Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey

Abstract Background Recent findings indicate that wide international variation in the prevalence of disabling regional musculoskeletal pain among working populations is driven by unidentified factors predisposing to pain at multiple anatomical sites. As a step towards identification of those factors...

Full description

Bibliographic Details
Main Authors: E. Rizzello, G. Ntani, I. Madan, D. Coggon
Format: Article
Language:English
Published: BMC 2019-03-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-019-2494-3
_version_ 1818293979278475264
author E. Rizzello
G. Ntani
I. Madan
D. Coggon
author_facet E. Rizzello
G. Ntani
I. Madan
D. Coggon
author_sort E. Rizzello
collection DOAJ
description Abstract Background Recent findings indicate that wide international variation in the prevalence of disabling regional musculoskeletal pain among working populations is driven by unidentified factors predisposing to pain at multiple anatomical sites. As a step towards identification of those factors, it would be helpful to know whether the prevalence of multisite pain changes when people migrate between countries with differing rates of symptoms; and if so, whether the change is apparent in first generation migrants, and by what age it becomes manifest. Methods To address these questions, we analysed data from an earlier interview-based cross-sectional survey, which assessed the prevalence of musculoskeletal pain and risk factors in six groups of workers distinguished by the nature of their work (non-manual or manual) and their country of residence and ethnicity (UK white, UK of Indian subcontinental origin and Indian in India). Prevalence odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression. Results Among 814 participants (response rate 95.4%), 20.6% reported pain at ≥3 anatomical sites. This outcome was much less frequent in Indian manual workers than among white non-manual workers in the UK (adjusted OR 0.06, 95%CI 0.01–0.36), while rates in Indian non-manual workers were intermediate (OR 0.29, 95%CI 0.12–0.72). However, within the UK, there were only small differences between white non-manual workers and the other occupational groups, including those of Indian sub-continental origin. This applied even when analysis was restricted to participants aged 17 to 34 years, and when second and later generation migrants were excluded. Conclusions The observed differences in the prevalence of multisite pain seem too large to be explained by healthy worker selection or errors in recall, and there was no indication of bias from differences in understanding of the term, pain. Our findings suggest that whatever drives the higher prevalence of musculoskeletal pain in the UK than India is environmental rather than genetic, affects multiple anatomical sites, begins to act by fairly early in adult life, and has impact soon after people move from India to the UK.
first_indexed 2024-12-13T03:24:27Z
format Article
id doaj.art-33f9f28d71784fc09c2a1f37547710d7
institution Directory Open Access Journal
issn 1471-2474
language English
last_indexed 2024-12-13T03:24:27Z
publishDate 2019-03-01
publisher BMC
record_format Article
series BMC Musculoskeletal Disorders
spelling doaj.art-33f9f28d71784fc09c2a1f37547710d72022-12-22T00:01:18ZengBMCBMC Musculoskeletal Disorders1471-24742019-03-012011710.1186/s12891-019-2494-3Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional surveyE. Rizzello0G. Ntani1I. Madan2D. Coggon3Department of Medical and Surgical Sciences (DIMEC), University of BolognaMRC, Lifecourse Epidemiology Unit, University of Southampton, Southampton General HospitalArthritis Research UK/MRC Centre for Musculoskeletal Health and WorkMRC, Lifecourse Epidemiology Unit, University of Southampton, Southampton General HospitalAbstract Background Recent findings indicate that wide international variation in the prevalence of disabling regional musculoskeletal pain among working populations is driven by unidentified factors predisposing to pain at multiple anatomical sites. As a step towards identification of those factors, it would be helpful to know whether the prevalence of multisite pain changes when people migrate between countries with differing rates of symptoms; and if so, whether the change is apparent in first generation migrants, and by what age it becomes manifest. Methods To address these questions, we analysed data from an earlier interview-based cross-sectional survey, which assessed the prevalence of musculoskeletal pain and risk factors in six groups of workers distinguished by the nature of their work (non-manual or manual) and their country of residence and ethnicity (UK white, UK of Indian subcontinental origin and Indian in India). Prevalence odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression. Results Among 814 participants (response rate 95.4%), 20.6% reported pain at ≥3 anatomical sites. This outcome was much less frequent in Indian manual workers than among white non-manual workers in the UK (adjusted OR 0.06, 95%CI 0.01–0.36), while rates in Indian non-manual workers were intermediate (OR 0.29, 95%CI 0.12–0.72). However, within the UK, there were only small differences between white non-manual workers and the other occupational groups, including those of Indian sub-continental origin. This applied even when analysis was restricted to participants aged 17 to 34 years, and when second and later generation migrants were excluded. Conclusions The observed differences in the prevalence of multisite pain seem too large to be explained by healthy worker selection or errors in recall, and there was no indication of bias from differences in understanding of the term, pain. Our findings suggest that whatever drives the higher prevalence of musculoskeletal pain in the UK than India is environmental rather than genetic, affects multiple anatomical sites, begins to act by fairly early in adult life, and has impact soon after people move from India to the UK.http://link.springer.com/article/10.1186/s12891-019-2494-3Multisite painMigrantIndiaUKWorkerRisk factor
spellingShingle E. Rizzello
G. Ntani
I. Madan
D. Coggon
Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
BMC Musculoskeletal Disorders
Multisite pain
Migrant
India
UK
Worker
Risk factor
title Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
title_full Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
title_fullStr Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
title_full_unstemmed Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
title_short Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey
title_sort multisite musculoskeletal pain in migrants from the indian subcontinent to the uk a cross sectional survey
topic Multisite pain
Migrant
India
UK
Worker
Risk factor
url http://link.springer.com/article/10.1186/s12891-019-2494-3
work_keys_str_mv AT erizzello multisitemusculoskeletalpaininmigrantsfromtheindiansubcontinenttotheukacrosssectionalsurvey
AT gntani multisitemusculoskeletalpaininmigrantsfromtheindiansubcontinenttotheukacrosssectionalsurvey
AT imadan multisitemusculoskeletalpaininmigrantsfromtheindiansubcontinenttotheukacrosssectionalsurvey
AT dcoggon multisitemusculoskeletalpaininmigrantsfromtheindiansubcontinenttotheukacrosssectionalsurvey