Work and back pain: A prospective study of psychological, social and mechanical predictors of back pain severity

Abstract

Studies relating occupational psychological and social factors to back pain have traditionally investigated a small number of exposure factors. The current study explored longitudinally a comprehensive set of specific psychological/social and mechanical work factors as predictors of back pain severity (defined as the product of back pain intensity and duration). Employees from 28 organizations in Norway, representing a wide variety of occupations, were surveyed with a follow-up period of 2 years. Several designs were tested: (1) cross-sectional analyses at baseline and follow-up; (2) prospective analyses with baseline exposure; (3) prospective analyses with average exposure over time [(T1+T2)/2]; and (4) prospective analyses with measures of change in exposure from T1 to T2. A total of 2808 employees responded at both time points. Fourteen psychological/social and two mechanical exposures were measured. Odds ratios (ORs) were computed by ordinal logistic regressions. Several psychological/social factors predicted back pain severity. After adjustment for age, sex, skill level, back pain severity at T1 and other exposure factors estimated to be potential confounders, the most consistent predictors of back pain were the protective factors decision control [lowest OR 0.68; 99% confidence interval (CI): 0.49-0.95], empowering leadership (lowest OR 0.59; 99% CI: 0.38-0.91) and fair leadership (lowest OR 0.54; 99% CI: 0.34-0.87). Some of the most important predictors included in this study were factors that have previously received little attention in back pain research. This emphasizes the importance of extending the list of factors possibly contributing to back pain.

Associations of objectively measured sitting and standing with low-back pain intensity: a 6-month follow-up of construction and healthcare workers

“…Sitting may be associated with jobs with higher levels of control and autonomy and more engaging tasks, reducing reported LBP intensity (38). Longer durations of sitting may also by exclusion be associated with lower exposures to other physical factors such as manual-materials handling (51).…”

“…Mechanical work factors such as awkward lifting, high muscular load, and stooped positions were found to be associated with LBP in a recent systematic review (35); accumulation of such exposures through high seniority may further increase the risk of LBP (36,37). Psychosocial factors including decision control, type of leadership, and the social climate at work sites are also associated with LBP (33,38,39). Accordingly, both individual and work-related factors must be controlled for when studying the association between sitting and standing at work and LBP.…”

The healthy worker effect: Do health problems predict participation rates in, and the results of, a follow-up survey?

“…The rather small differences in response rate between persons with and without health problems suggest that the health status of respondents at baseline has limited impact on the representativeness, and thereby external validity, of a follow-up assessment in prospective surveys and do therefore not support a HWE. As previous studies from the sample have shown that levels of mental distress and somatic complaints are highly stable from baseline to follow-up in the prospective sample (Christensen and Knardahl 2010, 2012a, b, 2014Nielsen and Knardahl 2014), we can rule out that the limited impact of the HWE is explained by reports of short-term pain.…”

Demand, Control and Support at Work Among Sick-Listed Patients with Neck or Back Pain: A Prospective Study

“…Unfortunately, we have no objective information indicating whether the work environment actually had been adapted. In previous prospective studies among workers, other work factors such as role conflict, social climate, empowering leadership, and fair leadership were closely associated with the level of neck and back pain intensity [35,36]. Therefore, it is possible that the demand, control, and support concepts are not the only important work aspects to study among neck and back pain patients.…”