a large, multicomponent study of hired Latinx child farmworkers, and the characteristics of children participating in this study.

METHODS

Survey interviews were conducted in 2017 with 202 Latinx children aged 10-17 years employed in agriculture across North Carolina (NC).

RESULTS

Most (81.2%) participants were born in the United States, 37.6% were female, and 21.3% were aged 10-13 years. Most (95.1%) were currently enrolled in school. Thirty-six (17.8%) were migrant workers. 34.7% had worked in agriculture for 1 year; 18.3% had worked 4+ years. 33.7% worked piece rate. 57.4% worked in tobacco. Participants in western NC differed in personal and occupational characteristics from those in eastern NC.

CONCLUSIONS

This study has enrolled a large and diverse child farmworker sample. This overview indicates several important issues for further analysis.

The prevalence of low back pain and its associated factors in Thai rubber farmers

Objectives:

Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in the general population, especially among manual laborers. Moreover, it often brings about lost wages and additional medical expenses. However, the potential risk factors for LBP are unknown. This study aimed to estimate the prevalence of LBP and to determine the individual, occupational, and psychosocial factors associated with LBP among rubber farmers.

Methods:

A cross-sectional survey was conducted among 450 Thai rubber farmers using cluster random sampling. Data were collected using face-to-face interviews and objective examination and were analyzed using multivariate logistic regression.

Results:

Of the 433 rubber farmers, the point and 12-month prevalence of LBP in rubber farmers was 33% and 55.7%, respectively. BMI, primary school education, exposure to pesticides, and tapping below knee level were statistically associated with LBP after controlling for other variables.

Conclusions:

Low back pain is common among rubber farmers. Only four factors were identified as being associated with the high prevalence of LBP. However, these factors might be altered if more variables are taken into account. Further research investigating the causal relation between these factors and LBP should be conducted.

Safety and injury characteristics of youth farmworkers in North Carolina: a pilot study

Agriculture is a unique US industry in how youth are involved. Youth employed in agriculture experience high rates of injury, and youth migrant and seasonal farmworkers may be extremely vulnerable. The primary aim for this analysis is to describe the personal characteristics, work characteristics, occupational safety behaviors, and occupational injuries of North Carolina youth farmworkers. This pilot study uses data from interviewer-administered questionnaires with 87 youth farmworkers. Participants included males (62.1%) and females (37.9%), with 26.4% aged 10-13 years, 39.1% 14-15 years, and 34.5% 16-17 years. The majority (78.2%) were born in the United States. Most worked in tobacco (46.0%), sweet potatoes (28.7%), and berries (28.7%). They were paid by the hour (54.0%) and piece rate (55.2%); 21.8% reported a problem getting paid the amount earned. Three quarters wore a hat, and 63.2% wore gloves while working. Five (5.7%) had received pesticide use training in the past year. Over half reported a musculoskeletal injury (54.0%), a traumatic injury (60.9%), or a dermatological injury (72.4%) in the last year. Six of the injuries led to medical treatment, and 10 resulted in missed school or work. Farmworker youth in North Carolina are at times not treated fairly when they work, occupational safety behaviors are limited (increasing exposure to pesticides and other environmental hazards), and they commonly experience injuries. Research on the occupational exposures and health experienced by youth farmworkers is needed to inform policy. Changes in policy are warranted to improve the safety of youth farmworkers.

Musculoskeletal pain among Midwest farmers and associations with agricultural activities

BACKGROUND

Although agricultural workers experience a high prevalence of musculoskeletal pain, associations between specific agricultural activities and musculoskeletal pain are not well characterized.

METHODS

Among 518 regional farmers, responses to a mailed questionnaire were used to estimate (i) the 2-week prevalence of low back, neck/shoulder, and elbow/wrist/hand pain, and (ii) associations between the average hours per week performing common agricultural activities and musculoskeletal pain.

RESULTS

The low back was the most common location of musculoskeletal pain (33.2%), followed by the neck/shoulder (30.8%) and elbow/wrist/hand (21.6%). Statistically significant adjusted associations were observed between performing equipment repair and maintenance and low back pain; milking animals and neck/shoulder pain; and manual material handling and elbow/wrist/hand pain, among others.

CONCLUSIONS

The observed prevalence estimates are consistent with previous literature, and the associations between agricultural activities and musculoskeletal pain provide an initial basis for targeted intervention research.

Low back pain among school teachers in Botswana, prevalence and risk factors

BACKGROUND

Although low back pain (LBP) represents a common occupational problem, few epidemiological studies have investigated the prevalence and risk factors for LBP among school teachers, particularly in Africa. School teachers are known to represent an occupational group among which there appears to be a high prevalence of LBP. The objective of this study was, therefore, to conduct one of the first epidemiological investigations of LBP among teachers in Botswana.

METHODS

A cross-sectional study was conducted among teachers in Botswana using self-administered questionnaires which were distributed to 3100 randomly selected school teachers and collected over a five-month period between July and November 2012. The questionnaire included low back pain information, demographic data, lifestyle, work-related characteristics and psychosocial factors. Data were analysed using Chi-squared and logistic regression models. The 12 month prevalence and LBP disability and associated risk factors were also analysed.

RESULTS

A total of 1747 teachers returned completed questionnaires, yielding a response rate of 56.3%. The 12-month prevalence of LBP was 55.7%, with 67.1% of them reporting minimal disability. The results of logistic regression analysis revealed that female gender [OR: 1.51, 95% CI: 1.14-2.00] and previous back injury [OR: 9.67, 95% CI: 4.94-18.93] were positively correlated to LBP. Awkward arm position [OR: 1.81, 95% CI: 1.24-2.62] and high psychological job demands [OR: 1.40, 95% CI: 1.02-1.93] were also significantly associated with LBP. Regular physical exercise was negatively associated with LBP [OR: 0.63, 95% CI: 0.43-0.93]. Female gender [OR: 2.67, 95% CI: 1.52-3.99] and previous back injury [OR: 3.01, 95% CI: 1.92-4.74] were also positively associated with LBP disability.

CONCLUSION

The prevalence of LBP appears to be high among school teachers in Botswana. A wide variety of LBP risk factors were identified in this study. Female gender and previous injury were both associated with LBP presence and disability. The complex nature of LBP risk factors found in this study suggests than no single specific preventative or intervention strategy will help in reducing these conditions. As such, to help reduce the prevalence, progression and burden of LBP among Botswana teachers, a greater emphasis should now be placed on ergonomics education, regular physical exercise and occupational stress.

A narrative literature review on the health of migrant farm worker children in the USA

Purpose

– The purpose of this paper is to provide a comprehensive narrative review of the literature on migrant farm worker child and adolescent health. It highlights current health issues and suggests methods to improve research and clinical practices with this underserved and vulnerable population.

Design/methodology/approach

– The methodology for this narrative review included a search of articles published between 2000 and 2012. From the primary search, 76 articles met the search criteria. A secondary search revealed three additional articles.

Findings

– The various methodologies used in the current literature have limited rigorous analysis of the health of pediatric migrant populations. The findings highlight the complex factors that influence migrant pediatric health. Despite the many challenges migrant farm worker children and their families face, they exhibit enormous resilience and strengths that may help counterbalance these challenges. Study categories that emerged from the analysis include health perspectives and behaviors, occupational health, access to care, utilization and satisfaction with health services, health outcomes and health disparities, and oral health. This review provides a strong foundation from which to work toward improving migrant pediatric health.

Originality/value

– This paper provides an original review of the unique health needs and the complex factors influencing the health of migrant farm worker children and adolescents. This will be of value to clinicians and researchers since migrant farm worker families are part of communities across the country. It offers public health professionals insight into services and programs that can improve the health and well-being of children, families, and communities.

Farm work exposure of older male farmers in Saskatchewan

BACKGROUND

The average age of farmers in North America is increasing each year. Research has determined that age and health status are both related to increased risk of injury. The purpose of this research was to determine the association of health and medication factors with exposure to farm work in older male farmers.

METHODS

As part of a cohort study to study determinants of injury on Saskatchewan farms, 5,502 farm people associated with 2,386 Saskatchewan farms were surveyed by mail questionnaire during the winter of 2007. The primary dependent variable was average hours per week of farm work. Independent variables included illnesses, age, and medication use.

RESULTS

The mean number of hours worked per week by farmers aged 55 years and older was 48. There was a significant relationship between age and hours worked with each year of age accounting for about 0.85 hr less work per week. Medication use was related to a reduction in weekly work hours during the busy fall season but was not related to work exposure averaged over the whole year. In multivariable linear regression analysis, the main contributing variables to farm work exposure were: retired status (-), working off farm (-), and age (-).

CONCLUSION

The amount of hours older farmers work on the farm is considerable compared to any other occupational category. While there is a declining trend in the amount of work, a 75-year-old farmer still works, on average, about 34 hr per week. Some farmers do appear to self-limit during busy times of the year if they are taking medication.

The association between smoking and low back pain: a meta-analysis

OBJECTIVE

To assess the association between smoking and low back pain with meta-analysis.

METHODS

We conducted a systematic search of the MEDLINE and EMBASE databases until February 2009. Eighty-one studies were reviewed and 40 (27 cross-sectional and 13 cohort) studies were included in the meta-analyses.

RESULTS

In cross-sectional studies, current smoking was associated with increased prevalence of low back pain in the past month (pooled odds ratio [OR] 1.30, 95% confidence interval [CI], 1.16-1.45), low back pain in the past 12 months (OR 1.33, 95% CI, 1.26-1.41), seeking care for low back pain (OR 1.49, 95% CI, 1.38-1.60), chronic low back pain (OR 1.79, 95% CI, 1.27-2.50) and disabling low back pain (OR 2.14, 95% CI, 1.11-4.13). Former smokers had a higher prevalence of low back pain compared with never smokers, but a lower prevalence of low back pain than current smokers. In cohort studies, both former (OR 1.32, 95% CI, 0.99-1.77) and current (OR 1.31, 95% CI, 1.11-1.55) smokers had an increased incidence of low back pain compared with never smokers. The association between current smoking and the incidence of low back pain was stronger in adolescents (OR 1.82, 95% CI, 1.42-2.33) than in adults (OR 1.16, 95% CI, 1.02-1.32).

CONCLUSIONS

Our findings indicate that both current and former smokers have a higher prevalence and incidence of low back pain than never smokers, but the association is fairly modest. The association between current smoking and the incidence of low back pain is stronger in adolescents than in adults.

Prevalence and risk factors of low back pain among Thai and Myanmar migrant seafood processing factory workers in Samut Sakorn Province, Thailand

This study assessed the prevalence of low back pain (LBP) and investigated risk factors for LBP among seafood processing factory workers in Thailand including migrant workers. The subjects were Thai and Myanmar workers in the typical seafood processing factory. A cross-sectional study was carried out with a self-administered questionnaire. Prevalence of LBP, general characteristics, life style, and working condition were investigated. The associations between LBP and risk factors were estimated by multiple logistic regression models. Of 254 workers, 165 completed the questionnaire. Half of these workers were Thai, the others were from Myanmar. The point prevalence of LBP was 28.5%. Risk factors for LBP were age over 40 yr, poor health status, history of back injury, twisting posture at work, and slipping on wet floors. The results suggest that health promotion should focus on working conditions rather than individual life style in order to prevent LBP. Furthermore, greater attention to other risk factors such as history of back injury and perception of health status after regular health check up, especially in older age groups may be needed.

"Pesticides protect the fruit, but not the people": using community-based ethnography to understand farmworker pesticide-exposure risks

OBJECTIVES

We used community-based ethnography and public health risk assessment to assess beliefs about pesticide exposure risks among farmworkers in the Lower Yakima Valley of Washington State.

METHODS

We used unstructured and semistructured interviews, work-site observation, and detailed field notes to gather data on pesticide exposure risks from 99 farmworkers.

RESULTS

Farmworkers' pesticide-relevant beliefs and attitudes could be grouped into 5 major themes: (1) dry pesticides are often perceived as a virtually harmless powder, (2) farmworkers who identify themselves as allergic to pesticides are more acutely affected by exposure, (3) the effect of pesticide exposure is more severe for those perceived as physically weak, (4) protective equipment is used selectively in response to financial pressure to work rapidly, and (5) some farmworkers delay decontamination until they find water deemed an appropriate temperature for handwashing.

CONCLUSIONS

We elucidated farmworkers' pesticide-relevant beliefs regarding perceived danger and susceptibility to pesticides, the need to put safety second to financial considerations, and reasons for delaying decontamination. Researchers and policymakers should incorporate these data in study designs and legislation concerned with farmworker exposure to pesticides.

Chronic back pain and associated work and non-work variables among farmworkers from Starr County, Texas

OBJECTIVES

This study estimated the prevalence of chronic back pain among migrant farmworker family members and identified associated work and non-work variables.

METHODS

Migrant farmworkers (n = 390 from 267 families) from Starr County, Texas were interviewed in their home once a year for 2 years. The original survey included items measuring demographics, smoking, sleep, farm work, and chronic back pain. For this cross-sectional analysis, multi-level logistic regression was used to identify associated work and other variables associated with chronic back pain while accounting for intraclass correlations due to repeated measures and multiple family members.

RESULTS

The prevalence of chronic back pain during the last migration season ranged from 9.5% among the youngest children to 33.3% among mothers. Variables significantly associated with chronic back pain were age (odds ratio [OR], 1.03, per year increase), depressive symptoms while migrating (OR, 8.72), fewer than 8 hours of sleep at home in Starr County (OR, 2.26), fairly bad/very bad quality of sleep while migrating (OR, 3.25), sorting crops at work (OR, 0.18), and working tree crops (OR, 11.72).

CONCLUSION

The role of work exposures, depressive symptoms, and sleep in chronic back pain among farmworkers warrants further examination. Refinements in outcome and exposure assessments are also needed given the lack of a standardized case definition and the variety of tasks and crops involved in farm work in the United States.

Adolescent back pain

PURPOSE OF REVIEW

Adolescent back pain poses a distinct diagnostic challenge to the physician due to skeletal maturity and activity levels seen in adolescent patients. The purpose of this review is to focus on the musculoskeletal causes of adolescent back pain and to review the current literature on the etiology, diagnosis and treatment options.

RECENT FINDINGS

Etiologies of adolescent back pain include a vast differential diagnosis, including traumatic, morphologic, infectious and neoplastic etiologies. Recent literature has focused on spondylolysis, back pack-related pain, disc herniations and back pain in adolescent athletes. Recent anatomic studies have demonstrated a distinct morphology to spondylytic spines attributing the etiology of spondylolysis in part to morphologic predispositions.

SUMMARY

Increasing numbers of active adolescents will lead to increasing complaints of back pain seen by the primary care physician. Recent epidemiological studies have suggested a correlation between adolescent back pain and adult-onset back pain. A systematic approach to the adolescent with back pain is for arriving at a clear diagnosis and guiding appropriate treatments.