BackgroundEpisodes of low back pain (LBP) are very common among workers. A number of occupational risk factors have been shown to increase the risk for LBP. One of these risk factors is exposure to whole body vibration, which is a known characteristic in driving professions. The aim of this study was to assess the impact of driving on LBP amongst young professional drivers.MethodsThis is an historical-prospective cohort study based on the Israel Defense Forces (IDF) database of male soldiers drafted between the years 1997–2006. Subjects’ medical history with specific reference to LBP medical history, clinical and radiographic findings were taken as part of the recruitment process to the IDF. The study group included subjects (n = 80,599) from three occupational groups: administrative units (AU), car drivers (CD) and truck drivers (TD) that were followed for 3 years. The incidence and recrudescence rates of LBP were calculated based on standardized LBP severity tiers.ResultsThe total incidence rate for LBP was 0.65%, 0.7% and 0.34% for AU, CD and TD respectively. In a comparison between subjects without a history of LBP (category 1) to subjects with a history of LBP without clinical findings (category 2) and subjects with a history of LBP with mild clinical / radiographic findings (category 3), the relative risk (RR) for severe LBP exacerbation was 1.4 (p < 0.001) and 3.8 (p < 0.01), respectively. The LBP exacerbation rates within different severity tiers yielded a similar trend amongst all profession groups.ConclusionsThis study included 80,000 soldiers who represent a population of driving and administrative occupations aged 18–21. The significant risk factors for developing LBP were a previous history of LBP and presence of LBP symptoms at the start of work. A correlation was identified between severity of LBP at the initial examination and further exacerbation of LBP in all examined occupations. Driving as a profession in our (young) age-group was not identified as a risk factor for LBP.

BackgroundLow back pain (LBP) is a leading cause of referral to occupational health clinics and of consequent work absenteeism. There is lack of data concerning ages 18–21. The objective of our study was to evaluate the occurrence of newly diagnosed LBP and the recurrence and worsening of preexisting LBP in young male military recruits.MethodsIn this retrospective cohort study, we examined the medical history of army recruits during the 30-month period after their induction into the Israel Defense Forces (IDF). The duty status of soldiers in combat units (CU), maintenance units (MU) and administrative units (AU) was evaluated according to their morbidity. The study’s end point was defined as significant findings on clinical examination with presence of neurological deficits which correlate to radiological findings on CT or MRI showing herniated disks, spinal stenosis or pressure on neurological roots.ResultsThe annual incidence rate of LBP in a total of 159,295 recruits was 0.05 %. The relative risk (RR) for developing LBP was significantly higher among subjects who were assigned to AU as compared to CU and MU in all LBP categories. The RR for LBP recurrence in soldiers with a positive history of LBP (categories 3 and 4) was 4.1 and 10.7 compare to category 1 respectively.ConclusionsThe lower than expected overall incidence rate of 0.05 % reflects the fact that severe LBP occurrences are not common at this age group. This finding is a more truthful reflection of LBP occurrence rates relative to other studies since the end point is based on precise clinical definitions in medical records and not on questionnaires, as in most studies. The RR for developing LBP was significantly higher among subjects who were assigned to AU as compared to CU and MU in all LBP categories. Childhood history of LBP was found as a significant risk factor for LBP exacerbations at adulthood. Positive history of LBP was found as a risk factor for the recurrence of LBP in all occupation types and particularly in sedentary ones.

Background: The exposure patterns of respirable crystalline silica based on environmental records, as well as the link to different diseases, are not well described. Aims and objectives: In this study, we evaluated the risk for various diseases in relation to occupational silica exposure, including Silicosis, pulmonary tuberculosis (TB), Autoimmune disorders (AIDs) and Renal diseases. Methods: We assessed the relationship between silica exposure and the rate of various diseases such as silicosis, pulmonary TB, AIDs and renal diseases in a cross-sectional study. We reviewed the medical records and exposure level of workers exposed to silica during the past two decades. Results: 261 workers were included in the study, total duration of exposure 15.6 years (±SD 8.74); 42.15% of them were employed in the artificial marble industry and 29.5% in manufacturing and construction industries. The average yearly silica exposure levels were 0.23 mg/m3 (±0.34). The average cumulative silica concentration was 3.59 mg/m3/y (±4.80). We found 25 (9.58%) incident cases of silicosis, 10 cases of chronic obstructive pulmonary disease (COPD) and emphysema (3.83%), six cases of several AIDs (2.30%), five cases of pulmonary TB (1.92%), three cases of renal diseases (1.15%), two cases of sarcoidosis (0.77%) and no lung cancer cases. When compared to studies with the same endpoint we found excess risk of silicosis (RR = 2.67/0.13 = 20.5, 95% CI 9.85 to 42.86)), pulmonary TB (RR = 30.70, CI 3.43–274.49, p = 0.002) and AIDs (RR = 2.87, 95% CI = 1.27 to 6.48 p = 0.01). Conclusions: Silica exposure was a significant risk factor for silicosis, pulmonary TB and AIDs. Our findings are important given persistent worldwide silica-related epidemics in low and high-income countries.

Atopy, particularly AR, is a risk factor for the development of new-onset asthma in young adults. Atopy has the highest significant effect in CU where the physical demands are higher.

Objective To study the long-term effectiveness of case-management rehabilitation intervention on vocational reintegration of patients after myocardial infarction (MI). Design Blinded simple randomization was used to construct an intervention and control groups that were followed up for two years. Subjects and setting 151 patients, aged 50.3 ±  5.9 years, who experienced uncomplicated MI and were enrolled in a cardiac rehabilitation program were recruited. Interventions included an early referral to an occupational physician, tailoring an occupational rehabilitation program, based on individual patient needs, coordination with relevant parties, psychosocial intervention, intensive follow-up sessions during a two-year follow-up. Main measures Return to work within six months of hospitalization and maintenance of employment at one and two years of follow-up. Results Return-to-work (RTW) rate in the intervention group was 89% and nearly all maintained employment at one year of follow-up (92%) and two years of follow-up (87%). Moreover, almost all of them returned to and maintained their previous jobs. The corresponding figures were: 98%, 94% and 98%, respectively. The figures for the RTW and employment maintenance for the control group were: 74%, 75%, and 72%, respectively. Only about 75%, in this group kept their previous job. The case-management intervention was associated with increased odds of maintaining employment at follow-up of one year (OR = 5.89, 95% CI 1.42–24.30) and two years (OR = 3.12, 95% CI 1.01–10.03). Conclusions The extended case-management rehabilitation intervention had a substantial positive impact on both the RTW of MI patients and their maintenance of employment at one and two years of follow-up. Trial Registration This trial is registered at US National Institutes of Health #NCT04934735.