Association between lifting and use of medication for low back pain: results from the Backworks Prospective Cohort Study

J Occup Environ Med. 2014 Aug;56(8):867-77. doi: 10.1097/JOM.0000000000000197.


Objective: To evaluate relationships between lifting and lowering of loads and risk of low back pain resulting in medication use (M-LBP).

Methods: At baseline, worker demographics, psychosocial factors, hobbies, LBP history, and lifting and lowering (quantified using the Revised NIOSH Lifting Equation) were assessed. A cohort of 258 incident-eligible workers was followed up for 4.5 years to determine new M-LBP cases and changes in lifting/lowering requirements. Proportional hazards regression with time-varying covariates was used to model associations.

Results: Factors predicting M-LBP included peak lifting index (PLI) and composite lifting index (PCLI), LBP history, anxiety, and housework. In adjusted models, PLI and PCLI showed exposure-response relationships with peak hazard ratios of 3.8 and 4.3, respectively (P ≤ 0.02).

Conclusions: Lifting of loads is associated with increased risk of M-LBP. The PLI and PCLI are useful metrics for estimating the risk of M-LBP from lifting.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Life Style
  • Lifting*
  • Low Back Pain / drug therapy*
  • Low Back Pain / epidemiology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Occupational Exposure
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Young Adult