eprintid: 10044693
rev_number: 24
eprint_status: archive
userid: 608
dir: disk0/10/04/46/93
datestamp: 2018-03-06 13:26:20
lastmod: 2021-12-05 00:44:44
status_changed: 2018-03-06 13:26:20
type: article
metadata_visibility: show
creators_name: Geere, J-A
creators_name: Bartram, J
creators_name: Bates, L
creators_name: Danquah, L
creators_name: Evans, B
creators_name: Fisher, MB
creators_name: Groce, N
creators_name: Majuru, B
creators_name: Mokoena, MM
creators_name: Mukhola, MS
creators_name: Nguyen-Viet, H
creators_name: Duc, PP
creators_name: Williams, AR
creators_name: Schmidt, W-P
creators_name: Hunter, PR
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
ispublished: pub
divisions: UCL
divisions: B02
divisions: D12
divisions: G19
note: This work is licensed under a Creative Commons Attribution 
4.0 International License (http://creativecommons.org/licenses/by/4.0/).
abstract: 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.”
date: 2018-06
date_type: published
official_url: http://dx.doi.org/10.7189/jogh.08.010406
oa_status: green
full_text_type: pub
pmcid: PMC5825974
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1540394
doi: 10.7189/jogh.08.010406
pii: jogh-08-010406
lyricists_name: Groce, Nora
lyricists_id: NEGRO89
actors_name: Laslett, David
actors_id: DLASL34
actors_role: owner
full_text_status: public
publication: Journal of Global Health
volume: 8
number: 1
article_number: 010406
event_location: Scotland
issn: 2047-2986
citation:        Geere, J-A;    Bartram, J;    Bates, L;    Danquah, L;    Evans, B;    Fisher, MB;    Groce, N;                                 ... Hunter, PR; + view all <#>        Geere, J-A;  Bartram, J;  Bates, L;  Danquah, L;  Evans, B;  Fisher, MB;  Groce, N;  Majuru, B;  Mokoena, MM;  Mukhola, MS;  Nguyen-Viet, H;  Duc, PP;  Williams, AR;  Schmidt, W-P;  Hunter, PR;   - view fewer <#>    (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  (1)    , Article 010406.  10.7189/jogh.08.010406 <https://doi.org/10.7189/jogh.08.010406>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10044693/1/jogh-08-010406.pdf