Disorders of the back and spine in construction workers. Prevalence and prognostic value for disability

Spine (Phila Pa 1976). 1997 Jul 1;22(13):1481-6. doi: 10.1097/00007632-199707010-00011.


Study design: A cohort study on back-related morbidity and its impact on early retirement resulting from disability among employees in the construction industry.

Objective: To describe the prevalence of back-related morbidity according to different measures in various occupational groups and to assess the prognostic value of these measures for early retirement resulting from disability.

Methods: The results of occupational health examinations conducted in 1986-1988 among 4,958 employees of the German construction industry aged 40-64 years were analyzed. Active follow-up evaluation was carried out between October 1992 and July 1994 to ascertain employment status.

Results: Compared with that of white-collar employees, no excess risk for self-reported back pain or sciatica was seen for any of the manual professions. In contrast, the age-adjusted prevalence of clinical findings of the spine was elevated among all employees in manual professions, and the prevalence of a recorded diagnosis related to disorders of the back and spine (ICD-9 position 720-724) was elevated among bricklayers compared with white-collar employees. The relative risk of being granted a disability pension in the follow-up period was 1.6 (95% Confidence Interval [Cl], 1.3-2.1) for persons reporting back pain or sciatica, 1.8 (95% Cl, 1.4-2.2) for persons with an abnormal clinical finding of the spine, and 1.5 (95% Cl, 1.2-1.8) for persons with a recorded medical diagnosis related to disorders of the back or spine (ICD-9 720-724).

Conclusion: Patterns of morbidity varied according to the evaluated morbidity measure. All three measures qualified as significant predictors of disability and helped to identify high-risk occupations and high-risk employees.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Back Pain / diagnosis
  • Back Pain / epidemiology*
  • Cohort Studies
  • Disability Evaluation*
  • Facility Design and Construction*
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology*
  • Pensions
  • Prevalence
  • Prognosis
  • Self-Examination
  • Spinal Diseases / diagnosis
  • Spinal Diseases / epidemiology*