Skip to main content
Top
Published in: International Archives of Occupational and Environmental Health 1/2020

Open Access 01-01-2020 | Back Pain | Original Article

Occupational lifting predicts hospital admission due to low back pain in a cohort of airport baggage handlers

Authors: Charlotte Brauer, Sigurd Mikkelsen, Ellen Bøtker Pedersen, Karina Lauenborg Møller, Erik Bruun Simonsen, Henrik Koblauch, Tine Alkjær, Karin Helweg-Larsen, Lau Caspar Thygesen

Published in: International Archives of Occupational and Environmental Health | Issue 1/2020

Login to get access

Abstract

Purpose

To examine if occupational lifting assessed as cumulative years as a baggage handler is associated with first-time hospital diagnosis or treatment for low back disorders.

Methods

This study is based on the Copenhagen Airport Cohort consisting of male baggage handlers performing heavy lifting every day and a reference group of unskilled men from the greater Copenhagen area during the period 1990–2012. We followed the cohort in the National Patient Register and Civil Registration System to obtain information on diagnoses, surgery, mortality, and migration. The outcomes were first-time hospital diagnosis or surgery for (1) lumbar disc herniation or (2) low back pain (LBP).

Results

Baggage handlers (N = 3473) had a higher incidence rate of LBP, but not of lumbar disc herniation, compared to the reference group (N = 65,702). Baggage handlers with longer employment had a higher incidence of LBP compared to baggage handlers with shorter employment. The linear association of cumulative years as a baggage handler on LBP was significantly increased with an incidence rate ratio of 1.16 (95% CI 1.07–1.25) for a 5-year increase of employment as baggage handler.

Conclusions

In this large cohort study, we found an increased incidence of LBP among baggage handlers compared to the reference group with indications of a dose–response relationship between years of employment and the outcome. For baggage handlers working on the apron, the incidence was particularly increased before introduction of technical lifting equipment, suggesting that preventive measures to reduce cumulative work load may have a positive effect.
Appendix
Available only for authorised users
Literature
go back to reference Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl2):S192–S300 Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl2):S192–S300
go back to reference Baker P, Reading I, Cooper C, Coggon D (2003) Knee disorders in the general population and their relation to occupation. Occup Environ Med 60:794–797 Baker P, Reading I, Cooper C, Coggon D (2003) Knee disorders in the general population and their relation to occupation. Occup Environ Med 60:794–797
go back to reference Barrero LH, Katz JN, Dennerlein JT (2009) Validity of self-reported mechanical demands for occupational epidemiologic research of musculoskeletal disorders. Scand J Work Environ Health 35:245–260 Barrero LH, Katz JN, Dennerlein JT (2009) Validity of self-reported mechanical demands for occupational epidemiologic research of musculoskeletal disorders. Scand J Work Environ Health 35:245–260
go back to reference Battie MC, Videman T, Levalahti E, Gill K, Kaprio J (2008) Genetic and environmental effects on disc degeneration by phenotype and spinal level: a multivariate twin study. Spine (Phila Pa 1976) 33:2801–2808 Battie MC, Videman T, Levalahti E, Gill K, Kaprio J (2008) Genetic and environmental effects on disc degeneration by phenotype and spinal level: a multivariate twin study. Spine (Phila Pa 1976) 33:2801–2808
go back to reference Battie MC, Videman T, Kaprio J, Gibbons LE, Gill K, Manninen H, Saarela J, Peltonen L (2009) The Twin Spine Study: contributions to a changing view of disc degeneration. Spine J 9:47–59 Battie MC, Videman T, Kaprio J, Gibbons LE, Gill K, Manninen H, Saarela J, Peltonen L (2009) The Twin Spine Study: contributions to a changing view of disc degeneration. Spine J 9:47–59
go back to reference Bergsten EL, Mathiassen SE, Vingard E (2015) Psychosocial work factors and musculoskeletal pain: a cross-sectional study among Swedish flight baggage handlers. Biomed Res Int 2015:798042 Bergsten EL, Mathiassen SE, Vingard E (2015) Psychosocial work factors and musculoskeletal pain: a cross-sectional study among Swedish flight baggage handlers. Biomed Res Int 2015:798042
go back to reference Bern SH, Brauer C, Moller KL, Koblauch H, Thygesen LC, Simonsen EB, Alkjaer T, Bonde JP, Mikkelsen S (2013) Baggage handler seniority and musculoskeletal symptoms: is heavy lifting in awkward positions associated with the risk of pain? BMJ Open 3:e004055 Bern SH, Brauer C, Moller KL, Koblauch H, Thygesen LC, Simonsen EB, Alkjaer T, Bonde JP, Mikkelsen S (2013) Baggage handler seniority and musculoskeletal symptoms: is heavy lifting in awkward positions associated with the risk of pain? BMJ Open 3:e004055
go back to reference Bernard BP (1997) Musculoskeletal disorders and workplace factors, a critical review. In: Bernard B (ed) Centers for disease control and prevention. National Institute for Occupational Safety and Health (NIOSH), USA Bernard BP (1997) Musculoskeletal disorders and workplace factors, a critical review. In: Bernard B (ed) Centers for disease control and prevention. National Institute for Occupational Safety and Health (NIOSH), USA
go back to reference Coenen P, Gouttebarge V, van der Burght AS, van Dieen JH, Frings-Dresen MH, van der Beek AJ, Burdorf A (2014) The effect of lifting during work on low back pain: a health impact assessment based on a meta-analysis. Occup Environ Med 71:871–877 Coenen P, Gouttebarge V, van der Burght AS, van Dieen JH, Frings-Dresen MH, van der Beek AJ, Burdorf A (2014) The effect of lifting during work on low back pain: a health impact assessment based on a meta-analysis. Occup Environ Med 71:871–877
go back to reference Danish Health and Medicines Authority (2011) Private hospital activity 2006–2010 [In Danish: Aktivitet på private sygehuse 2006–2010]. Sundhedsstyrelsen Danish Health and Medicines Authority (2011) Private hospital activity 2006–2010 [In Danish: Aktivitet på private sygehuse 2006–2010]. Sundhedsstyrelsen
go back to reference De Beeck OR, Hermans V (2000) Research on work-related low back disorders. European Agency for Safety and Health at Work, Luxembourg De Beeck OR, Hermans V (2000) Research on work-related low back disorders. European Agency for Safety and Health at Work, Luxembourg
go back to reference Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N (2002) Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine (Phila Pa 1976) 27:125–134 Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N (2002) Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine (Phila Pa 1976) 27:125–134
go back to reference Gallagher S (2005) Physical limitations and musculoskeletal complaints associated with work in unusual or restricted postures: a literature review. J Saf Res 36:51–61 Gallagher S (2005) Physical limitations and musculoskeletal complaints associated with work in unusual or restricted postures: a literature review. J Saf Res 36:51–61
go back to reference Greenland S, Pearl J, Robins JM (1999) Causal diagrams for epidemiologic research. Epidemiology 10:37–48 Greenland S, Pearl J, Robins JM (1999) Causal diagrams for epidemiologic research. Epidemiology 10:37–48
go back to reference Griffith LE, Shannon HS, Wells RP, Walter SD, Cole DC, Cote P, Frank J, Hogg-Johnson S, Langlois LE (2012) Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health 102:309–318 Griffith LE, Shannon HS, Wells RP, Walter SD, Cole DC, Cote P, Frank J, Hogg-Johnson S, Langlois LE (2012) Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health 102:309–318
go back to reference Hansson T (2001) [Low back pain and work]. Arbete och Hälsa 12:19–70. (Swedish) Hansson T (2001) [Low back pain and work]. Arbete och Hälsa 12:19–70. (Swedish)
go back to reference Harms-Ringdahl K, Hansson SO, Hagg O, Lundberg U, Mathiassen SE, Sundelin G, Svartengren M, Tropp H, Oberg B (2014) The importance of the working environment for back problems. A systematic review of literature. Swedish Agency for Health Technology Assessment (SBU), Stockholm, pp 11–643 (Swedish) Harms-Ringdahl K, Hansson SO, Hagg O, Lundberg U, Mathiassen SE, Sundelin G, Svartengren M, Tropp H, Oberg B (2014) The importance of the working environment for back problems. A systematic review of literature. Swedish Agency for Health Technology Assessment (SBU), Stockholm, pp 11–643 (Swedish)
go back to reference Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L (2011) Physical activity and low back pain: a systematic review of recent literature. Eur Spine J 20:826–845 Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L (2011) Physical activity and low back pain: a systematic review of recent literature. Eur Spine J 20:826–845
go back to reference Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM (2000) Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine (Phila Pa 1976) 25:2114–2125 Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM (2000) Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine (Phila Pa 1976) 25:2114–2125
go back to reference Hoy D, Brooks P, Blyth F, Buchbinder R (2010) The Epidemiology of low back pain. Best Pract Res Clin Rheumatol 24:769–781 Hoy D, Brooks P, Blyth F, Buchbinder R (2010) The Epidemiology of low back pain. Best Pract Res Clin Rheumatol 24:769–781
go back to reference Kaila-Kangas L, Kivimaki M, Riihimaki H, Luukkonen R, Kirjonen J, Leino-Arjas P (2004) Psychosocial factors at work as predictors of hospitalization for back disorders: a 28-year follow-up of industrial employees. Spine (Phila Pa 1976) 29:1823–1830 Kaila-Kangas L, Kivimaki M, Riihimaki H, Luukkonen R, Kirjonen J, Leino-Arjas P (2004) Psychosocial factors at work as predictors of hospitalization for back disorders: a 28-year follow-up of industrial employees. Spine (Phila Pa 1976) 29:1823–1830
go back to reference Koblauch H (2016) Low back load in airport baggage handlers. Dan Med J 63:B5233 Koblauch H (2016) Low back load in airport baggage handlers. Dan Med J 63:B5233
go back to reference Lenderink AF, Zoer I, Van Der Molen HF, Spreeuwers D, Frings-Dresen MH, van Dijk FJ (2012) Review on the validity of self-report to assess work-related diseases. Int Arch Occup Environ Health 85:229–251 Lenderink AF, Zoer I, Van Der Molen HF, Spreeuwers D, Frings-Dresen MH, van Dijk FJ (2012) Review on the validity of self-report to assess work-related diseases. Int Arch Occup Environ Health 85:229–251
go back to reference Lotters F, Burdorf A, Kuiper J, Miedema H (2003) Model for the work-relatedness of low-back pain. Scand J Work Environ Health 29:431–440 Lotters F, Burdorf A, Kuiper J, Miedema H (2003) Model for the work-relatedness of low-back pain. Scand J Work Environ Health 29:431–440
go back to reference Luoma K, Riihimaki H, Raininko R, Luukkonen R, Lamminen A, Viikari-Juntura E (1998) Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health 24:358–366 Luoma K, Riihimaki H, Raininko R, Luukkonen R, Lamminen A, Viikari-Juntura E (1998) Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health 24:358–366
go back to reference Lynge E, Sandegaard JL, Rebolj M (2011) The Danish National Patient Register. Scand J Public Health 39:30–33 Lynge E, Sandegaard JL, Rebolj M (2011) The Danish National Patient Register. Scand J Public Health 39:30–33
go back to reference Mariconda M, Galasso O, Imbimbo L, Lotti G, Milano C (2007) Relationship between alterations of the lumbar spine, visualized with magnetic resonance imaging, and occupational variables. Eur Spine J 16:255–266 Mariconda M, Galasso O, Imbimbo L, Lotti G, Milano C (2007) Relationship between alterations of the lumbar spine, visualized with magnetic resonance imaging, and occupational variables. Eur Spine J 16:255–266
go back to reference Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD (2008) Expenditures and health status among adults with back and neck problems. JAMA 299:656–664 Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD (2008) Expenditures and health status among adults with back and neck problems. JAMA 299:656–664
go back to reference Martirosyan NL, Patel AA, Carotenuto A, Kalani MY, Belykh E, Walker CT, Preul MC, Theodore N (2016) Genetic alterations in intervertebral disc disease. Front Surg 3:59 Martirosyan NL, Patel AA, Carotenuto A, Kalani MY, Belykh E, Walker CT, Preul MC, Theodore N (2016) Genetic alterations in intervertebral disc disease. Front Surg 3:59
go back to reference Mikkelsen S, Brauer C, Pedersen EB, Alkjaer T, Koblauch H, Simonsen EB, Helweg-Larsen K, Thygesen LC (2016) A cohort study on meniscal lesions among airport baggage handlers. PLoS One 11:e0157336 Mikkelsen S, Brauer C, Pedersen EB, Alkjaer T, Koblauch H, Simonsen EB, Helweg-Larsen K, Thygesen LC (2016) A cohort study on meniscal lesions among airport baggage handlers. PLoS One 11:e0157336
go back to reference Moller KL, Brauer C, Mikkelsen S, Loft S, Simonsen EB, Koblauch H, Bern SH, Alkjaer T, Hertel O, Becker T, Larsen KH, Bonde JP, Thygesen LC (2017) Copenhagen Airport Cohort: air pollution, manual baggage handling and health. BMJ Open 7:e012651 Moller KL, Brauer C, Mikkelsen S, Loft S, Simonsen EB, Koblauch H, Bern SH, Alkjaer T, Hertel O, Becker T, Larsen KH, Bonde JP, Thygesen LC (2017) Copenhagen Airport Cohort: air pollution, manual baggage handling and health. BMJ Open 7:e012651
go back to reference Nordic Medico-Statistical Committee (2011) NOMESCO Classification of Surgical Procedures (NCSP), version 1.16. Nordic Medico-Statistical Committee (NOMESCO) Nordic Medico-Statistical Committee (2011) NOMESCO Classification of Surgical Procedures (NCSP), version 1.16. Nordic Medico-Statistical Committee (NOMESCO)
go back to reference Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39:22–25 Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39:22–25
go back to reference Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Phila Pa 1976) 27:E109–E120 Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Phila Pa 1976) 27:E109–E120
go back to reference Plouvier S, Leclerc A, Chastang JF, Bonenfant S, Goldberg M (2009) Socioeconomic position and low-back pain–the role of biomechanical strains and psychosocial work factors in the GAZEL cohort. Scand J Work Environ Health 35:429–436 Plouvier S, Leclerc A, Chastang JF, Bonenfant S, Goldberg M (2009) Socioeconomic position and low-back pain–the role of biomechanical strains and psychosocial work factors in the GAZEL cohort. Scand J Work Environ Health 35:429–436
go back to reference Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490 Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490
go back to reference Seidler A, Bolm-Audorff U, Siol T, Henkel N, Fuchs C, Schug H, Leheta F, Marquardt G, Schmitt E, Ulrich PT, Beck W, Missalla A, Elsner G (2003) Occupational risk factors for symptomatic lumbar disc herniation; a case-control study. Occup Environ Med 60:821–830 Seidler A, Bolm-Audorff U, Siol T, Henkel N, Fuchs C, Schug H, Leheta F, Marquardt G, Schmitt E, Ulrich PT, Beck W, Missalla A, Elsner G (2003) Occupational risk factors for symptomatic lumbar disc herniation; a case-control study. Occup Environ Med 60:821–830
go back to reference Shiri R, Falah-Hassani K, Heliovaara M, Solovieva S, Amiri S, Lallukka T, Burdorf A, Husgafvel-Pursiainen K, Viikari-Juntura E (2019) Risk factors for low back pain: a population-based longitudinal study. Arthritis Care Res (Hoboken) 71:290–299 Shiri R, Falah-Hassani K, Heliovaara M, Solovieva S, Amiri S, Lallukka T, Burdorf A, Husgafvel-Pursiainen K, Viikari-Juntura E (2019) Risk factors for low back pain: a population-based longitudinal study. Arthritis Care Res (Hoboken) 71:290–299
go back to reference Shrier I, Platt RW (2008) Reducing bias through directed acyclic graphs. BMC Med Res Methodol 8:70 Shrier I, Platt RW (2008) Reducing bias through directed acyclic graphs. BMC Med Res Methodol 8:70
go back to reference Stalhammar HR, Leskinen TP, Kuorinka IA, Gautreau MH, Troup JD (1986) Postural, epidemiological and biomechanical analysis of luggage handling in an aircraft luggage compartment. Appl Ergon 17:177–183 Stalhammar HR, Leskinen TP, Kuorinka IA, Gautreau MH, Troup JD (1986) Postural, epidemiological and biomechanical analysis of luggage handling in an aircraft luggage compartment. Appl Ergon 17:177–183
go back to reference Stock SR, Fernandes R, Delisle A, Vezina N (2005) Reproducibility and validity of workers’ self-reports of physical work demands. Scand J Work Environ Health 31:409–437 Stock SR, Fernandes R, Delisle A, Vezina N (2005) Reproducibility and validity of workers’ self-reports of physical work demands. Scand J Work Environ Health 31:409–437
go back to reference Tafazzol A, Aref S, Mardani M, Haddad O, Parnianpour M (2016) Epidemiological and biomechanical evaluation of airline baggage handling. Int J Occup Saf Ergon 22:218–227 Tafazzol A, Aref S, Mardani M, Haddad O, Parnianpour M (2016) Epidemiological and biomechanical evaluation of airline baggage handling. Int J Occup Saf Ergon 22:218–227
go back to reference The Danish Data Protection Agency (2008) Standard terms for research projects—the act on processing of personal data The Danish Data Protection Agency (2008) Standard terms for research projects—the act on processing of personal data
go back to reference The National Committee on Health Research Ethics (DNVK) Copenhagen (2011) Guidelines about notification etc. of a biomedical research project to the committee system on biomedical research ethics The National Committee on Health Research Ethics (DNVK) Copenhagen (2011) Guidelines about notification etc. of a biomedical research project to the committee system on biomedical research ethics
go back to reference Thygesen LC, Daasnes C, Thaulow I, Bronnum-Hansen H (2011) Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving. Scand J Public Health 39:12–16 Thygesen LC, Daasnes C, Thaulow I, Bronnum-Hansen H (2011) Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving. Scand J Public Health 39:12–16
go back to reference Thygesen LC, Mikkelsen S, Pedersen EB, Moller KL, Alkjaer T, Koblauch H, Simonsen EB, Moller SP, Brauer C (2016) Subacromial shoulder disorders among baggage handlers: an observational cohort study. Int Arch Occup Environ Health 89:867–876 Thygesen LC, Mikkelsen S, Pedersen EB, Moller KL, Alkjaer T, Koblauch H, Simonsen EB, Moller SP, Brauer C (2016) Subacromial shoulder disorders among baggage handlers: an observational cohort study. Int Arch Occup Environ Health 89:867–876
go back to reference Undeutsch K, Gartner KH, Luopajarvi T, Kupper R, Karvonen MJ, Lowenthal I, Rutenfranz J (1982) Back complaints and findings in transport workers performing physically heavy work. Scand J Work Environ Health 8(Suppl 1):92–96 Undeutsch K, Gartner KH, Luopajarvi T, Kupper R, Karvonen MJ, Lowenthal I, Rutenfranz J (1982) Back complaints and findings in transport workers performing physically heavy work. Scand J Work Environ Health 8(Suppl 1):92–96
go back to reference Videman T, Levalahti E, Battie MC (2007) The effects of anthropometrics, lifting strength, and physical activities in disc degeneration. Spine (Phila Pa 1976) 32:1406–1413 Videman T, Levalahti E, Battie MC (2007) The effects of anthropometrics, lifting strength, and physical activities in disc degeneration. Spine (Phila Pa 1976) 32:1406–1413
go back to reference Waddell G, Burton AK (2001) Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med 51:124–135 Waddell G, Burton AK (2001) Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med 51:124–135
go back to reference Wahlstrom J, Burstrom L, Nilsson T, Jarvholm B (2012) Risk factors for hospitalization due to lumbar disc disease. Spine (Phila Pa 1976) 37:1334–1339 Wahlstrom J, Burstrom L, Nilsson T, Jarvholm B (2012) Risk factors for hospitalization due to lumbar disc disease. Spine (Phila Pa 1976) 37:1334–1339
go back to reference Wahlstrom J, Burstrom L, Johnson PW, Nilsson T, Jarvholm B (2018) Exposure to whole-body vibration and hospitalization due to lumbar disc herniation. Int Arch Occup Environ Health 91:689–694 Wahlstrom J, Burstrom L, Johnson PW, Nilsson T, Jarvholm B (2018) Exposure to whole-body vibration and hospitalization due to lumbar disc herniation. Int Arch Occup Environ Health 91:689–694
Metadata
Title
Occupational lifting predicts hospital admission due to low back pain in a cohort of airport baggage handlers
Authors
Charlotte Brauer
Sigurd Mikkelsen
Ellen Bøtker Pedersen
Karina Lauenborg Møller
Erik Bruun Simonsen
Henrik Koblauch
Tine Alkjær
Karin Helweg-Larsen
Lau Caspar Thygesen
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 1/2020
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-019-01470-z

Other articles of this Issue 1/2020

International Archives of Occupational and Environmental Health 1/2020 Go to the issue

Letter to the Editor

Letter to the editor