Assessment of lumbar pain in community health agents from the north of Minas Gerais State, Brazil

Oliveira, Fabrício Emanuel Soares de; Gomes, Dênio de Castro; Caldeira, Antônio Prates; Dias, Verônica Oliveira; Rocha, Josiane Santos Brant; Martelli Júnior, Hercílio; Almeida, Wellen Cavalcante de; Martelli, Daniella Reis Barbosa

doi:10.1590/2317-6369/03523pt2025v50e3

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Research article • Rev. bras. saúde ocup. 50 • 2025 • https://doi.org/10.1590/2317-6369/03523en2025v50e3 linkcopy

Assessment of lumbar pain in community health agents from the north of Minas Gerais State, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To evaluate low back pain in community health agents (CHA) and its associated factors.

Methods Cross-sectional study with a sample of 675 CHA. The presence of low back pain was assessed using the Japanese Orthopaedic Association Back Pain Evaluation (JOABPEQ) instrument, with a maximum score of 100, where higher scores indicate less low back pain. Data collection took place between August and October 2018 at the Regional Reference Center for Occupational Health (Cerest) in Montes Claros, Minas Gerais, Brazil. The data analysis consisted of describing the frequency (absolute and relative) and calculating the mean and standard deviation of the numerical variables.

Results A total of 675 CHA participated in the study, 565 (83.7%) of whom were female. Scores indicating worse health conditions related to low back pain were found among females [53.98 vs. 66.40 (males)], participants over 40 years old [52.63 vs. 62.52 (≤ 30 years)], married individuals [54.02 vs. 58.88 (single)], those working multiple jobs [50.55 vs. 56.56 (single job)], individuals with permanent employment contracts [46.69 vs. 59.24 (other contracts)], those with more than five years of experience in healthcare [49.06 vs. 62.80 (less than one year)], and those with over five years as CHA [48.42 vs. 64.25 (less than one year)].

Conclusion It was found that CHA with longer tenure in the role and in the healthcare field had scores indicating a negative impact of low back pain, highlighting the risk factors associated with the profession.

Community Health Agents; Occupational Health; Low Back Pain; Occupational Hazards

Sociodemographic variable	n	%
Sex
Male	110	16.3
Female	565	83.7
Age (in years)
≤ 30	194	28.8
31 a 40	250	37.0
≥ 41	231	34.2
Mean (sd*)	36.70 (9.85)	-
Education
Elementary/middle school	383	56.7
Incomplete higher education	126	18.7
Complete higher education	166	24.6
Family income (in minimum wages)**
< 2	204	30.2
2 a 3	334	49.5
≥ 3	137	20.3
Mean (sd*)	2.42 (1.18)	-
Number of people in the family
≤ 3	331	49.0
≥ 4	344	51.0
Mean (sd*)	3.55 (1.29)	-
Marital status
Single/divorced	272	40.3
Married/stable union	403	59.7
Skin color
White	87	12.9
Black	97	14.4
Brown	477	70.7
Indigenous/Yellow	14	2.0
Health training
No	434	64.3
Yes	241	35.7
Occupational characteristics	n	%
Length of time working in the health sector (in years)
< 1	165	24.4
1 a 5	199	29.5
> 5	311	46.1
Mean (sd*)	6.62 (5.83)	-
Length of time working as a CHA (in years)
< 1	178	26.4
1 a 5	204	30.2
> 5	293	43.4
Mean (sd*)	6.29 (5.67)	-
Weekly workload as a CHA
24 h	42	6.2
40 h	633	93.8
Mean (sd*)	39.00 (3.86)	-
Number of families monitored
Up to 120	354	52.4
More than 120	321	47.6
Mean (sd*)	120.89 (41.94)	-
Type of link
Civil servant	175	25.9
Contractor/lecturer/service provider	500	74.1
Works other jobs
No	610	90.4
Yes	65	9.6
Physical activity	n	%
Physical activity time in a week (in minutes)
< 150 (physically inactive)	218	32.3
≥ 150 (physically active)	457	67.7
Mean (sd*)	275.41 (219.79)
Total sitting time in a week (in minutes)
≤ 500	374	55.4
> 500	301	44.6
Mean (sd*)	533 (321.90)

Sociodemographic variable	Low back pain		Low back function		Walking		Function in social life		Mental health
Sociodemographic variable	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**
Sex
Male	66.40	27.91	87.50	21.20	92.86	14.74	84.91	16.77	68.99	17.05
Female	53.98	31.38	78.66	26.86	87.24	18.42	78.14	20.48	61.43	19.52
Age
≤ 30	62.52	30.00	88.83	17.81	92.05	15.05	84.66	16.92	65.03	19.13
31 a 40	53.97	31.70	80.17	25.37	87.27	18.32	76.95	20.96	61.11	19.73
≥ 41	52.63	30.84	72.62	30.52	85.81	19.39	77.10	20.74	62.28	18.97
Education
Elementary/middle school	54.56	32.04	76.81	28.53	86.82	18.51	77.60	20.95	62.73	20.23
Incomplete higher education	56.92	30.50	84.66	22.57	90.87	17.27	81.98	18.43	62.94	17.17
Complete higher education	58.53	29.56	84.14	21.93	89.13	17.09	80.88	18.92	62.24	18.87
Family income (in minimum wages)*
< 2	55.17	29.65	79.64	25.91	88.04	17.99	79.48	19.82	63.37	20.45
2 a 3	56.11	32.13	79.75	27.07	87.97	17.99	79.27	19.96	62.22	19.42
≥ 3	56.83	31.15	81.51	24.68	88.74	18.12	78.73	20.85	62.60	17.45
Number of people in the family
≤ 3	57.75	31.26	81.19	26.46	89.63	16.59	80.64	19.98	62.82	19.58
≥ 4	54.27	31.02	79.01	25.98	86.71	19.16	77.87	20.10	62.48	19.13
Marital status
Single / divorced	58.88	29.08	85.33	21.29	89.35	17.67	81.79	18.65	63.73	20.40
Married/stable union	54.02	32.38	76.53	28.56	87.33	18.18	77.50	20.82	61.91	61.91
Skin color
White	60.26	31.67	83.72	19.68	90.07	15.45	81.33	18.75	61.60	19.01
Black	57.00	31.71	77.84	28.05	84.83	20.93	76.87	22.88	63.11	21.95
Brown	55.04	30.95	80.12	26.69	88.62	17.57	79.41	19.73	62.75	19.03
Indigenous/yellow	54.08	32.27	71.43	31.47	83.16	22.69	76.25	19.08	62.41	12.91
Health training
No	58.50	29.68	82.47	23.88	89.35	16.02	80.97	19.17	64.60	18.09
Yes	51.45	33.24	75.80	29.54	85.98	20.93	76.09	21.29	59.14	20.98
Occupational characteristics	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**
Length of time working in the health sector (in years)
< 1	62.80	27.79	89.84	16.61	93.25	14.09	85.84	14.58	69.52	15.57
1 a 5	61.18	29.36	82.91	22.14	89.61	15.42	82.10	18.71	66.04	17.97
> 5	49.06	32.58	73.12	30.49	84.52	14.58	73.90	21.96	56.86	20.30
Length of time working as a CHA (in years)
< 1	64.25	27.67	90.40	16.17	93.54	13.76	86.50	14.30	69.44	15.69
1 a 5	59.68	29.33	82.35	22.16	88.99	15.64	81.88	18.75	66.35	17.89
> 5	48.42	32.71	72.27	30.92	84.30	20.70	72.99	22.02	55.97	20.21
Weekly workload as a CHA
24 h	46.26	25.59	75.00	33.02	85.88	20.53	77.73	22.79	59.94	17.44
40 h	56.62	31.41	80.41	25.70	88.30	17.82	79.32	19.90	62.83	19.46
Number of families monitored
Up to 120	57.47	30.81	81.16	25.23	88.18	18.20	79.31	19.67	63.32	19.38
More than 120	54.33	31.51	78.88	27.26	88.10	17.79	79.13	20.55	61.91	19.30
Type of link
Civil servant	46.69	33.24	70.57	32.94	82.49	22.83	72.12	22.74	54.26	21.41
Contractor/lecturer/service provider	59.24	29.75	83.42	22.51	90.13	15.50	81.72	18.44	65.59	17.66
Works other jobs
No	56.56	30.78	80.41	26.09	88.24	18.15	79.78	19.94	62.93	19.24
Yes	50.55	34.35	76.92	27.47	87.25	16.58	74.01	20.73	60.01	20.15
Physical activity	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**	-x*	sd**
Time spent doing physical activity in a week (minutes)
< 150 (physically inactive)	59.83	31.74	81.42	26.94	87.48	19.14	80.32	19.54	61.82	19.18
≥ 150 (physically active)	54.13	30.75	79.43	25.88	88.46	17.43	78.70	20.32	63.04	19.42
Total sitting time in a week (minutes)
≤ 500	56.30	29.78	78.64	26.86	87.28	18.21	78.76	20.27	63.96	18.86
> 500	55.57	32.85	81.86	25.34	89.21	17.68	79.81	19.85	61.01	19.82

	Average*	Standard deviation
Back pain
General	3.58	2.69
Sex
Male	2.61	2.32
Female	3.76	2.72
Age (in years)
≤ 30	2.87	2.50
31 a 40	3.67	2.80
≥ 41	4.06	2.61
Length of time working in the health sector (in years)
< 1	2.87	2.47
1 a 5	3.22	2.56
> 5	4.18	2.77
Length of time working as a CHA (in years)
< 1	2.76	2.44
1 a 5	3.27	2.48
> 5	4.28	2.81
Number of families monitored
Up to 120	3.46	2.73
More than 120	3.70	2.67
Physical activity time in a week (in minutes)
< 150 (physically inactive)	3.17	2.60
≥ 150 (physically active)	3.77	2.71
Pain in the buttocks or legs
General	3.42	2.89
Sex
Male	2.36	2.57
Female	3.63	2.90
Age (in years)
≤ 30	2.47	2.70
31 a 40	3.57	2.88
≥ 41	4.06	2.86
Length of time working in the health sector (in years)
< 1	2.14	2.36
1 a 5	3.41	2.76
> 5	4.11	3.00
Length of time working as a CHA (in years)
< 1	2.14	2.39
1 a 5	3.51	2.78
> 5	4.14	2.99
Number of families monitored
Up to 120	3.34	2.85
More than 120	3.52	2.93
Physical activity time in a week (in minutes)
< 150 (physically inactive)	3.05	2.81
≥ 150 (physically active)	3.60	2.92
Numbness in the buttocks or legs
General	2.14	2.64
Sex
Male	1.51	2.30
Female	2.26	2.69
Age (in years)
≤ 30	1.58	2.40
31 a 40	2.26	2.65
≥ 41	2.48	2.76
Length of time working in the health sector (in years)
< 1	1.29	2.08
1 a 5	2.03	2.50
> 5	2.66	2.87
Length of time working as a CHA (in years)
< 1	1.33	2.07
1 a 5	2.04	2.53
> 5	2.70	2.88
Number of families monitored
Up to 120	2.14	2.64
More than 120	2.14	2.64
Physical activity time in a week (in minutes)
< 150 (physically inactive)	2.10	2.71
≥ 150 (physically active)	2.16	2.61

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Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO Rua Capote Valente, 710 , 05409 002 São Paulo/SP Brasil, Tel: (55 11) 3066-6076 - São Paulo - SP - Brazil
E-mail: rbso@fundacentro.gov.br

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[TFN1001] * Standard deviation; ** Minimum wage in 2018: R$ 954.00.

[TFN2001] CHA: Community health agent.

[3] Source: Own elaboration.