Drivers of International Variation in Prevalence of Disabling Low Back Pain: Findings from the Cultural and Psychosocial Influences on Disability Study

Details

• Personal Author:
  Bonzini M ; Cattrell A ; Coggon D ; Felknor, Sarah A. ; Felli VE ; Habib RR ; Harari F ; Harcombe H ; Kadir MM ; Kelsall HL ; Matsudaira K ; Merisalu E ; Ntani G ; Nyantumbu-Mkhize B ; Palmer KT ; Quintana LA ; Rojas M ; Sadeghian F ; Solidaki E ; Vargas-Prada S ; Warnakulasuriya SSP
• Description:
  Background: Wide international variation in the prevalence of disabling low back pain (LBP) among working populations is not explained by known risk factors. It would be useful to know whether the drivers of this variation are specific to the spine or factors that predispose to musculoskeletal pain more generally. Methods: Baseline information about musculoskeletal pain and risk factors was elicited from 11,710 participants aged 20-59 years, who were sampled from 45 occupational groups in 18 countries. Wider propensity to pain was characterized by the number of anatomical sites outside the low back that had been painful in the 12 months before baseline ('pain propensity index'). After a mean interval of 14 months, 9,055 participants (77.3%) provided follow-up data on disabling LBP in the past month. Baseline risk factors for disabling LBP at follow-up were assessed by random intercept Poisson regression. Results: After allowance for other known and suspected risk factors, pain propensity showed the strongest association with disabling LBP (prevalence rate ratios up to 2.6, 95% CI: 2.2-3.1; population attributable fraction 39.8%). Across the 45 occupational groups, the prevalence of disabling LBP varied sevenfold (much more than within-country differences between nurses and office workers), and correlated with mean pain propensity index (r = 0.58). Conclusions: Within our study, major international variation in the prevalence of disabling LBP appeared to be driven largely by factors predisposing to musculoskeletal pain at multiple anatomical sites rather than by risk factors specific to the spine. Significance: Our findings indicate that differences in general propensity to musculoskeletal pain are a major driver of large international variation in the prevalence of disabling low back pain among people of working age. [Description provided by NIOSH]
• Subjects:
  Aging Anatomy Musculoskeletal Diseases Musculoskeletal System Nervous System Occupational Health Risk Assessment Risk Factors Safety Surveys And Questionnaires
• Keywords:
  Age Groups Body Regions Disabled Workers Global Health Health Surveys Humans Low Back Disorders Low Back Pain MSD Musculoskeletal Disorders Musculoskeletal System Occupations Pain Tolerance Psychosocial Factors Regression Analysis Risk Factors Spinal Cord Workers

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• ISSN:
  1532-2149
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  35-45
• Volume:
  23
• Issue:
  1
• NIOSHTIC Number:
  nn:20054192
• Citation:
  Eur J Pain 2019 Jan; 23(1):35-45
• Contact Point Address:
  David Coggon, Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK
• Email:
  dnc@mrc.soton.ac.uk
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  European Journal of Pain
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d306fa1a8918924b4465a991f79c5edd47a4b164a9cd760a932936472e9a6e5cf8f31b56efc0a050e105ad2d273cf253c1fc362e2fb14c769b2be461b10c1883
• Download URL:
  https://stacks.cdc.gov/view/cdc/216804/cdc_216804_DS1.pdf
• File Type:
  [PDF - 184.09 KB ]