Work-related psychosocial and mechanical risk factors for low back pain: a 3-year follow-up study of the general working population in Norway

Occup Environ Med. 2013 May;70(5):296-302. doi: 10.1136/oemed-2012-101116. Epub 2013 Jan 15.


Aims: This study examines the impact of work-related psychosocial and mechanical exposure on the development of low back pain (LBP) in the general working population.

Methods: A randomly drawn cohort from the general population in Norway aged 18-66 years was followed up for 3 years (n=12 550, response rate at baseline=67%). Eligible respondents were in paid work during a reference week in 2006 and 2009, or temporarily absent from such work (n=6745). Five work-related psychosocial factors and seven mechanical exposures were measured. Outcomes of interest were moderate or severe LBP at follow-up adjusted for baseline LBP.

Results: In total, 12.8% (861 individuals) reported LBP during the last month at follow-up. Work-related psychosocial predictors of LBP were high job demands (OR 1.41, 95% CI 1.16 to 1.72) and low job control (OR 1.26, 95% CI 1.01 to 1.57). Mechanical factors were prolonged standing (OR 1.48, 95% CI 1.20 to 1.83), awkward lifting (OR 1.55, 95% CI 1.28 to 1.88) and squatting/kneeling (OR 1.29, 95% CI 1.04 to 1.61). The estimated population risk attributable to these factors was approximately 42%. The risk for LBP associated with psychosocial exposure was not influenced by adjustment for mechanical risk factors, and vice versa. There was no substantial confounding related to age, gender, education, occupation or psychological distress.

Conclusions: Highly demanding jobs, prolonged standing and awkward lifting appear as the most consistent and important predictors of LBP.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / epidemiology
  • Low Back Pain / etiology*
  • Low Back Pain / psychology
  • Male
  • Middle Aged
  • Movement
  • Musculoskeletal Physiological Phenomena*
  • Norway / epidemiology
  • Occupational Diseases / etiology*
  • Occupational Diseases / psychology
  • Occupational Exposure / adverse effects*
  • Posture
  • Risk Factors
  • Stress, Psychological*
  • Weight-Bearing
  • Work*
  • Young Adult