Occupational loading, health behavior and sleep disturbance as predictors of low-back pain

Abstract

Miranda H, Viikari-Juntura E, Punnett L, Riihimäki H. Occupational loading, health behavior and sleep disturbance as predictors of low-back pain. Scand J Work Environ Health 2008;34(6):411-419.Objectives Risk factors for low-back pain are known to co-occur, but their joint effect has not often been studied.Little is also known about the variation of the risk factors or their effects with age.Methods This prospective study assessed the 1-year incidence of low-back pain by age group in a Finnish industrial population. The effects of the baseline variables on the risk of low-back pain in the follow-up were estimated with a log-binomial regression.Results Among 2256 blue-and white-collar workers free of low-back pain 12 months preceding the baseline, 21% reported low-back pain after 1-year of follow-up. Physical work load (sum of heavy lifting, awkward postures, and whole-body vibration) predicted low-back pain among those younger than 50 years [highest relative risk (RR) 2.4, 95% confidence interval (95% CI) 1.4-4.2], whereas health behavior (sum of smoking, overweight, and lack of physical exercise) increased the risk only among those 50 years or older (RR up to 2.8, 95% CI 1.4-5.4). Mental stress, dissatisfaction with life, and sleep problems were significant predictors in the group of 40-to 49-year-old workers. Work-related psychosocial factors were not associated with the outcome. ConclusionsIn this study, workers of different ages were affected by slightly different risk factors. The results support the provision of health promotion and stress management as part of programs to prevent work-related low-back pain. In particular, aging workers may benefit from such an integrated approach. More prospective studies on the joint effects of age-specific risk factors of low-back pain are warranted.

Physical activity and low back pain: a systematic review of recent literature

“…Lifting and carrying were explored in 10 studies [22-24, 27, 28, 34, 35, 42, 54, 56] whilst one study [26] focused on the association between strenuous arm movements in scaffolding and back pain. All studies reported positive associations with cumulative risk estimates associated with the accumulation of loads or frequency of lifts varying from 1.4 (1.0-2.1) [42] to 3.26 (1.52-6.98) [35]. The population-based studies by Bildt et al [24] and Vingård et al [57] reported significant risk estimates amongst men.…”

“…The percentage loss to follow-up varied between 11 [53] and 43% [31] in studies with a follow-up of B1 year [25,28,29,31,37,38,42,46,52,53,55,56], between 10 [54] and 60% [31] in studies with a follow-up [1 and B3 years [22,23,25,28,31,34,35,39,41,49,54,55] and between 12 [45] and 28% [30,44] in studies with a follow-up of more than 3 years. In studies with a follow-up of more than 15 years [24,33,43,47] percentages loss to follow-up varied between 38 [47] and 84% [24].…”

“…Eleven studies [25,30,32,33,42,46,49,50,54,55,57] exploring the intensities of physical workload reported a significant association of heavy workload or physically demanding work with LBP. Work-related risk factors were not just associated with the occurrence of LBP.…”

“…Eight studies specifically focused on a working population [22,23,26,28,34,35,42] and three studies were population-based [24,54,57]. Lifting and carrying were explored in 10 studies [22-24, 27, 28, 34, 35, 42, 54, 56] whilst one study [26] focused on the association between strenuous arm movements in scaffolding and back pain.…”

“…Ten studies, of which seven were based on a working population [35,38,42,[44][45][46]56] and three population-based studies [24,49,56] [45] for the twisted-bent positions. A twofold increased risk was observed in case of the inability to change posture regularly [56].…”