Low back disorders in agriculture and the role of stooped work: scope, potential interventions, and research needs

Low back disorders (LBDs) continue to be a major occupational health problem facing the agricultural workforce. Working in a flexed or stooped posture is one of several workplace factors associated with occupationally related LBDs and is highly prevalent in many agricultural tasks. The purpose of this article is to evaluate the role of stooped work in the problem of LBDs among agricultural workers by examining the epidemiological literature, evaluating the scope of stooped work in agriculture, and examining current and potential intervention approaches. The literature review indicates that the prevalence of LBDs in agriculture worldwide is considerably high and substantially reported. Workers who are exposed to stooped work in agriculture are estimated to be in the 100s of millions worldwide. However, stooped work has not been specifically investigated as an independent LBD risk factor. Plausible biomechanical and physiological mechanisms of how stooped work may lead to damage to the spinal structures are discussed, and this complements the epidemiological evidence of high prevalence of LBDs in agriculture. However, this study also identifies the need to conduct more thorough epidemiological studies that utilize accurate quantitative exposure and outcome assessment techniques for developing more appropriate dose-response relationships in agricultural stooped work. This will provide better means for evaluating current and future interventions for jobs involving stooped work. Various intervention approaches are summarized to control and abate stooped work in agriculture; however, it must be emphasized that any development of ergonomic interventions for stooped work in agriculture must incorporate a participatory ergonomics approach that integrates the opinions and concerns of workers, managers, and ergonomists.