Risk factors for hospitalization due to lumbar disc disease

Spine (Phila Pa 1976). 2012 Jul 1;37(15):1334-9. doi: 10.1097/BRS.0b013e31824b5464.


Study design: Prospective cohort study.

Objective: To study biomechanical factors in relation to symptomatic lumbar disc disease.

Summary of background data: The importance of biomechanical factors in lumbar disc disease has been questioned in the past decade and knowledge from large prospective studies is lacking.

Methods: The study basis is a cohort of 263,529 Swedish construction workers who participated in a national occupational health surveillance program from 1971 until 1992. The workers' job title, smoking habits, body weight, height, and age were registered at the examinations. The occurrence of hospitalization due to lumbar disc disease from January 1, 1987, until December 31, 2003, was collected from a linkage with the Swedish Hospital Discharge Register.

Results: There was an increased risk for hospitalization due to lumbar disc disease for several occupational groups compared with white-collar workers and foremen. Occupational groups with high biomechanical loads had the highest risks, for example, the relative risk for concrete workers was 1.55 (95% confidence interval [CI], 1.29-1.87). A taller stature was consistently associated with an increased risk. The relative risk for a man of 190- to 199-cm height was 1.55 (95% CI, 1.30-1.86) compared with a man being 170- to 179-cm height. Body weight and smoking were also risk factors, but weaker than height. Workers in the age span of 30 to 39 years had the highest relative risk (RR = 1.87; 95% CI, 1.58-2.23) compared with those aged 20 to 29 years, whereas men aged 60 to 65 years had a lower risk (RR = 0.86; 95% CI, 0.68-1.09).

Conclusion: This study indicates that factors increasing the load on the lumbar spine are associated with hospitalization for lumbar disc disease. Occupational biomechanical factors seem to be important, and a taller stature was consistently associated with an increased risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Height
  • Body Weight
  • Construction Industry
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intervertebral Disc Degeneration / epidemiology*
  • Intervertebral Disc Degeneration / etiology
  • Intervertebral Disc Displacement / epidemiology*
  • Intervertebral Disc Displacement / etiology
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / etiology
  • Occupational Health / statistics & numerical data
  • Population Surveillance
  • Prospective Studies
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Smoking
  • Sweden / epidemiology
  • Young Adult