|Year : 2019 | Volume
| Issue : 2 | Page : 127-133
Work-related musculoskeletal disorders among Nigerian police force
Adamu Ahmad Rufai1, Adewale Luqman Oyeyemi2, Stanley Monday Maduagwu3, Abah Daniel Fredrick4, Isma'ila Adamu Saidu2, Salamatu Umar Aliyu2, Aliyu Lawan1
1 Department of Physiotherapy, University of Maiduguri; Department of Physiotherapy, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
2 Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria
3 Department of Physiotherapy, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
4 Department of Physiotherapy, Federal Medical Centre, Nguru, Yobe State, Nigeria
|Date of Submission||25-Jan-2019|
|Date of Decision||11-Jun-2019|
|Date of Acceptance||18-Jun-2019|
|Date of Web Publication||19-Nov-2019|
Dr. Adamu Ahmad Rufai
Department of Physiotherapy, Faculty of Allied Health Sciences, College of Medical Sciences, University of Maiduguri, PMB 1096, Maiduguri
Source of Support: None, Conflict of Interest: None
Background: Work-related musculoskeletal disorders (WMSDs) have become a cause for concern in both the developed and developing countries. Objective: To determine the prevalence of WMSDs among the Nigerian Police Force in Maiduguri. Methods: A total of 253 police officers participated in this cross-sectional study. Modified Nordic Questionnaire was administered to assess the WMSDs of the participants. Descriptive statistics of mean, standard deviation, frequency, and percentages were used to describe the data, while the differences in the prevalence of WMSDs by sociodemographic characteristics and occupational factors were tested with Chi-square statistics. Results: The 12-month prevalence of WMSDs was 80.6%. Lower back was the most commonly affected body region with 74.1%. About 71% of police officers had a gradual onset of WMSDs. A majority of the participants (56.6%) identified working in the same position for a long period as the most common risk factor for WMSDs. Significant difference in the 12-month prevalence of WMSDs was found among police officers of different age groups (χ2 = 7.85; P= 0.002), years of working experience (χ2 = 10.05; P= 0.007), and hours spent at work per day (χ2 = 9.87; P= 0.007). Conclusion: There was a high 12-month prevalence of WMSDs among the police officers with the lower back being the most commonly reported body region. The prevalence of WMSDs was associated with higher age, higher working experience, and longer working hours/day. There is the need to integrate ergonomic education in the training of police officers to prevent/reduce the occurrence of WMSDs among this population.
Keywords: Musculoskeletal disorder, police force, police officers, prevalence
|How to cite this article:|
Rufai AA, Oyeyemi AL, Maduagwu SM, Fredrick AD, Saidu IA, Aliyu SU, Lawan A. Work-related musculoskeletal disorders among Nigerian police force. Niger J Basic Clin Sci 2019;16:127-33
|How to cite this URL:|
Rufai AA, Oyeyemi AL, Maduagwu SM, Fredrick AD, Saidu IA, Aliyu SU, Lawan A. Work-related musculoskeletal disorders among Nigerian police force. Niger J Basic Clin Sci [serial online] 2019 [cited 2020 Jan 24];16:127-33. Available from: http://www.njbcs.net/text.asp?2019/16/2/127/270998
| Introduction|| |
Musculoskeletal disorders (MSDs) are injuries or pain in the body that affect bodily structures such as joints, ligaments, muscles, nerves, tendons and supporting blood vessels of the limbs, neck, and back., The disorders cut across a range of inflammatory and degenerative conditions that affect these bodily structures with resultant ache, pain, or discomfort. When musculoskeletal injuries are sustained from work, they are referred to as work-related musculoskeletal disorders (WMSDs). WMSDs are major causes of pain, disability, absenteeism, reduced productivity, and heavy financial cost among workers worldwide.,, In the United States, the condition has greatly affected the private sector with about 3200 cases per year of lost work day, representing 29% of all claims due to lost day injury and illness.
A number of intrinsic and extrinsic factors have been involved in the etiology of WMSDs. Excessive repetitions, awkward posture, and heavy lifting are major biomechanical risk factors of WMSDs. Other factors such as physical activity level, psychosocial factors (stress), and absence of ergonomics viability may be linked with WMSD symptom and prevalence., All of the aforementioned are common occupational related risks. One of the occupations that can expose one to such MSDs is policing., Policing is a high-stress occupation that is prone to a high level of traumatic and nontraumatic stressors., Police officers fall under the category of workers who are exposed daily to violence, with high job demand and the risk of death; their activities are stressful, and sometimes demands physical tasks. The symptoms of MSDs seen in police officers may occur in different parts of the body, but with a higher prevalence for back and lower limbs.,
Police officers, however, represent an understudied occupational group, with only few studies available. One of such studies investigated the prevalence of low back pain among traffic police. Another study on prevalence of work-related musculoskeletal symptoms among traffic police in Navi Mumbai, India, showed regions of chronic pain to be lower back (38%), upper back (36%), and acute pain to be 15% and 13% for the lower back and upper back, respectively. Symptoms of MSDs among both operation and administrative categories of police officers were also studied in Sao Paulo, Brazil. In Nigeria, only one study investigated prevalence of low back among traffic wardens in Lagos. There is, however, scarcity of data on the prevalence of WMSDs among members of the police force in the north-east region of Nigeria. This study aimed to investigate the 12-month prevalence of WMSDs among members of the Nigerian police in Maiduguri, Borno State.
| Methods|| |
Police officers working under the Maiduguri Area command were recruited to participate in this study. Those included were police officers with at least 1 year working experience. Those excluded were retired police officers, police officers with an established previous musculoskeletal injuries, and/or neurological disorders. The sampling technique used to recruit participants in this study was sample of convenience. Sample size used was determined by the formula for a finite population according to Taro Yamane. The formula is thus
n = N/1 + N (e)2
where n = sample size, N = finite population, e = level of significance, and 1 = unit constant.
Hence, a total of 329 participants were required taking 30% attrition rate.
Instrument and procedure
A close-ended structured questionnaire, drafted and modified from the short version of the standardized Nordic Musculoskeletal Questionnaire for investigating work-related musculoskeletal symptoms in working populations, was used in this study. The questionnaire comprised two parts: The first part was meant for sociodemographic characteristics of the respondents. The second comprised questions on prevalence, risk factors, and coping strategies of WMSDs. Questions on prevalence portrayed a portrait of human structure with nine body parts as follows: neck, shoulders, upper back, lower back, elbows, wrists/hands, thighs, knees, and ankles. This structure was meant for a table that demands a “yes” or “no” response for each body part to three questions pertaining to 12 months prevalence, 7-day prevalence, and any disability during the last year (annual disability).
In all, 335 copies of the questionnaire were taken to various divisional police stations in Maiduguri through personal visits. After formal introduction, the audience of the prospecting participants was sought and the study was explained to them in detail as much as possible. This includes the merits and demerits (if any). Confidentiality and anonymity of all information obtained were as assured. It was also made clear to them that participation was voluntary. After obtaining their informed consent, questionnaires were distributed to the participants by one of the researchers (FDA). This questionnaire took less than 15 minutes to complete. Neither request was received nor provision was made for any inducement.
Standard protocol approval and patient consent
Prior to the commencement of this study, approval was sought and obtained from the Research and Ethics Committee of the University of Maiduguri Teaching Hospital. An introduction letter was taken to Borno State Police Command requesting permission to conduct the study. The purpose of the study was clearly explained to all the prospecting participants who were met at the various divisional police stations through personal visits by one of the researchers (FDA) before administering the questionnaire. Participants who were willing to take part in the study were then given an informed consent form to append their signature, and subsequently, the study questionnaire was given to them.
Statistical Package for Social Sciences (SPSS) version 20 was used for data analyses. Descriptive statistics of mean, standard deviation, frequency, and percentages were used to describe the data, while the differences in the prevalence of WMSDs by sociodemographic characteristics and occupational factors were tested by Chi-square test. Significant level was set at P < 0.05.
| Results|| |
A total of 253 respondents out of the 329 required sample participated in this study giving 76.9% response rate. They comprised 213 (84.2%) males and 40 (15.8%) females with a mean age of 38.26 ± 8.05 years and body mass index (BMI) of 23.84 ± 3.84 kg/m2. A majority of the participants had secondary level of education [127 (54.2%)], 10–20 years of working experience (51.8%), and worked for more than 12 hours per day (45.6%). The details of the participants' sociodemographic characteristics are presented in [Table 1].
|Table 1: Distribution of participants by sociodemographic characteristics (n=253)|
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Prevalence and pattern of WMSDs among the participants
The 12-month prevalence of WMSDs among the participants was 205 (81.0%). Over the past 12 months, the body region affected the most was the lower back [152 (74.1%)], followed by the neck [99 (48.3%)], and the least body region affected was the elbow (9.8%). In the last 7 days, lower back was the common body region affected by WMSD with a prevalence of 98 (47.8%), followed by the neck [60 (29.3%)], and the least body region affected was the elbow (4.9%). The distribution of WMSDs of participants is shown in [Table 2].
|Table 2: Previous 12 months and 7 days prevalence of WMSDs by body region (n=205)|
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Pattern of WMSDs affecting activities of daily living
The lower back was the most common body region that causes frequent limitation in activities of daily living (9.8%), followed by the neck (6.8%), and the least frequent was the elbow (2.1%). [Table 3] shows the pattern of WMSDs affecting activities of daily living.
Prevalence of WMSDs by sociodemographic characteristics
Higher prevalence of 93.3% and 83.1% was reported for age groups >55 and 36–55 years, respectively. Meanwhile, males had prevalence of 82.6% compared with 70% recorded for females. Also, participants who work for 24 hours, less than 10 years of working experience, and those who are overweight reported a prevalence of 80.5%, 76.2%, and 86.1%, respectively. There was no statistically significant difference in 12-month prevalence of WMSDs by gender, marital status, educational level, rank, job category, and BMI. However, there was statistically significant difference in 12-month prevalence of WMSDs among participants of different age groups (χ2 = 7.88; P = 0.019), years of working experience (χ2 = 10.05; P = 0.007), and hours spent at work per day (χ2 = 9.87; P = 0.007). The prevalence of WMSDs by sociodemographic characteristics of the participants is illustrated in [Table 4].
|Table 4: Prevalence of WMSDs by sociodemographic characteristics (n=205)|
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Onset, treatment, ergonomic training, and absence from work among police officers with WMSDs
It is reported in [Table 5] that 80 (39.0%) of police officers first experienced WMSDs within 2–5 years of policing, 146 (71.2%) had a gradual onset, and 173 (83.9%) had received treatment or are presently receiving treatment. However, a majority [147 (86.0%)] of the treatment were medication which were mostly prescribed by a doctor [86 (55.5%)]. Greater number of police officers [170 (82.9%)] have never had ergonomic training on WMSDs. Also, 44 (21.6%) of the participants have recorded absenteeism from work due to WMSDs.
Risk factors for WMSDs
Participants with WMSDs were asked to select among a list of 10 job risk factors, to show how each contributed to the manifestation of WMSDs. A majority [116 (56.6%)] of the participants identified “working in the same position for long period'' as the most common risk factor to their WMSDs, while working in awkward or cramped position was reported by 109 (53.2%) of the participants, to be the second risk factor of WMSDs. The least risk factor commonly identified by the participants was carrying, lifting, or moving heavy materials (eg., bulletproof vest, gun, etc.) [60 (29.3%)]. [Table 6] shows detailed information on job risk factors
The coping strategies adopted by police officers with WMSDs are shown in [Table 7]. Changing sitting and standing posture while on duty [82 (40.0%)] and frequent stretching [73 (35.6%)] were the two most commonly adopted strategies by the participants. The two least adopted coping strategies were selecting work/function that will not aggravate or provoke discomfort [10 (4.9%)] and seeking permission for absence from work [14 (6.8%)].
| Discussion|| |
The purpose of this study was to determine the 12-month prevalence and occupational factors of WMSDs among members of the Nigerian Police Force in Maiduguri area command. The majority of the participants in the study were males, which was found to be similar with a reported study from Brazil. Our finding confirms the assumption that the police force is a male-dominated profession in Nigeria. Also, the mean BMI of the participants in this study suggests that a majority of the police officers have normal body weight status and this was in line with a study that assessed symptoms of MSDs among Brazilian police officers.
The present study showed a high prevalence of WMSDs among police officers. Interestingly, this is similar to the 12-month prevalence rate of 75% among police officers in Brazil. The similarity was not surprising as the two populations shared common characteristics. This prevalence is, however, more than that reported among nurses (67.8%) in Ibadan. Perhaps, this could be attributed to little or no knowledge on ergonomic training among police officers compared with nurses who are healthcare professionals. In addition, high prevalence observed in this study, when compared with the prevalence among nurses, may be due to differences in the population studied. Also, a study conducted among self-employed sewing machine operators showed relatively lower prevalence (43.4%) in comparison to the present study. Here, the difference may be due to the fact that police officers are often deployed to work under supervision, which may not warrant them to decide when to be on duty at their own will. On the contrary, self-employed sewing machine operators have the autonomy to decide when to come/close to/from work. In the same vein, Tinubu et al. opined that subjectivity of terms, organizational differences in work settings, and perception of reporting of pain and disorders are adduced for the variation in rate of WMSDs in the different studies.
From the outcome of this study, the highest 12-month prevalence was reported in the lower back (74.1%). This finding is consistent with other figures reported in previous studies.,, A study among the traffic police by Hassan in Comilla city, Bangladesh, found 80% prevalence, while Ana-Paula et al. reported 51.5% prevalence among police officers in Sao Paulo, Brazil, whereas in a study among traffic wardens in Lagos, Nigeria, Akodu et al. showed 69.5% had low back pain. This could be as a result of incorrect work station and working in awkward position. The pattern of WMSDs on activities of the daily living among participants of this study revealed that lower back was the body region that negatively affected activities of daily living in a majority of the police officers. Lower back pain was reported by Choobineh and Kasson to be the major cause of disabilities among work place which tallies with this study.
In this study, there was significant difference in the prevalence of WMSDs among participants of various age groups. Participants >55 years old had the highest prevalence of WMSDs (93.3%) compared with their counterpart in the lower age groups. This finding implies that age is associated with prevalence, and this is in line with previous studies that identified an association between age and prevalence of WMSDs.,
Findings of this study reveal that there is significant difference in the prevalence of WMSDs among participants with different years of working experiences. The highest prevalence was reported among participants with >20 years of working experiences, followed by those with 10–20 years of working experience. This outcome implies that increased years of working experience is associated with higher prevalence of WMSDs and agrees with the results reported in an earlier study, which observed that increase in years of working experience was a predisposing factor to the development of WMSDs. Moreover, duration of service has been reported to be positively related to musculoskeletal symptoms.
Significant difference in the prevalence of WMSDs among the participants, with different hours spent at work per day, was observed. The prevalence rate of police officers who work less than 12 hours was 65.1% and those greater than 12 hours was 80.5%. This is in conformity with the findings of Beibei et al., who reported that prolong working hours is associated with WMSDs. Although the prevalence of WMSDs was not significantly different among job category, the highest prevalence of WMSDs was observed among participants within operation category. This finding could be because those within this category have high physical job demand and it is associated with MSDs.
Even though the prevalence of WMSDs was not significantly different among participants with different ranks. A Majority (88.9%) of the participants who are inspectors had the highest prevalence of WMSDs. This may be because increase in rank is linked with increased years of service and most of the inspectors in this study have increased years of working experience which may be associated with the prevalence of WMSDs. Another study reported that duration of service is positively related to musculoskeletal symptoms pain.
There are some limitations that should be considered when interpreting the findings of this study. The cross-sectional design used means that interpretation of the cause and effect to the variables found in the study may not be established. Sample of convenience was used for recruitment, and hence the participants may not be true representatives of the police in Maiduguri. However, the sample size was calculated using established scientific formula. Also, the Modified Nordic Questionnaire used in this study is the most common tool used for assessment of MSDs in various populations including the police. Together, these added to the strength of the study.
| Conclusion|| |
There was a high 12-month prevalence of WMSDs among the police officers with lower back being the most commonly reported body region. The prevalence of WMSDs was associated with higher age, higher working experience, and longer working hours/day. Based on the findings of this study, it is important to integrate ergonomic education in the training of police officers and improve their working condition. This is to prevent/reduce the occurrence of WMSDs and to promote health as well as improving the quality of life among this population.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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