Top

Published in:

Open Access 01-03-2013

Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A Prospective Cohort Study

Authors: Pieter Coenen, Idsart Kingma, Cécile R. L. Boot, Jos W. R. Twisk, Paulien M. Bongers, Jaap H. van Dieën

Published in: Journal of Occupational Rehabilitation | Issue 1/2013

Abstract

Purpose Much research has been performed on physical exposures during work (e.g. lifting, trunk flexion or body vibrations) as risk factors for low back pain (LBP), however results are inconsistent. Information on the effect of doses (e.g. spinal force or low back moments) on LBP may be more reliable but is lacking yet. The aim of the present study was to investigate the prospective relationship of cumulative low back loads (CLBL) with LBP and to compare the association of this mechanical load measure to exposure measures used previously. Methods The current study was part of the Study on Musculoskeletal disorders, Absenteeism and Health (SMASH) study in which 1,745 workers completed questionnaires. Physical load at the workplace was assessed by video-observations and force measurements. These measures were used to calculate CLBL. Furthermore, a 3-year follow-up was conducted to assess the occurrence of LBP. Logistic regressions were performed to assess associations of CLBL and physical risk factors established earlier (i.e. lifting and working in a flexed posture) with LBP. Furthermore, CLBL and the risk factors combined were assessed as predictors in logistic regression analyses to assess the association with LBP. Results Results showed that CLBL is a significant risk factor for LBP (OR: 2.06 (1.32–3.20)). Furthermore, CLBL had a more consistent association with LBP than two of the three risk factors reported earlier. Conclusions From these results it can be concluded that CLBL is a risk factor for the occurrence of LBP, having a more consistent association with LBP compared to most risk factors reported earlier.

Hamberg-van Reenen HH, Ariens GA, Blatter BM, van Mechelen W, Bongers PM. A systematic review of the relation between physical capacity and future low back and neck/shoulder pain. Pain. 2007;130(1–2):93–107.PubMedCrossRef

Wai EK, Rodriguez S, Dagenais S, Hall H. Evidence-informed management of chronic low back pain with physical activity, smoking cessation, and weight loss. Spine J. 2008;8(1):195–202.PubMedCrossRef

Leboeuf-Yde C. Back pain–individual and genetic factors. J Electromyogr Kinesiol. 2004;14(1):129–33.PubMedCrossRef

Manek NJ, MacGregor AJ. Epidemiology of back disorders: prevalence, risk factors, and prognosis. Curr Opin Rheumatol. 2005;17(2):134–40.PubMed

Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM. Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine. 2000;25(16):2114–25.PubMedCrossRef

Hartvigsen J, Lings S, Leboeuf-Yde C, Bakketeig L. Psychosocial factors at work in relation to low back pain and consequences of low back pain: a systematic, critical review of prospective cohort studies. Occup Environ Med. 2004;61(1):e2.PubMed

Macfarlane GJ, Pallewatte N, Paudyal P, Blyth FM, Coggon D, Crombez G, Linton S, Leino-Arjas P, Silman AJ, Smeets RJ, van der Windt D. Evaluation of work-related psychosocial factors and regional musculoskeletal pain: results from a EULAR Task Force. Ann Rheum Dis. 2009;68(6):885–91.PubMedCrossRef

Linton SJ. Occupational psychological factors increase the risk for back pain: a systematic review. J Occup Rehabil. 2001;11(1):53–66.PubMedCrossRef

Kuiper JI, Burdorf A, Verbeek JHAM, Frings-Dresen MHW, van der Beek AJ, Viikari-Juntura ERA. Epidemiologic evidence on manual material handling as a risk factor for back disorders: a systematic review. Int J Ind Ergonomics. 1999;24(4):389–404.CrossRef

10.

Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM. Physical load during work and leisure time as risk factors for back pain. Scand J Work Environ Health. 1999;25(5):387–403.PubMedCrossRef

11.

Bakker EW, Verhagen AP, van Trijffel E, Lucas C, Koes BW. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine. 2009;34(8):E281–93.PubMedCrossRef

12.

Griffith LE, Shanon HS, Wells RP, Walter SD, Cole DC, Côté P, Frank J, Hogg-Johnson S, Langlois L. Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health. 2012;102(2):309–18.PubMedCrossRef

13.

van Nieuwenhuyse A, Somville PR, Crombez G, Burdorf A, Verbeke G, Johannik K, Van den Bergh O, Masschelein R, Mairiaux P, Moens GF. The role of physical workload and pain related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow up. Occup Environ Med. 2006;63(1):45–52.PubMedCrossRef

14.

Tiemessen IJ, Hulshof CT, Frings-Dresen MH. Low back pain in drivers exposed to whole body vibration: analysis of a dose-response pattern. Occup Environ Med. 2008;65(10):667–75.PubMedCrossRef

15.

Hoogendoorn WE, Bongers PM, de Vet HC, Douwes M, Koes BW, Miedema MC, Ariens GA, Bouter LM. Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine. 2000;25(23):3087–92.PubMedCrossRef

16.

Burdorf A. The role of assessment of biomechanical exposure at the workplace in the prevention of musculoskeletal disorders. Scand J Work Environ Health. 2010;36(1):1–2.PubMedCrossRef

17.

Marras WS, Lavender SA, Leurgans SE, Fathallah FA, Ferguson SA, Allread WG, Rajulu SL. Biomechanical risk factors for occupationally related low back disorders. Ergonomics. 1995;38(2):377–410.PubMedCrossRef

18.

Marras WS, Lavender SA, Ferguson SA, Splittstoesser RE, Yang G. Quantitative dynamic measures of physical exposure predict low back functional impairment. Spine. 2010;35(8):914–23.PubMedCrossRef

19.

Norman R, Wells R, Neumann P, Frank J, Shannon H, Kerr M. A comparison of peak vs cumulative physical work exposure risk factors for the reporting of low back pain in the automotive industry. Clin Biomech. 1998;13(8):561–73.CrossRef

20.

Neumann WP, Wells RP, Norman RW, Frank J, Shannon H, Kerrb MS. A posture and load sampling approach to determining low-back pain risk in occupational settings. Int J Ind Ergonomics. 2001;27:65–77.CrossRef

21.

Kumar S. Cumulative load as a risk factor for back pain. Spine. 1990;15(12):1311–6.PubMedCrossRef

22.

Ariëns GA, Bongers PM, Douwes M, Miedema MC, Hoogendoorn WE, van der Wal G, Bouter LM, van Mechelen W. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occup Environ Med. 2001;58(3):200–7.PubMedCrossRef

23.

Karasek R. Job content instrument user guides: revision 1.1. 1985.

24.

de Jonge J, Reuvers MM, Houtman IL, Bongers PM, Kompier MA. Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence: baseline results from SMASH. Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health. J Occup Health Psychol. 2000;5(2):256–68.PubMedCrossRef

25.

Godin G, Jobin J, Bouillon J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health. 1986;77(5):359–62.PubMed

26.

Hildebrandt VH. Physical load and work: Questionnaire on musculoskeletal load and health complaints (Lichamelijke belasting en arbeid:vragenlijst bewegingsapparaat). Voorburg: Dutch Ministry of Social Affairs and Employment; 1991. p. S122–3.

27.

Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–7.PubMedCrossRef

28.

Dumas R, Cheze L, Verriest JP. Adjustments to McConville et al. and Young et al. body segment inertial parameters. J Biomech. 2007;40(3):543–53.PubMedCrossRef

29.

de Leva P. Adjustments to Zatsiorsky-Seluyanov’s segment inertia parameters. J Biomech. 1996;29(9):1223–30.PubMedCrossRef

30.

de Looze MP, Kingma I, Bussmann JBJ, Toussaint HM. Validation of a dynamic linked segment model to calculate joint moments in lifting. Clin Biomech. 1992;7:161–9.CrossRef

31.

Hof AL. An explicit expression for the moment in multibody systems. J Biomech. 1992;25(10):1209–11.PubMedCrossRef

32.

Brinckmann P, Johannleweling N, Hilweg D, Biggemann M. Fatigue fracture of human lumbar vertebrae. Clin Biomech. 1987;S1:94–6.CrossRef

33.

Matlab 7.7.0, The MathWorks Inc., Natick, MA, 2000.

34.

Rothman KJ, Greenland S. Causation and causal inference in epidemiology. Am J Public Health. 2005;95(Suppl 1):144–50.CrossRef

35.

Smedley J, Egger P, Cooper C, Coggon D. Prospective cohort study of predictors of incident low back pain in nurses. BMJ. 1997;314(7089):1225–8.PubMedCrossRef

36.

van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Cl Rh. 2002;16(5):761–75.CrossRef

37.

Holmstrom E, Moritz U. Low back pain–correspondence between questionnaire, interview and clinical examination. Scand J Work Environ Health. 1991;23(3):119–25.

38.

Roelen CA, Koopmans PC, Groothoff JW. Subjective health complaints in relation to sickness absence. Work. 2010;37(1):15–21.PubMed

39.

van der Beek AJ, Frings-Dresen MH. Assessment of mechanical exposure in ergonomic epidemiology. Occup Environ Med. 1998;55(5):291–9.PubMedCrossRef

40.

Paul JA, Douwes M. Two-dimensional photographic posture recording and description: a validity study. Appl Ergon. 1993;24(2):83–90.PubMedCrossRef

41.

Hoozemans MJ, Burdorf A, van der Beek AJ, Frings-Dresen MH, Mathiassen SE. Group-based measurement strategies in exposure assessment explored by bootstrapping. Scand J Work Environ Health. 2001;27(2):125–32.PubMedCrossRef

42.

Kromhout H, Tielemans E, Preller L, Heederik D. Estimates of individual dose from current measurements of exposure. Occup Hyg. 1996;3(1–3):23–39.

43.

Bao S, Howard N, Spielholz P, Silverstein B, Polissar N. Interrater reliability of posture observations. Hum Factors. 2009;51(3):292–309.PubMedCrossRef

44.

van der Beek AJ, van Gaalen LC, Frings-Dresen MH. Working postures and activities of lorry drivers: a reliability study of on-site observation and recording on a pocket computer. Appl Ergon. 1992;23(5):331–6.PubMedCrossRef

45.

van der Beek AJ, Braam IT, Douwes M, Bongers PM, Frings-Dresen MH, Verbeek JH, Luyts S. Validity of a diary estimating exposure to tasks, activities, and postures of the trunk. Int Arch Occup Environ Health. 1994;66(3):173–8.PubMedCrossRef

46.

van Dieen JH, Weinans H, Toussaint HM. Fractures of the lumbar vertebral endplate in the etiology of low back pain: a hypothesis on the causative role of spinal compression in aspecific low back pain. Med Hypotheses. 1999;53(3):246–52.PubMedCrossRef

47.

van Dieen JH, Kingma I. Effects of antagonistic co-contraction on differences between electromyography based and optimization based estimates of spinal forces. Ergonomics. 2005;48(4):411–26.PubMedCrossRef

48.

Wai EK, Roffey DM, Bishop P, Kwon BK, Dagenais S. Causal assessment of occupational lifting and low back pain: results of a systematic review. Spine J. 2010;10(6):554–66.PubMedCrossRef

Title: Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A Prospective Cohort Study
Authors: Pieter Coenen
Idsart Kingma
Cécile R. L. Boot
Jos W. R. Twisk
Paulien M. Bongers
Jaap H. van Dieën
Publication date: 01-03-2013
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 1/2013
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-012-9375-z

At a glance: The STEP trials

Springer Medicine

Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A Prospective Cohort Study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2013

Clinician–Patient Agreement About the Work Disability Problem of Patients Having Persistent Pain: Why it Matters

Vocational Rehabilitation Evaluation and the International Classification of Functioning, Disability, and Health (ICF)

The Impact of Psychological Symptoms on Return to Work in Workers After Occupational Injury

Determinants of Physical Therapy Use by Compensated Workers with Musculoskeletal Disorders

Predicting Work-Related Disability and Medical Cost Outcomes: Estimating Injury Severity Scores from Workers’ Compensation Data

Self-reported Work Ability and Work Performance in Workers with Chronic Nonspecific Musculoskeletal Pain