Document Type : Original Article
1 Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Emergency Medicine Center, Tabriz University of Medical sciences, Tabriz, Iran
3 Social Medicine Department, Social Determinants of Health Research Center, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
4 Community and Mental Health Nursing Department, Social Determinants of Health Research Center, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
5 Centre of Qualitative Studies, Tabriz University of Medical Sciences, Tabriz, Iran
Objective: Low back pain is one of the most important job injuries among emergency medical personnel. This study was carried out to investigate the prevalence of low back pain as well as its physical, mental and managerial predisposing factors among emergency medical personnel in Iran.
Methods: In this analytical cross-sectional study we recruited 298 pre-hospital emergency medical personnel based on census sampling. Data were gathered using Nordic and a research-made questionnaire related to physical, mental and managerial back pain factors. Data were analyzed using SPSS version 20. Descriptive and analytical tests including chi-square test were used appropriately. P value less than 0.05 was considered as the level of significance.
Results: Findings showed that 46.3% of pre- hospital emergency technicians had a history of low back pain with different intensities. We observed a significant relationship between age, work experience, occupational-physical factors with low back pain (P > 0.001). However, there was no significant relationship between occupational-managerial factors and mental-occupational factors with low back pain (P > 0.05).
Conclusion: Results show that the prevalence of back pain among emergency medical personnel is high. Identifying the factors associated with back pain can help the managers as well as the personnel to control the problem of back pain and increase employees’ productivity.
2. Beurskens AJ, de Vet HC, Koke AJ, van der Heijden GJ, Knipschild PG. Measuring the functional status of patients with low back pain. Assessment of the quality of four disease-specific questionnaires. Spine (Phila Pa 1976) 1995;20(9): 1017-28.
3. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain 2000; 84(1): 95-103.
4. Studnek JR, Crawford JM. Factors associated with back problems among emergency medical technicians. Am J Ind Med 2007; 50(6): 464-9. doi: 10.1002/ajim.20463.
5. Okada N, Ishii N, Nakata M, Nakayama S. Occupational stress among Japanese emergency medical technicians: Hyogo Prefecture. Prehosp Disaster Med 2005; 20(2): 115-21.
6. Young KM, Cooper CL. Occupational stress in the ambulance service: a diagnostic study. Journal of Managerial Psychology 1995; 10(3): 29-36.doi:10.1108/02683949510081356.
7. Sterud T, Ekeberg O, Hem E. Health status in the ambulance services: a systematic review. BMC Health Serv Res 2006; 6:82. doi: 10.1186/1472-6963-6-82.
8. Vlok J. An investigation into the prevalence and occupational risk factors of low back pain in emergency medical services personnel [dissertation]. KwaZulu Natal,South Africa: Durban University of Technology; 2005.
9. Rodgers LM. A five year study comparing early retirements on medical grounds in ambulance personnel with those in other groups of health service staff: Part II: Causes of retirements. Occup Med 1998; 48(2): 119-32. doi: 10.1093/
10. Crill MT, Hostler D. Back strength and flexibility of EMS providers in practicing prehospital providers. J Occup Rehabil 2005; 15(2): 105-11.
11. Palmer KT, Griffin MJ, Bendall H, Pannett B, Coggon D. Prevalence and pattern of occupational exposure to whole body vibration in Great Britain: findings from a national survey. Occup Environ Med 2000; 57(4): 229-36. doi:10.1136/oem.57.4.229
13. Maguire BJ, Hunting KL, Guidotti TL, Smith GS. Occupational injuries among emergency medical services personnel. Prehosp Emerg Care 2005; 9(4): 405-11. doi:10.1080/10903120500255065.
14. Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, et al. Rescuers at risk: a systematic review
and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol 2012; 47(6): 1001-11. doi:10.1007/s00127-011-0408-2.
15. Adib-Hajbaghery M, Zohrehea J. Back pain among paramedics: a pilot study. Nurs Midwifery Stud 2013; 2(4):103-4.
16. Deros BM, Daruis DD, Thiruchelvam S, Othman R, Ismail D, Faezah Rabani N, et al. Evaluation on ambulance
design and musculoskeletal disorders risk factors among ambulance emergency medical service personnel. Iran J Public Health 2016; 45(1): 52-60.
17. Mokhtarinia H, Shafiee A, Pashmdarfard M. Translation and localization of the Extended Nordic Musculoskeletal Questionnaire and the evaluation of the face validity and test-retest reliability of its Persian version. Journal of Ergonomics 2015; 3(3): 21-9.
18. Fisher TF, Wintermeyer SF. Musculoskeletal disorders in EMS: Creating employee awareness. Prof Saf 2012;57(7): 30-4.
19. Aliabadi Z, Kafaie S, Sarchahi K, PoorSadegh A, Kazemi M. Prevalence of herniated lumbar disk among nurses working in two educational hospitals of Birjand University of Medical Sciences. Mod Care J 2010; 7(1): 25-9.
20. Karahan A, Kav S, Abbasoglu A, Dogan N. Low back pain: prevalence and associated risk factors among hospital
staff. J Adv Nurs 2009; 65(3): 516-24. doi: 10.1111/j.1365-2648.2008.04905.x.
21. Liao H, Arvey RD, Butler RJ, Nutting SM. Correlates of work injury frequency and duration among firefighters. J Occup Health Psychol 2001; 6(3): 229-42.
22. Maetzel A, Li L. The economic burden of low back pain: a review of studies published between 1996 and 2001. Best
Pract Res Clin Rheumatol 2002; 16(1): 23-30. doi: 10.1053/berh.2001.0204.
prevention. J Occup Environ Med 1999; 41(12): 1024-31.
24. Stevenson JM, Weber CL, Smith JT, Dumas GA, Albert WJ. A longitudinal study of the development of low back pain
in an industrial population. Spine (Phila Pa 1976) 2001; 26(12): 1370-7.
25. Ernst E. Smoking and back pain. Ann Rheum Dis 1991; 50(9): 658-9. doi: 10.1136/ard.50.9.658-c.
26. Scott SC, Goldberg MS, Mayo NE, Stock SR, Poitras B. The association between cigarette smoking and back pain in
adults. Spine (Phila Pa 1976) 1999; 24(11): 1090-8.
27. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between smoking and low back
pain: a meta-analysis. Am J Med 2010; 123(1): 87.e7-35.doi: 10.1016/j.amjmed.2009.05.028.
28. Lipscomb J, Trinkoff A, Brady B, Geiger-Brown J. Health care system changes and reported musculoskeletal disorders
among registered nurses. Am J Public Health 2004; 94(8):1431-5.
29. Collins JW, Wolf L, Bell J, Evanoff B. An evaluation of a “best practices” musculoskeletal injury prevention program in
nursing homes. Inj Prev 2004; 10(4): 206-11. doi: 10.1136/ip.2004.005595.
30. Marras WS, Davis KG, Kirking BC, Bertsche PK. A comprehensive analysis of low-back disorder risk and spinal loading during the transferring and repositioning of patients using different techniques. Ergonomics 1999; 42(7): 904-26. doi: 10.1080/001401399185207.
31. Reminiac F, Jouan Y, Cazals X, Bodin JF, Dequin PF, Guillon A. Risks associated with obese patient handling in emergency prehospital care. Prehosp Emerg Care 2014;18(4): 555-7. doi: 10.3109/10903127.2014.912708.
32. Arial M, Benoit D, Wild P. Exploring implicit preventive strategies in prehospital emergency workers: a novelapproach for preventing back problems. Appl Ergon 2014;45(4): 1003-9. doi: 10.1016/j.apergo.2013.12.005.
33. Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM. Systematic review of psychosocial factors
at work and private life as risk factors for back pain. Spine(Phila Pa 1976) 2000; 25(16): 2114-25.
34. Yip Y. A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong. J Adv Nurs 2001; 36(6): 794-804.