Relationship of Healthy Building Determinants With Musculoskeletal Disorders of the Extremities: A Systematic Review

Abstract

Musculoskeletal disorders (MSDs) are a substantial societal burden and various factors affect their causation, recovery, and prognosis. Management of MSDs is complex and requires multifaceted interventions. Given the challenges of MSDs and their continued burden, it is possible that additional elements could impact these disorders that have not been fully researched, for example, indoor environmental quality. Our previous review provided preliminary evidence that healthy building determinants (HBDs) are associated with the risk of back and neck pain. However, the relationship of HBDs with extremity MSDs and general MSDs (i.e., MSDs involving multiple body regions or in which body regions were unspecified in the original reports) has not been formally studied. The purpose of this review was to conduct a systematic literature review to assess the relationship of HBDs with extremity and general MSDs (PROSPERO ID: CRD42022314832). PubMed, CINAHL, Embase, and PEDRo databases were searched through April 2022. Inclusion criteria for study eligibility were as follows: humans of ages ≥18 years, reported on one or more of eight HBDs (1. air quality and ventilation, 2. dust and pests, 3. lighting and views, 4. moisture, 5. noise, 6. safety and security, 7. thermal health, 8. water quality), and compared these HBDs with extremity MSDs or general MSDs, original research, English. Exclusion criteria were as follows: articles not published in peer-reviewed journals, full-text articles unavailable. Review procedures were conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Empirical evidence statements were developed for 33 pairwise comparisons of HBDs with MSDs. The search uncovered 53 eligible studies with 178,532 participants. A total of 74.6% (39/53) of the studies were cross-sectional and 81.1% (43/53) were fair quality. Overall, the majority of uncovered evidence indicates that HBDs are related to risk of extremity and general MSDs. Nineteen comparisons support that as HBDs worsen, the risk of MSDs increases. Six comparisons had conflicting evidence. Three comparisons support that poor HBDs are not related to increased risk of extremity and general MSDs. Five comparisons had no evidence. This systematic review builds upon previous work to provide useful starting points to enhance awareness about the HBD-MSD relationship. These findings can help inform research and public health efforts aimed at addressing suboptimal HBDs through appropriate interventions to improve the lives of those suffering from MSDs.

Impact of Indoor Air Quality and Breathing on Back and Neck Pain: A Systematic Review

“…Given the relationships of IAQ and breathing parameters with back pain and neck pain, along with the lack of clarity on which exercises are best for specific patients, it is plausible that interventions aimed at improving IAQ and breathing parameters, along with the array of other established risk factors, may be useful for reducing the risk of these disorders in public, residential, and workplace environments. While our previous reviews did not find any RCTs examining the efficacy of IAQ interventions on various MSDs [8,9], a recent systematic review found preliminary evidence from small randomized controlled trials (RCTs) to support the efficacy of breathing exercises on short-term pain measures for LBP [18]. Another systematic review on this topic uncovered one small RCT that assessed the independent effect of breathing exercises compared to non-breathing exercise control for LBP [19].…”

“…The current review incorporated similar methods, evidence synthesis procedures, and reporting structure as our earlier reviews that examined HBDs and MSDs [8,9]. The current review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [28] and other resources [1,12,[29][30][31][32][33][34] and was registered with PROSPERO (ID: CRD42022380515).…”

“…The PubMed search strategy is shown in the Appendices, and CINAHL, EMBASE, and PEDRo were searched using a comparable databasespecific approach. To identify additional studies, hand searches of published reports available to the authors were conducted, and an examination of references within studies obtained from the primary search was performed [8,9].…”

“…Inclusion and exclusion criteria are depicted using the PICOTS method: P -patients/people, I -intervention, C -comparator, O -outcomes/variables, T -time/timing, S -setting [8,9,28]. P -Patients/people: Studies were included if they assessed humans ≥ 18 years of age with back pain, neck pain, or related MSDs (e.g., cervical radiculopathy, lumbar radiculopathy, sciatica).…”

“…Numerous biopsychosocial risk factors have been identified for back pain and neck pain, such as age, previous history of the condition, obesity, sub-optimal fitness, low physical activity, psychological conditions, smoking, poor ergonomics, and awkward lifting [4,5]. Our recent systematic reviews found additional risk factors for back pain, neck pain, and other musculoskeletal disorders (MSDs) within the built environment that were not previously identified and classified as healthy building determinants (HBDs) [8,9]. For example, evidence was found to support an association between sub-optimal indoor air quality (IAQ) and increased risk of back pain and neck pain.…”