Prevalence and risk factors of low back disorders among waste collection workers: A systematic review

BACKGROUND: Waste management is a growing industry worldwide. Working conditions may entail risk factors for musculoskeletal disorders, and especially low back disorders (LBD). OBJECTIVE: The purpose of this study was to perform a systematic review on: (i) the prevalence of LBD; and (ii) risk factors for LBD among waste collection workers. METHOD: A search was conducted in three electronic databases: Ovid Medline, EMBASE, and Global Health ePublications. Data were extracted on study design, sampling strategy, geographical region, LBD prevalence, and risk factors. Data were reported narratively. RESULTS: Thirteen full-text articles met the study criteria. Using a range of definitions for LBD, the included articles reported a 12-month prevalence of 'LBD' between 16 to 74%, although none of the included studies quantified relationships between risk factors and LBD. None of the studies met all 9 risk of bias criteria. No articles investigated the association of risk factors and LBD, but even in absence this evidence authors of included studies suggested physical risk factors for LBD among waste workers: awkward posture, repetitive motion, and work duration. CONCLUSION: In light of these risks and future growth in this industry, the lack of high quality studies and investigation of risk factors highlight the need for more research in this sector which will support future LBD prevention efforts.