Work-Related Musculoskeletal Disorders, Risk Levels, and “Fear Avoidance Beliefs” among Workers in Oserian Farm Nakuru County

Abstract

Work-related Musculoskeletal Disorders (WMSD) are the most prevalent cause of disability in both developing and developed countries. They are a global public health concern to healthcare systems, social-care systems and the concerned individuals because, their overall result is reduced productivity, economic drain, work absence, physical disability and mental disorders. These are majorly caused by occupational activities. Psychological factors such as ‘Fear Avoidance Beliefs’ may influence the behavior of acute and chronic pain. Chronic pain manifests with catastrophizing pain that often lead to severe pain, re-injury or disability. The main objective of this study was to determine work-related musculoskeletal disorders, risk levels and ‘Fear Avoidance Beliefs’ among flower farm workers in Oserian farm Nakuru County. A descriptive cross-sectional study was conducted among flower farm workers in Oserian farm. A sample size of 270 respondents from a population of 897 farm workers was used. Data was collected using interviewer administered questionnaires, which included Nordic Musculoskeletal Questionnaire (NMQ) for determining the prevalence of work-related musculoskeletal disorders, the Rapid Entire Body Assessment Questionnaire (REBAQ) for occupational risk assessment and ‘Fear Avoidance Belief’ Questionnaire (FABQ) which determined the proportions of pain ‘Fear Avoidance Beliefs’. Statistical analysis was undertaken using SPSS version 25. The difference between parameters were deemed statistically significant at p< 0.05. Frequency tables and percentages were used to explore trends in the data of descriptive statistics. Chi-square statistics was used to test for association between variables. A total of 184 (68.1%) respondents reported musculoskeletal discomfort within the previous 12 months. Among the 184 respondents, 178 were performing general farm work. Most of the WMSD were reported in the lower back (38.1%), followed by the wrist and hands (24.1%) and ankle and feet (24.1%). There was a strong association between job designation as a general worker and WMSD (p=0.016). Age (p=0.027) and the length of time the farm worker had worked (p=0.041) was also associated with WMSD. Fear Avoidance beliefs of pain existed across all 184 respondents as, ‘decreased risk of persistent problems', 'increased risk of reporting no improvement', 'decreased risk for not returning to work', and 'increased risk of not returning to work' at 36.4%, 27.2%, 18.5%, and 17.9% respectively. There was medium, high and very high risk associated with developing WMSD at 26.6%, 43.5%, and 29.9% respectively. It was found out that work-related musculoskeletal disorders affect over two-thirds of flower farm workers, and the lower back is the most affected area. Specific farm job designations, the age of the worker, and the duration of time involved over the long term may predispose workers to various risks that may result in the development of WMSDs. ‘Fear Avoidance Beliefs’ exist and permeates across the entire flower farm work-force although at different levels of severity. Lastly, almost 75% farm workers report a higher risk to exposure of developing WMSD.