Elsevier

Preventive Medicine

Volume 31, Issue 5, November 2000, Pages 506-512
Preventive Medicine

Regular Article
Physical Load in Daily Life and Low Back Problems in the General Population—The MORGEN Study

https://doi.org/10.1006/pmed.2000.0737Get rights and content

Abstract

Background. We studied the contribution of physical load in daily activities, including activities in work, housekeeping, and leisure time, to the burden of low back problems (LBP) in the population.

Methods. Logistic regression models were used to calculate the association between physical load and several LBP parameters as assessed by questionnaire in a cross-sectional study on 22,415 randomly selected men and women in The Netherlands, controlling for well-known LBP determinants. The population attributable risk (PAR) percentage was estimated with the elimination method using the logistic model.

Results. Half of the population reported LBP during the past year and 19% chronic LBP. Activities characterized by an awkward posture, by the same posture for a long time, or by often bending and rotating the trunk increased the risk for LBP, with ORs between 1.1 and 1.6. More than 13% of the 1-year prevalence of LBP could be contributed to these activities. This PAR was higher for those belonging to the working population, for women, and for the more severe LBP parameters.

Conclusion. Because LBP present such a large public health problem, the estimated potential impact of eliminating (the unhealthy effect of) physical load is substantial. To assess the real health gain, more insight is necessary into the causality of the relationship and into effective preventive measures.

References (29)

  • I Kuorinka et al.

    Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms

    Appl Ergonomics

    (1987)
  • EL Hurwitz et al.

    Correlates of back problems and back-related disability in the United states

    J Clin Epidemiol

    (1997)
  • SMA A Evers

    Health for all indicators in health interview surveys

    Health Policy

    (1993)
  • Epidemiology review: the epidemiology and cost of back pain

    (1994)
  • JP Liira et al.

    Long-term back problems and physical work exposures in the 1990 Ontario Health Survey

    Am J Public Health

    (1996)
  • G Hultman et al.

    Physical and psychological workload in men with and without low back pain

    Scand J Rehab Med

    (1995)
  • JA Engels et al.

    Work related risk factors for musculoskeletal complaints in the nursing profession: results of a questionnaire survey

    Occup Environ Med

    (1996)
  • J Smedley et al.

    Manual handling activities and risk of low back pain in nurses

    Occup Environ Med

    (1995)
  • JJ Knibbe et al.

    Prevalence of back pain and characteristics of the physical workload of community nurses

    Ergonomics

    (1996)
  • T Skov et al.

    Psychosocial and physical risk factors for musculoskeletal disorders of the neck, shoulders, and lower back in salespeople

    Occup Environ Med

    (1996)
  • EB Holmström et al.

    Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors

    Spine

    (1992)
  • HH Raspe

    Back pain

  • Hildebrandt, V, H, Douwes, M, Validiteitsstudie vragenlijst bewegingsapparaat [Study on the validity of a questionnaire...
  • DG Kleinbaum et al.

    Epidemiologic research. Principles and quantitative methods

    (1982)
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    To whom correspondence should be addressed at the Department of Chronic Diseases Epidemiology, National Institute of Public Health and the Environment, CZE (PB 101), P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Fax: +31-30-2744407. E-mail: [email protected].

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