Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
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DOI：
10.7189/jogh.08.010406
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发表时间：
2018-06-01
影响因子：
7.2
通讯作者：
Hunter, Paul R.
中科院分区：
文献类型：
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作者：
Geere, Jo-Anne;Bartram, Jamie;Hunter, Paul R.
背景可持续发展目标包括消除贫困、促进全民教育、性别平等、水供应和人人享有体面工作的承诺。一个重要的制约因素是，每天都有数百万妇女和儿童，而男子则少得多，从小区外的水源取水回家。取水负担使妇女无法接受教育和从事有酬工作，从而加剧了两性不平等。尽管人们猜测取水可能对健康产生影响，但几乎没有经验证据。我们报告的第一个大的研究对妇女和children.Methods进行了横断面调查，在南非，加纳和越南在2012年的健康影响进行水。它调查了取水方法和健康状况。因为自我报告的疼痛区域是相关的，我们对报告疼痛的部位进行了因子分析，以解释疼痛报告的模式。使用广义估计方程（GEE）的回归分析研究了携带水作为一般健康和自我报告疼痛的风险因素。结果以前携带水的人报告手部疼痛的相对风险增加（风险比RR 3.62，95%置信区间CI 1.34至9.75）和上背部（RR 2.27，95% CI 1.17至4.40），目前携带水的人也是如此（RR手部疼痛3.11，95% CI 1.34至7.23; RR上背部疼痛2.16，95% CI 1.25至3.73）。因子分析结果表明，与头部和上背部、胸部/肋骨、手、脚和腹部/胃部疼痛相关的因子1“轴向压迫”与当前（0.30，95%CI 0.17至0.43）或先前（0.21，95%CI 0.01至0.42）携带水相关。因子2，“软组织劳损”，与颈部、肩部/手臂、下背部和臀部/骨盆或腿部疼痛相关，与当前（-0.18，95%CI-0.32至-0.04）携带水轻微负相关。因素'轴向压缩'是更强烈地与携带水containers on the head.Conclusions参与者报告的历史，目前或过去的水携带更频繁地报告疼痛的位置最有可能与持续的脊柱轴向压缩在颈部区域。鉴于颈椎疾病是全球最常见的残疾原因之一，我们的研究结果表明，水的携带，特别是头部负荷，是低收入国家肌肉骨骼疾病负担的一个主要因素。我们的研究结果支持了监测可持续发展目标6.1的拟议指标：“在家中使用安全管理的饮用水服务的人口比例。"
Background The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household's water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children.Methods A cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Generalised Estimating Equations (GEE) investigated water carrying as a risk factor for general health and self-reported pain.Results People who previously carried water had increased relative risk of reporting pain in the hands (risk ratio RR 3.62, 95% confidence interval CI 1.34 to 9.75) and upper back (RR 2.27, 95% CI 1.17 to 4.40), as did people who currently carry water (RR hand pain 3.11, 95% CI 1.34 to 7.23; RR upper back pain 2.16, 95% CI 1.25 to 3.73). The factor analysis results indicate that factor 1, 'axial compression', which is correlated with pain in the head and upper back, chest/ribs, hands, feet and abdomen/stomach, is associated with currently (0.30, 95% CI 0.17 to 0.43) or previously (0.21, 95% CI 0.01 to 0.42) carrying water. Factor 2, 'soft tissue strain', which is correlated with pain in the neck, shoulders/arms, lower back and hips/pelvis or legs, is marginally negatively associated with currently (-0.18, 95% CI -0.32 to -0.04) carrying water. The factor 'axial compression' was more strongly associated with carrying water containers on the head.Conclusions Participants who reported a history of current or past water carrying more frequently reported pain in locations most likely to be associated with sustained spinal axial compression in the cervical region. Given the fact that cervical spinal conditions are globally one of the more common causes of disability, our findings suggest that water carrying, especially by head loading is a major contributing factor in musculoskeletal disease burden in low income countries. Our findings support the proposed indicator for monitoring SDG6.1: "Percentage of population using safely managed drinking water services at home."