Equity in Whom Gets Studied: A Systematic Review Examining Geographical Region, Gender, Commodity, and Employment Context in Research of Low Back Disorders in Farmers

Abstract

Farmers are at high risk of having low back disorders (LBDs). Agriculture employs half the global workforce, but it is unclear whether all farming populations are represented equitably in the LBD literature. This systematic review quantifies the number and quality of research studies by geographical region, agricultural commodity, and farmer characteristics. MEDLINE, Web of Science, CINAHL, Scopus, and Embase databases were searched using conceptual groups of search terms: "farming" and "LBD." Screening and extraction were performed by two researchers in parallel, then reconciled through discussion. Extracted study characteristics included location of study; commodity produced; worker sex, ethnicity, and migration status; type of employment; and study quality. These were compared with agricultural employment statistics from the International Labour Organization and World Bank. From 125 articles, roughly half (67) did not specify the employment context of the participants in terms of migration status or subsistence versus commercial farming. Although in many regions worldwide women make up the bulk of the workforce, only a minority of low back disorder studies focus on women. Despite the predominance of the agricultural workforce in developing nations, 91% of included studies were conducted in developed nations. There was no significant difference in study quality by geographic region. The nature of the world's agricultural workforce is poorly represented by the literature when it comes to LBD research. If developing nations, female sex, and migrant work are related to increased vulnerability, then these groups need more representation to achieve equitable occupational health study.

A Review on Ergonomics in Agriculture. Part I: Manual Operations

“…Thus, determining the principal risk factors for MSDs and testing interventions for their decrease are of major importance. The present results agree, to a great extent, with the findings of Trask et al [28], who examined, among other factors, the geographical distribution of the research organizations engaging with low back disorders due to agricultural occupation.…”

“…Investigations dealing with milking, fishing, and livestock were also excluded. Moreover, review papers were found that either summarized papers that were performed before 2010 or studied safety, geographical, and psycholsociological factors [27][28][29]. As a consequence, they were also excluded from the present literature survey.…”

Musculoskeletal Disorders in Agriculture: A Review from Web of Science Core Collection

“…On the other hand, MSDs are directly related to gender anthropometry. Women not only perform agricultural work but household chores also fall to them (China, India, Iran, Ethiopia, Spain, France, Sweden, Poland, Finland, Germany, Canada and Italy) [23,24,36,80,83,103,[165][166][167][168][169][170][171][172][173][174].…”

“…In a review study, they reported that 91% of the studies had been conducted in developed countries. Furthermore, only very few deal with lower-back disorders in women (Canada) [171].…”

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

“…A search was conducted in three main electronic published databases from inception: Ovid Medline (1946 to 2015), EMBASE (1974 to 2015), and Global Health ePublications (1973 to 2015). The main search terms included conceptual groups of synonyms for "low back disorders" as applied in previous reviews [21], and "waste collection workers" (a full list of search terms is shown in supplemental materials). After the initial search was conducted, the reference lists of included articles were also searched for relevant articles.…”