Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam

Background The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, ca...

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Autores principales: Geere, J., Bartram, J., Bates, L., Danquah, L., Evans, B., Fisher, M.B., Groce, N., Majuru, B., Mokoena, M.M., Mukhola, M.S., Hung Nguyen-Viet, Phuc Pham Duc, Williams, A.R., Schmidt, W.P., Hunter, P.R.
Formato: Journal Article
Lenguaje:Inglés
Publicado: International Society of Global Health 2018
Materias:
Acceso en línea:https://hdl.handle.net/10568/91210
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author Geere, J.
Bartram, J.
Bates, L.
Danquah, L.
Evans, B.
Fisher, M.B.
Groce, N.
Majuru, B.
Mokoena, M.M.
Mukhola, M.S.
Hung Nguyen-Viet
Phuc Pham Duc
Williams, A.R.
Schmidt, W.P.
Hunter, P.R.
author_browse Bartram, J.
Bates, L.
Danquah, L.
Evans, B.
Fisher, M.B.
Geere, J.
Groce, N.
Hung Nguyen-Viet
Hunter, P.R.
Majuru, B.
Mokoena, M.M.
Mukhola, M.S.
Phuc Pham Duc
Schmidt, W.P.
Williams, A.R.
author_facet Geere, J.
Bartram, J.
Bates, L.
Danquah, L.
Evans, B.
Fisher, M.B.
Groce, N.
Majuru, B.
Mokoena, M.M.
Mukhola, M.S.
Hung Nguyen-Viet
Phuc Pham Duc
Williams, A.R.
Schmidt, W.P.
Hunter, P.R.
author_sort Geere, J.
collection Repository of Agricultural Research Outputs (CGSpace)
description Background The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household’s water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children. Methods A cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Generalised Estimating Equations (GEE) investigated water carrying as a risk factor for general health and self-reported pain. Results People who previously carried water had increased relative risk of reporting pain in the hands (risk ratio RR 3.62, 95% confidence interval CI 1.34 to 9.75) and upper back (RR 2.27, 95% CI 1.17 to 4.40), as did people who currently carry water (RR hand pain 3.11, 95% CI 1.34 to 7.23; RR upper back pain 2.16, 95% CI 1.25 to 3.73). The factor analysis results indicate that factor 1, ‘axial compression’, which is correlated with pain in the head and upper back, chest/ribs, hands, feet and abdomen/stomach, is associated with currently (0.30, 95% CI 0.17 to 0.43) or previously (0.21, 95% CI 0.01 to 0.42) carrying water. Factor 2, ‘soft tissue strain’, which is correlated with pain in the neck, shoulders/arms, lower back and hips/pelvis or legs, is marginally negatively associated with currently (-0.18, 95% CI -0.32 to -0.04) carrying water. The factor ‘axial compression’ was more strongly associated with carrying water containers on the head. Conclusions Participants who reported a history of current or past water carrying more frequently reported pain in locations most likely to be associated with sustained spinal axial compression in the cervical region. Given the fact that cervical spinal conditions are globally one of the more common causes of disability, our findings suggest that water carrying, especially by head loading is a major contributing factor in musculoskeletal disease burden in low income countries. Our findings support the proposed indicator for monitoring SDG6.1: “Percentage of population using safely managed drinking water services at home.”
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spelling CGSpace912102024-05-01T08:19:24Z Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam Geere, J. Bartram, J. Bates, L. Danquah, L. Evans, B. Fisher, M.B. Groce, N. Majuru, B. Mokoena, M.M. Mukhola, M.S. Hung Nguyen-Viet Phuc Pham Duc Williams, A.R. Schmidt, W.P. Hunter, P.R. health water women gender Background The Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household’s water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children. Methods A cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Generalised Estimating Equations (GEE) investigated water carrying as a risk factor for general health and self-reported pain. Results People who previously carried water had increased relative risk of reporting pain in the hands (risk ratio RR 3.62, 95% confidence interval CI 1.34 to 9.75) and upper back (RR 2.27, 95% CI 1.17 to 4.40), as did people who currently carry water (RR hand pain 3.11, 95% CI 1.34 to 7.23; RR upper back pain 2.16, 95% CI 1.25 to 3.73). The factor analysis results indicate that factor 1, ‘axial compression’, which is correlated with pain in the head and upper back, chest/ribs, hands, feet and abdomen/stomach, is associated with currently (0.30, 95% CI 0.17 to 0.43) or previously (0.21, 95% CI 0.01 to 0.42) carrying water. Factor 2, ‘soft tissue strain’, which is correlated with pain in the neck, shoulders/arms, lower back and hips/pelvis or legs, is marginally negatively associated with currently (-0.18, 95% CI -0.32 to -0.04) carrying water. The factor ‘axial compression’ was more strongly associated with carrying water containers on the head. Conclusions Participants who reported a history of current or past water carrying more frequently reported pain in locations most likely to be associated with sustained spinal axial compression in the cervical region. Given the fact that cervical spinal conditions are globally one of the more common causes of disability, our findings suggest that water carrying, especially by head loading is a major contributing factor in musculoskeletal disease burden in low income countries. Our findings support the proposed indicator for monitoring SDG6.1: “Percentage of population using safely managed drinking water services at home.” 2018-06 2018-02-28T16:21:56Z 2018-02-28T16:21:56Z Journal Article https://hdl.handle.net/10568/91210 en Open Access International Society of Global Health Geere, J., Bartram, J., Bates, L., Danquah, L., Evans, B., Fisher, M.B., Groce, N., Majuru, B., Mokoena, M.M., Mukhola, M.S., Hung Nguyen-Viet, Phuc Pham Duc, Williams, A.R., Schmidt, W.-P. and Hunter, P.R. 2018. Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam. Journal of Global Health 8: 010406.
spellingShingle health
water
women
gender
Geere, J.
Bartram, J.
Bates, L.
Danquah, L.
Evans, B.
Fisher, M.B.
Groce, N.
Majuru, B.
Mokoena, M.M.
Mukhola, M.S.
Hung Nguyen-Viet
Phuc Pham Duc
Williams, A.R.
Schmidt, W.P.
Hunter, P.R.
Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title_full Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title_fullStr Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title_full_unstemmed Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title_short Carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries: a cross-sectional survey in South Africa, Ghana and Vietnam
title_sort carrying water may be a major contributor to disability from musculoskeletal disorders in low income countries a cross sectional survey in south africa ghana and vietnam
topic health
water
women
gender
url https://hdl.handle.net/10568/91210
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