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Effect of Occupational Back Health Assessment on Work-Related Back Problems Detection among Commercial Drivers in Nigeria

Abstract

Work-related back problems are an important occupational health concern among commercial drivers in Nigeria due to prolonged sitting, whole-body vibration, poor driving posture, extended working hours, inadequate rest periods, road conditions, manual loading activities, and other occupational demands. Persistent back problems may affect drivers' comfort, mobility, concentration, work performance, productivity, and ability to continue driving safely. However, work-related back problems may remain undetected because drivers may normalize pain and discomfort, self-medicate, have limited access to occupational health services, or delay seeking professional assessment because of financial, geographical, and time-related barriers. Occupational back health assessment provides an opportunity to identify drivers experiencing back pain, functional limitations, and other musculoskeletal concerns through workplace health programmes, transport unions, driver associations, occupational health clinics, and other accessible platforms. Early detection may facilitate appropriate clinical assessment, ergonomic interventions, physiotherapy, health education, work modification, and timely referral. Against this background, this study investigates the effect of occupational back health assessment on work-related back problems detection among commercial drivers in Nigeria. The study will be anchored on the Job Demands–Resources Model, Biopsychosocial Model of Musculoskeletal Disorders, and Health Belief Model. The Job Demands–Resources Model explains how occupational demands such as prolonged sitting, long driving hours, whole-body vibration, workload, and insufficient recovery may contribute to work-related back problems, while workplace resources and support may reduce their impact. The Biopsychosocial Model recognizes the interaction of physical, psychological, occupational, and social factors in the development, experience, reporting, and management of back problems. The Health Belief Model explains how drivers' perceptions of susceptibility to work-related back problems, perceived severity, perceived benefits of occupational assessment, perceived barriers, and cues to action may influence participation in back health assessment and healthcare-seeking behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how occupational back health assessment may influence work-related back problems detection among commercial drivers in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adult commercial drivers operating buses, taxis, minibuses, and other commercial passenger vehicles in selected locations across Nigeria. A multistage sampling technique will be used to select states, local government areas, transport terminals, motor parks, driver associations, routes, and eligible commercial drivers. Occupational back health assessment will be measured using indicators such as availability of assessment programmes, assessment coverage, frequency of assessments, assessment of driving duration, daily sitting time, years of driving, whole-body vibration exposure, driving posture, manual loading activities, rest periods, previous back problems, physical activity, ergonomic practices, availability of occupational health personnel, back-health education, and referral arrangements. Work-related back problems detection will be assessed using indicators such as lower back pain, upper or mid-back pain, recurrent back discomfort, pain duration and frequency, pain severity, functional limitations, difficulty sitting or driving, reduced mobility, work-related aggravation of back symptoms, newly identified back problems, drivers requiring further clinical assessment, referrals for physiotherapy or medical evaluation, and documented musculoskeletal conditions where appropriately established. Data will be collected using structured questionnaires, validated musculoskeletal and back-pain assessment instruments, occupational exposure assessment forms, physical or ergonomic assessment checklists where appropriate, occupational health records, and referral documentation. Descriptive statistics will be used to summarize drivers' demographic and occupational characteristics, driving patterns, exposure factors, back-health indicators, and detection rates. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of occupational back health assessment on work-related back problems detection. Where appropriate, detection rates before and after implementation of occupational back health assessment activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that occupational back health assessment has a significant positive effect on work-related back problems detection among commercial drivers in Nigeria. Drivers who participate in systematic occupational back health assessment are expected to have a higher likelihood of previously unrecognized work-related back problems being identified than drivers without access to such assessment. Routine assessment may facilitate early recognition of lower back pain, recurrent musculoskeletal symptoms, functional limitations, posture-related problems, and other conditions associated with prolonged driving and occupational exposure. Early detection may provide opportunities for ergonomic education, appropriate driving posture, stretching and physical activity recommendations, physiotherapy, clinical evaluation, work-rest adjustments, and referral where necessary. Conducting assessment through transport terminals, driver associations, occupational health programmes, and other accessible platforms may reduce geographical, financial, and time-related barriers to healthcare access. Occupational health education may also improve drivers' awareness of the relationship between prolonged sitting, vibration exposure, posture, workload, and back health. Conversely, fear of losing income, limited access to healthcare, inadequate occupational health services, financial constraints, normalization of pain, shortage of trained personnel, and weak referral and follow-up systems may reduce the effectiveness of occupational back health assessment. The study therefore expects systematic, accessible, and appropriately implemented occupational back health assessment to contribute significantly to improved detection and early management of work-related back problems among commercial drivers in Nigeria. The study is expected to contribute to the literature on occupational back health assessment, work-related back problems detection, commercial drivers' health, occupational musculoskeletal disorders, ergonomics, workplace health and safety, occupational health surveillance, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Labour and Employment, Federal Ministry of Health and Social Welfare, state ministries of health, occupational health and safety authorities, transport unions, driver associations, employers, occupational physicians, physiotherapists, nurses, ergonomists, public health practitioners, development partners, and policymakers regarding strategies for reducing work-related musculoskeletal problems among commercial drivers. The study will also provide evidence-based recommendations for expanding occupational back health assessment programmes, strengthening ergonomic education, improving access to occupational health and physiotherapy services, promoting appropriate work-rest schedules, reducing prolonged static sitting and excessive vibration exposure, strengthening referral and follow-up systems, and integrating routine musculoskeletal health assessment into appropriate occupational health and safety programmes for commercial drivers across Nigeria.

Keywords: Occupational back health assessment, work-related back problems detection, commercial drivers, low back pain, occupational musculoskeletal disorders, ergonomics, occupational health, workplace health, musculoskeletal health, driver health, Nigeria, public health.