The prevalence of low back pain and risk factors in academic teaching staff at King Abdulaziz University Jeddah:\\ A cross-sectional study

Abstract

BACKGROUND:

Low back pain (LBP) is one of the most common musculoskeletal disorder symptoms affecting adults’ health in the workplace including academic settings.

OBJECTIVE:

To estimate the prevalence of LBP among academic teaching staff at King Abdulaziz University, as well as to identify its socio-demographic and work-related risk factors.

METHODS:

A cross-sectional study design was used to estimate the prevalence of LBP and the risk factors in 123 academic teaching staff members at King Abdulaziz University. Data on LBP history and disability using Oswestry Disability Index (ODI), work-related and socio-demographic characteristics of study participants were collected using a semi-structured questionnaire. The prevalence of low back pain data was analyzed using frequency and percentage descriptive statistics, and Chi-square was used to identify group differences.

RESULTS:

A total of 123 academic teaching staff with a mean age of 37.5 years old of whom 79 (64.2%) were females and 44 (35.8%) were males completed a self-administrative questionnaire. Using a self-rating scale, approximately a quarter of academic teaching staff had moderate disability 25.2%; 4.9% had a severe disability; only one subject 0.8% was crippled. There has been a significant relationship between the number of years of experience and the extent of low back disability (P < 0.05). The Chi-square test revealed 56.3% of takes part with 11–15 years of experience have moderate disability relative to those with 0–5 years of experience (11.1%). There was a trend towards significance among academic teaching staff for the effect of the faculty stream on low back disability (P = 0.077, Chi-square test revealed teaching staff in the medical stream had the highest percentage of participates with minimal disability (78.7%) whereas in the scientific stream had the lowest percentage of minimal disability (52%).

CONCLUSION:

The findings of this study have shown that there is a major problem of low back pain among academic staff at King Abdulaziz University and that the situation in other higher education institutions in Saudi Arabia is changing.

Keywords

University teaching staff low back pain prevalence risk factors

1 Introduction

One of the most prevalent and serious musculoskeletal disorder symptoms affecting adult public health in the workplace is low back pain (LBP) [1 –6]. Low back pain was the world’s first major contributor to disability among the 291 diseases studied in 2010 and the third disability evaluation in Eastern Sub-Saharan Africa [7].

The prevalence of musculoskeletal pain was 77.8% among faculty members at Prince Sultan bin Abdulaziz University in Saudi Arabia, and the most common site of musculoskeletal pain was two of the three (low back, neck, and shoulder), with a prevalence of 38.9% [8].

The first study, undertaken in Saudi Arabia, evaluated the incidence of work-related musculoskeletal disorders among faculty members, with more than half of the 55 percent reporting musculoskeletal complaints [9]. The study’s participants, however, were limited to faculty from the College of Applied Medical Sciences.

Low back pain is one of the most common symptoms that causes medical attention. It’s the most prevalent musculoskeletal condition, [10]. The frequency of LBP in the general population ranges from 15% to 45% worldwide [11]. They reported the prevalence of LBP to be 18.8% among the general population in Saudi Arabia [12]. According to the 2017 Global Burden of Disease report, MSDs are the biggest cause of global disability, accounting for 16 percent of all years spent disabled, with low back pain (LBP) being the major cause of disability since 1990 [13].

Musculoskeletal disorders affect a third of the world’s population, making them the biggest cause of chronic disability. These problems frequently result in inability to work, absences, poor quality of work, lack of job satisfaction, and a higher risk of work-related injuries [14 –17]. Because of the required skills and type of work, they well documented in the literature that certain occupations are more prone to a higher prevalence of work-related MSDs than others [18, 19]. In healthcare settings, work-related illnesses and injuries have a higher prevalence compared to the general population.

Low back pain is a major problem among healthcare workers in Saudi Arabia, as it is in many other nations, particularly among nurses. The prevalence and risk factors in Saudi Arabia have previously been explored and found to be equivalent to values reported in the literature, ranging from 61.7% in Jeddah city [20] to 80% in Riyadh city [21]. The average global prevalence of LBP is 31% and for Africa, the 12-month prevalence is 33% for teenagers and 50% for adults [22]. The prevalence of back pain among doctors and dentists in India was found to be 50%, 61.9% between Ugandan nurses [23], 77.2% among theater nurses in Nigeria [24]. They predicted that in their history, over 80% of people deal with LBP [25].

Many recent studies in Saudi Arabia have investigated the prevalence of MSDs, particularly LBP [27 –29]. [27, 29]. A recent systematic review found that the prevalence of LBP in Saudi Arabia ranged from 53.2%–79.2% [26, 27]. Up to this point, research on the prevalence of MSDs in Saudi Arabia’s dentistry industry have mostly concentrated on dentists and dental students [28 –31]. Since the prevalence of LBP varies between 49% and 90%, most people will experience it at some stage in their lives [32]. This leads to high economic consequences, which are affected by reduced working hours, early retirement, lower population and lower productivity, and regular sick leave and works absence [22 , 33–37]. Low back pain is characterized by localized pain in the lumbar vertebrae, gluteal region, posterior thigh, and leg pain lasting one day [7 , 38–40].

Low back pain is a common burden in developing countries, with a prevalence of over 70% across the lifespan [39, 41]. Many studies have found that inadequate activity hurts spinal health [42, 43]. Heavy workloads, repetitive sitting, lifting, standing, bending, twisting, and excessive movement are all well-known risk factors for LBP, according to prevalence studies [36 , 44–47]. It is a commonly diagnosed disease among all work-related musculoskeletal conditions, such as low back intervertebral disks are susceptible to greater mechanical loading, repetitive pressure, intra-articular degenerative changes, and compressive force changes [6 , 48].

Studies in Ireland have shown that musculoskeletal disorders are one of the major factors for health retirement for teaching, such as LBP, which accounts for around 10% of the poor health of the population [49]. The job description of teaching includes several duties and activities that may affect LBP teaching. For example, teachers may experience prolonged sitting at home or in the workplace when preparing teaching materials.

To date, few studies have been carried out among the university’s academic teaching staff in developing countries, while teachers are a high-risk LBP community. To the authors’ knowledge, there have been no published studies in Saudi Arabia that have estimated risk factors for LBP among teaching staff. They have conducted only a few studies in the faculty of dentists, particularly in the city of Jeddah, Saudi Arabia. The aim of this study was to estimate the prevalence of LBP and risk factors among academic teaching staff at King Abdulaziz University.

2 Methods

2.1 Study design

A cross-sectional study was carried out at King Abdulaziz University, where the faculty of medical rehabilitation sciences is one of the university’s 32 constituent faculties.

2.2 Participants

A total of 129 (age ranged 25–50) with a mean age of 37.5, with 123 members of the academic teaching staff taking part. However, 6 participants were excluded from the analysis because of incomplete responses to the survey and the socio-demographic characteristics of the participants in Table 1. The study was conducted during the period October 2019 to March 2020, and the sample size was based on nonprobability with a convenient sampling technique. All university academic teaching staff who were eligible to take part in the study participated in the study samples. The selected participants were recruited based on full-time included university teaching staff providing lecturers between≤3 working hours a day and age25 years or older with working experience of over 12 months in the full-time.

Table 1
Socio-demographic characteristics

N N%

Age

•25–30 11 8.9%

•31–35 23 18.7%

•36–40 23 18.7%

•41–45 23 18.7%

•45–50 15 12.2%

•50+ 28 22.8%

Gender

•Male 44 35.8%

•Female 79 64.2%

Faculty tracks

•Medicine Track 47 38.2%

•Science track 25 20.3%

•Engineering track 14 11.4%

•Arts track 37 28.1%

Total 123 100%

	N	N%
Age
•25–30	11	8.9%
•31–35	23	18.7%
•36–40	23	18.7%
•41–45	23	18.7%
•45–50	15	12.2%
•50+	28	22.8%
Gender
•Male	44	35.8%
•Female	79	64.2%
Faculty tracks
•Medicine Track	47	38.2%
•Science track	25	20.3%
•Engineering track	14	11.4%
•Arts track	37	28.1%
Total	123	100%

All part-time faculty members who did not teach at least three days per week and who had a serious medical history, such as ankylosing spondylitis, gynecological diseases, tumors, infection, rheumatoid arthritis affecting the lumber spine, and all part-time faculty members who did not teach at least three days per week, were excluded. Before taking part in the study, each participant read and signed the consent form. They got the sampling frame for the academic teaching staff from the faculty list.

2.3 Data Collection

Data was collected by using self-administrative questionnaires. The questionnaire was divided into 3 components. The first component was given written informed consent to participate in the current study. The second component included socio-demographic characteristics of the study participants (age, gender, faculty), job characteristics of the study participants (Designation, Years of experience, Hours of lectures, Desk job per day, Posture), disability (Minimal disability, Moderate disability, Severe disability, Crippled). Component 2 titled the Oswestry Disability Index (ODI) also known as Oswestry low back pain Disability Questionnaire is a valid and reliable used by researchers and examiners of the condition to assess the permanent functional disability of an individual [50]. It is a pain-related disability measure for people with LBP. It comprises 10 topics relating to pain severity, lifting, ability to care for oneself, ability to walk, ability to sit, sex life, standing, social life, sleeping, and traveling. Six statements outlying various scenarios relating to the subject in the patient’s life followed each subject category. All participates were provided instructions on how to fill out the survey, and informed consent was obtained from each subject. The academic teaching staff then tests the statement, which resembles their condition most closely. The questionnaires scored from zero to five for each segment, on how pain affects daily activities, zero showing no disability, and scored 5 showing severe disability. The scores are summed for all the questions answered, and then multiplied by two to get the index (range 0 to 100). Zero is equal to no disability, 0 to 20% to a minimal disability, 21% to 40% to moderate disability, 41% to 60% to severe disability, 61% to 80% to cripple, and 81% to 100% to maximum disability [51].

2.4 Data analysis

Data were analyzed using SPSS version 22 and Microsoft Excel 2016. Descriptive statistics frequency and percentage (%) were used to demonstrate study main outcome measures and Chi-square tests were used to identify group differences. Pearson’s product-moment correlations were used to measure the relationships between the Oswestry Disability Index and age, gender, job designation, years of experience, hours of lectures, and desk job hours per day. A p < 0.05 value was found to be statistically significant.

3 Results

3.1 Descriptive statistics

A sample size of 129 (age ranged 25–50) with mean age 37.5 in teaching university staff 79(64.2%) were females and 44 (35.8%) were males completed a self-administrative questionnaire focused on LBP. However, 129 participants, 6 participants were excluded from the analysis due to incomplete responses to the survey and the socio-demographic characteristics of the participants in Table 1. Therefore, 123 participants were considered in the analyses.

3.2 Job characteristics of university teaching staff

Most of the participants were assistant professors (34.1%, Table 2). Most participants had 6–10 years of experience (24.4%, Table 2). Most of the participants had 3–4 hours of lectures (48.8%, Table 2) and 0–2 hours of deskwork per day (41.5%, Table 2). Most of the participants had alternate positions during their working hours (69.9%, Table 2).

Table 2
Job characteristics of study participants

N N%

Designation

Teaching assistant 16 13.0%

Lecturer 34 27.6%

Assistant Professor 42 34.1%

Associate professor 22 17.9%

Professor 9 7.3%

Years of experience

•0–5 27 22.0%

•6–10 30 24.4%

•11–15 16 13.0%

•16–20 16 13.0%

•21–25 17 13.8%

•25+ 17 13.8%

Hours of lectures

•0–2 18 14.6%

•3–4 60 48.8%

•5–6 30 24.4%

•7–8 7 5.7%

•9–10 8 6.5%

Desk job per day

•0–2 51 41.5%

•3–4 39 31.7%

•5–6 19 15.4%

•7–8 10 8.1%

•9–10 4 3.3%

Posture

•Standing 26 21.1%

•Sitting 11 8.9%

•Alternate 86 69.9%

	N	N%
Designation
Teaching assistant	16	13.0%
Lecturer	34	27.6%
Assistant Professor	42	34.1%
Associate professor	22	17.9%
Professor	9	7.3%
Years of experience
•0–5	27	22.0%
•6–10	30	24.4%
•11–15	16	13.0%
•16–20	16	13.0%
•21–25	17	13.8%
•25+	17	13.8%
Hours of lectures
•0–2	18	14.6%
•3–4	60	48.8%
•5–6	30	24.4%
•7–8	7	5.7%
•9–10	8	6.5%
Desk job per day
•0–2	51	41.5%
•3–4	39	31.7%
•5–6	19	15.4%
•7–8	10	8.1%
•9–10	4	3.3%
Posture
•Standing	26	21.1%
•Sitting	11	8.9%
•Alternate	86	69.9%

3.3 Low back disability in the academic teaching staff of the university

The majority of 85 (69.1%) of the prevalence of low back disability among academic teaching staff of the university revealed minimal disability as shown in table 3. About 31(25.2%) of LBP university teaching staff reported a moderate disability. A comparatively small proportion of academic teaching staff with LBP reported a severe disability and being crippled; 6(4.9%) and 1(0.8%) respectively as shown in Table 3. There was a significant relationship between the number of years of experience and the severity of low back disability (P < 0.05).

Table 3
Low back disability prevalence among university teaching staff

Disability N N%

Minimal disability 85 69.1%

Moderate disability 31 25.2%

Severe disability 6 4.9%

Crippled 1 0.8%

Disability	N	N%
Minimal disability	85	69.1%
Moderate disability	31	25.2%
Severe disability	6	4.9%
Crippled	1	0.8%

3.4 Correlation analysis

Table 4 shows that there was no correlation between the ODI and age, gender, job designation, years of experience, hours of lectures, and desk job hours per day (p > 0.05).

Table 4
Relationship between ODI and age, gender, job designation, years of experience, hours of lectures, and desk job hours per day

ODI, r(p)

Age 0.165(0.069)

Gender 0.102(0.262)

Job designation 0.086(0.343)

Years of experience 0.093(0.308)

Hours of lectures 0.067(0.465)

Desk job hours per day 0.042(0.644)

	ODI, r(p)
Age	0.165(0.069)
Gender	0.102(0.262)
Job designation	0.086(0.343)
Years of experience	0.093(0.308)
Hours of lectures	0.067(0.465)
Desk job hours per day	0.042(0.644)

In Table 5, 43.8% of participates with 10–15 years of experience have a moderate low back disability compared to those with 0–5 years of experience (11.1%). The Chi-square test results indicated a trend toward significance for the effect of faculty on low back disability among university teaching staff (P = 0.077; Table 5). Academic teaching staff in the medical stream had the highest percentage of participates with minimal disability (78.7%) while teaching staff in the science stream had the lowest percentage of participates with minimal disability (52%; Table 5).

Table 5

Relationship between job characteristics and low back disability in university academic staff

	Disability
	Minimal disability	Moderate disability	Severe disability	Crippled	Total	χ²P-value
	n(%)	n(%)	n(%)	n(%)	n(%)
Designation
Teaching assistant	13(81.3%)	1(6.3%)	1(6.3%)	1(6.3%)	16(100%)	19.890.069
Lecturer	24(70.6%)	8(23.5%)	2(5.9%)	0(0.0%)	34(100%)
Assistant Professor	26(61.9%)	16(38.1%)	0(0.0%)	0(0.0%)	42(100%)
Associate professor	14(63.6%)	5(22.7%)	3(13.6%)	0(0.0%)	22(100%)
Professor	8(88.9%)	1(11.1%)	0(0.0%)	0(0.0%)	9(100%)
Years of experience
0–5	24(88.9%)	3(11.1%)	0(0.0%)	0(0.0%)	27(100%)	25.3040.046
6–10	19(63.3%)	7(23.3%)	4(13.3%)	0(0.0%)	30(100%)
11–15	9(56.3%)	7(43.8%)	0(0.0%)	00.0%)	16(100%)
16–20	10(62.5%)	4(25.0%)	2(12.5%)	0(0.0%)	16(100%)
21–25	10(58.8%)	7(41.2%)	0(0.0%)	0(0.0%)	17(100%)
25+	13(76.5%)	3(17.6%)	0(0.0%)	1(5.9%)	17(100%)
Hours of lectures
0–2	14(77.8%)	3(16.7%)	1(5.6%)	0(0.0%)	18(100%)	8.2770.663
3–4	43(71.7%)	14(23.3%)	3(5.0%)	0(0.0%)	60(100%)
5–6	17(56.7%)	10(33.3%)	2(6.7%)	1(3.3%)	30(100%)
7–8	4(57.1%)	3(42.9%)	0(0.0%)	0(0.0%)	7(100%)
9–10	7(87.5%)	1(12.5%)	0(0.0%)	0(0.0%)	8(100%)
Desk job hours per day
0–2	38(74.5%)	11(21.6%)	2(3.9%)	0(0.0%)	51(100%)	5.7860.926
3–4	24(61.5%)	11(28.2%)	3(7.7%)	1(2.6%)	39(100%)
5–6	14(73.7%)	5(26.3%)	0(0.0%)	0(0.0%)	19(100%)
7–8	6(60.0%)	3(30.0%)	1(10.0%)	0(0.0%)	10(100%)
9–10	3(75.0%)	1(25.0%)	0(0.0%)	0(0.0%)	4(100%)
Posture
Standing	17(65.4%)	8(30.8%)	1(3.8%)	0(0.0%)	26(100%)	7.420.284
Sitting	5(45.5%)	6(54.5%)	0(0.0%)	0(0.0%)	11(100%)
Alternate	63(73.3%)	17(19.8%)	5(5.8%)	1(1.2%)	86(100%)
Faculty stream
Medicine stream	37(78.7%)	5(10.6%)	4(8.5%)	1(2.1%)	47(100%)	15.5430.077
Science stream	13(52.0%)	12(48.0%)	0(0.0%)	0(0.0%)	25(100%)
Engineering stream	7(70.0%)	3(30.0%)	0(0.0%)	0(0.0%)	10(100%)
Arts stream	28(68.3%)	11(26.8%)	2(4.9%)	0(0.0%)	41(100%)

Data are shown as frequency (n) and percentages (n%); n = 123. There was a significant relationship between the number of years of experience and severity of low back disability (P < 0.05, Chi-square test).

4 Discussion

The current study was an attempt to estimate the prevalence of LBP among academic teaching staff at King Abdulaziz University, as well as to identify its socio-demographic and work-related risk factors.

4.1 Prevalence of LBP

The LBP prevalence in the current study was reported to be 69.1%. This is a greater prevalence than other teaching research in which the prevalence of LBP ranged from 22.3% (Thailand) to 57.5% (Ethiopia), 64.0% (Nairobi) [36 , 53]. This difference can be due to the difference in age between participants in the study, with those reported being younger on average (mean age: 34.7–38 years) than all those reported in the current study (age from 25 to 50 years). In contrast the current study has a lower prevalence than studies conducted among academics at the University of Limerick (85%) [54]. Pernambuco University in Brazil and Malaysia’s Mara University each received 78.9%, while Obafemi University in Nigeria received 71.7% [55]. Variations in data gathering methods, sample size, or sampling strategy procedures could explain this difference. There are differences between the Brazilian and Nigerian studies in that the Brazilian study used a small sample size [49] and data was collected through a self-reported questionnaire. In the Nigerian study, participants were non-teaching members of the staff employed by the Nigerian postal service.

4.2 Risk factors for LBP

Overall, 123 questionnaires were obtained due to a lack of interest in a positive response from faculty members, and 79 female participants were responded to complete the survey. The data for males consisted of 44 participants. The data collection survey reflects most female faculty members who have suffered from low back pain based on the response rate. While most faculty members were male.

The prevalence among females was higher than among males. In Punnett’s review, the LBP attributes factor was also higher among men (63%) than among women (37%). In contrast, the LBP factor in the current study was higher among females (64.2%) compared to males (35.8%). The present study is consistent with the previous study, which found that females complain more than males of low back pain [6 , 22–24]. One possible explanation is that females are more likely than males to involve in jobs associated with heavy physical activity in teaching and housework. In the current study, among 123 participates, 69.1% were had a minimal disability, and 25.2% were a moderate disability. These results showed that the prevalence of LBP among King Abdulaziz University takes part is very significant. They found these results could be due to alternate-working posture between standing and sitting years of experience. While most LBP respondents reported minimal disability in the present study, they need strategic measures in place to minimize their disability progression from minimal to severe disability. These strategies may also aim to reduce pain to a minimal level of disability in people with moderate/severe disabilities. Academic teaching staff should take responsibility for their health by implementing preventive measures and coping strategies for work-related injuries such as LBP. As part of a strategic vision to improve care quality, it should encourage regular physical activity as a preventative intervention to lower the risk of LBP and other occupational disorders, as well as to improve general academic teaching staff health.

A few limitations are inherent in this study. One of the limitations of the current study is that a limited sample size did not match any of the demographics of the respondent. Since non-responders systematically vary about a variety of health outcomes from the respondents, they expect the prevalence of the present study to underestimate the true load of LBP in such a sample population.

Working at a specific university had no bearing on a participant’s probability of developing LBP. This is reasonable considering that the respondents’ work responsibilities are likely to be comparable, such as preparing teaching materials, lecturing, grading students’ papers, mentoring, and supervising, all of which require extended durations of sitting and standing. They could see this regularity in the distribution of office furniture designs among universities as a prevalent similarity. The teachers will stand up for a long time while delivering presentations, or take uncomfortable positions such as bending, touching, and rotating. Such different postures can cause pain to the back muscles continuously loading [35 , 56]. A few research studies reported a high prevalence of Nairobi health conditions: 76.5% of the sedentary population and 90.5% of hospital workers [57].

There are certain limitations to the current study. The authors did not estimate the sample size since they considered the study was not a clinical examination, but a survey sent to academic university teaching staff who might request to take part via social media. The second drawback was that only one outcome score, low back pain among university teaching employees, was used. There is no explanation for why the current study is being conducted. The prevalence of low back pain in this population is likely to be underestimated in the current study. Researchers should keep in mind that the findings are simply hypothesis generators, and that better study designs, such as randomized controlled trials, are needed.

5 Conclusions

The results show that there is a significant problem with LBP among teaching staff at King Abdulaziz University and that the situation is shifting in other Saudi institutions of higher education. Given the similarity of demographics and working conditions across Saudi public and private universities, these findings widely apply to other public universities and faculties or colleges around the world.

Ethical approval

All methods in studies involving human subjects were carried out in accordance with the institutional and/or national research committee’s ethical standards, as well as the 1964 Declaration of Helsinki and its subsequent revisions or comparable ethical standards. The King Abdulaziz University Ethics and Research Committee approved the study (KAU-June 13, 2020/234).

Author contributions

MFM, AAA, AMA, ZN, SSA, and SM were involved in the conception and design, as well as data analysis and interpretation; the drafting of the paper; critical revision for intellectual content; and final approval of the published version. All authors agree to be accountable for all aspects of the work. All authors drafted or critically revised the content before submitting it, and they all granted their consent.

Informed consent

Participants signed a written informed consent form indicating their desire to take part in the study.

Conflict of interest

The authors declare that they have no competing interest.

Footnotes

Acknowledgments

The authors thank God for facilitating and helping us complete this study and the Faculty of Medical Rehabilitation Sciences. Finally, we thank all academic teaching staff at King Abdulaziz University who gave us some of their time to be part of the study.

Funding

This project was not funded by the Deanship of Scientific Research at King Abdulaziz University, Jeddah, Saudi Arabia. The funding agency had no role in designing, conducting, or writing up the study.

Availability of data and materials

The data used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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The prevalence of low back pain and risk factors in academic teaching staff at King Abdulaziz University Jeddah:\\ A cross-sectional study

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Keywords

1 Introduction

2 Methods

2.1 Study design

2.2 Participants

2.4 Data analysis

3 Results

3.1 Descriptive statistics

3.2 Job characteristics of university teaching staff

Table 3 Low back disability prevalence among university teaching staff Disability N N% Minimal disability 85 69.1% Moderate disability 31 25.2% Severe disability 6 4.9% Crippled 1 0.8%

4.1 Prevalence of LBP

4.2 Risk factors for LBP

5 Conclusions

Ethical approval

Author contributions

Informed consent

Conflict of interest

Footnotes

Acknowledgments

Funding

Availability of data and materials

References

Table 3
Low back disability prevalence among university teaching staff

Disability N N%

Minimal disability 85 69.1%

Moderate disability 31 25.2%

Severe disability 6 4.9%

Crippled 1 0.8%