This study supports the current view of a multifactorial etiology in idiopathic LB problems, and emphasizes the importance of multiple intervention strategies in industrial settings.

The objective was to determine the association between the prevalence of lower back problems (LBP), fear-avoidance beliefs and pain coping strategies using an analytical cross-sectional epidemiological study among a group of 366 workers in a South African stainless steel industry. Outcome (LBP) was defined using a questionnaire and a functional rating index. Exposure to psychosocial risk was determined using the Fear-Avoidance Beliefs (FABQ) and Coping Strategies (CSQ) questionnaires. Multivariate logistic regression analyses for LBP indicated the following significant risk factors: work-related fear-avoidance beliefs (OR 3.40; 95% CI 2.20-5.25), catastrophizing (1.31; 1.01-1.7) and pain coping self statements (1.47; 1.16-1.87). Significant protective associations were found for increased activity levels (OR 0.57; 95% CI 0.42-0.78). These findings have utility in preventative screening procedures to identify workers with such beliefs and coping strategies who are at risk for prolonged work restrictions.

Introduction Back complaints are a common in society. Methods An analytical cross-sectional epidemiological study was carried out among 366 steel plant workers to examine the prevalence and association between lower back problems (LBP) and family and workplace related psychosocial risk factors. Results Using inclusive and stringent definitions for LBP, point prevalence was 35.8% and 15.3%, respectively. Logistic regression analyses indicated significant adjusted odd ratios (OR) for negative perceptions of workplace support (2.32; CI 1.09-4.92), unexpected events (2.58; CI 1.19-5.59) and working under time pressures and deadlines (2.83; CI 1.24-6.48). A significant protective association was found for control over the order and pace of working tasks (OR 0.30; CI 0.14-0.63). A significant univariate association was further found between LBP and negative perceptions of family (1.97; CI 1.06-3.68) support. Conclusion These findings suggest that workers who feel more in control on the job and who have good family and workplace support systems in tact are less likely to experience LBP. Supervisors are therefore encouraged to develop appropriate support and organizational systems which may be an inexpensive, but potentially beneficial, means of reducing worker stress and LBP.